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YALE 
MEDICAL  LIBRARY 


HISTORICAL 
LIBRARY 


Um( 


,-V»Av 


Date  ")ile 


Digitized  by  the  Internet  Archive 

in  2011  with  funding  from 

Open  Knowledge  Commons  and  Yale  University,  Cushing/Whitney  Medical  Library 


http://www.archive.org/details/dutlinesofhistorOOunse 


OUTLINES 


OF 


THE  HISTOEY  OF  MEDICINE 


THE  MEDICAL  PROFESSION. 


BY 


JOH.  HERMANN  BAAS.  M.  D. 


TRANSLATED,  AND  IN  CONJUNCTION   WITH   THE  AUTHOR   REVISED  AND  ENLARGED, 


BY 


H.  E.  HANDERSON,  M.  A..  M.  D. 


NEW  YORK : 

J.  H.  VAIL  &  CO., 

21  Astor  Place  and  142  Eighth  Street. 
1889. 


Entered  according  to  act  of  Congress,  in  the  year  1889. 

by  H.  E.  Handerson, 
in  the  office  of  the  Librarian  of  Congress  at  Washington. 


H.iotr 

RI3\ 


Author's  Preface. 


The  historj-  of  medicine,  of  all  the  branches  of  that  art,  is  the  one  to 
which  least  attention  is  devoted  b}T  physicians ;  and  yet  its  study  not  only 
possesses  great  scientific  value,  but  likewise  includes  an  important  germ  of 
practical  information. 

To  attain  both  the  objects  thus  indicated,  by  bringing  to  the  notice  of 
his  colleagues,  the  practitioners  of  medicine,  the  histoiy  of  their  depart- 
ment and  their  profession,  was  the  original  design  of  the  author  in  the 
publication  of  the  present  work.  For  those  who  are  interested  solely  in 
literary  aims  his  book  was  not  written,  and  accordingly  he  has  omitted 
extended  bibliographical  notices,  preferring  to  refer  the  reader  for  these  to 
the  larger  manuals  on  this  subject. l  His  plan  has  been  to  consider  first  the 
genetic  side  of  the  subject,  introducing  for  this  purpose  a  sketch  of  even 
prehistoric  medicine,  and  next  to  set  forth  the  histoiy  of  the  medical  pro- 
fession in  considerable  detail.  In  both  departments  he  has  striven  to 
present  the  subject  in  such  a  manner  as  should  awaken  and  maintain  the 
interest  of  the  reader.  Whether  he  has  failed  in  his  purpose  or  fallen 
behind  the  aims  which  he  had  set  before  him  it  is  not  for  him  to  decide. 
No  man  is  perfect ;  neither  is  anjr  book.  But  in  so  weighty  an  undertaking 
as  the  publication  of  a  work  on  general  history  the  author  hopes  for  that 
indulgence  which  may  be  claimed,  indeed,  by  every  man  who  has  done  his 
work  honestly,  according  to  the  measure  of  his  strength,  and  who  seeks  to 
appear  no  greater  than  he  really  is. 

Of  course,  for  most  of  the  facts  recorded  in  the  present  work  the  author 
is  indebted  to  others.  Still  he  has  everywhere  preserved  the  right  of  inde- 
pendent examination  and  judgment  as  to  who,  among  the  often  conflicting 
authorities,  seems,  on  the  whole,  the  most  reliable.  Many  things,  however, 
he  has  proved  by  reference  to  the  original  authorities,  and  thus  made  them, 
as  it  were,  his  own.  The  conception  of  the  history  of  medicine  as  a  branch 
of  the  general  history  of  civilization,  a  large  portion  of  the  history  of  the  ' 
profession  and  his  account  of  the  most  ancient  and  most  recent  develop- 
ments of  medical  art,  he  believes  he  may  also  justly  claim  as  original. 

That  the  book  has  found  so  conscientious  a  collaborator,  to  whom  it 
is  indebted  for  considerable  amplification  —  particularly  in  the  sections  on 
English  and  American  medicine,  with  which  he  was,  of  course,  better 
acquainted  than  the  author  —  and  numerous  corrections,  is  an  advantage 
which  no  one  can  better  appreciate  than  the  author  himself. 

The  latter  trusts  that  the  constellations  of  the  West  may  prove  pro- 
pitious to  his  work  and  enable  it  to  serve  the  cause  for  which  it  pleads. 

JOH.  HERMANN  BASS. 
Worms  on  the  Rhine,  March,  1889. 

:1.  In  order  to  economize  space  the  bibliography  of  the  author's  original  German  edi- 
tion has  been  omitted. 


Translator's  Preface. 


The  object  of  the  present  work,  so  far  as  the  translator  is  concerned, 
is  to  present  to  the  American  medical  profession  a  treatise  on  the  history 
of  medicine  neither  so  superficial  and  "  sketch}-  "  as  to  disappoint,  nor  yet 
so  voluminous  and  philosophical  as  to  weary  the  reader. 

The  "  Grundriss  der  Geschichte  der  Medicin  "  of  Dr.  Baas  seemed  to 
the  translator  to  meet  the  above  requirements  more  nearly  than  any  other 
treatise  with  which  he  was  acquainted,  and  his  proposal  to  render  the  work 
into  English  met  with  the  heartiest  co-operation  on  the  part  of  the  author, 
whose  notes  for  his  own  second  edition  were  freely  placed  at  his  disposal. 
How  extensive  these  notes  were  may  be  inferred  from  the  fact  that  the}- 
have  increased  the  size  of  the  book  about  one  third,  and  at  least  correspond- 
ingly enhanced  its  usefulness. 

The  sections  of  the  original  work  on  English,  and  particularly  en 
American  medicine  have  been  largely  expanded  by  the  translator,  and  he 
hopes  that  these  will  prove  a  feature  of  special  attraction  to  the  American 
reader.  In  everything  the  desire  has  been  to  render  the  book  a  useful  one, 
and  to  this  object  perfect  symmetry  and  literary  elegance  have  been  occa- 
sional^ partially  sacrificed. 

The  additions  of  the  translator  are  distinguished  by  brackets  or  his 
initial  (except  as  otherwise  indicated  in  the  work  itself),  and  for  these  he 
alone  is  responsible. 

No  pains  have  been  spared  to  render  the  names,  dates  etc.  as  accurate 
as  possible,  but  in  a  work  involving  such  an  infinity  of  details  of  this 
nature  it  would  be  unreasonable  to  expect  that  some  errors  and  omissions 
should  not  be  found.  For  these  the  translator  can  merehy  beg  the  mantle 
of  that  charity  which,  according  to  the  apostle,  "  shall  cover  the  multitude 
of  sins  ". 

H.  E.  HANDEKSON. 

Cleveland,  Ohio,  June,  1889. 


INTRODUCTION  AND  ARRANGEMENT. 


"  Hoc  illud  est  praecipue  in  cosnitione  rerum  sal- 
ubre  ac  frugiferum,  onmis  te  exempli  documenta  in 
illustri  posit  a  monumento  intueri." 

Livii  praefatio. 

The  study  of  the  history  of  medicine  and  the  medical  profession 
unquestionably  offers  even  to  the  layman,  from  certain  points  of  view, 
many  features  of  interest.  In  the  first  place,  as  an  extensive  and  import- 
ant branch  of  the  general  history  of  culture,  it  is  indispensable  to  the 
historian  of  civilization,  though  singularly  enough,  up  to  the  present  time 
it  has  not,  in  this  point  of  view,  been  duly  estimated.  It  shows  itself 
requisite  too  for  the  statesman  and  jurist,  since  manifestly  they  can  per- 
manently and  properly  adjust  the  estimation  and  the  position  of  physicians 
in  the  state,  only  by  a  thorough  cognizance  of  the  historical  development  of 
their  professional  relations.  It  likewise  permits  the  philosopher  to  see  the 
influence  of  his  science  upon  medicine,  and  conversely  the  influence  of 
medicine  upon  philosophy — a  reciprocal  influence  which,  from  the  begin- 
ning of  time  down  to  the  present  day,  has  been  strongly  manifested.  Even 
for  the  theologian  also  the  stud}'  of  the  history  of  medicine  possesses  a 
scientific  value,  because  it  shows  that  medicine  and  theology,  now  it  would 
seem  irreconcilably  at  variance,  were  in  their  early  periods  of  development 
most  intimately  united,  like  twin  sisters  in  the  womb,  whom  we  are  unable 
for  a  long  period  to  recognize  as  distinct  beings,  and  of  whom  even  after 
birth  we  cannot  say  which  is  the  elder,  since  both  were  born  at  the  same 
time.  '  To  the  naturalist  it  teaches  how  the  branches  of  his  science,  which 
lift  their  heads  so  proudly  to-da}T,  were  original]}'  mere  offshoots  of  medi- 
cine, and  have  been  only  recently  planted  as  independent  growths  upon 
a  soil  of  their  own.  Finally  it  gives  to  the  man  of  genuine  education  the 
best  opportunity  for  judging  medical  ability  and  medical  activity.  An 
acquaintance  with  the  history  of  his  science  is,  however,  especially  indis- 
pensable to  the  practical  physician,  if  he  would  thoroughly  comprehend 
and  penetrate  the  secrets  of  his  profession.  To  him,  indeed,  it  is  the  bright 
and  polar  star,  since  undoubtedly  it  alone  can  teach  him  the  principles  of  a 
medical  practice  independent  of  the  currents,  the  faith  and  the  superstition 
of  the  present.  Moreover,  it  offers  him  as  scientific  gain,  through  the 
knowledge  of  the  past,  the  measure  for  a  just  and  well-founded  criticism 
of  the  doings  of  his  own  time,  places  in  his  hand  the  thread  by  which 
he  unites  past  conditions  and  efforts  with  those  of  the  present,  and  sets 
before  him  the  mirror  in  which  he  may  observe  and  compare  the  past  and 
present,  in  order  to  draw  therefrom  well-grounded  conclusions  for  the 
future. 

(1) 


An  acquaintance  with  the  views  and  the  knowledge  of  epochs  already 
submerged  in  the  shoreless  ocean  of  time,  frees  the  mind  from  the  fetters 
and  currents  of  the  day,  with  its  often  oppressive  restraint,  widens  the 
horizon. for  a  glance  into  the  past,  and  an  insight  into  the  present  of  human 
activity,  deepens  the  view  for  a  comprehension  of  the  ideas  which  guided 
the  earlier  and  the  more  recent  physicians,  and  gives,  on  the  other  hand,  to 
our  daily  professional  labor  a  higher  consecration,  by  inserting  it  as  a  most 
useful  and  necessary  link  in  the  chain  of  development  of  past  and  future 
humanity.  The  significance  of  the  work  of  the  individual,  and  his  true 
value  and  true  position  with  regard  to  all  humanity,  are  first  revealed  to  us 
clearly  in  and  through  history. 

When,  however,  we  have  reviewed  the  labors  of  thousands  of  years, 
and  have  seen  how  in  their  course  our  science  ha&  been  advanced,  albeit 
in  unexpectedly  tedious  wa}s  ;  when  too  w7e  have  found  how  little  service, 
on  the  whole,  has  been  rendered  to  the  main  object  of  medicine — the  cure 
of  disease — and  above  all  in  internal  medicine,  which  enjoys  the  most  ex- 
tensive field  of  activit}',  we  are  at  first  sadly  disappointed.  For  in  spite  of 
all  therapeutics,  the  word  of  the  Psalmist  preserves  its  internal  truth  : 
"  As  for  man  his  days  are  as  grass  :  as  a  flower  of  the  field  so  he  flourish- 
eth.  For  the  wind  passeth  over  it,  and  it  is  gone."  But  on  a  closer  study 
of  the  subject,  this  knowledge  awakens  another  feeling. 

For  as  no  other  department  of  the  medical  sciences  is  so  well  adapted 
to  educate  the  physician  in  conscious  modest}",  so  on  the  other  hand,  none 
is  so  fitted  to  fill  his  consciousness  with  just  pride  in  his  often  contested 
and  self-sacrificing  labors.  As  the  histoiy  of  medicine  shows  him  the 
inadequacy  of  medical  knowledge  and,  in  the  majority  of  cases,  the  absolute 
nullity  of  medical  skill  in  the  struggle  with  the  laws  of  an  all-powerful 
nature,  so  it  places  before  his  eyes  the  unwearied  struggles  of  the  physicians 
of  all  ages — struggles  to  investigate  those  laws,  and  to  appropriate  to  the 
healing  and  blessing  of  suffering  humanity  the  knowledge  alread}'  acquired, 
or  to  be  acquired,  thereby.  Hence  we  prize  infinitely  less  the  fact  that 
history,  among  almost  all  people,  presents  to  our  eyes  the  immortal  gods 
as  the  authors  of  medical  art,  than  that  it  teaches  us  how  mortal  men  have 
struggled  continually  after  god-like  aims — the  prevention,  the  cure,  or  at 
east  the  alleviation  lof  the  woe  and  suffering  imposed  as  an  unavoidable 
heritage,  and  in  a  thousand  different  forms,  upon  us  created  beings — even 
though  to-day,  as  in  the  past,  these  aims  have  been  only  imperfectly  at- 
tained. The  histoiy  of  medicine  also  teaches  us  to  honor,  indeed  to 
admire,  humanit}-,  particularly  physicians  and  their  past  and  present 
struggles,  while  our  daily  practice  and  the  daily  actions  of  individuals 
might  perhaps  readily  lead  us  to  an  opposite  feeling.  It  shows  us  how 
man}-  a  noble  man  has  served  medical  science,  and  art,  and  humanit}', 
devoting  his  self-denying  strength  and  life  to  the  sick,  the  feeble,  the  per- 
secuted, the  poor,  and  the  insane,  and  performing  deeds  which  have  not,  in- 
deed, dazzled  and  carried  away  the  multitude  b}_  their  brilliant  results,  but 


have  worked  on  quietly  and  beneficently  through  all  futurity,  leading 
humanity  nearer  to  the  lofty  aims  of  humane  thought  and  action.  For  the 
consolation  of  these  men  there  has  often  remained  only  the  beautiful  say- 
ing, that  even  had  their  life  been  glorious.  }et  it  would  have  been  but  labor 
and  sorrow. 

In  like  manner  history  brings  before  us  those  spirits  who  have 
struggled  for  such  noble  aims  throughout  the  whole  course  of  the  known 
centuries,  both  the  highly-gifted,  victorious  and  great,  who  have  borne  aloft 
before  our  eyes  the  brightness  of  their  immortal  names,  and  those  who. 
less  favored  by  nature,  have  shone  with  a  more  modest  light,  and  must 
thus  be  sought  for  in  their  homes,  only  that  we  ma}-  learn  to  prize  and 
honor  their  struggles  and  their  perseverance  the  more  freely,  because  their 
desires  were  supported  by  less  eminent  natural  endowments.  History 
shows  us,  too,  those  whose  actions  have  shone  with  a  false  and  almost 
unearthly  gleam  in  times  of  intellectual  night.  It  teaches  us  how  those 
spirits  strove  to  recognize — and  in  some  small  degree  did  actuall}-  recog- 
nize— the  forces  acting  upon  and  in  man,  how  they  pointed  them  out, 
and  utilized  them,  how  in  the  midst  of,  and  in  spite  of  this  constant 
struggle  and  search,  that  saving  from  the  mouth  of  the  most  gracious 
of  mankind  has  proven  its  eternal  truth  :  "  Fragmentaiy  are  all  our  knowl- 
edge and  our  actions,  and  our  gaze  ambiguous  as  in  a  mirror.'' 

Thus  change  in  our  views  seems  to  be  the  only  permanent  phenomenon, 
and  in  no  science  has  the  maxim:  '-Much  arises  which  has  already  per- 
ished, and  what  is  now  honored  is  already  declining,"  attained  such  ex- 
tended verification  as  in  the  veiy  science  of  medicine.  Even  so  in  this 
same  science  has  been  proven  the  truth  of  that  other  saying:  '■  As  long  as 
man  struggles  he  errs  ".  To  err  in  its  struggles  after  the  truth  is,  however, 
according  to  the  resigned  expression  of  Lessing,  the  portion  of  humanity, 
and  absolute  truth  is  of  God  alone. 

This  observation,  however,  ought  not  to  discourage  us.  On  the  con- 
trary it  should  spur  us  on,  that  each  individual,  as  a  member  of  the  great 
"whole,  in  the  flight  of  moments,  days  and  years,  may  add  his  allotted  share. 
however  great  or  modest  it  ma}*  be,  to  the  completion  of  the  work  of  thou- 
sands of  years  of  pure  sense  and  sincere  heart.  For  a  thousand  years  are. 
indeed,  to  humanity  "as  a  watch  in  the  night,  Thou  earnest  them  away  as 
with  a  flood";  but  on  histoiy  and  in  history,  great  and  small  work  equally 
in  the  service  of  that  supreme  power,  whose  laws,  to  our  comprehension  in- 
herent and  active  in  matter,  arc  but  very  partially  explored  and  under- 
stood— that  power  to  whose  purposes,  unfathomed,  though  freel\-  discussed 
from  the  origin  of  the  human  race,  we  mortal  creatures,  living  and  strug- 
gling, dy'ing  and  vanishing  in  the  twilight  of  consolatory  hopes,  are  inevit- 
abby  committed.  History — that  of  medicine  included — seems  to  the  mind's 
eye  like  an  immense  wave  of  past  and  present  action,  now  strong  and 
rushing,  now  quietly  advancing,  with  sparkling  mountains  and  valleys 
deep  as  night. — a  wave  whose  ebb    and    flow   in   the  eternity  of  the  past 


we  understand  not  and  can  but  diml}-  conjecture.  A  supreme  power,  what- 
ever its  essence  and  however  named  of  men.  gives  to  it  its  direction  and 
individual  phases  in  accordance  with  a  design  and  purpose  to  us  forever 
inscrutable.  The  eternal  wave  rises  up  to  heaven,  it  sinks  again  into  the 
dark  depths,  bearing  mankind  ever  upon  its  rolling  crest  and  billowy  field, 
through  hundreds  and  thousands  of  years,  uniting  organically  with  each 
other  the  epochs  and  grades  of  human  development,  both  past  and  future. 
Millions  on  millions  have  perished  without  contributing  to  the  progress  of 
humanity  :  they  have  no  history.  Thousands  have  promoted  at  least  the 
foundations  of  future  knowledge  :  history  records  their  names,  for  they 
labored.  But  only  a  few  chosen  spirits  have  performed  the  highest  servi- 
ces allotted  to  man.  The}-  summed  up  the  past  and  discovered  new 
and  great  truths,  the  intellectual  product  of  man}'  bygone  factors  of  knowl- 
edge ;  they  led  humanity  onward,  and  thus  form  the  landmarks  of  its  his- 
tory. The  study  of  the  history  of  medicine,  above  that  of  all  other  medical 
branches,  should  give  a  more  ideal  direction  to  our  conception  of  our  call- 
ing by  showing  that  its  duties  and  its  rewards  are  not  to  be  found  exclu- 
sively in  our  daily  labors  and  scanty  pay  (as  is,  alas,  too  often  the  popular 
belief),  and  by  pointing  out  the  fact  that  only  in  struggles  and  labors  di- 
rected to  the  intellectual  advancement  of  humanity — struggles  unnoticed 
even  in  the  present,  and  probabh',  too,  long  in  the  future — lie  the  fertile' 
germs  of  futurity  and  a  scion  of  improvement  for  all  mankind. 

To  the  physician  is  assigned  in  tbe  first  place  the  difficult,  frequently 
the  impossible,  task  of  preserving  the  corporeal  health,  and  of  restoring  it 
when  disturbed  or  endangered  03-  disease  ;  next,  and  partly  necessaril}'  and 
consequently,  the  duty  of  preserving  or  restoring  the  faculties  of  the  mind. 
Impotent,  however,  as  it,  alas,  often  is  and  must  remain  in  opposition 
to  the  irreversible  laws  of  nature — and  history  teaches  most  strikingl}' 
this  impotence — the  medical  profession  when  no  longer  able  to  supply  the- 
technical  aid  which  we  think  ought  to  be  expected  of  it,  must  claim  as  its 
right  a  still  higher  significance,  a  duty  far  above  the  technical  services  of 
its  own  department — the  duty  of  being  in  truth  and  in  deed  a  humane  call- 
ing. For  there  can  be  no  doubt  that  we  physicians  too  are  active  co- 
workers in  the  sublimest  task  assigned  to  humanit}-  : 

"  Dass  das  Gute  wirke,  wachse,  fromme, 
Unci  der  Tag  des  Edlen  endlich  komme !" 

-That  the  good  may  work,  increase,  profit. 
And  the  day  of  the  noble  come  at  last.1' 


MEDICAL  SCIENCE  ON  THE  WHOLE, 
as  regards  its  various  phases  or  epochs  of  development,  may  be  likened  to 
a  large  picture,  whose  atmosphere,  tinted  by  unmeasured  distance,  displays 
only  a  few  clearer  cloudforms  in  somewhat  definite  outlines  and  masses,, 
while  the  limited  background  exhibits  in  perspective  lofty  temples,  about 


"whose  portals  wander  priests  in  ample  mantles,  to  guard  them  from  the 
entrance  of  the  uncalled.  On  either  side  appear  mighty  crags  and  groups 
of  lofty  trees,  whose  foliage  is  penetrated  by  the  powerful  rays  of  the 
noonday  sun,  while  the  foreground  greets  us  in  undimmed  brilliancy  and 
instinct  with  life.  To  the  distant  sky  with  its  cloudy  forms  we  may  com- 
pare the  mythical  era  of  medicine,  with  its  storied  gods  and  demigods  of 
punishment  and  of  healing.  To  the  background,  the  cognate  priestly  era, 
with  its  sacerdotal  physicians  and  theurgic  medicine,  and  its  works  hallow- 
ed by  faith.  The  middle  ground  may  be  likened  to  the  union  of  terrestial 
and  celestial  philosophy  with  medicine,  the  philosophic  period  ;  and  finally 
the  clear  foreground,  to  the  scientific  epoch,  with  its  practical  principles 
and  ideas.  These  various  periods  of  development  with  different  nations 
extend  over  distinct  and  long  eras.  Some  of  these  periods  with  certain 
people  have  never  been  abandoned  ;  others  have  not  been  traversed,  and 
still  others  never  attained.  All.  however,  encroach  on  each  other  more  or 
less,  and  the  last  two  particularly  are  practically  distinguished  from  each 
other  only  by  adopting  as  the  basis  of  such  a  distinction  the  tendency  to  ab- 
stract philosophical  reasoning  or  to  reasoning  based  upon  the  observation 
of  the  senses.  The  predominance  of  the  one  or  the  other  of  these  intel- 
lectual tendencies  then  affixes  its  stamp  to  the  whole  period,  though  a 
complete  separation  of  the  two  has  never  existed. 

THE  DEVELOPMENT  OF  MEDICAL  SCIENCE 

is  best  traced  in  some  one  people,  and  most  easily  among  the  Greeks,  inas- 
much as  a  number  of  their  works,  following  each  other  in  regular  succes- 
sion from  the  earliest  to  the  later  periods  of  development,  have  been  pre- 
served to  us.  Thus  in  the  earliest  writings  we  can  perceive  that  the  first 
medical  services  were  of  a  surgical  character,  and  that  these  had  already 
attained  a  certain  degree  of  perfection  at  a  period  when  scarcely  any  traces 
of  internal  medicine  were  to  be  found.  That  the  latter — undoubtedly  an- 
ticipated by  ophthalmology — was  also  preceded  by  a  knowledge  of  mid- 
wifery, which,  indeed,  until  a  late  day  was  generally  regarded  as  belonging 
to  surgery,  seems  apparent  from  the  earl}-  appearance  of  midwives— and 
obstetrical  goddesses,  a  species  of  divinity  now,  alas,  extinct  and  fre- 
quently substituted  by  individuals  of  the  masculine  gender.  What  we  now 
call  internal  medicine  first  developed,  at  all  events,  after  the  mythical  or 
heroic  period,  and  probabl}-  not  until  the  end  of  the  philosophic  period  of 
Greek  medicine.  Medical  services  too  in  those  days  were  not  divided  into 
separate  departments,  but  the  various  branches  were  first  separated  from 
the  original  and  long  pre-existing  trunk  of  general  medicine  some  centu- 
ries before  the  commencement  of  our  era — in  the  Alexandrian  period — 
to  be  once  more  subdivided  during  the  age  of  the  Roman  Empire,  an  age 
in  which  the  Greeks  were  almost  the  sole  representatives  of  medical  science. 
In  the  course  of  later  ages  (particularly  in  the  beginning  of  the  16th  cen- 
tury i   this  subdivision,   in    proportion  to    the  increasing  material    of  the 


science  and  the  greater  number  of  physicians,  became  still  more  marked. 
Indeed  at  the  present  day  the  numerous  special  departments  represent  a  kind 
of  German  ■  Bund  ',  within  which  the  unity  of  medical  science  and  the  ap- 
preciation of  that  unity  appear  and  live  almost  entirely  in  those  medical 
circles  composed  of  what  we  call  practising  physicians,  while  the  great 
potentates  in  this  medical  confederation  must,  for  the  most  part,  be  con- 
tented to  cultivate  and  to  understand  their  special  states,  be  the}'  larger  or 
smaller,  but  are  often  not  required  to  investigate  in  any  way  the  depart- 
ments of  others. 

THE  DEVELOPMENT  OF  THE  MEDICAL  PROFESSION, 

as  the  practical  evidence  of  the  tendency  of  medical  science,  naturally  took 
about  the  same  course  as  the  latter  itself.  For  a  long  period  there  were 
general  physicians  only  ;  then  they  divided  themselves  into  some  few  de- 
partments ;  but  as  the  medical  profession  became  overcrowded  and  began 
to  decline  there  have  always  appeared  specialists,  frequently  an  infinite 
number  of  them. 

PROGRESS  OF  MEDICAL  CULTURE   IN   THE  VARIOUS  OEOGRAPHICAL 
DIVISIONS  OF  THE  EARTH. 

This  followed  such  a  course  that,  as  early  as  the  beginning  of  the 
second  millennium  B.  C,  northern  Africa  and  eastern  Asia  possessed  an 
independent  medical  literature  (corresponding  to  the  development  of  the 
period),  and  the  countries  between  the  limits  mentioned,  e.  g.  Palestine. 
Phoenicia^  Babylonia,  Syria,  Persia,  as  well  as  China  and  Japan,  were  also' 
at  a  very  early  date  in  the  enjoyment  of  a  medical  literature,  though  all  did 
not,  like  the  countries  first  mentioned,  possess  a  purely  professional  litera- 
ture. After  these,  Europe,  the  youngest  member  of  the  old  world,  was 
the  first  to  enter  upon  a  medical  culture  of  its  own.  It,  however,  in  con- 
trast to  the  others,  continued  a  permanent  and  wider  development,  Within 
the  countries  of  Europe,  however,  medicine  followed  the  general  direction 
of  all  culture,  tending  from  the  south-east  toward  the  west.  In  the  so- 
called  New  World  were  found  only  traces  of  a  mythical,  theurgic.  utterly 
gross  and  empirical  medicine,  whose  nutrient  vessels,  tied,  alas,  by  the 
whites,  were  prevented  from  supporting  a  further  development,  The  civil- 
zed  America  and  Australia  of  the  present  day  were  (and  are  still)  in  great 
part  educated,  in  both  medicine  and  all  other  departments  of  science,  by 
Europe  and  her  sons,  though  they  are  now  beginning  in  many  respects  a 
development  of  their  own. 

While  in  the  earliest  ages  the  Arian  stock  had  attained  a  tolerably 
high,  and  the  Mongolian  a  less  elevated,  grade  of  medical  knowledge,  sub- 
sequently the  latter  race,  disappeared  utterly  from  the  ranks  of  progressive 
medical  science  — the  Japanese,  however,  seem  desirous  recently  of  resum- 
ing their  lost  position-  and  at  the  present  day  the  Arians  alone,  in  their 
various    branches,  are  the  sole   representatives  of  such  scientific  progress. 


But  even  within  the  Arian  stock  we  do  not  observe  an  equal  advance 
among  all  its  branches.  The  peculiar  medical  cultures  of  the  Egyptians, 
Jews,  Babylonians,  Assyrians,  Phoenicians  and  Medo-Persians,  with  their 
respective  states  and  the  independent  existence  of  their  supporters,  have 
utter!}-  disappeared  ;  the  science  of  the  Indians  has  remained  stationary", 
and  the  medical  culture  of  the  Greeks,  with  its  offshoots  the  medicine  of  the 
Romans  and  Arabians,  existed  and  in  part  still  exists  only  in  very  late, 
though  certainly  decided,  after-effects.  The  offspring  of  the  Romans,  the 
Romanic  peoples,  however,  are  struggling  to-day  on  even  terms  with  the 
far  younger,  and  therefore  more  vigorous  Germans,  for  the  olive-braneh 
of  victory  and  the  laurel  of  fame.  The  Sclaves  too  have  recently  entered 
independently  into  the  struggle,  and  long  hereafter,  when  the  former  nations 
have  become  old  and  feeble  in  the  progress  of  the  world,  the  Sclaves  will 
probably  dispossess  both  the  Romanic  nations  and  the  Germans  of  their 
pre-eminence.  The  negroes  have  been  from  the  outset,  and  now  are,  with- 
out any  importance  in  the  development  of  the  medical  sciences,  as  well  as 
in  every  other  way.  and  the  Indians,  devoted,  alas,  to  destruction  b}T  that 
vampire  of  human  races,  the  whites,  though  intellectually  much  more 
highly  organized  than  their  destroyers,  have  exercised  no  influence  upon 
the  progress  of  medical  science.  The  same  remark  may  also  be  made  of 
the  inhabitants  of  the   Australian  archipelago. 

As  regards  the  periods  within  which  the  different  branches  of  the 
human  race  entered  upon  medical  culture,  on  a  general  survey  the  writings 
still  preserved  to  us  furnish  for  very  ancient  times  the  most  secure  basis. 
In  this  way  it  may  be  regarded  as  settled  for  the  Egyptians  that  some  of 
their  extant  special  medical  works  were  composed  in  the  17th  century  B.  C. 
On  the  other  hand  the  Indians  are  able  to  exhibit  such  works  only  from  the 
11th  century  before  our  era.  The  medical  knowledge  of  the  Jews  (Moses, 
about  B.  C.  1500),  the  ancient  Persians  (Zend  Avesta  about  B.  C.  500), 
and  the  Chinese,  is  scattered  through,  and  incorporated  in  their  religious  and 
poetical  writings  of  very  early  date,  while  of  the  equall}-  ancient  Phoeni- 
cians no  written  remains  are  preserved  to  us.  The  Greeks,  whose  spirit 
was  destined  to  rule  all  later  humanity,  show  some  traces  of  medical 
knowledge  in  poems  whose  contents  are  assigned  to  the  period  about  B.  C. 
1000,  but  the}'  did  not  begin  to  create  a  medical  literature  proper  until 
the  fifth  century  before  Christ.  After  the  death  of  Alexander  the  Great 
(B.  C.  323),  the  city  of  Alexandria  became  the  chief  nursery  of  med- 
ical science.  From  Alexandria  and  the  schools  founded  by  her  pupils, 
the  latter  was  transplanted  among  the  Romans  about  B.  C.  100.  From 
Byzantium,  b}'  way  of  Alexandria,  an  offshoot  of  Greek  medicine  of  his- 
torical importance  was  imported  to  the  Persians  and  Arabians  by  the 
Nestorians.  who  were  banished  for  heresy  in  the  fifth  century  and  founded 
or  continued  schools  in  Gondisapor  and  other  places.  Under  the  indirect 
influence  of  the  latter,  and  chiefly  by  means  of  Jewish  physicians,  there 
arose  in  the  0th  century  the  medical  schools  of  lower  Italy  at  Monte  Casino 


and  Salerno,  which  in  the  darkest  periods  of  the  Middle  Ages  preserved 
for  medicine  a  secure  but  narrow  place  of  refuge,  until  through  the  Ital- 
ians in  the  14th  century  human  anatomy  was  created  to  furnish  a  founda- 
tion for  a  new  science  of  medicine.  The  new  epoch  was  also  specially  in- 
augurated by  the  Greeks  banished  from  Byzantium  on  the  capture  of  this 
city  by  the  Turks  (1453).  Henceforth,  however,  medicine  entered  upon  a 
broader  road  and  extended  its  influence  over  a  larger  number  of  people. 
Among  the  French,  Pare,  about  the  middle  of  the  16th  centur}',  created 
modern  surgery  in  a  method  characteristic  and  valid  even  down  to  the 
present  day,  while  the  Englishman  Harvey  in  the  following  century  by  his 
discovery  of  the  circulation  laid  the  foundation  of  physiology,  and  Para- 
celsus, earlier  than  either,  created  among  the  Germans  a  new  science  of 
medicine.  Thus  general  medicine  in  these  lands  celebrated  a  new  Spring- 
time and  a  veritable  Easter  festival,  while  preserving  the  impulse  for  fur- 
ther development — a  development  which  in  power  and  extent  left  far  behind 
that  of  the  earlier  ages,  and  seems  in  our  own  age  to  be  passing  through 
its  proper  fructification.  In  the  most  recent  times,  however,  the  advanc- 
ing wave  of  medical  culture,  chiefly  by  the  aid  of  American  and  Australian 
representatives  of  the  white  race,  has  reached  Japan,  one  of  the  oldest 
homes  of  medicine  in  eastern  Asia,  and  thus  the  circuit  of  the  world  is 
being  completed,  centuries  after  its  commencement. 

The  form  of  development  of  medicine  in  its  entirety  ma}",  accordingly, 
be  compared  to  a  tree,  whose  perennial  stem  is  formed  by  the  Egyptians, 
Indians.  Babylonians,  Persians,  Chinese,  etc.,  and  its  tap-root,  by  which  the 
stock  is  continued,  is  represented  by  the  Greeks.  From  this  stock,  which 
first  pushed  forth  the  barren  shoot  of  Roman  medicine,  and  subsequently 
that  of  the  Arabians  during  its  miserable  existence  in  the  course  of  the 
Middle  Ages,  there  finally  developed  a  powerful  branch  at  the  beginning  of 
the  modern  era,  and  after  its  transplantation  into  the  soil  of  the  West. 
Gradually  there  appeared  five  main  branches,  the  Italian,  the  French,  the 
German,  and  the  English,  with  the  less  vigorous  Spanish,  which  originally 
promised  so  much,  but  jet  remained  feeble  and  miserable.  These  first  four 
main  branches,  with  their  dependent  twigs,  now  tower  above  all  small  and 
modern  civilized  peoples  and  states.  But  in  the  formation  of  the  complete 
crown,  as  in  the  system  of  universal  medicine,  all  people  will,  at  some  time, 
take  part. 

Till-]  DIVISION  OF  MEDICAL  HISTORY   INTO  PERIODS 

is  commonly  made  in  such  a  way  that  the  era  of  Antiquity  closes  with 
Galen  ;  then  follow  the  Middle  Ages  of  medicine,  and  the  modern  history 
of  this  science  begins  with  Harvey. 

If  we  look  upon  the  history  of  medicine  as  a  department  entirely 
separable  from  the  general  history  of  civilization,  it  is  justifiable  to  fix 
upon  special  epochs,  and  to  regard  particular  services  of  representative 
persons  within  these  epochs  as  special  landmarks.     The  propriety  of  this 


idea  we  certainly  cannot  den}-.  Yet  the  history  of  medicine  may,  with 
equal  justice,  claim  to  be  exclusively  a  part  of  the  general  history  of  cul- 
ture, with  whose  course,  as  may  readih-  be  seen,  it  keeps  pace,  and  from 
which  it  cannot  ever  be  entirely  separated — and  we  believe  that  from  this 
point  of  view  the  generally  received  divisions  of  the  latter  ought  also  to 
be  preserved  as  the  most  practical  in  the  history  of  medicine,  inasmuch  as 
they  have  received  general  acceptance,  and  maintain  the  idea  of  the  unit}' 
of  the  history  of  medical  and  general  culture.  Again,  the  landmarks 
mentioned  above  do  not  limit  with  absolute  truth  and  precision  the  be- 
ginning and  end  of  the  medical  epochs  in  question.  For  the  Greco-Roman 
medicine  e.  g.,  though,  like  the  ancient  peoples  themselves,  it  had  greatly 
deteriorated,  still  existed  and  exercised  exclusive  control  over  medical 
science  long  after  the  days  of  Galen.  It  was  not  until  the  downfall  of  the 
Roman  Empire  in  the  West  that  medical  culture  was  gradually  transferred 
to  new  peoples,  and  began  a  new  phase  of  development  upon  a  new  soil. 
By  such  phenomena,  however,  the  epochs  of  a  science,  as  of  culture  in 
general,  are  most  distinctly  divided.  The  same  thing  occurred  at  the 
beginning  of  the  modern  era,  when  medicine  migrated  from  Italy  to  the 
civilized  nations  of  the  Germanic  stock,  who  now  control  it.  and  thus  won 
a  field  for  development  much  broader  than  in  the  times  past. 

Another  point  of  view  from  which  this  subject  may  be  regarded,  is 
found  in  the  following  facts  : 

Nations,  as  regards  their  services  to  medicine,  may  be  divided  into 
two  sufficiently  sharply  defined  groups,  the  one  embracing  those  nations 
who  have  withdrawn  from  the  stage  of  history,  or  who,  though  still  pres- 
ent, no  longer  manifest  any  progress  or  independence  in  their  medical 
knowledge  ;  the  other  including  those  who  possessed  at  one  period,  or  who 
still  possess,  a  progressive  development  of  their  own  in  medicine. 

Accordingly  we  present  the  following  division  : 

SECTION  FIRST. 

The  Medical  Culture  of  those  Nations  whose  Development  in  Medicine  is 
either  already  closed  or  is  stationary  (or  not  independent).  The  His- 
tory of  the  Most  Ancient  Medicine  and  the  Medicine  of  Primeval 
Peoples. 

I.  The  Medicine  of  the  Egyptians. 

II.  The  Medicine  of  the  Ancient  Persians  (Chaldeans,  Babylonians.  As- 
syrians, Syrians,  Medes)  and  Phoenicians  (Carthagenians ,. 

III.  The  Medicine  of  the  Jews. 

IV.  The  Medicine  of  the  Indians. 

V.  The  Medicine  of  the  Chinese  and  Japanese. 

VI.  Medical  Views  and  Economy  among  other  Nations,  of  whom  some 
have  disappeared  from  history,  some  are  stationary  in  their  develop- 
ment, and  others  possess  as  yet  no  medical  culture  of  their  own 
(Seythians,  Kalmucks.  Siamese.  Turks,  etc..  etc.  t. 


—  10  — 

SECTION  SECOND. 

The  Medical  Culture  of  those  Nations  whose  Development  in  Medicine  has 
been  or  is  progressive. 

FIRST     PERIOD. 

The  Medicine  of  the  Greeks  (and  Romans)  to  the  Downfall  of  the  Western 
Empire  in  the  year  470.     History  of  Ancient  Medicine. 

SECOND    PERIOD. 

Medicine  from  the  Downfall  of  the  Western  Empire  to  the  Discover}-  of 
America,   from   A.  D.  -176-1492.     History  of  Mediaeval  Medicine. 

THIRD    PERIOD. 

Medicine  from  the  Discovery  of  America  to  the  close  of  the  First  French 
Revolution  by  the  Consulate,  from  1492-1800  A.  D.  History  of  More 
Modern  Medicine. 

FOURTH    PERIOD. 

Histoiy  of  the  Medicine  of  the  19th  Century.  History  of  the  Most  Re- 
cent Medicine. 


.*->>^pp--£<-*- 


SECTION  FIRST. 


THE    MEDICAL   CULTURE  OF  THOSE    NATIONS    WHOSE    DEVEL 
OPMENT  IN  MEDICINE  IS  EITHER  ALREADY   CLOSED  OR 
IS  STATIONARY    (OR    NOT    INDEPENDENT).         THE 
HISTORY    OF    THE    MOST    ANCIENT    MEDI- 
CINE AND  THE   MEDICINE  OF  PRIM- 
ITIVE    PEOPLES. 


EGYPTIAN  MEDICINE. 

Udvra  fiei. — Heraclitus. 

Egypt,  if  not  the  oldest,  is  undoubtedly  one  of  the  oldest  of  civilized 
lands.  Mesopotamia  may  alone  with  some  justification  dispute  her  claim 
to  the  first  rank  in  antiquity.  If  too  there  is  an}-  truth  in  the  hypothesis 
that,  at  the  dawn  of  the  world's  history,  the  home  of  primeval  man  la}"  to 
the  south-east  of  Africa,  in  the  region  long  since  submerged  lyy  the  ocean,, 
it  is  also  probable  that  the  progenitors  of  the  ancient  Egyptians  wandered 
into  upper  Egypt  along  the  course  of  the  modern  Bar  el  Asrek,  and  estab- 
lishing here  a  permanent  settlement,  founded  the  earliest  home  of  civiliza- 
tion. The  tradition  of  the  ^Ethiopians  that  Egypt  was  one  of  their  colo- 
nies supports  this  hypothesis,  as  well  as  the  fact  that  the  settlement  of  the 
valley  of  the  Nile  undoubtedly  followed  the  current  of  that  stream.  Recent 
investigators  (including  Ebers)  suppose,  however,  that  the  Egyptians,  un- 
doubtedly an  Indo-Germanic  people,  migrated  across  Phoenicia  into  their 
present  home.     But  in  language  they  belong  to  the  Semitic  stock. 

The  extreme  antiquity  of  Egyptian  civilization,  from  which  many  of 
the  most  ancient  nations  (including  even  the  Greeks)  manifestly  borrowed  a 
part  of  their  science  and  their  culture,  is  evidenced  by  its  venerable  edifices 
and  monuments,  which  indicate  considerable  technical  skill,  b}"  the  records 
of  the  dynastic  registers,  and  especially  b}T  the  medical  works  of  the  ancient 
Egyptians,  which  have  been  preserved  to  our  day.  These  reach  back  to  a 
period  which  we  can  as  yet  indicate  by  trustworthy  figures  in  the  case  of  no 
other  people  ;  and  yet  they  presuppose  a  long  antecedent  course  of  devel- 
opment, extending  from  the  age  of  primeval  rudeness  to  the  attainment  of 
such  a  grade  of  civilization  as  that  by  which  they  were  themselves  pro- 
duced. In  the  great  number  of  their  writings  already  discovered,  as  well 
as  in  the  fact  that  the  ancient  Egyptians  decorated  their  monuments  and 
mummy-cases  with  hierogl}phics,  we  also  find  evidence  to  the  same  effect. 
Later  grades  of  civilization  alone  mature  a  literature  so  extensive  as  that 
which  we  find  among  the  Egyptians.  Indeed  this  is  so  considerable  thatr 
basing  our  argument  upon  it  alone,  we  might  defend  the  view  that  the 
Egyptian  people,  even  at  the  very  early  period  when  this  literature  arose, 
had  alread}'  considerably  degenerated,  and  were  in  fact  verging  on  senes- 
cence. For  youthful  peoples  are  especially  proud  of  physical  abilities,  and 
devote  attention  to  these  alone,  while  it  is  only  nations  which  are  growing 
old  that  lay  the  chief  importance  upon  scientific  culture,  and  are  fond  of 
writing.  The  truth  of  this  statement  is  confirmed  by  the  history  of  the 
Greeks,  the  Romans,  and  even  by  our  own  age. 

(13) 


—  14  — 

In  accordance  with  such  facts  and  considerations,  there  is  no  internal 
improbability  in  assigning  the  foundation  of  the  first  kingdom  of  Egypt  to 
the  sixth  millennium  before  Christ.1  An  especial  ground  for  referring 
this  event  to  so  early  a  period,  a  period  of  whose  medical  writings  especially 
we  have  acquired  no  knowledge  in  the  case  of  any  other  people,  may  be 
found  in  the  fact  that  the  sober,  earnest  and  heavy  intellect  of  the  ancient 
Egyptians,  as  we  meet  it  in  their  surviving  and  characteristic  works  of 
architecture,  sculpture  and  painting,  unlike  the  boundless  vanity  of  the 
Chinese,  or  the  overflowing  fancy  of  the  natives  of  India,  was  not  suited  to 
originate  supposititious  history. 

The  Egyptians,  like  all  other  people,  had  several  divinities  who  presided 
over  the  cure  of  disease.  The  principal  of  these  deities,  Isis,  was  at  once 
the  sister  and  the  wife  of  Osiris.  For  among  the  Egyptians,  as  well  as  the 
pagan  North-Germans  (though  in  contrast  with  the  custom  of  the  Jews), 
marriages  with  sisters  were  permissible  and  usual  even  for  their  gods,  and 
this  custom,  in  accordance  with  popular  prejudice,  was  adopted  or  retained 
by  the  Grecian  Ptolemies.  Isis  had  demonstrated  her  eminent  medical  skill 
by  recalling  to  life  her  son  Horus.  Imhotep,  the  Egyptian  ^Esculapius, 
whose  temple  stood  at  Memphis,  and  Chunsu,  the  counsellor  of  the  sick,  were 
of  lower  rank.  The  cat-headed  Pacht  (Bubastis)  and  Ape  were  worshipped 
as  the  deities  of  parturient  women  or  of  child-blessedness  ;  for  children 
among  the  Egyptians  were  esteemed  a  great  blessing,  as  they  were,  and 
indeed  still  are,  by  their  docile  pupils  the  Jews.  The  cat  was  sacred  to 
Pacht,  and  this  animal  was  held  in  such  honor  that  the  death  penalt}-  was 
prescribed  for  killing  a  "  mau  "  (cat).  Thot  (Thout,  Thuti),  a  god  repre- 
sented sometimes  with  the  head  of  an  ibis,  sometimes  with  that  of  a  dog, 
enjoyed  greater  respect,  and  was  regarded  as  the  inventor  of  art  in  general, 
and  especially  of  the  healing  art.  By  many  he'  is  regarded  as  the  Egyptian 
,Esculapius.  though  he  enjoys  many  peculiarities  in  common  with  the 
Greek  Hermes  and  the  Phoenician  Esmun." 

Thot  is  supposed  to  have  been  the  author  of  the  oldest  Egyptian  medi- 
cal works,  whose  contents  were  first  engraved  upon  pillars  of  stone.  Subse- 
quently collected  into  the  book  Ambre  or  Embre  (a  title  based  upon  the 
initial  words  of  this  book,  viz.  :  "  Ha  em  re  em  per  em  hru  ",  i.  e.  "Here 
begins  the  book  of  the  preparation  of  drugs  for  all  parts  of  the  human 
body")    they   formed   a  part  of  the  so-called    "Hermetic  Books",    from 

1.  The  period  of   Chufu    (Cheops),    who   built,  the   famous   pyramid,    and    had    the 

Sphinx  restored,  is  assigned  (according  to  Buchta)  by  Lepsius  to  ol 24  B.  C,  by 
Brugsch  to  S7354,  by  Unger  to  tS45,  and  by  Champollion  to  B.  C.  5000.  Wiedemann 
takes  as  the  mean  date  £845  B.  C.  Now  since  the  Sphinx  at  this  period  already 
required  to  be  restored,  its  erection  must  be  referred  to  a  period  hundreds,  indeed 
thousands  of  years  before  the  days  of  Cheops,  for  the  climate  of  Egypt  (unlike 
that  of  America)  is  very  favorable  to  the  preservation  of  stone  monuments. 

2.  Esmun  was  one  of  the   ancient    Cabin,  and  the  iEsculapius  of  the  Phoenicians. 

Famous  temples  in  his  honor  stood  at  Carthage  and  Berytus.  (H.) 


—  15  — 

whose  prescriptions  no  physician  might  deviate,  unless  he  was  willing  to 
expose  himself  to  punishment  in  case  the  patient  died.  This  punishment 
was  threatened  because  the  substance  of  the  medical,  as  well  as  the  relig- 
ious works  of  the  Egyptians — and  the  science  of  the  priests  united  in  itself 
medicine,  theology  and  philosophy- — was  given,  according  to  their  view,  by 
the  gods  themselves,  and  a  disregard  of  their  prescriptions  would  be  noth- 
ing less  than  sacrilege.  The  remains  of  these  books1  are  probably  pre- 
served to  us  in  the  two  papyri  of  Leipzig  (papyrus  Ebers)  and  Berlin, 
especialby  in  the  former.  The  Leipzig  papyrus  was  committed  to  writing- 
in  the  16th  century  B.  C,  and  is  the  offspring  of  an  epoch  of  high  civiliza- 
tion in  Egypt :  for  in  this  same  century  of  Sesostris  or  Ramses-Miamuir 
(died  B.  C.  1511)  lived  and  sung  the  old  Egyptian  epic  poet  Pentaur.  and 
Mesu  (Moses)  was  also  educated  at  the  same  period  in  Egypt2  (Lauth). 
The  Berlin  Papyrus  was  committed  to  writing  in  the  middle  of  the  14th 
centun'  B.  C,  and  the  substance  of  both  these  works  is  referred  back  to 
the  fourth  millennium  before  our  era.  Thosortes  ( Athotis).  who  also  reigned 
during  the  course  of  this  latter  period,  received  the  surname  of  ':  Imhotep", 
i.  e.  "  physician  ",  in  consequence  of  his  medical  knowledge  ! 

The  papyrus  Ebers  is  only  partially  deciphered,  but  it  is  believed  to  have  been 
written  between  1550-1517  B.  C,  and  it  exhibits  to  us  a  compilation,  whose  contents 
are  the  work  of  several  persons,  for  even  an  oculist  of  Byblos  in  Phoenicia  is  men- 
tioned as  one  of  the  associate  authors.  In  this  we  have  proof  that,  even  at  this  extra- 
ordinarily early  period,  medical  science  was  international,  and  that  even  then  (as  we 
see  in  Ziemssen's  Codex  to-day)  savants  of  a  foreign,  though  neighboring  nation, 
took  part  in  such  compilations.  This  papyrus  compiled  under  the  king  Ba-kerh-ra, 
probably  at  On  (  Heliopolis),  where  was  located  a  famous  sacerdotal  college  (in  which, 
as  in  the  Museum  at  Alexandria  at  a  later  period,  policlinical  treatment  was  practised), 

1.  The  "  Todtenbuch  "  (Book  of  the  Dead),  also  belongs  among  them.     This  was  "a 

sort  of  guide-book,  which  every  Egyptian  must  possess  in  order  to  travel  with 
safet}*  in  the  other  world.  The  use  of  this  book  was  extremeh'  simple  and  inge- 
nious. It  was  sufficient  to  have  learned  it  by  heart,  or  to  have  merely  transcribed 
it,  in  order  to  know  it  after  death.  For  those  who  had  neglected  this  precaution 
during  life,  the  son  or  some  other  relative  performed  the  service  of  reading  or  re- 
citing the  necessary  chapters  at  the  burial.  Finallj-  by  the  donation  of  a  more 
or  less  complete  copy  of  the  work,  sufficient  knowledge  of  the  formula'  inscribed 
therein  was  secured  to  the  dead."     (Buchta.) 

2.  The  mummy  of  Ramses  II..   Miatnun,  is   still   preserved  in  the   museum  at  Bulaq. 

The  complete  name  of  the  king  was  Ra-Userma  Sotep-en-ra  Ramessu  Miamun 
A-nachtu  (the  victor'. 

3.  A  thousand  years  before  this  the  Egyptians  possessed  an  exercise-book  of  elemen- 

tary mathematics  (papyrus  Rhind),  probably  composed  under  Amenemlia  III. 
(B.  C.  2221-2179).  This  was  copied  about  B.  C.  1700  by  a  writer  named  Ahainesu, 
and  its  contents,  almost  word  for  word,  are  ajrain  found  in  a  book  of  the  Alexan- 
drian Heron.  Probably  there  also  existed  a  theoretical  text-book  of  mathematics 
in  Egypt,  which  Euclid  had  at  his  command.  The  work  first  mentioned  comprises 
exercises  in  the  four  primar}-  rules  of  arithmetic,  and  especially  fractions  (Eisen- 
lohr).  Brugsch  has  recently  discovered  in  a  papyrus  the  fables  of  ^Esop,  which 
must  either  have  been  of  Egyptian  origin  or  imported  into  Egypt  from  Greece. 


—  1G  — 

bears  the  title  given  in  the  preceding  paragraph,  and  contains:  remedies  for  diseases- 
of  the  stomach,  the  abdomen,  the  urinary  bladder;  for  the  removal  of  the  glands  in 
the  groin  (buboes)  and  the  "kehn-mite";  "The  book  of  the  Eyes";  remedies  for 
ulcers  of  the  head,  for  grayness  of  the  hair,  and  promotion  of  its  growth  ;  ointments  to 
heal  aiid  strengthen  the  nerves ;  medicines  to  cure  diseases  of  the  tongue,  to  strengthen 
th<j  teeth,  to  remove  lice  and  fleas ;  remedies  for  the  hearing  and  for  the  organs  of  smell : 
the  preparation  of  the  famous  Kyphi;  "The  Secret  Book  of  the  Physician  (The  Science 
of  the  Movement  of  the  Heart,  and  the  Knowledge  of  the  Heart,  according  to  the 
priestly  physician  Nebsuchet)" ;  prescriptions  for  the  eyes  according  to  the  views  of 
the  priest  Chui,  ;i  Semite  of  Byblos ;  "  Book  of  the  Banishing  of  Pains";  recipes  for 
mouth-pills  for  women,  to  render  the  odor  of  the  mouth  agreeable;  the  various  uses 
of  the  tequem  tree,  etc.  The  papj'rus  has  marginal  notes,  like  "  liefer"  (good)  etc.. 
which  Lauth  assigns  to  the  year  1469  B.  C,  an  evidence  that  its  prescriptions  had 
been  tested  in  practice. 

These  so-called  '•  Hermetic  Books  "  in  the  post-Alexandrian  age.  and 
still  later,  served  as  the  source  of,  and  a  mask  for,  the  vagaries  of  magic,  and 
the  extravagances  and  frauds  of  the  alchemists.  Most  of  them,  however,  are 
forgeries.  Apis  and  Serapis  were  also  regarded  as  skilled  in  the  healing 
art,  and  the  ibis  was  popularly  supposed  to  have  been  the  hallowed  inventor 
of  one  of  the  most  useful  medical  operations — the  use  of  clysters — for  it 
was  believed  that  when  constipated  she  administered  them  to  herself  with 
the  aid  of  her  long  bill. 

The  magnificent  and  wealthy  sacerdotal  schools  were  the  institutions  for  instruc- 
tion in  medicine.  The  best  of  these  were  located  in  Thebes  "with  its  hundred  gates," 
in  Memphis.  Sai's,  Heliopolis  (Egyptian  Ann,  Heb.  On,  now  Matarieh  hear  Cairo), 
and  Chennn  (Silsilis).  They  corresponded  somewhat  with  the  later  colleges  of  Alex- 
andria, but  had  a  purely  esoteric  character.  We  may  regard  them  also  as  the  uni- 
versities of  that  ancient  period,  provided,  as  they  were,  with  a  library,  laboratories, 
boarding-houses  for  students,  etc.  Heliopolis  especially  was  considered  a  school  of 
practical  medicine. 

The  medical  knowledge  of  the  ancient  Egyptians  was  tolerably  exten- 
sive, and  gauged  by  the  measure  of  those  early  ages,  by  no  means  unim- 
portant. It  was  at  all  events  quite  characteristic.  Medicine  was  divided 
into  the  science  of  higher  degree  (conjurations,  dissolving  the  charms  of 
the  gods  by  prayer,  interpretations  of  the  revelations  received  by  the  sick 
during  incubation  in  the  temples),  and  ordinary  medical  practice. 

The  highest  class  of  priests  (sages,  soothsayers),  whose  privilege  and 
duty  it  was  to  study  the  first  3G  Hermetic  books,  officiated  as  physicians  of 
the  higher  science.1  Ordinary  medicine  was  practiced  by  priests  of  the 
lowest  grade,  the  Pastophori.  The  latter — hence  their  name — carried  the 
image  of  the  sacred  (sam-)  barge  in  their  religious  processions,  and  it  was 
their  duty  to  study  the  last  six  of  the  Hermetic  books.  These  treated  of 
anatomy,  patholog}',  pharmacology  (pap}'rus  Ebers  ?),  ophthalmolog}',  and 
gynecology,    if  we  employ  modern  terms  for  their  designation.       There 

1.  Undoubtedly  the  oldest  physicians  known  to  us  by  name  are  the  primitive  medi- 
cal colleagues  and  kings  Teta  and  Tseshorta  (5th  millennium  B.  C),  Nebsuchet, 
the  Senac  of  the  Egyptians,  and  Chui,  an  oculist. 


—  17  — 

was  too  still  another  class  of  priestly  physicians,  who  followed  the  army 
and  enjoyed  a  salary  from  the  state,  military  physicians.  Besides  these, 
there  were  veterinary  physicians,  whose  methods  of  treatment  are  still 
partially  preserved  upon  the  monuments,  and  who  were  mainly  specialists, 
fowl-doctors,  cattle-doctors,  etc.  In  fact  their  general  sj'stem  of  special- 
ties (as  we  learn  already  from  the  papyrus  Ebers)  was  so  complete,  that 
according  to  the  account  of  Herodotus,  there  were  physicians  in  Egypt  for 
each  part  of  the  bod}".  This  specialism  is  per  se  an  evidence  of  a  civiliza- 
tion of  high  development,  indeed  of  one  tending  towards  its  downfall,  and  in 
Egypt  it  attained  a  perfection  which  our  own  system,  with  all  its  complete- 
ness, has  not  yet  reached.  We  know  that  the  sick  were  visited  and  treated  at 
their  homes  by  the  physicians.  The  latter  must  first,  however,  be  sent  for  to 
the  President  of  the  temple,  who  then  selected  and  despatched  to  the  patient 
the  specialist  best  suited  to  his  case.  The  sick  were  also  treated  as  out- 
patients in  the  temples.  Persons  of  rank  had  their  physician-in-ordinary. 
Whether  there  were  hospitals  in  Eg}Tpt  is  doubtful ;  at  all  events  the  state- 
ment that  the  sick  were  exposed  in  the  streets,  so  that  passers-by  might 
impart  advice  to  them  and  inform  them  how  they  had  themselves  been 
cured,  is  opposed  to  such  a  supposition. 

In  consequence  of  the  strict  division  of  castes  which  stamped  its  im- 
press upon  all  the  arrangements  of  the  ancient  Egyptians,  the  adoption 
of  the  medical  profession  was  permitted  to  the  sons  of  physicians  only, 
and  was  associated  with  birth  and  hereditary  succession.  The  distinctions 
of  caste  were  not,  however,  so  rigid  as  among  the  Indians,  and  persons  of  a 
lower  caste  could,  b}r  means  of  eminent  services,  work  themselves  up  into  a 
higher. 

The  income  of  the  priestly  physicians  was  partially  independent  of  their 
"  practice,"  inasmuch  as  it  depended  upon  the  proceeds  of  extensive  and 
untaxable  temple  endowments.  Besides  this,  the  patients  dispensed  to  the 
gods  (as  well  as  to  the  priests)  votive  offerings,  which,  under  certain  circum- 
stances, were  required  to  be  promised  in  advance,  so  that,  even  at  that 
time,  it  was  customary  to  chaffer  about  fees. 

Coined  money  was  unknown  to  the  Egyptians  before  the  time  of  Alexander  the 
Great,  but  instead  of  it  they  made  use  of  weighed  rings  of  gold  and  silver,  of  different 
values.  Herodotus  reports  of  the  Eg3rptian  priests  and  physicians  :  "  Their  profits  are 
large,  they  eat  the  cooked  offerings  and  receive  every  day  many  geese  and  much  beef. 
Wine  is  also  given  to  them."  So  they  had  no  very  bad  time.  Such  were  the  ordinary 
offerings. 

A  special  form  of  payment  or  offering,  of  which  examples  have  been  pre- 
served to  us,  were  the  so  called  "  anathemata,"  models  in  silver,  gold,  etc.  of 
diseased  limbs,  feet,  hands,  or  deformed  arms,  which  the  sick  hung  up  in 
the  temples  for  the  benefit  of  the  gods.  These  were  then  sold  anew  by  the 
priests  to  other  patients,  and  again  offered  to  the  gods,  and  so  on  ad 
infinitum,  a  primitive,  lucrative  and  pious  practice  which  has  been  pre- 
served in  our  pilgrimage  churches  of  the  present  day,  though  obsolete  in 

9 


—  IS  — 

private  practice.     The  object  was   the  same  as  that  sought  even  to-day 
in  Kevlaar : 

"  Whoe'er  a  wax  hand  offers,  regains  his  own  hand  sound, 
And  who  a  wax  foot  offers,  his  foot  is  freed  from  wound." 

Ordinary  hygienic  measures  were  dail}'  baths,  friction  and  inunction 
of  the  body,  abstinence  from  certain  kinds  of  food,  e.  g.  cow's  flesh  and 
pork  (though  the  flesh  of  oxen  might  be  eaten),  the  flatulent  bean  (while 
the  far  more  suspicious  onion  and  garlic  were  much  liked),  and  less  fre- 
quently gymnastic  exercises.  In  addition  the  Egyptians  maintained  a  simple 
mode  of  life  and  practised  a  careful  system  of  nurture  and  hardening  from 
childhood.     For  the  sake  of  cleanliness  linen  clothing  was  worn. 

The  simplicity  of  their  system  of  rearing  children  was  so  great,  that  die  expense 
of  raising  a  child  to  manhood  amounted  to  only  about  $4,00,  an  inexpensiveness  due 
chiefty  to  the  cheapness  of  all  the  necessaries  of  life. 

Moreover  the  Egyptians  took  a  purgative  and  an  emetic  regularly 
three  times  a  month  (on  the  principle  that  all  diseases  arise  from  the  food, 
and  are  to  be  prevented  in  this  way),  and  for  these,  as  well  as  for  the  daily 
evacuations,  and  even  for  coitus,  definite  times  were  prescribed.  It  is  dif- 
ficult to  understand  how  such  prescriptions  (especially  the  last  mentioned) 
could  have  been  carried  out  in  practice,  for  the  ancient  Egyptians  were 
very  obscene,  and,  like  the  Scythians,  Persians  and — modern  students — 
were  very  fond  of  drinking  to  excess.  Beer  was  the  favorite  beverage, 
while  with  the  Persians  it  was  wine.  The  prescriptions  of  the  Egyptian 
physicians  for  the  expulsion  of  vermin  from  houses  and  clothing,  several 
of  which  have  been  preserved  to  us,  may  also  be  classed  under  the  head  of 
sanitary  regulations.  In  order  to  avoid  defilement  before  the  gods  bjr 
such  vermin,  the  priests  likewise  wore  linen  clothing,  and  shaved  off'  every- 
day the  hair  upon  their  whole  body.  In  epidemics  fumigations  were  prac- 
tised to  purify  the  air. 

In  surgery,  and  especially  in  operative  surger}',  the  physicians  of  the 
warlike  Pharaohs1  accomplished  considerable,  and  obtained  results  fully 
capable  of  refuting  the  denials  of  this  fact  dictated  by  the  self-sulficient 
national  vanity  of  the  old  Greek  writers.  They  bandaged  suppurating 
ulcers  (ubennu),  practised  venesection  and  cupped  by  means  of  horns 
sawed  off  near  the  point.  They  performed  circumcision,  in  accordance 
with  the  precepts  of  their  religion,  using  apparently  knives  of  flint,  and 
they  also  practiced  castration  b}T  crushing  or  pounding  the  testicles,  and 
more  rarely  with  the  knife.  In  fact  this  latter  operation  was  performed 
with  such  success  and  dexterity,  that,  even  as  late  as  the  Iioman  period, 
most  of  the  eunuchs  were  supplied  by  P^gypt.  They  practised  lithotoni}' 
with  a  dexterity  preserved  as  a  secret,  and,  indeed,  performed  amputations, 
as  pictures  found  at  Thebes  and  Denderah  testify.  In  ophthalmic  surgery 
they  were  especially  skilful,  and  it  is  high!}-  probable  that  the}'  even  opera- 

1.   Pharao  is  the  Hebrew  form  of  the  Egyptian  royal  title  "Per-aa",  "Great  House", 
about  equivalent  to  our  modern   "Sublime  Porte". 


—  19  — 

ted  for  cataract.  Imperfectly  united  fractures  and  artificial  teeth  have 
been  found  in  mummies — the  latter  an  evidence  that  dentistry  and  dentists 
.are.  at  all  events,  as  old  as  the  coquetry  for  which  Egyptian  women  were 
notorious.  From  the  preceding  remarks  we  might  infer  that  the  Egyptians 
were  experienced  in  the  construction  and  invention  of  instruments,  but, 
in  addition  to  this,  n  great  number  of  surgical  instruments  have  been 
Actually  discovered. 

The  pathological  knowledge  of  the  ancient  Egyptians  comprised  a 
knowledge  of  fever  and  of  diseases  of  the  eyes,  in  the  treatment  of  which 
Egyptian  physicians  enjoyed  special  reputation  throughout  all  antiquity. 
They  must  therefore  be  regarded  as  the  earliest  oculists.  They  were  even 
summoned  to  foreign  courts,  and  furnish  us  the  earliest  examples  of  practi- 
tioners who  traveled  among  foreign  people.  Gray  cataract  was  called  an 
"  ascent  of  the  water,"  out  of  which  the  Greeks  made  a  "  descent."1 

The  Egyptians  were  also  acquainted  with  pterygium  and  the  arcus  senilis,  with  in" 
flammation  in  the  vascular  parts  of  the  eve,  ophthalmic  catarrh,  lippitudo,  smaragdus, 
or  green  disease  (glaucoma?),  blood  in  the  eye,  fatty  degeneration,  granulations  and 
whitening  of  the  latter;  with  diseases  of  the  heart,  of  the  ears,  of  the  skin  (including 
leprosy,  small-pox,  acne  of  the  face,  eruptions  upon  the  head,  erysipelas,  itching  of  the 
leg,  sweating  of  the  feet,  etc.) ;  with  diseases  of  the  hair,  verminous  diseases,  hematuria, 
dysuria,  too  frequent  urination,  the  urinary  troubles  of  children;  with  diseases  of  the 
sexual  organs,  of  the  stomach,  tooth-ache,  head-ache,  etc. 

Under  the  titles  Sti,  Hmaou,  disease  of  the  Ra,  Chatj,  Bosou,  Zana- 
rojt,  Uchedu  (pains)  etc.,  are  preserved  certain  forms  of  disease,  whose 
analogues  of  the  present  day  cannot  be  precisely  determined.  As  an 
•example  of  Egyptian  symptomatolog}'  we  quote  the  description  of  the 
disease  last  mentioned  (gastric  cancer?): 

"  His  belly  is  heavy,  the  mouth  of  his  stomach  is  diseased,  his  heart  burns,  his 
clothes  hang  down  loose,  even  abundant  clothing  cannot  warm  him.  In  the  night 
thirst  torments  him,  his  taste  is  perverted  like  that  of  a  man  who  has  eaten  the  figs 
-of  the  sycomore:  his  flesh  is  wasted  away  as  that  of  a  man  who  is  ill.  If  he  goes  to 
stool  his  bowels  refuse  to  act.  In  his  belly  there  is  inflammation,  the  savor  of  his 
heart  is  ill:  when  he  rises  he  is  like  a  man  who  is  restrained."     (Haeser. ) 

The  following  passage  may  serve  as  an  example  of  old  Egyptian 
•diagnosis  and  therapeutics  : 

"  When  thou  findest  anyone  with  a  hardness  in  his  re-hel  (pit  of  the  stomach),  and 
when,  after  eating,  he  feels  a  pressure  in  his  intestines,  his  stomach  (het)  is  swollen,  and 
he  feels  bad  in  walking,  like  one  who  suffers  from  heat  in  his  back;  then  observe  him 

1.  The  ancient  Greek  terms  for  our  modern  "cataract"  were,  u-o^u/ia  or  hypochy- 
ma,  and  b-irtvaiq,  hypochysis,  both  of  which,  like  the  equivalent  Latin 
"suffusio",  imply  a  "pouring  down".  The  use  of  the  Latin  "cataracta"  or 
"cataractes"  to  designate  a  disease  of  the  eyes,  is  of  comparatively  recent  origin. 
The  earliest  Latin  writers  in  whom  I  have  met  it,  are  Gilbertus  Anglicus,  and  the 
"  Four  Masters"  of  Salerno,  both  of  whom  flourished  probably  in  the  last  quarter 
of  the  13th  century.  Ambroise  Pare  says  the  term  cataract  was  employed  by 
the  Arabians.  According  to  Plinj^,  the  Alexandrian  herb  Anagallis  arvensis 
was  employed  as  a  mydriatic.   (H.) 


—  20  — 

when  he  lies  stretched  out,  and  if  thou  findest  his  intestines  hot,  and  a  hardness  in  his- 
re-het,  say  to  th}'self  this  is  a  disease  of  the  liver.  Then  prepare  for  thyself  a  remedy, 
according  to  the  secrets  of  the  (botanical)  science,  from  the  plant  pa  che-test  and 
dates',  mix  them  (misce),  and  give  (da!)  in  water,  etc."     (Ebers.) 

We  have  little  information  concerning  the  midwifery  of  the  Egyptians, 
except  that  the}-  had  midwives  (meschennu),  and  that  the  Egyptian  women, 
who  were  delicate  and  luxurious,  bore  children  with  greater  difficulty  than  the 
Hebrew.  In  difficult  cases  physicians  were  also  called  in,  and  there  were 
special  lying-in  apartments.  From  their  gynaecology  we  know,  among  other 
things,  certain  prescriptions  for  the  promotion  of  conception,  and  certain 
rules  for  the  recognition  of  fruitfulness,  and  of  existing  pregnancy  in  women. 
If  e.  g.  a  woman  takes  a  drink  prepared  from  the  herb  boudodou-ka  and 
the  milk  of  another  woman,  who  has  borne  a  boy,,  and — vomits — she  is 
pregnant:  if,  however,  she  simply  eructates,  she  is  not.  (Idiosyncrasy  of 
the  pregnant  ?) 

In  physiology  they  held  that  until  the  age  of  fifty  years  the  heart 
gains  annually  about  two  drachms  in  weight,  but  that  afterwards  it  loses 
about  the  same  amount  each  year,  so  that  finally,  in  old  people,  death  is- 
occasioned  by  this  continual  loss.  The}'  also  assumed  that  four  demons 
ruled  over  the  body.  Hunger  and  thirst  were  not  regarded  as  bodily  wants, 
but  as  quasi-poisonous  substances,  which  forced  themselves  into  the  body 
and  required  to  be  neutralized  by  eating  and  drinking,  in  order  that  they 
*  might  not  destroy  it.  A  similar  superstition  also  prevailed  regarding  the- 
dead,  and  thus  these  too  required  food.     (Buchta.) 

The  Egyptians,  who  did  not  shrink  from  human  dissection  as  much 
as  the  Greeks,  were,  indeed,  acquainted  with  anatomy,  but  not  to  the 
degree  which  we  might  expect  from  their  other  medical  knowledge.  Yet 
Athotis,  the  son  of  king  Menes  (lived  according  to  Boekh  B.  C.  5702,  accord- 
ing to  Lauth  B.  C.  4157),  who  is  himself  said  to  have  been  a  physician, 
had  written  on  anatomy.  Both  of  these  were  kings,  and  thus  furnish  evi- 
dence of  the  high  estimation  of  medicine  and  of  physicians  in  Egypt. 
The  Egyptians  assumed  theoretically  the  existence  of  two  kinds  of  vessels 
and  nerves  (or  tendons,  metu),  of  which  there  were  in  the  body  from  24  to 
32.  Such  a  "  metu"  e.  g.  extends  from  the  little  finger  to  the  heart ;  hence 
the  custom  of  dipping  this  finger  into  their  libations.  They  were  acquainted 
with  the  heart,  the  lymphatic  glands  and  the  crystalline  lens  of  the  eye. 
When  we  consider  the  method  in  which  the  operation  of  embalming 
was  performed,  it  is  manifest  that  the  custom  could  result  in  no  anatomical 
knowledge,  even  if  the  persons  who  made  embalming  their  business  had 
been  of  a  different  class  from  that  to  which,  as  a  matter  of  fact,  the}'  really 
belonged.  The  bodies  of  handsome  women  (when  they  could  not  be  em- 
balmed by  their  own  sex,  as  was  the  usual  custom),  were  never  entrusted 
to  the  embalmers  until  three  or  four  days  after  death.  The  mode  of  pro- 
cedure in  embalming  was  as  follows  :  in  the  first  place  it  was  determined  by 
the  friends  of  the  deceased  in  which  of  the  three  prevalent  styles  the  ope- 


—  21  — 

ration  should  be  performed.  In  the  more  expensive  stjles  patterns  were 
exhibited  for  their  selection.  If  the  highest  style  (which  cost  about 
$1125)  was  selected,  one  of  the  sacred  scribes,  hierogrammateus,1  marked 
eight  lines,  one  upon  the  left  side,  following  the  direction  and  length  of 
which  an  associate  from  the  "disreputable"  and  most  deeply  despised 
.caste  of  the  ancients,  the  "  paraschistes,"  with  a  sharp  stone — an  evidence 
of  the  high  antiquity  of  the  custom — made  an  incision  into  the  cavity  of 
the  abdomen.  He  then  ran  awa}-,  so  as  not  to  be  stoned  for  his  offence 
against  the  dead.  Now  began  the  work  of  the  embalmers  — colchytes — 
who  existed  as  a  guild  down  even  to  the  time  of  the  Roman  empire.  The 
viscera  were  removed  and  preserved  in  canopen,  i.  e.  vases  of  cla}',  lime- 
stone, or  alabaster,  the  lids  of  which  were  decorated  with  representations  of 
■one  of  the  four  Genii  of  the  dead — Amset,  Hapi,  Tuamutef  and  Kheb- 
sennuf — .to  whom  the  canope  in  question  was  dedicated.  After  the  cranial 
cavity  was  cleared  of  the  brain  by  means  of  hooks  inserted  through  the 
nose,  the  cavities  of  both  the  cranium  and  abdomen  were  filled  with  spices. 
The  salters — taricheutes — then  laid  the  corpse  in  a  solution  of  carbonate 
of  soda,  where  it  was  left  for  sevent}-  da}-s.  At  the  expiration  of  this 
period  it  was  again  washed  in  caustic  soda,  then  coated  over  with  gum, 
and  finall}-  wrapped  in  a  cloth  of  fine  linen.  The  corpse,  thus  prepared,  was 
placed  by  the  friends  in  a  bivalvular  wooden  coffin,  hollowed  out  to  suit 
ithe  size  and  form  of  the  body,  and  often  adorned  with  beautiful  hiero- 
glyphics. The  mummy,  thus  completed,  was  then  placed  in  the  catacombs, 
where,  as  we  know,  they  have  been  found  in  a  good  state  of  preservation 
after  thousands  of  years.  In  "embalming  of  the  second  class,"  which  cost 
$300,  melted  cedar  resin  was  injected  into  the  unemptied  cavities  of  the 
bod}',  which  was  then  salted  down  for  seventy  days,  after  which  the  viscera 
.and  resin  were  removed  together.  "  Embalming  of  the  third  class"  consisted 
in  simply  salting  the  body  after  it  had  been  washed.  Besides  these  meth- 
ods, the  Egyptians  also  often  buried  their  dead  in  the  ordinary  way.  In 
fact,  the  poor  were  even  buried  in  the  sand  without  any  shroud,  and 
those  possessed  of  a  little  means,  in  arched  vaults  built  of  brick.  The 
Egyptians  too  were  the  earliest  nation  to  have  a  belief  in  immortality,  a 
•doctrine  which  they  held  as  much  as  3000  years  B.  C. 

The  ancient  Egyptian  custom  of  embalming  the  dead  was  also  preserved  for  a 
long  time  among  the  Christians.  Thus  e.g.  as  late  as  A.  D.  734  the  papyrus  Copticus 
■was  found  beside  a  Christian  mummy.  With  respect  to  the  foundation  of  the  custom 
■of  embalming,  Herodotus  says:  "The  Persians  worship  fire  as  a  god,  and  the  burning 
•of  corpses  is  unusual  with  both  people:  with  the  Persians,  because  they  say  it  is  not 
becoming  in  the  god  to  consume  a  dead  bod}-;  with  the  Egyptians,  because  they 
believe  fire  to  be  an  animated  being,  which  consumes  everything  that  it  seizes  upon  ; 
when,  however,  it  has  eaten  its  fill,  it  dies  upon  its  food.  Now  it  is  not  customary 
■with  them  to  give  a  dead  body  to  the  beasts,  and  therefore  they  embalm  the  corpses  in 

'.1.  The  scribe,  from  the  time  of  the  Egyptians  down  to  the  invention  of  printing,  was 
a  very  important  personage,  as  he  is  even  to-day  in  the  East,  as  well  as  in  Italy. 
iHe  ranks  among  the  learned,  and  as  a  professional  man. 


order  that  they  ma}'  not  be  devoured  by  worms."  It  was  also  a  question  of  religious 
views,  and  not  entirely  a  matter  of  hygiene. 

According  to  more  recent  investigations,  the  custom  of  embalming  was  connected 
with  the  belief  in  immortality,  which  the  Egyptians  first  possessed.  The  body  contains 
a  portion  of  the  Great  Intelligence,  a  divine  spark,  c/nt,  which,  inasmuch  as  by 
itself  it  would  destroy  the  body,  is  enclosed  in  the  soul,  ba,  and  thus  loses  its  shining 
covering.  When  the  man  dies,  chu  is  freed,  and  is  converted  into  a  demon.  Bu,  how- 
ever, does  not  perish,  but  remains  in  the  dead  (under  the  title  lea),  as  a  kind  of  phan- 
tom of  him  to  whose  body  it  is  united,  and  hence  the  body  must  be  preserved. 
Accordingly  the  custom  of  embalming,  with  the  presentation  of  food  and  furniture^ 
like  chairs,  stools,  etc.,  was  introduced,  for  the  support  and  convenience  of  the  souls- 
of  the  dead.  The  donation  to  all  corpses  was  therefore  the  same  in  kind,  but  more  or 
less  expensive,  and  indicated  sometimes  merely  by  pictorial  representations  of  the 
furniture  of  the  dead.  The  funeral  banquets  were  also  designed  merely  for  the 
support  of  the  ka,  who  was  supposed  to  share  in  the  feast,  and  to  take  whatever  food, 
was  left  over.      (Richard  Buchta.) 

Other  methods  of  disposing  of  the  dead  were  also  in  common  use. 

The  Egyptians  were  acquainted  with  a  considerable  number  of  drugs, 
and  had  numerous  formulae  for  their  preparation.  Prominent  remedies 
were  opium,  strychnus,  squill  and  vegetable  remedies  in  general,  though, 
medicines  of  animal  origin  and  of  a  disgusting  kind  were  also  employed. 
Among  the  latter  we  may  notice  the  urine  of  a  wife  faithful  to  her  spouse 
(for  which  a  king  was  compelled  to  look  for  ten  years  among  the  Egyp- 
tian women  !),  as  a  rented}'  for  the  eyes,  the  excrement  of  animals  and 
even  whole  lizards  etc.  This  disgusting  practice  need  not  occasion  us 
much  surprise  :  indeed  we  ought  readily  to  pardon  the  ancient  Egyptians 
when  we  reflect,  that  in  our  own  boasted  age  similar,  or  even  worse  reme- 
dies, e.  g.  roasted  placenta,  the  juice  of  fresh  cow-dung,  human  urine  mixed' 
with  brandy  etc.,  are  quite  commonly  employed  in  domestic  and  quack 
medicine.  The  Egyptians  also  made  use  of  metallic  preparations  like  anti- 
mony (a  paint  for  the  e3-es),  verdigris,  white-lead  etc.  Ointments,  oils 
(which,  in  consequence  of  their  excellence,  were  imported  from  Egypt  by 
even  the  Greeks  in  Hippocrates'  time),  plasters,  pills  (mixed  with  hone}'  and 
afterwards  rolled  into  form),  steam  for  inhalations,  poultices,  enemata, 
decoctions  etc.,  were  recognized  preparations.     The  fumigatory  Kyphi'  was 

1.  The  Kyphi  was  an  aromatic  compound  of  varying  composition,  employed  as  a 
fumigatory,  as  a  medicine  and  in  embalming.  In  the  papyrus  Ebers  it  consists 
of  juniper  berries,  myrrh,  fenugreek,  mastic,  olibanum,  raisins,  (?  temten)  and 
several  other  ingredients  not  identified.  Other  formula?  for  its  preparation  are 
given  by  Dioscorides  and  Galen.  Among  the  more  familiar  drugs  mentioned  in 
the  papyrus  Ebers  are  also  acacia,  calamus,  coriander,  saffron,  1  yoscyamus, 
lettuce,  mandragora,  olive  oil,  pomegranate,  and  perhaps  the  castor  oil  bean. 
Castor  oil  (kiki  oil)  was  used  by  the  Egyptians  for  burning,  and  also  in  inunctions, 
but  not,  so  far  as  I  know,  as  a  cathartic.  A  powerful  Egyptian  poison  was  the 
halicacabon,  which  Ebers  believes  to  have  been  the  /uo/.u,  moh',  of  Homer. 
Pliny  speaks  of  it  as  a  soporific,  more  active  than  opium,  and  the  drug  is  men- 
tioned also  by  Celsus,  Dioscorides  and  Galen.  Sprengel  is  inclined  to  identify  it 
with  the  Physalis  somnifera.  The  identity  of  Homer's  Nepenthe  still  remains  a 
question  to  test  the  ingenuity  and  profundity  of  pharmacologists  and  critics.    (H.). 


—   23  — 

especially  famous,  a  fact  which  furnishes  proof  that  luxury  and  the  cos- 
metic art,  which  obtained  great  vogue  in  Egypt  in  later  times,  flourished 
also  in  the  earliest  periods.  Such  directions  as  "In  the  evening,"  "The 
fourth  part  every  four  days,"  were  frequently  employed,  and  the  quantity 
of  drugs  by  measure  and  weight  was  given. 

Egyptian  recipes  for  disease  of  the  intestines:  Caraway  seed,  gt  drachm; 
G  )Ose-grease,  g  drachm:  Milk,  1  tenat  (about  f  pint).  Rub  up  the  seed  of  the  plant 
tehni  (?)  with  vinegar,  and  give  to  the  patient.  Pomegranate  seed,  g  drachm  ;  sycomore 
fruit,  I  drachm;  beer  (first  brewed  by  the  Egyptians,  and  drunk  lustily),  1  tenat: 
boil,  stir,  eat ! 

These  prescriptions  too  furnish  evidence  of  a  cultivated  pharmacy, 
and  it  is  very  possible  that  the  Arabians,  to  whom  the  invention  of  this 
art  has  been  ascribed,  only  borrowed  it  from  the  Egyptians ;  for  it  is  un- 
doubted that  the}-  frequently  made  use  of  Egyptian  prescriptions.  From 
the  fact  too  that  apothecaries  are  mentioned  in  the  books  of  Moses  it 
may  be  concluded  that  a  distinct  class  of  apothecaries  existed  among  the 
Egyptians,  from  whom  Moses  borrowed  most  of  his  regulations.  There 
were  quite  certainly  domestic  medicine  chests  among  the  Egyptians,  of 
which  that  of  the  queen  Mentuhotep,  found  in  the  Berlin  Museum,  may 
furnish  an  example. 

In  the  preparation  of  remedies,  as  well  as  before  taking  the  same, 
prayer  was  offered,  definite  forms  for  which  are  still  extant.  One  of  these 
runs  as  follows  : 

"May  Lsis  heal  me,  as  she  healed  Horus  of  all  the  ills  inflicted  upon  him  when 
Set  slew  his  father,  Osiris.  O  lsis,  thou  great  enchantress,  free  me,  deliver  me  from 
all  evil,  bad  and  horrible  things,  from  the  tiod  and  <roddess  of  evil,  from  the  "od  and 
goddess  of  sickness,  and  from  the  unclean  demon  who  presses  upon  me,  as  thou  didst 
loose  and  free  thy  son  Horus." 

The  "  Black  Art ",  however,  was  punished  with  death  from  very 
early  times,  and  even  as  late  as  the  reign  of  Ramses  II.  Mental  dis- 
eases were  laidjto  the  charge  of  the  demons  (chu),  and  amulets  were  in 
common  use,  especially  in  the  treatment  of  diseases  of  the  nervous  system. 
(Nowadays  we  employ  galvanic  belts  and  metallotherapy — mere  varieties 
of  amulets.)  Astrology  also  was  called  into  counsel  in  the  treatment  of 
disease. 

From  what  has  been  already  said  the  etiological  ideas  of  the  Egyptians. 
may  be  readily  inferred,  and  especially  the  theurgic  character  of  ancient 
Egyptian  medicine  during  the  period  of  pure  Egyptian  civilization. 

When,  however,  Psammetichus  I.  (B.  C.  664-610),  by  the  aid  of  foreign 
troops,  drove  out  the  princes  of  the  Dodekarchy,  and  largely  diminished  the 
ancient  isolation  of  Egypt — an  isolation  which,  in  ancient  times,  punished 
with  death  every  foreigner  who  entered  the  country  ;  more  especially  when 
his  son  Nechao  (Necho)  II.  succeeded  him  in  610,  and,  with  the  aid  of 
Phoenician  sailors,  accomplished  the  circumnavigation  of  Africa,  and  began 
piercing  the  Isthmus  of  Suez  ;  finally  when  Amasis  (570-526)  received  the 


—  24  — 

Greeks1  into  his  country  with  open  arras,  the  original  old-Egyptian  medicine 
began  to  decline  more  and  more,  until  after  the  last  Egyptian  king, 
Nectanebus,  and  the  death  of  Alexander,  through  the  efforts  of  the  Ptole- 
mies", it  entirely  vanished  before  the  Greek  S3'stem,  to  survive  henceforth 
only  as  a  wretched  abortion  of  magic  and  alchemy.  In  the  Middle  Ages, 
as  we  know,  Egyptian  wisdom  was  regarded  as  identical  with  sorcery  the 
search  for  the  philosophers'  stone,  alchem}*  and  astrology. 

II.  THE  MEDICINE  OF  THE  BABYLONIANS,  ASSYRIANS,  PHOENICIANS 
(CARTHAGENIANS),  MEDES  AND  ANCIENT  PERSIANS. 

The  lands  of  the  central  portion  of  Western  Asia,  between  the  Caspian 
Sea  on  the  North,  the  Persian  Gulf  on  the  South,  the  Syrian  Desert  on  the 
West,  and  the  Indus  on  the  East,  were  in  the  remotest  ages  the  seat  of  a 
high  civilization. 

The  non-Semitic  people  of  Accad  (Sumerians)  are  considered  the  old- 
est representatives  of  this  cradle  of  civilization.  Their  culture  was  subse- 
quently entirely  adopted  by  the  Semitic  races  who  succeeded  them,  and 
especially  by  the  Jews,  whose  doctrines  of  the  creation,  the  fall  of  man,  the 
patriarchs  and  their  names,  the  flood,  the  tower  of  Babel  etc.,  display  the 
greatest  similarity  to  the  Assyrio-Babylonian  traditions  and  narratives 
deciphered  from  the  cuneiform  inscriptions.2  Upon  this  primeval  seat  of 
civilization  developed,  after  the  disappearance  of  the  Accadians,  the  states 
of  the  Babylonians  (between  the  Euphrates  and  the  Tigris,  south  of  Meso- 
potamia) ;  the  Assyrians3  (beyond  the  Tigris,  east  of  Mesopotamia);  and 
the  Syrians  (west  of  the  Euphrates).  All  of  these  nations  belonged  to  the 
Semitic  stock.  In  addition  to  the  states  now  mentioned,  we  find  also 
developing  upon  this  same  region  the  kingdom  of  the  Medo-Persians 
(between  the  Tigris  and  the  Indus),  who,  however,  belonged  to  the  Indo- 
Germanic  stock,  and  were  younger  than  the  preceding  peoples. 

Babylon,  the  oldest  of  these  states,  at  a  very  early  period  (B.  C.  2000) 
became  a  province  of  Assyria  under  Niuus.  At  a  later  period  under 
Nebuchadnezzar  (B.  C.  604-561)  it  again  obtained  the  ascendancy,  until 
finally,  under  the  reign  of  Nabonides,  Bab3-lonia  (with  S}'ria  under  Croesus) 
was  subjected  to  the  Persian  power  by  Cyrus  (Kurusch,  Koresch,  B.  C.  559- 
529)  in  the  year  538  B.  C. 

1.  By  the  introduction  of  the  papyrus  into  Greece  the  Greeks  first  received  a  suitable 

material  for  permanent  writing,  as  they  had  received  from  the  Phoenicians  the 
alphabet  (a  Phoenician  word),  as  a  suitable  means  for  the  same  object  (Max 
Miiller).  While  they  received  materials  and  means  also  from  other  peoples,  so 
they  speedily  surpassed  them  all  in  the  importance  of  their  writings. 

2.  The  language  of  the  Accadians  had  become  a  dead  language  as  early  as  the  17th 

century  B.  C.  It  was  written  and  read,  like  the  Chinese,  from  above  downwards, 
and  in  columns  which  followed  each  other  from  right  to  left. 

3.  As  early-  as  B.  C.  1900  the  Assyrians  possessed  libraries  of  cuneiform  writing?,  and 

astronomical,  irrammatical  and  lexicographical  works.  At  a  still  earlier  period 
they  were  acquainted  with  the  art  of  working  in  gold,  silver  and  bronze. 


—  25  — 

In  the  gray  dawn  of  antiquit}'  there  immigrated  into  Babylonia  from 
the  North  a  Turanian  people,  the  Chaldees,  whose  dominant  element  con- 
sisted of  the  servants  of  the  deity.  The  latter  thus  rose  to  be  an  influen- 
tial priesthood,  and  accordingly  the  name  Chaldee — the  Magi  of  the  Bible — 
was  employed  to  designate  both  these  immigrants  and  their  priests.  The 
Chaldees  were  scattered  over  the  provinces  of  the  states  mentioned  above, 
and  enjoyed  great  esteem  as  mathematicians  (the}-  adopted  the  sexagesimal 
system,1  because  this  has  the  most  divisors),  astronomers  (they  prepared 
the  first  calendars)  and  also  astrologers,  interpreters  of  dreams  and  (theurgic) 
physicians.  According  to  Herodotus,  however,  the  Babylonians  had  no 
regular  physicians,  who  visited  the  sick,  but  the  latter  were  exposed  upon 
the  streets,  and  interrogated  by  those  who  passed.  If  an}'  of  these  visitors 
had  recovered  from  a  similar  disease,  he  was  expected  to  counsel  the  sick 
as  to  the  means  by  which  he  had  been  himself  cured. 

The  Zend-Avesta  (Living  Word),  composed  in  the  Zend  dialect  of  the 
old  Persian  language,  and  its  later  and  daughter  dialect,  the  Pehlwi,  is  re- 
garded as  a  work  which  originated  substantially  with  the  guild  of  the 
Chaldeans,  but  which  was  committed  to  writing  b}'  Zarathustra  (Zerdutscht, 
Zoroaster),  a  Destur-Sapetman,  i.  e.  priestly  law-giver,  who  lived  B.  C.  2500 
(?),  or  at  least  before  B.  C.  500,  probably  in  the  age  of  Darius  Hjstaspes 
(B.  C.  521-485),  and  was  a  member  of  that  priesthood.  This  work  was 
subsequently  lost,  but  afterwards  collected  from  memory  into  a  book  of  its 
present  form.  It  now  consists  of  the  Yazna  (a  liturgy),  the  Vispered 
(prayers),  and  the  Jescht  and  Bundehesch  (history  and  cosmology).  The 
medical  portion  (which  must  be  regarded  as  common  to  all  the  people 
mentioned  above),  is  preserved  in  the  section  Vendidad.'2  The  Javidani- 
chired,  or  Book  of  Eternal  Wisdom,  was  older  than  the  Zend-Avesta,  but 
has  been  lost. 

The  mythology  of  the  Persians  distinguishes  a  good  principle,  Or- 
muzd  (Ahuramazda),  belonging  to  the  light,  from  whom  emanate  the 
good  spirits,  the  supreme  Amschaspands  (Ahmeschacpenta),  whose  decrees 
are  diligently  executed  by  their  subordinate  Izeds  (angels,  archangels),  32 
in  number.  Among  the  latter  Korschid,  the  sun,  and  Mithra,  in  the  middle 
between  the  sun  and  moon,  are  especially  conspicuous.  It  also  recognizes 
Ahriman  (Angramandscha)  the  evil  principle,  darkness,  and  the  supreme 
Diws   (Dews,   Dewas),    Aschmosch,    Eghetasch,   Bochasp,   Astujacl,   Tarik, 

1.  From  them  it  passed  over  to  the  Greeks  etc.,  and  our  division  of  the  hour  into 

sixty  minutes  is  a  remnant  of  Babylonian  mathematics  or  astronomy.  The 
double  standard  or  relative  value  of  gold  and  silver  Max  Midler  also  derives  from 
the  Bab}rlonians,  from  whom  the  Persians  acquired  it,  and  first  introduced  it  into 
practice.     With  the  latter  the  relative  value  of  the  two  metals  was  1 :  IS. 5. 

2.  This  is  slightly  confused.     The  remains  of  the  reputed  writings  of  Zoroaster  are 

divided  into:  1.  The  Yendidad-Sade,  consisting  of  the  Vendidad,  the  Yacna  and 
the  Vispered.  2.  The  Yesht-Sade :  3.  The  Bundehesch.  The  first  two  are 
written  in  the  Zend  dialect,  the  last  in  the  Pehlwi.   (H.) 


—  26  — 

Tosius,  emanating  from  him.  and  to  whom  Ahriman  himself  belongs.  These 
Diws  convey  to  men,  and  are  the  causes  of  all  diseases,  while  the  cure  of  the 
latter  is  effected  03-  means  of  the  second  Amschaspand.  Ardibehescht,  but 
through  the  mediation  of  the  priests  (everywhere  active  in  the  beginning 
of  medical  culture)  the  Mazdayacnas  (faithful),  who  employ  : 

"Trees  and  herbs.  Some  are  cured  by  the  Knife,  others  bj-  the  WORD.  For  by 
the  celestial  or  god-like  WORD  diseases  are  most  surely  cnred.  The  most  perfect 
cures  are  the  work  of  the  ;  god-like  WORD'",  since  in  this  way  the  soul  also  shares- 
in  the  cure.  Magicians  too  are  regarded  as  the  most  excellent  physicians.  Besides 
these  there  were  herb-doctors  and  knife-doctors  (surgeons). 

Ainyama  was  called  the  god  of  healing,  and  Thrita,  who  (like  the 
physicians,  his  disciples)  was  highly  esteemed,  was  regarded  as  the  god  of 
physicians. 

Besides  the  statement  that  Cyrus,  out  of  care  for  his  arm\-,  surrounded 
himself  with  (military)  physicians,  we  find  for  later  times  the  information 
that  Egyptians  and  Greeks  came  with  special  frequenc}-  as  physicians  to 
the  Persian  court,  and  that  these, — everything  has  its  earlier  example  -  if 
their  treatment  was  not  fortunate  in  its  results,  were  in  similar  danger  to 
that  incurred  by  the  ordinary  physicians  of  the  Caliphs  and  the  physicians 
of  mediaeval  kings,  who,  in  such  cases,  were  occasionally  crucified.  In  still 
later  times,  Jews  and  Xestorians  filled  these  positions,  while  about  A.  D. 
1000  they  were  occupied  by  the  Arabian  physicians,  among  whom  we 
usuall}*  include  also  native  Persians. 

The  Old-Persian  medicine  too,  so  far  as  we  may  judge  from  our  ex- 
ceedingly scant\*  information,  was  thenrgic  in  its  character.  Thus  e.  g.  if 
menstruation  in  a  woman  continued  more  than  seven  days,  this  domestic 
calamity  was  ascribed  to  the  presence  of  a  demon,  and  the  unfortunate 
woman  was  beaten  in  order  to  banish  him.  A  woman  during  the  continu- 
ance of  the  lochial  or  menstrual  discharge  was  regarded  as  unclean  (as 
among  the  Jews,  and  on  similar  hygienic  grounds),  while  intercourse  with 
pregnant  and  suckling  women  was  considered  sinful.  After  the  birth  of  a 
dead  child — a  dead  bod}-  was  regarded  as  polluting — the  lying-in  woman 
was  required  to  purify  herself,  i.  e.  for  three  days  she  must  enjoy  no  meat, 
bread  or  wine,  she  must  wash,  or  at  least  sprinkle  her  body  and  her  cloth- 
ing with  the  urine  of  a  cow  ;  she  received  as  nourishment  hot  milk,  and 
was  brought  to  the  place  of  purification  thirty  paces  from  the  fire,  water 
and  the  holy  bundle  of  twigs,  three  paces  from  pure  men.  Artificial  abor- 
tion was  forbidden.  Leprosy  was  ascribed  to  offences  against  the  sun.  and 
the  sufferer  was  compelled  to  live  apart  from  the  healthy  (Herodotus). 
Amulets  played  an  important  role. 

"Each  city,  every  province  had  its  Genius;  sparkling  stones  were  worn  for  love 
of  the  Genii,  and  in  this  way  originated  the  reliance  upon,  and  belief  in,  the  virtues 
of  stones.  They  served  to  avert  evil,  and  were  especially  useful  against  the  venom  of 
serpents  and  scorpions,  the  creatures  of  Ahriman;  they  mitigated  the  pains  of  labor, 
of  disease  and  of  wounds,  since  it  was  believed  that  fire  and  water,  the  male  and 
female  Genius  of  nature,  were  active  in  them.     Hence  the  doctrine  of  the  Magi  as  to 


their  composition  ;   hence  the  prescriptions  as  to  their  use;   hence  the  XiOixa  in  the 
Orphic  mysteries,  which  were  transported  from  the  Black  and  Caspian  seas."  (Herder.) 

The  Persians  seem  to  have  been  especially  famous  for  their  knowledge 
of  poisons.  The  Hauma-drink — a  drink  prepared  from  the  plant  Hauma, 
which,  like  the  mandragora,  was  a  god — increased  fruitfulness,  and  was 
prescribed  by  the  physicians  for  pains  in  the  limbs,  catarrhal  obstructions 
and  urinary  diseases.     All  very  meager  traditions  ! 

The  regulations  of  the  ancient  Persians  with  respect  to  medical  fees 
and  examinations  are  known  to  us  more  full}-  than  their  medicine.  The 
priests  alone  were  very  bad  pay,  a  simple  benediction  sufficing  to  satisfy 
their  score.  All  other  persons,  however,  paid  well.  Thus  the  chief  of  a 
tribe  paid  with  a  farm  ;  a  local  magnate,  and  a  boy  of  good  family,  paid  one 
large  draught-ox  ;  a  house-holder,  a  small  draught-ox  ;  women  were  to  be 
treated  more  cheaply.  Thus  the  fee  for  the  lad}-  of  the  house  was  one 
she-ass  ;  for  the  wife  of  the  chief  of  a  family,  one  cow  ;  for  the  wife  of 
the  chief  of  a  tribe,  one  mare  (a  horse  in  the  times  of  Darius  was  worth 
50  Persian  darics,  which,  if  of  gold,  were  equivalent  to  five  dollars,  if  of 
silver,  to  fifty  cents);  the  wife  of  the  lord  of  the  province  paid  one  she- 
camel.  Thus  the  famous  doctors  of  that  day  were  able  to  acquire  in  the 
end,  in  place  of  our  modern  stocks,  a  tolerably  fine  collection  of  live  stock, 
especially  as  it  was  considered  among  the  Persians  the  greatest  disgrace 
to  remain  in  debt  (and  to  lie) — an  idea  which,  as  we  know,  is  entirely  ex- 
ploded in  the  present  day,  at  least  as  regards  physicians.  Even  the 
veterinary  surgeons  were  not  forgotten  in  the  Old-Persian  tariff.  They  too 
were  paid  in  cattle,  receiving  for  the  cure  of  a  large  draught-ox,  one  of 
medium  size ;  for  that  of  a  medium  sized  ox,  a  small  one,  and  for  the  cure 
of  a  small  one,  the  value  of  it  in  feed  ;  sick  dogs  (the  dog  was  a  sacred 
animal)  must  be  treated  like  human  beings. — As  regards  examinations, 
(which  were  limited  to  "practical  cases"),  any  physician  who  had  "cut" 
three  unbelievers,  and  on  these  occasions  had  "  done  for"  them  all,  failed 
to  pass;  if,  however,  the  unbelievers  survived,  the  faithful  might  give  him 
a  trial. 

"  At  his  pleasure  let  him  treat  the  faithful,  and  at  his  pleasure  let  him  cure  them 
by  cutting." 

These  minute  regulations  seem  to  indicate  a  higher  education,  even  in 
medicine,  than  we  have  been  aware  of  up  to  the  present  time.  Yet  it  is  also 
known  that  their  other  knowledge,  especially  in  architecture,  astronomy, 
technics,  postal  matters  etc.,  attained  considerable  height.  It  is  quite  pos- 
sible too  that  the  Persian  medicine  proper  occupied  a  low  position  (for  only 
Egyptians  and  Greeks  are  known  to  us  as  court  physicians),  and  that  these- 
regulations  as  to  fees  were  directed  against  extortion  on  the  part  of  the 
lower  native  sacerdotal  physicians  only. 

It  is  well  known  that  the  Assyrians  also  belonged  among  the  most 
powerful  and  cultivated  peoples  of  ancient  times,  a  fact  indisputably 
established  by  the  recently  deciphered  cuneiform  inscriptions  and  the  monu- 


—  28  — 

anents  lately  discovered.  As  early  as  B.  C.  2000  such  danger  from  the 
kingdom  of  Assur  threatened  the  Egyptians,  even  then  beginning  to  decline 
in  power  and  culture,  that  the  subject  princes  of  the  Hygschos  were  com- 
pelled to  protect  themselves  against  it  by  the  foundation  of  border  fortresses. 
Yet,  in  spite  of  the  high  position  which  the  Assyrians  held  among  the  peo- 
ple, whose  writings  have  been  preserved  to  us,  our  information  with  regard 
to  their  medical  views  is  very  scanty,  at  least  up  to  the  present  time.  A 
few  traces  of  their  medicine  are,  however,  found  in  the  epic  poem  "  Istar's 
Journey  to  Hell,"  recentl}-  deciphered  by  Schrader.  Though  identical  with 
Ast  arte,  this  goddess  among  the  Assyrians  was  divided  into  Istar  and  Baaltis, 
the  former  (the  supreme  god  of  the  Accadians)  resembling  the  heavenly 
Venus  Urania,  the  latter,  the  animal  Astarte.  Istar  presided  over  sexual 
fruitfulness  and  generation.  In  addition  to  this  medico-mythological 
information,  we  find  in  this  epic  the  following  passage  relating  to  the 
pathology  of  the  Assyrians  : 

"  Go  forth,  lead  her  forth  to  suffer  her  punishment;  disease  of  the  eyes,  of  the 
hips,  of  the  feet,  of  the  heart,  shall  strike  her !  " 

.a  tone  which  harmonizes  perfect^  with  that  of  the  Holy  Writ,  and  shows 
that  the  culture  of  all  Semitic  races  is  similar  in  substance  as  well 
as  form, — a  fact  which  points  to  their  common  source  (Accad).  Here 
also  every  disease  is  a  punishment  from  the  gods.  This  explains  how  the 
Jews  adopted  so  many  things  from  the  Assyrians  (and  Accadians?),  even 
the  observance  of  the  Sabbath,  which  was  so  strict  among  the  Assyrians, 
that  in  the  cuneiform  inscription  translated  b}'  George  Smith  it  is  said  : 

"The  seventh  day,  feast  of  Marodach  arid  Zir:  Panibu,  a  great  feast,  a  day  of 
rest.  The  prince  of  the  people  will  eat  neither  the  flesh  of  birds  nor  cooked  fruits. 
He  will  not  change  his  clothing.  He  will  put  on  no  white  robe.  He  will  bring  no 
offering.  The  king  will  not  ascend  into  his  chariot.  He  will  not  perform  his  duties 
as  royal  law-giver.  In  a  garrison  city  the  commander  will  permit  no  proclamations 
to  his  soldiers.     The  art  of  the  pl^sician  will  not  be  practised." 

Thus  on  the  Sabbath  even  the  sick  must  dispense  with  the  ptysician. 
The  following  charm  may  be  considered  a  theurgic  remedy  against  the  ele- 
mentary spirits,  who  were  regarded  as  the  carriers  of  internal  diseases. 
These  diseases,  inasmuch  as  their  origin  was  not  directly  cognizable  by  the 
senses,  were  inexplicable  to  the  masses  : 

"  Let  the  witch  sit  upon  the  right; 
Let  her  leave  the  left  side  free! 
Adisina,  do  thou  tie  the  knot, 
Bind  up  the  head  of  the  sick, 
His  limbs  in  like  manner  with  fetters! 
Seat  thou  thj'self  on  his  bed, 
With  the  water  of  youth  besprinkle  him!  " 

The  influence  of  the  elementary  spirits,  of  the  so-called  Adisina,  was 
also  regarded  as  a  general  cause  of  disease — those  spirits  who, 

"  In  the  depths  of  the  sea  as  in  the  ether  of  heaven,  are  not  male  nor  yet  female. 
Order  and  custom  they  know  not;   prayer  and  supplication  they  heed  not." 


—  29  — 

Yet  they  yield  to  the  charm  of  the  enchantress,  who  envelops  the  sick 
likewise  with  magic  bands.1  The  pain  of  circumcision  (an  operation  intro- 
duced among  them,  as  among  all  Semitic  races)  is  said  to  have  been  miti- 
gated l>3r  the  compression  of  the  vessels  of  the  neck  until  the  operation  was 
completed.  It  is  worth  remarking  in  the  history  of  civilization  that  much 
of  the  superstition  (even  medical  superstition)  cherished  by  the  Greeks 
and  Romans,  and  descended  from  them  to  later  nations,  had  its  origin  with 
the  Bab}'lonians  and  Assyrians.  (The  first  book  on  astrology  is  that  of 
Sargon  I.) 

In  reviewing  the  medical  culture  of  the  Phoenicians  it  is  important  to 
remember  that  in  the  papyrus  Ebers  it  is  stated  that  one  of  its  books  is 
the  work  of  a  physician  of  Byblos.  What  we  know  of  this  book  permits' 
us  to  conjecture  much  more  important  medical  knowledge  than  has  been 
heretofore  suspected  in  this  Semitic  race,  distinguished  for  its  technical, 
nautical  and  meteorological  knowledge,  as  well  as  for  its  activity  in  coloni- 
zation, its  commerce  and  its  luxury,  and  which  also  exercised  an  important 
influence  upon  the  Greeks.  That  the  Phoenicians  indulged  in  an  extremely 
sensual  religious  worship  is  known.  In  their  disgusting  cultus  of  Phallus 
and  Astarte  (Mylittacultus)  they  worshipped  the  visible  instrument  of 
male  procreative  power,  viewed  in  a  religious  light.  It  is  also  known  that 
their  supreme  deity  Baal-Zebul,  the  Beelzebub  of  the  Bible,  was  a  god  of 
medicine,  and  was  interrogated  by  even  the  Jews  as  an  oracle  of  health 
and  disease.  His  priests  were  clad  in  red  clothing  (the  earliest  example  of 
the  red  garments  of  the  physician  ?).  Their  special  god  of  medicine,  how- 
ever, was  Esmun,  the  eighth  of  the  Cabiri  (identical  with  the  Idaean 
Dactyli,  Corybantes,  Curetes),  who,  in  female  attire  reaching  to  the  feet, 
with  shaven  heads  and  exhibiting  an  erect  phallus,  challenge  comparison 
with  certain  modern  black-clothed  Cabiri,  save  that  with  the  latter  the  dis- 
tinctive phallus  slinks  away  into  privacy.  The  ancient  Cabiri  also  occu- 
pied themselves  with  serpent  charming,  rather  than  with  other  arts  and 
medicine. 

The  Phoenicians  were,  as  we  know,  the  inventors  of  writing,  an  art  which,  when 
compared  with  the  Egyptian  hieroglyphs  and  the  Assyrian  cuneiform  writing,  may 
claim  for  ancient  and  mediaeval  times  the  same  importance  in  the  history  of  civiliza- 
tion as  the  art  of  printing  compared  with  the  handwriting  in  vogue  up  to  the  period 
of  its  discovery.  The  Phoenician  writing,  too,  was  the  model  for  the  letters  of  all 
later  peoples.  2 

1.  A  very  striking  similarity  with  the  first  Assyrian  incantation  is  found  in  the  follow- 

ing charm  coming  down  from  the  Merseburg  incantations  and  German  pagan 
antiquity:  "Einst  sassen  Idise  (Weiber),  sassen  hier  und  dort;  einige  banden 
Bande,"  etc.     This  probably  points  to  prehistoric  relations. 

2.  The  ancestors  of  the  Phoenicians,  who  were  settled  for  an  unknown  period  on  the 

shores  of  the  Persian  Gulf,  possessed  antique  universities  as  early  as  B.  C.  2000. 
These  were  located  upon  the  islands  Tyros  and  Arados,  two  of  the  modern 
Bahrein  Islands.  A  third  island,  called  Dilm'oun,  situated  on  the  coast  of  Susiana, 
a  short  distance  from  the  mouth  of  the  Tigris,  was  also  devoted  to  sacerdotal  in- 


—  30  — 

Of  the  medical  customs  of  the  Carthagenians,  who  were  Phoenician 
•colonists,  we  know  nothing  more  than  that  the  same  deities,  even  in  med- 
icine, were  worshipped  by  them,  and  in  a  manner  differing  but  slightly 
from  that  of  the  parent  stock.  They  had  certain  regulations  as  to  food 
(according  to  which  e.  g.  when  sitting  to  administer  justice,  or  when  in 
camp,  they  must  drink  plain  water),  a  religious  and  hygienic  institution 
■common  to  all  Semitic  people  down  to  the  present  day.  We  may  find 
evidence  that  the  connection  between  the  mother  and  daughter  state  con- 
tinued to  a  late  period  in  the  fact  that  the  Carthagenian  Mago  (between 
B.  C.  250  and  140)  had  written  in  the  Phoenician  language  a  book  on  rural 
economy,  including  veterinary  medicine.  This  was  subsequently  translated 
into  Greek  b\'  Cassius  Dionysius  (about  B.  C.  100),  and  still  later  an 
epitome  of  it  was  published  by  Piophanes. 

III.  JEWISH  MEDICINE. 

If  views  are  divided  as  to  the  route  by  which  the  Egyptians  immi- 
grated into  their  country,  it  is  well  established  with  regard  to  the  Jews, 
that,  wandering  as  nomads  from  the  regions  bordering  upon  the  middle 
Euphrates  and  Tigris,  they  came  at  a  very  early  period  by  way  of  Palestine 
into  Egypt  ;  that,  after  a  short  sojourn  here,  they  returned  to  Palestine, 
and  that  they  subsequentl\T  (B.  C.  1900)  revisited  Egypt  for  a  long  period. 
From  Egypt  (upon  whose  monuments  their  name  has  been  re-discovered  in 
our  own  day  under  the  title  Aperu,  Aperiu,  i.  e.  Hebrews)  they  were 
again,  after  the  lapse  of  four  hundred  years,  and  after  the}'  had  become  a 
numerous  people,  led  back  by  Moses  (Egyptian  Mesu,  B.  C.  1500? — 1-180, 
or  1531—1450),  their  great  and  terrible  lawgiver,  a  pupil  of  the  Egyptian 
priests,  whose  doctrines  he  parti}'  and  almost  literally  adopted.  This  man, 
the  elder  of  the  two  world-renowned  founders  of  religion  among  the  Jews, 
as  a  statesman  looked  at  medicine  from  the  purely  political  standpoint 
only.  After  completing  his  education  in  the  golden  age  of  Egyptian 
culture,  he  did  not,  as  we  know,  lead  the  Israelites  to  the  completion  of 
the  conquest  of  Canaan,  and  did  not  survive  to  see  the  political  independ- 
ence of  his  race.  Yet  this  very  fact  rendered  his  laws  only  the  more 
secure  from  change,  and  more  indisputably  binding — a  statement  applicable 
not  only  in  religious  matters  but  also  in  medicine. 

The  medicine  of  the  most  enduring  and  most  persistent,  as  well  as  the 
most  pliant  race  of  all  the  people  of  history,  a  people  scattered  throughout 
the  whole  world  and  adapting  itself  to  all  circumstances,  }'et  always  pre- 
serving its  exclusiveness,  its  ancient  God  and  his  commandments  —  the 
medicine  of  this  people,  I  say,  was  far  different  in  its  character  during  the 
■complete  independence  of  the   Hebrew  kingdom,  from  what  it  appeared 

struction.  In  these  ancient  universities  astronomy  was  diligently  cultivated,  and 
we  owe  to  them  the  invention  of  the  zodiac,  with  its  division  into  signs,  degrees 
and  minutes,  the  division  of  the  day  into  twelve  equal  hours  etc.   (Maspero).  (H.) 


—  31  — 

after  this  period  had  gone  by,  and  when  an  intermixture  of  this  obstinately 
faithful  nation  with  its  neighbors  of  a  more  highly  cultivated  stock  could 
be  no  longer  avoided.  Such  was  the  result  first  of  the  Assyrian  captivity 
(about  B.  C.  722),  and  subsequently  of  the  Babylonish  captivity  (about 
B.  C.  604).  But  Jewish  medicine  was  never  a  science  of  indigenous 
growth.  The  most  eminent  representative  of  the  Semitic  race,  like  all  its 
other  branches,  lacked  an}'  conspicuous  and  independent  scientific  creative- 
ness.  In  the  period  after  the  complete  dispersion  of  the  Jews  the  influence 
of  Greek  science  predominated  in  its  teachings. 

The  first  of  these  two  periods  furnishes  us  the  medicine  of  the  Old 
Testament ;  the  last,  the  medicine  of  the  Talmud.  The  former  manifests 
plainly  its  origin  in  the  priestly  schools  of  Egypt,  and  just  as  clearly  its 
conformity  to  Assyrian  ideas.  It  displays  pre-eminently  the  purest  char- 
acter of  priestly  (theurgic)  medicine,  and  in  this  respect  surpasses  even  the 
Assyrio-Babylonian  and  the  Egj'ptian,  its  models. 

The  Semitic  race,  especially  the  Jews,  exercised,  as  is  well  known, 
a  controlling  influence  not  only  upon  the  faith,  but  also  upon  the  supersti- 
tion of  the  West,  and  thus  the  greatest  portion  of  the  mystic  ingredients 
of  all  medical  art  is  to  be  referred  to  the  Semites,  in  the  same  degree  as 
its  scientific  and  artistic  elements  are  referable  to  the  Greeks. 

Old  Jewish  medicine  too  was  almost  exclusively  a  medicine  of  the 
.State,  not  a  private  profession.  Talmudic  medicine,  on  the  other  hand, 
gave  undeniable  precedence  to  Greek  methods  and  Greek  science,  and  ex- 
cluded what  we  may  call  Jewish  medicine  from  further  development. 

As  the  old  Jewish  medicine,  originally  borrowed  in  all  probability  from 
peoples  already  highly  cultivated  (Egyptians,  Assyrians  and  Babylonians), 
lacked  a  mythical  phase,  so  also,  in  consequence  of  its  strong  and  all- 
pervading  monotheism  (characteristic  of  the  Semitic  race  in  general,  as 
well  as  of  the  Egyptians,  who  were  in  this  respect  the  teachers  of  the  Jews), 
it  lacked  mythical  representatives.  Accordingly  Jehovah  (the  god  of 
light,  Ila,  according  to  Lauth),  of  whom  it  is  written  "I,  Jehovah,  am  th}- 
physician,"  is  alone  to  be  regarded  as  such  a  representative.  Among  his 
people,  too,  who  originally  lacked  a  belief  in  immortality,  He  was  regarded  as 
a  general  cause  of  disease.  He  punished  with  diseases  the  transgressions  of 
his  commandments,  and  thus  it  comes  that  Christian  etiologj-  down  to 
Luther,  and  even  later,  considered  diseases  a  punishment  for  sins.  This 
irascible  Deity,1  as  a  punishment  for  violation  of  his  commands,  utters,  b}- 
the  mouth  of  Moses,  the  following  threats  : 

'The  Lord  shall  make  the  pestilence  cleave  unto  thee,  until  he  have  consumed 
thee  from  off  the  land  whither  thou  goest  in  to  possess  it.     The  Lord  shall  smite  thee 

1.  The  translator,  while  recognizing  the  truthfulness  and  justice  of  the  author's 
frequent  and  bitter  arraignment,  of  the  folly,  wickedness  and  bigotry  of  the 
mediaeval  Church,  feels  called  upon  to  disclaim,  once  for  all,  any  sympathy  with 
the  agnosticism  which  mars,  in  his  judgment,  this  and  a  few  other  passages  of  an 
otherwise  excellent  work.     (H.) 


—  32  — 

with  consumption,  and  with  fever,  and  with  inflammation,  and  with  fiery  heat,  and' 
with  the  sword,  and  with  blasting,  and  with  mildew;  and  they  shall  pursue  thee  until' 

thou  perish The  Lord  shall  smite  thee  with  the  boil  of  Egypt,  and  with  the 

emerods,  and  with  the  scurvy,  and  with  the  itch,  whereof  thou  canst  not  be  healed. 
The  Lord  shall  smite  thee  with  madness,  and  with  blindness,  and  with  astonishment 
of  heart.     .     .     .     Thou  shalt  betroth  a  wife,  and  another  man  shall  lie  with  her."    (!!!) 

From  the  theurgic  character  of  this  medicine  it  is  self-evident  that, 
during  the  earliest  epoch,  the  Levites1  alone  could  act  as  physicians. 
They  officiated  in  the  public  service  exclusively.  Of  any  private  medical 
practice  on  their  part,  at  least  in  the  earlier  periods  of  Jewish  history,  noth- 
ing is  known — a  fact  which  finds  no  parallel  in  the  case  of  any  other  peo- 
ple. The  Levites  examined  cases  of  leprosy,  investigated  the  purity  of 
men  and  women,  sexual  maturity  etc.  A  Levite  practising  as  a  ph}'sician 
must  not  be  blind  of  one  e}Te,nor  have  his  vision  impaired  ;  nor  could  he  pur- 
sue his  investigations  at  earl}*  dawn,  nor  in  the  evening  twilight,  nor  even 
within  a  chamber  on  a  cloudy  day.  King  Solomon  (reigned  B.  C.  1020-980), 
who  cured  diseases  b}*  exorcism,2  and  the  prophets,  in  special  cases,  were 
also  called  ph}'sicians.  Thus  Elisha  awakened  the  son  of  the  Shunemite 
woman  from  apparent  death,  and  cured  the  Syrian  general  Naaman  of  lepro- 
sy by  bathing  in  the  Jordan.  Elijah  and  Ahijah  also  supplied  prophetic 
prognoses.  After  the  two  captivities,  and  the  consequent  contact  of  the- 
Jews  with  foreign  nations,  there  arose  also  a  class  of  temple  physicians  and 
special  surgeons.  In  the  latter  centuries  before  the  Christian  era  there  were 
also  city  or  communal  phj'sicians  and  surgeons.3  They  must  have  been  held 
in  high  esteem,  for  Jesus,  the  son  of  Sirach  (2-3  century  B.  C),  who  was  a 
physician  and  savant  of  Egypt,  characterizes  these  later  physicians  and 
their  social  position  as  follows  : 

"  Honor  a  physician  !     ....     The  skill  of  the  physician  shall  lift  up  his  head, 
and  in  the  sight  of  great  men  he  shall  be  in  admiration When  thou 


1.  The  individual  tribes  had  special  banners.     That  of  the  Levites  bore  the  colors 

of  the  German  empire,  though  different]}-  arranged. 

The  view  stated  in  the  text  is  denied  by  Wunderbar  (Biblisch-talmudische  Mediein), 
and  is  also  questioned  by  Trusen  (Die  Sitten,  Gebrauche  und  Krankheiten  der 
alten  Hebriier).  Certainly  the  cases  of  king  Asa  (965-914  B.  C.)  and  Jehoram 
(896-884  B.C.),  as  recorded  in  II  Chron.,  xvi,  12  and  II  Kings,  viii,  29,  would  seem 
to  imply  the  presence  and  activity  of  other  physicians  than  the  Levites.     (H.) 

2.  The  Talmud  often  mentions  a  medical  work  entitled  "  Sepher  Rephuoth",  ascribed 

to  the  pen  of  king  Solomon.     (H.) 

3.  In  Talmudic  times,   although  every  physician,  as  a  rule,  practised'  surgerj-  also, 

there  still  existed  a  few  special  surgeons,  who  devoted  their  entire  attention  to 
surgery.  The  latter  were  called  "Uraan",  while  the  physicians  bore  the  title 
of  "  Rophe-Uman  ",  or  simple  "  Rophe".  Both  classes  of  medical  men  were 
under  the  immediate  jurisdiction  of  the  local  courts  of  justice  (Beth-Din),  without 
whose  license  no  one  was  permitted  to  practice.  Each  city  was  compelled  to 
have  at  least  one  '"  Rophe-Uman".  The  Talmud  also  mentions  11a,  a  veterinary 
surgeon  of  Jabne.    (H.) 


—  33  — 

feelest  sick  call  upon  God,  and  bring  the  physician:  for  a  prudent  man  scorneth  not 
the  remedies  of  the  earth."  i 

In  contrast  with  this  enthusiastic  panegyric,  we  meet  among  the  Hebrews,  as 
among  all  cultivated  people,  satirical  remarks  upon  physicians,  such  as  the  following 
from  the  Bible  itself:    "  Physician,  heal  thyself!  "—the  sharpest  and  curtest  satire! 

There  were  midwives  as  early  as  the  period  of  the  sojourn  in  Egypt, 
e.  g.  Shiphrah  and  Puah ;  but  instead  of  rendering  assistance  to  lying-in 
women,  "in  difficult  cases  the}'  comforted  them  until  they  died"  (Siebold). 
Delivery  took  place  either  upon  the  delivery-stool,  or  upon  the  lap  of  an- 
other woman.     The  new-born  infant  was  rubbed  down  with  salt. 

Obstetrical  operations  seem,  however,  to  have  been  entirely  unknown  ;  for  even 
in  cases  of  prolapse  of  the  hand  everything  was  left  to  nature.  When  Tamar  e.  g.  is 
said  to  have  borne  twins,  the  midwife  merely  bound  a  red  thread  around  the  prolapsed 
hand,  and  then  allowed  it  to  return.  Inasmuch  as  the  Hebrew  women,  then  as  now, 
bore  children  easily  and  often,  operations  were  superfluous.  A  special  blessing  as 
respects  child-bearing  rested,  and  still  rests,  upon  the  people  of  God.  The  Jews  of  the 
old  kingdom  were  also  by  no  means  so  effeminate  and  luxurious  as  thpjT  are  to-day. 

Besides  the  diseases  preserved  in  the  passages  of  the  Bible  quoted 
above,  the  Hebrew  pathology  mentions  "  The  Egyptian  plagues  "  as  the  oldest 
of  epidemic  diseases,  though  the  precise  nature  of  these  plagues  is  un- 
known. We  read  also  of  the  "  Plague  of  Baal  Peor  "  (which  the  Moab- 
itish  women  were  careful  to  communicate  to  the  children  of  Israel,  as  a 
memorial  of  their  love)  ;  the  "  Disease  of  the  Philistines  ";  the  "  Disease  of 
Saul";  the  "  Disease  of  Nebuchadnezzar"  etc.,  and  especially  "The  issue 
of  the  body  ",  "  The  white  issue  ",  the  disease  of  the  (male  and  female) 
flesh,  and  its  bastard  form,  the  "White  and  red  leprosy."  The  symptoms 
of  the  last  two  diseases  are  described  as  follows  : 

"  And  the  priest  shall  look  on  the  plague  in  the  skin  of  the  flesh  :  and  if  the  hair 
in  the  plague  be  turned  white,  and  the  appearance  of  the  plague  be  deeper  than  the 

skin  of  the  flesh,  it  is  the  plague  of  leprosy, And  when  the  flesh  hath 

in  the  skin  thereof  a  boil,  and  it  is  healed,  and  in  the  place  of  the  boil  there  is  a 
white  rising,  or  a  bright  spot,  reddish-white,  then  it  shall  be  shewed  to  the  priest;  and 
the  priest  shall  look,  and  behold  if  (he  appearance  thereof  be  lower  than  the  skin,  and 
the  hair  thereof  be  turned  white,   then  the  priest  shall  pronounce  him  unclean:  it  is 

the  plague  of  leprosy,  it  hath  broken  out  in  the  boil But  if  there  be  in 

the  bald  head  or  the  bald  forehead  a  reddish-white  plague,  it  is  leprosy  breaking  out 
in  his  bald  head,  or  his  bald  forehead  "  etc. 

The  symptoms  of  the  benign  scab  are  : 

"And  when  a  man  or  a  woman  hath  in  the  skin  of  their  flesh  bright  spots,  even 
white  bright  spots,  then  the  priest  shall  look;  and,  behold,  if  the  bright  spots  in  the 
skin  of  their  flesh  be  a  dull  white,  it  is  a  tetter,  it  hath  broken  out  in  the  skin  ;  he  is 
clean." 

1.  A  farrago   from    Ecclesiasticus,     part   of   which   is   not   found    in    our    English 
version.      See    Ecclesiasticus,    chap,  xxxviii.     (H.) 
According  to  the  views  of  Pfleiderer  (in  "Die  Philosophie  Heraklit's  etc.,  '85),  the 
author  of  the  book  of  Wisdom  was  a  Hellenistic  Jew  of  the  first  century  B.  C, 
who  likewise  wrote  the  2d  and  4th  "  Pseudo-Heraclitan  "  letters.     (Baas.) 


—   34  — 

It  is  said  of  Moses,  that  his  eyes  in  extreme  old  age  were  not  darkened,  an  in- 
direct evidence  of  a  knowledge  of  presbyopia,  or  senile  cataract. 

The  above  descriptions  lead  us  to  that  branch  of  medical  science, 
which  was  of  all  the  best  cultivated  among  the  Jews  —  public  h}giene  or 
medical  police.  It  corresponds  to  the  reality,  in  both  the  actual  and 
chronological  point  of  view,  to  consider  the  Jews  (Moses)  as  the  creators  of 
the  science  of  public  hygiene. 

The  regulations  of  this  branch  relate  especially  to  the  leprosy  "of  men, 
houses  and  clothing  ",  to  sexual  intercourse  and  its  abuses,  to  bathing 
after  coitus  and  to  pollutions,  to  the  marriage  of  kindred  (forbidden  also 
among  the  Egyptians  and  Phoenicians),  to  the  situation  of  cemeteries,  the 
time  of  burial,  the  isolation  of  the  sick,  the  use  of  vessels  employed  by  the 
latter  and  to  cases  of  doubtful  diseases.  Here  too  should.be  included  the 
strict  regulations  regarding  the  kind,  and  mode  of  preparation,  of  food  and 
of  slaughtered  animals,  as  well  as  the  precepts  relative  to  permissible 
animals  and  their  mode  of  death  —  regulations  which  must  be  studied  by 
their  rabbis  and  butchers  even  at  the  present  day. 

The  attainments  of  the  Jews  in  surgery  were  exceedingly  scanty.  Of 
operative  measures,  only  "  The  Seal  of  the  Covenant",  an  expression  applied 
to  circumcision  (an  operation  which  they  probably  adopted  from  the 
Egyptians  and  performed  with  a  stone  knife),  seems  to  have  been  practised. 
Castration  was  likewise  at  least  known  to  them,  though  they  were  for- 
bidden its  practice.  The  Jews  were  also  acquainted  with  hernia,  and  its 
existence  occasioned  expulsion  from  the  congregation.  Their  knowledge 
of  obstetrics  was  likewise  scanty.  Jn  their  doctrines  relating  to  child-bed 
(the  management  of  which  was  again  regulated  especially  from  the  hygienic 
point  of  view),  the  red  and  white  lochia  were  distinguished,  and  it  is  stated 
that  the  former  continue  after  the  birth  of  a  boy  seven  days  ;  after  that  of 
a  girl,  fourteen  days.  The  white  lochia  are  said  to  continue  after  the  birth 
of  a  boy  thirty-three  days  ;  after  that  of  a  girl,  sixty-six  days.  In  the 
nearl}-  related  science  of  gynaecology,  we  learn  that  they  distinguished 
between  menstruation  and  metrorrhagia.  These  latter  discharges,  even 
after  their  cessation,  render  the  woman  unclean  in  the  e}-e  of  the  law  for 
seven  full  da3-s,  and  during  their  continuance  are  guarded  with  dreadful 
severity  against  a  characteristic  of  the  Jews  —  Moses  knew  his  people  !  — 
as  the  following  passage  will  testify  : 

"And  if  a  man  shall  lie  with  a  woman  having  her  sickness,  and  shall  uncover 
her  nakedness:  he  hath  discovered  her  fountain,  and  she  hath  uncovered  the  fountain 
of  her  blood:   and  both  of  them  shall  be  cut  off  from  among  their  people." 

In  contrast  to  the  Greeks  and  Romans,  artificial  abortion  was  for- 
bidden. 

In  consequence  of  the  stern  prohibition  against  contact  with  the  dead, 
a  Jewish  anatomy  is  not  to  be  thought  of :  The  bones  and  vessels  only 
are  ver}r  vaguely  mentioned  (Job  x).  Nothing  too  is  known  of  any 
Jewish  physiology.     But '[the  almost  complete  Labsence  of  a  pharmacology 


—  35  — 

among  the  Jews  is  remarkable  ;  for  they  were  acquainted  with  a  great 
number  of  plants,  and  the  Egyptians,  among  whom  the}'  lived  for  so  long  a 
time,  had  a  very  large  number  of  remedies,  which  they  might  have  appro- 
priated. Figs,  the  heart,  liver  and  gall  of  fishes,  are  mentioned  as  medi- 
cines, and  bathing  in  the  Jordan  as  a  remedy  for  leprosy.1  This  lack  of 
remedies  is.  doubtless,  to  be  explained  by  the  purely  theurgic  character  of 
Hebrew  medicine.  Yet  the  mortality  of  the  Jews  was  not,  for  this  reason, 
any  greater  than  that  of  other  people  who  employed  "remedies"  in  abund- 
ance. At  a  later  period,  when  the  belief  in  demons  had  been  introduced 
among  the  Jews  by  the  Chalcheans,  oracles  for  the  cure  of  diseases  were 
sought  even  from  Beelzebub,  and  there  were  then  also  witches  for  men  and 
beasts. 

A  bond  of  union  between  the  ancient  medicine  of  the  Jews  and  that  of 
the  Talmudists  is  found  in  their  common  tendency  to  religious  law,  and 
although  Talmudic  medicine  is  substantially  quite  distinct  from  the  older 
form  of  Jewish  medicine,  it  seems  proper,  for  this  reason,  to  include  it  in 
the  present  chapter.  The  erection  of  colleges  for  the  preservation  and 
explanation  of  the  pure  faith,  necessitated  by  the  destruction  of  the  temple 
at  Jerusalem  and  the  simultaneous  downfall  of  its  schools,  was  the  occasion 
of  the  origin  of  the  learned  Talmudic  medicine.  Although,  in  consequence 
of  the  dispersion  of  the  Jews,  these  schools  were  founded  in  places  widel}- 
separated  from  each  other,  —  at  Jabneh  near  Jerusalem,  Nahardea  in 
Mesopotamia,  Mathae-Mechasja  on  the  Euphrates,  Sura,  Alexandria  and 
Tiberias  ;  Rabbi  Gamaliel  taught  at  Jabneh,  the  Rabbis  Simeon  and 
Jehuda  Hakkadosch  at  Tiberias,  Rabbi  Abba  Aricha  at  Mechasja,  Rabbi 
Samuel  at  Nahardea.  Rabbi  Asche  at  Sura,  Rabbi  Tudus  at  Alexandria, 
Tobias  of  Modaim  near  Jerusalem  (about  A.  D.  185),  who  belonged  among 
the  followers  of  Erasistratus,  Channina  Ben  Chama.  about  the  same  period, 
who  inserted  natural  and  wooden  teeth2 — they  still  maintained  with  each 
-other  a  spiritual  union.  Their  golden  age  falls  within  the  first  five  centu- 
ries after  Christ.  These  colleges,  however,  did  not  remain  free  from  the 
influence  of  other  oriental  people,  and  especially   did   not  escape  that  of 

1.  Music  was  regarded  as  a  psychical  remedy,  and  sleeping  with  young  maidens  was 
recommended  as  a  means  of  physical  recreation  lor  all  men.  Wound-balsam 
was  also  mentioned  as  a  surgical  remedy. 

1.  Other  prominent  Jewish  physicians  of  the  Talmudic  period  were  Theudas  of 
Laodicea  (11.  A.  D.  120),  one  of  the  last  and  best  teachers  of  the  Empiric  school, 
who  wrote  a  treatise  upon  the  branches  of  medicine  {Indicatoria,  Cvratoria  et 
Salubris)  ;  Rabbi  Chanina  Ben  Dosa,  who  flourished  about  the  same  period,  and 
established  the  prognosis  of  his  patients  by  the  fluency  of  his  prayers  in  their 
behalf;  Ishmael  Ben  Elisha  (Ha  Cohen,  "Rabbi  Ishmael")',  an  anatomist  of  the 
close  of  the  first  century,  whose  pupils  were  distinguished  for  their  acquaintance 
with  anatomy  and  physiology,  and  whose  school,  under  the  title  "  Debbe  Rabbi 
Ismael",  was  held  in  high  esteem  among  the  Talmudists.  Tobias  of  Modaim 
(mentioned  above),  the  "  Tobia  Harophe  "  of  the  Talmud,  wrote  a  treatise  upon 
the  functions  of  the  brain.     (H.) 


—  36  — 

the  Greeks.  —  The  sect  of  the  Essenes  (Therapeutic),  which  gave  a  special 
character  to  the  medicine  of  the  later  period  of  Antiquity,  arose,  about  B.  C. 
150,  from  an  intermixture  of  various  philosophical  views.  To  this  subject 
we  shall  revert  hereafter.  —  The  Talmud  originated  in  a  compilation  of  all 
the  interpretations,  traditions  and  decretals  of  the  Rabbis,  originally 
entitled  Mishna,  and  completed  between  A.  D.  200  and  A,  D.  250.  Under 
the  title  Gemara  further  explanations  of  this  work  were  written  (A.  D, 
370-390).  These  two  works  taken  together  formed  the  Talmud  of  Jeru- 
salem, which  was  again  revised.  At  last  a  final  revision  produced  the 
Talmud  of  Bab3"lon,  consisting  of  the  Mishna,  the  Gemara  and  their  suc- 
cessive explanations. 

The  medical  contents  of  the  Talmud  are  substantially  as  follows: 

Its  surgery  embraces  a  knowledge  of  dislocations  of  the  femur,  contusions  of  the 
skull,  perforation  of  the  lungs,  oesophagus,  stomach,  small  intestine  and  gall-bladder, 
of  wounds  of  the  spinal  cord,  trachea,  pia  mater,  of  fractures  of  the  ribs  (all  of  which 
were  considered  very  dangerous,  unless  immediate  medical  aid  could  be  obtained),  of 
oral  and  nasal  polypi,  the  latter  of  which  were  considered  a  punishment  for  past  sins. 
In  sciatica  a  curious  direction  is  given  to  rub  the  hip  sixty  times  with  meat-broth. 
Still  more  singular,  however,  is  the  treatment  of  stone  in  the  bladder,  and  among  the 
various  procedures  we  notice  only  the  following:  catch  a  louse  from  a  man,  and 
another  from  a  woman  ;  fix  the  one  upon  the  breast  of  the  woman,  the  other  upon  the 
penis  of  the  man:  then  let  them  urinate  upon  a  blackberry  bush,  while  somebody 
watches  whether  the  stone  escapes  !  Besides  the  ordinary  operations,  e.  g.  venesection, 
which  was  performed  by  mechanics  or  barbers,  mention  is  made  of  the  circumcision 
of  hermaphrodites,  of  an  operation  bjr  which  these  unfortunate  beings  might  be  made 
capable  of  coitus,  and  of  the  operation  for  imperforate  anus.  The  execution  of  the 
latter  operation  is  described  very  minutely:  the  anal  region  is  to  be  first  oiled  well, 
and  then  exposed  to  the  rays  of  the  sun  !  An  incision  is  then  made  of  the  size  of  a 
barley-corn. 

The  Talmudic  pathology  ascribes  diseases  to  a  constitutional  vice,  to  evil  influ- 
ences affecting  the  body  from  without,  or  to  the  effect  of  magic.  It  recognizes,  among 
other  things,  the  origin  of  jaundice  from  retention  of  bile,  and  of  dropsy  from  sup- 
pression of  urine.  The  latter  disease  in  general  was  divided  into  anasarca,  ascites 
and  tympanites.  Prognostically  it  is  declared  that  hydrocephalus  internus  is  always 
fatal,  while  hydrocephalus  ex  tern  us  is  not  necessarily  so :  that  rupture  and  atrophy 
of  the  kidneys  are  followed  by  death;  that  hydatids  of  the  liver,  on  the  contrary,  are 
not  fatal;  that  suppuration  of  the  spinal  cord,  induration  of  the  lungs  etc.,  are  in- 
curable,— views  which  may  have  been  based  upon  the  dissection  of  animals,  and  may 
be  considered  germs  of  pathological  anatomy.  Sweating,  sneezing,  defecation, 
nocturnal  pollutions  and  dreams  promising  a  favorable  termination  of  existing 
disease,  pass  for  critical  symptoms. 

In  therapeutics  natural  remedies,  both  external  and  internal,  were  employed,  as 
well  as  the  arts  of  magic.  The  Rabbis,  at  other  times  so  strict,  allow  to  the  sick  even 
prohibited  articles  of  diet,  if  they  have  a  desire  for  them.  Among  their  special  pre- 
scriptions we  notice:  onions  for  worms;  wine  and  pepper  in  disorders  of  the  stomach; 
milk  sucked  directly  from  the  teat  of  a  goat  in  dyspnoea;  emetics  in  nausea;  a  mix- 
ture of  gum,  alum  and  saffron  in  too  profuse  menstruation;  a  dog's  liver  for  the  bite 
of  a  mad  dog;  injections  of  oil  of  turpentine  in  cases  of  stone  in  the  bladder;  a  drop 
of  cold  water  in  the  eye  in  the  morning,  with  warm  foot  and  hand  baths  in  the  even- 
ing for  sore  eyes:   bleeding  and  the  warm  baths  of  Tiberias.     Asafoetida  and  many 


other  drugs  are  certainly  derived  from  Grecian  medicine  ;  the  laj'ing-on  of  hands, 
prayer  and  conjurations  are  with  less  certainty  due  to  the  same  source.  In  dietetics 
it  was  recommended  before  the  age  of  forty  to  take  more  food  than  drink  ;  after  that 
age,  to  reverse  the  habit:  after  meals  to  eat  salt,  and  then  to  drink  water  freely,  but 
not  to  work  too  much,  nor  to  walk,  sleep,  nor  indulge  in  venery  or  wine.  On  the 
other  hand,  it  is  advised  to  visit  the  water-closet  regularly  every  morning,  and  to 
bathe,  anoint  and  wash  frequently. 

The  anatomy  of  the  Talmudists  is  based  chiefly  upon  the  dissection  of  animals, 
though  Rabbi  Ishmael,  at  the  close  of  the  first  century,  dissected,  or  rather  "skeleton- 
ized" by  boiling,  the  body  of  a  prostitute1  (dissection  in  the  interests  of  science  was 
permitted  by  the  Talmud),  on  which  occasion  he  found  '252  (instead  of  232)  bones. 
They  recognized  the  origin  of  the  spinal  cord  at  the  foramen  magnum,  and  its  termin- 
ation in  the  cauda  equina;  allowed  two  coats  to  the  resophagus;  included  the  lungs 
in  two  coverings,  and  gave  a  special  coat  to  the  fat  about  the  kidneys.  As  regards 
explorative  measures,  the}'  were  very  well  acquainted  with  their  favorite  subject  of 
investigation,  and  called  the  uterus — the  sleeping  chamber;  the  cervix  uteri — the 
porch;  the  "  seed-vessels" — the  store-room;  the  vagina— the  outer  house;  the  hymen 
(unknown  even  to  the  Greeks,  but  not  overlooked  by  the  Talmudists  in  their  very 
zealous  investigations  of  this  region)  was  called  the  virginity  ;  the  labia  majora — the 
hinges;  the  prolabia — the  doors;  the  clitoris — the  key.  The  whole  female  body  was 
compared  to — a  larder!  They  assumed  the  existence  of  a  fabulous  "Ossiculum  Lus", 
an  indestructible  part  of  the  body,  believed  to  serve,  like  seed,  for  the  reconstruction 
of  the  whole  body  in  the  resurrection,  and  called  by  the  Arabians  "Aldabaran" 
(Langer). 

In  physiology  they  assume  cold,  heat,  dryness  and  moisture  as  component  forces. 
In  experimental  physiology  they  point  out  that  removal  of  the  spleen  is  not  fatal,  and 
distinguish  between  semen  and  albumen  by  the  fact  that  the  former,  under  the  influence 
of  heat,  deliquesces,  while  the  bitter  coagulates. 

The  knowledge  of  the  Talmudists  in  the  natural  sciences  embraces  the  Mosaic 
zoology,  while  the,ir  botanical  knowledge  extends  bej'ond  the  Bible.  According  to 
them  the  elementary  bodies  are  earth,  air,  fire  and  water.  In  midwifery  they  teach 
that  pregnancy  continues  270-273  days,  and  cannot  be  determined  before  the  fourth 
month.  As  a  means  of  recognizing  this  condition  they  give  the  deeper  sinking-in  of 
the  pregnant  female  in  walking  over  soft  ground.  The  foetus  born  in  the  eighth 
month  is  not  viable.  Normally  the  foetus  lies  folded  together  like  a  roll  of  parchment, 
the  hands  upon  the  temples,  swimming  in  the  amnion  like  a  nut  in  the  water.  Cesa- 
rean section  on  the  living  female  was  practised  with  success  (Israels),  and  they  were 
also  acquainted  with  version,  evisceration,  abortion,  moles  and  monsters  (including 
absence  of  the  extremities,  imperforate  anus,  hermaphroditism,  cryptorchidism, 
hypospadias  etc.),  which  are  ascribed  to  coitus  of  a  demon  or  beast  with  a  woman, 
or  of  a  man  with  a  beast.  Quite  as  remarkable,  but  much  more  important,  is  the 
knowledge  of  the  rabbis  in  the  history  of  generation  and  development,  as  well  as  in 
gynecology.  With  respect  to  the  first  subject  especially,  their  statements  seem  to 
depend  upon  "their  own  experiments".  For  example,  they  say  that  introduction  of 
the  whole  penis  is  not  always  necessary  for  impregnation,  but  that  mere  introduction 
of  the  glans,  —  what  the  lascivious  rabbis  (the  discoverer  of  this  learned  Talmudic  ex- 
pression must  have  prided  himself  no  little  upon  it!)  call  osculatio  glandis — is  suffi- 

I.  Prostitutes  were  numerous  among  the  Jews.  They  were  required  to  veil  their 
faces  while  walking  upon  the  streets,  and  to  solicit  custom  only  while  sitting 
before  their  houses.  The  latter  regulation  was  designed  to  prevent  street 
prostitution. 


—  38  — 

cient.     They   also  declare  that  pregnancy  cannot   take   place    stantibus  tnuliere  ac 

viro,  a  statement  which,  however,  seems  refuted  by  more  recent  experiments;  that 
the  man,  by  holding  on  to  the  right  or  left  testicle,  has  it  literally  in  his  own  hands  to 
beget  boys  or  girls ;  and  other  similar  experiments  !  The  foetus  is  supposed  to  develop 
from  the  head,  the  upper  and  lower  extremities  originating  in  the  7th  week,  the 
genitals,  mouth,  nose  and  eyes  in  the  6th  week,  the  first  hairs  after  three  or  three  and 
one-half  months,  at  which  period  also  the  sex  may  be  safely  determined.  Man  origi- 
nates from  the  purest  portion  of  the  semen,  not  from  the  whole  fluid,  while  the  white 
tissues  (bones,  sinews,  the  brain,  the  white  of  the  eye)  spring  from  the  male  semen, 
and  the  red  tissues  (skin,  muscle,  hair,  the  black  part  of  the  eye)  from  that  of  the 
female.  To  this  compound  body  God,  however,  supplies  its  spiritual  powers!  Jn 
compliance  with  the  precepts  of  their  religion  the  Talmudists  especially  delighted  in 
vaginal  exploration  with  the  oiled  finger,  and  in  practising  inspection  of  the  genital1 
organs.  Thus  they  determined  that  two  hairs,  one  on  the  mons  Veneris  (how  in  the 
world  did  they  find  it  ?),  and  one  in  the  axilla,  furnished  entirely  satisfactory  proof 
of  the  puberty  of  the  female;  that  menstruation  might  occur  even  in  children  etc. 

The  Talraudic  directions  for  practice  give  evidence  of  the  practical 
common-sense  of  these  physicians.  "  Look  to  your  pay,  0  physician  I 
For  that  for  which  nothing  is  paid,  the  same  never  cures  " — a  maxim  which 
still  holds  good. 

With  the  medicine  of  the  Talmud  terminated  medicine  as  treated  in 
special  Jewish  works,  though  in  the  Middle  Ages,  as  in  the  present  day, 
Jews  in  great  numbers  officiated  as  esteemed  physicians.  Thus  Charles  the 
Bald  (A.  J).  822-877)  had  for  his  ordinary  physician  a  certain  Sedechias. 
Among  the  so-called  Arabian  physicians  there  were  also  main*  Jews,  and 
in  Salerno  they  officiated  as  teachers,  though  since  then,  even  down  into 
the  present  century,  such  duties  have  been  forbidden  to  them.1 

IV.     INDIAN    MEDICINE. 

The  land  of  the  sacred  Ganges,  wreathed  in  poesy  and  rich  in  gods 
and  temples,  bred  in  the  earliest  ages  a  highly  cultured  people,  who.  even 
in  hoary  antiquity,-  had  already  made  long  strides  in  medicine,  and  had 
attained  a  grade  of  scientific  knowledge,  beyond  which  they  have  never 
since  advanced.  Yet  India  did  not  produce  her  present  inhabitants.  The 
Indians,  that  gentle  though  tenacious,  extraordinarily  fanciful,  though 
thorough  and  profound  people  of  the  Indo-Germanic  stock,  had  not  their 
original  home  in  the  India  of  to-da}-,  but  immigrated  here  from  the  north 
at  a  period  far  from  determinable  (B.  ('.  4000  ?-2000  ?).  After  driving 
out  the  Dravidas,  the  dusky  inhabitants  of  the  south,  they  had  founded 
flourishing  states  in  Bengal  as  early  as  B.  C.  1900  (or  according  to  others. 


1.  The   medicine  of  the    Talmudists,    in    its   dependence    upon    that  of  the   Greeks, 

furnishes  us  a  preliminary  poiiit  d'appui  for  an  interesting  comparison  of  the 
latter  with  the  medicine  of  the  Indians. 

2.  Max  Miiller  regards   the    Indians  as  considerably  older  than   even   the  Egyptians. 

He  speaks  of  a  language  (from  which  words  have  been  transferred  into  our  own 
tongue)  which  existed  "  before  there  was  a  single  Greek  statue,  a  single  Babylo- 
nian bull,  or  a  single  Egyptian  Sphinx". 


—  39  — 

about  B.  C.  1300.)  At  this  period  the}'  were  already  acquainted  with 
writing,  but  during  the  prevalence  of  the  primitive  Agni-  or  Varuna-cultus 
the}'  knew  nothing  of  the  later  distinctions  of  caste.  These  distinctions, 
so  hostile  to  development,  originated  in  the  establishment  of  the  Brahmanic 
doctrine  of  the  Trinity,  at  which  period — about  B.  C.  800 — the  priests  also 
began  to  rule.  After  this,  time  the  distinction  of  caste  was  much  stronger 
than  in  Egypt,  so  strong  e.  g.  that  a  Sudra  who  should  seat  himself  in  the 
place  of  a  Brahman,  would  have  had  the  actual  cautery  applied  to  that 
portion  of  the  body  adapted  to  sitting,  or  would  have  had  a  cut  inflicted 
upon  it  ! — a  prelude  to  the  later  branding  of  heretics  by  Christians  !  But 
a  Brahman  who  took  a  Sudra  merely  for  a  concubine  was  disgraced.  The 
precepts  of  Manu  (B.  C.  700-600)  are  to  be  regarded  as  the  law-book  of 
this  period.  About  B.  C.  400  the  Buddhistic  doctrine  attained  vogue. 
According  to  this  doctrine,  which  contrasts  strongly  with  the  Brahmanic, 
all  men  everywhere  have  equal  rights — and  this  was  a  purely  moral  precept, 
independent  of  God  ;  an  atheistic  doctrine,  which  does  not  pretend  to  be  a 
divine  revelation,  but  simply  a  human  idea  !  ' 

Even  before  this,  about  the  year  B.  C.  416,  the  first  Greek  physician, 
Ctesias,  physician  to  the  Persian  court,  came  to  India,  and  in  the  year 
B.  C.  327  the  yoke  of  Alexander  the  Great  fell  upon  the  frontiers  of  that 
country.  About  the  year  B.  G.  300  Megasthenes  officiated  as  embassador 
at  the  court  of  Sandracottus.2  Whether  these,  or  other  later  Greek  physi- 
cians became  at  all  acquainted  with  the  medical  views  of  the  Indians,  or  in 
any  way  exercised  upon  them  a  permanent  influence,  is  very  doubtful  ;  for 
the  Greeks  themselves  acquired  only  a  scanty  acquaintance  with  Indian 
views,  and  could- therefore  impart  to  them  probably  none  of  their  own. 

Ctesias  reports  e.  g.  that  the  Indian  physicians  were  especially  skilful  in  the 
treatment  of  the  bites  of  serpents,  ;ind  Megasthenes  declares  that  they  live  a  very 
simple  life,  use  few  drugs,  and  make  their  wives  as  fruitful  as  can  he  imagined,  while 
by  the  administration  of  certain  medicines  they  could  beget  boys  or  girls  with  incon- 
ceivable certainty. 


1.  Its  author  was  the  great  Sakvamuni  (  Buddha,  died  B.  C.  412),  son  of  king  Dsuhoma 

of  Kapulivastu.  It  was  first  elevated  to  the  position  of  the  sole  religion  author- 
ized by  the  state  by  king  Azoka  (B.C.  2;">9-222 )  of  Magadha  about  B  C.  250. 
Since  the  9th.  century  of  our  present  era,  however,  it  lias  been  again  driven  out  of 
India  by  the  Brahmanic  religion,  so  that,  to-day  it  is  almost  entirely  exterminated 
there,  and  now  flourishes  only  among  the  Chinese.  Discussion  of  the  literature, 
art,  technics  etc.  of  the  Indians  here  would  lead  us  too  far  from  our  subject. 
We  will  only  remark  that  these  were,  on  the  whole,  at  least  equal  to,  and  in  many 
respects  far  surpassed  those  of  the  Egyptians.  In  poetry,  too,  the  Indians  need 
not  dread  comparison  with  the  Greeks,  if  they  had  only  kept  their  poems  within 
the  bounds  of  moderation. 

2.  The  Chandragupta  of  Sanscrit  writers.    Megasthenes,   also  a  physician,   was  em- 

bassador from  the  court  of  Seleucus  Nicator.  He  wrote  a  work  in  four  books, 
entitled,  zd  'Ivdtxd,  of  which  fragments  onl}'  remain.  We  learn  from  Megasthenes 
that  in  his  day  a  registry  of  births  was  kept  in  India.     (H.) 


—   40   — 

Most  important,  however,  for  the  Indians  was  the  conquest  of  their 
country  by  the  Mohammedans,  about  A.  D.  1000. l  From  this  period  the 
independence  of  the  people  ceased,  and  the  thread  of  development  of  their 
original  civilization  was  cut  off. 

Indian  medicine,  if  we  except  the  Egyptian,  Babylonish  and  Jewish,  is 
the  oldest  in  the  world.  Like  the  others,  it  is  also  a  priestly  medicine. 
In  its  whole  extent  it  grew  up  upon  Indian  soil,  although  at  a  late  period, 
and  in  special  branches,  e.  g.  midwifen-,  foreign  views,  especially  those  of 
the  Greeks,  were  probably  interwoven.  The  extreme  antiquity  of  origin 
claimed  (in  accordance  with  their  peculiarly  fanciful  chronology)  for  the 
oldest  of  the  Indian  medical  works  yet  known  to  us  is  unfortunately  not 
satisfactorily  settled.  Were  this  question  determined,  it  would  furnish  us, 
of  course,  a  favorable  stand-point  from  which  to  decide  upon  the  independ- 
ence of  their  medicine.  The  views  as  to  the  period  of  their  composition, 
however,  vary  between  B.  C.  1000  and  A.  I).  1000.  The  earlier  period 
seems  to  be  accepted  as  the  more  probable,  and  accordingly,  if  we  select 
this  tolerably  certain  date  as  the  basis  of  our  judgment  concerning  the 
antiquity  of  Indian  medicine  in  general,  we  niaj'  conclude  that  it  is  the  fourth 
in  point  of  antiquity  of  any  known  to  us. 

The  medical  writings  of  the  ancient  Indians  are  contained  in  their 
sacred  books,  the  Yedas,  which  originated  about  B.  C.  1500,  and  were  pre- 
served by  oral  tradition  until  about  A.  D.  1500." 

Of  these  books  there  are  four  :  the  Rigveda  ( hymnolog}'),  the 
V  a  y  n  r  v  e  d  a  (science  of  pra}er),  the  Atharvaveda  (science  of  in- 
cantations), and  the  Samaveda  (science  of  song).  There  are  also  later 
supplements  to  these  books,  the  Upanishads  and  Vedanta.  The  Yayurveda 
is  also  regarded  as  an  Tpanishad  to  the  Atharvaveda.  To  the  (younger) 
second  of  the  Yedas  belong  the  Yayurvedas  of  the  physicians  Charaka  and 
Susruta,  the  origin  of  which  is  assigned  to  about  B.  C.  1000.  These  are 
the  oldest  special  Indian  medical  works  of  which  we  have  an}-  precise 
knowledge.  Besides  these  physicians,  Agastya.  who  wrote  38  treatises, 
embracing  the  whole  sphere  of  medicine,  and  Atre}'a,  the  author  of  the 
Sanhita  (a  work  which  mentions  many  diseases,  and  says  that  everything 
spoken  by  Manu  is  medicine),  are  classed  as  very  ancient  professors  of  the 
medical  art.  The  oldest  of  these  works  (and  the  source  of  the  other  Yedas). 
the  Rigveda,  contains  simple  medical  charms  : 

"Ye  breezes,  healing  blow,  and  waft  his  pain  away  : 
The  gods  have  sent  you  forth  with  stores  of  healing  drugs. 

The  cold  water  treatment  of  febrile  diseases,  recently  introduced  among 
us  as  something  of  a  novelty,  is  apparently  mentioned  in  the  passage  : 

1.  Under  Mahmoud  of  Ghazni.      (  H.) 

2.  Max  Miiller  holds  that  in   the  entire  so-called  Vedic  period,  and  even  later,  the 

Indian  works  were  transmitted  by  oral  tradition  alone,  that  no  written  documents 
are  demonstrable  prior  to  the  time  of  Azoka  (who,  according  to  him,  reigned 
B.  C.  259-222),  and  that  the  earliest  inscriptions  original!  d  in  his  time. 


—  41  — 

"  Healing  are  the  watery  billows,  water  cools  the  fever's  glow, 
Healing  against  every  plague,  health  to  thee  brings  water's  flow," 

In  the  Atharvaveda  are  also  found  charms,  which  indicate  from  the 
color  of  drugs  their  effect  upon  the  body,  as  e.  g.  gold-hammer  and  saffron 
in  jaundice,  red  remedies  and  especially  red  cows  in  diseases  of  the  vital 
force  (the  blood).  From  the  formula  "  Form  to  form,  force  to  force  " 
( rupamrupam,  vayovayas)  we  may  even  deduce  a  sort  of  primitive 
homoeopath}*. 

Finally,  in  the  following  passage  we  find  an  ancient  and  very  humilia- 
ting trace  of  the  association  of  physicians  with  ordinary  tradesmen, 
together  with  a  nice  knowledge  of  human  nature  : 

"Various  are  the  desires  of  men :  the  wagoner  longs  for  wood,  the  doctor  for 
diseases" — an  example  of  the  proverbial  wisdom  of  the  Indians,  of  which  the  best 
specimens  are  to  be  found  particularly  in  the  Vedanta.1 

The  medical  mythology  of  the  Indians  names.-  as  the  god  of  physi- 
cians and  physician  to  the  gods,  Dhanvantari  (Danavantra,  Danavantri), 
who,  entwined  by  the  serpent  Vasuki,  leans  upon  Mandar,  the  mountain  of 
the  gods,  which  shoots  up  out  of  the  milky  sea.  According  to  tradition, 
he  was  sent  upon  the  earth  by  Indra,  when  the  world  was  sick,  and  here 
educated  man}'  physicians,  among  whom  was  Susruta,  son  of  the  Fakir- 
king  Visvamithra,  of  whom  Heine  sings  so  disrespectfully.  Brahma  him- 
self was  likewise  a  god  of  medicine,  as  well  as  his  son  Dakshas,  and  the 
two  sons  of  the  sun  Asvin,  together  with  Buden,  whose  mother,  the  wife 
of  Brahaspati.  conceived  him  in  adulter}-  with  Tschandra.  A  female 
'•specialist"  among  the  Indian  deities  was  Duti  ka  Takurani  (goddess  of  the 
small-pox). 

Numerous  priests  from  the  caste  of  the  Brahmans,  and  their  sub-castes, 
the  Vaisya  and  Vaidya,  officiated  as  teachers  of  medicine  and  as  physicians 
among  the  Indians.  The  Yaidyas,  as  the  higher  of  the  two  sub-castes,  in- 
cluded the  physicians  proper,  while  the  Vaisyas.  or  lower  caste,  furnished 
nurses.  Besides  the  practising  physicians,  there  were  the  ordinary  physi- 
cians of  princes  (who  had  also  kitchen-doctors),  as  well  as  others  who 
accompanied  them  to  war,  that  is  military  physicians.  In  like  manner 
there  were  veterinarians,  some  of  them  too  possessed  of  considerable  scien- 
tific attainments.     Indeed  even  the  ordinary  physicians  paid  some  atten- 

1.  Vedanta,  the  end,  object  or  philosophy  of  the  Veda.     It  is  a  mark  of  wisdom,  too, 

that  these  speak  not  only  of  a  dread  of  death,  but  also  of  a  fear  of  life,  which  is 
often  more  justifiable.  As  the  Indian  medicine  of  the  present  day  is  still  identi- 
cal with  the  ancient  doctrines,  so  the  religion  of  the  Indians  about  50  years  ago 
recurred  to  the  Vedanta,  or  Upanishads.  For  New  Bralnnanism  ( Brahmasamaj), 
begun  about  50  years  ago  by  Ram-Mohun  Roy,  and  advanced  by  Keshub  Chunder 
Sen  (died  1882),  is  nothing  but  a  reformation,  mutatis  mutandis.  All  of  which 
is  proof  of  the  tenacious  force  of  primeval  forms  of  culture. 

2.  Like  almost  all  people  who  live  in  a  state  of  nature,  the  Indians  practised  origin- 

ally a  worship  of  their  ancestors  (Max  Miiller),  from  which  may  have  developed 
everj-where  the  anthropomorphic  doctrine  of  gods. 


—  42  — 

tion  to,  or  rather  wrote  upon  veterinary  medicine,  e.  g.  Susruta.  A  penalty 
was  imposed  upon  the  fault}'  treatment  of  the  lower  animals,  and  in  India, 
even  to-day,  there  are  institutions  for  the  care  of  beasts  (introduced  by 
Azoka),  and,  strange  to  say,  for  even  vermin.  Indian  medical  practice  is 
distinguished  from  that  of  all  other  people  of  antiquity  by  the  fact  that  it 
recognizes  no  proper  specialists,  but  simply  physicians  practising  general 
medicine. 

The  study  and  practice  of  the  Indian  physicians,  however,  are  con- 
trolled by  regulations,  which  give  evidence  of  a  very  earnest  and  worths- 
conception  of  the  medical  profession,  and  embody  truths  acknowledged 
even  to-day  ;  yet  they  impose  upon  the  physician  certain  external  require- 
ments, the  estimation  of  which  is  characteristic  of  the  childlike  mind  of  the 
people,  though  the  adoption  of  some  of  them  would  seem,  if  not  necessaiy, 
at  least  useful,  for  us  of  the  present  day.  There  were  demanded  of  the 
physician  :  a  fine  person,  absence  of  passion,  decorum,  chastit}',  temperance, 
amiability,  veracity,  consideration  for  the  sick,  generosity,  diligence, 
earnestness,  freedom  from  boasting,  secrecy,  a  desire  for  knowledge,  which 
scorns  not  even  the  lessons  of  an  enemy,  and  above  all  reflection  and  inde- 
pendence of  thought.     Moreover  it  is  said  : 

"  A  physician  who  desires   success  in   his  practice,   his  own  profit,  a  good  name, 
and  finally  a  place  in  heaven,  must  pray  daily  for  the  welfare  of  all  living  creatures, 

first  of  the  Brahmans  and  of  the cow  (a  sacred  animal  also  among  the  Egyptians). 

.  The  physician  should  wear  his  hair  short,  keep  his  nails  clean  and  cut 
close,  and  wear  a  sweet-smelling  dress  (  for  this  we  require  no  special  directions  to-daj'). 
He  should  never  leave  the  house  without  a  cane  or  umbrella;1  he  should  avoid  espe- 
cially any  familiarity  with  women Let,  his  speech  be  soft,  clear,  pleasant. 

Transactions  in  the  house  should  not  be  bruited  abroad."  I  Haeser. )  The  last  advice 
is  found  also  in  the  Hippocratic  Oath. 

Medical  instruction,  which  comprises  the  learning  by  heart  of  the 
medical  doctrines  taught  orally.'  is  imparted  by  the  Brahmans,  and  begins 
in  early  youth,  a  regulation  which  we  find  again  among  the  Greeks,  and 
indeed  in  the  ordinances  of  Charlemagne.  The  pupil  must  first  select  a 
good  text-book  and  then  a  good  teacher.  Instruction  embraces  the  theory 
of  medicine  and  a  practical  course  at  the  bedside,  with  the  performance  of 
operations  on  gourds,  onions,  skins  filled  with  water  etc.  The  pupil  must 
begin  to  study  early  in  the  morning  (after  having  rinsed  his  mouth,  evacu- 


1.  It,  seems  we  must  ascribe  to  this  ancient  source  the  famous  doctors  -staff,  which 

plays  so  nice  a  role  of  grave  augury  in  Hogarth's  "Consultation".  The  yellow 
sun-shade  is  just  being  introduced  among  us 

2.  Even  at  the  present  day  the  Indian  students— the  Srotriyas — learn  the  Veda  from 

the  lips  of  their  Guru  (teacher),  never  from  a  manuscript,  and  still  less  from  a 
printed  edition.  Subsequently  they  again  teach  it  in  the  same  way  to  their  own 
pupils.  T heological  students  pursue  their  studies  for  eight  years,  and  learn  by 
heart  about  12  lines  a  day  I  Max  Midler).  Among  the  Greeks,  or  Hippocratists, 
and  the  scholars  of  the  age  of  Charlemagne,  the  methods  of  teaching  and  learning 
were  the  same,  and  hence  it  was  ordered  that  instruction  should  begin  at  an, 
early  period,  b?cause  in  youth  the  memory  is  strongest. 


—  43  — 

ated  his  bowels  and  prayed  to  the  cow  and  the  gods),  and  cease  late  in  the 
evening.  On  the  other  hand  the  teacher  must  be  extremel}'  careful  in  the 
selection  of  the  pupil,  and  very  conscientious  in  the  performance  of  his 
duties,  a  regulation  which  would  do  no  harm  to-day.  Conference  with 
fellow-students  is  enumerated  among  the'  means  adapted  to  give  the 
student  a  better  insight  into  his  studies. 

Old  Indian  medicine,  which  continues  to  be  practised  to-day,  is  exposed  to  the 
greatest  danger  from  the  colleges  erected  since  the  English  conquest.  Of  these,  the 
college  in  the  Pundjaub  was,  in  187 7,  raised  to  the  rank  of  a  university,  with  the 
right  to  give  diplomas.  The  number  of  physicians  of  the  old  and  new  school,  in  a 
population  of  about  225  millions,  amounted  in  1881  to  1 1 3,570  (1  in  2,250  inhabitants, 
as  in  Germany). 

The  position  of  the  medical  profession  is  regulated  b}'  law.  In  this 
way  e.  g.  are  determined  the  medical  honoraria,  among  which  is  reckoned 
a  place  after  death  in  the  heaven  of  Indra  (probably  in  those  cases, 
numerous  there  as  here,  where  no  payment  in  cash  is  possible).  Thus  too 
is  determined  the  penalty  for  errors  in  treatment  etc.  The  unfortunate, 
Brahmans,  relatives  and  friends  of  the  physician  are  entitled  to  treatment 
free  of  charge.  From  women  also  the  physician  ma}'  accept  food  only. 
On  the  other  hand  the  property  of  one,  who,  after  recovery,  will  not  pa}-  the 
proper  fee,  is  forfeited  entirely  to  the  physician.  The  Rajahs  were  expected 
to  watch  over  the  execution  of  these  ordinances,  and,  since  permission  to 
practice  in  any  place  was  granted  by  them,  they  often  among  the  Indians 
also  favored  unworthy  persons, 

"  Who  flatter  the  friends  of  the  patient,  and  are  careful  to  accept  a  small  honor- 
arium, and  to  ascribe  their  evil  results  to  the  improper  behavior  of  the  invalid,  not  to 
themselves"  (nor  to  their  predecessor  in  the  treatment  of  the  case>, — a  description 
which,  such  is  the  irony  of  history,  seems  drawn,  partially  at  least,  from  our  own 
daily  life.  Indian  humor  demands,  in  order  to  render  a  residence  agreeable,  that 
there  should  be  there  a  rich  man  who  lends  money,  a  Brahman,  who  expounds  the 
Vedas,  and  a  physician.  It  also  declares  that  the  physician  lives  by  patients,  as  the 
sacrificer  by  offerings,  and  the  discreet  man  by  fools. 

Midwives,  as  a  special  class,  seem  to  have  been  wanting  among  the 
Indians,  but  their  duties  were  performed  by  ordinary  women.1  In  some- 
what difficult  cases,  however,  as  among  the  Egyptians,  male  assistance  was 
procured,  in  which  respect  the  Indians  were  in  advance  of  the  Christians 
until  the  16th  century  ! 

The  sphere  of  Indian  medicine,  if  we  except  the  Greek,  is  the  most 
comprehensive  known  to  us  throughout  all  antiquity.  So  true  is  this  that 
it  has  at  different  times  awakened  question  as  to  the  genetic  connection  of 
the  two  sciences,  without,  however,  as  yet  affording  an y  evidence  of  such  a 
relation.  In  other  branches  of  science  the  same  question  arises  ;  e.  g. 
Greek  and  Indian  mathematics  present  many  points  of  similarity.  —  The 
medical  science  of  the  Indians  embraces  almost  all  our  branches  of  the 
present  day,  though,  in  accordance  with  their  early  period,  the}'  naturally 

1.    In  villages  the  wife  of  the  washerman  is  the  official  midwife.      (Max  Midler.) 


—  44  — 

are  not  made  such  specialties  as  at  present,  and  are  in  some  respects  incom- 
plete and  imperfect. 

The  Yayurveda  of  Susruta,1  a  physician  who,  in  consequence  of  his 
extensive  knowledge,  was  after  death  translated  among  the  gods,  and 
during  his  life  was  a  famous  teacher,  is  the  work  best  known  to  us.  This 
treatise  is  divided  into  six  sections  :  1.  Sutrasthana,  i.  e.  the  doctrine  of 
principles  ;  2.  Nidanasthana.  i.  e.  pathology  ;  3.  Sarirasthana,  doctrine  of 
the  body  ;  4.  Chikitsitasthana,  therapeutics  ;  5.  Kalpasthana,  doctrine  of 
antidotes  :.  (!.  Uttaratantra,  conclusion.  The  materials,  however,  are  not 
accurately  arranged  and  divided  according  to  this  plan.  The  contents  of 
this  work  form  the  basis  of  the  following  exposition  of  Indian  medicine. 

Its  general  pathology  points  out  as  the  characteristics  of  health,  a 
serene  spirit,  clear  sense  and  perfect  understanding,  uniform  warmth  from 
a  uniform  mixture  of  the  fluids  and  elements,  and  undisturbed  regularity 
of  the  secretions  and  functions  of  the  body.  Diseases  are  divided  into 
natural  and  supernatural  (the  work  of  demons),  with  subordinate  classes, 
as  accidental,  corporeal,  mental,  original  and  complicating,  secondary, 
internal  and  external.  Pain  is  considered  a  symptom  of  all  diseases,  and 
fever  a  symptom  of  all  severe  affections.  Etiologically,  diseases  are 
ascribed  to  an  unequal  or  perverted  action  of  the  five  common  elements, 
aether,  air,  fire,  water  and  earth.  These,  however,  in  the  first  place,  through 
the  influence  of  food,  season,  conditions  of  the  atmosphere  and  the  climate, 
form  proximate  causes  of  disease,  while  corruption  of  the  three  "elementary 
fluids",  bile,  mucus  and  air.  is  looked  upon  as  the  remote  cause.  The  latter 
fluid  has  a  retreat  between  the  hip  and  anus.  Above  the  hip  and  anus, 
and  beneath  the  umbilicus  is  the  seat  of  "the  concocted"';  between  the 
concocted  and  the  crude  is  the  seat  of  the  bile,  while  the  seat  of  the  mucus 
is  also  that  of  the  crude.  If  the  fluids,  separately  or  together,  are  cor- 
rupted, immediately  the  "corporeal  elements",  chyle,  blood,  the  flesh, 
cellular  tissue,  bones,  marrow  and  semen  are  also  morbidly  altered,  and 
therefore  the  disturbances  of  these  are  conceived  of  as  special  proximate 
causes  of  disease,  through  which  again  the  excretions,  urine,  sweat,  fa?ces, 
milk  and  menstrual  blood  are  atfected.  If  the  chyle  is  in  excess,  the  heart 
becomes  sodden  ;  if  the  blood,  the  vessels  become  swollen  and  the  limbs 
and  eyes  become  livid  ;  if  the  flesh  is  too  abundant,  the  buttocks,  face,  lips, 
sexual  organs  etc.  increase  in  size.  If  the  excretions,  faeces,  milk,  sweat, 
urine  and  menstrual  blood  are  increased,  these  corresponding  results  show 


1.  H.  Haas  declares  that  an  old  Indian  physician  Susruta  never  existed,  that  the 
work  which  bears  his  name  originated  in  the  16th  century  and  is  founded  upon 
Arabian  translations  and  elaborations  of  Hippocrates.  The  name  Hippocrates 
in  Arabic  is  Bucrat,  from  which  is  formed  the  Sanscrit  Susruta.  Conversely, 
Wise  declares  that  Hippocrates,  on  his  travels,  robbed  Susruta  of  such  of  his 
teachings  as  belong  to  the  latter.  Thus  uncertain  is  our  knowledge  of  the  old 
Indian  medical  works !  According  to  Max  Muller  the  most  ancient  Sanscrit 
manuscripts  are  of  the  15th  century  A.  I). 


—  45  — 

themselves  ;  swelling  and  pain  in  the  abdomen,  enlargement  of  the  breasts, 
increased  flow  of  milk  with  tenderness,  a  bad  odor  and  itching  of  the  skin, 
profuse  sweating,  debility,  frequent  and  painful  urination,  and  finally 
inflammation  of  the  lower  portions  of  the  body.  Other  evils  arise  from 
draughts  of  air,  water,  the  passions,  bad  habits  of  life,  insufficient  clothing, 
unclean  dwellings  etc. 

Worms  also  play  an  important  part  in  the  etiology  of  diseased  condi- 
tions of  the  body  or  its  parts,  and  the  existing  superstition  to  this  effect, 
among  both  the  masses  and  the  "  educated  ",  probably  had  its  origin  in  this 
Indian  idea. 

The  Indians  were  acquainted  with  numerous  diseases  belonging  to  the 
department  of  surgery,  such  as  fractures,  lithiasis,  hernia,  abscesses,  ulcers 
etc.     Under  the  latter  head  syphilis  is  thus  described  : 

"In  women  the  humors  resulting' from  venereal  excitement  involve  the  sexual 
organs  and  occasion  very  tender,  foul-smelling,  fungous  growths  (condylomata),  which 
secrete  a  slimy  blood The  cause  of  nlcers  of  the  penis  is  too  vigorous  inter- 
course with  a  woman  whose  vagina  is  diseased Remedies  are  sulphate  of 

copper  and  red  arsenic.  If,  however,  the  member  already  smells  offensive,  it  must  be 
cauterized  with  a  red-hot  probe."  Phimosis,  paraphimosis,  orchitis  and  epididymitis, 
fistula  in  ano,  hemorrhoidal  tumors,  tumors  in  general,  together  with  lepra,  elephan- 
tiasis and  wounds  are  also  described. 

In  the  line  of  instruments,  scalpels,  forceps,  specula,  saws,  needles, 
moxas,  the  actual  cauteiy,  enema-syringes  and  animal  bladders  fitted  with 
tubes,  b}-  means  of  which  injections  were  made. into  the  bladder,  just  as  in 
the  present  day,  etc.  are  known,  but  the  hand  is  very  properly  distinguished 
as  the  best  of  all  instruments.  In  respect  to  form,  too,  instruments  are 
adapted  to  the  requirements  of  every  operation.  Operative  surgery  attained 
such  a  position  among  the  Indians  that  they  did  not  shrink  from  the 
greatest  and  most  difficult  operations.  We  may  notice  first  the  dressing 
of  wounds,  concerning  which  the  Ramayana1  says  : 

"  The  wounded  in  battle  should  be  quickly  picked  up,  carried  into  a  tent,  the 
bleeding  stayed,  and  upon  the  wounds  should  be  dropped  an  anodyne  oil  with  the 
juice  of  healintr  herbs." 

Next  we  may  quote  the  apothegm  : 

"The  fire  cures  diseases  which  cannot  be  cured  by  physic,  the  knife  and  drugs, " 
— a  saying  which  reminds  us  of  the  well-known  Hippocratic  aphorism. - 

Under  this  head  are  embraced  also  the  minor  surgical  operations,  such 
as  venesection,  extraction  of  arrow-heads,  piercing  of  the  ears,  opening  of 
abscesses — in  those  of  the  breasts  avoiding  the  milkducts — besides  check- 
ing hemorrhage  by  pressure  and  cold,  the  bloody  suture  and  paracentesis 
abdominis.     We  observe,  moreover,  that  attention  was  paid  to  even  the 

1.  The  Ramayana  is  the  greatest  of  the  Indian  epic  poems,  ascribed  to  the  poet 

Valmiki,  who  is  supposed  to  have   flourished  about  B.  C.  250.     It  contains  no 
less  then  24,000  verses,  devoted  to  the  history  of  Rama.     (II.) 

2.  "Qua?    medicamenta  non  sanant,   ea  ferrum  sanat;     quae  ferrum   non  sanat,  ea 

ignis   sanat;  qua'  vero  ignis  non  sanat,    ea  insanabilia  reputare  oportet."     (H. ) 


—  40  — 

lodging  and  situation  of  those  operated  upon.  The  Indians  also  knew  and 
practised  (though  not  very  satisfactorily)  the  operative  treatment  of  hare- 
lip, oto-,  cheilo-,  and  rnino-plasty,  herniotomy,  laparotomy,  the  extirpation 
of  tumors,  removal  of  the  ovaries  in  women  in  order  to  restrain  their  lust 
(an  operation  practised  also  for  the  Lydian  kings), — another  "modern'' 
operation  so  early  performed  !  —  the  operative  treatment  of  fistula  in  ano, 
cataract,  and  other  operative  procedures.  Among  the  latter,  however,  we 
may  distinguish  lithotomy  in  men.  For  the  latter  the  high  operation  was 
prescribed,  while  in  women  the  incision  was  to  be  made  through  the  urethra 
or  vagina  : 

"The  physician  presses  with  his  hand,  passing  from  the  navel  of  the  patient 
downwards,  until  the  stone  has  slipped  down.  Then  he  carries  the  oiled  fingers  (the 
left  index  and  middle  finger,  the  nails  of  which  have  been  cut  close). into  the  anus, — 
passing  along  the  raphe — stretches  earefulW  but  forcibly  the  tissues  between  the  penis 
and  anus,  grasps  the  insensitive,  undistended  and  smooth  bladder,  pressing  strongly 
upward  with  the  two  fingers,  so  that  the  stone  projects  as  a  hard  tumor  above  the 
symphysis  pubis.  At  this  point  he  makes  an  incision  and  extracts  the  stone.  The 
physician  should  take  pains  to  avoid  splitting  or  breaking  the  stone,  for  a  single 
fragment  left  behind,  even  though  it  be  small,  grows  up  anew.  Therefore  the 
physician  should  draw  out  the  entire  stone  with  the  forceps." 

In  operative  midwifery,  also,  the  Indians  displa}-ed  important  know- 
ledge. Besides  Caesarean  section  upon  women  who  die  in  the  latest  period 
of  pregnancy,  cephalic  and  podalic  version,  embryotomy,  embryulcia, 
craniotomy  etc.  were  performed. 

"  When  the  child  cannot  be  brought  forth,  the  physician  may  employ  the  knife  in 
such  a  way  that  he  by  no  possibility  cuts  a  living  child  with  it:  for  if  the  child  is 
injured,  the  physician  may  destroy  both  mother  and  child  together.  Having  cheered 
up  the  woman,  he  then  grasps  in  his  hand  a  sickle-shaped  knife,  cuts  in  pieces  the 
head  of  the  (dead)  child,  drags  down  the  cranial  bones,  seizes  with  a  hook  the  breast 
or  shoulder  of  the  child,  and  draws  it  out  by  the  cut  head,  the  eje  or  the  chin.  If 
the  shoulder  is  near,  he  cuts  off  the  arm  close  up,  makes  an  incision  into  the  abdomen, 
distended  like  a  bellows  or  filled  with  air,  extracts  the  intestines.,  and  draws  out  the 
now  pliant  child,  or  drags  down  the  hip  bones.  Whatever  limb,  however,  the  physi- 
cian seizes  must  be  cut  off  and  drawn  out,  and  he  must  preserve  the  woman  carefully 
from  injury." 

The  history  of  generation  and  of  development,  ordinary  midwifery  and 
gynaecology,  likewise  enjoyed  the  attention  of  the  Indians.  The  time  of 
menstruation  was  remarkabby  beautifully  and  poetically  (as  the  subject 
deserves),  pointed  out  as  the  period  best  suited  for  conception, 

"  For  then  the  mouth  of  the  womb  is  open,  like  the  flower  of  the  water-lily  to  the 
beams  of  the  sun  ;  " 

probably  because  the  Indians  assumed  that  the  embryo  originated  from  the 
union  of  the  "delicate"  male  semen  and  the  "fiery"  menstrual  blood.  If 
the  former  predominated  a  male  was  produced  ;  if  the  latter,  a  female  ; 
if,  however,  both  are  equal,  an  androgynous  individual  was  the  result. 
The  man  attains  puberty  at  the  age  of  25  years,  the  woman  at  12.  After 
conception  is  accomplished  the  emmyo  fixes  itself  in  the  first  month  ;  in 


the  second,  it  becomes  oval  or  spherical  :  in  the  third,  the  head  and  ex- 
tremities begin  to  manifest  themselves  ;  in  the  fifth,  the  outlines  of  the 
trunk  and  head  are  visible  and  the  intellect  develops  ;  in  the  sixth  and 
seventh,  these  become  more  evident;  in  the  eighth,  the  child  becomes  rest- 
less ;  in  the  ninth,  tenth,  eleventh  or  twelfth,  it  is  born.  Before  birth, 
however,  the  child  turns  itself  over  (cidbute),  i.  e. 

"The  child,  who  sat  with  the  head  erect,  the  mouth  directed  toward  the  spine, 
praying  therewith  to  God,  and  beholding  the  heaven,  the  earth,  and  the  regions 
beneath," 

inverts  itself,  so  that  the  head  now  lies  beneath,  a  doctrine  which  recently, 
as  the  result  of  investigations  upon  the  changes  of  position  of  the  foetus 
during  pregnancy,  has  received  confirmation  and  acceptance,  although  of 
a  more  limited  and  precise  character.  Regular  accouchement  requires  the 
aid  of  four  stout  women  only.  If,  however,  the  position  of  the  child  is 
faulty  (in  which  are  included  footling,  back,  breech,  side  and  breast  presen- 
tations, as  well  as  presentations  of  the  arms,  head,  hands  and  feet  together), 
it  must  be  either  improved  by  the  physician,  or  the  labor  must  be  termin- 
ated artificial]}'.  The  same  must  be  done  in  the  case  of  an  unusually  large 
head,  in  contracted  pelvis,  or  in  false  positions  incapable  of  correction. 
The  sexual  life  and  sphere  of  woman,  in  conditions  of  both  health  and 
disease,  among  the  Indians,  as  among  all  other  oriental  people,  are  subjects 
of  earnest  study. 

Their  special  pathology  includes  among  internal  diseases,  rheumatism, 
gout,  haemorrhoids,  inflammations,  fever,  catarrh,  diabetes  mellitus  (first 
mentioned  among  the  Greeks  by  Demetrius  of  Apamea),  diarrhoea,  jaundice, 
cough,  verminous  diseases,  epilepsy,  mania  a  potu,  the  exanthemata,  djsen- 
tery,  phthisis  etc. 

Diagnosis  is  effected  b}'  the  aid  of  the  senses  and  by  examination  of  the 
sick,  and  the  physician  was  expected  to  pay  especial  attention  to  the  pulse, 
the  bodily  temperature,  the  color  of  the  skin,  the  urine  and  faeces,  the  eyes, 
the  strength  of  the  voice,  and  the  noise  of  the  respiration  (!). 

The  symptomatology  of  the  Indians  is  very  complete,  though  the 
oriental  descriptions  sound  strange,  and  the  forms  of  disease  have  no 
analogues  with  us.  "Disease  of  the  heart"  manifests  different  symptoms 
according  to  its  origin  : 

"  If  the  heart-disease  lias  originated  from  the  air,  the  heart  becomes  strained  and 
tossed  to  and  fro,  it  is  agitated,  lacerated,  rent  and  shaken.  Thirst,  heat,  warmth, 
inflammation  and  cardiac  fatigue,  ante  in  bilious  heart-disease.  Flatulence,  des- 
pondency, sweating,  dryness  of  the  mouth,  weight,  salivation,  disgust  for  food,  stupor, 
lack  of  passion,  a  sweet  taste  in  the  mouth,  arise  when  the  heart  is  diseased  from 
mucus.  Abdominal  colic,  expectoration,  rigors,  pain,  eructation,  vertigo,  disgust  for 
food,  redness  of  the  eyes  and  emaciation  11133-  arise  when  the  disease  depends  upon 
worms.  Vertigo,  lassitude,  faintness  and  emaciation  are  symptoms  when  this  disease 
originates  in  worms,  but  they  also  appear  in  patients  affected  with  both  worms  and 
mucus." 

The  therapeutics  of  the  Indians  are  guided  b}'  the  curabilit}-  or  incur- 
ability of  the  disease.     If  the  disease  belongs  to  the  incurable  class  the 


—  48  — 

ph}Tsicians  do  not  take  the  patient  under  treatment  at  all,  but  advise  him 
plainly,  honestly  and  unselfishly, 

"  To  go  forth  upon  a  narrow  foot-pat li  to  the  invisible  north-eastern  tongue  of  land. 
to  live  on  water  and  air,  until  this  earthly  tabernacle  sinks  down  and  his  soul  is 
united  with  God."     (Haeser. ) 

Herodotus  similarly  relates:  "Whosoever  among  the  Indians  becomes  sick  goes 
out  into  a  desert  and  lays  himself  down  there.  No  one  troubles  himself  about  him, 
whether  he  be  sick  or  dead."1 

If,  however,  the  disease  is  curable,  attention  must  be  paid  in  the  cure  to 
the  disease  itself,  the  season,  the  organic  fire,  the  age,  bodily  habit,  the 
strength,  the  intelligence,  —  according  to  the  Indian  ideas  the  stupid  are 
cured  more  quickly  than  the  intelligent,  because,  thinks  the  open-hearted 
Susruta,  they  are  more  obedient.  —  nature,  idiosyncrasies,  remedies  and  the 
regions  of  the  earth.  In  :<  disease  of  the  heart"  the  cure,  with  all  due  regard 
to  the  above  circumstances,  is  managed  somewhat  as  follows  : 

"  If  the  heart  is  diseased  through  the  air,  the  patient  should  be  first  of  all 
anointed,  then  take  an  emetic,  and  thereafter  a  drink,  consisting  of  numerous  ingredi- 
ents. When  now  he  is  regularly  "purified",  he  is  given  food,  consisting  of  old  rice 
in  meat-broth  with  butter,  then  an  enema,  and  finally  another  emetic.  If  the  heart  is 
corrupted  by  mucus,  the  patient  first  of  all  takes  an  emetic,  then  the  drink  recommended 
in  heart-disease  depending  upon  air.  next  antidysenteric  food,  or  a  purgative; 
finally — the  physician  skilful  in  the  administration  of  enemata,  gives  him  an  enema 
of  oil  and  Pavonia  odorata."  2 

The  Materia  Medica  of  the  Indians  is  most  copious,  in  fact  almost  as 
rich  as  ours  of  to-day.  It  embraces  remedies  from  the  animal,  vegetable 
and  mineral  kingdoms,  together  with  the  arts  of  magic.  Remedies  are  used 
both  externally  and  internally  ;  they  are  divided  into  pharmaco-dynamic 
classes,  and  are  either  simple,  or  (as  is  more  frequently  the  case)  exceed- 
ingl}"  complex  in  their  nature.  Venesection  and  cupping,  especially  the 
former,  play  an  important  part,  as  well  as  means  for  exciting  and  strength- 
ening the  desires  and  delights  of  love  in  both  the  feeble  and  the  strong — a 
genuine  oriental  specialty.  Even  inhalations  into  the  mouth  and  nose  by 
the  aid  of  tubes  are  known.  The  ancient  Indians  had  hospitals.  Inocula- 
tion of  the  natural  and  artificial  virus  of  sinall-pox  was  practised  in  a 
prophylactic  view.     The  Brahmans  always  performed  this  operation  in  the 


1.  Even  at  the  present  day  persons   hopelessly  ill,  or  supposed  to  be  in  a  hopeless 

condition,  are  carried  to  the  banks  of  the  Ganges,  where  their  relatives  fill  the 
mouth  and  nose  of  the  invalid  with  the  sacred  mud  of  this  stream,  and  then 
abandon  him  to  the  waters.  If  the  persons  thus  exposed  chance  to  recover,  they 
atje  no  longer  acknowledged  by  their  relatives,  but  are  regarded  as  dead.  They 
are  then  compelled  to  take  refuge  in  the  "  Villages  of  the  dead  men"  (found  in 
the  vicinity  of  large  cities),  and  there  to  prolong  a  wretched  life.  (Prof.  Ed. 
Hildebrandt,    "  Reise  urn  die  Erde",  6  ed.,  Berlin,  1879). 

2.  Such  "Indian  cures"   frequently  enough  with  us  also  attract   the  common  people> 

and  from  their  manifest  activity  procure  a  thriving  business. 

The  "  Pavonia  odorata"  is  an  Indian  plant  of  the  order  of  Malvacea\      (H. ) 


—  49  — 

beginning  of  the  warm  season.  The  skin  was  rubbed,  a  few  incisions  made, 
and  virus  of  the  preceding  year,  with  which  pledgets  of  cloth  had  been 
saturated,  was  bound  upon  the  abraded  surface.  The  persons  thus  inocu- 
lated were  compelled  to  remain  in  the  open  air  (Indian  method  of  inocula- 
tion). Boys  were  inoculated  upon  the  outside  of  the  forearm,  girls  upon 
the  upper  arm.  Vaccination  is  now  obligatory  in  the  larger  cities,  but  else- 
where the  old  plan  is  generally  carried  out. 

Dietetics  are  carried  to  the  extreme,  and  carefully  regulated.  The 
Indians  are  forbidden  to  eat  meat. 

Their  knowledge  of  toxicology  is  considerable.  Such  an  acquaintance 
too  with  natural  history  as  is  necessary  to  a  knowledge  of  remedial  agents, 
is  possessed  by  the  Indians  in  a  remarkable  degree.  On  the  other  hand, 
anatomy  forms  the  weakest  side  of  Indian  medicine. 

This,  however,  ought  not  to  occasion  much  surprise  when  we  consider 
the  prohibition  of  contact  with  the  dead — an  offence  always  to  be  expiated, 
though  only  lightly.  The  method  of  preparing  bodies  and  the  sole  instru- 
ments employed  in  this  process  are  very  original,  but  certainly  not  adapted 
to  afford  a  good  insight  into  the  structure  of  the  human  body. 

"Let  the  physician  leave  a  corpse  fastened,  together  with  its  receptacle,  in  a 
brook,  to  macerate  in  a  clear  place,—  a  corpse  which  has  a  body  uninjured,  uncor- 
rupted  by  poison,  unshaken  by  chronic  disease,  unhandled  a  hundred  times,  un- 
clothed, —  and  draw  it  out  when  maceration  is  completed.  The  corpse  at  the 
expiration  of  seven  days  should  then  be  rubbed  with  pieces  of  bark  ;  he  can  then 
with  his  eyes  see  the  skin  and  all  the  external  and  internal  parts.'' 

These  pieces  of  bark1  form  the  entire  dissecting  case  of  the  Indians. 
From  such  methods  of  preparation,  singular  views  in  regard  to  anatomy 
ought  not  to  surprise  us.  Accordingly  the  human  bod}7  consists  of  six 
members  (the  four  extremities,  the  trunk  and  head),  and  has  7  membranes, 
7  segments,  70  vessels,  500  muscles,  900  sinews,  300  bones,  212  joints,  but 
only  24  nerves,  and  9  organs  of  sense,  etc.  The  vessels  contain  not  only 
blood,  but  they  carry  also  bile,  mucus  and  air  about  through  the  body. 
Of  the  nerves,  which  take  their  origin  from  the  navel,  10  ascend,  10  descend 
and  4  run  transversely.  As  soon  as  the  10  ascending  nerves  reach  the 
heart,  however,  they  divide  into  30. 

The  physiology  of  the  Indians  supplies  something  more  than  such 
fanciful  theories.  They  distinguish  excretion  and  digestion,  chyme  and 
ch}-le,  from  the  latter  of  which  the  blood,  after  birth,  originates.  The 
natural  heat  is  regulated  by  the  nerves,  which  also  control  the  motion  of 
the  breath,  urine,  blood,  semen,  and  menstrual-blood  in  their  several  chan- 
nels. They  assume  the  existence  of  a  vital  force  which,  it  is  true,  is  recog- 
nized by  its  effects  only,  but  which  animates  all  portions  of  the  body  etc. 

To  sum  up  our  judgment  of  Indian  medicine,  we  must  assign  to  it,  at 
all  events,  a  superiority  over  the  Egyptian  and  the  Jewish  ;  indeed,  it  ma)7 
claim   even  the  very  first  rank  among  those  examples  of  medical  culture 

1.    Wise  says  a  brush  made  of  reeds,  hair,  or  bamboo-bark.     (H.) 
4 


—  50  — 

which  have  not  experienced  a  continuous  development.  That  it  was  not  far 
behind  Greek  medicine,  both  in  the  extent  of  its  doctrines  and  in  its  inter- 
nal elaboration,  furnishes  us  only  a  very  superficial  comparison.1  It  can- 
not fail  to  extort  our  admiration  when  we  consider  the  very  early  period  in 
which  it  developed  and  attained  so  high  a  grade,  and  when  we  take  into 
account  also  the  people  who  accomplished  so  great  a  work.  Yet  we  can 
never  measure  it  by  our  standard  of  to-day.  Such  a  course  would  be  as 
false  as  unhistorical. 

V.     THE  MEDICINE  OF  THE  CHINESE  AND  JAPANESE. 

If  we  may  consider  it  a  characteristic  of  the  ancient,  as  well  as  modern 
Indo-Ger manic  peoples,  that  they  have  all  developed  after  the  type  of  the 
organic  kingdom,  in  other  words,  that  their  civilization  has  sprung  up.  de- 
veloped, bloomed,  decayed,  and  finally  perished  (sometimes  together  with  the 
people  itself)  ;  on  the  other  hand,  the  Mongolian  races  have  followed  the 
type  of  the  inorganic  kingdom.  They  and  their  civilization,  like  mountains, 
having  attained  a  certain  limited  height,  have  existed  there,  inflexible  and 
almost  unchanged,  for  thousands  of  years.  Thus  they  are  more  en- 
during, and  defy  longer  time  and  destruction,  so  that  up  to  the  present 
time  the  dictum  that  to  stand  still  is  to  die.  seems  in  their  case  to 
lack  verification.  Their  very  inflexibility  preserves  them  from  the  diseases 
of  development,  and  from  ultimate  destruction.  The  germ  of  their  civiliza- 
tion and  their  forms  remain  unchanged.  This,  however,  has  been  possible 
only  from  the  fact  that  they  have,  up  to  the  present  time,  been  able  to 
preserve  themselves  from  intellectual,  and.  if  possible  still  more  strictly, 
from  physical  intermixture  with  foreign  races. - 

The  people  of  Kong-fu-tse  (died  B.  C.  479),  the  Chinese,  quick-witted 
indeed  and  fanciful,  but  wanting  in  art.  in  the  higher  sense  of  that  term. 
are  commonly  regarded  as  the  type  of  the  Mongolian  race.  Their  literature 
is  apparently   immense,  though   but   little  of  it  is    known  to  the  outside 

1.  A  transfer  of  Greek  medicine  to  India  is  still  assumed,  so  that  the  originality  of 
Indian  medicine  would  be  doubtful.  In  support  of  this  assumed  transmission 
are  adduced  the  facts  that,  even  in  antiquity,  intercourse  with  farther  Asia 
occurred  (Solomon,  Megasthenes,  Alexander  the  Great,  etc. ),  and  that  active 
commercial  associations  existed  even  in  Roman  times.  A  number  of  gold  darics. 
found  near  Benares  some  few  years  ago,  furnish  positive  evidence  of  such  inter- 
course. Pliny,  however,  asserts  that  more  than  twenty  millions  of  dollars  in  gold 
and  silver  flowed  into  India  annually  in  the  way  of  barter.  (Max  Muller. ) 
Actual  transmission  of  scientific  information  from  Greece  to  India  on  the  subject 
of  astronomy  can  be  proven,  according  to  Muller.  Aryabhata  (A,  D.  47tj)  taught 
the  revolution  of  the  earth  upon  its  axis,  and  explained  the  origin  of  solar  and 
lunar  eclipses;  indeed  actual  Greek  names  are  found  in  the  poet  Kalidasa,  whose 
poetry  displays  evidences  of  Grecian  influence.  Hence  Muller  speaks  of  the 
"Indian  era  of  the  renaissance". 

2.  The  recent  discovery  of  Roman  imperial  coins  in  the  vicinity  of  Canton,  is  satis- 
factory evidence  of  commercial  intercourse  between  the  ancient  Romans  and 
the  Chinese. 


—  51  — 

world.1  Judges  of  it,  like  Von  der  Gabelentz,  affirm,  however,  that  it 
demonstrates  the  activit}'  of  the  general  law  of  development,  even  among 
the  Mongolians,  though  the  course  of  this  development  may  be  slower  than 
among  the  Indo-GTermanic  peoples. 

That  the  Chinese  possess  an  ancient  civilization,  entirely  characteristic, 
and  in  its  way  even  highly  developed,  is  well  known.  While,  however,  they 
themselves  place  the  beginning  of  their  political  life  man}-  thousand  years 
before  the  Christian  era,  it  is  certain  that  their  reliable  history  reaches  back 
no  farther  than  a  few  centuries  before  Christ.  They,  however,  ascribe  to 
the  emperor  Huang-ti  (B.  C.  2637)  a  treatise  on  medicine  still  extant,  and 
entitled  Nuy-kin  (Neiszin,  Heidsin),  probablj"  a  forgery  of  the  beginning 
of  our  era.  In  like  manner  they  ascribe  to  the  emperor  Chin-nong  (B.  C. 
2699)  a  kind  of  pharmacopoeia  or  catalogue  of  the  herbs  of  the  celestial 
kingdom,  and  they  further  relate  that  Tsehing-wang,  the  second  emperor 
of  the  Tsin  dynasty  (founded  by  Tschwang-siang-wang,  the  builder  of  the 
Chinese  wall,  B.  C.  248),  authorized  the  destruction  of  all  books,  except 
those  treating  of  agriculture  and  medicine,  in  order  to  abolish  every  tradi- 
tion of  custom  and  law.     The  whole  story,  however,  is  very  untrustworthy. 

The  ancient  and  unlimited  liberty  of  choosing  one's  occupation  in 
China,  which  contrasts  so  strongly  with  our  own  custom,  has  resulted  in 
making  the  medical  profession  perfectly  enormous.  From  the  earliest 
times,  therefore,  there  have  been  found  several  physicians  in  every  village, 
as  has  recently  become  the  case  with  us.  In  China  any  person  ma}-  bo  a 
physician  to  the  poor  and  the  faithful  (that  is  to  the  masses  abandoned  to 
ever}'  impostor),-  without  having  given  any  previous  evidence  of  his  profes- 
sional competency.     Anyone,  too,  may  assume  the  title  of  physician. 

Recently,  however,  the  Chinese  government  has  had  its  eye  upon  the  physicians. 
"The  doctors",  so  runs  an  edict  of  1882,  "have  the  bad  habit  of  not  visiting  their 
patients  before  one  o'clock  in  the  afternoon.  Some  of  them  even  smoke  opium  and 
drink  tea''  (we  should  say  spirits)  "until  late  in  the  evening.  These  are  abuses, 
which  the  government  will  under  no  circumstances  permit.  Doctors  must  visit  their 
patients  at  all  times;  if  necessary,  they  must  visit  them  several  times  a  day.  They 
must  think  more  about  them,  and  less  about  their  fees.  The  public  and  all  officials 
are  notified  that  a  physician,  who  does  not  come  at  once  when  called,  can  claim  only 
the  half  of  his  fee  and  his  expenses.  If  you  physicians  put  off  your  calls,  you 
manifest  your  godlessness  and  sin  against  yourselves."     ("Unsere  Zeit".) 

The  court-physicians  only,  as  a  matter  of  precaution,  are  compelled  to 
pass  an  examination  before  a  college  at  Pekin.  Physicians  belonging  to  old 
(medical)    families   are  held  in  special  esteem.     There  are  also  in  China 


1.  According  to  Kwotse  Kieti,  Pekin  possesses  an  immense  library,  founded  in  the 
12— 13th  century.  Every  city  has  its  state-library  under  the  administration  of 
mandarins.  Besides  these  there  are  private  and  circulating  libraries,  the  latter 
of  which,  in  contrast  with  our  similar  institutions,  are  patronized  only  by  the 
lowest  classes,  and  chiefly  by  women  and  girls.  Chinese  ^host-stories  and  love- 
tales,  romances,  plays  etc.  form  the  literary  provender  of  the  patrons  of  the 
circulating  libraries  even  in  China. 


—  52  — 

special  dentists,  oculists  and  minor  surgeons  (Vay-ko),  whose  residences 
are  distinguished  by  firm-names  and  signs  as  with  us  ;  only  the  practical 
Chinese,  among  whom  newspaper  advertising  is  as  yet  not  greatly 
developed,  add  thereto  the  grateful  certificates  of  their  convalescent 
patients  and  similar  matters,1  as  charlatanical  recommendations — a  custom 
which  has  not,  at  least  as  yet,  come  into  vogue  with  us. 

As  regards  business  signs,  it  is  said  :  "  From  the  number  of  bright-colored  pictures 
we  have  to  deal  with  a  man  of  consideration.  On  one  side  of  his  doorway  we  read  : 
'Twai  IV.,  great-grandson  of  Twai  I.,  of  Ningpo,  whose  specialty  is  the  treatment  of 
fractures  and  dislocations.'  The  other  side  shows  us  the  worthy  man  himself,  as,  with 
three  fingers  and  an  air  of  importance,  he  feels  the  pulse  of  a  patient.  Beneath  are 
the  words:  '  Excellent  ability  inherited  from  his  ancestors',  a  notification  which  rarely 
fails  of  its  effect  upon  the  Chinese." 

In  China,  however,  as  in  certain  parts  of  Switzerland,  ph}sicians  are 
also  in  some  degree  apothecaries.  The  visits  to,  and  examinations  of  the 
wealthy,  which  often  last  for  hours  —  though  in  the  case  of  the  poor  they 
are  superficial  enough,  —  are  very  reasonable  in  price  (about  25  cents),  and 
the  prescriptions  furnished  are  remarkably  large  and  long.  The  Chinese 
have  no  public  hospitals,  for  everyone,  even  the  extremely  poor,  would 
consider  it  a  great  disgrace  according  to  Chinese  customs,  if  he  did  not 
himself  take  care  of  his  sick  dependants  or  relatives.  Piety  towards  the 
deceased  members  of  one's  family  is  so  great  that,  even  in  the  notices  of 
death,  the  remedies  emplo3-ed  in  the  special  case  are  given,  in  order  to 
guard  against  reproach.  The  Chinese,  from  their  conservative  disposition, 
employ  their  own  physicians  even  in  foreign  countries,  e.  g.  in  America, 
where,  however,  these  physicians  are  cunning  enough  to  provide  themselves 
with  the  title  of  doctor  and  a  white  clientele. 

"The  Chinese  are  even  greater  fatalists  than  the  Turks.  Hence  they  always  pre- 
fer to  cover  all  possible  parts  of  the  body  with  green  plaster,  and  to  swallow  down 
mighty  mixtures,  fearfully-  and  wonderfully  brewed,  which  for  ever  so  many  hundred 
years  have  been  mentioned  as  infallible  remedies.  It  is  only  in  dangerous  cases  that 
they  call  upon  their  quack-doctors,  of  whose  cures  the}'  boast,  without  ever  blaming 
them  for  their  failures  (a  habit  which  would  be  very  agreeable  among  us!),  which  the 
will  of  the  gods  has  always  determined.  As  soon,  however,  as  a  foreign  physician 
appears  at  the  bedside  they  forget  that  medicine  is  an  uncertain  science,  and  expect 
certain  success.     On  the  whole  the  Chinese  despise  our  science." 

Chinese  apothecaries,  before  they  can  canyon  their  business,  must 
have  passed  an  examination,  and  must  exhibit  a  diploma  from  the  examin- 
ing board.  Powerful  remedies,  like  opium,  arsenic  etc.  are  forbidden  to  be 
dispensed  by  them  without  the  prescription  of  a  physician.  The  pharma- 
cies are  fully  supplied  with  the  necessar}-  drugs  (a  Chinese  pharmacopoeia 
contains  650  different  kinds  of  leaves),  and  they  are  kept  in  a  very  orderh' 


1.  Many  physicians  nail  up  on  the  front  of  their  houses  the  plasters  used  by  their 
patients  and  then  returned  to  the  physician,  and  this  process  is  continued  until 
finally  the  whole  house  is  covered.  They  also  wear  large  spectacles,  made  of 
window-glass,  to  convey  the  impression  that  they  are  savants. 


—  53  — 

condition.     Besides  pills  as  large  as  musket-balls,  their  proprietors  also 
prepare  love-potions  etc. 

The  pharmacies  also  have  curious  kinds  of  signs,  e.  g.  a  row  of  lanterns  over  the 
entrance,  adorned  on  all  sides  with  figures,  flowers  and  characters,  while  from  within 
comes  a  powerful  odor.  Over  the  door  is  the  name  of  the  pharmacy,  "  The  Double- 
headed  Eagle",  and  within  are  found  tablets  with  notices  like  the  following:  "All 
medicines  from  every  province  of  the  kingdom  for  sale";  'Powders  carefully 
mixed"  etc.  The  prescriptions  of  physicians  are  prepared  Iry  the  apothecary,  as  with 
us,  but  the  latter  combines  also  with  his  business  the  occupation  of  fortune-telling. 

Medical  study  consists  in  mechanically  learning  by  heart  the  old 
Chinese  medical  works,  and,  where  possible,  the  inherited  knowledge  of 
remedies,  all  in  accordance  with  the  genuine  Chinese  maxim  :  u  The  older 
the  better." 

Chinese  surgery  (Wae-ka)  embraces  the  practice  of  acupuncture  (our 
Baunscheidtism),  which  is  regarded  as  a  universal  remedy,  and  has  for  its 
object  the  quickening  of  the  "  vital  spirits."  It  is  practised  by  twisting  or 
driving  in  a  needle  inserted  into  the  body,  and  in  the  first  case  is  called 
Nedschibari,  in  the  last,  Udschibari.  By  this  operation  a  free  passage  is 
supposed  to  be  made  for  the  "winds".  Besides  this,  Chinese  surgery  in- 
cludes the  application  of  moxas,  cupping,  inoculation  (a  crust  upon  cotton 
in  the  nose  !),  which  the  physician  Go-mei-schan  is  said  to  have  invented 
about  A.  D.  1000,  paracentesis  of  the  eye  and  bleeding.  The  latter  opera- 
tion is,  however,  practised  rarely,  and  is  performed  with  a  potsherd  or  small 
lancet,  after  which  tallow  and  oil  are  applied  to  the  wound  without  any 
bandage.  Enemata  are  not  employed,  since  they  are  offensive  to  the 
modesty  of  the  dignified  Chinese.  Under  ordinary  circumstances,  they 
make  shift  with  poultices  —  in  this  line  cats'  liver  and  fowls'  entrails  are 
specially  popular,  —  while  fractures  are  treated  b}-  extension.  Kneading 
of  the  muscles  (Massage),  which  is  also  said  to  have  been  in  use  2000  years 
before  Christ  (though,  according  to  Wernich,  of  Japanese  origin),  is  like- 
wise practised.  The  Chinese  also  claim  to  have  been  able  for  thousands 
of  years  to  produce  anaesthesia  by  means  of  the  preparation  Mago.  Inocu- 
lation of  modified  small-pox  too  has  recently  been  practised  by  them.  Their 
surgeons  are  extremely  ignorant,  are  assigned  to  inferior  service  and  receive 
little  pay,  so  that  their  shops  are  poor.  Castration  is  practised  by  members 
of  the  guild  of  surgeons.  The  thighs  and  hypogastrium  are  first  bandaged 
to  prevent  excessive  haemorrhage,  after  which  the  penis  and  scrotum  are 
cut  off  close  up  to  the  body  !  The  instrumental  apparatus  of  Chinese  sur- 
geons is  very  incomplete  (as  is  manifest  from  their  practice  in  bleeding),  so 
that  e.  g.  in  the  extraction  of  teeth  they  employ  ordinary  forceps. 

Practical  midwifery  is  in  the  hands  of  old  women,  and  is  nowhere 
managed  by  physicians.  At  best  we  find  only  a  kind  of  midwives,  who 
study  the  position  of  the  child  according  to  plates  in  the  books  for  mid- 
wives,  and  make  use  of  a  great  number  of  superstitious  manipulations, 
amulets,  delivery-stockings  etc.  The  physicians,  on  the  other  hand,  busy 
themselves  with  prescribing  remedies,  which  are  supposed  to  improve  even 


—  54  — 

the  position  of  the  child  in  the  womb,  though  they  know  nothing  of  either 
the  uterus  or  its  functions.  Hence  we  can  sa)T  nothing  of  an  obstetric  art 
in  China. 

Military  hygiene  is  totally  unknown.  Neither  in  the  army  nor  in  the 
marine  service  are  there  any  military  physicians. 

The  pathology  (Shang-hau)  of  the  Chinese  is  very  incomplete.  All 
diseases,  especially  epidemic  diseases,  are  ascribed  to  spirits  and  winds,  cold 
and  warm  humors  etc.,  and  are  assigned,  in  accordance  with  their  benign  or 
malign  character,  to  Yo  (the  good  principle),  or  Yn  (the  evil  principle). 
To  Yo  belongs  e.  g.  acute  inflammatory  fever,  to  Yn,  hectic  fever,  etc. 
There  are.  according  to  Chinese  pathology.  10,000  varieties  of  fevers. 
Among  their  diagnostic  procedures  are  examination  of  the  tongue  and  the 
eyes,  and  feeling  of  the  pulse.  The  pulse  flows  from  the  "  spirits  "  of  a 
certain  part  of  the  bod}",  which  manifest  their  presence  in  a  given  place. 
By  means  of  it  both  the  cause  and  the  seat  of  disease  are  to  be  found. 

The  art  of  feeling  the  pulse  is  very  old  and  extremely  elaborate.  It  is  performed 
elegantly,  by  placing  several  fingers  upon  a  certain  point,  and  then  raising  or  depress- 
ing each  in  turn,  as  is  done  in  playing  the  piano — the  Chinese  "  play  upon"  the  pulse 
where  we  simply  fee!  it.  In  this  practice  the  changes  of  the  moon  and  the  season  of 
the  3rear  are  considered,  according  to  certain  rules.  The  performance  often  lasts 
several  hours,  sometimes  on  the  "  heavenly  spot "  (the  upper  part  of  the  carotid 
artery),  or  on  the  "  earthly  spot"  (the  tibalis  posticus  near  the  ankle),  or  on  the 
"  human  spot"  (the  radial  artery  at  the  wrist) — the  latter  must  be  felt  with  the  three 
fingers  mentioned  below ! — sometimes  on  the  right  arm,  sometimes  on  the  left,  now 
higher  up,  now  lower  down,  now  on  one  side  only,  again  on  both  sides,  one  after  the 
other  etc.  Three  fingers  particularly  were  emploj'ed:  Dzun  (the  index-finger,  indi- 
cating the  spirits  of  the  liver),  Quoan  (the  middle  finger,  indicating  the  spleen),  and 
Shaku  (the  little  finger,  indicating  the  heart).  In  diseases  of  the  heart  e.  g.  the  left 
pulse  is  investigated;  in  those  of  the  liver,  the  right  etc.  Each  speck  upon  the 
tongue  and  every  discoloration  of  this  organ  points  to  special  diseases  and  viscera. 
Thus  a  red  tongue  indicates  warmth  of  the  heart — and  the  south  ;  a  white  tongue,  the 
lungs — and  the  west,  etc. — absurdities  for  which  analogues  might  have  been  found, 
not  long  since  even  in  civilized  Europe. 

Chinese  pharmacolog}*  (the  work  of  Lee-Shee-Tshin,  consists  of  40 
octavo  volumes),  contains  remedies  from  the  vegetable  and  animal  king- 
doms almost  exclusively,  and  is  very  copious.  It  includes  elephant's  bile, 
dried  spiders,  bugs,  toads,  lizards,  snakes,  claws,  ears,  tongues,  hearts  and 
livers  of  numerous  animals,  excrements,  dragon-bone,  cotton,  ivory,  musk, 
rhubarb,1    gentian,  camphor,2   Chinese  seeds,   leaves  in  large  doses,    and 


1.  Rhubarb  is   mentioned  in    an    herbal,    entitled    Pen-king,    and   ascribed   to   the 

emperor  Chin-nong  (B.  C.  2737-2697).  Cassia  is  also  here  noticed  under  the 
title  Kwi'i.     (H.) 

2.  The  camphor-tree  was  known  to  the  Chinese  as  early  as  the  6th  century,  but  the 

first  notice  of  the  preparation  of  the  gum  from  the  wood  is  probably  to  be  found 
in  the  herbal  Pun-tsaou-kang-muh,  written  by  Le-she-chin,  near  the  middle  of  the 
16th  century.  The  Sumatra  camphor,  however,  is  prescribed  by  Aetlus  ( A.D.  550), 
though  as  a  considerable  rarity.      (H.) 


innumerable  other  things.  The  genuine  ginseng-root  (worth  about  $25 
an  ounce),  and  the  edible  nests  of  the  swallow  (Colloealia  esculenta)  are 
considered  veritable  panaceas,  and  are  specially  prized  by  the  Chinese  as 
aphrodisiacs  (the  mediaeval  monks  used  similar  stimulants). 

In  therapeutics  too  great  importance  is  laid  upon  strict  diet,  frequent 
baths  etc.  The  chief  task  of  the  physician,  after  making  his  diagnosis,  is 
to  remove  the  materia  morbi,  which  has  entered  b}'  way  of  digestion, 
the  nerves,  or  the  circulation.  In  general  the  maxim  contraria  contrariis 
is  followed  :  hence  in  debility  e.  g.  the  extract  of  tiger's  blood  is  prescribed. 
Almost  every  animal  supplies  a  distinct  specific,  particularly  its  blood  and 
its  liver.  Then  of  course  exorcism  by  physicians  (in  epidemics  with  dra- 
gon-banners in  front,  burning  scraps  of  colored  paper  inscribed  with  for- 
mulae of  incantation,  fire-crackers  etc.),  and  similar  superstitious  observan- 
ces are  not  wanting.  Often  too.  especially  among  the  wealth}7,  the  whole 
store  of  Chinese  remedies  must  be  exhibited,  until  the  proper  specific  is 
found,  and  the  patient  either  restored  to  health,  or  cured  —  to  death.  In 
the  latter  event  the  patient,  according  to  the  Chinese  idea,  is  indeed  cured 
by  the  suitable  remedy,  but  the  physician  has  not  had  the  time  to  rid  him 
of  his  poisonous  drug,  and,  as  the  result  of  this  unfortunate  want  of  time, 
the  patient  is  doomed  to  die.     (Wernich.) 

Anatomy  and  physiology  occupy  the  lowest  grade  in  Chinese  medical 
science,  though  a  few  very  old  and  imperfect  plates  are  in  existence,  and 
European  anatomical  works  have  been  translated,  e.  g.  that  of  Pierre 
Dionis.1  In  their  veneration  of  the  dead  dissection  of  the  human  body  is 
of  course  excluded.  The  Chinese  assume  six  chief  organs  in  which  the 
"  moisture  "  is  located,  viz.  the  heart,  liver,  two  kidneys,  spleen  and  lungs  ; 
six  others  in  which  is  the  seat  of  "  warmth,''  viz.  the  small  and  large  in- 
testine, the  gall-bladder,  the  stomach  and  the  urinary  apparatus.  They 
enumerate  365  bones,  including  8  for  the  male,  b"  for  the  female  cranium  ; 
12  ribs  in  men,  14  in  women.  The  Chinese,  in  place  of  the  fire  and  earth 
of  the  Greeks,  class  wood  and  metal  as  elements,  and  heat  and  moisture 
(whose  union  produces  life,  their  separation  death)  are  regarded  as  funda- 
mental qualities.  With  death  everything  is  ended,  for  the  Chinese,  and 
the  doctrines  of  Cong-fu-tse  recognize  no  immortality.  The  qualities,  how- 
ever, wander  from  time  to  time,  and  therefore  the  physician  must  know 
the  six  springs  of  life — .very  incomprehensible  things  for  us  of  the 
present  day,  though  something  more  than  a  hundred  }-ears  ago  they  were 
also  heard  of  among  us  !  The  circulation  flows  outward  from  the  lungs  five 
times  in  twenty-four  hours,  and  terminates  in  the  liver.  The  bile,  as  it  is 
one  of  the  most  powerful  remedies,  so  also  is  it  the  special  seat  of  courage 
(the  Chinese  are  courageous  only  when  in  passion)  ;  the  lungs  give  origin 

1.  "  L'anatomie  de  l'homme,  snivant  la  circulation  du  sang  et  les  dernieres  decou- 
vertes",  Paris  1(590.  It  was  translated  into  Chinese  by  Pere  Par  renin,  a  Jesuit 
missionary,  early  in  the  ISth  century,  at  the  request  of  Cam-Hi,  the  reigning 
emperor  (died  1723).     (H.) 


—  56  — 

to  the  voice  ;  the  spleen  is  the  seat  of  reason  and,  with  the  heart,  furnishes 
ideas  ;  the  liver  is  the  granary  of  the  soul,  while  the  stomach  is  the 
resting-place  of  the  —  mind  etc. 

"The  "Instructions  for  Coroners"  contain  a  kind  of  legal  medicine,  which 
enumerates  innumerable  nonsensical  signs,  supposed  to  remain  valid  long  after  death. 
The  bones  of  parents  may  be  identified  by  the  child,  if  the  latter  inflicts  upon  himself 
a  wound  with  a  knife  and  allows  the  blood  to  fall  upon  the  suspected  bones.  If  the 
latter  absorb  the  blood,  they  belong  to  the  parents ;  if  not,  they  are  the  bones  of  a 
stranger.  The  important  point  is  that  in  this  way  a  criminal  is  always  discovered  — a 
result  easily  attained  by  this  or  any  other  procedure  —  among  the  Chinese! 
(L.  Katscher. ) 

The  Chinese  in  their  extremely  comprehensive  literature  possess  numer- 
ous medical  works  of  widely  different  periods.  Among  these  are  the  Ching- 
che-chun-ching  (Approved  Guide  to  Medical  Practice),  in  forty  volumes,  a 
treatise  on  pharmacology  entitled  Pen-zao-gan-mu,  both  voluminous  com- 
pilations and  encyclopaedias — compendious,  but  good  books,  impress  the 
Chinese  no  more  than  the}r  do  us, —  works  entitled  Zsin-io-zschuan-schu, 
Benzao-gan-mu,  as  well  as  translations  of  European  (particularly  French) 
works. 

The  reader  will  discover  that  very  much  of  Chinese  medicine  has  the 
appearance  of  either  a  caricature  or  a  satire  of  our  own. 

[Even  Chinese  exclusiveness,  however,  has  been  compelled  to  yield  some- 
thing to  the  influence  of  Western  science.  In  1868  the  Chinese  government 
established  a  university  at  Pekin.  to  which  European  and  American  professors 
were  called.  .  All  the  foreign  settlements  and  missionary  stations,  of  course, 
contain  resident  European  or  American  ph}sicians,  and  in  some  of  the 
larger  cities  these  representatives  of  Western  medicine  are  men  of  excellent 
ability  and  considerable  experience.  To  these  the  better  educated  and 
more  wealth}-  of  the  Chinese  not  uncommonly  apply  for  medical  advice, 
especially  after  the  failure  of  the  efforts  of  the  native  practitioners.  In 
1880  Li  Hung  Chang,  viceroy  of  Pi-Chi-Li,  at  the  instance  of  Dr.  Mackenzie, 
an  English  physician  attached  to  the  London  Mission,  opened  a  hospital 
for  the  natives  in  Tien  Tsin,  the  port  of  Pekin.  This  hospital  contains  40 
"beds",  with  a  dispensary,  waiting,  operating  and  lecture  rooms,  and  is 
under  the  direction  of  Dr.  Mackenzie.  The  nature  of  the  so-called  beds 
will  be  best  understood  from  the  following  description  given  by  a  corres- 
pondent of  the  Philadelphia  Medical  News  : 

"They  are  constructed  of  large  bricks,  set  in  mortar,  having  a  fire-place  beneath 
each,  in  which  straw,  hay  and  brush  are  burned  for  heating  the  whole.  Thus  each 
patient  has  his  own  fire,  by  which  all  his  food  is  cooked  in  utensils  furnished  by 
himself.  Now  when  a  Chinaman  takes  to  one  of  these  beds,  which  might  with  pro- 
priety be  termed  a  brick  oven,  he  immediately  proceeds  to  divest  himself  of  all 
clothing  down  to  the  skin;  nothing  remaining  on  the  body  save,  it  may  be,  a  piece  of 
cloth  about  the  loins.  He  then  places  himself  between  two  thick,  coarse,  plank-like 
quilts,  with  his  neck  upon  a  wooden  pillow.  This  is  the  Chinese  fashion  of  preparing 
for  and  going  to  bed,  and  although  it  has  drawbacks,  yet  it  allows  certainly  of  free 
inspection  of  the  individual  at  a  moment's  notice. 


—  57  — 

With  the  co-operation  of  the  same  Li  Hung  Chang,  Dr.  Howard,  a 
female  phj-sician  and  graduate  of  the  Medical  College  at  Ann  Harbor, 
Michigan,  has  organized  in  a  temple  at  Tien  Tsin  a  dispensary  for  females, 
who  b}'  Chinese  custom  are  absolutely  denied  all  medical  aid  from  male 
practitioners.  Many  of  the  missionary  stations  have  hospitals  and  dispen- 
saries attached  to  their  other  institutions.  Thus  the  Methodist  mission  at 
Soochow  has  a  hospital  and  dispensary,  and  organized  in  1883  a  medical 
school,  which  in  1884  had  eleven  native  students.  The  lectures  are  deliv- 
ered in  Chinese,  and  text-books  are  also  furnished  in  the  native  tongue. 
The  curriculum  comprises  a  course  of  instruction  of  five  j'ears'  duration. 
In  the  hospital  and  attached  dispensary  nearl}'  12,000  patients  were  treated 
in  1884.]  (H.) 

JAPANESE  MEDICINE. 

The  imaginative,  busy  Japanese,  the  "  French  of  the  East",  more 
disposed  to  art  than  the  Chinese,  and  fond  of  novelty,  are  a  mixture  of  the 
aboriginal  Ainos  (now  almost  extinct)  and  the  conquering  Malays,  whose 
blood  at  present  predominates.  (According  to  Baeltz,  however,  the  Japa- 
nese are  pure  Mongols.) 

They  have  advanced  in  independent  medicine  no  further  than  the 
Chinese,  from  whom  (according  to  Gierke)  they  adopted  their  medical  knowl- 
edge about  the  fourth  or  fifth  century  of  our  era.  Recently,  however,  they 
have  endeavored  to  push  forward,  partly  by  calling  European  physicians  to 
the  medical  schools  of  their  own  county,  partly  by  sending  their  young 
men  to  be  educated  as  physicians  in  foreign  universities,  especially  those 
of  North  America  and  Germany  (e.  g.  Munich,  Berlin).1 

Medical  schools,  after  the  model  of  those  of  Europe  and  America,  exist  in 
Nagasaki,  Osaka,  Kangoschina,  Sanga,  Hakadot  and  Nadegoja.  A  most  complete 
academy  or  university  on  the  German  model,  and  in  which  even  t lie  German  language 
is  employed  in  teaching,  was  erected  at  Yeddo,  in  1871.  Here,  however,  the  instruc- 
tion is  given  more  as  in  our  Gymnasia,  and  is  divided  into  several  grades.  The 
text-books  are  European  works  translated  into  Japanese.  Even  a  medical  journal 
appears  regularly,  edited  by  an  Englishman,  and  bears  the  title  Kin-se-i-Selzu,  or 
"  Medical  News".2 

The  Japanese,  especially  the  wealthy  among  them,  worship,  as  the  god 
of  health,  good  cheer  and  fruitfulness  in  women,  Hotei,  a  fat,  jolly  god  — 
plumpness  is  considered  a  sign  of  happiness  and  comfort  —  whose  belly  as 
he  sits  overhangs  his  short  legs,  and  who  seems,  therefore,  to  have  a  good 

1.  No  less  than  500  students  were  sent  to  the  United  States,  among  them  the  brother 

of  the  Mikado,  who  became  a  studetit  in  the  U.  S.  Naval  Academy  at  Annapolis. 
Among  these  students  were  five  ladies,  the  first  of  their  sex  to  leave  Japan  for 
educational  purposes.  Harvard  University  received  a  number  of  the  Japanese 
students,  and  others  attended  various  other  eastern  colleges.     (H.) 

2.  In   1884  about  a  dozen  medical  journals  were  published   in   Japan,  all  of  which 

were  said  to  receive  a  fair  support.     (H.) 


—  58  — 

practice  and  to  be  a  good  celestial  colleague.  On  the  other  hand,  Almtto. 
who  belongs  to  the  gods  of  the  second  class,  is  invoked  by  the  poor  and  by 
mariners,  who  now  and  then  cast  into  the  water  a  small  coin  as  a  fee.  To 
test  whether  or  not  their  pra}er  has  been  heard  by  the  god,  they  throw 
spitballs  of  amulet  paper  against  his  image  ;  if  these  stick  fast  it  is  a  good 
sign,  but  if  the}7  fall  to  the  ground  the  pra}'er  remains  unheard  !  Shion-ro 
or  Giogin  is  the  god  of  long  life.  To  rid  themselves  of  infectious  diseases 
the  Japanese  celebrate  the  feast  Kusurikari,  on  the  fifth  of  May,  when  herbs 
are  gathered  with  superstitious  observances.  Jammabos  or  conjurors  cure 
diseases  by  providing  themselves  with  a  description  of  them,  laying  this 
before  an  idol,  twisting  the  paper  into  pills,  and  finally  giving  these  pills  to 
the  sick. 

In  the  pathology  of  the  ancient  Japanese  medicine,  external  and  in- 
ternal diseases  are  said  to  be  distinguished.  A  disease  peculiar  to  the 
Japanese  pathology  is  the  lesion  of  the  spine,  called  Kakkeh.  The  most 
wonderful  things  are  regarded  as  therapeutic  measures  ;  e.  g.  in  small-pox 
the  decoration  of  the  sick-room  with  red  hangings.1 

The  general  prevalence  of  prostitution  in  Japan  (under  which  head  we  must  not 
however,  class  the  peculiar  Japanese  temporary  marriages,  permitted  even  to 
foreigners),  renders  syphilis  of  frequent  occurrence.  In  its  treatment  the  native 
practition-ers  employed  superstitious  remedies,  but  mercury  also.  According  to 
Brunner,  a  favorite  domestic  remedy  for  gonorrhoea  was  three  times  three  hairs  from 
the  mons  Veneris  of  a  woman,  and  sulphur  baths  from  the  famous  mountain  Fusi-Yama 
(the  Japanese  Aix  la  Chapelle)  were  employed  as  the  last  resort  in  syphilis.  That 
the  venereal  disease  was  introduced  into  Japan  by  the  early  European  missionaries, 
as  has  been  stated,  is  quite  possible,  for  venereal  disease  and  the  priesthood  neither 
exclude  nor  imply  each  other.2 

The  Japanese  apply  moxas  (according  to  Wernich  a  Japanese  inven- 
tion, prophylactic  in  design),  and  the  body  of  ever}7  native  bears  the  cica- 
trices of  these  applications.  Acupuncture  is  also  practised,  and  the  acqui- 
sition of  this  art  formed  the  key-stone  of  ancient  medical  education  (prior 
to  1820).  They  are  acquainted  with  numerous  medicaments,  partby  native) 
partly  adopted  from  the  Chinese,  and  indeed  they  have  plates  of  remedial 
herbs.3  Besides  moxas  and  acupuncture,  warm  baths  (in  which  the  tub 
once  filled  suffices  for  the  whole  family)  may  serve  for  an  example  of  their 
hygienic  measures.     The  Japanese  have  been  acquainted  with  cremation 


1.  It  is  curious  to  note  that  this  identical  plan  of  treatment  in  the  sinall-pox  was 

practised  by  the  famous  John  Gaddesden  on  the  son  of  king  Edward  II.  early  in 
the  14th  century.  Gaddesden  was  professor  of  medicine  in  Merton  College, 
Oxford,  and  the  first  native  court-physician  of  England,  but  nevertheless,  as 
Watson  says,  "a  very  sad  knave".     (H.) 

2.  A  Japanese   medical   work  of  the   Dai-do   period    (806-810  A.  D.),    and    entitled 

"  Dai-do-ru  shiu-ho",  is  said  to  mention  syphilitic  chancre,  bubo,  ulceration  of  the 
throat,  and  affections  of  the  skin,  joints  and  bones.     (H.) 

3.  Our  modern  extract  of  malt,  under  the  name  "  midzu  ame",  has  been  employed  in 

Japan  for  centuries.     (H.) 


—  50  — 

since  the  6th  century,  and  they  also  perform  vaccination  with  cow- 
pox,  a  practice  introduced  into  Japan  by  Phil,  von  Siebold.  between  1820 
and  1830. 

The  Japanese  have  also  a  real  art  of  midwifery  of  considerable  elabora- 
tion, and  exercised  by  men.  They  practice  in  accordance  with  the  precepts 
of  the  famous  obstetrician  Kagawa-gen-ets,  who  in  the  year  1795  published 
his  book  on  this  subject  entitled  San  rong  (Description  of  Labor).1  In 
this  work  are  discussed  the  development  of  the  foetus,  the  theory  and  prac- 
tice of  pregnane}',  the  selection  of  the  lying-in  apartment,  the  position  dur- 
ing labor — Japanese  women  bear  children  upon  the  knee — the  management 
of  labor,  the  use  of  labor-stools  and  the  abdominal  bandage,  a  cap  for  the 
extraction  of  the  foetus,  fillets  for  extraction  and  turning  (Wernich),  and 
finally  version  by  external  manipulation. 

In  the  artificial  induction  of  premature  labor,  a  certain  root  is  inserted  between 
the  uterus  and  the  membranes,  and  left  in  position  for  one  or  two  days:  or  silk 
threads,  dipped  in  a  solution  of  musk,  are  introduced  into  the  os  uteri  during  the 
fourth  or  fifth  month.  Artificial  abortion  is  indeed  prohibited  by  law,  and  besides 
this  is  regarded  as  a  sin  by  the  women  of  the  higher  classes,  but  it  is  frequent,  in  fact 
custamarj',  among  women  pregnant  by  a  temporary  marriage,  and  among  those  of  the 
lower  class.  In  the  latter  it  is  performed  by  ignorant  women,  just  as  among  servant- 
girls  with  us.  In  the  temporary  marriages  the  question  is  asked  whether  children 
are  desired  or  not,  and  the  orders  received  on  this  subject  are  scrupulously 
executed  by  the  female  contractors  (tampon?).  Obstetricians  were  not  required 
to  pass  any  examination,  and  learned  their  art  practically  from  observation  ot  their 
teachers. 

On  the  whole,  the  medicine  of  the  Japanese  bore  almost  as  strong  a 
theurgic  character  as  that  of  the  Chinese,  from  whom,  as  we  have  already 
seen,  it  was  adopted.  Both  too  may  be  considered  philosophical  sciences, 
inasmuch  as  neither  was  ever  a  sacerdotal  medicine  proper. 

The  relations  of  the  medical  profession  in  Japan,  during  the  period 
when  the  influence  of  foreigners  was  almost  entirely  wanting,  were  quite 
different  from  those  which  have  prevailed  since  this  influence  has  become 
dominant, — since  about  1820.  and  more  strongly  since  about  1860. 

In  ancient  Japan  students  studied  for  two  years  with  a  teacher  of  their 
own  caste.  The}T  recited  to  the  latter  certain  Chinese  medical  works  (which 
were  very  rarely  explained),  learned  to  prepare  medicines,  acquired  certain 
manipulations,  and  finally  completed  their  education  by  practising  acu- 
puncture for  about  two  da\-s.  The  higher  physicians  belonged  to  the 
"  Long- sleeves,"  i.  e.  the  learned,  and  as  such  had  their  heads  shaved, 
except  in  the  capital,  where  the  influence  of  Buddhism  was  not  felt.  Here 
they  wore  their  hair  in  a  cue,  twisted  upon  the  crown  of  the  head.  Ordinary 
physicians  sprung  from  the  lower  caste,  composed  of  artisans,  merchants 
and  peasants,  or  were  the  sons  of  physicians.     The  latter  was  more  fre- 

1.    Ten  years  later,    Kagawa's   adopted   son  and  assistant  published  some   commen- 
taries on  the  San  rong,  entitled  San  rong  yoku.     (H.) 


—  BO  — 

quently  the  case.  In  the  former  case  the  medical  men  by  their  transfer 
among  the  Long-sleeves  enjoyed  an  elevation  of  rank,  that  is  they  were 
allowed  to  wear  one  sword.1  The  physician's  honorarium  consisted  of  so- 
called  •'  presents  "  —  in  1862  the  ordinance  provided  about  three  cents  !  — 
which  were,  indeed,  ordinarily  given,  but  could  not  be  sued  for.  By  cring- 
ing and  flattery  the  physicians  endeavored  to  increase  these  honoraria. 
The  earlier  physicians  of  Japan,  like  those  of  China,  had  advertising 
signs,  but  the  Japanese  had  depicted  upon  their  signs  actual  cases  of 
disease,  even  syphilitic  lesions  upon  gigantic  penes  (Hildebrandt). 
The  latter  organs  were  depicted  too  in  the  most  unconstrained  way  in 
other  localities,  e.  g.  on  the  "  coffee-houses ".  Medicines  were  made  a 
special  charge,  and  when  the  physician  was  consulted  at  his  own  residence, 
were  alone  charged.  In  villages  the  physicians  were  particularly  looked 
up  to  as  "  savants".  Specialists  (obstetricians,  venereal  doctors,  den- 
tists etc.),  with  the  exception  of  those  physicians  who  performed 
acupuncture,  were  less  respected  than  the  general  physicians,  quite 
in  contrast  to  the  custom  .with  us.  If  a  physician  of  the  lower  class 
rendered  himself  specially  famous  he  might  become , physician  to  the  prince, 
which  of  course  happened  only  exceptionally.  These  physicians  to  the 
prince  wore  two  swords,  and  looked  down  with  infinite  scorn  upon  their  in- 
ferior colleagues.  As  a  rule  they  sprung  from  the  Samurai  caste,  and  were 
considered  degraded  members  of  the  same  :  hence  they  were  recruited  only 
from  the  sons  of  the  Samurai  physically  unfit  for  military  service.  If 
mentally  incompetent  the}'  beeame  priests  !  Only  when  compelled  by 
necessit}-  did  they  practise  like  the  popular  physicians  ;  as  a  rule  they 
held  position  near  the  princes.  They  too  had  special  distinctions  of  rank  : 
the  lowest  class  stood  between  the  foot  and  mounted  Samurais,  though 
nearer  to  the  latter.  The  superior  Daimio-physicians,  like  the  ordinary 
physicians  of  the  Shiogoon,  belonged  to  the  Samurai  caste.  The  real  phy- 
sicians-in-ordinary of  the  Shiogoon,  on  the  other  hand,  belonged  to  the 
nobility  of  the  empire,  possessed  small  estates  and  castles  and  were  dis- 
tinguished by  titles.  The  physicians  of  the  Mikado  —  about  fifty  in  num- 
ber, including  twent}'  superior  physicians,  and  one  president,  to  whom  all 
the  others  were  subordinate —  possessed  the  highest  rank  of  all  physicians. 
Many  of  these  higher  Daimio-,  Shiogoon-  and  Mikado-physicians  were  rather 
companions  and  entertainers  of  their  lords  than  medical  counsellors,  and 
only  a  few  of  them  served  as  physicians-in-ordinary.  The  Daimio-physi- 
cians, if  of  higher  rank,  had  the  right  to  be  borne  in  a  litter,  Kango,  on  the 
journeys  of  their  master  to  the  court  of  the  Shiogoon,  those  of  lower  rank 


1.  Even  in  the  last  centurj-  European  physicians,  as  we  know,  were  permitted,  as 
members  of  the  upper  class,  to  wear  a  straight  sword.  The  privilege  of  wearing 
a  sword  was  a<iain  given  to  the  state  physicians  of  Hesse  during  the  present 
century,  though  the  least  of  them  were  thus  made  members  of  the  "  Long- 
sleeves". 


—  61  — 

must  travel  on  foot,  and  a  litter  was  assigned  to  them  only  in  case  of 
fatigue.1 

In  "  New  Japan  "  too  all  legal  regulation  of  the  payment  of  physicians 
is  wanting ;  still  the  old  principle  continues  in  vogue  : 

"  Since  men  of  this  world  can  never  be  free  from  diseases,  the  philosophers  of 
antiquity,  full  of  compassion,  have  created  the  healing  art.  When,  therefore,  their 
disciples  also  cure  diseases  skilfully  and  have  success,  ye  ought" — a  negative  regula- 
tion— "to  concede  to  them  no  great  income  indeed,  for  if  they  were  in  possession  of 
the  same  thej'  would  necessarily  neglect  their  profession", — a  philosophy  which 
seems  to  have  suggested  our  low  tariff  of  fees, — "but  as  often  as  they  have  performed 
a  cure,  ye  ought  to  give  them  a  fee  corresponding  to  the  greatness  of  their  success. 

The  physicians  educated  in  the  universities  of  "  New  Japan  "  are  said 
to  be  about  like  our  old  country  physicians  ;  the  best  educated  of  themr 
however,  stand  higher.  The  physicians  of  the  advanced  school  "  even  way 
back  in  the  countr}-,  have  provided  themselves  alread}7  with  percussion 
hammers,  pleximeters  and  stethoscopes,  and  indeed  with  medical  thermo- 
meters, which  they  carry  proudly  and  openly  in  their  belt,"  as  our  whole 
younger  generation  carrj-  them  in  their  breast-pockets.  In  1878  Wernich, 
to  whom  we  owe  all  this  information,  thought  that  in  three  years  the  whole 
country  would  be  settled  with  such  university  pupils.  The  government 
sends  a  medical  journal  into  each  district. 

Besides  the  physicians  there  are  also  midwives,  Sambas,  a  very  ancient 
class  of  women,  who,  according  to  Wernich's  view,  supplied  the  principles 
for  the  teachings  of  Kagawa.  Then  again,  there  are  practitioners  of  mas- 
sage, Ammasau  (blind  kneaders,  likewise  blind  men),  who  are  practised  in 
the  art  of  muscular  kneading.  The  specialists  in  acupuncture  practise 
their  art,  according  to  minute  and  numerous  rules,  on  certain  places  which 
have  names  like  "  Great  Ocean  "  (Kiokai),  a  point  situated  one  inch  below 
the  navel,  "  Heavens  Axis  "  (Sensu),  an  inch  on  either  side  of  the  navel, 
etc.  The  acupuncture  figures  most  used  are  triangular,  imperfecta  right- 
angled  or  right-angled.  The  operation  is  regarded  merely  as  a  measure 
of  prevention.  In  1834  there  was  also  a  private  ophthalmic  clinic  in 
Tokio. 

[Some  idea  of  the  almost  incredible  rapidity  of  the  advance  of  Japan  in  medical 
science  may  be  formed,  when  we  state  that  in  1881  no  less  than  267  medical  works 
(principally,  however,  translations)  were  published  in  the  Japanese  language,  and 
that  in  188H  some  400  volumes  of  Japanese  medical  text-books  were  sent  by  the 
government    to   the    library   of  the   office   of  the    Surge'on   General    at  Washington. 


1.  The  medical  arrangements  of  "Old  Japan",  as  described  in  the  text,  will  probably 
be  better  understood  if  we  explain  that  until  1867  the  Mikado  was  the  actual 
spiritual  and  the  nominal  political  head  of  the  government,  while  the  Shiogoon 
or  Tycoon  was  the  actual  political  ruler.  The  revolution  of  1867-68  resulted  in 
the  deposition  of  the  Shiogoon  and  the  restoration  of  the  Mikado  to  his  original 
supremacy  in  both  religion  and  politics.  The  daimios  were  the  ancient  feudal 
lords  of  Japan,  owing  allegiance  to  the  Shiogoon,  but  independent  in  their  own 
sphere,  while  the  Samurai  were  the  military  nobility  next  in  rank  beneath 
the  daimios.     (H.) 


—  62  — 

Excellent  and  elaborate  health  reports  (weekly)  for  the  city  and  province  of  Nagasaki 
were  also  published  by  the  authorities  in  1883,  and  in  1885  a  Health  Department  for 
Japan  was  established,  under  the  charge  of  Dr.  Mansanori  Agata,  professor  of 
hygiene  in  the  university  at  Tokio.  and  a  former  student  in  Munich,  Leipsic  and 
Berlin.  The  Sei  I  Kwai,  or  Society  for  the  Advancement  of  Medical  Science  in 
Japan,  consists  of  86  members,  possesses  a  museum  and  a  library,  and  in  1885 
published  its  Transactions  in  English  and  Japanese.  And  all  this  the  work  of  about 
twenty  years  in  the  extreme  Orient! 

A  German-Japanese  medical  dictionary,  based  upon  the  "  Dictionary  of  German 
Terms  used  in  Medicine"  of  our  countryman  Dr.  G.  R.  Cutter,  has  just  been  published 
in  Japan  It  was  compiled  by  Dr.  Shigu.  a  government  medical  examiner,  and 
Messrs.  Take  and  Shibatta.   officers  of  the  Sanitary  Bureau.     (H.i] 


VI.    MEDICAL    VIEWS  AND    ECONOMY   AMONG    OTHER  ANCIENT    AND 

MODERN  PEOPLES,   WHOSE    MEDICAL    CULTURE   HAS  NOT 

BEEN   PROGRESSIVE,   INCLUDING  WHAT  MAY  BE 

CALLED  PREHISTORIC  MEDICINE. 

The  people  whose  medical  views  are  here  to  be  eonsidered  belong 
partly  to  antiquity,  partly  to  modern  times,  and  to  both  the  old  and  the 
new  world.  But  though  they  differ  widely  from  each  other  both  in  chron- 
ological order  and  geographical  location,  and  occupy  also  very  different 
grades  of  civilization,  they  may  yet  be  considered  together  and  from  the  same 
point  of  view,  inasmuch  as  they  possess,  or  did  possess,  merely  the  rudiments 
of  medical  science,  whether  original  with  themselves,  or  borrowed  from 
another  people.  Most  of  them,  indeed,  occupied  the  lowest,  or  what  we 
might  even  call  a  prehistoric,  grade  of  medical  knowledge  and  thought. 
But  the}-  cannot  be  utterly  ignored  in  forming  our  conception  of  medicine 
as  a  part  of  civilization  in  its  entirety.  This  is  especially  the  case  with 
regard  to  a  few.  who  furnish  us  valuable  information  concerning  the  be- 
ginning of  the  development  of  medical  culture.  Others  belong  here  only 
because  they  have  developed  no  original  medicine  of  their  own,  but  have 
adopted  the  science  of  some  other  civilized  people. 

We  begin  with  the  Scythians,  whose  home  lay  in  the  regions  to  the 
north  of  the  Black  Sea.  They  came  very  early  into  commercial  and  other 
relations  with  the  Greeks,  who  employed  them  as  pedagogues,  policemen 
and,  indeed,  as  slaves,  and  ascribed  to  them  special  knowledge  in  the  art  of 
healing.  Their  priests  Abaris,  Anacharsis  and  Toxaris  (the  two  latter  of 
whom  came  to  Athens  in  the  time  of  Solon,  039-559  B.  C.)  are  mentioned 
among  others  as  possessed  of  skill  in  medicine. 

In  their  own  country,  the  women  were  the  chief  physicians,  as  they  are  to-day 
among  the  Russian  tribes,  who  now  occupy  their  old  homes.  Yet  they  had  also  male 
physicians,  who  probably  practised  surgery  alone.  At  least  upon  a  vase  of  electron 
(a  mixture  of  gold  and  silver)  found  in  the  Crimea,  two  men  are  depicted,  one  of  whom 
is  bandaging  the  leg  of  a  patient  secundum  artem,  while  the  other  explores  with  his 
finger  the  mouth  of  another  patient,  who  screws  up  his  face  with  pain — a  very  rare 
picture  of  prehistoric  medical  treatment. 


—  83  — 

Physicians  too  of  a  repulsive  type  were  the  Scythian  -  Enarees  "  (an- 
drogvni),  who  threw  themselves  into  artificial  convulsions  and  then  pre- 
dicted the  result  of  diseases.1 

Herodotus  relates  of  the  Scythians  that  they  were  lusty  drinkers,  and  that 
Cleomeries  learned  from  them  to  drink  so  hard  that  he  became  for  a  time  insane  (the 
first  example  of  delirium  tremens?):  and  further,  that  diseases  of  the  king  were 
ascribed  by  the  soothsayers  to  false  oaths  sworn  by  his  name. 

Quite  similar  to  the  •' Enarees  " —  indeed  their    successors — are  the 

•  Shamans'",  who  still  pass  for  magicians  and  pln-sicians  among  the  people 

of  Asia  from  Tartary  to  Kamtchatka.  and  who  b}T  screaming,  drum-beating 

and  furious  dancing,  work  themselves  and  the  spectators  into  the  frame  of 

mind  necessary  to  enable  them  to  cany  on  their  medical  impostures. 

They  pretend  to  remove  diseases  by  sucking  upon  the  skin  and  then  exhibit,  as 
evidence  of  their  success,  the  corpora  delicti  in  the  form  of  stones  etc. 

The  Usbeks,  a  Turkish  tribe,  besides  Shamanism,  also  embrace  Par- 
see  views,  ascribing  a  special  curative  power  in  all  diseases  to  the  setting 
sun.     (Yambery.) 

The  Mongolian  tribes,  who  inhabit  middle  Asia  and  embrace  Lamaism. 
when  suffering  from  disease  have  recourse  either  to  amulets,  to  the  revolu- 
tion of  the  pra}ing  cylinder  (kurudu),  or  to  special  healing  idols.  Among 
their  amulets  is  included  the  excrement  of  the  Dalai-Lama,  which  is  taken 
internally  in  the  form  of  pills  ! 

Among  the  idols,  one  called  Otschirbani  by  the  Kalmucks  is  especially  distin- 
guished, and  for  his  utility  in  practice  we  must  feel  the  greatest  respect.  From  his 
mouth  to  his  anus  runs  a  canal,  through  which  the  priests  administer  to  the  sick  pills 
consecrated  by  this  transit,  the  *'  unmentionable"  of  the  idol  having  been  first  placed 
upon  the  mouth  of  the  patient.  On  the  other  hand  the  old  men  of  the  Kalmucks  call 
upon  the  idol  Aiuschi  to  rejuvenate  them,  since  it  rests  in  his  power  to  apportion 
health,  long  life  and  renewal  of  youth,  though  he  is  manufactured  of  plates  of  brass. 
The  natives  of  Thibet.  Burmah,  East  Turkestan,  Tamil-land,"  Ceylon 
and  Java,  for  the  most  part  are  devoted  to  the  grossest  superstition.  When 
e.  g.  in  1879  a  member  of  the  royal  family  of  Burmah  died  of  small-pox. 
400  human  beings  were  offered  up  to  the  demons.  Such  medical  knowledge 
as  the}-  possess  is  borrowed  from  the  Indians,  some  of  whose  medical  works 
they  (as  well  as  the  Siamese)  have  translated  from  the  Sanscrit.  The  most 
important  medical  treatise  of  the  Siamese  bears  the  title  '•  Pathom-Cinda." 
i.  e.  "  The  First  Mirror."  They  distinguish  five  kinds  of  blood,  enumerate 
300  bones  and  recognize  the  investing  membranes  of  the  liver,  the  spleen, 
the  brain  and  the  bones,  the  covering  of  which  looks  "  like  worn-out  linen." 

Their  midwifery  is  curious  and  barbarous.  "When  a  woman  is  taken  in  labor 
several  female  acquaintances  and  the  midwife  are  summoned.  The  patient  is  laid 
upon  her  back,   and  one  of  the  attendants  continually  presses  the  belly  and  uterus 

1.  Further  information   with   regard   to  these   unfortunate  beings   may  be  found  in 

Herodotus  (I.  c.  105:  IV  c.  67  |,  and  in  Hippocrates  "  De  sere,  locis  et  aquis".   I  EL) 

2.  I.  e.  Southern   India,     especially    the    Carnatic.     where    the    Tamil    language    is 

spoken.     I  H. ) 


-  64  — 

alternately  downward  and  backwards,  if  necessary  for  four  or  five  hours.  If  this 
plan  fails,  one  of  the  women  then  treads  with  her  feet  upon  the  abdomen  of  the 
patient  above  the  uterus.  If  this  too  does  not  succeed,  a  bandage  is  passed  beneath 
the  arms  of  the  parturient  woman,  and  she  is  raised  aloft,  while  several  other  women 
hang  on  to  her  feet  until  the  child  is  born  and  the  perinasum  ruptured".  Such  vigorous 
manipulations  occur  frequentlj'  among  rude  people,  and  were  even  to  be  met  with 
among  us  until  after  the  Middle  Ages.  Recently,  however,  some  improvements  in 
medicine  seem  to  have  found  entrance  into  Siam.  At  least  the  king  of  this  country, 
in  an  address  to  Ex-President  Grant  in  1879,  emphasized  the  fact  that  the  Americans, 
besides  other  sciences,  had  brought  his  people  improved  medical  knowledge  and 
books. 

The  inhabitauts  of  Borneo,  Sumatra,  Celebes,  the  Moluccas,  Sumbawa, 
Bali,  Timor  etc.  seek  their  physicians  among  wandering  magicians  and 
serpent-charmers,  who  by  incantations  banish  the  evil  spirits,  the  bearers  of 
disease. 

Circumcision  is  practised  by  manj'  of  the  Islanders,  chiefty  in  boys,  though  also 
in  grown  persons,  with  the  object  of  facilitating  sexual  intercourse. 

Of  modern  Persian  medicine  it  is  to  be  said  that  it  is  adopted  in  a 
corrupted  form  from  the  old  Arabian,  and  is  strongly  mixed  with  supersti- 
tion. European  court-physicians  sojourning  temporarily  in  Persia  have  not 
been  able  to  improve  it  much. 

Still  Jac.  Ed.  Polak,  ordinary  physician  of  the  Shah,  and  a  teacher  in  the 
medical  school  in  Teheran,  educated,  apparently,  some  able  pupils,  e.  g.  Mirza  Abdul 
Ali,  who  presented  to  Europe  in  1877  a  report  on  the  plague!  Polak,  before 
chloroforming  a  patient  for  operation,  was  always  compelled  to  see  that  his  horse  was 
ready  saddled,  so  that  in  case  his  patient  died  under  chloroform  he  might,  be  able  to 
leave  the  kingdom  at  once.  The  natives  looked  upon  chloroformization  as  a  kind  of 
witchcraft ! 

In  the  apothecary  shops  a  pharmacopoea  compiled  in  1681  by  a  certain 
"Father",  and  containing  over  1000  formulae  of  Greek,  Arabic  and  Persian 
origin,  is  the  chief  authority.1 

The  drugs  are  still  divided  into  "hot"  and  "cold".  The  "hot",  e.  g.  cinchona, 
wine,  aromatics  etc.,  are  administered  in  "cold"  diseases;  the  "cold",  like  bloodletting 
and  purgatives,  are  employed  in  "hot".  One  drug  is  administered  after  another 
until  one  is  found  which  is  effective,  so,  of  course,  the  purest  empiricism  prevails. 
Calomel  is  very  popular.2  Surgery  scarcely  exists.  Midwives  are  unknown,  their 
place  bein^  filled  by  old  women.  Labor  takes  place  in  the  sitting  posture.  If  a  per- 
son of  rank  is  sick,  the  native  physicians  are  sent  to  him  b}T  his  superiors  and  sub- 
ordinates, and  these,  after  consultation,  submit  their  views  to  the  patient  himself,  in 
order  that  he  may  decide  upon  the  method  of  treatment  which  seems  to  him  the  best. 
If.  however,  he  is  unable  to  come  to  any  conclusion,  the  priests  decide  for  him  on  the 
principles  of  the  Koran. 

The  Turks  also  have  no  independent  medicine,  but  even  to-day,  follow. 

1.  The  "  Pharmacopoeia  Persica"  of  Ange  de  la  Brosse  ("Pere  Ange"),  a  Carmelite 

friar,  who  traveled  as  a  missionary  in  Persia  1664-1678.     (H.) 

2.  In   this  pharmacopoeia  wine,   alcohol,   blood,   urine,  faeces,  the  dog,  the  hog,  and 

Kafir  (Christ)  are  classified  as  "unclean".     Thus  Christ  is  branded  with  Persian 
abhorrence,  even  in  a  pharmacopoeia! 


—  65  — 

like  the  other  Orientals,  in  study  and  practice  the  ancient  Arabians,  beyond 
whose  ideas  they  are  not  able  to  make  any  independent  advance.  A  full- 
blood  Turk,  especially  if  he  belongs  to  the  "  better  "  classes,  scorns  med- 
icine, and,  like  the  Roman  patricians,  considers  even  the  study  of  it  beneath 
his  dignity.  Even  the  physicians  who  have  been  educated  in  European 
universities,  or  in  institutions  of  instruction  erected  and  conducted  by 
foreign  physicians  upon  Turkish  soil,  lapse  into  the  prejudices  imbibed  in 
youth,  as  soon  as  they  are  withdrawn  from  the  influence  of  these  schools, 
which  are  constructed  upon  the  French  model.  Medical  matters,  however, 
especially  public  and  military  medicine,  are  managed  (at  least  on  paper) 
comparatively  well,  and  chiefl}'  in  the  French  style. 

The  Turkish  Academy  of  Sciences  with  its  40  Immortals,  which  was  opened  in 
1870,  has  held  one  session  ! 

The  tolerably  numerous  and  excellent  European  physicians  who  have 
immigrated  into  Turkey,  and  whom  the  Turk,  unless  utterly  given  over  to 
the  Kismet,  receives  gladly,  have  attained  no  controlling  influence  in 
medicine.  On  the  other  hand,  in  their  ordinary  private  practice  the}'  have  al- 
wa}-s,  though  by  no  means  everywhere,  broken  through  the  barriers  erected  by 
the  Koran,  so  that  they  venture  to  practise  even  midwifery  and  gynaecology. 

These  branches,  even  in  the  capital,  are  to  a  considerable  extent  in  the  hands  of 
ignorant  old  women,1  so-called  "midwives",  before  whom  a  simple  delivery-stool 
is  borne  as  a  sign  of  their  occupation.  (Seligmann.)  In  the  smaller  cities  the  employ- 
ment of  these  midwives  becomes  the  rule,  to  which  in  country  districts  there  are  no 
exceptions. 

There  is,  indeed,  a  special  medical  school,  or  rather  a  university,  in 
Giilhan(5,  a  "  Sock'tt'  Impenale  de  Mc'decine  "  etc.  in  Constantinople,  and 
likewise  a  medical  journalism  in  the  Turkish  language.  The  latter  is  often 
tiresome  enough,  as  is  loses  itself  in  the  stupidities  of  ancient  Turke3'dom. 
Even  in  the  larger  cities,  and  especially  in  Constantinople,  the  situation  of 
practical  medicine  is  far  from  good,  in  consequence  of  the  over-supply 
of  physicians,  not  a  few  of  whom  are  without  any  fundamental  education. 
The  varieties  of  treatment  practised  by  physicians  of  different  nationalities 

1.  rJ lie  condition  of  general,  and  more  especially  of  medical  culture  among  the  Turks 
of  the  present  day,  is  strikingly  shown  by  the  fact  that  a  short  time  ago  (1875) 
the  Sultana  Valide,  i.  e.  the  mother  of  the  Sultan,  revived  an  old  law,  according 
to  which,  after  the  succession  was  secured,  all  pregnant  women  in  the  palace  must 
suffer  abortion,  or  all  children  who  came  into  the  world  should  be  killed  by 
neglecting  to  tie  the  umbilical  cord  !  Abortions  are  very  general  in  Turkey, 
partly  with  the  object  of  preserving  the  charms  of  the  women,  partly  to  avoid 
being  bound  to  any  definite  man  in  case  the  female  is  a  slave  who  may  be  subse- 
quently set  free.  Many  nuptials  thus  become  unfruitful,  even  if  this  does  not 
result  from  too  early  marriage  (10-12  years).  Turkish  women  with  three  children 
are  therefore  a  rare  exception  (Kollner),  and  Turks,  who,  like  the  Mahdi,  leave 
35  wives  at  once  in  an  interesting  condition,  no  longer  exist.  For  the  poor  Turks 
such  extravagance  is  no  longer  practicable !  Most  of  them  are  actually 
monogamists. 

5 


—  66  — 

and  their  bad,  i.  e.  doubtful,  compensation,  conduce  to  the  same  result. 
Superstition,  lack  of  education,  barbarity  etc.,  make  practice  even  dangerous 
for  inland  physicians.  In  fact,  Sayda,  a  physician  educated  in  Egypt,  and 
an  apothecary,  who  also  practised  medicine,  when  the  cholera  in  1875  swept 
off  their  patients,  were  stoned  in  the  Biblical  st}'le  ! 

Legal  medicine,  if  we  may  speak  of  such  a  science  in  Turkey,  is  yet 
in  the  same  position  which  it  occupied  with  us  during  the  Middle  Ages.  At 
best  it  amounts  to  no  more  than  the  external  inspection  of  the  bod}"  in 
cases  of  manslaughter,  murder  etc.  —  The  insane,  until  a  short  time  ago, 
were  kept  in  iron  collars  and  chains  in  genuine  mediaeval  style.  Now  there 
is,  indeed,  an  asylum  for  the  insane  in  Topfaschi,  but  for  the  most  part 
only  dangerous  cases  are  received  here.  The  remainder  are  treated  at 
home  by  exorcisms,  or  allowed  to  run  about  at  will,  even  in  the  paradisiacal 
costume  of  Adam  and  Eve.  A  few  3-ears  ago  the  couching  of  cataract  was 
performed  by  the  ordinary  popular  physicians  and  rude  empirics,  and  even 
in  Constantinople  "an  old  Turk,  who,  sitting  in  a  court-yard,  received  and 
operated  upon  his  patients,"  enjo3'ed  the  utmost  confidence.  (T.  Hirschberg). 

The  institutions  for  the  instruction  of  military  physicians  in  Galata- 
Serai  are  said  to  be  good.  "  The  course  in  one  of  these  schools  embraces  a 
period  of  ten  years,  four  of  which  are  passed  in  the  preparatory  school,  and 
six  in  that  of  the  medical  department  proper."  The  physician  must  then 
pass  two  years  more  in  the  militaiy  service,  where,  however,  in  strong  con- 
trast with  our  service,  in  which  the  physician  begins  with  the  rank  of  vice- 
sergeant,  he  enters  with  the  rank  of  captain. 

Besides  physicians  (hechim),  there  are  in  (he  arm}-  surgeons  (djerrah)  and 
assistants  (tiuiardscJii).  In  1877  each  batallion  in  the  field  was  required  to  have  two 
surgeons,  and  each  regiment  one  regimental  surgeon,  with  whom  was  also  associated 
an  physician.  Each  company  was  to  have  an  ambulance  corps  of  eight  soldiers 
and  two  beasts  of  burden,  the  latter  of  which  (in  old  Byzantine  style)  bore  on  each 
side  a  cushioned  bag  or  basket  for  the  reception  of  the  wounded. 

The  Sultan  of  course  has  his  body-physicians  and  body-surgeons,  the 
chief  of  whom  bear  the  titles  Hechim-Baschi  and  Djerrah-Baschi.  In  1880 
he  had  also  his  court  astrologers.  Pharmaceutical  matters  are  organized 
(on  paper)  after  the  French  style,  and  apothecaries  are  expected  to  be' 
educated  in  the  schools.  They  often  take  the  place  of  the  very  ignorant 
Turkish  physicians.  Many  of  them  are  Greeks,  Armenians  etc.  ;  others, 
natives  of  the  West,  and  of  course  never  of  the  best  class.  National  Turk- 
ish preparations  are  the  Madjum  and  the  Tenasukh,  which  are  consumed 
in  large  quantities — even  by  the  Sultan — and  are  to  be  regarded  as  soporific 
and  aphrodisiac  remedies. 

Militan*  physicians  are  the  most  highly  esteemed  b}*  both  the  people 
and  the  officials.  On  the  other  hand  the  few  district  physicians  (memleket 
hekimi),  composed  chiefly  of  rejected  and  inefficient  pupils  of  the  imperial 
schools,  are  poor  fellows  who  are  half-starved  in  spite  of  a  monthly  salarjr 
of  $75  (which,  however,  is  never  paid),  and  who,  therefore,  as  a  rule  keep 


—  67  — 

a  kind  of  pharmacy  or  medical  booth,  by  the  profits  of  which  they  support 
themselves.  They  are  never  called  in  by  the  common  people,  and  are 
exempt  from  the  poll-tax.  The  busiest  fellows  are  the  popular  physicians 
(Volksarzte),  and  among  these  chiefly  tbe  Chodschas.1  They  feel  the  pulse 
(the  only  means  of  making  a  diagnosis  known  to  them  !),  and  then  hang 
upon  the  patient  amulets  inscribed  with  passages  from  the  Koran,  or  they 
pronounce  a  charm  over  him  and  finally  breathe  upon  him  with  their  gar- 
licky breath — a  Chodscha  with  an  agreeable  breath  is  a  famous  man  !  For 
pay  they  receive  offerings  in  kind,  just  as  did  the  oldest  pln-sicians  among 
the  Hellenes.  These  offerings  consist  mostly  of  eggs,  or  a  fowl.  Next  to 
the  Chodschas  come  tbe  barbers  ;  itinerant  lithotomists.  some  of  them 
shepherds  by  calling,  who  perform  lithotomy,  often  quite  skilfully  with  a 
pocket-knife  ;  dervishes  who  practise  a  theurgic  medicine  and  sell  universal 
remedies  —  e.  g.  blood-stone  (Jcantaschi)  for  all  haemorrhages  ;  panzechir, 
i.  e.  gall-stones  of  a  ruminant,  useful  against  all  poisons  and  diseases,  if  it 
please  Allah  ;  olibanum  for  urinary  calculus  ;  amulets  for  the  same  purpose, 
and  useful  besides  against  the  devil  and  "the  evil  eye'';  cords  knotted  or 
furnished  with  buttons,  which  serve  as  a  kind  of  rosary  for  saying  pra}Ters, 
and,  if  often  kissed,  are  useful  against  fevers  etc.  Besides  these  are  old 
women  who  brew  potions,  free  negresses,  so-called  Bobbali,  who  practise 
medical  incantations  against  evil  spirits  of  different  degree  ;  "  Persians," 
who  are  reputed  to  be  good  oculists,  and  finally  the  Kali  Tatri  whose 
acquaintance  we  shall  make  in  a  subsequent  paragraph.2  All  these  charac- 
ters, however,  are  not  specifically  Turkish,  but  are  found  with  every  people 
in  their  age  of' rudeness  or  semi-civilization.  For  only  the  most  highly 
civilized  states  possess  a  well  arranged  medical  faculty,  and  even  with  them 
it  is  accompanied  by  a  multitude  of  charlatans  of  all  kinds. 

Medical  and  pharmaceutical  affairs  in  Iioumania,  like  those  of  Turkey, 
are  arranged  chiefly  upon  the  French  model. 

The  same  is  true  of  modern  Greece,  though  here  some  German  regula- 
tions also  make  their  appearance. 

A  medical  school  or  Faculty  has  existed  in  Athens  since  1833.  Popular  physi- 
cians, who  perform  even  major  operations  and  travel  throughout  the  whole  Orient, 
are  the  Kali  Tatri,  mentioned  above.  These  are  members  of  certain  Greek  families, 
who  practise  in  accordance  with  ancient  tradition,  and  give  to  their  medical  knowledge 
the  air  of  an  hereditary  secret,  thus  representing  as  it  were  a'posthurnous  progeny  of 
the  ancient  Greek  itinerant  Asclepiada?.  Popular  medicine  flourishes  generally  in 
modern  Greece,  just  as  in  the  Orient  proper.  God,  the  devil,  enchantment,  "worms" 
etc.  are  considered  causes  of  disease.  Prayer,  exorcism  and  magic  arts,  certain 
saints  (o,.  g.  St.Vissunas  in  coughs,  St.  Jacob  in  deafness,  St.  Varvara  in  small-pox  etc.), 
charms  containing  the  name  of  Christ,  God  and  the  holy  virgin  (all  mediaeval  relics!), 
in  epidemics  circumscribing  the  affected  locality  with  a  new  plough  and  heifers,  both 

1.  That  is  "Learned  in  the  Holy  Writ"  (Koran). 

2.  In   surgical  operations  of  importance,  a  license  from   the   magistrates  (sened)  is 

appropriate,   to   avoid  the   necessity  of  indemnifying  the   relatives  in  case  the 
operation  has  an  unfortunate  result. 


—  GS  — 

of  which  are  then    buried   (the  latter  alive!)  —  all  these  are  regarded   as  effective 
medical  agents. 

The  Arabian  tribes,  both  the  independent  and  those  subject  to  the 
Turkish  rule,  show,  even  less  than  the  Turks  themselves,  any  traces  of  an 
original  medical  development.  On  the  contrary  the}'  cherish  the  corrupted 
relics  of  the  old  Arabian  medicine,  richly  garnished  with  superstition  and 
even  idolatry.  Popular  physicians  and  learned  Hakim  practise  magic 
medicine,  prepare  philters,  and  administer,  or  have  hung  up,  scraps  of 
paper  inscribed  with  verses  from  the  Koran.  They,  however,  also  esteem 
the  science  of  foreign  physicians,  but  only  so  far  as  it  does  not  offend 
against  the  Koran  and  strict  orthodoxy.  Old  women,  instructed  in  mid- 
wifery by  their  own  repeated  experiences,  fill  the  position  of  midwives 
even  to-day,  just  as  the}'  did  in  the  West  until  the  beginning  of  the  modern 
period. 

The  present  inhabitants  of  Egypt,  on  the  other  hand,  under  a  govern- 
ment (in  an  oriental  point  of  view)  more  enlightened,  manifest,  at  least  in 
regard  to  medicine,  a  greater  capacity  for  education.  They  have  their  own 
good  institutions  of  instruction,  supplied  with  native  and  foreign  teachers, 
including  among  them  the  eminent  physicians  Clot-Bey,  Billharz  and 
Bulard,  with  the  apothecaiy  Pruner-Be}',  of  Pfreimed  in  Bavaria,  who  died 
in  1882  at  the  age  of  74,  having  written  in  1S47  his  famous  work  on  the 
diseases  of  the  Orient.  In  these  schools  are  educated  plrysicians,  veterina- 
rians, apothecaries  and  native  midwives,  the  latter  of  whom  professor 
Winkel  in  Munich  found  i  at  least  some  of  them)  well  instructed  even  in 
operative  measures.  The  schools  are  constructed  upon  the  French  model. 
Moreover  many  Egyptians  study  at  European  universities,  so  that  the 
Eg}'ptian  medicine  of  to-day  may  be  considered  a  tolerabl}'  perfect  off-shoot 
of  the  European  or  French  science.  There  exist  well-conducted  hospitals  in 
connection  with  the  schools,  e.  g.  at  Abu-Zabel,1  Cairo,  Alexandria  etc. 

The  Abyssinians,  although  possessed  of  tolerabl}'  high  natural  endow- 
ments even  in  the  arts  (painting,  the  art  of  the  goldsmith),  are  yet  devoted 
to  prayer  and  sunk  in  the  grossest  superstitions,  sprinkling  with  holy  water 
by  the  priests,  enchantments,  amulets  etc.  This  ought  not  to  surprise  us 
when  we  consider  their  Christianity,  which  is  purely  external,  though 
strongly  idolatrous.  They  even  have  no  midwives,  though  they  employ 
drugs  empiricall}-,  particularly  in  the  treatment  of  worms,  a  disease  neces- 
saril}-  frequent  among  them  from  their  common  use  of  the  juice  of  raw 
beef.     In  its  treatment  the  indigenous  kousso  is  the  favorite  remedy. 

According  to  Gerhard  Rohlfs,  the  leprous  are  given  prolonged  baths,  and  take  in- 
ternally a  decoction  of  sarsaparilla,  while  they  wear  amulets  about  the  head  (like  the 
Arabs,  Berbers  and  Turks),  although  the  chief  sacerdotal  physician  declared  all  these 
measures  ineffective.  Syphilis  too  is  treated  with  prayers  and  amulets,  though  re- 
cently sarsaparilla  and  mercury  have  come  into  use.  Spitting  in  the  eyes  is  regarded 
as  an  excellent  remedy  for  the  diseases  of  these  organs.    Epileptics  are  beaten,  under 

1.    A  town  of  Middle  Egypt,  14  miles  north  of  Cairo.     (H.) 


—  69  — 

the  idea  that  they  are  possessed  of  the  devil.  Scaly  eruptions  are  very  frequent,  for  the 
Abyssinians  never  wash,  but  anoint  themselves  abundantly  with  butter.  Circumcision 
is  practised  even  on  maidens,  in  consequence  of  their  tendency  to  excessive  hyper- 
trophy of  the  labia  minora.  Carrion-crows,  hyaenas,  jackals  etc.  perform  the  duties 
of  medical  police  after  battles.  During  epidemic  diseases  etc.,  earthen  pipes,  about 
20  inches  deep,  are  left  in  the  ground  forming  the  floor  of  the  house,  to  serve  as  privies, 
and  when  these  are  sufficiently  full  they  are  covered  over  lightly  and  a  new  one  put 
into  position.  These  give  rise  to  foul  odors  and  frequent  disease!  Wounded  enemies 
are  slain  or  castrated.  Putting  out  the  eyes  is  a  frequent  punishment,  and  is  per- 
formed by  the  smiths  with  a  red-hot  iron.  Lepers  toam  about  the  country  begging, 
but  are  excluded  from  the  villages. 

The  negroes  too  everywhere  have  faith  in  talismans,  fetiches  etc. 
Accordingly  almost  all  tribes  have  magicians,  who  are  at  the  same  time 
priests,  rain-makers  etc.,  and  by  means  of  poisonous  potions  provide  for 
the  execution  of  God's  judgments.  Among  the  Zulus  the  rain-doctors  are 
called  Tnwula,  the  witch  doctors  Tsinjanja.  It  is  the  special  business 
of  the  latter  to  look  out  for  witches,  to  whom  all  diseases  and  deaths  are 
ascribed,  as  was  generally  the  case  among  us  during  the  Middle  Ages.  Be- 
sides this,  it  is  their  duty  to  interpret  dreams,  since  in  these  the  Ttongo,  i.  e. 
the  spirit  of  the  dead,  is  manifested,  a  manifestation  useful  as  a  remedy  in 
diseases.  These  dream-specialists  often  become  wealthy,  as  the}'  are  richly 
rewarded  with  cattle.  Diseases  are  likewise  regarded  as  warnings  from  the 
Amatongo  (the  progenitors  of  the  tribe,  from  whom  proceeds  every  fortune 
and  misfortune  of  their  earthly  descendants)  when  the}'  are  hungry,  and  to 
propitiate  them  and  satisfy  their  hunger  sacrifices  are  offered,  which  the 
priests  of  course  eat.  The  Ukulunkulu,  a  kind  of  mythical  supreme  pro- 
genitors, are  the  teachers  of  oneiromancy  and  medication  against  witch- 
craft. On  the  birth  of  a  child  "  everyone  in  the  kraal  eats  certain  drugs 
and  a  magic  powder,  which  guard  the  child  from  malign  influences.  Incis- 
ions are  also  made  into  the  body  of  the  new-born  infant,  and  the  magic 
powder  rubbed  into  them."  Twins  are  disliked,  and  one  o  fthe  children  is, 
therefore,  usually  permitted  to  die.  The  dead  are  buried  in  the  sitting- 
posture.     (Unsere  Zeit,  1880.) 

According  to  Max  Buchner,  the  negroes  of  the  west  coast  of  Africa  and  the 
basin  of  the  Congo  ( Bondo,  Minnugs  etc.)  endeavor  to  prevent  disease  by  sprinkling 
the  healthy  with  certain  decoctions.  Like  all  negroes  they  employ  exorcism  of  the 
fetiches,  praj'ers,  inunction,  massage  etc.,  and,  in  consequence  of  their  acquaintance 
with  the  Portuguese,  they  likewise  practise  venesection.  Incurable  and  dangerously 
sick  patients  among  the  tribes  of  south  Africa  (Bantu,  Caffirs  etc.)  are  isolated  and 
abandoned  to  their  fate,  as  is  the  custom  among  all  uncivilized  people.  The  popular 
physicians  or  magicians  of  the  Bechuanas  majr  be  adduced  as  the  type  of  such 
characters,  to  be  met  with  in  all  early  periods  of  human  development.  Their  office  is 
either  hereditary,  or  its  duties  are  taught  for  a  consideration  to  members  of  other 
families.  The  tribal  ruler  is  the  chief  magician,  though  he  himself  practises  in  a  few 
cases  only  the  art  of  rain-making,  enchantment  etc.  Ordinarily  he  leaves  the  per- 
formance of  the  magic  rites,  the  practice  of  medicine  etc.  to  the  Linjaka,  who  are 
acquainted  with,  and  make  use  of  a  few  medicinal  herbs.  The  very  clothing  of  these 
magicians  is  superstitious  in  its  character.     They  are  hung  over  with  amulets,  and  are 


—  70  — 

also  painted.  Their  clothing  proper  consists  of  a  baboon's  skin  and  similar  articles. 
They  also  impart  instruction  in  the  gathering  of  herbs,  and  the  "  burial  of  morbid 
matters",  which  they  think  they  have  removed  from  the  sick  by  means  of  sweating, 
cupping  etc.  (a  purely  ontological  conception  of  disease!).  The  course  of  instruction 
costs- one  cow  !  Exorcism  of  evil  beasts  and  men,  throwing  a  kind  of  dice  to  estab- 
lish a  diagnosis,  and  public  exorcisms  in  cases  of  general  calamity  are  under  their 
special  care.  They  also  "church"  lying-in  women  and  their  husbands,  bless  youths 
and  maidens,  and  circumcise  the  former  and,  indeed,  the  latter  also.  The  honorarium 
for  the  latter  service  is  not  paid  to  the  magicians  (or  their  heirs)  until  the  maidens 
are  married.  Besides  this  the}-  prepare  remedies  to  render  their  patrons  "  bullet-proof" 
in  war,  and  purify  dwellings  and  women  who  have  neglected  the  prescribed  "  purifica- 
tions" during  the  public  exorcisms.  The  Bafiotes,  on  the  coast  of  South  Guinea, 
practise  cupping  even  at  the  present  day,  just  as  the  ancient  Egyptians  performed  the 
operation.  Incisions  are  made  into  the  skin,  and  upon  these  are  placed  horns,  which 
have  been  sawed  off  to  the  suitable  length;  from  these  rude  cups  the  air  is  exhausted 
by  sucking,  and  the  withdrawal  of  blood  is  thus  accomplished.  Midwifery  is  practised 
in  Africa  chiefly  by  women,  and  men  are  called  in  only  in  cases  of  necessity.  Felkin 
even  saw  in  Central  Africa  a  case  of  Cesarean  section  performed  by  a  man.  At  one 
stroke  an  incision  was  made  through  both  the  abdominal  walls  and  the  uterus;  the 
opening  in  the  latter  organ  was  then  enlarged,  the  haemorrhage  checked  by  the  actual 
cautery,  and  the  child  removed.  While  an  assistant  compressed  the  abdomen,  the 
operator  then  removed  the  placenta  and  the  clots  through  the  os  uteri.  The  bleeding 
from  the  abdominal  walls  was  then  checked.  No  sutures  were  placed  in  the  walls  of 
the  uterus,  but  the  abdominal  parietes  were  fastened  together  by  seven  figure  of  8 
sutures,  formed  with  polished  iron  needles  and  threads  of  bark.  The  wound  was  then 
dressed  with  a  paste  prepared  from  various  roots,  the  woman  placed  quietly  upon  her 
abdomen,  in  order  to  favor  perfect  drainage,  and  the  task  of  this  African  Spencer 
Wells  was  finished!1 

The  negroes,  like  the  Hottentots,  have  practised  natural  inoculation  of  the  small- 
pox from  remote  times.  Even  in  Central  Africa,  according  to  Livingstone,  who  was 
both  a  physician  and  missionary,  inoculation  is  performed.  In  Tumale  an  Imam  is 
said  to  have  even  practised  a  kind  of  auscultation  in  diseases  of  the  lungs.  For  the 
propitiation  of  the  evil  spirits,  and,  in  consequence  of  the  great  thirst  of  some  tribes 
for  human  blood,  enormous  human  sacrifices  are  offered  to  the  bearers  of  disease  in 
case  of  the  sickness  of  their  chiefs.  Cases  of  death  from  natural  causes,  as  well  as 
from  being  devoured  by  crocodiles  and  other  disagreeable  accidents,  are  often  con- 
sidered by  the  negroes  the  work  of  a  human  sorcerer  or  of  a  witch.  In  such  an  event 
an  ordeal  is  prepared  for  the  real  or  the  reputed  agents  of  the  calamity.  If  satisfac- 
tory evidence  of  their  guilt  seems  to  be  obtained,  they  are  executed  by  means  of 
poisonous  potions  etc.,  especially  if  they  are  poor  and  unable  to  bribe  the  magician  to 
decide  in  their  favor,  i.  e.  to  employ  a  harmless  drink  for  the  ordeal.  Thus  for  one 
single  person,  who  lias  died  of  disease  or  of  the  infirmities  of  age,  two  or  three  times 
that  number,  or  even  more,  of  perfectly  innocent  persons  are  sacrificed  —  just  as  they 
were  in  the  earlier  trials  for  witchcraft  among  us  whites ! 

In  Baghirmi,  which  is  inhabited  by  a  mixed  Arabian  people,  epileptics — sufferers 

1.  The  patient  was  first  rendered  half  unconscious  by  banana-wine,  and  the  first  in- 
cision not  only  penetrated  the  abdominal  walls  and  the  uterus,  but  also  act- 
ually wounded  the  shoulder  of  the  child.  One  hour  after  the  operation  the 
patient  was  doing  well,  and  her  temperature  never  rose  above  101°  F.,  nor  her 
pulse  above  108.  On  the  11th  da}-  the  wound  was  completely  healed,  and  the 
woman  apparent!}' as  well  as  usual.     (H.) 


—  71  — 

from  the  morbus  sacer  of  the  Greeks —  who  are  regarded  as  bewitched,  are  treated  by 
being  beaten  to  death,  certainly  a  radical  remedy.  In  Wadai,  castration  of  the  guards 
of  the  harem  —  also  a  safe  practice  !  —  is  performed  by  the  chief  of  the  blacksmiths, 
who  is  in  addition  a  kind  of  body-barber  to  the  king  and  shaves  his  head  every  week. 
The  same  individual  is  also  physician  to  the  harem,  and  after  the  accession  of  a  new 
king  is  compelled  to  blind  all  the  male  offspring  of  the  former  king  by  passing  a  red- 
hot  iron  across  the  cornea.  —  European  civilization  too  seems  to  have  already  pene- 
trated even  Central  Africa.  The  English  in  1876  had  erected  a  hospital  and  a 
pharmacj*  in  Ujiji  and  Tanganyika.  Unfortunately  European  phj'sicians  are  still 
looked  upon  simply  as  great  magicians,  which  is  not  to  their  advantage. 

The  circumcision  practised  by  the  Hovas,  a  Malay  tribe,  may  perhaps  be  re- 
garded as  a  surgical  operation.  Queen  Ranovolona  II.  in  1883  provided  herself  with 
a  German  physician  named  Havernann  of  Rostock.  — The  Negro-Arabian  portion  of 
the  inhabitants  of  Madagascar,  the  Salaclava,  drive  out  those  possessed  with  evil 
spirits  b}'  beating  them.  The  practice  of  circumcision  is  so  universally  diffused 
among  the  negroes  of  South  Africa  that  the  uncircumcised  are  refused  by  the  maidens; 
indeed  the  latter  are  themselves  circumcised,  and  Winkel  found  circumcised  maidens 
in  Egypt  also.     Footling  births  and  children  born  with  teeth  are  put  to  death. 

Among  the  people  of  Europe,  who  in  progress  of  time  have  almost 
disappeared  by  intermixture  with  foreign  blood,  the  Celts,  who  dwelt 
originally  in  France,  and  emigrated  thence  to  England,  occupy  the  first 
place,  in  consequence  of  their  antiquity  and  their  civilization,  early  intro- 
duced from  the  Greek  settlers  in  Marseilles.1  Among  these  the  Druids,2  who 
formed  a  guild  with  an  elective  chief,  Coibhi  Druid,  and  whose  wives  (?) 
were  the  Alraunen  (Druida?,  Druidesses),  practised  as  physicians.  The 
former  cured  diseases  by  means  of  incantations  and  magic  arts,  as  well  as 
by  the  aid  of  herbs  (especially  the  misletoe)  collected  with  secret  ceremo- 
nies.3 The  Alraunen  or  priestesses  (a  term  also  emplo}-ed  to  designate 
a  class  Of  witches  or  idols),  prophesied  from  the  blood  of  their  enemies 
whose  heads  they  had  cut  off  after  the  battle. 

Among  the  Celtic  inhabitants  of  Wales  the  bards  are  regarded  as 
physicians  (philosophers  and  astronomers). 

The  old  Welsh  physician,  Cettwy,  the  philosopher,  was  the  author  of  the  following 
hygienic  rules :  1.  He  who  desires  to  attain  a  great  age  should  play  until  he  is  20, 
work  until  he  is  40  and  then  rest  to  the  end  of  his  days.  2.  He  should  rise,  and  go  to 
bed  with  the  lark.  3.  He  should  eat  when  hungry,  drink  when  thirsty,  and  rest  when 
tired.     4.  He  should  guard  against  too  dainty  i'ood,  too  strong  drink  and  too  severe 


1.  As  they  believed   in   the  transmigration  of  souls  their  civilization    was  probably 

derived  in  part  also  from  the  Egyptians. 

2.  Their  pupils  were  instructed   orally   alone,  and   were   not  permitted  to  write  down 

their  verses,  but  were  required  to  learn  them  by  heart,  a  process  which  (accord- 
ing to  Caesar  "De  bello  Gallico",  VI.)  often  required  twenty  years. 

3.  Druids  clad  in  white  cut  it  with  a  golden  sickle  and  collected  it  in  white  napkins, 

since,  in  order  to  retain  its  efficacy,  it  must  not  touch  the  earth.  Even  at  the 
present  day  the  farmers  at  Christmas  hang  it  up  in  their  homes,  and  on  New 
Year's  Day  in  England  a  youth  may  kiss  the  maidens  with  impunity  under  the 
misletoe  —  a  process  in  which  the  plant  seems  to  retain  something  of  its  magic 
and  fascinating  powers. 


work.  5.  He  should  shun  strife,  love  peace  and  refrain  from  too  much  anxiety.  G. 
Let  him  be  cheerful,  generous  and  just.  7.  Let  him  have  onl}'  one  wife,  be  strong  in 
the  faith  and  pure  in  conscience.  8.  Let  him  be  thoughtful  in  the  morning,  indus- 
trious at  noon  and  sociable  at  night.  9.  Let  his  thoughts  be  serene,  his  amusements 
blameless,  the  air  wholesome  for  his  respiration.  10.  Let  not  his  clothing  be  old,  let 
his  home  be  clean  and  inviting,  and  let  him  be  contented  with  his  lot.  11.  Let  his 
clothing  be  light,  his  food  light  and  his  heart  light.  12.  Let  his  demeanor  be  affable, 
his  mind  active.  13.  Let  him  observe  the  laws  of  his  country,  the  duties  of  his  calling 
and  the  commands  of  the  gods.  14.  Thereby  will  his  body  be  health}',  his  feelings 
light  and  his  conscience  pure.  15.  His  life  will  be  long  and  his  end  blessed.  —  These 
rules  if  observed  to-day  'would  be  profitable  to  everyone.  The  physician  of  the 
domestics  of  the  old  kings  of  Wales  was  called  Meddyd,  and  belonged,  as  among  the 
Romans,  to  the  servile  class. 

Our  German  forefathers,  so  highly  extolled  in  the  writings  of  Tacitus, 
also  possessed  healing  witches  and  idols.  The  latter,  dipped  in  water,  im- 
parted to  this  fluid  the  power  to  remove  all  diseases,  both  of  man  and  beast, 
to  ease  the  pangs  of  labor  and  to  put  an  end  to  unfruitfulness  in  married 
women,  precisely  like  certain  of  our  medical  springs  of  the  present  day. 
Amulets  were  also  worn. 

Equally  ancient  with  the  Celts  are  the  Scandinavians,  whose  medical 
mythology  displays  among  the  demi-gods  a  female  JEsculapius,  Eira, 
another  goddess,  Fricco,  invoked  for  fruitfulness  in  wedlock,  and  Holla,  the 
aider  of  women  in  labor.  On  the  other  band.  Hela,  a  ghastly  form,  received 
all  those  who  died  of  disease  into  her  residence  Niflheim,  which  contained 
the  hall  Elidnir  (pain),  her  bed  Koer  (disease)  and  the  table  Hungur.  Some 
fragments  of  genuine  medical  practice  and  information  of  a  later  period 
have  also  been  preserved  to  us.  Thus  the  Scandinavian  physicians  in  cases 
of  dropsy  are  said  to  have  had  recourse  to  the  actual  cauteiy,  and  in  asthma 
to  have  resorted  to  venesection,  while  for  bearing  the  wounded  those  war- 
riors were  selected  who  possessed  soft  hands.  Their  anatomy  mentions  214 
bones,  315  vessels  and  only  30  teeth.  Their  physiology  locates  love  in  the 
liver,  passion  in  the  bile,  memory  in  the  brain  — data  which  remind  us  of 
Indian  ideas. 

Among  the  people  of  the  North  the  ancient  Prussians  possessed  the 
most  complete  medical  mythology.  In  their  trinity  of  Pikollos,  Potrimpos 
and  Perkunnos.  the  latter  was  the  dispenser  of  health.  He  also  maintained 
a  sacred  fire,  whose  ashes  cured  almost  all  diseases,  save  those  sent  directly 
as  punishment  for  sins.  In  his  daily  journey  as  isochronous  god  of  the  sun, 
the  rough  country  doctor  became  so  dusty  that  Perkunatete  must  perforce 
administer  to  him  a  bath  every  evening.  Besides  the  sacred  ashes,  a  popu- 
lar remedy  was  the  water  of  the  sacred  springs  in  the  vicinity  of  the  tem- 
ples, which  was,  however,  to  be  first  purchased  from  the  priests.  The  chief 
temple  was  located  at  Romove.  Lai  in  a  was  the  goddess  of  parturient  and 
unfruitful  women,  the  latter  of  whom  were  relieved  by  the  skin  of  sacred 
serpents.  Yet  if  the  care  of  these  serpents  was  neglected  by  the  inhabit- 
ants, they  might  become  genuine  causes  of  disease.      Ausweikis  passed  for 


the  iEsculapius  of  the  Prussians,  aud  was,  therefore,  invoked  by  all  the 
sick  and  feeble.     Gittina  was  the  bearer  of  painful  death. 

The  Sclavs,  who  in  the  6th  century  A.  D.  drove  out  the  Germans  and 
immigrated  into  their  present  home,  like  their  descendants  of  the  present 
day,  superstitiousl}'  accused  the  Zernebogs  of  introducing  diseases.  Man}- 
diseases,  too,  had  special  goblins  as  their  authors  ;  the  nightmare  e.  g.  was 
ascribed  to  Kodotta.  The  appearance  of  the  spectre  Smertnitza  announced 
immediate  death  to  the  sick,  and  the  convulsions  and  death-rattle  of  the 
dying  were  evidences  of  the  force  employed  by  her  in  the  separation  of  soul 
and  body.  The  Sclavs  of  themselves,  however,  never  advanced  beyond  the 
first  traces  of  theurgic  medicine. 

Medical  superstition,  magic  etc.  are  very  prevalent  among  the  masses 
■even  to-da}-,  and  the  cleigy.  together  with  the  ATidatschi  (i.  e.  magicians, 
who  never  operate  unsuccessfull}-)  and  the  lay  brothers  vie  with  each  other 
in  theurgic  or  semi-theurgic  practice.  To  these  must  be  added  the 
"Wratschars  and  Wratscharitzas,  who  prepare  mystical  potions. — In  Servia 
we  find,  however,  an  entirely  modern  medical  and  military  S}-stem,  though 
it  is  not  very  thoroughl}-  carried  out. 

Recently  the  Sclavs  have  joined  with  energy  in  the  march  of  advancing 
science,  following  chiefly  the  lead  of  the  Germans  and  the  French.  — Rou- 
manian medicine  is  also  connected  with  the  French.  The  latter  people 
likewise  exercise  the  predominant  influence  among  the  Russians,  with  whom, 
particularly  in  the  frontier  and  larger  cities,  the  relations  of  practice  are 
for  the  most  part  the  same  as  with  us.  On  the  other  hand,  in  man}-  districts 
of  the  interior,  in  spite  of  the  existence  of  district  physicians,  a  scarcit}- 
of  medical  men  prevails,  so  that  in  numerous  places  within  the  borders  of 
this  colossal  empire  the  great  land-holders  or  their  wives  supply  medical 
attendance  to  the  common  people,  at  least  in  internal  diseases.  —  Among 
man}-  tribes  in  southern  Russia  and  in  the  Asiatic  portions  of  the  empire, 
attention  to  medical  art  is  still  considered  an  occupation  unworthy  of  a 
man,  and  medicine  is  therefore  practised  by  women  of  the  same  tribe,  or 
by  Russian  women  residing  in  the  vicinit}-.1  Indeed  in  consequence  of 
this  prejudice  the  government  is  compelled  to  send  female  physicians  to 
these  tribes.  Pay,  when  demanded,  consists  of  presents,  more  rarely  of 
money.  That  superstitious  practices  frequentl}-  slip  in.  under  the  guise  of 
medical  art,  among  these  degraded  people  is  the  less  astonishing,  when  we 
reflect  that  among  us  the  grossest  superstition  in  regard  to  the  treatment 
of  diseases  daily  raises  its  unabashed  head.  — In  Montenegro  in  1875  there 
were  no  phjsicians.  and  even  no  midwives,  so  that  in  difficult  labors  out- 
rageous and  dangerous  cruelties,  like  those  of  the  Siamese,  were  practised 
upon  the  unfortunate  sufferers. 

Even   among  the    Samoyedes  (Lapps)  we  may  recognize   traces  of  a 

1.    This  is  an  example  historically  remarkable,  but  not  unique,  of  a  population  which 
accepts  only  female  physicians. 


—  74  — 

theurgic  medicine.     According  to  their  ideas  demon-priests  control  health 
by  propitiating  the  evil  spirits,  the  Tatebi. 

One  of  their  invocations  runs  :  "  I  have  brought  thee  an  offering ;  I  have  satisfied 
thee,  and  thy  belly  is  now  full  etc.  Grant  us,  I  pray  thee  now,  a  blessing  for  our 
beasts  and  our  health." 

The  Esquimaux,  their  neighbors  on  the  western  continent,  also  display- 
similar  traces  of  theurgic  medicine.  They  believe  in  ubiquitous  good  and 
evil  Innuits,  the  latter  of  whom  ma}-  be  appeased  by  the  Angekoks,  who  are 
at  once  magicians  and  physicians.  To  the  latter  they  apply  for  the  cure 
of  disease  and  to  foretell  death.  These  Angekoks  understand  themselves 
very  well,  and  are  said  to  have  practised  massage  from  time  immemorial. 

The  Indians  of  North  America  have  in  their  conjurors  (medicine-men) 
a  class  Of  physicians  who  all}-  themselves  with  Manittu,  the  great  spirit,  in 
order  to  be  able  to  foretell  whether  the  patient  is  curable  or  not. 

In  some  tribes  these  conjurers  are  called  Medas,  and  pronounce  incantations  and 
health-charms.  The  Dacotah's  have  amulets  of  various  sizes,  scarcely  any  two  of  which 
are  alike,  but  the  composition  of  each  of  which  is  revealed  by  Wakan-tan.ua  in  a 
dream.  The  portable  amulets  are  called  medicines.  Besides  these  they  have  others, 
designed  to  be  placed  in  front  of  the  wigwams,  and  called  great  medicines.  Both 
varieties  are  considered  extremely  sacred.  Among  the  Sioux,  after  the  usual  exor- 
cisms, incisions  are  made  in  the  skin  of  the  forehead  and  abdomen,  and  the  blood  is 
then  sucked  out  by  women  in  order  to  remove  the  disease. 

The  Chunipies,  on  the  outbreak  of  the  small-pox,  avoid  the  direct  road  and 
travel  in  curves  and  serpentine  courses.  Other  Indians  follow  the  same  custom. 
(  According  to  Dr.  Sepp,  this  habit  is  analogous  to  the  earlier  "  plague-dances",  de- 
signed to  propitiate  the  deity,  and  to  the  "  grave-dances",  still  customar}-  in  the  Orient. 
In  Sachsenhausen,  near  Frankfort-on-the-Main,  as  late  as  the  beginning  of  the  present 
century,  dances  were  performed  in  the  church-yard,  and  the  "  Schafflertanz",  practised 
yet  every  ten  years  in  Munich,  is  merely  an  anachronistic  plague-dance.) 

The  medical  mythology  of  the  ancient  Aztecs  of  Mexico,  the  brave 
sons  of  Montezuma  (died  1520  A.  D.),  with  all  their  devotion  to  cruel  relig* 
ious  sacrifices,  was  very  complete.  They  had  a  special  iEsculapius.  Ixtit- 
lon,  whose  wife,  Tzapotleman,  was  the  discoverer  of  healing  spices.  Tetz- 
catlipoca,  however,  the  god  of  providence,  passed  for  the  author  of  diseases, 
which  he  sent  as  punishment  for  evil  deeds.  They  had  priestly  physicians, 
the  Teopixqui.  These  endeavored  to  prevent  or  improve  false  positions 
of  the  foetus  by  kneading  the  belly  of  the  pregnant  woman  from  the  7th 
month  on.  If  the  child  did  not  thereby  assume  the  correct  position,  the 
mother  was  seized  by  the  legs  and  shaken  until  the  head  presented  itself  (as 
among  the  Japanese).  The  Aztec  priests  practised  circumcision,  and  even 
beasts  were  nursed  and  cared  for  by  physicians. 

Even  the  Caribees  constructed  for  themselves  at  least  a  heaven.  Hu- 
jukhu,  where  there  were  no  diseases,  and  where  many  wives  and  plenty  of 
intoxicating  drinks  were  promised  to  the  men.  They  also  practised  a  kind 
of  circumcision. 

The  Indians  of  Florida  likewise  had  their  physicians,  Jawas. 


—  75  — 

"  When  they  wish  to  cure  a  patient,  they  are  accustomed  to  rub  him,  press  him,  to 
bite  and  blow  upon  him,  and  finally,  by  strong  suction  upon  some  portion  of  his  body, 
they  shuffle  out  a  fish-bone,  a  thorn  or  a  bone,  which  they  then  declare  the  cause  of  the 
disease.  Others  perform  very  dangerous  manipulations  upon  themselves,  instead  of 
upon  the  patient,  and,  in  order  to  propitiate  the  evil  spirit,  swallow  knives,  stones  and 
gun-barrels.     These  physicians  are  particularly  cunning  and  crafty." 

The  physicians  of  the  natives  of  Guiana,  who  are  called  "Piay",  one  of  whom  is 
possessed  by  each  tribe,  manage  in  a  similar  wajr.  They  treat  the  sick  b}r  prayer, 
blowing  upon  and  scratching  with  a  fragment  of  stone  the  painful  points,  and  then 
sucking  out  the  blood.  Their  whole  body  is  striped  with  red  paint — ihe  special  color 
of  the  Faculty  !  Upon  the  head  they  wear  three  feathers,  and  upon  the  shoulders 
two  wings.1 

The  sons  of  the  sun,  the  Incas  of  Peru,  possessed  so  high  a  civilization, 
that  the}'  enjoyed  a  complete  political  system,  and  had  attained  great 
advancement  in  architecture,  road-building,  postal  arrangements  etc.,  while 
even  in  art  and  dramatic  works  of  metrical  form  (some  of  which  have  been 
recently  translated  into  German)  they  were  by  no  means  deficient.  The}' 
likewise  employed  numerous  medicinal  drugs,  pre-eminent  among  which 
was  the  cinchona.  Led  by  empirical  instinct  these  people  had  employed 
the  bark  in  appropriate  cases,  long  before  the  Europeans  had  learned  from 
them  its  properties.  They  had  no  special  god  of  medicine,  and  indeed 
recognized  only  one  god,  Pachacamac.  At  the  festival  called  Citua,  the 
feast  of  atonement,  the  Inca  consecrated  four  sons  of  the  sun,  who  by 
means  of  this  ordination  became  physicians. 

As  the  Peruvians,  like  the  Egyptians,  were  devoted  to  the  cultus  of  the  dead,  they 
preserved  their  corpses  partly  in  bales  of  grass  and  woven  materials,  rolled  up  like 
mummies.  Finally  the  inhabitants  of  Terra  del  Fuego  have  conjurers,  and,  according 
to  the  account  of  an  English  phj-sician,  the  defunct  members  of  the  medical  profes- 
sion— epileptics  are  its  chosen  representatives — are  regarded  as  genuine  devils,  to  be 
kept  off  by  appropriate  ceremonies.  The  dead  are  converted  into  skeletons  by  a 
noble  lady  immediately  after  death,  and  the  bones  are  then  buried  provisorily,  until 
some  flesh  still  clinging  to  them  is  removed  by  putrefaction.  When  this  process  is 
completed,  the  skeleton  is  finally  placed  in  a  grave  in  the  sitting  posture. 

Among  all  Indian  tribes  we  have  found  undoubted  traces  of  principles  of  medicine, 
and  from  these  there  would  unquestionably  have  been  constructed  (as  among  civilized 
peoples  in  the  course  of  centuries)  a  real  science  of  medicine,  had  not  a  home  and 
freedom,  the  life-blood  of  all  independent  progress,  been  cruelly  cut  off  by  the  race- 
destroying  whites.  Alas,  however,  the  whole  race  will  ere  long  be  exterminated,  and 
thenceforward  exist  only  as  an  impeachment  of  their  destroyers  before  the  tribunal 
of  history !  Yet  their  medicine  had  already  attained  the  same  height  reached  by  that 
of  the  Greeks  but  a  short  time  before    Homer !     That  medical  ideas  and  practices, 


1.  My  own  humble  opinion  is  that  this  red  paint  of  the  Piays  is  a  prehistoric  example 
of  the  later  red  cloak  of  the  Faculty.  As  the  Indians  wear  no  clothing,  they 
can,  of  course,  replace  the  latter  only  with  red  paint.  The  three  feathers  may 
point  to  their  license  to  practise  medicine,  surgery  and  midwifery,  and  the  two 
wings  may  indicate  that  they  enjoy  hiyh  flights  of  thought  as  investigators,  as 
well  as  practitioners.  If  such  a  medical  man  should  conclude  to  practise  among 
us  civilized  people,  he  would  certainly  at  the  present  dajr  find  an  enormous 
practice  among  high  and  low — except  in  the  diseases  of  children  ! 


—  76  — 

whatever  their  kind,  belong  to  the  earliest  manifestations  of  human  thought,  is  shown 
by  even  the  natives  of  New  Holland,  who  occupy  the  lowest  grade  in  the  scale  of 
civilization.  They  possess  priests,  Karraji,  of  the  good  and  evil  spirit  (Koyan  and 
Petoyan),  who  are  likewise  phj-sicians,  curing  wounds  and  diseases,  and  foretelling 
the  future.  At  King  George's  Sound  these  priest-physicians  are  called  Mulgaradok, 
and  are  highly  esteemed,  inasmuch  as  they  know  how  to  create  and  disperse  tempests, 
rain  and  diseases.  In  Hawaii  they  are  called  Kahuna-laau,  and  by  prayers  and 
sacrifices,  especially  of  dogs  and  swine,  the}'  propitiate  the  divinity.  In  the  Feejee 
Islands,  however,  the  pln-sician  bears  the  ironical  title  of  "The  Carpenter  of  Death". 
The  ordinarj"  obstetricians  of  the  Sandwich  Islands  are  old  men,  who  take  the  par- 
turient women  on  their  knees  and  rub  the  abdomen  from  behind  until  the  child  is 
expelled.  The  umbilical  cord  is  then  cut  long.  Women  draw  the  tongue  of  the 
mother  out  of  her  mouth  until  she  vomits  and  the  after-birth  comes  away.  Next  the 
mother  takes  a  bath  in  the  sea,*and  at  once  resumes  her  ordinary  duties.  If  the  labor 
is  difficult,  the  attendants  know  that  they  have  to  do  with  a  half-breed  with  a  large 
head,  and  the  child  is  ordinarily  killed,  as  is  usual  among  other  uncivilized  people. 
The  South  Sea  Islanders  know  how  to  perform  trepanning,  and  the  natives  of 
Australia  perform  even  ovariotomj',  and  produce  artificial  hypospadias  b}'  slitting  up 
the  urethra  to  produce  sterility  and  impotence.  ( H.  Tillmanns.)  On  the  other  hand, 
many  Polynesian  tribes  practise  circumcision  to  facilitate  coitus. 

If  the  medical  ideas  and  customs  set  forth  in  the  foregoing  pages 
(and  their  number  might  easily  be  increased)  are  wanting  in  thoroughly 
scientific  and  technical  value,  they  }'et  undoubtedly  furnish  evidence  that 
no  people  exists  without  medical  views  and  regulations  of  some  kind,  and 
that  medical  efforts  and  conceptions,  though  only  under  the  form  of  rude 
superstition  and  belief  in  witchcraft  and  similar  phenomena  of  a  more 
highly  developed  theology,  belong  among  the  earliest  manifestations  of  the 
infancy  of  human  civilization.  Indeed  we  ma}'  affirm  that  medical  defence 
against  diseases  and  death  is  a  fundamental  characteristic  of  man  even  in 
primeval  periods,  and  one  which  distinguishes  him  from  all  other  beings. 
Hence  these  accounts  possess,  as  we  believe,  a  certain  value  for  the  history 
of  the  development  of  humanity,  and  not  simply  for  that  of  medicine. 
From  all  the  foregoing  considerations  there  seems  to  be  the  greatest  proba- 
bility  that  the  necessit}'  for  medical  aid  in  the  widest  sense,  the  dread 
of,  and  resistance  to,  the  annihilation  of  our  being,  were  the  chief  agents  in 
the  formation  of  religious  representatives  and  conceptions,  as  an  expression 
of  the  natural  instinct  of  self-preservation  directed  primarily  to  the  body. 
It  is  also  quite  possible  that  a  medical  necessit}'  (if  such  an  expression  is 
allowable)  may  have  been  the  fundamental  cause  of  the  origin  of  religion, 
and  consequently  of  the  beginning  of  a  higher  civilization  among  all  people. 
Disease  with  its  consequences,  pain,  helplessness,  destitution  and  despair 
of  earthl}'  aid,  may  well  have  been  the  proper  source  of  the  belief  in  a 
supernatural  helper,  just  as  we  now  observe  daily  that  disease  with  its  con- 
sequences disposes  even  the  most  sensible  to  the  acceptance,  or  readmission 
of  superstitious  practices.  Certain  it  is,  at  all  events,  that  medical  and 
religious  ideas  originated  at  least  contemporaneously  in  the  earliest  ages 
of  human  history,  for  nearly  all  the  earliest  gods  of  almost  every  people 


—  77  — 

were  also  gods  of  medicine,  and  almost  all  the  priests  of  the  gods  were  in 
like  manner  physicians. 

From  the  special  data  furnished  in  our  last  section  a  prehistoric 
medicine  might  almost  be  constructed,  especially  with  the  aid  of  the  state- 
ments regarding  the  people,  who  at  the  present  day  occupy  the  lowest 
grade  of  civilization.  In  fact  the  latter  are  still  found  in  their  prehistoric 
phase  of  development,  a  phase  which  the  civilized  nations  proper  have  long 
passed,  and  concerning  which  all  written  information  is  either  entirely 
wanting,  or  preserved  only  sparingly  in  saga  and  tradition.  But  without 
much  danger  of  error  we  may  infer  the  character  of  prehistoric  medicine 
from  the  analogous  conditions  of  the  rude  tribes  of  tire  present  day. 
Hence  the  medical  customs  and  practices,  as  well  as  the  medical  personnel 
of  these  tribes  now  devoted  to  destruction,  acquire  the  greatest  interest  in 
the  history  of  civilization. 

Medicine,  in  the  childhood  of  mankind,  was  regarded  partly,  if  not  en- 
tirely, as  a  kind  of  religion,  and  its  practice  was  a  religious  occupation, 
while  its  results  were  the  united  work  of  gods  and  men.  Among  all  races, 
but  especially  among  the  Semitic,  all  diseases  were  considered  originally 
(and  even  after  the  opening  of  a  tolerably  high  civilization)  visitations  or 
punishments  from  some  god  or  another,  who  must  be  propitiated  and 
called  upon  for  aid  and  cure,  and  this  idea  is  so  firmly  rooted  in  the  less 
highly  cultivated  portion  of  mankind,  that,  as  we  know,  it  is  retained  by 
even  ;' the  faithful''  of  the  present  day.  Religion  and  medicine,  the  latter 
of  which  was  among  all  people  originally  theurgic  and  grossly  empirical, 
separated  from  each  other  at  first  gradually,  and  medicine  after  a  long 
period  then  first  reached  the  point  which  for  that  early  day  must  be  called 
the  beginning  of  science.  Yet  its  character  and  extent,  like  the  civilization 
of  the  people  to  whom  it  belonged,  did  not  at  first  attain  a  grade  which  we 
are  accustomed  to  dignify  by  the  name  of  science.  Here  too  our  ideas 
must  be  guided  by  the  people  of  the  age,  and  the  civilization  to  which  they 
had  already  attained.  The  medicine  of  the  people  already  mentioned,  in 
order  to  win  our  respect,  and  indeed  our  admiration,  must  be  measured  by 
the  rule  of  civilization  of  their  period,  the  civilization  which  the}*  could,  or 
actually  did,  attain.1 

The  medical  culture  already  described  (except  much  of  that  in  the  last 
section)  belongs  to  the  last  half  of  the  first  great  wave  of  civilization  known 
to  us,  and  which  completed  its  descending  course  in  the  trough  represented 

1.  The  discovery  of  human  skulls  of  the  neolithic  period,  bearing  evidences  of  tre- 
panning,  deserves  notice  here  as  an  example  of  prehistoric  surgical  practice. 
An  excellent  resume  of  our  knowledge  on  this  subject  by  Robert  Fletcher,  M.  R. 
C.  S.  Eng.,  A.  A.  Surg.,  U.  S.  A.,  will  be  found  in  the  "  U.  S.  Geographical  and 
Geological  Surve)'  of  the  Rocky  Mountain  Region,"  vol.  v.,  1882.  Evidences  of 
the  prehistoric  existence  of  syphilis,  in  both  Europe  and  America,  are  also  con- 
stantly accumulating,  and  may  already  claim  to  have  rendered  quite  probable 
such  an  early  existence  of  this  reputed  modern  disease.     (H.) 


by  the  beginning  of  the  Middle  Ages.  From  this  trough  arose  a  second 
wave  of  civilization,  upon  whose  crest  we  now  stand.  Whether  other  waves 
preceded  that  first  one,  we  know  not  :  but  such  an  assumption  is  not  op- 
posed to  the  experience  of  history. 

The  preceding  remarks  have  proven,  and  what  follows  will  further 
prove,  that  medical  culture,  like  human  culture  in  general,  "  transforms 
itself  in  accordance  with  eternal  laws,  in  substance  the  same,  in  forms 
differing  through  the  ever  new  expression  of  the  ages  and  their  guiding 
thoughts."     (Gregorovius  Siciliana,  iv.,  p.  138.) 


*->^®d;  «*«-*■ 


SECTION  SECOND. 


THEJUEDICAL    CULTURE    OF    THOSE    NATIONS    WHOSE 
DEVELOPMENT    IN    MEDICINE    HAS    BEEN    OR 
IS    PROGRESSIVE. 


FIRST    PERIOD. 


ANTIQUITY. 


THE    MEDICINE    OF    THE    GREEKS  (AND  ROMANS)    DOWN   TO 
THE  PERIOD  OF  THE  OVERTHROW  OF  THE  WEST- 
ERN   EMPIRE    IN    THE    YEAR  476  A.  D. 


A.     MEDICINE   UNDER  THE   INFLUENCE   OF  GRECIAN   VIEWS. 
I.     THE  MEDICINE  OF  THE  GREEKS. 

The  intimate  eonnexion  of  later  grades  of  the  development  of  humanity 
with  those  which  have  gone  before,  is  almost  always  most  pleasantly  shown 
by  the  history  of  civilization,  although  frequently  manifested  in  onl}-  a  few 
facts,  which  illuminate,  like  the  electric  light,  the  dark  paths  of  human  cul- 
ture. And  our  knowledge  of  these  paths,  and  of  the  methods  by  which 
humanity  has  effected  its  intellectual  extension  from  people  to  people  in  the 
course  of  centuries,  has  recently  so  greatly  increased  that  very  many  pre- 
ceding gaps  and  interruptions  are  filled  up.  or  bridged  over,  by  researches 
in  comparative  philology,  by  the  study  of  the  monuments,  by  the  exhuma- 
tion of  objects  of  artistic  and  technical,  as  well  as  of  luxurious  and  ordinary 
use,  and  finally  by  the  discovery  of  very  ancient  records  etc.,  just  as  in  the 
physical  world  we  learn  to  explain  the  origin  of  later  forms  and  species 
from  an  examination  of  those  which  have  long  since  perished. 

Thus  the  Greeks  undoubtedly  incorporated  into  their  own  culture  orig- 
inal portions  of  the  primitive  civilizations  which  we  have  alread}'  considered. 
We  need  mention  only  the  use  of  letters  and  mathematics,  which  they 
borrowed  from  the  Phoenicians  and  Egyptians  ;  the  very  early  examples  of 
art  with  which  the  excavations  at  Tiryns  (founded,  according  to  Schliemann, 
R.  C.  1500)  and  Mycenae  have  recently  made  us  familiar,  and  which  point 
to  a  "prehistoric,"  pre-Homeric  or  pre-Hellenic  civilization,  at  one  time  to 
Scythian,  at  another  to  Phiygian  and  Thracian  tribes,  now  to  Asiatic,  again 
to  Egyptian1  models.  But  we  should  specially  recall  the  fact  that  much  of 
the  old  Egyptian  medicine  is  met  with  again  in  the  Greek  (even  in  that 
of  Hippocrates),  and  particularly  in  the  Alexandrian  medicine.  The  Greeks, 
however,  in  accordance  with  their  happy  mental  organization,  raised  these 
foreign  elements  at  once  to  an  extraordinary  perfection  and  development. 
Whatever  they  touched  intellectually,  or  incorporated  from  without,  they 
improved,  purified,  elevated  and  refined.  The  simple  knowledge  of  these 
primitive  peoples  they  developed  and  elevated  into  the  liberal  sciences, 
which  they  created,  and  the  stereot}-ped,  mechanical  forms  of  the  former 

1.   The  oldest  forms  of  the  gods  among  the  Greeks  also  had  the  heads  of  animals! 
6  (81) 


—  82  — 

became,  under  their  hands,  a  genuine  art,  which  seeks  and  conceals  its  laws, 
not  in  external  precepts,  but  in  its  own  inmost  being. 

Thus,  in  accordance  with  their  peculiar  disposition,  the}'  exercised  a 
unique  influence  upon  all  futurity,  and  became  naturally  the  leaders  of  the 
whole  great  second  phase  of  civilization  (after  the  disappearance  of  the 
first  Egyptian  and  Semitic  phase),  among  whose  sustaining  factors  we  too 
belong. 

Accordingly  no  people  of  history  has  exercised  so  controlling  an  in- 
fluence upon  the  formation  of  all  succeeding  humanity  —  and  with  it  upon 
the  medicine  of  all  civilized  people — as  the  ancient  Greeks  ;  and  no  people 
too  has  since  attained  such  a  harmony  of  mental  culture.  Poets,  artists, 
historians,  philosophers,  mathematicians  and  physicians  admire,  even  to- 
day, the  Hellenic  spirit,  and  adopt  its  works  as  their  models — that  spirit 
at  once  so  rich,  so  deep,  so  graceful  and  so  comprehensive,  as  to  worthily 
deserve  the  imitation  of  all  posterit}-.  Coupled  with  creative  fancy  and, 
therefore,  strong  in  formative  power,  it  interwove  the  world  with  magic 
forms  of  noblest  poesy,  and  beautified  the  existence  of  mankind  with  higher 
ideals  of  every  art.  For  to  the  Hellenes,  above  all  other  people,  artistic 
creation  was  given  b}'  nature  as  their  peculiar  inheritance.  In  earnest  and 
most  profound  intellectual  labor  too  the  Greeks  created  loft}"  models  for  all 
exalted  effort,  whose  eternal  worth  is  based  upon  their  perfection  and  their 
direction  to  the  great  whole.  For  the  Greek  mind  strove  always  for  the 
profound  and  the  entire,  and  wras  always  directed  more  to  the  essence  of 
things,  not  so  much  to  fleeting  appearances.  It  was  not  contented  with 
knowledge  alone,  in  medicine  with  "facts"  alone,  but  ever  sought  likewise 
the  inmost  essence,  aim  and  object.  It  contemplated  the  world  from 
general  standpoints,  not  passing  from  the  special  to  the  general  so  frequently 
as  we  ourselves  do. 

The  world  of  appearances,  which  demands  minute  observation  of  nature 
or  absolute  experiment,  remained  to  them  almost  a  stranger  ;  at  least  their 
services  in  this  sphere  were  not  great.  The  Greeks,  indeed,  strove  after  a 
knowledge  of  the  world  of  appearances,  but  still  more  after  a  knowledge 
of  their  essence  and  their  ground  ;  in  medicine  more  after  a  knowledge 
of  disease  in  itself,  than  of  individual  species  of  disease  and  their  peculiar 
phenomena. 

The}'  proved  their  profound  and  yet  practical  sense  too  in  treating  and 
striving  to  cure  rather  sickness  than  diseases  ;  for  sickness  in  the  abstract 
continues,  even  to-day,  the  most  successful  point  of  attack  for  medical  art, 
which  is  unable  to  battle  against,  and  to  conquer,  as  such,  the  individual 
diseases  laid  down  in  the  books. 

The  Hellenes  found  in  medicine  all  the  elements  of  a  philosophy,  in 
the  physician,  the  philosopher  (r^-oiic  yap  <fi/.otT<><f<>c  i<r60eo<;)  :  they  always, 
and  especially  in  their  best  classical  period,  considered  medical  practice  and 
medical  treatment  a  genuine  art,  and  the  physician  himself  at  once  a  phil- 
osopher and  an  artist. 


1,  MYTHICAL  AND  SACERDOTAL  MEDICINE,  THE  MEDICINE  OF  HOMER, 
The  Hellenes,  like  all  other  people,  assigned  to  medicine  as  its  foun- 
ders and  supporters  certain  ever- ruling  gods  and  godesses.  Transforming 
human  efforts  and  hopes  for  the  alleviation  of  human  sufferings  and  infirm- 
ities into  poetic  creations,  they  thus  produced  their  individual  deities,  obey- 
ing in  this,  with  refined  sensibility  and  like  "genuine,  joyous  heathen", 
rather  the  laws  of  the  beautiful  than  those  religious  precepts  which  charac- 
terized the  gloom)-  and  coarsely  sensual  Semitic  races.  Thus  Hera  (Juno), 
the  justly  jealous  and  irritable  wife  of  the  highest  of  the  gods,  concealing 
the  amorous  deeds  of  the  cloud-glittering  Zeus,  and  prone  to  curtain- 
lectures,  was  the  natural  protectress  of  lawful  and  conjugal  birth,  while  in 
union  with  her  obstetrical  daughter  Ilithyia,  she  rebuked  with  stern  auster- 
ity all  offences  against  the  code  of  morality.  This  fact  Alcmene  and  even 
Leto,  the  mother  of  twin  gods,  learned  by  sad  experience.  Juno,  Apollo 
(Paean)  and  Artemis  were  also  deities  of  healing,  Apollo  the  bearer  of  pes- 
tilence, Artemis  the  goddess  of  parturition.  The  latter,  indeed,  terrified  by 
her  mother's  pangs  at  her  own  birth,  besought  from  Zeus  the  favor  of  eternal 
virginity  ;  yet,  in  admiration  of  the  beaut)'  of  the  sleeping  Endymion,  she 
yielded  to  all-powerful  nature,  drew  the  youth  with  her  own  hands  into  a 
cave,  and  in  punishment  of  her  earlier  prudery,  by  a  truly  godlike  super- 
foecundation,  became  the  mother  of  fifty  daughters  at  once.  Pallas  Athene, 
on  the  contrary,  the  special  patroness  of  the  eyes  (but  fortunately  more 
learned,  and  thus  a  sterile  blue-stocking),  though  the  protectress  of  mighty 
warriors,  remained  yet  a  virgin. 

The  proper  god  of  medicine  was  iEscuIapius,  son  of  Coronis  and 
Apollo,  "  bearded  son  of  a  beardless  sire,"  as  the  Greeks  jestingly  said. 
His  life  was  with  difficulty  preserved  ;  for  Apollo  brought  the  pregnant 
Coronis  (who  nevertheless  is  said  to  have  been  betrothed  to  Ischys)  to  the 
funeral  pile,  and  only  by  taking  him  out  of  his  mother's  womb  was  iEscu- 
lapius  saved,  begotten,  like  other  great  men,  in  concubinage,  and  born  by 
Caesarean  section.  According  to  other  authorities,  Arsinoe'  was  his  mother. 
If  he  was  in  danger  of  being  burned  in  the  womb  of  Coronis,  he  is  said,  on 
the  other  hand,  to  have  been  abandoned  by  Arsinoe  after  birth,  and  to  have 
been  saved  from  starvation  by  a  goat,  thus  affording  us  the  first  example 
of  the  artificial  feeding  of  children.  The  wife  of  ^Esculapius  in  his  first 
marriage  was  Epione,  who  was  accorded  divine  honors  with  him.  His 
second  wife  was  Lampetia,  daughter  of  the  sun-god.  The  former  bore  to 
him  Hygieia,  the  constant  companion  and  colleague  of  her  father,  and  the 
feeder  of  his  serpent  (the  symbol  of  rejuvenation,  and  probably  also  an  in- 
dication of  the  earlier  serpent-worship  of  the  magicians),  as  well  as 
Machaon  and  Podalirius,  "good  physicians  both."  Besides  these,  Panacea 
(whose  temple  stood  at  Oropus),  Jaso  and  iEgle  were  children  of  JEscula- 
pius  by  Epione.  while  Janiscon  and  Alexanor  were  his  sons  by  Lampetia. 
Telesphorus,  the  bearer  of  convalescence,  is  often  found  in  attendance  upon 
^sculapius,  and  is  represented  as  a  boy  with  a  long  robe  and  a  Phrygian 


—  84  — 

cap.  Mythology  also  derives  vEsculapius  from  Memphis  in  Egypt,  and  de- 
clares that  he  immigrated  into  Greece,  bringing  medicine  with  him  ;  a  myth 
from  which  we  might  also  conclude  that  Egyptian  medicine  was  the  mother 
of  the  Greek. 

iEsculapius  received  instruction  in  the  healing  art  from  Chiron,  who, 
in  spite  of  his  offensive  combination,  half  horse,  half  man,  was  the  most 
versatile,  famous  and  popular  of  the  celestial  professors. 

Orpheus,  Medea,  Circe,  Hercules.  Prometheus  and  Melampus  were  also 
associated  with  the  earliest  medicine  of  the  Greeks.  Hercules  was  the  dis- 
coverer of  warm  baths  (hence  called  Heraclean),  and  a  mythical  hygienist. 

The  services  of  JEsculapius  (who  has  also  been  considered  a  real  physician  of 
about  the  period  B  C.  1250),  were  especially  of  a  surgical  nature,  but  extended  like- 
wise to  internal  diseases.  In  addition  to  natural  remedies,  he  employed  magic  songs 
to  aid  their  effect : 

"  Lulling  the  pain  with  force  of  soothing  charm. 
Refreshing  drinks  he  gave,  or  grateful  salve 
Unto  their  wounds  applied  ;  employed  the  knife 
To  raise  up  others  from  their  bed  of  pain." 
In  consequence  of  the  unexampled  results  of  his  art  JEsculapius  made   himself 
hateful  to  Pluto,  who  accordingly   accused    him    to   Zeus  of  desolating   the   realm    of 
shades,  (such  a  charge  would   scarcely  pass   muster   to-day,    in    spite  of  unnumbered 
/Esculapii !)  and  Zeus  slew  him  with  his  thunderbolt,  a  mythical  and  palpable  declara- 
tion that  the  law  of  death  could  not  be  altered  in  favor  of  physicians. 

After  his  death  he  was  exalted  to  the  position  of  the  god  of  medicine, 
and  a  special  cultus  was  introduced  by  his  priests.  The  places  devoted  to 
his  cultus  were  the  so-called  Asclepieia,  of  which  the  most  famous  were  at 
Tricca.  Epidaurus,  Cos,  Cnidos,  Pergamus,  Mycenae  and  Sicyon. 

These  localities  were  situated  on  wooded  slopes,  or  in  the  vicinity  of  medicinal 
springs,  and  contained  images  of-the  god,  and,  of  course,  many  priests,  who,  among 
the  Greeks  too,  inaugurated  civilization,  and,  like  the  mediaeval  monks,  selected  the 
best  positions.  Neither  d3"ing  persons  nor  parturient  women  were  permitted  to 
remain  in  their  vicinitj',  a  sanitary  regulation  imitated  to-day  in  some  of  our  bathing, 
and  other  private  medical,  institutions.  For  the  reception  of  the  sick,  or  their  repre- 
sentatives, in  the  sacred  treatment,  there  were,  however,  inns  and  boarding  houses 
connected  with  the  temple,  but  the  capacity  of  these  was  never  sufficient  for  the 
demand.  The  proceedings  of  the  priests  were  somewhat  as  follows:  the  patient,  or 
his  deputy,  was  prepared  by  the  interdiction  of  certain  kinds  of  food  and  of  wine,  or 
by  absolute  fasting;  for  without  such  preparation  no  person  might  enter  the  temple. 
As  he  entered  the  latter,  the  priests  in  their  robes,  accompanied  by  their  daughters, 
recounted  wonderful  stories  of  the  deeds  of  the  god,  of  cures  effected,  and  of  remedies, 
whereby  the  imagination  of  the  patient,  and  his  expectations,  of  course,  were  excited 
to  the  highest  pitch,  and  the  ground  levelled  fur  what  was  to  follow.  Next  came 
prayers  and  a  bath  in  the  warm  or  cold  springs,  followed  by  frictions  and  inunction 
of  the  body  and  other  manipulations.  Then  was  arranged  before  the  statue  of  the 
god  the  offering,  in  the  shape  of  a  cock  or  a  ram,  which  was,  of  course,  of  more  im- 
portance to  the  priest  than  to  the  god.  Now  followed,  in  the  presence  of  the  priests, 
or  in  the  vicinity  of  the  temple,  the  ceremony  of  Incubation,  during  which,  according 
to  Aristophanes,  all  kinds  of  pranks  were  practised,  even  down  to  absolute  vulgarity. 
Sleep,  through  the  preceding  excitement  of  the  imagination,  was  filled  with  dreams, 


—  85  — 

whose  interpretation  was  the  business  of  the  priests.  The  latter  now,  however,  ordered 
certain  remedies,  e.  g.  cathartics,  emetics,  bleeding — according;  to  all  accounts  to  an 
enormous  extent, — fasting  etc.  ]f  a  cure  followed,  then  the  will  of  the  god  had  been 
obeyed;  but  if  not,  then  the  patient  had  always  in  some  way  committed  an  over- 
sight,— just  as  is  the  case  with  some  doctors  to-day.  If  the  patient  was  cured,  the 
convalescent  then  offered  consecrated  offerings,  e.  g.  golden,  or  ivory,  or  terra  cotta 
(museum  in  Naples)  models  of  the  diseased  parts  (anathemata) ;  or  he  hung  medals 
upon  the  legs  of  the  god,  which  were  then  carried  off  by  the  priests.  In  certain 
emples  the  medical  history  of  the  convalescent  and  the  remedies  employed  in  the 
case  were  inscribed  upon  the  posts  of  the  temple,  or  upon  suspended  votive  tablets, 
which  thus  served  a  purpose  similar  to  the  crutches  of  the  cured  hung  up  in  certain 
of  our  baths  and  pilgrim-resorts  of  to-day,  but  also  had  this  advantage,  that  they 
furnished  to  the  later  science  of  therapeutics  its  first  empirical  principles.  The 
purport  of  one  of  these  tablets  of  a  later  period  was  as  follows  : 

"Julian,  after  spitting  blood,  seemed  hopelessly  lost.  The  god  ordered  him  to 
come  and  take  from  the  altar  pistachio  nuts,  and  to  eat  these  for  three  days  mixed 
with  honey.     He  was  restored  and  came  and  thanked  the  god  before  the  people." 

We  see  that  then,  as  now,  confiding  simplicity  enjoyed  the  best  claim  to  success. 
Yet  such  theurgic  customs  had  likewise  their  realistic  side,  if  such  an  expression  is 
allowable.  If,  for  instance,  a  valuable  remedy  was  discovered,  its  composition  was 
engraved  upon  the  posts  of  the  temple,  or  upon  special  tablets,  and  thus  was  finally- 
collected  a  kind  of  pathology  and  a  store  of  drugs,  such  as  may  have  given  origin 
e.  g.  to  the  "  Coan  Prognoses'. 

The  priests  of  Hvsculapius  were  not.  however,  the  direct  founders  of  Grecian 
medicine.  This  was  the  work  of  the  Asclepiarlae,  guilds  of  purely  lay  physicians, 
which  existed  in  various  localities,  even  where  there  were  no  famous  sanctuaries  of 
yEsculapius  ( e.  g.  in  Crotona),  and  whose  members — like  the  Kali  Tatri  of  the  Orient 
to-day — traveled  about  in  the  practice  of  their  profession  and  to  make  their  fortune. 
These  were  called  to  attend  the  sick,  or  were  visited  bjT  the  latter  at  their  own 
residences.  Some  of  them  acquired  special  reputation  and  won  posthumous  fame, 
even  as  writers.  Doubtless  these  were  the  most  highly  gifted  and  the  best  educated, 
who  gained  their  higher  education  chiefly  from  intercourse  with  celebrated  men  whom 
they  met  in  their  travels.  In  fact  it  was  in  this  way  that  the  ancient  Greeks  generally 
obtained  their  higher  education,  and  not  from  frequenting  schools.  Of  course  the 
most  famous  Asclepiads  were  great  travelers,  even  Hippocrates,  the  most  distinguished 
of  them  all.  These  Asclepiadae,  however,  who  were  considered,  and  professed  to  be 
descendants  of  ^Esculapius,  originally  appropriated  the  substance  of  the  medicine  of 
the  temples,  and  increased  it  by  such  drugs  as  were  discovered  by  any  of  their 
members.  Possibly  (as  there  is  nothing  new  under  the  sun)  some  of  the  original 
assistants  of  the  priests,  entrusted  with  the  administration  or  preparation  of  the 
medicaments  prescribed  by  the  latter  (in  spite  of  their  generally  theurgic  treatment), 
may  have  finally  emancipated  themselves  entirely,  and  set  up  business  on  their  own 
account  in  the  neighborhood  of  t lie  temples.  These  gradually  expanded  their 
business  beside  that  of  the  priests,  just  as  we  shall  see  done  mutatis  mutandis  in 
Salerno,  which  was  also  originally  a  place  of  miraculous  cures,  and  then  developed 
into  that  school  of  physicians,  which,  during  the  Middle  Ages,  was  as  famous  as  any 
of  the  Asclepions.     These  Asclepiada1  bequeathed1  their  knowledge  to  their  descend- 

1.  All  the  earliest  intellectual  creations  were  preserved  by  oral  tradition  from  teacher 
to  pupil,  and  it  was  not  until  a  later  period  that  they  were  fixed  hy  writing.  In 
order  to  be  learned  more  easily  they  were  composed  in  verse,  e.  g.  the  Vedas, 
Homer,  the  verses  of  the  Druids  etc.     Among  the   Greeks   the  Aoidoi  were  the 


—  80  — 

ants,  or  to  those   received   into   their  guild,   who,    by    this  reception,  'became  genuine 
"  Asclepiadae". 

In  Homer's  poems  we  find  no  intimation  of  the  worship  of  ^Esculapius, 
though  Herodotus,  who  places  Homer  in  the  9th  century  B.  C,  considers 
and  designates  him  the  chief  manufacturer  of  gods.  It  may,  therefore,  have 
originated  after  the  age  of  the  poet.  JEsculapius  is  mentioned  only  as  an 
unrivalled  physician  and  as  the  father  of  Machaon  and  Podalirius.  The 
latter  were  not  only  physicians,  but  also  warriors  in  the  fray,  and  accord- 
ingly placed  upon  complete  equality  with  the  other  combatants,  for 

"Full  thirtj*  sail  the  sparkling  waves  divide, 
Which  Podalirius  and  Machaon  jruide." 

They  were  held  in  high  esteem,  for 

"  A  wise  physician  skilled  our  wounds  to  heal 
Is  more  than  armies  to  the  public  weal." 

And  were  manifestly,  in  that  day.  regarded  as  artists,  not  as  trades- 
men : 

"  Who  then  will  ask  a  stranger  to  his  board, 
Except  a  public  servant ;   in  a  word 
A  seer,  physician  in  our  times  of  need, 
Or  architect,  or  bard  inspired  to  lead 
Our  hearts  to  joy  b}r  strains  of  godlike  song." 

Pseeon  (Paeon),  who  healed  with  divine  celerit}*  the  wound  of  Ares. 

''Thus  he  who  shakes  Olympus  with  his  nod 
Then  gave  to  Paeon's  care  the  bleeding  god. 
With  gentle  hand  the  balm  he  poured  around, 
And  healed  the  immortal  flesh,  and  eloped  the  wound," 
was  physician  to  the  wounded  gods. 

Besides  these  "men  of  .healing."  or  to  use  our  modern  term,  "army 
surgeons,"  Homer  also  introduces  female  physicians.  Helen,  Agamede,  "the 
fair-haired,  who  all  healing  herbs  well  knew."  and  others. 

Internal  medicine  was  not  entirely  unknown  in  Homeric  antiquity,  but 
surgery  was  the  chief  business  of  the  physicians.  They  cut  out,  or  drew 
forth,  darts,  swords  and  lances,  checked  the  haemorrhage,  washed  the  wounds 
with  tepid  water,  applied  bandages  after  sprinkling  them  with  soothing 
drugs,  and  in  addition  administered  a  restorative  drink.  There  were  no 
stationary  or  movable  field-hospitals,  but  the  soldiers'  tents  or  barracks 
took  their  place,  and  possibly  also  served  for  the  reception  of  the  wounded 

guardians  of  these  verses.  The  earliest  written  works  of  the  Greeks  were  ac- 
counts of  travels  by  land  or  sea  (periodoi  or  periplus),  and  were  written  upon 
small  pieces  of  leather  (diphtherai  I  by  the  Logographoi  about  the  6th  centuiy 
B.  C.  Anaximander  also  wrote  out  his  philosophical  rules  of  life.  It  was  not 
until  the  introduction  of  papyrus  from  Egypt  that  a  written  literature  became 
possible.  The  earliest  collections  of  Greek  literature  were  made  by  Peisistratus 
and  Polycrates  (Max  Midler).  Hippocrates  was  the  first  to  commit  medical 
ideas  to  writing,  and  thus  became  the  father  of  medical  literature  or  medicine. 
Before  his  day  it  had  been  taught  orally  only  among  the  Greeks. 


—  87  — 

and  the  sick.  (Frolich.)  Internal  diseases  are  never  mentioned  by  Homer, 
except  an  epidemic  of  nine  days  excited  by  the  darts  of  Apollo.1 

Homer's  anatomical  knowledge  does  not  exceed  those  rudiments  to  be 
acquired  by  the  slaughter  and  eating  of  animals.  Sinews,  bones,  intestines 
etc.  are  mentioned,  terms  which  correspond  very  closely  with  those  of 
Hippocrates. 

His  acquaintance  with  materia  medica  is  equally  scanty.  It  is  certain, 
however,  that  he  was  acquainted  with  Egyptian  drugs,  of  which  there  was 
a  very  large  number,  for  Helen  gives  to  Telemachus  such  a  drug,  which  she 
had  received  from  queen  Polydamna,  wife  of  the  Theban  king  Thon.  (Lauth.) 
Homer  also  says  that  all  the  Egyptians  were  physicians.  Besides  charms, 
we  may  conjecture  something  in  the  line  of  medicine  in  the  "drink  of  obliv- 
ion"2 (opium),  to  which  may  be  added  such  dietetic  remedies  as  the  odor- 
ous onion  (eaten  freely  and  gladly,  together  with  garlic,  by  the  ancient 
Greeks,  in  spite  of  their  devotion  to  the  beautiful),  honey,  wine  etc.  Chief 
of  all,  however,  was  the  bath,  followed  by  inunction.  After  Homer's  time 
Machaon  was  regarded  rather  as  a  surgeon,  and  Podalirius  as  a  physician. 

2.    THE  PHILOSOPHY  OF  THE  GREEKS  DOWN  TO  THE  TIME  OF  PLATO,  AND 

ITS  SHARE  IN  THE  THEORY  AND  MATERIAL  OF  MEDICINE. 

(about  b.  c.  600  to  b.  c.  430.) 

The  philosophy  of  the  Greeks  exercised  so  essential  an  influence  upon 
their  medicine — the  philosophers  were  not  only  metaphysicians,  but  also 
physicists  (natural  philosophers),  and  many  of  them  also  physicians  —  that 
the  fundamental  doctrines  of  the  former  formed  the  theoretical  principles 
of  the  latter,  and  we  cannot  well  keep  the  two  separate.  Above  all,  the 
method  of  investigation  of  the  Grecian  philosophers  at  an}-  given  period 
was  the  method  employed  in  medicine  at  the  same  period,  and  the  same 
has  been  the  case  even  down  to  our  own  da}'.  Hence  the  whole  medicine  of 
the  Greeks  bears  the  special  character  of  a  philosophical  science,  if  we  except 
that  of  Hippocrates  alone.  He  among  all  the  Ancients  was  almost  the  only 
one  who,  while  cultivating  tried  observation  and  experience,  yet  yielded 
its  proper  place  to  pure  reason  as  such,  and  trod  the  analytico-synthetic  path. 

That  civilization  made  its  entrance  into  Greece  proper  in  part  fiom  Asia  and 
Egypt,  and  by  way  of  Ionia  and  the  islands,  is  shown  b}'  the  earliest  natural  phil- 
osophy developed  after  the  primitive  Gnosticism,  the  so-called 

IONIC  SCHOOL  (ABOUT  GOO  B.  C.) 

Its  founder  was  Tholes  of  Miletus  (639-544  B.  C),  a  pupil  of  the  Egyptian 
priests  and  a  contemporary  of  Alcasus  of  Mytilene  (about  600  B.  C.)  and  Sappho 
(about  628-568  B.  C).     He  assumed  water  and  reason  (deity)  as  the  principle  and 

1.  A  pestilence  in  Crete,  which  has  been  associated  with  the  siege  of  Troj',  also  falls 

in  the  age  of  Homer.  It  may  be  remarked  here  that  the  "evil  eye",  so  much 
dreaded  even  at  the  present  day  in  the  Orient,  e.  g.  by  the  negroes,  the  modern 
Greeks  and  the  inhabitants  of  southern  Italy,  played  a  great  role  in  etiology, 
even  in  the  da}rs  of  Homer. 

2.  Nepenthe.     (H.) 


—  88  — 

first  cause  of  nil  things.  Of  these  the  first  predominates,  and  in  all  transformations 
of  form  in  the  secondary  elements  —  earth,  air  and  fire  —  preserves  its  characteristics. 
Iu  mechanical  separation  and  union,  or  through  active  contraction  and  dilatation,  of 
these -elements  everything  which  exists  has  its  origin.  Thales  is  said  to  have  been 
the  first  to  introduce  geometry  from  Egypt.  Anaximander  of  Miletus  (born  B.  C.  61 1) 
assumed  undivided  matter  (to  aizetpov)  as  the  primary  principle,  from  which  heat, 
cold,  dryness  and  moisture  developed  themselves  in  such  a  way  that  the  kindred 
principles  found  themselves  united  (elective  affinity).  On  the  other  hand  Anaximenes 
of  Miletus  (B  C.  570-500)  considered  air  in  its  essence  the  unchangeable  principle 
of  all  things,  ascribing  to  it  immeasurability,  endlessness  and  constant  motion  as 
characteristics.  Either  he  or  Anaximander  brought  the  sun-dial  into  Greece.  Isr- 
aeli Ins  of  Ephesns  (about  556-460  B.  C),  "the  weeping  philosopher",  "the  obscure  . 
assumes  fire  as  the  primal  matter,  and  enmity  (-o/.s/i.o:,  epts)  of  the  minutest  parts 
as  the  cause  ot  decay,  while  their  friendship  (6/j.uXnyia,  slpyjvrl')  is  the  ground  of 
origin  of  all  things.  An  anima  mundi  is  the  sculptor  of  the  equally  fiery  human  soul, 
which  latter  is  derived  from  the  former  in  respiration.  He_djini£5_the_ejnbrjo  from 
the  male  semen  alone,  assigning  to  the  uterus  simply  the  role  of  a  place  of  develop- 
ment. Far  more  important  is  the  philosophy  of  Anaxagoras  of  Clazomence  in  Asia 
Minor  (B  C.  500-428),  the  teacher  of  Pericles  (died  of  the  plague  B.  C.  429).  and 
likewise  an  able  astronomer.  He  regarded  the  planets  and  the  moon  as  bodies 
analogous  to  the  earth,  and  considered  the  moon  to  be  inhabited.  He  was  a  kind  of 
ancient  Galilei,  inasmuch  as  he  was  accused  and  convicted  of  impiety  by  the  Eumol- 
pida?  on  account  of  his  doctrines,  but  escaped  punishment  by  flight.  Anaxagoras 
assumed  matter  and  spirit  (v«D?)  as  the  elementary  principles  of  the  world,  of  which 
the  first  consisted  of  innumerable,  similar  most  minute  particles  (Homceomeriaj), 
transformed  by  the  creative  activity  of  the  spirit  into  animate  and  inanimate  objects, 
and  governed  as  dead  matter.  His  physiological  and  pathological  views  are  as 
follows:  The  animal  body,  by  means  of  a  kind  of  affinity,  appropriates  to  itself  from 
the  nutritive  supply  the  portions  similar  to  itself.  Males  originate  in  the  right, 
females  in_thp_Jfifr  sMp  »f  the  uterus^  Diseases  are  occasioned  by  the  bile,  which 
penetrates  into  the  blood-vessels,  the  lungs  and  the  pleura.  Diogenes  of  Apollonia 
(  B.  C.  550-460),  the  founder  of  a  theory  of  vessels,  in  which  are  contained  intimations 
of  the  left  ventricle,  the  aorta,  the  carotid  and  the  pulse,  assumed  air  as  the  funda- 
mental element,  from  which  matter  and  spirit,  all  things  in  general,  are  formed,  and 
from  which  everything  receives  life.  In  the  animal  body  it  goes  from  the  left  ven- 
tricle into  all  the  vessels,  and  mingles  there  with  the  blood. — The  most  important 
influence  upon  later  times  was  exercised  by  Empedovles  of  Agrigenttim  (B  C.  504- 
443),  who  assumed  the  four  elements,  Water,  Air,  Fire  and  Earth.  Nothing  can 
either  originate  or  be  destroyed,  but  all  changes  are  simply  those  of  form.  Every 
thing  originates  in  the  friendship  (<suia)  everything  is  destroyed  by  the  enmity, 
(i.  e.  separation  )  of  these  elements.  Men,  beasts  and  plants  he  considered  demons 
punished  by  banishment,  who,  through  purification,  might  again  attain  to  a  residence 
in  the  Sphairos,  the  seat  of  the  gods.  It  was  in  accordance  with  these  views  that 
he  treated  all  diseases  by  theurgic  means.1  The  sex  of  the  embryo  was  determined 
by  the  predominance  of  heat  or  cold  in  the  parents.  He  believed  that  the  embryo 
was  nourished  through  the  navel,  and  to  him  we  owe  the  terms  amnion  and  chorion. 

1.  However  he  also  banished  epidemics  by  building  fires  and  draining  the  water  from 
swamps,  a  proceeding  which  Na'geli  has  recently  again  recommended  on  the 
principles  of  bacteriology.  In  contrast  with  Homer  he  understood  the  etiology 
of  pestilential  diseases,  and  introduced  a  treatment  in  some  respects  quite 
realistic,  leaving  out  the  gods  and  working  himself. 


—  89  — 

Death,  however,  resulted  from  the  extinction  of  heat,  the  effect  of.  separation  of  the 
elements.  Expiration  arose  from  motion  of  the  blood  upwards,  and  consequently  of 
the  air  outwards;  inspiration,  in  an  inverse  way.  He  desired  to  be  considered  a  god 
and  to  appear,  like  a  god,  in  the  dress  of  a  charlatan  (Gregorovius).  He  is  said  to 
have  raised  a  woman  from  the  dead  (most  of  these  people  raised  from  the  dead  are 
women !),  and  to  have  gone  into  heaven  in  a  blaze  of  glorj',  i.  e  to  have  been  received 
among  the  gods.     The 

ITALIAN  SCHOOL,  OR  SCHOOL  OF  CROTONA,  (ESTABLISHED  ABOUT  B.  C.  550), 

was  founded  by  Pythagoras  of  Santos  (B.  C.  580-489)  at  Crotona  in  Magna  Graecia, 
whither  he  had  fled  before  Polycrates,  the  tyrant  of  his  native  land.  He  had  visited 
Egypt  and  acquired  in  that  birthplace  of  mathematics  the  principles  of  his  doctrine, 
— another  evidence  of  the  influence  of  that  primeval  home  of  civilization  upon  Grecian 
science.  His  teacher  was  Onnuphris  (Unnofre)  of  Heliopolis.  Pythagoras  formed 
at  the  outset  a  sect  of  his  followers,  who  should  make  it  their  study  to  rule  their  whole 
life  bj'  definite  principles,  among  which  were  included  some  of  a  medicinal  or  dietetic 
character.  Number,  as  the  purest  conception,  formed  the  basis  of  his  philosophy. 
Unity  was  the  symbol  of  perfection,  the  first  cause  of  all  things;  God  himself  '\  he 
number  2  represented  the  material  world.  The  whole  universe  was  based  upon  the 
number  12,  which  is  divisible  into  thrice  4:  whence  we  have  3  worlds  and  4  spheres. 
These  in  turn  result  from  the  4  elements,  —  water,  air,  fire  and  earth.  The  corporeal 
elements  are  comprised  in  the  number  10,  in  which  again  each  single  number  has 
its  counterpart.  Bodies  originate  under  various  combinations  of  the  endless  and 
unendless,  the  direct  and  indirect,  unity  and  plurality,  right  and  left,  male  and  female 
the  motionless  and  the  moving,  the  straight  and  curved,  the  bright  and  dark,  the  good 
and  evil,  the  square  and  parallelogram,  opposites  10  by  10  together.  All  this  united 
forms  the  Music  of  the  Spheres.  The  animal  soul  is  an  emanation  from  the  anima 
mundi,  and  consists  of  the  intellect,  the  reason  and  the  soul  proper.  God  is  the  soul 
universal,  light  of  lights,  author  of  himself.  Between  the  two  exists  a  gradation  of 
higher  or  lower  beings  (demons).  Man  is  the  lowest  of  the  higher  and  the  highest  of 
the  lower  beings.  He  was  the  first  among  the  Greeks  to  teach  the  immortality  of  the 
soul  and  the  decay  of  the  body  after  death,  though  others  affirm  that  the  same  thing 
was  taught  by  his  master  Pherecydes  of  Syracuse.  After  death  the  human  soul 
ascends  or  descends,  the  former  for  reward,  the  latter  for  punishment:  hence  the 
doctrine  of  metempsychosis.  Nature  is  capable  of  the  highest  perfection.  - —  The 
basis  of  life  is  heat.  New  life  originates  from  the  semen  (which  springs  from  the 
male  brain  and  contains  a  warm  halitus)  together  with  the  moisture  of  the  brain  of 
the  female.  The  semen  is  the  foam  of  the  noblest  blood.  The  good  is  like  unity, 
godlike.  Striving  after  this  gives  moral  health.  Diet  and  gymnastics  however  serve 
to  maintain  physical  health.  In  diseases,  which  are  occasioned  by  the  demons, 
prayer,  offerings  and  music  to  restore  the  harmony  of  the  spirits  are  useful.  Magic- 
virtues  reside  in  certain  plants,  e.  g.  the  cabbage  (a  special  food  of  the  sect),  squill 
and  anise.  Surgical  interference  is  inadmissible;  salves  and  poultices,  on  the  other 
hand,  are  allowable.  This  medley  of  high  sounding,  but  groundless,  sentences  main- 
tained great  influence  in  succeeding  ages  even  in  medicine.  —  Among  the  pupils  of 
Pythagoras  Alcmceon  of  Crotona  (Biuttium,  in  Magna  Gneeia,  B.  C  500,)  was  the 
most  famous  in  medicine.  He  was  manifestly  the  first  (animal)  anatomist  and  is  said 
to  have  discovered  the  optic  nerves  and  the  Eustachian  tubes.  In  physiology  he  like- 
wise admits  the  origin  of  the  semen  from  the  brain,  and  believes  that  the  head  of  the 
foetus  is  the  first  part  developed.  Health  depends  upon  harmony,  disease  upon  dis- 
cord, of  the  component  parts  of  the  body,  of  heat  and  cold,  dryness  and  moisture, 
bitterness   and  sweetness  etc.,— a  doctrine   amplified   in   later  systems   of  medicine. 


—  90  — 

His  theory  of  hearing,  of  which  Theophrastus,  of  Eresus,  (according  to  Albert) 
gives  an  account,  is  very  well  worth  notice  :  "  We  hear  with  the  ear  because  it  con- 
tains a  vacuum,  and  this  occasions  the  sound.  In  the  cavity,  however,  the  sound  is 
generated,  the  air  resounding  against  it."  In  generation  both  parents  furnish  semen, 
and  whichever  of  the  two  supplies  the  most,  this  one  determines  the  sex  of  the  embryo. 

In  consequence  of  the  banishment  of  the  Pythagoreans  from  Crotona  (about 
B.  C.  500),  such  philosophic  physicians,  so-called  "  Periodeuta?"  (itinerant  physicians), 
spread  themselves  abroad  in  all  directions.  Among  them  Democcdes,  court-physician 
of  Polycrates  of  Samos  (535-522  B.  C.),1  was  especially  notable.  He  received  an 
annual  salary  of  about  $2,000  from  Polycrates,  and  after  his  death  went  to  the  court 
of  Persia,  where  he  cured  Darius  of  a  dislocation,  which  his  Egyptian  physicians  did 
not  understand  how  to  relieve,  and  his  wife,  Atossa,  of  an  abscess  of  the  breast. 
Other  distinguished  "  Periodeutaj"  were  Acron  of  Agrigentum,  who  put  an  end  to 
the  plague  of  Athens,  though  this  is  also  ascribed  to  Hippocrates,  Metrodorus  and 
Epicharmus  (540-450  B.  C.  |. 

THE    ELKATIC    SCHOOL 

was  founded  by  Xenpphanes  of  Co/op/ton,  in  Elis,  about,  B.  C.  450.  The  Eleatics 
held  God  and  the  world  to  be  one  and  the  same  thing,  and  were  also  pantheists. 

THE    MATERIALISTIC    (ATOMIC)    PHILOSOPHY    (B.  C.  450), 

of  Leucippus,  a  contemporary  of  Pythagoras,  and  of  Democrilus  of  Abdera  in 
Thrace,  the  "laughing  philosopher''  (400-360  B.  C),  one  of  the  greatest  spirits  of  all 
time,  rejected  creative  reason,  and  replaced  it  by  necessit}-.  It  sought  in  matter  the 
foundation  of  t lie  world  and  of  thought;  indeed  it  professed  to  find  the  principle  of 
all  things  in  the  infinitely  minute,  identical,  not  eternal  nor  inimitably  divisible,  but 
still  infinitely  numerous  Atoms.  Within  these  reside  order,  position,  form  and 
motion.  They  differ  in  size,  and  to  this  difference  their  weight  corresponds.  The 
differences  of  the  elements,  fire,  water,  air  and  earth,  depend  upon  differences  in  the 
form  and  size  of  the  atoms.  The  soul  consists  of  round  and  smooth  atoms,  and  its 
expressions,  like  life  in  general,  are  a  result  of  the  motion  of  the  atoms.  These 
smooth  and  round  atoms  exist  in  the  whole  body.  In  special  parts  they  are  particu- 
larly active,  so  that  the  heart  e.  g.  occasions  wrath;  the  liver,  desire;  the  brain, 
thought.  The  perceptions  of  the  senses  originate  in  the  motion  of  the  atoms  of  ex- 
ternal objects  (whose  imajie  they  are)  toward  our  organs  of  sense,  and  produce  in 
these  organs  a  palpable  impression,  the  perception.  Spirit  and  body  are  identical; 
a  healthy  condition  of  the  brain  implies  mental  health;  and  disease  of  the  same 
organ  implies  mental  disease,  —  a  point  of  view  not  reached  again  until  the  18th 
century.  No  medical  writings  of  Uemocritus  are  at  present  extant.  'I  hey  related  to 
epidemics  (which  he  explained  b\r  a  downfall  of  the  atoms  of  destroyed  heavenly 
bodies),  and  also  to  fever,  diet,  prognosis,  hydrophobia  etc. 

In  a  considerably  less  degree  the  following  systems  also  were  concerned  in  the 
development  of  the  theory  of  medicine.  The  School  of  Sophists,  the  founders  of 
which  were  Gorglas  of  Leontium?  (B.  C.  485-H78),  and  Protagoras  of  Abdera9  (B.C. 

1.  According  to    Herodotus,     Polycrates    brought    the    physicians   of   Crotona   into 

reputation.     Next  to  them  in  fame  stood  those  of  Cyrene. 

2.  In   Sicily,   whose  population,    according  to  Gregorovius,  even  at  the  present  day, 

has  sophistical  tendencies. 

3.  As  an  example  of  his  precepts,  we  quote:   "  Man  is  the  measure  of  all  things;  of 

those  which  are,  that  they  are ;  of  those  which  are  not,  that  they  are  not. 
"  Contradictory  affirmations  are  equally  true."  (He  might  have  added,  "Doubt- 
ful things  are  uncertain."     H.) 


—  91  — 

489-404),  degraded  philosophy  into  mere  dialectic  artifices,  in  order  to  utilize  the 
masses  both  politically  and  materially  for  their  own  advantage.  Their  greatest 
opponent,  though  himself  educated  in  their  art,  was  Socrates  (B.  C.  4G9-399),  a  con- 
temporary of  Hippocrates,  and  the  profound  creator  of  a  purer  conception  of 
morality,  who  fell  a  victim  to  Athenian  intolerance  and  persecution.  The  pupils  of 
Socrates,  Euclides  of  Megara  (about  B.  C.  400),  and  Phcedon  of  Eretria,  in  Euboea, 
discarded  completely  the  perceptions  of  the  senses,  and  allowed  them  no  existence 
whatever.  Aristippus  of  Gyrene  (B.  C.  485),  however,  was  the  founder  of  the 
Cyrenaic  School,  which  rejected  all  systems  of  morals  and  declaied  pleasure  the 
highest  and  only  good.  On  the  other  hand,  Antisthenes  of  Athens  (born  B  C.  444) 
preached  absolute  contempt  for  riches,  the  vanities  of  this  world,  and  for  science 
itself,  and  thus  became  the  founder  of  the  School  of  Cynics,  whose  best  known 
member  was  his  pupil,  Diogenes  (B.  C.  414-324). 

In  concluding  this  section  it  may  be  remarked  that  in  Greece  it  was  not  entirely 
devoid  of  danger  to  be  possessed  of  an  eminent  mind,  and  particularly  to  teach  in 
opposition  to  the  superstition  and  credulity  of  the  masses  and  the  piejudices  and 
authority  of  the  priests.  As  early  as  B.  C.  432,  on  motion  of  Diopeithes,  a  special 
paragraph  against  those  who  denied  God,  and  studied  nature,  was  incorporated  in  the 
legal  code  of  Athens. 

3,    SCHOOLS  OF  THE  ASCLEPIADfll  AND  GYMNASTS. 

From  societies  founded  by  iEsculapius,  or  rather  from  medical  associ- 
ations simply  named  after  him,  proceeded  those  medical  guilds  or  "facul- 
ties'" (to  explain  ancient  econom}-  by  our  own),  which  are  distinguished  as 
the  schools  of  the  Asclepiadae.  These  were  devoted  to  medical  instruction 
and  practice,  and  divided  their  doctrines  into  exoteric  and  esoteric  Indeed 
medicine  at  this  period  was  rather  a  faculty  united  with  the  individual  and 
maintained  as  a  secret,  than  a  science  possessed  of  fixed  rules  and  diffused 
by  writings.  It  was  chief!}-  a  system  bequeathed  immediately  from  father 
to  son  or  to  pupil ;  an  art  preserved  and  transmitted  by  oral  instruction  from 
man  to  man. — In  these  schools  of  the  Asclepiadae  (as  in  the  later  schools 
of  the  Jews  and  the  Arabians,  and  the  Christian  Cathredal  schools)  instruc- 
tion in  medicine  began  at  an  early  age  (10-12  years),  and  was  imparted  not 
solel}'  to  those  who  belonged  by  birth  to  the  family  of  a  physician,  but  also 
to  others  who  were  merely  adopted,  in  order  that  they  might  select  a 
teacher  from  this  family,  who  instructed  them  in  return  for  a  certain  hono- 
rarium.1 At  the  conclusion  of  their  course  of  instruction  the  pupils  were 
compelled  to  take,  and  subscribe  to,  an  oath,  the  words  of  which  we  here 
introduce  as  the  oldest  written  monument  of  Grecian  medicine  : 

"  I  swear  hy  Apollo,  the  physician,  by  ^Eseulapius,  by  Hygeia,  Panacea,  and  all 
the  gods  and  goddesses,  that,  according  to  my  ability  and  judgment,  I  will  keep  this 
oath  and  stipulation,  to  reckon  him  who  teaches  me  this  art  equally  dear  to  me  as  my 
parents;   to  share  my  substance  with  him  and   relieve  his  necessities,   if  required;  to 


1.  The  Sophists  were  the  first  teachers  in  Greece  who  imparted  instruction  for 
money.  Their  fees  were  often  very  high.  Gorgias  demanded  190  minae  (about 
$3,350)  from  each  pupil.  Yet  it  was  regarded  as  a  disgrace  that  they  took  pay 
for  instruction;  and,  as  the  same  thing  was  done  by  teachers  of  medicine,  it  is 
probable  that  the  latter  did  not  belong  to  the  higher  classes  of  Grecian  freemen. 


—  92  — 

look  upon  his  offspring  on  tbe  same  footing  as  my  own  brothers,  and  to  teach  them 
this  art,  if  they  shall  wish  to  learn  it,  without  fee  or  stipulation  ;  and  that  by  precept, 
lecture,  and  every  other  mode  of  instruction,  I  will  impart  a  knowledge  of  this  art  to 
my  own  sons,  to  those  of  my  teachers,  and  to  disciples  bound  b}r  a  stipulation  and 
oath  according  to  the  law  of  medicine,  but  to  no  others.  I  will  follow  that  system  of 
regimen  which,  according  to  my  ability  and  judgment,  I  consider  for  the  benefit  of 
of  my  patients;  and  abstain  from  whatever  is  deleterious  and  mischievous ;  I  will  give 
no  deadly  medicine  to  any  one,  if  asked,  nor  suggest  any  such  counsel  ;  and  in  like 
manner  I  will  not  give  a  woman  a  pessaiy  to  produce  an  abortion.1  With  purity  and 
with  holiness  I  will  pass  my  life  and  practise  my  art.  I  will  not  cut  persons  laboring 
under  the  stone,  but  will  leave  this  to  be  done  by-  men  who  are  practitioners  of  this 
work.  Into  whatever  houses  1  enter,  I  will  go  into  them  for  the  benefit  of  the  sick, 
and  will  abstain  from  every  voluntary  act  of  mischief  and  corruption;  and,  further, 
from  the  seduction  of  females  and  males,  of  freemen  and  slaves.  Whatever,  in  con- 
nection with  my  professional  practice,  or  not  it!  connection  with  it,  I  see  or  hear,  I 
will  not  divulge,  as  reckoning  that  all  such  things  should  be  kept  secret.  While  I 
continue  to  keep  this  oath  inviolate,  may  it  be  granted  to  me  to  enjoy  life  and  the 
practice  of  my  art,  respected  b}-  all  men  at  all  times!  But,  should  I  trespass  and 
violate  this  oath,  may  the  reverse  lie  my  lot!  " 

Such  schools  of  the  Asclepiadre'2  existed  in  Rhodes,  Crotona  in  lower 
Italy,  and  CjTene,  now  Barca,  on  the  northern  coast  of  Africa.  The  most 
celebrated,  however,  were  those  of  Cnidos  in  Asia  Minor,  and  Cos  (now 
Stanchio),  one  of  the  Sporades. 

The  school  of  Cnidos  (in  Caria)  is  said  to  have  laid  especial  weight 
upon  the  subjective  statements  of  the  sick,  the  relation  of  the  symptoms  to 
individual  parts  of  the  bod}T  and  the  use  of  active  remedies,  especially 
drastics  Ccoccum  Gnidium.  the  berries  of  the  Daphne  Gnidium).  Less 
attention  was  devoted  to  diet.  It  cultivated  the  science  of  diagnostics  and 
recognized  some  auscultatory  signs,  e.  g.  the  pleuritic  friction  sound  (!),  and 
satisfactorily  distinguished  many  diseases,  such  as  phthisis,  typhus,  diseases 
of  the  urinary  bladder,  the  kidneys,  the  bile  etc.  The  Cnidians  also  per- 
formed even  major  operations,  like  trepanning  the  ribs,  excision  of  the 
kidneys  (recently  revived  as  something  new  !)  etc.,  and  though  always  em- 
pirics, they  were  bold  operators.  In  opposition  to  the  ph}-sicians  of  Cos, 
however,  they  discarded  venesection.  The  Cnidian  Sentences  3  are  supposed 

1.  Latin  "  neque  sirnili  ratione  mulieri  pessum  subdititium  ad  fnetum  corrumpendum 

exhibebo." 

2,  There  were  guild-schools  for  the  bards  also  at  this  period.     With  regard  to  these, 

Maehly  (Geschichte  der  antiken  Lit.)  says:  "But  how  were  these  bards  educated? 
By  family  and  oral  traditions.  These  bard-schools  represented  simply  an  en- 
larged family  union,  which,  perhaps,  felt  itself  entwined  by  the  ethical  bond  of 
common  duties.  Thar  a  definite  technique,  with  fixed  rules,  was  thus  bequeathed, 
is  clear."  The  same  thing,  mutatis  mutandis,  is  doubtless  true,  also,  for  the 
contemporary  schools  of  the  Asclepiada-.  In  the  latter,  of  course,  Hippocrates 
tilled  the  place  of  Homer. 
H.  The  "Cnidian  Sentences"  was  probably  a  collection  of  aphotisms  culled  from 
the  votive  tablets  of  the  temple  of  .Esculapius,  at  Cnidos.  Euryphon,  a  senior 
contemporary  of  the  great  Hippocrates,  is  said  to  have  been  the  compiler.     They 


—  03  — 

to  have  emanated  from  this  school.  Among  the  famous  physicians  of  the 
school  of  Cnidos  were  Eudoxus  (B.  C.  408-355)  ;  Ctesias,  physician  at  the 
court  of  Atarxerxes  I.  (B.  C.  465-425),  who  has  been  already  mentioned  in 
the  section  on  Indian  medicine,  and  who,  as  an  historian,  was  called  by  the 
ancients  a  liar  and  a  fabulist  ;  Euryphon,  who  is  said  to  have  been  the 
author  of  the  Cnidian  Sentences,  and  to  have  been  the  first  to  employ  the 
actual  cautery;  Nicomachus,  the  father  of  Aristotle,  and  others. 

The  school  of  Cos  (which  was  flourishing  as  early  as  B.  C.  600),  in 
contrast  to  that  of  Cnidos,  cultivated  especially  objective  investigations, 
symptomatology,  prognosis,  the  relation  of  the  S3-mptoms  to  the  entire  body, 
etiology,  and  expectant  and  mild  therapeutics,  though  it  recommended 
venesection  :  in  short  it  practised  all  that  we  can  praise  in  the  medicine 
of  Hippocrates  and  the  Hippocratists.  These  two  schools  are  the  first 
examples  of  those  two  opposing  tendencies  which  have  characterized  med- 
icine down  to  the  present  day,  and  which  have  always,  alas,  made  war  upon 
each  other  ;  for  in  therapeutics,  the  most  uncertain  branch  of  uncertain 
medicine,  each  boasted,  and  could  boast,  of  equally  good  results  !  Among 
the  pln-sicians  of  Cos  the  following  are  specially  well  known  :  Apollonides  ; 
Nebrus ;  his  son  Gnosidicus  ;  Hippocrates  I.,  the  son  of  Gnosidicus.  a 
contemporary  of  Miltiades  (died  B.  C.  489),  and  the  grandfather  of  Hippo- 
crates the  Great. 

Far    beneath    the    pupils  of  the    schools   of    the    Aselepiadae    stood 

THE    (JYMNASTS. 

These  were  originall}-  teachers  of  g}-mnastic  exercises,  but  as  Aliptae 
also  took  charge  of  bathing  and  anointing  the  bod}',  furnished  assistance 
in  cases  of  wounds,  fractures  and  dislocations,  and  dabbled  bravely  likewise 
in  internal  medicine.  Their  superintendent  was  the  gymnasiarch,  whose 
office,  the  g3-mnasiarchia  (i.  e.  the  oversight  of  the  gymnastic  exercises,  the 
g\-mnasia  and  the  instruction  in  the  agonistic  sports,  which  formed  a  part 
of  the  public  festivals)  was  a  high  official  position;  for  triumph  in  these 
contests  was  valued  more  highly  than  one  in  the  intellectual  field  !  Beneath 
him  stood  the  xystarch  who  had  charge  of  the  apparatus.  Among  the 
gymnasts  the  following  were  especially  famous  :  Iccus  of  Tarentum,  who 
devoted  himself  chiefby  to  dietetics  ;  Herodicus  of  Selymbria  in  Thrace 
(called  also  Prodicus,  and  Herodicus  of  Megara),  a  teacher  of  Hippocrates, 
who  treated  even  acute  diseases  by  gymnastic  exercises,  e.  g.  wrestling, 
pedestrian  tours,  long  races  etc.,  and  it  is  said  to  have  been  the  first  to 
demand  medical  honoraria  in  place  of  the  free-will  offerings  heretofore  cus- 
tomary. The  union  of  gymnastics  with  medicine  Plato  (Politics,  book  I.) 
calls  one  of  the  greatest  of  nuisances. 

are  quoted  by  Plato,  the  comic  poet  (B.  C.  440),  noticed  by  Hippocrates,  and 
were  in  existence  as  late  as  the  time  of  Galen  (A.  D.  170).  Littre  conjectures 
that  several  books  preserved  in  the  Hippocratic  collection  may  be  the  offspring 
of  the  school  of  Cnidos.     (Oeuvres  d'Hippocrat,  torn,  vii,  p.  304.)     (H. ) 


—  94  — 

These  gymnasts  must  not,  however,  be  confounded  with  the  athletae,  who  culti- 
vated mere  bodily  activity  and  skill  in  certain  special  exercises,  and  were  pugilists 
and  wrestlers.  They  were  compelled  to  abstain  from  wine  and  women,  and  had 
special  regulations  as  to  food  (something  like  our  trainers  of  the  present  day;  there 
is  nothing  new  under  the  sun  !),  which  latter  consisted  of  roast  meat,  dry  diet  etc.,  in 
order  to  preserve  their  strength.  With  the  same  object  they  piactised  inunction,  for 
the  ancients  considered  inunction  of  the  skin,  even  with  simple  oil,  a  means  of 
hardening  themselves. 

4.    THE  MEDICAL  FACULTY  AB0UT,THE  TIME  OF  HIPPOCRATES. 

It  should  be  remarked  at  the  outset  that  the  medical  profession  among 
the  Greeks,  as  among  the  Orientals,  was  always  held  in  great  respect. 
Moreover,  both  before  and  during  the  age  of  Hippocrates,  the  practice  and 
social  position  of  physicians  were  in  many  respects  very  similar  to  those 
which  exist  among  us.  Physicians  generally  practised  both  medicine  and 
surgery,  i.  e.  the}'  were  general  practitioners.  There  were  also  medical 
professors  and  students,  though  the  former  limited  their  activit}-  to  private 
teaching.  No  formal  matriculation  seems  to  haA'e  taken  place,  but  on 
leaving  the  teacher  or  medical  "school"  the  oath  quoted  above  (the  model 
of  our  doctors'  oath)  was  administered.  Moreover  there  were  physicians 
appointed  b}'  the  State,  who  even  presented  their  own  qualifications  in  the 
public  assembl}'  by  a  speech,  somewhat  as  the  English  physicians  of  the 
present  day  do  in  the  papers  when  they  desire  to  obtain  a  hospital  position. 
These  might  be  called  State-physicians.  Besides  these  there  were  physicians 
chosen  and  paid  by  certain  communities,  for  the  special  purpose  of  taking 
care  of  the  poor  free  of  expense  —  communal  or  charit}'  physicians.  Then 
there  were  simple  practising  pin'sicians  who  either  had  permanent  residen- 
ces, or  were  so-called  "  periodeuta?  "  (itinerant  physicians,  like  the  itinerant 
bards  of  that  period),  and  who  practised  from  city  to  city.  Some  of  these 
carried  along  with  them  their  own  drug  shops.  There  were  also  court  phy- 
sicians who  practised,  often  with  high  salaries  ($1100-2200),  at  the  court 
of  foreign  tyrants  or  kings,  and  were  frequently  the  ordinary  physicians  of 
these  princes,  like  the  Jewish  physicians  of  the  Middle  Ages.  Finally, 
even  at  this  early  period,  there  were  arm}'  and  naval  surgeons  also,  who 
were  engaged  for  certain  definite  periods,  e.  g.  for  a  single  campaign. 

Inscriptions  have  been  discovered  containing  the  agreements  of  such  physicians, 
and  specifying  then-  duties,  salary  etc.  Donations  for  special  services  were  given  to 
physicians  at  a  very  early  period.  Thus  a  physician,  Onasilos  and  his  brother,  as 
early  as  the  5th  century  B.  C,  received  lands  from  king  Stasikypros,  of  Idalion,  in 
return  for  their  disinterested  aid  on  occasion  of  a  massacre  of  the  citizens  of  that 
city  by  the  Persians. 

Whether  there  were  regular  surgeons  with  the  armies,  and  if  so,  how  many  were 
allotted  to  each  division,  is  unknown.  That  such  physicians  existed,  however,  at  an 
earlj"  period,  may  be  inferred  from  the  fact  that,  according  to  the  laws  of  Lycurgus, 
(about  B.  C.  800)  their  presence  was  required  among  the  Spartans.  It  would  thus 
seem  as  if  surgeons  were  one  of  the  earliest  products  of  war.  Lycurgus  classed  them 
among  the  "officials",   not  as  combatants,  a  position  which  they  also  occupied  in  the 


—  95  — 

German  army  down  to  1870.  Hippocrates  too  permitted  his  son  Thessalus  to 
accompany  Alcibiades  (B.  C.  451-404)  to  Sicily,  in  the  position  of  army-physician. 
Critobulus  cured  the  wound  of  Philip  of  Maeedon  (B.  C.  382-336),  received  during 
the  siege  of  Methone,  though  only  with  the  loss  of  vision  in  the  wounded  eye. 
Alexander  (B.  C.  356—323),  we  know,  had  Philip  of  Acarnania  as  his  ordinary 
physician,  and  the  latter  lias  become  the  classical  model  of  medical  honesty  and 
fidelity.  From  the  same,  or  a  later  period  we  know  Callisthenes,  whose  unfortunate 
fate  has  secured  for  him  lasting  remembrance;  Glaucias,  Alexippus,  Critodemus, 
Androcydes  and  Pausanias.  Since,  however,  Xenophon  (B.  C.  445-354)  had  eight 
field-surgeons  with  his  "Ten  Thousand",  we  may  infer,  as  Hecker  believes,  that  one 
surgeon  was  attached  to  about  each  1,000  of  the  troops  (chiliaichia).  We  find  no 
mention  of  special  field-hospitals,  though  these  existed  among  the  Egyptians  from 
whom  the  Greeks  borrowed  many  regulations.  The  sick  and  wounded  were  sheltered 
in  the  neighboring  villages  and  cities;  while  on  the  march  they  were  carried  in  rear 
of  the  troops.  In  camp  thev  were  placed  in  ordinary  tents.  (Seethe  "Anabasis").1 
Young  and  old  women  from  "the  baggage" — so  Xenophon  says — shared  in  the  care 
of  the  wounded,  so  that  we  see  this  class  following  the  military  hosts  of  that  day  as 
well  as  the  mercenary  troops  of  a  later  period.  Markets  too  were  held  in  the  camps 
i  an  antique  style  of  suttling),  though,  as  a  rule,  the  requisitions  and  thefts  were  not 
confined  to  the  simple  7iecessaries  of  life,  for  everything  was  regarded  as  booty. 

Famous  and  popular  physicians  bad  their  assistants  who.  for  the  most 
part,  took  care  of  slaves  and  the  poor,  and  were  notorious  for  their  rough- 
ness. Finally  there  were  natural-physicians  (indeed  even  popular  writers 
on  medicine),  bathing-physicians  (for  the  wealthy  of  Athens  even  now  went 
to  the  baths  in  summer),  magicians,  male  and  female  empirics  and  mid- 
wives,  in  whose  hands  was  placed  the  entire  practice  of  obstetrics,  except 
formidable  operations  after  the  death  of  the  child.  The  latter  were  prac- 
tised by  men  alone,  and  most  frequently  resulted  in  the  death  of  the 
mother. 

The  midwives  were  called  "navel-cutters"  (bmphalotomai),  and  at  a  later  period 
maiai,  and  in  addition  to  the  ordinary  services  of  a  midwife,  including  kneading  and 
rubbing  the  abdomen  to  improve  the  position  of  the  child,  the  administration  of 
medicines  etc.,  they  also  undertook  the  execution  and  direction  of  the  sacred  songs 
sung  during  labor.  In  children  born  apparently  dead  they  pressed  the  blood  back 
out  of  the  umbilical  vessels,  presented  the  new-born  to  the  father,  in  order  that  he 
might  lift  it  and  thus  acknowledge  it  for  his  own,  determined  the  existence  of 
pregnancy,  produced  abortions,  and  exposed  the  children,  if  requested— a  practice 
allowed  without  question.  In  consequence  too  of  their  knowledge  as  to  what  p-uties 
were  physicially  suited  to  each  other  (for  the  Greeks  looked  upon  matrimony  as  a 
purely  sexual  institution),  they  had  a  kind  of  antique  matrimonial  bureaus,  and  took 
charge  of  those  who  "found  it  necessary  to  withdraw  from  observation  for  a  con- 
siderable period", — for  the  most  part  exactly  as  they  do  with  us!  The  midwives  also 
treated  the  diseases  of  women,  but  were  distinct  from  the  "  Doctresses",  like  Aspasia 
and  Artemisia,  who  occupied  themselves  particularly  with  cosmetics  and  free-love. 

For  the  exercise  of  medical  practice,  which  was  very  often  carried  on 
for  a  long  distance  from  the  permanent  residence  of  the  physician,  there 


1.  It  may  be  remarked,  en  j)assant,  that  Xenophon  mentions  snow-blindness  in  this 
book,  and  reccom mends  for  its  prevention  that  something  black  be  held  before 
the  ej'es. 


—  96  — 

was  required  (in  certain  provinces  only)  some  evidence  of  capacit}*  in  the 
form  of  a  certificate  from  his  teacher.  In  general,  however,  practice  was 
perfectly  free,  as  it  is  with  us  to  day,  except  that  while  free  physicians 
might  treat  all  patients,  without  regard  to  their  social  position,  servile 
physicians  could  treat  slaves  only,  a  restriction  based  upon  the  social  ideas 
of  the  Ancients,  and  prevailing  also  in  other  arts.  Malpractice  was  not 
liable  to  punishment.  The  treatment  was  carried  on  either  at  the  house 
of  the  patient,  or  in  the  Iatreion  of  the  pln'sician. 

These  Iatreia,  places  for  prescribing  or  operating,  at  once  clinics  for  out-patients 
and  private  hospitals,  form  the  most  striking  peculiarity  of  Greek  practice,  and  were 
pretty  numerous.  The  sick,  however,  could  enjoy  in  them  only  a  temporary  recep- 
tion, though  they  were  mostly  very  spacious  and  supplied  with  all  necessary  apparatus 
and  instruments.  The  latter  were  often  spread  out  ostentatiously,  in  the  style  of 
charlatans,  and  were  made  of  costly  and  glittering  materials, — an  old  "humbug"  met 
with  here  and  there  even  to-day!1  These  medical  shops  for  the  most  part  enjoyed  a 
good  business  and  (like  the  barber-shops  of  the  Middle  Ages)  served  also  as  places  of 
amusement,  in  the  absence  of  saloons  and  newspapers,  to  spread  the  (not  infrequent) 
scandals  of  Antiquity.  Besides  private  Iatreia,  there  were  also  others  belonging  to 
certain  communities  and  to  the  state,  and  designed  for  the  care  of  the  poor;  but 
hospitals,  in  our  sense  of  the  term,  did  not  exist  in  Grecian  antiquity. 

Most  physicians2  occupied  themselves  with  general  practice,  as  the 
science  of  medicine  itself  was  still  quite  simple  and  midwifery  was  not  as 
yet  separated  from  surgery, — a  separation  not  made  until  after  the  Middle 
Ages.  A  few  only  were  specialists,  chief!}7  the  lithotomists  whose  occupa- 
tion, as  is  manifest  from  the  terms  of  the  Hippocratic  oath,  was  generally 
considered  a  disreputable  one.  Yet  oculists  and  dentists  seem  to  have 
been  specialists  also. 

Besides  skilful  physicians,  many  of  whom  enjoyed  a  general  education  and  pos- 
sessed philosophic  minds,  there  was,  of  course,  a  crowd  of  charlatans  ;  and  besides 
medical  men  whose  walk  was  worthy  of  their  calling,  there  were  fools.  Hence  strife, 
envj'  and  other  evils  were  prevalent,  so  that  at  times,  even  among  the  Greeks,  the 
medical  profession  could  no  longer  be  reckoned  a  respectable  one."'  An  experience 
which  that  profession,  alas,  has  been  compelled  to  suffer  among  many  nations  and 
for  long  periods  of  time.  From  this  statement  must  of  course  be  excepted  many 
physicians  who  lived  and  labored  with  high  honor.     Even  Hippocrates  declared: 

1.  Ivory    stethoscopes   inlaid    with    gold     among  the   coryphaei!        "The   ignorant 

physicians  have  ivory  boxes,  silver  cupping  apparatus  and  knives  inlaid  with 
gold  made  for  them.  But  when  compelled  to  use  these  instruments,  they  do  not 
know  how  to  handle  them,  and  an  expert,  with  a  rust}',  but  sharp,  knife,  must  free 
the  patients  from  their  suffering."     (Lucian.) 

2.  As  regards   the    number  of  physicians   in   ancient   Athens,    nothing   can  be  said. 

Whether  it  ever  reached  the  160  living  at  the  present  day  in  that  city  is  doubtful. 
Instruction  in  the  22  preparatory  schools  of  the  kingdom  is  free,  and  anyone  can 
go  from  these  to  the  university  at  Athens.  A  portion  of  the  students  of  this 
institution  earn  their  living  by  blacking  boots  etc.     (See  Urlichs. ) 

3.  Besides  soothsayers,  sophists  etc.,  Aristophanes  declares  that  physicians  owe  their 

existence  to  the  clouds. 


—  97  — 

"  Through  our  wrangling  the  whole  art  has  fallen  into  great  disrepute  among  the 
laity,  so  that  they  do  not  believe  even  in  the  existence  of  an  art  of  healing.  For  in 
acute  diseases  practitioners  differ  so  widely  from  each  other,  that  what  one  declares 
to  be  the  best  treatment  is  rejected  by  another  as  bad.  In  this  way  medicine  may  be 
compared  to  the  art  of  the  soothsayer,  who  holds  as  propitious  the  bird  which  appears 
on  the  left,  while  the  same  bird  appearing  upon  the  right  is  considered  unlucky.  In 
like  manner  from  the  flight  of  birds  one  soothsayer  will  predict  one  thing,  another, 
another."     (Hseser.) 

The  honorarium  of  the  ph}*sician  consisted  originally  of  voluntary 
offerings,  but  at  a  later  period  its  amount  was  determined  by  an  agreement 
entered  into  before  the  treatment  was  begun.  The  Hippocratists,  however,, 
from  feelings  of  delicacy  and  honor,  never  adopted  the  latter  custom, 
probably  because  they  did  not  consider  their  profession  a  trade  in  wares. 
Moreover,  there  were  city  and  district  physicians,  and  for  these  public 
physicians  there  were  provided  fixed  salaries.  The  latter  were  often  rela- 
tively high,  as  e.  g.  at  Athens,  where  an  annual  salary  of  $1,875  was  once 
paid  to  a  physician. 

A  large  sum  which  furnishes  a  measure  and  evidence  of  the  prosperity  of  Athens 
in  its  days  of  glory!  A  good  horse  iu  the  time  of  Xenophon  was  worth  $150;  a 
choenix  (about  one  quart)  of  meal  —  the  daily  ration  of  a  slave  —  cost  at  the  same 
time  about  18  cents,  and,  from  the  scarcity  of  corn-land  in  Greece,  often  more.  Of 
wine  and  meat — the  Greeks,  in  contrast  to  the  Romans,  cultivated  cattle-raising  more 
than  agriculture  — there  was  no  lack,  especially  as  the  Greeks,  in  addition  to  game, 
poultry  and  particularly  fish,  ate  all  kinds  of  domestic  animals,  hogs,  horses,  asses, 
dogs  and  even  foxes,  hedgehogs  etc.  Moreover  prices  in  Greece  corresponded  to 
the  fluctuating  value  of  monej'.  Thus  in  the  time  of  Solon  an  ox  was  worth  about 
84  cents,  and  a  sheep  only  16  cents. 

In  addition  to  what  may  be  called  the  regular  faculty  of  medicine, 
there  was  also  a  considerable  number  of  dealers  in  drugs,  pharmacopolse 
and  pharmacotribae  (a  special  sort  of  merchants  comparable  with  our 
grocers),  who  kept  medicines  for  sale  in  their  booths,  but  must  not  be 
regarded  as  pharmaceutists  in  the  present  sense  of  that  term,  unless  we 
consider  them  a  kind  of  old  Greek  apothecaries,  as  is  often  done.  As  a 
rule,  however,  plrysicians  prepared  and  dispensed  their  own  drugs.  The 
class  first  mentioned,  in  addition  to  drugs,  dealt  in  burning-glasses,  cosmet- 
ics etc.,  something  as  our  apothecaries  sell  petroleum-lamps,  insecticides 
and  perfumeries. 

Of  a  still  lower  rank  were  the  rhizotomists  (root-cutters  and  gatherers), 
who  collected  drugs  with  strange  and  superstitious  ceremonies,  often  at 
night.  Among  these  were  many  cunning  knaves  and  itinerant  mounte- 
banks, such  as  existed  among  the  Romans  and  later  peoples  even  down  to 
the  present  century.  The  worst  reputation,  however,  belonged  to  the 
pharmaceutics,  a  term  almost  synoivymous  with  abortionists. 

This  class  of  persons  must  have  occasioned  much  mischief  in  ancient  Athens  and 
Sparta,  for  Solon,  in  order  to  get  rid  of  their  business,  erected  B.  C.  594  the  first 
brothels,  and  filled  them  with  female  slaves  purchased  abroad,  and  Lycurgus  published 
laws  according  to  which   they  were  driven  out  of  the  country  and  foreigners  were 

7 


—  08  — 

licensed  to  prepare  medicines,  in  their  stead.  Paederasty  was  recommended  by 
Solon,  and  instituted  by  the  State  in  Sparta  and  Thebes,  in  order  to  prevent  over- 
population. It  was  also  recommended  for  the  same  purpose  by  Plato  and  Aristotle, 
and  in  contrast  with  this  disgusting  practice  the  Neo-Malthusian  sponge  is  a  remedy 
of  immaculate  purity  ! 

Finall}*  the  gymnasts  also  belonged  to  the  medical  profession  of  the 
ancient  Greeks. 

That  veterinary  physicians  existed  in  Grecian  antiquity  may  be  con- 
cluded from  the  fact  that  the  diseases  and  anatom}-  of  animals  were  dis- 
cussed b}*  very  early  writers,  e.  g.  by  Aristotle.  Even  regular  physicians 
occupied  themselves,  as  much  as  they  could,  with  the  treatment  of  animals, 
especially  that  of  horses.  The  Greeks  possessed  also  sanitary  officials 
who  had  the  oversight  of  street-cleaning  etc.  Epaminondas,  among  others, 
was  appointed  such  an  officer,  though  onby  to  humiliate  him. 

5.    HIPPOCEATES  THE  GREAT,  AND  THE  HIPPOCRATISTS. 

The  period  of  the  highest  political,  material,  artistic  and  literary 
grandeur  of  Greece,  when  the  Persian  wars  had  been  fought  to  a  victorious 
end,  and  that  mournful  internecine  slaughter  of  the  Greeks  which  bears  the 
name  of  the  Peloponnesian  war,  had  not,  or  rather  had  just,  begun  ;  when 
poets,  philosophers,  artists  and  statesmen  struggled  for  the  victorious 
laurel,  forming  a  line  of  combatants,  such  as.  in  innate  greatness  displayed 
upon  so  narrow  a  field,  and  at  such  a  time,  no  people  and  no  age  has  since 
beheld,  —  this  period  offered  also  the  most  favorable  conditions  for  the  ap- 
pearance and  labors  of  a  genius  who,  a  model  to  all  futurity,  taught  those 
principles  in  accordance  with  which  the  medical  art  should  be  practised. 

To  characterize  this  age,  or  rather  its  intellectual  elevation,  it  is  doubtless  suffi- 
cient to  recall  to  the  reader  merely  the  names  of  a  few  of  the  great  men  who  lived 
shortly  before,  contemporaneous  with,  or  not  long  after  Hippocrates,  and  who  sealed 
for  all  succeeding  centuries  the  supremacy  of  the  Grecian  spirit.  At  this  time 
Paeonius  created  his  Nike,  Phidias  in  ivory,  gold  and  marble  his  statue  of  Zeus  and 
the  Parthenon,  Praxiteles  his  Hermes  (B.  C.  364);  Polygnotus,  Zeuxis  (about  B.  C. 
400)  and  Parrhasius  won  immortal  fame  as  painters.  Oratory  shone  forth  in  Lysias 
(born  B.  C.  458),  and  soon  after  reached  its  zenith  in  xEschines  (B.  C.  392-317)  and 
especially  in  Demosthenes  (B.  C.  385-322).  Philosophers  like  Anaxagoras,  Protag- 
oras of  Abdera.  Prodicus  of  Ceos  and  other  Sophists,  Democritus  of  Abdera, 
Socrates,  Plato  and  many  others,  established  the  laws  of  human  thought  and  human 
existence,  as  well  as  those  of  nature.  Aristotle,  the  greatest  investigator  of  antiquity, 
followed  their  footsteps  in  the  natural  sciences.  Herodotus  (B.  C.  484-407),  an 
exception  among  the  ancient  historians  who  devoted  themselves  almost  exclusively 
to  the  history  of  their  own  people,  opened  the  road  of  historical  investigation  and 
devoted  considerable  attention  to  the  history  of  the  barbarians,  while  Thucydides  and 
Xenophon  have  left  us  imperishable  models  for  historical  writing.  The  drama  is  the 
peculiar  creation  of  the  Greeks,  entirely  wanting  among  Semitic  races,  and  in  this 
department  J^schylus  (B.  C.  525-456),  Sophocles  (B.  C.  495-405)  and  Euripides 
(B.  C.  480-406)  have  furnished  us  the  models  for  tragedy,  Cratinus  (B.  C.  520-423), 
Eupolis  (born  about  B.  C.  445)  and  Aristophanes  (born  about  B.  C.  410),  for  comedy, 


—  99  — 

••and  Pindar  (B.C.  521-441),  for  the  loftier  lyric  art.  Statesmen  like  Themistocles, 
Cimon,  Miltiades,  Pericles,  Alcibiades,  Nicias  and  others,  representatives  of  the 
smallest  of  states,  though  supported  by  a  great  colonial  power,  guided  the  destiny  of 
Greece,  and  with  it  the  fate  of  the  whole  of  the  then  civilized  world. 

In  such  an  epoch  appeared  —  great  men  are  far  more  the  offspring 
than  the  creators  of  their  epochs — the  greatest  and  most  famous  physician 
of  all  antiquity,  a  man  endowed  with  the  most  unique  gifts  for  his  profes- 
sion, Hippocrates  II.  of  Cos. 

Son  of  the  midwife  Phaenarete  (18th  in  descent  from  Hercules)  and  the 
Asclepiad  Heraclides  (17th  in  descent  from  JEsculapius),  he  was  born  B.  C. 
460,  and  even  during  his   lifetime  won  the  title  of  "  the  Great." 

That  he  appeared  in  such  an  age  is  an  expression  of  that  ever  active  law  of 
national  development,  by  virtue  of  which  the  great  minds  of  any  people  appear  to- 
gether or  in  close  succession  to  each  other,  and  as  a  rule  occupy  but  brief  periods  of 
time.  In  these  periods  too  the  nation  itself  passes  through  its  golden  age  in  a  political, 
social  and  economical  point  of  view,  ere  national  vigor  is  corrupted  and  overwhelmed 
by  the  general  prosperity. 

The  first  teacher  of  Hippocrates  was  his  father.  Leaving,  however, 
the  guild  of  the  Asclepiaclae  in  his  native  place,  after  the  death  of  his 
parents  he  went  to  Athens,  where  the  sophist  Gorgias  of  Leontini  (whose 
wile  had  been  one  of  his  patients)  and  his  brother,  the  gymnast  Herodicus. 
were  his  teachers.  He  travelled  extensively  (it  is  said  for  twelve  years),  so 
that  he  became  a  genuine  periodeutes  or  itinerant  physician. 

This  was  doubtless  the  origin  of  his  great  power  of  observation,  of  his  regard  for 
the  influence  of  climate  and  locality,  the  corporeal  and  mental  constitution  of  men  etc. 
He  studied  the  book  of  nature  (as  Theophrastus  von  Hohenheim  demanded  of  the  true 
physician),  and  here  learned  to  value  her  powers  and  to  utilize  them  at  the  sick  bed; 
indeed  his  whole  therapeutic  bent  is  commonly  designated  Ph}rsiatry. 

Hippocrates  resided  in  Asia  Minor,  on  the  coast  of  the  Black  Sea, 
upon  the  island  of  Thasos,  and  probably  also  in  Egypt,1  but  lived  for  the 
greater  part  of  his  life  at  Larissa  in  Thessaly,  where  he  is  said  to  have  died 
B.  C.  377  (according  to  others  370).  His  tomb  was  shown  in  the  vicinity 
of  this  cit}'  as  late  as  the  second  century  of  our  era. 

His  best  epitaph  is  furnished  by  his  own  famous  precept :  "  Life  is 
short,  opportunity  fleeting,  judgment  difficult,  treatment  easy,  thought  hard, 
but  treatment  after  thought  is  proper  and  profitable."  An  ancient  plane- 
tree  is  still  pointed  out  in  Cos,  beneath  which  Hippocrates  is  said  to  have 
held  his  consultations.  Tradition,  which  surrounds  all  greatness  with  a 
halo  of  glory,  illumined  also  the  grave  of  Hippocrates  with  the  story  that 
a  swarm  of  bees,  whose  honey  was  specially  useful  in  the  treatment  of  aph- 
thae in  children,  made  their  hive  within  its  walls. 

Hippocrates  was  the  creator  of  profane,  as  distinguished  from  sacer- 
dotal or  guild  medicine,  which  had  prevailed  until  his  day  ;  of  public,  in 


1.    Recently  much  of  the  Hippocratic  writings,  which  had  heretofore  been  looked  upon 
as  peculiarly  Greek,  has  been  recognized  as  Egyptian  in  its  origin. 


—  100  — 

place  of  the  preceding  secret  medicine.     In  a  word  he  was  the  great  creator 
of  scientific  medicine  and  of  artistic  practice. 

Besides  the  case  of  the  wife  of  Gorgias  above  mentioned,  the  plague  at 
Athens,1  Abdera  and  in  Illyria,  the  cure  of  the  "  lovesickness "  (nowadays  falsely 
called  broken  heart)  of  king  Perdiccas  of  Macedonia,  and  his  professional  dictum 
regarding  the  mental  disease  of  Democritus  (who  was  considered  insane  by  the 
Abderites  because  he  dissected  animals),  are  mentioned  as  examples  of  his  practice. 
A  call  from  Artaxerxes  Machrocheir  (reigned  465-425  B.  C.)  he  declined.  All  this, 
however,  is  unproven,  as  well  as  the  absurd  story  that  Hippocrates,  before  his 
departure  from  Cos,  set  fire  to  the  temple  of  ^Esculapius,  in  order  that  the  honor  of 
the  invention  of  the  "Aphorisms"  might  remain  his  without  dispute.  If  he  simply 
borrowed  these  from  the  temple  (a  charge  probabty  partially  true),  it  shows  at  least 
that  he  recognized  their  importance  and  preserved  and  published  them,  a  service  in 
itself  of  great  medical  and  historical  importance.  The  following  is  the  genealogical 
tree  of 

HIPPOCRATES  AND  HIS  FAMILY. 

Nebrus    (about  584  B.  C.) 
Gnosidicus,         Chrysus,         Elaphos. 
Hippocrates  I.,  (about  500  B.  C.) 
Heraclides — Phainarete. 

Hippocrates  II.,  (460-377,  or  370  B.  C.) 
Thessalus,  Draco,  wife  of  Polybus,  wife  of  Ctesias  (?),. 

Hippocrates  III.  Hippocrates  IV. 

of  which  ? 


Thymbraeus. 


of  whom  ? 


Hippocrates  V.  Hippocrates  VI. 

of  which  ? 

Praxianax. 

Hippocrates  VII. 

Besides  these  there  are  reckoned  in  the  Hippocratic  family  Dioxippus,  Philinus- 
and  Praxagoras,  all  of  Cos,  and  Plistonicus,  Eudoxus,  Philotimus  and  Cbrysippus  of 
Locri.  These  all  lived  between  B.C.  400  and  B.C.  286,  and  from  Thessalus  down  were 
followers  of  the  medicine  of  their  school. 

1.  Hippocrates  does  not  mention  this  "plague".  It  raged  B.  C.  430-425,  and  carried 
off  in  the  last  year  but  one  of  its  prevalence  10,000  citizens,  400  foot-soldiers  and 
400  cavalr}-.  In  spite  of  the  masterly  description  of  Thucydides,  it  is  unsettled 
under  what  form  of  disease  of  the  present  day  this  plague  should  be  included. 
Thucydides  (471-400  B.  C.)  does  not  mention  Hippocrates. 


—  101  — 

The  Hippocratic  writings  *  are  written  in  the  Ionic  dialect,  and  are  53 
in  number  (though  divided  b}'  others  into  80).  But  a  small  part  of  them 
are  the  work  of  Hippocrates  himself.  Some  were  written  b)-  one  or  the 
other  of  the  ph)'sicians  already  mentioned ;  others  by  unknown  physicians 
of  the  same,  or  a  different  period.  The)'  received  the  form  in  which  they 
have  descended  to  us  chiefly  in  the  Alexandrian  period,  and  are  accordingly 
defaced,  and  some  of  them  entirely  falsified.  A  few  originated  in  the  pre- 
Hippocratic  age,  others  in  the  time  of  Hippocrates  himself,  and  still  others 
in  much  later  ages  (even  after  Christ).  The  authors  are  called  by  the 
generic  title  of  Hippocratists,  though  differing  remarkably  from  Hippo- 
crates and  from  each  other. 

The  philosophico-pli3Tsiological  and  general  pathological  views  of  the  Hippoc- 
ratists are  based  upon  the  assumption  of  the  four  elements  of  Empedocles,  water, 
fire,  air  and  earth,  whose  mixture  (crasis)  and  cardinal  properties  (dryness,  warmth, 
coldness  and  moisture)  form  the  bod}-  and  its  constituents.  To  these  correspond  the 
cardinal  fluids,  yellow  bile,  blood,  mucus  and  black  bile,  in  the  order  mentioned. 
(Here  we  find  the  first  theory  of  humoral  pathology).  Health  consists  in  a  uniform, 
disease,  in  an  irregular,  action  and  reaction  of  all  these  upon  and  between  each  other. 
"'Acridity"  is  also  assumed  as  an  additional  cause  of  disease.  —  The  fundamental 
condition  of  life  is  the  innate  heat  (calidum  innatum,  efjL&urov  6epfiov),  the  evapora" 
tion  of  which  occasions  death.  The  production  of  heat  is  greatest  in  youth,  and, 
therefore,  at  this  age  most  nourishment  is  necessan",  while,  as  this  production  declines 
in  old  age.  the  need  for  nourishment  declines  with  it.     The  proportion  also  holds  true 

1.  The  following  account  of  the  doctrines  of  the  Hippocratists,  as  well  as  the  sub- 
sequent exposition  of  those  of  Galen,  is  arranged,  for  the  most  part,  in  accordance 
with  the  writings  of  Haser,  Leclerc  and  others,  and,  in  consequence  of  the  im- 
portance of  both  these  writers  in  medicine,  is  preserved  as  complete  as  possible. 

The  "Oath"  is  considered  ''pre-Hippocratic'  .  The  "De  affectionibus",  "De 
septimestri  et  octimestri  partu",  "De  morbis  mulierum",  "De  dentitione",  "De 
embryonis  excisione"  and  "De  superfcetatione"  are  regarded  as  "Cnidian":  the 
"Prognosticon",  "Praenotationes  Coacae ",  "Praedicta"  and  others,  as  "Coan": 
the  "De  sere,  aquis  et  locis",  "Epidemiorum  libri",  "De  victu  in  acutis",  and 
"De  capitis  vulneribus",  as  "genuine":  the  "De  arte",  "De  prisca  medicina ", 
"Lex  de  medico",  "De  liquidorum  usu",  "De  genitura"  and  other  (especially 
surgical)  writings,  as  "contemporary"  :  the  "De  natura  hominis",  "De  glandulis  ', 
"De  corde"  (post-Aristotelian),  "De  diebus  criticis"  (post-Galenic)  and  others  as 
"post-Hippocratic". 

What  singularities  and  (to  speak  mildly)  what  peculiar  observations,  incap- 
able of  justification  by  all  the  explanations,  childish  interpretations  and  praises 
lavished  upon  them,  are  to  be  found  in  the  Hippocratic  works,  is  shown  e.  g.  b}- 
the  following  aphorisms  :  "A  woman  is  never  ambidextrous"  :  "  Pains  extending 
from  the  spine  to  the  elbows  are  removed  by  venesection":  "  Rigors  in  women 
begin  chiefly  from  the  loins,  and  move  by  the  spine  to  the  head.  In  men  they 
begin  more  from  behind  than  from  the  anterior  parts  of  the  body,  as  from  the 
elbows  and  thighs.  They  have  also  a  thin,  dnr  skin,  as  shown  by  the  hair"  etc. 
The  Hippocratic  works  also  contain  much  that  is  incomprehensible  to  us.  Their 
uncritical  reference  of  many  things  to  supernatural  influences  smacks  of  ignor- 
ance; their  contempt  for  other  things  (especially  many  of  the  acquisitions  of 
«xact  science)  indicates  a  lack  of  scientific  spirit. 


—  102  — 

in  a  similar  way  with  fevers  at  different  ages.  The  pneuma  which,  in  the  form  of  air 
circulates  in  the  vessels  is,  however,  also  necessary  for  the  maintenance  of  life.  Its 
regular  circulation  is  the  condition  of  health,  while  modifications  of  this  beget  disease. 
In  this  we  must  not,  however,  understand  circulation  in  its  modern  acceptation,  for 
Hippocrates,  though  holding  that  the  blood  runs  to  the  periphery,  and  thence  back- 
again  to  the  internal  parts  in  the  form  of  a  circle,  recognizes  and  mentions  no  point 
of  origin  for  this  circulation.  A  third  active  force  in  the  body  is  the  "enormon".1  All 
three  of  these  are  forces  inherent  in  the  bodj',  without  manifesting  any  vital  power 
of  their  own.  —  Diseases  are  cured  by  restoration  of  the  disturbed  harmony  in  being 
and  action  of  the  elements,  elementary  qualities,  cardinal  fluids  and  cardinal  forces. 
Nature  {fixn:),  i.  e.  the  vital  forces  inherent  in  the  body,  accomplishes  the  cure, 
however,  in  the  best  way.  If  nature  works  undisturbed,  the  disease  runs  a  resrular 
course  through  the  three  stages  of  crudity,  coction  and  crisis.  In  the  first  of  these  a 
degeneration  of  the  fluids  predominates;  in  the  second  they  are  prepared  for 
evacuation;  in  the  third  they  are  removed.  If  this  course  fails,  and  especially  if 
the  "crisis"  is  wanting,  there  result  secondary  diseases,  or  incurable  conditions. 
The  crises  occur  particularly  upon  the  odd,  so-called  critical,  days.  Hence  the 
interference  of  the  physician  (and  in  this  his  art  consists)  is  directed  always  to 
choosing  the  right  instant'-1  for  lending  aid.  This  is  especially  the  case  in  fever.-, 
which  are  caused  by  heating  or  excess  of  mucus  due  to  a  check  of  the  secretions. 
Besides  the  proximate  causes  of  disease  mentioned  here  and  above,  Hippocrates 
constructed  especially  the  important  doctrine  of  remote  causes.  Such  are  offences 
against  a  judicious  mode  of  life,  climatic  and  meteorological  influences,  the  peculiar- 
ities of  the  season  (constitutio  annua ),  endemic  and  epidemic  constitution,  place  of 
residence  etc. 

To  this  was  joined  Dietetics,  a  science  also  founded  by  Hippocrates.  This 
science  regarded  the  age, — "  Old  persons  use  less  nutriment"  than  the  young", — the 
season, — "In  winter  abundant  nourishment  is  wholesome;  in  summer,  a  more  frugal 
diet", — the  bodily  condition, —  'Lean  persons  should  take  little  food,  but  this  little 
should  be  fat;'  fat  persons,  on  the  other  hand,  should  take  much  food,  but  it  should 
be  lean", — the  habits  etc.  In  addition,  respect  was  also  paid  to  the  easy  digesti- 
bility of  food, — white  meat  is  more  easily  digested  than  dark, — and  to  its  preparation. 
Water,  barley-water  and  wine  were  recommended  as  drinks.  Baths,  inunction, 
gymnastic  exercises,  and  the  frequent  use  of  emetics  were  also  commended  as 
dietetic  measures,  and  the  dietetic  principles  of  Hippocrates  in  febrile  diseases  arc 
substantially  observed  at  the  present  day.  By  means  of  some  of  the  foregoing  and 
other  precepts  Hippocrates  extended  the  doctrine  of  indications,  which  constitute^ 
one  of  his  greatest  services  to  medicine. 

1.  The  only  passage  of  the  Hippocratic  writings  in  which  this   word   occurs,  (and 

if  an  Hibernianism  may  be  pardoned  it  does  not  occur  here)  is  found  in  the 
i spurious)  6th  book  of  Epidemics,  and  is  couched  in  the  following  terms: 
To.  inyovra  5j  ir>(/>j.<7j;7>Ji  ~rt  b;'.<T'/J>!).v;a  frcuij.ura.  This  is  unintelligible  enough,  and 
the  entire  importance  of  the  "enormon"  is  due  to  Kaau-Boerhaave,  who  in  1745 
published  a  work  entitled,  "  Impetum  faciens  dictum  Hippocratis  etc.",  in  which 
he  elaborated  the  idea  of  an  enormon,  a  substance  intermediate  between  bod} 
and  spirit.     (See  Hecker  and  Haeser. )     (H.) 

2.  This  "right  instant"  has  been  familiar,  but  by  no  means  definitely  determinable. 

ever  since  the  days  of  Hippocrates,  and  accordingly  the  expression  may  often 
conceal  the  charlatan. 

3.  He  designates  it  fuel,  quite  in  accordance  with  our  modern  theories. 


—  103  — 

The  Diagnostics  of  Hippocrates  (though  he  does  not  recognize  any  such  special 
branch)  was  founded  especially  upon  objective  investigation  by  means  of  the  senses, 
and  made  use  of  every  aid.  The  ear  supplied  a  knowledge  of  the  mucous  rfde 
("  like  the  bubbling  of  boiling  vinegar "')  and  of  succussion  ;  the  sight  furnished  a 
survey  of  secretion  and  excretion,  the  bodily  frame,  the  attitude  of  the  body  and  its 
members,  the  gait  etc.  (inspection,  adspection) ;  feeling  (the  hand  upon  the  bi-east) 
supplied  an  idea  of  the  bodily  temperature,  and  perhaps  likewise  of  the  pulse 
(though  he  certainly  knew  nothing  of  counting  the  latter) ;  moreover  vaginal 
touch  was  practised,  and  the  taste  and  sense  of  smell  were  equally  put  to  service.  The 
sense  of  touch  was  also  armed  with  leaden  sounds,  garlic-stalks,  and  the  like,  for 
diagnostic  purposes  ;  the  sight  was  assisted  e.  g.  by  specula  ani.  Anamnesis  gave 
consideration  to  heredity,  preceding  diseases  and  tendencies  to  disease,  as  well  as  to 
such  matters  as  experience  proved  to  be  profitable  or  hurtful.  Yet  the  subjective 
symptoms  were  also  not  neglected. 

The  near]}7  allied  science  of  Semeiology  was  still  more  highly  elaborated.  In 
fact  the  whole  Greek  disposition  was  adapted  to  the  estimation  of  the  normal  in 
form,  deportment  etc.,  as  a  basis  for  the  comprehension  of  morbid  variations  of  all 
kinds;  for  the  Greek  eye  had  received  an  artistic  education  from  the  multiplicity  of 
works  of  art  by  which  it  was  surrounded. 

One  of  the  chief  services  of  Hippocrates  to  medicine  was  the  foundation  of  the 
science  of.  Prognosis.  This  was  based  upon  the  excellent  maxim:  "  In  order  to  be 
able  to  prognosticate  correctly  who  will  recover  and  who  will  die,  in  whom  the 
disease  will  be  long,  in  whom  short,  one  must  know  all  the  symptoms,  and  must 
weigh  their  relative  value."  It  considered  the  perspiration,  the  sleep,  mucous  rales 
in  the  throat,  the  visage  (facies  Hippocratica  )  carphologia,  the  appearance  or  absence 
of  the  "  crises"  on  the  appointed  days  etc. 

In  iEtiolog}",  he  paj-s  particular  attention  to  age,  constitution,  meteorological 
influences  etc.,  and  utilizes  in  practice,  as  well  as  in  prognosis,  the  following  passage: 
"  Catarrhs  are  dangerous  in  old  people  when  a  dry  spring  follows  a  winter  with  south 
winds  and  rain.  If,  however,  the  summer  is  dry  and  north  winds  prevail,  with  south 
winds  in  a  rainy  autumn,  coughs,  hoarseness  and  catarrhs  arise." 

The  surgical  knowledge  of  Hippocrates  is  considerable,  both  as  regards  the- 
number  of  diseases  recognized  by  him,  and  their  treatment  with  or  without  operation. 
Fractures  are  handled  particularly  well  as  regards  the  method  of  reduction  and 
dressing,  the  mode  of  repair,  and  the  duration  of  this  process.  If  e.  g.  a  fracture  is 
healed  with  considerable  shortening,  he  is  of  the  opinion  that  it  is  better  to  break  the 
corresponding  sound  bone,  so  as  to  equalize  the  shortening.  The  same  may  be  said 
of  dislocations.  Hippocrates  e.  g.  recognizes  luxations  of  the  humerus  inwards, 
downwards  and  outwards:  ''The  head  of  the  humerus  is  often  luxated,  but  not 
upwards,  in  consequence  of  the  acromion;  nor  backwards,  by  reason  of  the  scapula  ; 
nor  forwards,  in  consequence  of  the  biceps  muscle  ;  but  rarel.y  inwards  or  outwards, 
yet  frequently  and  chiefly  downwards."  He  employs  also  a  great  number  of  methods 
of  reduction.  Diseases  of  the  joints  (and  their  treatment  by  massage),  and  wounds, 
especiall}'  of  the  skull,  are  well  managed.  The  latter,  in  consequence  of  the  fact 
that,  until  the  time  of  the  discovery  of  explosive  weapons,  arms  designed  to  strike  or 
cut  were  chief!}'  used,  formed  the  favorite  field  of  surgical  labor.  Hippocrates  also 
recognized  the  fact  that  wounds  of  one  of  the  cerebral  hemispheres  produce  paralysis 
or  spasms  of  the  opposite  side.  The  treatment  and  healing  of  wounds  by  first  and 
second  intention,  fistula1,  ulcers  and  tumors  were  also  judiciously  discussed.  Hernia 
was  less  fully  treated. 

On  the  other  hand,  his  operative  surgery  recognizes  a  considerable  number 
of  instruments,   but  is  limited  in  major  operations  to  such  measures  as  allowing  tin 


—  104  — 

haemorrhage  to  cease  of  itself,  or  through  the  influence  of  syncope,  or  to  arresting  it 
da*  the  use  of  cold  water,  while  a  kind  of  amputation  or  rather  ablation  was  practised 
e.  g.  in  gangrene,  only  after  formation  of  the  line  of  demarcation.  Hippocrates  too 
calls  war,  quite  justly,  the  school  of  surgeons:  "  He  who  desires  to  practise  surgery 
must  go  to  war."  Trepanning,  paracentesis  thoracis  and  abdominis  etc.  were, 
however,  practised.  Stress  was  laid  upon  the  necessity  of  a  good  position,  good 
illumination,  and  good  assistants  in  an  operation  ;  but  the  chief  weight  was  placed 
upon  the  practice  and  the  dexterity  of  the  physician.  The  hot  iron  was  employed 
frequently,  a  practice  to  which  reference  is  made  especially  in  the  famous  Aphorism  : 
"What  drugs  fail  to  cure,  that  the  iron  (or  knife)  cures;  what  iron  cures  not,  that 
the  fire  cures;  but  what  the  fire  fails  to  cure,  this  must  be  called  incurable".1  The 
obstetrical  operations  were  also  assigned  to  operative  surgery,  since  there  was  no  such 
thing  as  ordinary  male  midwifery.  His  surgical  therapeutics  recognizes  a  very 
judicious  plan  for  reposition  of  the  gut  in  prolapsus  ani,  and  is  acquainted  with 
luxation  of  the  acromial  end  of  the  clavicle  (the  knowledge  of  this  dislocation  was 
entirely  lost  from  the  age  of  Hippocrates  until  the  last  century).  The  latter  accident, 
as  well  as  fracture  of  the  clavicle,  was  treated  very  judiciously  and  simply,  and  in 
fracture  Hippocrates  (according  to  Albert)  even  lays  stress  upon^simplicity  in 
dressing.  Other  surgical  remedies  were  bandages,  poultices,  plasters,  ointments, 
styptics,  caustic  (even  shoe-blacking2  was  thus  employed),  cold  and  compression, 
suppositories,  pessaries,  enemata,  cupping  etc.  The  rudiments  of  orthopaedic 
surgery  are  also  to  be  found  in  Hippocrates,  who  treats  club-foot  with  suitable  manipu- 
lations, bandages,  and  proper  shoes.  (Kroner.)  It  may  be  remarked  in  passing  that 
illustrations  of  bandaging,  extracting  darts  etc..  are  to  be  found  in  works  of  art  of 
the  4th  and  5th  centuries  B.  C. 

The  Ophthalmology-  of  Hippocrates  refers  most  diseases  of  the"  ejres  to  the 
descent  of  injurious  humors  from  the  brain  (catarrh)  into  the  eyes.  It  was  limited  to 
an  acquaintance  with  the  external  and  manifest  disorders  of  the  eye,  tumors,  blenor- 
rhcea,  ectropium,  entrppium,  epidemic  inflammations,  styes,  gray  (senile)  cataract, 
which  he  calls  glaucoma  etc.  Visual  troubles  like  amblyopia  were  also  indicated, 
and  a  few  operations,  like  e.  g.  that  for  the  relief  of  trichiasis,  were  known.  What 
nice  observations  Hippocrates  had  made  may  be  judged  from  the  fact  that  he  was 
acquainted  with  blindness  due  to  wounds  of  the  supraorbital  nerve.  "  In  wounds  of 
the  eyebrows  and  somewhat  higher  up  the  sight  becomes  darkened.  As  long  as  the 
wound  is  fresh  more  or  less  sight  is  preserved,  but  the  longer  the  cicatrix  persists,  so 
much  the  blinder  the  patients  become."  According  to  Hippocrates,  the  vitreous 
body'  and  the  lens  were  the  proper  organs  of  sight.     (Magnus.) 

Obstetrical  science  discussed  the  position  of  the  parturient  woman  (kneeling  in 
bed,  or  sitting  upon  the  labor-stool);  adhesion  and  deliverance  of  the  placenta 
(the  child,  still  attached  by  the  cord,  was  laid  upon  a  bladder  filled  with  water,  and 
the  bladder  was  then  punctured,  in  order  that  the  delivery  of  the  placenta  might  take 
place  without  violence,  as  the  result  of  the  gradual  evacuation  of  the  bladder) ;  the 
position  of  the  child  (presentation  of  the  head  was  normal;  that  of  the  pelvic  ex- 
tremity was  dangerous  to  both  mother  and  child;  hence  cephalic  version  was  exclu- 
sively recommended,  though    no  practical  method  for  its  accomplishment  was  given.) 

1.  jEschylus,  who  was  older  than    Hippocrates,   introduces  the  same  climax  in  his 

"  Agamemnon"  :  "  What  is  lacking  in  the  physician  and  drugs,  I  will  then  destroy 
utterly  with  the  knife  and  fire",  so  that  this  famous  aphorism  is  pre-Hippocratic. 
(It  will  also  be  found  in  Indian  medicine.     See  page  45.     H. ) 

2.  Melanteria    (jxsXavr/jpirj).      It  was   employed  as  an  application  to  lwmorrhoidal 

tumors,  and  is  mentioned  also  by  Dioscorides  and  Galen.     (H.) 


—  105  — 

Hippocrates  assumes  that  the  "  culbute"  of  the  French  is  completed  by  the  7th 
month.  He  discusses  the  death  of  the  child,  its  viability  (in  the  seventh  month);  the 
change  in  the  os  uteri  during  pregnancy ;  abortion  and  its  artificial  induction,  which 
the  Hippocratists,  however,  (in  opposition  to  Greek  ideas)  rejected,  and  therein 
proved  themselves  good  physicians.  For  the  production  of  abortion  numerous 
methods  are  given ;  among  them  the  tampon  and  the  following  verj- ingenious  one: 
to  leap  up  with  both  feet,  and  at  each  spring  to  strike  against  the  buttocks  with  the 
heels  until  abortion  ensues.  This  was  prescribed  with  the  desired  result  for  an 
amorous  and  much  loved  singer,  "  who,  as  such,  had  much  intercourse  (professional 
virtues  were  the  same  then  as  to-da}T!)  with  men."  The  opening  of  the  cranial 
cavity  (by  means  of  suitable  instruments),  amputation  of  the  extremities,  opening 
of  the  thorax  and  abdomen  of  the  child,  and  its  extraction  by  means  of  a  hook,  are 
also  described.  Monstrosities,  the  altered  countenance  of  the  pregnant  woman  (with 
male  children  supposed  to  be  red),  were  known,  and  it  was  held  that  the  foetus  during 
pregnancy  sucked  upon  the  cotyledons,  organs,  which,  from  the  observation  of  the 
lower  animals,  were  singularly  enough  transferred  to  the  human  being,  although 
human  placenta;  could  be  had  every  day.  If  menstruation  continues  during  pregnancy, 
the  foetus  is  diseased,  and  being  deprived  of  the  blood,  which  is  designed  to  serve  as 
its  nourishment,  abortion  ensues.  The  birth  of  the  child  was  effected  by  its  own 
exertions  in  pushing  with  its  feet  against  the  womb,  whereby  the  head,  aided  by  the 
weight  of  the  body,  ruptured  the  membranes,  and  opened  the  os  uteri.  Hunger 
forces  the  child  to  this  action,  since  in  the  later  months  of  pregnancy  it  is  insuffi- 
ciently nourished.  Dead  children  are  unable  to  bring  themselves  into  the  world,  and 
hence  their  birth  is  dangerous  to  the  mother — a  fatal  interchange  of  cause  and  effect. 
Children  born  during  the  8th  month  Hippocrates  considered  not  viable.  Quite 
modern  abuses  seem  to  have  been  known,  e.  g.  empechenrs  against  conception 
(The  Oath),  for  in  general  among  "the  good  people  of  the  olden  time''  sexual 
intercourse  and  sexual  excesses  were  much  more  artfully  managed  than  in  our, 
in  many  respects  comparatively  innocent,  age.  Yet  to  the  honor  of  the  profession 
be  it  said,  such  things  were  done  chiefly  by  the  midwives,  who  principally  practised 
the  obstetric  art,  while  the  physicians  were  only  called  to  the  most  difficult  cases, 
where  the  child  was  dead,  "in  which  then  the  death  of  the  mother  too  was  almost 
■certain." 

In  spite  of  the  frequencj'  of  artificial  abortions  at  this  period — a  frequency  which 
depended   upon   the   lawfulness  of  the  operation — and   in   spite  of  the  observations     \ 
upon  the  hatching  of  eggs,  the  history  of  foetal  development  was  but  scantily  known. 
As  early  as  the  seventh  day  all  parts  of  the  foetus  were  held  to  be  perfectly  visible  etc. 

The  knowledge  of  Gymecology,  like  that  of  the  branches  mentioned  above,  was 
not  far  advanced.  Diseases  of  the  uterus,  however,  were  tolerably  well  kncwn.  For 
hysteria  "  matrimony  as  the  best  cure"  was  judiciously  advised.  Singular  views, 
like  those  held  witli  reference  to  the  "wandering  of  the  uterus"  in  the  body  of  the 
sick,  prevailed  also  with  respect  to 

Gkxeratiox. — It  was  believed  that  by  holding  the  right  testicle  one  could  beget 
boys;  that  the  male  semen  penetrated  to  the  female  (the  mucus  secreted  by  the 
genital  tract),  that  the  female  semen  for  boys  originated  in  the  right  ovarium,  that  for 
girls  in  the  left,  so  that  the  sex  was  preformed  in  these  organs,  and  the  male  semen 
supplied  merely  the  excitation  necessary  for  development.  The  fruitfulness  of  women 
was  tested  by  fumigation  of  the  vagina,  the  fumes  in  the  most  favorable  cases  pene- 
trating upward  even  as  far  as  the  head  etc.  The  assertion  that  thin  women  conceive 
more  easily  than  fat,  small  women  than  large  etc.,  was  based  upon  the  observation  of 
nature,  while  the  advice  to  effect  conception  during  menstruation,  as  the  most  favorable 
time,  was  the  result  of  a  filthy  assumption. 


—   1U6  — 

We  will  remark  here  that  the  Greeks,  even  in  the  time  of  Hippocrates,  were 
probably  in  sexual  matters  the  most  licentious  of  all  nations,  at  least  if  Aristophanes 
depicts  only  half  the  reality.  We  have  reason  to  believe  that  paederasty,  amor 
Lesbicus,  hetajrism  and  harlotry  prevailed  generally  among  the  Greeks,  who  were  in 
other  respects  also  very  human.  As  respects  Pathology  it  is  surprising,  in  spite  of 
his  masterly  observation  of  the  special  phenomena  of  disease  in  general,  how  few 
special  diseases  are  distinguished  bj"  name.  More  general  conditions,  like  phthisis, 
catarrh,  dropsjr,  cynanehe  etc.  were  classed  together,  while  the  symptoms  described 
point  clearly  to  a  knowledge  of  intermittent  fever,  puerperal  peritonitis,  pneumonia, 
epilepsy,  ileus,  meningitis,  diseases  of  the  kidney  (in  which  the  urine  deposits  a 
sediment  and  foams)  etc.  Hippocrates  regards  diseases  of  the  skin  as  mere  critical 
expressions  of  internal  diseases,  and  employs  in  their  designation  for  the  most  part 
the  same  names  in  use  at  the  present  da.y.  In  his  doctrine  of  catarrh  (which  con- 
tinued in  vogue  for  thousands  of  years  down  to  the  time  of  Schneider)  Hippocrates 
holds  that  the  catarrhal  mucus,  formed  by  all  the  vapors  ascending  from  the  whole 
lower  part  of  the  body,  becomes  condensed  in  the  brain  and  then  flows  down  again 
through  the  ethmoid  bone  into  the  lungs,  intestines  etc.  If  this  theoretical  explana- 
tion is  false,  still  his  emphasizing  the  importance  of  catarrhs  shows  how  good  a 
practitioner  Hippocrates  was.  For  though  catarrhs  are  stricken  out  of  the  general 
causes  of  most  diseases,  lesions  of  the  mucous  membranes  continue  to  be,  even  to-day. 
the  most  important  and  most  successful  field  of  professional  activity. — In  Psychiatry 
too  Hippocrates  did  not  distinguish  the  different  forms  of  mental  disorder  strongly 
from  each  other,  but  he  yet  recognized  most  of  their  symptoms.  Even  delirium 
tremens  was  known  to  the  Hippocratists.  Indeed  in  that  time,  and  in  fact  as  early 
as  the  days  of  Homer,  very  considerable  quantities  of  liquor  were  drunk  on  occasions 
As  an  example  of  a  Hippocratic  history  of  disease  we  may  quote  the  following: 

"Angina,  which  had  befallen  Aristion,  in  whom  it  first  began  in  the  tongue  : 
speech  unintelligible,  tongue  red  and  dry.  On  the  first  day  a  rigor  and  fever,  a  red 
superficial  swelling  upon  the  neck  and  breast  of  both  sides,  limbs  cold,  livid,  respira- 
tion blowing.  Drinks  regurgitate  through  the  nose,  she  cannot  swallow.  Stools  and 
urine  retained.  On  the  fourth  day  all  the  symptoms  are  worse.  On  the  fifth  she 
died  as  the  result  of  the  angina."  Most  medical  histories  terminate  with  the  death  of 
the  patients — clear  evidence  that  physicians  did  not  deceive  themselves  as  to  the 
limits  of  medical  art.  On  this  account,  however,  discredit  was  cast  upon  Hippocrates, 
and  his  art.  was  called  the  medicine  of  death.  Celsus,  on  the  contrary,  thought  that 
Hippocrates  needed  not,  like  lesser  minds,  to  cover  his  failures  with  silence:  for  in 
spite  of  these  he  had  reputation  enough  to  counterbalance  them. 

Hippocrates    already    distinguishes    between     acute    diseases    and     epidemics. 

"Acute  diseases  are  those  which  the  ancients  name  pleuritis,  peri-pneumonia, 
phrenitis,  lethargus,  causus.  and  the  other  diseases  included  in  these,  and  in  which 
the  fever  is,  for  the  most  part,  a  continued  one.  At  periods  when  no  general  pestil- 
ential disease  prevails  epidemically,  there  die  of  these  diseases  more  than  of  all 
other  diseases  together." 

The  most  brilliant  and  eternal  contribution  of  Hippocrates  to  medicine  are 
his  therapeutic  maxims:  "Follow  nature";  "The  physician  is  a  servant,  nor  a 
teacher  of  nature",  though  also  ''The  physician  is  a  servant  of  art"  ;  "  Natures  are 
the  physicians  of  diseases"  ; x     "The  physician  should  benefit,  or  at  least  not  injure.' 

1.  By  "  nature  "  Hippocrates  understands  a  force  in  the  organism  inexplicable  to  us, 
but  which  maintains  the  body,  and  which  he  calls  sometimes  ro  Oswv.  some- 
times to  ftattxoviov   and  sometimes  r<5  ivonaubv.     (Marx.) 


—   107   — 

In  accordance  with  such  convictions  (especially  the  last,  which  is  capable  of  n< 
arbitrary  interpretation),  Hippocrates  would  not  forcibly  control  the  course  of  the 
disease,  but  would  manage  it  by  observing  and  awaiting  its  subsidence,  in  order  to 
interfere  for  the  first  time  actively  when  nature  herself  gave  him  the  hint.  Even 
during  antiquity  therefore  he  was  reproached  with  doing  too  little  in  disease, — a 
charge  which  certainly  redounds  to  his  credit.  He  desired  to  do  neither  too  little  nor 
too  much.  Hence  he  says  :  "Timidity  indicates  incapacity;  rashness  is  evidence  of 
unskilfulness."  That  Hippocrates  was  the  founder  of  the  method  of  treatment  (that 
of  indications)  adapted  to  the  constitution  and  the  kind  of  disease,  has  been  already 
mentioned. — In  feverish  diseases  he  allowed  much  drink  (ptisan),  and  withdrew 
nourishment. 

"The  more  we  nourish  unhealthy  bodies,  the  more  we  injure  them.  -  -"  The  sick 
upon  whom  the  fever  seizes  with  the  greatest  severity  from  the  very  outset,  must  at 
once  subject  themselves  to  a  rigid  diet." — Yet  he  was  not  prejudiced,  nor  devoted 
to  a  stereotyped  system  :  We  should  examine  also  the  strength  of  the  sick,  to  see 
whether  they  may  be  in  condition  to  maintain  this  spare  diet  to  the  crisis  of  the 
disease."  "  Complete  abstinence  often  acts  ver.y  well,  if  the  strength  of  the  patient 
can  in  anjr  way  maintain  it."  "  In  the  application  of  these  rules  we  must  be  always 
mindful  of  the  strength  of  the  patient  and  of  the  course  of  each  particular  disease, 
as  well  as  of  the  constitution  and  ordinary  mode  of  life  with  respect  to  both  food  and 
drink."  Golden  rules  ! — His  fundamental  principle  was  coniraria  cantrariis  oppon- 
enda,  and  3Tet  similia  similibus.  He  regulated  the  diet  very  carefully,  and  indeed 
was  the  creator  of  dietetics  for  the  sick.  If,  as  just  mentioned,  in  acute  diseases, 
he  at  first  withdrew  nourishment  and  selected  chieHj-  liquid  articles  of  food,  especially 
ptisan,  in  chronic  diseases,  on  the  other  hand,  he  adopted  a  ver}'  strengthening  plan 
of  treatment  and  prescribed  exercises,  bathing,  the  milk-cure  etc.  In  the  beginning 
and  during  the  height  of  painful,  acute  diseases,  particularly  of  the  great  viscera,  the 
lungs,  liver  etc.,  he  instituted  frequent  bleeding  in  the  vicinity  of  the  diseased  part 
and  upon  the  same  side,  proportioned  to  the  strength  of  the  patient 

In  diseases  of  the  upper  half  of  the  body  he  selected  the  arm,  head,  neck  or 
tongue  as  places  for  bleeding  ;  in  those  of  the  lower  half,  the  feet.  In  febrile  diseases 
he  adopted  the  "moist"  treatment,  gave  an  abundance  of  drinks,  and  at  the  period 
of  the  crisis  discarded  medicine,  to  avoid  producing  anjr  disturbance.  He  was  fond 
of  purgation,  i.  e.  the  use  of  cathartics  and  emetics,  but  did  not  administer  them  in 
acute  diseases  until  the  stadium  of  "coction"  made  its  appearance.  He  also  purged 
the  head  and  lungs,  the  former  e.  g.  with  hellebore,  the  latter  by  shaking  the 
body,  metallic  remedies  etc.  This  he  did  especially  in  acute  diseases,  where  the 
urine  was  muddy,  but  not  where  it  was  clear.  He  also  purged  the  intestines  with 
enemata.  Gargles  were  prescribed  in  the  pharyngeal  diseases,  which  seem  to  have 
been  so  common  in  that  day.  In  l^gienic  matters  Hippocrates  advises  one  to  observe 
what  he  tolerates  well,  and  what  bad!}',  and  to  manage  accordingly  ;  to  labor,  rest, 
sleep,  all  in  their  due  season  ;  not  to  eat  too  little,  nor  with  too  absolute  regularity 
that  deviation  from  the  rule  may  not  produce  harm;  to  drink  pure  spring-water,  as 
well  as  wine  mixed  with  water  more  or  less,  according  to  the  season;  occasionally  to 
get  a  little  tipsy,  so  that  accidental  excesses  may  not  occasion  harm  :  in  fact  to  get 
drunk  often  (a  piece  of  advice  which  even  the  disciples  of  iEsculapius  have  always 
cheerfully  followed),  but  also  to  control  the  passions  etc.  Among  his  numerous 
remedies  (265  have  been  enumerated,  in  spite  of  his  constantly  emphasizing  the 
assistance  of  nature),  Hippocrates  emploj'ed  chiefly  vegetable  substances,  though 
drugs  derived  from  the  animal  kingdom  also  were  not  discarded.  Some  of  these 
remedies  were  also  articles  of  food,  e.  g.  the  flesh  of  the  horse,  ass,  fox  and  dog, 
cabbage-juice,  7  pints  of  asses'  milk  as  a  mild  purgative  etc.     Metallic  remedies  were 


—  108  — 

also  recognized,  e.g.  copper,  alum  and  lead.  He  used  as  "diuretics":  radishes, 
cantharides,  squill,  asparagus,  garlic  etc. ;  as  drastics  (which,  however,  he  employed 
very  unwillingly),  hellebore,  euphorbiuin,  colocynth,  scammony,  the  grana  Gnidia 
etc.  ;  as  diaphoretics, — sweating  was  likewise  not  one  of  his  favorite  methods  of  treat- 
ment,— warm  water,  warm  drinks  etc.;  as  narcotics,  lettuce,  mandiagora  and  lollium 
(not  opium)  etc.;  as  astringents,  nut-galls,  oak-bark,  sanguis  draconis  etc.;  as 
emetics,  a  decoction  of  lentils,  vinegar  and  honey,  tickling  of  the  pharynx,  hjssop 
with  vinegar  and  salt  etc. ;  as  expectorants,  ptisan  with  oxymel ;  as  corrigents,  dried 
figs  etc.  To  these  ma}-  be  added  such  external  remedies  as  vesicants,  cupping- 
glasses,  poultices  etc.  It  is  a  striking  fact  that  Hippocrates  kept  himself  almost 
entirely  free  from  all  superstitious  and  theurgic  methods  of  treatment.  He  abandoned 
these  to  the  charlatans.  Yet  the  Greeks  at  that  time  had  already  adopted  from  the 
Asiatics  the  belief  in  demons! 

The  anatomical  knowledge  of  Hippocrates  was  very  imperfect,  as  must  naturally 
have  been  the  case,  inasmuch  as  it  was  based  upon  the  dissection  of  animals  only. 
The  different  parts  were  not  kept  distinct  enough  from  each  other,  but  were  often 
interchanged,  intermingled  and  artificially  constructed.  In  detail  the  bones  were 
best  known  (cranial  sutures,  diploe),  while  misty  views  alone  prevailed  with  reference 
to  the  muscles.  On  the  other  hand  the  intestines  were  better  distinguished.  Nerves, 
sinews  and  ligaments  were  confounded  together,1  while  as  regards  the  vessels2  (which 
contained  partly  blood  and  partly  pneuma),  and  especially  as  to  their  course,  his 
views  were  most  singularly  artificial.  He  was  acquainted  with  the  pericardium,  the 
two  ventricles,  the  thickness  of  the  walls,  the  muscular  nature  and  internal  appear- 
ance of  the  heart ;  he  knew  that  the  left  ventricle  is  emptjr  after  death,  and  he  was 
acquainted  with  the  valves  of  the  great  vessels  of  the  heart.  He  also  knew  that  the 
auricles  do  not  contract  exactly  contemporaneously  with  the  ventricles.  Four  pairs 
of  vessels  were  assumed,  one  originating  behind  from  the  nucha,  a  second  out  of  the 
head  behind  the  ears,  the  third  from  the  temples,  the  fourth  from  the  brow.  These 
cross  each  other  partially  in  their  course  etc.  The  brain  is  regarded  as  a  gland  which 
condenses  into  mucus  the  ascending  vapors,  which  then  (as  said  above)  flow  down 
through  the  nose.  The  kidneys  are  also  glands,  connected  with  the  bladder  by 
"  veins".  The  liver  is  an  organ  for  the  preparation  of  blood  and  bile,  has  five  lobes 
and  is  more  vascular  than  all  other  parts.  The  vena  cava  with  several  bronchia  pass 
from  it  to  the  heart,  and  one  vein  goes  from  it  to  the  spleen.  Hippocrates  was 
acquainted  with  the  duodenum,  the  colon,  the  mesenteiy,  the  seminal  vesicles  and 
the  rectum,  but  no  clear  description  of  them  is  given  anywhere.  The  nerves  are 
hollow  and  convey  the  spiritus  animales  throughout  the  body,  an  idea  which  occasioned 
lively  discussion  as  late  as  the  17th  century. — All  this  we  shall  criticise  more  mildl}- 
when  we  reflect  how  difficult  was  the  diffusion  of  correct  anatomical  views  even  down 
to  our  own  century  ! 

Of  Physiology  in  the  works  of  Hippocrates  we  cannot  with  propriety  speak. 
Still  we  may  adduce  here  the  facts  that  it  was  assumed  that  the  food  was  cooked  in 
the  stomach,  which  possessed  a  peculiar  warmth,  increased  by  the  liver;  that  the 
blood  is  "  warm  "  in  the  left  heart,  while  in  the  right  it  is  still  "  cold";  that  the  cause 
of  its  warmth  is  the  pneuma,  received  from  the  air  by  means  of  the  "cold"  lungs  etc. 
Hippocrates'  profound  comprehension  and  appreciation  of  the  history  of  medicine  is 
expressed  in  the  following  maxim  :  "  The  physician  must  know  what  his  predecessors 
have  known,   if  he  does  not  wish  to  deceive  both   himself  and  others." — He  recom- 

1.    They  were  called  indiscriminately   viypov  or    r^wc.       (H.) 
.2.    Both  arteries  and  veins  were  called  (pKifizz  ;   apTypfy    is  the  trachea.     iH.i 


—  109  — 

mends  as  a  rule  in  practice  that  the  physician  should  win  the  admiration  of  his 
patients,  an  object  to  be  accomplished  particularly  by  good  diagnoses  and  prognoses: 
that  he  should  not  be  too  officious,  nor  roll  up  his  sleeves,  like  an  athlete,  when 
he  wishes  to  bleed  or  administer  an  enema — evidence  that  even  the  little  arts  of 
practice  were  fully  understood  even  in  the  days  of  Hippocrates. 

The  preceding  data  did  not,  indeed,  originate  with  Hippocrates  and  his 
pupils  alone,  but  are  borrowed,  partially  at  all  events,  from  earlier  Greek 
(and  apparently  foreign  —  Egyptian)  physicians,  so  that  as  we  assume  a 
Homer  before  Homer,  we  must  also  assume  an  Hippocrates  before  Hippoc- 
rates. This  fact  he  himself  points  out  by  laying  stress  upon,  and  demand- 
ing respect  for  "  the  Ancients."  Hippocrates,  on  the  one  hand,  summed 
up  the  knowledge  of  preceding  physicians  unknown  to  us,  and  on  the  other 
added  thereto,  doubtless,  much  that  was  new  !  In  details  Hippocrates  too- 
is,  of  course,  not  exempt  from  the  deficiencies  of  his  age  and  of  his  individ- 
ual mind. 

The  undying  importance  of  Hippocrates  in  medicine  rests,  first  of  all, 
not  so  much  upon  his  enrichment  of  science  with  new  material  (though  this 
honor  too  is  his  unquestioned  due),  as  upon  the  creation  of  a  scientific 
(lay-)  medicine  and  art ;  upon  the  method  and  really  great  principles  which 
he  introduced  for  all  time  into  science,  and  especially  into  practice.  His  in- 
vestigation and  determination  of  the  phenomena  of  disease  and  of  the  science 
of  aetiology,  and  still  more  his  improvement  of  professional  treatment,  have 
also  won  for  him  immortal  reputation.  Hippocrates  was  above  all  else  a  prac- 
titioner who  desired  chiefly  not  to  impose  upon  his  fellow-men  with  showy 
discoveries  and  theories,  but  to  assist  them  to  the  utmost  of  his  power. 
And  this  he  did  !  Hence  his  godlike  words  :  "Where  is  love  for  art,  there  is 
also  love  toward  man '-' — a  maxim  which  raises  him  to  that  genuine  human- 
ity which  we  ascribe  to  Christianity  alone.  Hence  too  his  declaration  : 
"  Such  is  my  view  ;  others  may  hold  another.  The  victor  in  such  a  strife 
proves  ordinarily  only  his  own  lingual  dexterity."  The  latter  idea,  in  like 
manner,  displays  so  deep  an  insight  into  the  attainable  knowledge  of  his  time, 
that  we  cannot  sufficiently  admire  Hippocrates'  self-criticism  and  freedom 
from  prejudice.  On  the  other  hand  his  practical  activity  supplied  to  him, 
as  to  all  great  physicians,  a  fertile  soil  for  the  development  of  the  germ 
of  his  genius,  and  we  must  consider  the  great,  practical  doctrines  (partly 
purely  intuitive,  partly  deductive)  which  he  transmitted  to  posterity  for  its 
guidance,  the  ripe  fruit  of  that  development.  To  his  eminently  practical 
bent  is  to  be  ascribed  also  the  fact  that  he  created,  and  specially  cul- 
tivated, those  branches  of  medicine  which  are  profitable  in  practice  :  Semei- 
ology,  prognostics,  diagnostics,  aetiology,  symptomatology  and  therapeutics, 
and  in  a  much  less  degree  sj'stematic  pathology,  anatomy  etc..  Yet  he  did 
not  create  one  single  name  for  his  pictures  of  disease  !  Throughout  all  his 
efforts  he  remains  as  free  as  possible  from  the  perplexities  of  theory.  How 
correct  was  his  judgment  in  this  is  shown  by  the  career  of  his  immediate 
followers,  who  confined  their  thoughts  less  by  the  fetters  of  fact  and  sober 


—  110  — 

observation,  and  fell  into  errors  which  prevailed  for  centuries,  but  are  now 
long  forgotten.  Yet  Hippocrates  lives  and  will  continue  to  live,  the  im- 
mortal model  of  medical  thought,  and  still  more  of  medical  practice,  so  long 
as  medical  science  itself  exists  ! 

Finally,  to  draw  for  ourselves  a  picture  of  Hippocrates,  the  man  and 
the  author,  we  should  sa}',  to  judge  from  his  words,  he  was  a  philanthropic 
physician,  philosophically  educated,  enlightened  in  religion,  and  free  from 
superstition,  as  such  very  active,  probabty  rather  short  and  stoutly  knit. 
Certainly,  from  his  aphorisms  and  clinical  conversation,  we  should  say  he 
was  not  without  humor  and  sarcasm.  Moreover  he  was  a  careful  and  un- 
prejudiced observer,  trusty,  circumspect  ;  though  not  entirely  free  from  en- 
thusiasm, yet  without  great  fancy  ;  he  had  a  high  conception  of  his  profes- 
sion, which  was  stamped  upon  his  demeanor  ;  he  was  free  from  all  delusions 
concerning  himself  and  the  bounds  placed  upon  his  art  by  nature. 

"  Moreover  it  is  not  sufficient  that  we  do  what  is  proper  for  the  ease  and  the 
time,  but  the  sick  themselves  and  their  attendants  must  do  the  same,  and  the  circum- 
stances must  be  suited  to  the  object  in  view." 

As  a  writer  Hippocrates  is  distinguished  by  the  simplicity,  force  and 
precision  of  his  expressions,  which  not  infrequently  display  an  oracular 
brevit3"  and  a  dramatic  pathos.  He  has  always  the  right  word  at  his  dis- 
posal, and  not  infrequently  he  constructs  for  himself  new  compounds  when 
he  is  describing  his  own  observations,  in  which  peculiarity  he  is  not  unlike 
Homer.  Finally  in  language  he  is  surpassed  by  but  few  (J reek  writers,  and 
ma}T  be  classed  unhesitatingly  among  the  classical  authors  of  his  own,  and 
indeed  of  all,  time  ! 

Moreover  he  was  very  well  acquainted  with  mankind,  which  continues  in  all  aires 
the  same:  "  The  physician  visits  a  patient  suffering  from  fever  or  a  wound  and  pre- 
scribes for  him.  On  the  next  day,  if  the  patient  feels  worse,  the  blame  is  laid  upon 
the  physician:  if,  on  the  other  hand,  he  feels  better,  nature  is  extolled  and  the 
physician  reaps  no  praise."  A  regard  for  decency  is  also  inculcated  :  "  One  must 
never  strip  bare,  nor  exhibit  to  the  by-standers,  without  necessity,  those  parts  of  the 
body  which  should  be  covered."  "  One  should  say  something  agreeable  to  the  patient, 
Hatter  his  sense  and  humor  his  fancies,  if  they  are  not  dangerous."  Even  the  rage  of 
physicians  and  patients  for  novelties  and  braggadocio  was  well  known  to  Hippocrates. 
No  prolonged  study  is  required  "to  set  a  broken  arm,  and  any  physician  is  capable 
of  doing  this',  jet  I  know  certain  pl^-sicians  who  create  a  reputation  for  dexteritjr  by 
the  unnecessary  parade  of  their  manners,  a  matter  which  corrupts  the  public. 
.  A  novelty,  the  advantage  of  which  is  not  known,  is  praised  more  than  the 
ordinary  method,  whose  excellence  has  been  proved;  and  surprising  things  are  more 
highly  prized  than  those  which  are  obvious  in  themselves." 

Although  Hippocrates,  as  we  have  seen,  exercised  upon  the  medicine 
of  his  time  an  influence  so  powerful  as  to  give  it  direction  and  a  name  for 
all  future  ages,  and  although  he  himself  enjo^-ed  the  greatest  respect  and 
reputation,  even  among  his  own  contemporaries,  yet  the  influence  of  his 
principles  was  surprisingly  short.  Their  decline  began  almost  during  his 
lifetime,  and  after  his  death  took  a  very  rapid  course.     This  observation 


—  Ill  — - 

would  be  highly  surprising,  were  it  not  at  once  evident  that  the  Hip- 
poeratic  plan  of  simple  observation  and  sober  appropriation  of  the  facts 
observed,  with  the  least  possible  speculation,  suited  neither  the  mode  of 
thought  nor  the  spirit  of  the  Grecian  people.  For  the  latter  was  eminently 
philosophic  and  theoretic,  but  b}-  no  means  unprejudiced,  observing  or  dis- 
posed to  natural  science — a  spirit  represented  in  all  antiquity  b}T  Hippocra- 
tes alone. 

The  connexion  of  medicine  with  natural  science  did  not,  as  Seeger 
says,  increase  the  respect  of  the  masses  for  the  medical  art.  Hippocrates 
laid  weight  even  upon  mathematics,  and  accordingly  recommended  its  study 
to  Thessalus.  He  calls  a  philosophic  physician,  indeed,  a  godlike  man,  but  he 
is  himself  no  philosopher  in  the  sense  of  a  definite  "  school  "  and  doctrine. 
He  is  no  school  philosopher,  and  thus  few  traces  of  the  wideby  extended 
philosophical  doctrines  and  theories  of  his  time  are  to  be  found  in  his 
writings.  Yet  he  is  a  philosopher  in  his  method,  in  his  treatment  of  sub- 
jects, in  his  investigations  of  the  causes  of  disease  and  of  the  inner  con- 
nexion of  all  the  phenomena  manifested  in  the  human  body  and  in  nature. 

After  his  day  a  philosophy  which  paid  slight  respect  to  all  facts  and 
held  all  observation  by  the  senses  to  be  deceptive,  won  a  controlling  in- 
fluence over  medicine.     I  refer  to 

6.  THE  PHILOSOPHY  OF  PLATO 

(B.  C.  427-347.), 

whose  speculative  contemplations  (Dogmatism),  a  comprehensive  system 

formed  from  his  own,  Socratic,  Pythagorean  and  religious  doctrines,  assumed 

two  principles,  absolute  intelligence  (godlike  reason,  God),  and  matter.1 

The  human  soul  is  an  emanation  from  the  former.  Its  immortal  part  dwells  in 
the  spherical  head,  which  in  its  form  resembles  the  cosmos,  while  its  mortal  part  re- 
sides in  the  body,  and,  indeed,  as  mind  has  its  seat  above  the  diaphragm  in  the  heart: 
the  lower,  sensual  part  resides  beneath  the  diaphragm  in  the  stomach.  Certaint}-  of 
knowledge  depends  upon  the  remembrance  of  ideas,  the  pre-existing,  innate,  super- 
natural models  of  all  things,  but  not  upon  the  perceptions  of  the  senses,  which  supply 
merely  the  external  appearances.  The  world  is  formed  of  the  four  elements,  which 
are  not  indivisible.  (Fire  consists  of  pyramidal,  earth  of  cubical,  air  of  octagonal, 
and  water  of  twenty-sided,  atoms.)  In  addition  to  these  there  is  also  the  aether. — 
Plato,  like  Pythagoras,  laid  great  weight  upon  mathematics,  which  he  too 
had  studied  especially  during  his  residence  of  thirteen  jears  in  Heliopolis.  His 
teacher  was  Sechnuphis  (Sichnun),  a  priest  of  Memphis.  Plato  was  so  partial  to 
geometry,  that,  as  is  well  known,  he  would  receive  no  scholar  who  was  ignorant  of  this 
branch.  Everything  in  the  body  has  in  view  the  spirit.  With  respect  to  temporal 
affairs  Plato  held  quite  ''modern"  ideas.  He  thought  e.  g.  that  the  state  should  as- 
sume the  regulation  of  the  subject  of  reproduction,  should  introduce  a  kind  of  com- 
munity of  women,  and  unite  maidens  with  old  men,  and  young  men  with  older  women 

1.  How  fond  the  Greeks  were  of  artistic  form,  even  in  abstract  works,  may  be  in- 
ferred from  the  dramatic  form  which  Plato  gave  to  his  writings,  clothing  them  in 
the  dress  of  dialogues,  and  stamping  them  with  plastic  pictures  of  the  Greek 
life  of  his  day. 


—  112  — 

etc.  In  fact  he  was  an  antique  social-democrat,  who  (in  contrast  with  Aristotle,  who 
laid  more  emphasis  upon  the  rights  of  the  individual)  subordinated  everything  to  the 
state.  Plato  too  would  by  his  doctrines  guard  against  pauperism  and  over-population, 
goblins  which  even  in  that  day  excited  apprehension.  It  may  be  remarked  incident- 
ally that  we  learn  from  Plato's  "Politics"  that  the  Greek  mothers,  even  of  the  better 
classes,  suckled  their  own  children,  though,  says  Plato,  they  should  not  continue  this- 
business  too  long,  but  soon  take  nurses  for  their  children,  for  fear  of  becoming  too 
feeble  to  bear  other  offsprings. 

The  heart  is  the  origin  of  the  bloodvessels,  and,  as  the  seat  of  the  mind,  receives 
through  them  the  commands  of  the  superior  soul.  The  lungs,  which  receive  through 
the  trachea  a  portion  of  the  drink  in  addition  to  the  air,  serve  to  cool  off  the  heart. 
The  liver  serves  the  lower  desires  and  for  the  purpose  of  divination.  The  spleen 
furnishes  an  abode  for  the  impurities  of  the  blood.  The  intestine  is  long  and  tortuous 
in  order  that  the  food  may  remain  the  longer  therein,  so  that  the  mind  may  not  be 
disturbed  too  often  in  its  contemplations  b}r  the  renewal  of  nutriment  necessitated  fre- 
quently bj'  greater  shortness  of  the  gut.  Breathing  takes  place  by  inward  pressure 
of  the  air,  for  no  vacant  space  can  exist  in  the  bodj7  (horror  vacui).  The  muscles 
with  the  bones  serve  as  a  protection  to  the  marrow  against  heat  and  cold.  The  mar- 
row itself  consists  of  triangles,  and  its  most  perfect  portion  is  the  brain,  which  gene- 
rates the  semen.  Death  is  occasioned  by  a  separation  of  the  soul  from  the  marrow. 
Sight  originates  in  a  union  of  the  light  flowing  out  of,  and  into  the  eyes  ;  hearing,  in 
a  shock  of  the  air  (correct  even  now),  which  is  communicated  to  the  brain  and  the 
blood,  and  even  to  the  soul.  Taste  is  due  to  a  solution  of  sapid  atoms  by  means 
of  small  vessels,  which  latter  conduct  these  from  the  tongue  to  the  heart  and  soul; 
smell,  however,  possesses  no  imatreas  its  foundation,  and  is  therefore  very  transitorj-. 
Plato  considered  the  uterus  a  wild  beast,  which  never  follows  reason,  and,  through 
non-satisfaction  of  its  desires,  roams  about  in  the  body,  and  also  excites  inordinate 
lust  etc.  Disease  originates  in  a  disturbance  of  both  the  quantity  and  quality  of  the 
fluids.  The  most  frequent  cause  of  disease  is  the  downflow  of  mucus  and  acridity;  the 
most  dangerous,  is  corruption  of  the  marrow.  Another  cause  is  the  yellow  and  black 
bile,  through  whose  aberrations  inflammations  arise.  Continued  fever  is  occasioned 
by  fire,  quotidian,  by  air,  tertian,  by  water,  quartan,  by  earth.  Mental  diseases  are 
the  result  of  corporeal  evils  or  of  bad  education.  Besides  bodily  exercise  and  diet, 
remedies  are  formed  from  drugs,  which  constitute  an  opposing  treatment  for  diseases, 
before  which  they  flee  away.  Of  physicians  he  sa3-s  that  they  must  be  rulers  of  the 
sick  in  order  to  cure  them,  but  they  must  not  be  money-makers. 

In  accordance  with  Plato's  partial,  speculative  and  fantastic  method 
was  built  up  the  so-called 

7.  DOGMATIC  SCHOOL. 

The  physicians  of  this  doctrinaire,  humoral  sect  may  be  called  the 
representatives  of  the  prevalent  a  priori  tendency  of  Greek  medicine  :  in- 
deed we  may  regard  them  as  the  representatives  of  a  reaction  against  the 
analytic  portion  of  the  method  of  Hippocratic  medicine.  Since  their  day 
this  alternation  of  a  priori  and  inductive  methods  of  investigation  has 
constantly  recurred  in  histoiy.  The  Dogmatists  placed  reflection  above,  or 
rather  before,  experience :  yet  they  did  not  reject  experience  entirely,  con- 

1.  With  respect  to  hearing  he  says  that  we  hear  with  the  ears  because  there  is  within 
them  a  vacant  space  ;  for  this  gives  the  sound  —  exactly  like  Alcnnvon. 


—  113  — 

sidering  it,  however,  simply  accessor  proof  of  the  correctness  of  reason. 
Hence  the}'  first  sought  after  the  causes  of  disease  ;  not,  however,  the  actual 
causes,  but  those  discovered  in  a  speculative  way  and  not  based  upon  pre- 
ceding observation.  They  also  cultivated  a  purely  a  priori  method  in  aeti- 
ology. The  mucus  flowing  down  from  the  brain,  the  different  kinds  of  bile 
etc.  were  assumed  as  the  cause  of,  and  the  principle  of  classification  for, 
diseases,  and  the  latter  were  then  formed  into  classes  and  named  in  accord- 
ance with  the  humors  adopted  in  each  case.  Thus  there  were  mucus 
diseases,  bilious  diseases  etc.,  and  if  one  only  knew  the  nature,  i.  e.  the 
systematic  position  of  a  disease,  the  remedy  was  easily  found — it  was  one 
antagonistic  to  mucus,  bile  etc.  Moreover  the  physicians  of  this  school, 
like  the  similarly  reviled  philosophical  physicians  of  the  19th  century  (with 
whom  too  they  shared  a  common  predilection  for  certain  subjects,  e.  g. 
physiology  or  the  history  of  development— generation  of  the  chick,  of  man 
etc.)  were  not  entirely  devoid  of  merit.  The  appearance  of  Dogmatic  after 
Hippocratic  medicine  was  the  first  example  of  that  law  of  development  of  the 
sciences  (including  medicine),  by  virtue  of  which  a  period  of  realistic 
methods  of  investigation  is  always  followed  b}'  another  in  which  the  ideal- 
istic methods  predominate,  and  conversely. 

Of  the  writings  of  physicians  of  this  school  little  but  fragments,  pre- 
served in  the  works  of  other  authors,  have  come  down  to  us.  The  school 
itself  belongs  to  the  period  of  the  Thirty  Years'  War  of  Greece  (as  the  Pe- 
loponnesian  War  is  justly  called  by  Jaeger),  and  to  the  epoch  of  rapid  de- 
cline of  Greek  life.  Its  founders  were  Thessalus  (B.  0.  380),  who  lived  at 
the  court  of  the  Macedonian  king  Archelaus  ;  Draco,  physician  of  Queen 
Roxana,  both  sons  of  Hippocrates,  and,  most  important  of  all,  their  brother- 
in-law,  Polybus,  who,  like  Thessalus,  was  author  of  some  of  the  so-called 
Hippocratic  writings. 

The  latter  enriched  the  medicine  of  his  day  with  a  knowledge  of  the  egg-mem- 
brane and  observations  upon  the  hatching  of  hens'  eggs,  in  support  of  a  more  certain 
basis  for  the  history  of  development.  According  to  Polybus,  the  egg-membrane  orig- 
inates in  the  curdling  after  coitus  of  the  male  and  female  semen  in  the  bipartite  ute- 
rus by  means  of  heat,  and  the  formation  of  a  crust,  the  membrane  itself.  The  sex  of 
the  embryo  —  a  problem  which,  though  exceedingly  old,  has  never,  even  to  this  day. 
been  solved  either  theoretically  or  practically  —  depends  upon  the  greater  strength 
of  one  of  the  two  semina.  Its  growth  takes  places  through  attraction  of  kindred  parts 
and  the  vital  air  conveyed  to  it  by  the  mother.  Polybus  assumed  bile,  mucus,  blood 
and  water  as  the  causes  of  disease,  while  Thessalus  claimed  only  the  excess  of  the 
two  former  as  such  causes,  and  generalized  the  down-flow  of  mucus  as  the  effective 
agent  in  the  production  of  catarrhal  diseases. 

The  remaining  Dogmatic  physicians,  even  more  than  those  already 
mentioned,  drifted  into  empty  speculations  frequently  bordering  upon  the 
limits  of  absurdity.  Even  anatomy,  whose  importance  in  the  investigation 
of  the  causes  of  disease  was  so  fully  understood  that  they  recommended 
and  defended  the  opening  of  those  who  died  of  disease,  and,  indeed,  of  liv- 
ing convicts,  was  constructed  in  accordance  with  theoretical  considerations. 


—  114  — 

The  temptation  to  do  this,  in  consequence  of  the  want  of  human  dis- 
sections and  the  rarity  of  even  the  dissection  of  animals,  was  very  great, 
and  Hippocrates  himself  had  set  the  example  in  this  respect,  as  in  most 
other  of  the  views  of  the  Dogmatists.  A  very  curious  example  of  this 
constructive  tendency  is  found  in  the  doctrine  of  the  "  Crossing  of  the  ves- 
sels "  advanced  by  Syennesis  of  Cyprus  (about  B.  C.  360),  and  the  much 
earlier  Diogenes  of  Apollonia. 

The  latter  physician  by  reflection  even  discovered  that  the  embryo  originates 
from  the  semen  of  the  male  alone  (Leeuwenhoek  2000  years  later  taught  the  same 
doctrine,  mutatis  mutandis,  but  based  it  upon  the  microscope),  and  that,  if  of  the  male 
sex,  it  is  completely  formed  in  five  months. 

Dioxippus  of  Cos  (B.  C.  370) 
followed  the  Platonic  doctrine  of  the  partial  penetration  of  drink  into  the  lungs,  and 
sought  to  uphold  this  view  in  defiance  of  the  epiglottis.  The  latter  organ,  in  his  view, 
separates  the  grosser  portion  of  the  drink  from  the  finer,  so  that  the  latter  only 
reaches  the  lungs,  while  the  former  passes  on  into  the  stomach.  Hence  birds,  which 
merely  sip  water,  have  no  epiglottis.  —  This  view  was  also  maintained  by 

Philistion  of  Locri,  a  contemporary  of  Plato, 
who  occupied  himself  with  anatomy,  and  explained  respiration  as  a  process  for  cool- 
ing the  innate  heat. 

Petro  (or  Petronas)  is  credited  with  the  following  Dogmatic  treatment 
of  fever.  (From  the  creation  to  the  present  daj'  what  has  not  been  exacted 
from  the  sick !) 

At  the  outset  promote  perspiration  by  an  abundance  of  bed-clothes;  in  the  remis- 
sion drink  a  quantity  of  pure  water,  in  order  to  again  excite  perspiration.  This  pro- 
cess he  regarded  as  necessary  until  the  crisis  of  fever.  If  under  this  treatment  the 
crisis  did  not  occur,  he  then  administered  salt  and  water  as  an  emetic,  following  it  up 
by  as  much  wine  as  the  patient  would  hold.  Petro  was  also  the  inventor  of  sweat- 
boxes. 

The  treatment  of  Acesias1  was  proverbial  for  its  bad  results. 

Eudoxus  of  Cnidos  (B.  C.  406-353)  studied  priestly  medicine  in 
Egypt2  and  introduced  the  Pythagorean  doctrine  of  numbers  into  the 
medical  art  of  his  time.  He  was  an  astronomer,  the  friend  of  Plato  and 
the  teacher  of 

Chrysippus  of  Cnidos  (B.  C.  340), 
with  whom  he  spent  fifteen  months  at  Heliopolis  as  a  pupil  of  the  priest 
Chonnuphis,  engaged  in  the  study  of  Egyptian  wisdom. 

Chrysippus  made  use  of  vegetable  remedies  only,  and  paved  the  way  for  the  long 
prevalent  and  utter  rejection  of  purgatives  and  venesection  —  the  latter  because, 
according  to  Pythagoras  (and  the  Bible),  the  blood  contains  the  soul,  a  doctrine  of 
Egyptian  origin.     In  fevers  he  withdrew  all  nourishment  and  administered  emetics 

1.  Acesias  was  the  name  of  a  physician  of  an  unknown  age  and  country,  notorious  for 

his  want  of  success.  Hence  Aristophanes  says  (Suidas  s.  v.  Acesias)  'Azsacat; 
tatraro  i.  e.  "  He  is  getting  no  better  very  fast".  He  must  have  lived  prior  to 
B.  C.  400.     (H.) 

2.  Greek  physicians  frequently  travelled  in  this  country,  and  thus  Egypt  gained  an 

ever  increasing  influence  upon  Greek  education. 


—  115  — 

and  etiemata,  while  in  haemorrhage  he  placed   ligatures  around  the  limbs  to  retain 
the  blood  (Esmarch's  s}'Stem?). 

Medius,  Aristogenes,  the  physician  of  Antigonus  Gonatas,  Metrodo- 
rus,  the  son-in-law  of  Aristotle  and  teacher  of  Erasistratus,  Phaon,  Ariston, 
Philetas,  Pherecydes,  Acumenes,  Dionysius  "  the  Humpbacked",  who 
observed  the  "  Pest ",  Hermippus  and  Histomachus,  authors  of  works  on 
the  history  of  medicine  now  lost,  were  all  members  of  the  Dogmatic  School. 
Earlier  than  these  physicians  lived  Meton  of  Athens,  who  sought  to  combine 
medicine  and  mathematics.  He  computed  B.  C.  432  that  19  solar  years  (235  months) 
made  a  so-called  Metonic  period,  a  calculation  subsequent^'  corrected  by  Hipparchus 
and  Calippus  (B.  C.  160-125).  We  ma}-  add  that  Hipparchus  utilized  the  results  of 
Pytheas,  a  geographical  investigator  and  merchant,  who  about  B.  C.  400  made  the  first 
(designed)  expedition  to  the  north  pole,  determined  the  first  meridian  (of  Marseilles), 
and  is  the  first  to  mention  the  Teutons,  a  people  who  dwelt  around  the  mouths  of  the 
Rhine,  and  whom  he  reckons  among  the  Scythians.  This  Hipparchus  of  Rhodes  (about 
160  B.  C. )  was  the  first  who  taught  a  heliocentric  solar  system  and  calculated  the  solar 
parallax  in  order  to  determine  the  distance  of  the  sun, while  Aristarchus  of  Samos  (about 
B.  C.  280)  reckoned  the  revolution  of  the  earth  and  moon,  and  endeavored  to  deter- 
mine the  former  by  the  moon's  phases.  He  also  demonstrated  that  motion  of  the 
earth  around  the  fixed  sun  was  compatible  with  the  endlessness  of  the  world,  asserted 
by  Heraclides  of  Pontus.  The  Chaldsean  Sileucus,  of  Seleucia  on  the  Tigris,  taught 
about  B.  C.  160  the  heliocentric  solar  system  as  a  doctrine  of  his  own  (Ueberweg). — 
We  bring  forward  these  facts  to  show  the  degree  of  exact  education  (which  was  intro- 
duced into  Alexandria  as  early  as  the  fifth  century  B.  C.  and  subsequently  attained 
the  grade  just  described),  and  still  more  because  it  counted  physicians  as  its  most 
eminent  representatives. 

Diocles  of  Carystus  (B.  G.  350) 
in  Bubcea  was  one  of  the  most  famous  physicians  of  antiquity,  compared  even  with  Hip- 
pocrates himself.  He  wrote  a  great  number  of  treatises  on  fevers,  materia  medica,  poi- 
sons, dietetics,  anatomical  subjects,  the  history  of  development  etc.,  and  distinguished 
between  pneumonia  and  pleurisy,  as  well  as  dropsies  depending  upon  disease  of  the 
liver  or  spleen,  established  the  differential  diagnosis  between  ileus  and  colic  etc.  He 
interpreted  fever  as  a  symptom  and  held  sweating  to  be  unnatural,  opposed  the  views 
of  his  predecessors  regarding  the  course  of  the  vessels,  demonstrated  that  the  male 
semen  is  not  foam,  since  it  is  heavier  than  water  etc.  He  also  embraced  the  Pythag- 
orean doctrine  of  numbers.     Other  Dogmatists  were 

Mnesitheus  of  Athens,  who  wrote  on  systematic  medicine  and  on  die- 
tetics, including  the  feeding  of  children  ;  Xenophon  of  Gos,  a  follower  of 
Chrysippus  in  regard  to  ligation  of  the  limbs  ;  Dieuches,  who,  on  the  other 
hand,  discussed  the  cabbage  ;  Plistonicus,  who  wrote  upon  food  ;  and 
Philotimus,  a  good  anatomist.  The  latter  physicians,  together  with  Lysi- 
machus,  were  pupils  of 

Praxagoras  of  Cos  (about  B.  C.  335),  the  son  of  Nikarchus,  and 
teacher  of  Herophilus. 

Praxagoras  has  acquired  immortal  fame  by  his  discovery  of  the  distinction 
between  arteries  and  veins,  of  which  the  former  were  the  active  agents  in  the  forma- 
tion of  the  pulse.  Under  ordinary  circumstances  they  contain  air  only,  but  in  the 
case  of  wounds  blood  is  also  found  in  them,  having  been  drawn  in  from  all  the  sur- 
■rounding  parts.     He  considered  respiration  an    action   designed  to  strengthen  the 


—  116  — 

heart  by  forcing  air  into  that  organ  ;  the  brain  was  a  mere  dependence  of  the  spinal 
cord,  but  the  heart  was  the  origin  of  the  nerves.  Praxagoras  was  a  Humorist  of  the 
purest  water,  and  as  such  assumed  no  less  than  eleven  humors:  the  sweet,  uniformly 
mixed,  vitreous,  acid,  salt,  salty,  bitter,  pungent,  fixed,  leek-green  and  yellow.  He 
sought  the  source  of  fever  in  the  great  vena  cava,  and  called  attention  to  the  differen- 
ces of  the  pulse  in  conditions  of  health  and  disease.  He  practised  taxis  in  every 
possible  way  in  cases  of  strangulated  hernia,  and  even  performed  (though  this  is  diffi- 
cult to  decide)  the  operations  of  herniotomy  (at  least  in  "iliac  passion"  he  recommends 
cutting  into  the  abdomen,  removing  the  fasces,  and  then  sewing  it  up  again)  and  am- 
putation of  the  uvula.  In  therapeutics  he  favored  bleeding,  though  only  before  the 
fifth  day  in  inflammations,  employed  vegetable  remedies  almost  exclusively,  and  laid 
great  weight  on  the  diet.  In  the  time  of  the  Dogmatic  school  originated  the  prohibi- 
tion of  drink  in  feverish  diseases,  the  revival  of  which  not  many  decennia  ago  cost  the 
life  of  many  typhus  patients. 

8.  ARISTOTLE  AND  HIS  PUPILS. 

Aristotle  (B.  C.  384-321),  the  teacher  of  Alexander  the  Great,  was  the 
son  of  Nicomachus,  a  physician  of  Stagira  in  the  vicinity  of  mount  Athos, 
descended  from  the  family  of  the  Asclepiadse,  and  practising  at  the  court 
of  the  Macedonian  king  Amyntas  (died  B.  C.  369),  the  father  of  Philip  II. 
(B.  C.  383-336).  He  exercised  no  such  important  and  immediate  influence 
upon  the  views  of  ancient  medicine  as  did  Plato,  though,  on  the  other  hand, 
during  the  Middle  Ages  his  authority  was  held  in  the  highest  esteem.  He 
did  not,  like  Plato,  call  about  him  a  numerous  school  of  followers,  yet  his 
great  mind  supplied  for  thousands  of  years  the  principles  of  thought  and 
observation,  and  the  material  for  the  extension  of  all  branches  of  knowl- 
edge, but  especially  of  the  natural  sciences,  of  which  he  is  considered  the 
creator.  He  granted  to  the  perceptions  of  the  senses  their  full  rights,  and 
thus  opened  the  way  for  what  may  be  called  Grecian  Realism  ;  in  opposition 
to  the  Idealism  of  Plato  and  the  Materialism  of  Democritus  he  took  the  road 
of  analysis,  and  thus  exercised  undoubtedly  a  favorable  influence  upon  phi- 
losophy. Yet,  on  the  other  hand,  his  influence  was  prejudicial  in  awakening  an 
exaggeration  of  the  art  of  forming  conceptions — an  art  built  up  by  him  in  a 
masterly  manner  only  to  be  corrupted  b}'  others  into  subtlety  and  artifice. 
Yet  "  to  estimate  the  activit\T  of  Aristotle,  to  explain  his  relation  to,  and  to 
exhibit  his  agency  in,  the  formation  of  the  human  mind,  this  is  to  give  the 
histoiy  of  all  science  and  art,  and  to  describe  the  whole  political  life  of  the 
ancients  ;  and  such  a  work  would  demand  a  mind  like  that  of  Aristotle 
himself!"  In  his  da}-,  too,  Greek  culture  had  already  begun  its  decline, 
and  Hellenic  activity  in  the  department  of  mind  lost  more  and  more  its 
creative  power,  degenerating  graduall}'  into  a  simple  pedantry  which  con- 
tented itself  with  imitation  and  compilation.  The  petty  jealousies  and 
quarrelsomeness  too  of  the  Greeks  themselves  prepared  the  way  for  the  in- 
curable wound  inflicted  by  Philip  II.  of  Macedon,  and  Grecian  independence 
was  lost  in  spite  of  the  patriotic  orations  of  Demosthenes. 

Aristotle,  the  creator  of  logic,  like  Plato,  assumed  five  elements  as  components 
of  the  body,  and  assigned  to  them  three  cardinal  qualities,  form,  substance  and  mo- 


—  117  — 

tion  or  rest.  Experience  was  the  basis  of  all  science;  the  knowledge  of  the  powers 
subservient  to  the  soul,  the  entelecheia,  was  its  object.  The  body  is.  the  instrument 
of  the  soul,  and  both  body  and  soul  are  in  essence  one  and  the  same.  Life  is  move- 
ment; the  heart,  however,  is  the  seat  of  warmth,  the  source  of  motion,  sensibility 
and  desire.     It  is  the  "Acropolis  of  the  body". 

The  investigations  of  Aristotle  in  natural  science  (in  aid  of  which  Alexander 
supplied  him  with  money  and  material)  extended  especially  over  the  animal  king- 
dom. He  was  a  famous  zoologist  and  the  founder  of  comparative  anatomj-.  It  is 
only  through  physiology  that  he  comes  into  contact  with  medicine,  since  pathology, 
particularly  that  of  man,  is  only  slightly  and  incidentally  considered.  He  refers  dis- 
eases to  the  blood  and  the  humors,  through  the  abundance  or  lack  of  which,  as  the 
case  may  be,  their  differences  arise.  He  made  observations  on  the  influence  of  the 
weather,  the  season,  the  food,  drugs  etc.  On  the  other  hand  his  labors  in  anatomy, 
which  he  studied  in  animals,  are  of  great  importance.  He  distinguished  the  nerves 
as  such,  but  called  them  canals  of  the  brain,  which  latter  organ  he  described  as  blood- 
less, and  of  the  largest  size  in  man.  Yet  by  the  term  "neura"  he  understands  ten- 
dons and  ligaments,  which  he  thinks  originate  from  the  heart.  He  recognized  the 
optic  nerve,  but.  explained  the  auditory  nerve  as  a"  vessel".  The  common  origin  of 
the  vessels  from  the  heart  is  also  one  of  his  theses,  and  he  discovered  independent^ 
the  difference  between  arteries  and  veins.  He  gave  its  name  to  the  aorta,  and  speaks 
of  theTgreat  vena  cava.  Yet  He^Ead-Lotalfv-in correct  views  concerning  the  course  of 
the^vessels^_  Thus  one  ran  from  the  liver  to  the  right  arm,  another  from  the  spleen  to 
the  left  arm;  hence  venesection  upon  the  side  of  the  organ  affected  by  disease  was 
especially  efficacious.  He  described  the  ureter  correctly,  and  the  organs  of  sensation 
inexactly.  In  his  physiology  he  assumes  that  vessels,  tendons  etc.,  as  "homogeneous 
parts",  preside  over  sensation,  while  the  other  "non-homogeneous  parts"  control  mo- 
tion. Chyle  originates  in  the  process  of  coction  in  the  stomach  (pepsis,  dyspepsis), 
and  is  thence  carried  into  the  heart.  In  his  view  the  blood  is  the  nutritive  material 
designed  for  the  formation,  growth  and  warming  of  the  body,  and  for  the  supply  of  its 
waste.  It  is  brought  to  the  tissues  by  the  vessels,  and  in  its  normal  condition  is  an 
indifferent  fluid  which  contains  neither  mucus,  bile  (either  black  or  yellow),  nor 
water.  But  in  conditions  of  disease  the  blood  becomes  mixed  with  these  extraneous 
fluids.  AVater  he  considers  the  essence  of  sight;  air  that  of  hearing;  water  and  air, 
of  smell;  earth,  of  feeling;  while  fire  is  mixed  with  either  all  or  none  of  the  senses. 
All  of  the  senses  act  by  means  of  a  medium,  e.  g.  sight  bjT  light.1  Sleep  is  a  restrained 
energy  of  sensation,  with  unrestrained  capacitj*  therefor.  In  respiration  the  pneuma, 
which  serves  for  the  purpose  of  cooling,  passes  through  the  trachea  into  the  heart. 
The  semen  is  the  noblest  moisture  of  the  body,  and  contains  a  spiritual  element; 
while  the  testicles  serve  to  retain  it,  and  are  also,  according  to  Aristotle,  organs  for 
the  promotion  of  chastity.  The  color  of  the  semen,  even  in  negroes,  is  white.  Genera- 
tiorf  is  due  to  an  intermixture  of  the  male  semen  with  the  menstrual  blood,  which 
latter  is  then  coagulated  by  the  spiritual  elements  of  the  semen,  and  the  result  is  the 
origin  of  the  embryo.  The  capacity  for  fcecundation,  with  rare  exceptions,  is  closely 
connected  with  the  existence  of  the  menstrual  flow.  "More  than  five  children  can 
neither  be  begotten,  nor  born,  at  one  time.  Superfcetation  is  possible.  In  embry- 
ology (by  his  observation  of  hatching  eggs),  he  discovered  the  pundit m  saliens,  and 
also  the  vessels  proceeding  from  this  point,  which  latter  form  the  first  evidence  of 
development.  The  heart  of  the  embiyo  moves,  as  he  saw  in  hatching  eggs,  and  does 
not  stand  still  as  was  believed.  He  disputed  the_  development  of  the  male  embryo  in 
the  right,  and  the  female  in  the  left  side,  and  asserted  that  the  foetus  could  not  respire 

1.    The  first  intimation  of  the  undulator}-  theory  is  ascribed  to  Aristotle. 


—  118  — 

before  it  was  completely  born.  Aristotle  emphasizes  the  necessity  and  advantage  to 
the  physician  of  a  knowledge  of  the  natural  sciences.  "It  is  the  business  of  the 
naturalist  to  know  also  the  causes  of  health  and  disease.  Hence  most  naturalists 
see  in  medicine  the  conclusion  of  their  studies;  and  of  physicians,  those  at  least  who 
display  some  scientific  knowledge  in  the  practice  of  their  art  begin  the  study  of 
medicine  with  the  natural  sciences" — quite  modern  ideas!  He  also  emphasizes  the 
fact  that  the  better  class  of  physicians  lay  great  weight  upon  anatomj'.  Yet  in  spite  of 
his  nice  knowledge  of  nature,  Aristotle  was  not  free  from  the  superstition  of  his  age, 
and  was  a  believer  in  dreams,  the  happy  significance  of  a  sneeze,  chiromancy  etc. 

A  pupil,  and  the  successor,  of  Aristotle  in  the  Lyceum,  was  the  learned 
Theophrastds  (properly  Tyrtamus)  of  Eresus.  in  Lesbos  (B.  C.  372-285). 

He  is  of  especial  importance  as  the  first  botanist,  and  described  500  plants, 
partially  from  his  own  observation  in  travelling,  and  partially  (especially  the  foreign 
species),  from  the  reports  of  merchants.  Moreover  he  instituted  experiments  upon 
the  sense  of  smell,  and  wrote  on  this  subject,  as  well  as  upon  sweating,  vertigo, 
fainting,  palsy  etc.  In  like  manner  with  his  book  "On  Stones"  (//e/n  kitito-J)  he  was 
the  founder  of  the  department  of  mineralogj',  or  rather  the  first  "  mineralogist."  For 
weakness  of  sight,  or  rather  to  strengthen  the  eyes,  according  to  Theophrastus  (and 
Pliny  makes  the  same  statement),  emerald  seal  rings  were  worn,  "  in  order  to 
strengthen  the  sight  by  their  aspect."  (Magnus.)  In  this  work  lie  makes  mention  too 
of  quicksilver. 

After  him  Strato,  of  Lampsacus  in  Mysia  (B.  C.  280),  was  President  of  the 
Lyceum  and  teacher  of  Ptolemy  Philadelphus  of  Alexandria.  He  likewise  wrote 
on  special  sensations,  as  well  as  on  diseases,  growth,  generation  etc. 

Other  Peripatetics,  like  Lycon  of  Troas  (a  physiologist  between  B.  C. 
269  and  226),  the  successor  of  Strato,  Eudemus  of  Rhodes  (B.  0.  260), 
Menon,  Clearchus  and  Callisthenes  (died  about  B.  C.  326),  a  kinsman  of 
Aristotle,  famous  for  his  tragic  death  occasioned  by  his  own  candor,  occu- 
pied themselves  also  with  medical  matters. 

9.    THE  SCHOOL  OF  ALEXANDRIA, 

which  comprises  the  followers  of  Herophilus,  Erasistratus  and  the  Empir- 
ics, was  a  late  bloom  of  the  Grecian  spirit  cultivated  upon  the  soil  of  the 
ancient  Pharaohs  by  the  ostentatious  and  luxurious  Ptolemies  (233-30 
B.  C),  the  successors  of  Alexander  in  Egypt. 

The  latter  kingdom  at  this  period  contained  l->0,000  towns,  with  seven  millions  of 
inhabitants,  and,  as  the  mistress  of  the  commerce  of  the  world,  possessed  immense 
wealth. 

The  patronage  of  Alexander's  generals,1  now  elevated  to  the  position 
of  kings,  who,  in  order  to  confer  lustre  upon  their  thrones,  condescended  to 
take  an  interest  in  the  sciences,  was  the  sun  to  whose  artificial  beams  this 
intellectual  bloom  was  due.  Yet  for  these  rulers  the  sciences  were,  for  the 
most  part,  merely  a  new  kind  of  luxury  or  a  pastime,  as  they  were  at  a 
later  period  with  Louis  XIV.  and  his  imitators.  The  favor  and  fancy  of 
princes  at  this  time,  however,  acted  with  exceptional  permanency  upon 
science  by  supplying  to  men  of  genius,  who  would  otherwise  have  probably 

1.    A  short   time  before  the  death  of  Alexander  there  broke  out  in   his   army  an 
epidemic  skin-disease,  which  has  been  by  some  considered  small-pox. 


—  119  — 

died  inactive,  the  means,  the  occasion  and  the  leisure  for  their  labors.  This 
is  especially  true  of  human  anatomy.  At  this  period,  for  the  first  time  in 
all  antiquity,  were  human  bodies,  in  spite  of  the  prejudice  of  the  Greeks 
and  still  more  of  the  Egyptians  against  such  "godless"  proceedings, 
freely  placed  at  the  disposition  of  investigation.  But  that  living  men,  as 
seems  proven,  were  also  dissected  at  that  time  by  the  representatives  of 
science  (in  order  to  search  out  the  seat  of  the  soul  and  the  origin  of  dis- 
ease), we  must  declare  a  lamentable  cruelty,  unpardonable  even  to  an  ex- 
cess of  scientific  zeal.  As  little  can  we  excuse  the  regular  annual  repetition 
of  animal  vivisections,  already  performed  a  hundred  times,  and  practised 
to-day  in  illustration  of  lectures  designed  to  demonstrate  anew  phenomena 
already  a  hundred  times  demonstrated,  as  well  as  to  show  our  modern  pre- 
cision and  the  dexterity  of  the  experimenter. 

Taken  all  in  all  the  intellectual  culture  of  the  Alexandrians  was  rather  extensive 
than  intensive  ;  one  which  devoted  its  energies  less  to  original  and  creative  intellectual 
labor,  than  to  explanation,  criticism  and  elaboration  of  the  labors  of  others,  and 
especially  of  the  works  of  Hippocrates.  This  tendency  favored  the  origin  of 
scholastic  and  learned  opinions,  to  be  attacked  and  defended  with  equal  obstinacy, 
and  promoted  the  growth  of  those  "schools",  which  were  the  natural  result  of  these 
disputes.  From  the  intimate  contact  of  the  Alexandrians  with  the  Orientals,  their 
tendency  to  refinements  and  dialectics,  which  had  always  suited  the  Grecian  mind, 
throve  with  considerably  more  vigor  than  among  the  ancient  Greeks.  "  The  latter 
had  brought  all  the  proper  arts  to  perfection,  and  no  intellectual  activity  possible 
without  erudition,  without  immense  wealth,  and  without  other  encouragement  than 
that  supplied  by  their  own  enthusiasm,  had  been  foreign  to  them.  On  the  other  hand, 
everything  useful,  elegant  and  brilliant,  which  owes  its  creation  simply  to  the  favor 
of  a  government,  and  to  external  support  and  encouragement,  is  the  work  of  the 
Ptolemies  and  their  age..  The  condition  of  the  arts  at  the  time  of  these  rulers 
furnishes  about  the  measure  of  that  which  later  antiquity  had  attained,  and  in  a  few 
branches  only  did  the  Romans  make  a  still  further  advance.  (Schlosser).  It  was 
the  practical  sciences,  whose  bloom  in  the  life  of  the  people  ever  corresponds  with 
the  summit  of  their  culture  (or  rather  with  the  decline  which  speedily  follows  the 
attainment  of  this  summit),  and  usually  for  a  considerable  time  maintains  tbis 
elevation — it  was,  I  sa3r,  the  practical  sciences  which  now  occupied  the  foreground. 
The  chief  fame  of  the  Alexandrians  is  based  upon  mathematics,  astronomy,  mechanics, 
architecture,  ship-building,  commerce  and  trade.  To  these  we  majr  add  bibliography, 
for  which  special  institutions  existed  with  the  design  of  facilitating  the  replenishment 
of  magnificent  libraries.  The  cultivation  of  the  natural  sciences,  botany  and  pharma- 
colog}',  zoology  etc.v  was  closely  related  to  medicine.  For  the  former  as  well  as  the 
latter,  and  particularly  for  anatom3r,  there  existed  great  collections  or  museums.  In 
short  this  was  an  age,  which  in  many  respects  resembled  that  of  the  Reman  emperors 
and  our  own  dajr.  It  showed  its  proper  productiveness  only  in  the  natural  sciences, 
mechanics  and  medicine,  branches  in  which  a  high  creative  power  may  be  dispensed 
with,  and  may  be  replaced  by  an  intellectual  force  founded  upon  observation  by 
means  of  the   senses,   quite   in   contrast  with   the   arts  and  higher  mental  sciences. 

(Schlosser.) 

The  Alexandrians  were  partly  commentators  and  compilers,  and  partly  inde- 
pendent workers.  They  also  corrupted  and  falsified  many  writings  of  the  earlier 
authors.  Their  educational  institutions  were  the  "  Museum"  in  the  Bruchium,  which 
was  closed  by  the  outrageous  Caracalla  (A.  D.  188-217),  and  the  "Serapeum",  the 


—  120  — 

former  situated  in  the  eastern,  the  latter  in  the  western  part  of  Alexandria.  The 
Museum  was  founded  by  Ptolem\r  Philadelphus,  the  Serapeum  by  Ptolemy  Soter. 
Both  contained  large  libraries,  which  the  Ptolemies,  in  emulation  of  the  kiugs  of 
Pergamus,  increased  until  they  are  said  to  have  contained  700,000  rolls  of  papyrus. 
The  library  of  the  Museum  was  thrice  consumed  by  fire,  viz.  in  B.  C.  47,  and  A.  D.  H90 
and  632;1  that  of  the  Serapeum  was  destroyed  A.  D.  391  at  the  instigation  of  the 
fanatical  Christian  bishop  Theophilus.  The  scientific  treasures  amassed  in  these 
edifices  consisted,  however,  not  of  books  only,  but  also  of  collections  of  every  kind, 
especially  anatomical,  zoological,  botanical  preparations,  and  mechanical  apparatus, 
all  of  which  were  open,  in  the  most  liberal  manner,  to  the  disposition  of  both  teachers 
and  students. 

In  consequence  of  her  preference  for  the  departments  of  natural  science  Alex- 
andria was,  even  far  into  the  Middle  Ages,  the  special  school  for  their  study.  Indeed 
from  her  walls  a  knowledge  of  these  branches  was  spread  abroad  to  the  Arabians  in 
the  East,  so  that  "  The  University  of  Alexandria"  was  regarded  as  the  most  important 
of  all  the  educational  institutions  of  the  Ancients.  In  later  Roman  and  early 
medireval  times,  the  study  of  medicine  in  Alexandria,  as  Ammianus  Marcellinus 
remarks,  was  a  great  recommendation — as  great  as  when  a  physician  of  the  present 
day  can  say  that  he  has  studied  in  Vienna,  Paris  or  London,  though  it  may  be  that 
he  was  chiefly  occupied  with  verjf  different  matters  from  medicine  while  in  those 
cities.2  Medicine,  botany,  phj-sics  and  mathematics  were  especially  cultivated  here. 
Both  teachers  and  scholars  dwelt  in  the  institution,  or  in  its  vicinit}'.  The  former 
received  high  salaries  and  a  free  residence,  and  many  students  also  had  their 
residence  and  maintenance  free  of  all  expense.  Here  met  and  mingled  Greeks, 
Egyptians  and  Jews,  in  a  manner  totally  unlike  that  of  any  scientific  institution 
of  ancient  times.  Hence  this  university,  alone  among','  those  of  all  antiquity, 
received,  almost  from  the  outset,  an  international  character,  and  educated  the  most 
physicians  of  all  the  ancient  schools. 

The  Museum  contained  also  (in  imitation  of  the  Egyptian  temples)  places  for 
prescribing  for  the  sick,  a  sort  of  clinic  for  out-patients. 

To  belong  to  the  Museum,  or  to  be  from  the  Museum,  had  as  great  a  charm  for 
the  savants  of  that  day,  and  rendered  them  as  conscious  of  their  own  importance,  as 
our  titles  "  Fellow  of  the  Academy  of  Sciences"  etc.  have  upon  our  professors  of  the 
present  day.     (Schlosser.) 

This  epoch  which,  when  compared  with  the  preceding  dogmatic  ten- 
dency of  medicine,  must  be  regarded  as  an  epoch  of  realism,  or  rather  an 

1.  The  Museum  was  first  burned  during  the  struggle  between  Ca?sar  and  Pompey,  by 

an  extension  of  the  flames  from  Cassar's  fleet.  It  was  probably  restored  by 
Cleopatra,  and  is  said  to  have  been  again  destroyed  during  a  revolt  which  broke 
out  in  the  reign  of  Gallienus,  about  A.  D.  265.  I  know  nothing  of  any  calamity 
to  the  Museum  A.  D.  390,  unless  the  author  supposes  it  to  have  shared  the  fate 
of  the  Serapeum  noticed  in  the  text.  The  date  A.  D.  632  evidently  refers  to  the 
destruction  of  the  librarj-  by  the  Saracens,  which,  however,  Gibbon  places 
in  640.     (H.) 

2.  Ammianus  Marcellinus,  who  wrote  about  A.  D.  378,  saj-s  :  "Again  of  medicine, 

the  aid  of  which  in  our  present  extravagant  and  luxurious  way  of  life  is  incessantly 
required,  the  study  is  carried  on  with  daily  increasing  eagerness;  so  that  while 
the  employment  be  of  itself  creditable,  it  is  sufficient  as  a  recommendation  for 
any  medical  man  to  be  able  to  say  that  he  was  educated  at  Alexandria.  And 
this  is  enough  to  say  on  this  subject."     (H.) 


—  121   — 

epoch  of  realistic  reaction  against  Dogmatism,1  was  distinguished  by  the 
appearance  of  the  famous  founder  of  human  anatom}',  a  physician  compared 
by  antiquity  with  Hippocrates  himself  : 

Herophilus  of  Chalcedon  (about  335-280  B.  C).  A  pupil  of  Praxag- 
oras  of  Cos,  ordinary  physician  of  Ptolemy  Soter  (B.  C.  323-284),  and  the 
teacher  of  Agnodice  (who  practised  midwifery  in  Athens  under  the  same  dif- 
ficulties at  the  hands  of  her  male  colleagues  as  those  which  meet  our  doc- 
tresses  at  the  present  day),  Herophilus  inherited  from  Praxagoras  a  pre- 
dilection for  anatomical  investigation,  and  pursued  his  studies  upon  human 
corpses  and  even  upon  the  living  bodies  of  convicts.  —  A  contemporary 
of  Herophilus,  and  a  physician  valued  no  less  highly  in  all  antiquity,  was 

Erasistratus  of  Iulis  on  the  island  of  Ceos,  one  of  the  Cyclades. 
His  teachers  were  Chrysippus  of  Cnidos,  Metrodorus  and  Theophrastus. 
At  first  he  was  a  simple  practitioner  and  acquired  great  reputation  by  his 
diagnosis  and  treatment  in  the  case  of  Antiochus  I.  Soter  (B.  C.  281-262), 
the  son  of  Seleucus  Nicator  (B.  C.  312-281).  Antiochus  had  fallen  des- 
perateh*  in  love  with  his  step-mother  Stratonice,  and  Erasistratus,  who  was 
the  ordinary  ph}Tsician  of  king  Seleucus,  recognized  the  cause  of  the 
prince's  illness  by  his  palpitation,  trembling,  perspiration  and  blushing  on 
the  entrance  of  that  lad}*,  and  cured  him  by  the  homoeopathic  treatment  of 
matrimony  with  the  object  of  his  desire.  His  success  was  rewarded  with  a 
fee  of  100  talents  (about  $100,000).  Subsequently  Erasistratus  lived  in 
Alexandria  as  ordinary  physician  of  Ptolem}*  Philadelphus  (B.  C.  284-246), 
a  sovereign  of  great  scientific  importance  in  the  history  of  that  city.  Era- 
sistratus died  about  B.  C.  280  and  was  buried  near  the  mountain  Mycale, 
opposite  Samos. 

From  the  doctrines  of  each  of  these  physicians,  who  belonged  to  the 
golden  age  of  Alexandrian  erudition,  but  of  whose  teachings  very  little 
has  been  preserved  to  us,  descended  a  school,  which  survived  to  a  late 
period  —  that  of  the  Herophilists  until  about  A.  D.  100,  and  that  of  the 
followers  of  Erasistratus  until  about  A.  D.  200.  They  fought  with  learned 
pertinacity  to  the  very  end. 

To  mark  the  doctrines  of  their  founders  we  place  them  here  in  contrast  with 
each  other. 

Herophilus.  Erasistratus. 

Anatomy  and  Physiology.  Anatomy  and  Physiology. 

Knew    the   nerves;    ascribed   to   them  Divided  the  nerves  into  those  of  sensa- 

capucity  for  sensation ;   divided  them  into  tion  and  those  of  motion,  the   former  of 

those    subject    to    the    will,    and    those  which  arise  from  the  brain  substance,  the 

which   extend  from   bone  to  bone,  which  latter    from    the    membranes.      He    also, 

latter    are    not    controlled    by    the    will  however,    confounded    nerves    and     liga- 

(cont'usion  with  ligaments).     He  derived  ments.      As  regards   the   brain,   he   des- 

the   nerves  from   the  brain,  in  which   he  cribed   accurately   its   structure,  convolu- 

discovered  the   calamus  scriptorius,    the  tions  and   ventricles.      He   regarded    the 

1.    It  might  also  be  called,  without  much  error,  the  epoch  of  antique  scientific   or 
exact  medicine. 


122  


tela  choroidea,  the  venous  sinuses,  and 
the  torcular  Herophili.  According  to 
him  the  fourth  cerebral  ventricle  is  the 
seat  of  the  soul. 


He  discovered  the  chyliferous  and 
lymphatic  vessels. 

Described  accurately  the  liver,  Fallo- 
pian tubes,  epididymis,  duodenum  (to 
which  he  gave  its  name),  and  also  the 
os  hyoides,  the  uvea,  the  vitreous  humor, 
the  retina,  and  the  ciliary  processes. 

He  called  the  pulmonar}'  artery  the 
vena  arteriosa,  and  the  pulmonary  vein 
the  arteria  venosa,  and  knew  that  the 
left  spermatic  vein  sometimes  originated 
from  the  renal. 

He  distinguished  in  respiration  asystole- 
a  diastole,  and  a  period  of  rest,  the  last 
of  which  arises  from  the  desire  to  both 
expire  and  inspire.  The  vessels  receive 
pneuma  from  the  lungs  and  the  skin 
(perspiration?). 

He  founded  the  doctrine  of  the  pulse 
(rythm,  the  bounding  pulse,  varieties 
according  to  age).  The  pulse  is  com- 
municated by  the  heart  to  the  walls  of  the 
arteries.  He  distinguishes  between  arter- 
ies and  veins,  and  admits  that  the  former 
contain  blood. 


.Etiology. 
Diseases  originate  in  a  corruption  of 
the  humors.  Paralysis  is  due  to  a  lack 
of  influence  of  the  nervous  force.  Sudden 
death  depends  upon  paralysis  of  the 
heart.  He  laid  little  weight  upon  ^Etiol- 
ogy, but  much  more  upon  Symptomatol- 
ogy. 


convolutions  of  the  cerebrum,  and  still 
more  of  the  cerebellum,  as  the  seat  of 
thought,  and  located  mental  diseases  in 
the  brain.  The  development  of  the  em- 
bryo takes  place  by  new  formation  (epige- 
nesis). 

Knew  the  lymph  and  chyle  vessels,  and 
gave  as  their  contents  air  and  milk  alter- 
nately. Named  the  parenchyma  of  the 
liver,  whose  invisible  canals  discharge  the 
bile,  the  trachea  (heretofore  called  "arte- 
ria"), the  valve  of  the  vena  cava  (val- 
vula  trichlogyna),  the  chorda?  tendinea^ 
of  the  heart.  The  latter  organ,  accord- 
ing to  him,  contains  no  blood,  an  idea 
which  Galen  refuted  by  puncturing  its 
walls.  Theoretical]}'  he  assumed  anas- 
tomoses of  the  arteries  and  veins,  which, 
however,  normally  terminate  in  closed 
extremities  opposite  each  other. 

Respiration  is  the  introduction  of  pneu- 
ma, which  at  first  goes  into  the  pulmo- 
nary veins,  and  thence  through  the  heart 
into  the  bloodless  arteries.  This  pneuma 
in  the  heart  is  vital  spirits,  in  the  brain 
animal  spirits. 

The  influx  of  the  pneuma  into  the 
arteries  occasions  their  dilatation  and 
thus  the  pulse,  which  is  a  passive  process 
propagated  from  the  heart.  The  arteries 
contain  simple  air. 

Digestion  takes  place  through  friction 
of  the  walls  of  the  stomach  (Iatro-physi- 
cian!);  nutrition,  by  the  addition  of  new 
particles;  secretion  by  the  non-attractive 
force.  The  bile  is  useless  ;  likewise  the 
spleen  and  other  viscera.  Drinks  do  not 
enter  the  air  passages. 

He  shows  traces  of  pathological  anat- 
omy :  induration  of  the  liver  in  dropsy. 

^Etiology. 
The  chief  cause  of  disease  is  plethora 
and  aberration  of  the  humors  {error  loci); 
in  fevers  in  the  larger,  in  inflammation  in 
the  smaller  arteries.  Inflammation  arises 
when  the  blood  is  detained  in  the  small 
vessels  by  the  pneuma  driven  from  the 
heart  into  the  arteries  :  fever  occurs  when 
the  pneuma  is  crowded  back  to  the  heart 
by  the  venous  blood,  and  blood  gets  into 
the  large   arteries.     Dropsy   always  pro- 


123 


Semeiology. 
Herophilus   divided   this    science   into 
Diagnosis,  Prognosis  and  Anamnesis.1 

Therapeutics. 
Herophilus  followed  in  part  Hippoc- 
rates; laid  great  stress  upon  diet;  bled 
frequently;  used  freely  compound  and 
so-called  specific  remedies.  In  hemor- 
rhage he  practised  ligation  of  the  limbs, 
and  was  the  first  to  administer  cooking- 
salt  (a  remedy,  as  we  know,  still  given 
to-day  without  effect  in  haemoptysis).  He 
was  a  friend  of  much  medication. 


Pharmacology. 
He  preferred  vegetable  remedies,  and 
was  a  good  botanist.     He  designated  rem- 
edies as  "  Hands  of  the  gods." 

Surgery. 
Herophilus   likewise    cultivated    espe- 
cially the  treatment  of  ulcers. 


ceeds  from  the  liver.  Paralysis  is  due  to 
an  aberration  of  the  moisture  which  nour- 
ishes the  nerves  of  motion. 

Semeiology. 
Critical  evacuations  can  be  distinguished 
from  those  which  are  injurious  with  great 
difficulty  onky. 

Therapeutics. 
Erasistratus  rejected  Hippocrates,  and, 
like  Chrysippus,  utterly  discarded  bleed- 
ing, as  well  as  purgation  ;  recommended 
baths,  enemata,  emetics,  friction,  cupping, 
temperance  of  life,  ligation  of  the  limbs 
to  close  the  anastomosing  vessels,  which 
in  haemorrhage  are  open.  Was  a  fore- 
runner of  Hahnemann  in  his  acceptance 
of  the  powerful  effects  of  the  smallest 
doses  of  medicine:  three  drops  of  wine 
was  a  very  beneficial  drink  in  bilious 
diarrhoea. 


Surgery. 
Erasistratus  discarded  paracentesis  ab- 
dominis; opened  the  abdomen  to  apply 
remedies  directly  to  the  affected  spot  ; 
invented  a  kind  of  catheter.2  In  order  to 
explain  haemorrhage  during  surgical  oper- 
ations, he  supposes  that  the  pneuma  first 
escapes  out  of  the  arteries,  and  is  then 
replaced  by  venous  blood,  so  that  no 
Obstetrics.  bleeding  arises  from  the  bloodless  arteries. 

He  knew  the  changes  of  the  portio 
vaginalis  in  pregnane}1,  and  regarded 
menstruation  as  necessary  to  pregnancy 
and  to  health.  Difficult  labors  arise  from 
transverse  position,  incomplete  dilatation 
of  the  cervix,  non-rupture  of  the  mem- 
branes, inertia  uteri,  death  of  the  foetus, 
haemorrhage,  tumors  etc. 

It  is  easy  to  understand  that  such  differences  of  doctrine,  rude  in 
themselves,  and  still  more  rudely  defended,  afforded  abundant  opportunities 
for  learned  disputes  and  the  foundation  of  "schools",  and  that  these 
opportunities  might  easily  continue  to  exist  in  an  age  of  erudition  and 
artificiality.     To  this  was  added  too  the  superabundance  of  physicians,  a 

1.  Remembrance  or  recollection  of  what  has  occurred.     (H.) 

2.  The  catheter  was  employed  as  early  as  the  age  of  the  Hippocratists.     The  instru- 

ment of  Erasistratus  was  shaped  like  the  Roman  S.     (H.) 


—  124  — 

condition  which  always  favors  specialism  in  practice,  and  which  was  far 
more  marked  in  this  age  than  in  the  classical  period  proper.  Among  this 
class  of  specialists  the  lithotomists  were  prominent,  and  among  these  again 
the  name  of 

Ammonius  of  Alexandria  (about  B.  C.  230)  deserves  special  notice.1 
The  lithotomists,  or  some  of  them  at  least,  degraded  their  art  b}'  the  most 
infamous  practices.2 — At  this  period  medicine  was  divided  more  decidedly" 
than  heretofore  into  Pharmacy,  Surgery  and  Dietetics  (medicine  proper).3 

a.  The  Herophilists  (B.  C.  290  to  about  A.  D.  100),  who  in  later 
times  fell  into  subtile  refinements,  particularly  with  reference  to  the  pulse, 
had  their  original  headquarters  at  Alexandria.  After  the  expulsion  of  the 
literati,  however,  b}-  Ptolemy  Physcon  (B.  C.  145-117),  the}'  took  refuge  at 
Laodicea.     Among  the  earlier  of  them  belong 

Eudemus  the  Anatomist  (B.  C.  290), 
who  described  the  bones,  the  nerves,  the  brain  and  the  fringes  of  the  Fallopian  tubes; 

Demetrius  of  Apamea  in  Cilicia  (B.  C.  276), 
who  named  and  described  diabetes,  but  was  especially  distinguished  as  an  obstetrician. 
He  divided  haemorrhages  into  those  arising  from  an  injur}'  of  the  vessels,  and  those 
which  have  their  origin  in  atony,  "anastomosis"  or  simple  exudation  of  blood, 
without  any  lesion  of  the  vessels,  but  simply  as  the  result  of  thinness  of  the  blood  or 
of  the  vascular  walls.  Dropsy  he  divided  inaccurately  into  tympanites  and  ascites. 
He  cultivated  pharmacologj'  and  particularly  obstetrics,  in  which  latter  department 
he  ascribed  difficult  labor  to  abnormities  of  the  foetus,  the  passages,  or  to  the  condition 
of  the  womb,  (excessive  size  of  the  head  or  of  the  other  parts,  false  position,  death 
and  emphysema  of  the  foetus,  small  pelvis,  diseases  of  the  womb,  mental  and  physical 
disturbances  etc).  In  the  normal  position  the  head  was  downward,  the  arms  on  the 
thighs,  or  the  feet  down.  Abnormal  positions  were  the  presentation  of  one  or  both 
hands,  or  the  existence  of  wrong  rotation  of  the  head. 

Callianax  (B.  C.  270), 
notorious  for  his  harshness  (4)  ; 

Bacchius  (B.  C.  264), 
who  wrote  commentaries  upon  Hippocrates,  mentioned  four  causes  of  haemorrhage: 
laceration,  suppuration,  anastomosis  and  exudation  (the  latter  the  chief),  and  declared 
that  the  pulse  originated  in  the  whole  body,  a  doctrine  violently  opposed  by  the  parti- 
sans of  Erasisti  atus ; 

Chrysermus, 
who  considered  the  pulse  a  function  of  the  arteries  alone,  and  entirely  excluded  the 
heart  from  its  formation; 


1.  He  invented  a  kind  of  lithotrhe.      (H.) 

2.  Antiochus  VI.,   of  Syria,   was   murdered,  at  the  instigation   of  Tryphon,   by  the 

lithotomists  in  a  pretended  operation  for  stone  (B.  C.  148).     (H.) 

3.  That,  even  as  early  as  the   age  of  Herodotus,  Greek  physicians  divided  medicine 

into  specialties,  may  be  inferred  from  the  expression  of  that  author,  in  which  he 
saj's  that  the  Egyptians  "also"  divided  up  the  medical  art,  the  "also"  of  course 
implying  that  the  Greeks  did  likewise. 

4.  To  a  patient,  who  lamented  that  he  must  die,  Callianax  replied  shortly  :  "Patroclus, 

too,  must  die".  Simon,  of  Alexandria,  who  wrote  on  the  diseases  of  women, 
lived  before  Callianax. 


—  125  — 

Mantias  (B.  C.  250), 
who  was  a  cultivator  of  pharmacolog}-.  pharmacy  and  bandaging.     He  was  the  first 
who  collected  the  preparations  of  drugs  into  a  special  book. 

Cydias  of  Mylasa  in  Caria  (B.  C.  250) 

wrote  commentaries  on  Hippocrates. 

Callimachus  (B.  C.  246) 
likewise  wrote  commentaries  on  Hippocrates. 

Heraclides  of  Erythr.ea  in  Bo30tia  (B.  C.  230), 

a  pupil  of  Chrysermus,  who  elaborated  the  doctrine  of  the  pulse. 

Andreas  of  Carystus  (B.  C.  210) 
wrote  on  the  history  of  medicine,  pharmacology,  adulterations  of  opium,  invented 
bandages  and  described  rabies  canina  and  pantophobia  as  special  diseases. 

Agatharchides  (B.  C.  170) 
described  the  dracunculus. 

Zeno  of  Laodicea  (B.  C.  210) 
wrote  commentaries   upon   Hippocrates,   regarded   the  heart  as    appendage   to   the 
arteries,  and  explained  the  pulse  by  an  alternate  contraction  and  dilatation  of  the  latter. 
He  also  invented  some  compound  remedies. 

Zeuxis, 
who  wrote  commentaries  upon  Hippocrates,  also  founded  a  special  school  at  Laodicea,1 
to  which  belonged: 

Dioscorides  Phacas  (about  B.  C.  40), 
physician  of  Cleopatra  and  author  of  24  books  on  medicine; 

Alexander  Philalethes  (A.  D.  20), 
who  made  some  subtle  definitions  of  the  pulse,  to  which 

Demosthenes  Philalethes  (under  Nero), 
the  famous  physician  of  Marseilles,  subscribed  with  few  alterations.  The  latter  was 
the  most  celebrated  oculist  of  his  time,  and  his  work  on  diseases  of  the  eye  (now  lost) 
was  the  authority  upon  this  subject  until  about  A.  D.  1000.  The  use  of  the  term 
hypochysis  for  cataract  (instead  of  the  glaucoma  of  Hippocrates),  originated  with  this 
school,  though  it  was  probably  borrowed  from  the  Egyptians, 

Aristoxenes  (A.  D.  79) 
devoted  himself  to  the  pulse  and  pharmacolog}-. 

Apollonius  Mys,  Apollonius  Ther  of  Tyre 
and  others  also  belong  among  the  later  Herophilists. 

To  the  followers  of 

b.  Erasistratus,   whose  school  continued  from  B.  C.  280  to  about 
A.  D.  200,  belong: 

Strato  of  Berytus  in  Cozle-Syria  (B.  C.  280), 
who  wrote  commentaries  on  Hippocrates  and  discarded  venesection  because  of  the 
difficulty  of  distinguishing  between  arteries  and  veins.     One  of  his  pupils  was  Apol- 
lonius Stratonicus : 

Xenophon  of  Cos  (about  B.  C.  290) 
lived  before  Apollonius  of  Memphis  (B.  C.  250),  and  wrote  on  botany,  the  pulse,  med- 
icines and  diseases  of  women.     He  regarded  the  departure  of  worms  from  the  body  a 
dangerous  sign  in  diseases. 

1.  Zeuxis  flourished  probably  about  B.  C.  50.     (H.) 


—  126  — 

Apollophanes  (B.  C.  200) 
was  physician  of  Antiochus  the  Great  (B.  C.  222-186). 

Nicias  of  Miletus  (about  B.  0.  290), 
a  friend  of  Theocritus,  the  inventor  of  the  idyl  (the  only  new  species  of  poetry  of  the 
Alexandrian  age), 

Charidemus  (between  B.  C.  290  and  260), 
as  well  as  his  contemporaries 

Artemidorus,  Hermogenes,  Athenion,  Miltiades 

(the  last  two  writers  upon  the  diseases  of  women),  and  Apemantes,  an  opponent  of 
venesection,  are  regarded  as  partisans  of  Erasistratus. 

A  special  school,  whose  principles  were  opposed  to  all  bleeding,  was 
founded  by  Hicesius  of  Smyrna  (B.  C.  30),  Ptolem^eus  and  Menodorus, 
the  friend  of  Hicesius. 

They  cultivated  pharmacology  and  dietetics.  To  this  school — though  the  period 
of  the  physicians  of  this  "age  of  schools"  and  their  precise  distribution  are  not  in- 
frequently uncertain  —  belong  also: 

Philoxenus  (about  B.  C.  260), 
a  famous  surgeon,  and  author  of  a  surgical  text-book,  now  lost,  and  the  far  later 

Martialis  (A.  D.  150), 
who  cultivated  anatomy.     The  following  physicians  and  surgeons  of  the  Alexandrian 
period  should  also  be  mentioned: 

Demetrius  of  Bithynia, 

an  eminent  ph}'sician  ;  Sostratus,  Nymphodorus,  and  Nileus  (all  about  B.  C.  260); 
Euelpistus,  Tryphon,  both  of  Sidon ;  Amj-ntas  of  Rhodes,  the  famous  Pasicrates; 
Perigenes  (the  three  latter  between  B.  C.  60  and  30),  and  others,  who  devoted  their 
energies  to  the  invention  of  machines,  bandages  etc.,  to  which  thejr  gave  curious 
names,  while  a  few  rendered  service  to  the  study  of  hernia,  as  e.  g. 

Heron, 
an  Alexandrian  mathematician,  ptn-sicist  and  physician,  a  contemporary  of  Archi- 
medes of  Syracuse  (born  about  B.  C.  280),  and  the  describer  of  the  water-organ 
invented  by  his  teacher  Ctesibius.1  Heron  lived  about  B.  C.  250,  and  his  memorjr  is 
preserved  in  medicine  down  to  the  present  day  bj'  an  invention  (Heron's  pad).  He 
also  discussed  umbilical  hernia,  enterocele  and  epiplocele,  while 

GORGIAS 
proved  that  umbilical  hernia  might  contain  simple  air  etc. 

The  disciples  of  Herophilus  and  Erasistratus  fell  more  and  more 
into  the  discussion  of  empt}'  subtilties  —  and  so  the  aid  afforded  by  the 

1.  An  instrument  in  which  air  was  driven  into  flute-like  tubes  by  a  stream  of  water. 
It  was  played  something  like  our  orchestrion.  It  may  be  remarked  here  that 
(according  to  Nohl)  the  serious  music  of  the  ancient  Greeks  had  degenerated 
even  in  the  Alexandrian  period  into  virtuosoship,  and  brilliant  effects  were 
sought  by  the  employment  of  numbers.  Ptolemy  Philadelphia  e.  g.  presented 
600  musicians,  including  300  singers  who  pla}*ed  upon  the  cithara.  Among  the 
Romans  this  tendency  was  carried  still  further,  and  in  Cassar's  time  on  one 
occasion  1200  singers  and  musicians  performed  together  in  Rome,  a  phenomenon 
again  witnessed  in  our  day.  The  Greek  musical  notation  was  transmitted  to  us 
by  the  Alexandrian  Alypius,  about  B.  C.  360. 


—  127  — 

Ptolemies  to  the  advancement  of  science  bore  no  fruit  of  importance,  if  we 
except  from  this  judgment  anatomy,  and  perhaps  materia  medica. 

As  the  schools  already  mentioned  may  be  ascribed  to  the  influence  of 
Aristotle,  so  the  third  Alexandrian  school, 

c.    The  School  of  Empirics  (B.  C.  280  to  about  A.  D.  117),  was 

especially  due  to  the  influence  of  the  skeptics.  Skepticism,  inaugurated  by 
Pyrrho  of  Elis  (B.  C.  376-288),  was  introduced  b}r  iEnesidemus  '  into 
the  medicine  of  the  Empirics,  who  assumed  originally  the  title  of  Teretics, 
or  Mnemoneutics,  and  only  at  a  later  period  took  that  of  Empirics. 

This  school  (if  we  except  that  of  Hippocrates)  undoubtedly  defended 
the  best  principles,  and  is  of  great  importance  in  the  development  of  the 
methods  of  medical  investigation  and  treatment.  The  Empirics  rejected 
as  useless  all  search  after  the  causes  of  disease,  and  all  knowledge  of 
anatomy — certainly  a  grave  mistake  —  but,  on  the  other  hand,  laid  the 
greatest  weight  upon  experience.  The  foundations  of  the  latter  were 
accident,  history  (the  remembrance  of  earlier  cases  and  anamnesis),  and  the 
application  of  similar  cases  (analogy),  which  together  composed  the  so-called 
"Empiric  tripod".  In  new  diseases  there  was  added  thereto  invention, 
which,  as  practical  experience,  in  so  far  as  it  was  awakened  by  earlier 
experience,  formed  a  fourth  category.  They  rejected  all  a  priori  reasoning, 
and  had  recourse  to  the  so-called  hypotyposes  (i.  e.  definitions,  in  which  no 
attention  was  paid  to  the  hidden  causes),  as  well  as  to  "  nominal,  instead 
of  real,  definitions  ",  and  to  the  epilogism  (i,  e.  a  knowledge  of  the  causes 
of  disease  acquired  from  actual  observation),  by  which  all  fruitless  antece- 
dent reasoning  was  cut  off.  If  e.  g.  a  person  has  become  insane,  and  a  scar 
is  also  found  upon  his  head,  one  infers  from  the  latter  the  hidden  exciting 
cause  of  the  disease,  the  wound  of  the  head.  The  Empirics  also  discarded 
the  doctrine  of  indications.  The}'  wished  only  to  cure  the  patient — an 
undeniabl}'  practical  aim — and  thus  to  fulfil  the  highest  dutjr  of  medicine, 
which  is  not  aided  by  fine-spun  theories.  According  to  their  views,  disease 
is  a  coincidence  of  accidents,  which  always  concur  in  the  human  body  in 
the  same  way,  and  whose  number  is  of  the  greatest  importance,  since  from 
a  single  accident  one  can  seldom  judge  of  diseases,  and  determine  their 
treatment.  For  the  latter  purpose  the  addition  of  more  recent  cases,  the 
time  and  the  order  of  their  occurrence  are  also  of  controlling  importance. 

The  founder  of  the  School  of  Empirics,  whose  aim  was  opposition  to 
the  absolute  rule  of  the  Dogmatism  of  that  period,  was 

Philinus  of  Cos  (B.  C.  280), 
a  pupil  of  Herophilus,  and  a  commentator  on  the  writings  of  Hippocrates.     He  dis- 
carded all  dogmas  and  laid  weight  upon  autopsy2  alone,  a  term  which  became  sub- 

1.  iEnesidemus  was  a  native  of  Crete  who  flourished  at  Alexandria  probabhy  about 

B.  C.  40.     He  wrote  eight  books  in  defence  of  the  doctrines  of  Pyrrho.     (H.) 

2.  It  should  be  remarked,  however,  that  the  Empirics  employed  the  term  autopsia 

in  its  strictly  etymological  sense  to  designate  personal  observation,  and  not  as 
synonomous  with  autopsia  cadaverica  or  post  mortem  examination,  as  the  term 
is  very  frequently  employed  at  the  present  day.     (H.) 


—  128  — 

sequent]}-  the  shibboleth  of  the  Empiric  sect,  and  is  again  met  with  in  the  17th 
century  and  the  pathological  schools  of  the  19th.  Yet  Philinus  declared  that  the 
anatomical  knowledge  which  he  had  acquired  from  Herophilus  had  not,  as  such, 
helped  him  at  all  in  the  cure  of  the  sick.     His  successor,  however. 

Serapion  of  Alexandria  (B.  C.  270), 
from  his  importance  in  the  school  was  also  styled  its  second  founder.  He  was  always 
at  war  with  Hippocrates,  and  gave  vogue  to  several  curious  remedies,  e.  g.  the 
testicles  of  the  wild  boar  in  epilepsy.  He  likewise  recommended  sulphur  in  chronic 
diseases  of  the  skin,  the  heart  of  the  hare,  turtle's  blood  and — crocodile's  dung. 
The  latter  through  his  influence  is  said  to  have  acquired  a  verj-  high  price.  Serapion 
wished  to  discard  all  hypotheses  and  to  avoid  all  wrangling.  He  lived  about  the 
period  of  the  greatest  scientific  activity  in  Alexandria,  under  Ptolemy  Euergetes 
(B.  C.  246-221),  who  authorized  the  translation  of  the  Bible  known  as  the  Septuagint. 

Glaucias  (B.  C.  260) 
wrote  a  collection  of  alphabetical  commentaries  upon  Hippocrates,  with  the  design 
of  proving  him  a  supporter  of  the   Empirics.     He  was  likewise  the  inventor  of  the 
"Empiric  tripod',  and  prided  himself  greatly  upon  his  invention. 

Zeuxis  the  Empiric  (B.  C.  250) 
was  also  an  eminent  phj'sician. 

Heraclides  of  Tarentum  (B.  C.  240). 
a  pupil  of  Mantias  the  Herophilist,  was  the  most  distinguished  of  the  Empirics,  and 
wrote  extensive  commentaries  upon  Hippocrates,  with  treatises  on  the  cure  of 
internal  diseases,  pharmacy,  food,  the  pulse  etc.  He  employed  opium  internally 
to  procure  sleep,  and  treated  "phrenitis"  in  a  darkened  chamber,  with  daily  enemata, 
venesection,  and  poultices  to  the  head.  He  likewise  occupied  himself  with  the  cos- 
metic art  and  the  study  of  poisons,  and  mentions  the  strangulation  of  hernia. 

Apollonius  "the  Empiric"  (about  B.  C.  230)  and 

Apollonius  Biblas  (B.  C.  230-200) 
wrote  commentaries  upon  the  writings  of  Hippocrates,  and  the  latter  was  also  the 
author  of  treatises  upon  drugs. 

Apollonius  of  Cittium  in  Cyprus, 
lived  much  later — about   B.  C.  50 — but  likewise  wrote  commentaries  upon   Hippoc- 
rates with  some  original  treatises.      He  was  a  pupil  of  Zopyrus. 

The  subjects  of  medicines  and  poisons  in  this  da}'  claimed  so  much 
interest  that  even 

Attalus  III.  of  Pergamus1  in  Mysia  (B.  C.  138-133),  and  Mithri- 
dates  the  Great  of  Pontus  (B.  C.  124-64), 

occupied  themselves  with  their  study,  established  botanical  gardens  for  this  purpose, 
and  experimented  with  poisons  and   antidotes.     The  so-called  "  Mithridaticum ",   a 

1.  Capital  of  one  of  the  kingdoms  formed  from  the  ruins  of  the  empire  of  Alexander, 
and  the  seat  of  a  university  and  academy  of  fine  arts  (Altar  of  Pergamus).  It 
was  long  a  rival  of  Alexandria,  especially  in  regard  to  its  library,  which  was 
founded  by  Eumenes  II.  (B.  C.  197-159).  When  Ptolemy  II.  had  prohibited 
the  exportation  of  papyrus,  in  order  to  deprive  the  kings  of  Pergamus  of  the 
material  for  the  increase  of  their  collection  of  books,  parchment  is  said  to  have 
been  invented  here  to  take  its  place.     (Baas.) 

Pergamus    was    the   birthplace    of    Galen,    and   the   seat   of  a   very   famous 
Asclepieion,  which  was  visited  by  Caracalla  as  late  as  A.  D.  215.     (H.) 


—  129  — 

highly  prized   universal   antidote   esteemed   down   even  to  modern  times,  derived  its 
name  from  the  latter  monarch.     At  this  period  too  lived 

Cleophantus  (B.  C.  138), 
who  was  the  teacher  of  Asclepiades  of  Bithynia  and  wrote  on  remedies,  and  the  poet, 
grammarian  and  physician 

Nicander  of  Colophon  (B.  C.  136)  in  Lydia, 
educated  in  Alexandria,  whose  poems  "Theriaca"  (On  poisonous  beasts)  and 
"  Alexipharmaca"  (antidotes)  are  still  extant.  The  first  contains  descriptions  of 
the  bites  of  serpents,  especially  of  the  viper,  mentions  leeches,  cups  and  burning  out 
the  bitten  part.  The  second  poem  teaches  the  removal  of  the  poison  in  the  first 
place  by  emetics,  and  its  envelopment  by  drinks  (milk,  oil,  wine  etc.).  It  also 
describes  in  general  the  symptoms  in  cases  of  internal  poisoning,  especially  by  opium. 
colchicum,  henbane,  litharge,  white  lead  etc. 
In  the  last  century  before  Christ  lived 

Cratevas  (B.  C.  70), 

a  famous  rhizotomist,  who  dedicated   to   Mithridates  a  work  on    pharmacology  with 
colored  plates. 

Posidonits  (B.  C.  70) 
too  is  reckoned  among  the  Empirics,  and  indeed,  even  Cleopatra  (B.C.  69-30), 
daughter  of  Ptolemy  Auletes,  the  magnificent  and  captivating  spouse  of  her  brother 
Ptolemy  XII..  Dionysus,  is  mentioned  in  this  connexion,  in  consequence  of  her 
literary  labors  on  the  subjects  of  cosmetics  and  diseases  of  women.  Her  course  of 
life  was  undoubtedly  adapted  to  give  her  abundant  experience  in  these  branches,  and 
we  need  only  admit  that  her  amours  with  Ca?sar,1  Antony  and  others  left  her 
sufficient  leisure  to  devote  to  their  study.2 

In  this  too  she  had  as  models  her  predecessors,  the  beautiful  and  starry-haired 
Berenice,  the  wife  of  Ptolemy  Soter,  and  Arsinoe,  the  daughter  of  Berenice  and  wife 
of  Ptolemy  Philadelphia,  both  of  whom  had  invented  famous  ointments  and  per- 
fumeries. Indeed,  according  to  the  papyrus  Ebers,  articles  of  luxury  and  cosmetic 
appliances  were  in  common  use  in  Egypt  at  an  extremely  early  period,  and  were  as 
popular  there  as  under  Louis  XIV.  and  the  regency,  though  their  fragrance  could  not 
at  either  period  remove  the  odor  of  the  vices  of  society. 

Cleopatra  prescribes,  e.  g.  for  ulcers  of  the  vulva:  arsenic,  burnt  paper,  elaterium, 
lathyris,  sulphur  aa.  6.6  grammes.  Rub  together  and  apply,  or  insert  as  a  pessary, 
twice  daily,  night  and  morning,  until  the  ulcer  is  healed.  She  is  also  acquainted 
with  condylomata,  rhagades  and  gonorrhoea,  and  discusses  diseases  of  pregnant 
parturient  and  lying-in  women  etc.  Whether  the  queen  was  the  real  authoress  of  the 
work  ascribed  to  her  pen  is  doubtful. 

The  number  of  the  later  Empirics  is  great,  but  even  their  period  is 
not  always  well  established.     We  notice  only 

Heras  of  Cappadocia  (B.  C.  30), 
who  wrote  a  treatise  on  pharmacology  (Narthex) ; 

1.  Even  in  this  fallen   age  of  the  kingdom  of  the  Ptolemies  science  in    Alexandria 

stood  so  high  that  Caesar,  the  ruler  of  the  Romans  (at  that  time  at  the  summit 
of  their  power),  authorized  t lie  Alexandrian  Sosigenes  to  reform  the  calendar. 

2.  With  Cleopatra  disappeared   from  the  stage  of  history  the   Greek   family  of  the 

Ptolemies,  only  to  survive,  however,  (something  like  our  Hohenstaufen  family) 
in  the  immortal  records  of  poetry  and  romance.  Its  Conradin,  however  was 
named  Csesarion,  and  was  put  to  death  after  the  battle  of  Actium  by  the  cowardly 
Octavianus. 

9 


—  130  — 

Mknodotus  of  NlCOMEDIA  (A.  D.  100), 
the  inventor  of  the  "  Epilojrism  "  ; 

Zofyrus  (about  B.  C.  80), 
a  cultivator  of  pharmacology  : 

Theudas  of  Laodicea  (A.  D.  117).  a  Jewish  physician  educated  in 
Alexandria  and  famous  as  an  anatomist,  but  opposed  by  Galen  ;  Quintus, 
Lycus,  Satyrus,  iEscHRiON  of  Pergamus,  Pelops  of  Smyrna,  Phecianus, 
Callicles  and  Numesianus,  who  were  all  teachers  of  Galen. 

Still  later  Empirics  were  Agrippa  and  Sextus  Empiriclts  (A,  D.  193), 
who  exercised  great  influence  even  in  modern  times,  as  e.  g.  upon  Pierre 
Bayle.  Sextus  thought  the  same  thing  might  be  defended  or  opposed  on 
equivalent  grounds,  and  was  a  pessimist  also  in  regard  to  the  object  of 
existence.  Both  these  latter  physicians  belonged  to  the  philosophical  sect 
of  the  Skeptics,  the  last  offshoot  of  the  Empiric  school,  which  continued 
also  to  the  very  close  of  antiquity. 

That  the  partisans  of  the  two  last  mentioned  "  Schools  "  fell  into  all 
sorts  of  wrangles  and  quarrels,  may  be  judged  both  from  the  known  facts, 
and  from  the  special  dialectic  training  and  ability  of  the  later  Greeks, 
increased,  if  not  awakened,  b}T  their  active  and  not  alwa}'S  pure  political 
and  part}'  life — }'et  the  Empirics  ma}7  remind  us  that  diseases  are  cured 
by  remedies,  not  by  eloquence.  Our  own  experience  too  of  the  course  of 
affairs  in  later  times  may  lead  us  to  the  same  conclusion.  Alexandrian 
science  exercised  a  controlling  influence  upon  all  subsequent  antiquit}',  and 
supplied  even  to  mediaeval  medicine  its  educational  material.  Very  much 
of  what  is  ascribed  to  the  later  writers  among  the  Ancients,  and  especially 
to  Galen,  really  belongs  to,  and  was  taken  from,  the  earlier  Alexandrian 
physicians,  whose  works  have  mostly  perished. 

10.    VETERINARY  MEDICINE. 

Some  fragments  of  the  veterinary  work  of  Simon  of  Athens  are  still 
extant.  Xenophon  and  Aristotle,  too,  touch  upon  veterinary  subjects,  and 
special  works  on  this  branch  were  written  by  the  famous  Diocles  and 
Epicharmus  of  Cos  (about  B.  C.  250),  though  no  relics  of  them  now  remain. 

We  must  here  interrupt,  however,  for  a  short  time,  the  further  discus- 
sion of  declining  Grecian  medicine,  to  examine  the  scanty  traces  of  inde- 
pendent medicine  among  the  Romans, — the  next  most  highly  civilized 
people  of  the  old  world. 


II.     THE  MEDICINE  OF  THE  ROMANS, 

so  far  as  we  can  speak  of  such  an  art,  did  not  rise  above  the  very  first 
rudiments.  In  this  department  also  the  productive  genius  of  the  Greeks 
was  lacking  among  the  Romans,  and  here  too  the  greatest  and  undeniably 
the  most  original  people  of  antiquity  in  political  science,  borrowed  from  the 
Greeks  intellectual  grafts  to  improve  their  own  dull  (though  vigorous)  un- 


—  131  — 

interesting  and  none  too  fruitful  mental  culture,  —  a  culture  which  in  fact 
lived,  so  to  speak,  upon  the  imported  spices  of  Grecian  spirit.  And  this 
Grecian  spirit,  so  boundlessly  rich,  so  attractive  and  yet  so  profound,  could 
supply  to  this  people, undoubtedly  great  in  that  element  wherein  lay  its  own 
weakness,  and  even  in  the  ruin  of  its  native  land,  an  adequate  and  perfect 
pollen,  which  has  for  centuries,  indeed,  fructified  our  own  civilization. 
There  were  then  among  the  Romans  a  semi-original,  mythological  medicine, 
and  traces  of  theurgic  practices  alone.     All  else  belongs  to  the  Greeks  ! 

According  to  the  well-known  testimony  of  Pliny  the  Romans  had 
originally  no  physicians,  at  least  none  whom  we  can  consider  educated  in 
their  art.  ('  The  Roman  people  for  more  than  600  years  were  not,  indeed, 
without  medical  art.  but  they  were  without  physicians."  This  art  consisted 
merel}'  in  prayers,  dietetic  measures,  prescriptions  from  the  Sibylline  books, 
charms  etc.  That  the  Romans  cherished  much  grosser  superstitions  than 
the  Greeks  is  well  known.  With  rude  simplicity  the}'  elevated  into  divin- 
ities those  evils  which  especially  harassed  them,  in  order  probably  to  rid 
themselves  of  them  by  such  promotion,  and  then  worshipped  these  deities 
with  fervor.  Thus  fever  and  foul  odors  were  worshipped  as  the  goddesses 
Febris  and  Mephitis  ;  in  great  weakness  Fessonia  was  invoked  ;  when  the 
cloacae  exhaled  foul  odors,  Cloacina  !  Even  a  goddess  Scabies  was  not 
wanting,  and  a  plague-gOd  Angeronia  ;  a  goddess  of  menstruation  and  of 
the  womb,  Fluonia  and  Uterina  ;  and  Ossipaga.  goddess  of  the  navel  and 
bones  of  children  !  Most  numerous  were  the  goddesses  of  midwifery,  as 
Carna.  who  also  guarded  the  powers  of  the  stomach.  Dea  Natio,  Dea?  Car- 
menta?,  Prosa  and  Postverta,  who  were  invoked  in  false  presentations. 
These  goddesses  designed  for  the  female  sex  seem  to  have  originated  in 
the  fancy  of  the  midwives.  The  inventive  genius  of  servants  manifestly 
supplied  the  necessities  of  male  superstition  with  the  god  Priapus,  the 
visible  representative  of  male  generative  activity,  whose  worship  we  have 
already  noticed  among  the  Phoenicians,  and  likwise  existed  among  the  Jews 
in  their  Lingamcultus.  The  presiding  divinity  in  medicine,  however,  was 
Dea  Salus.  who  watched  over  both  public  and  private  weal.  Yet  even  of 
these  gods  and  goddesses  none  seem  original,  but  all  to  have  been  invented 
by  Roman  fancy  at  Grecian  suggestion.  The  last  mentioned  goddess  e.  g.  first 
received  a  temple  at  Rome.  B.  C.  450, '  after  Apollo  Medicus.  who  enjoyed  one 
as  earhr  as  B.  C.  467. 2  AVith  this  deity  and  their  own  divinities,  who  owed 
their  very  existence  and  names  to  an  inapt  and  rude  fancy,  the  Romans 
were  not  satisfied,  but  worshipped  also  Phrygian,  Egyptian  and  Grecian 
medical  gods,  and  built  for  them  temples  at  Rome  and  in  other  places.  In 
these  temples  the  ministrations  were  offered  in  part  by  the  original  fellow- 
countrymen  of  the  deities  concerned,  lest  perchance  they  might  be  improp- 

1.  A.  U.  C.   450  or   B.  C.    302.     It  was  founded   by  the  censor  C.  Junius  Bubulcus 

B.  C.  305  and  dedicated  B.  C.  302.     (H.) 

2.  This  temple  was  vowed  on  the  occasion  of  a  severe   epidemic  at  Rome.  B.  C.  430, 

and  dedicated  by  C.  Julius,  consul,  B.  C.  428.     (  H. 


—  132  — 

erly  executed.  Thus  the)1  sacrificed  to  iEsculapius  (who  was  summoned 
from  Epidaurus,  B.  C.  294.  to  be  a  Roman  God),  to  Isis  and  Serapis,  to 
Juno  and  Diana  Lucina,1  and  they  solemnized  the  mysteries  of  the  Cabiri. 
The  theurgic  practices  to  be  followed  in  public  calamity  under  the 
form  of  disease  were  fulfilled  by  the  Haruspices  and  Augurs,  who  were  of 
Etruscan  origin,  and  rather  ministers  of  state  than  of  religion.  Numa 
Pompilius  (reigned  B.  C.  715-G72),  who  promulgated  the  law  relative  to 
the  excision  of  the  child  in  case  of  the  death  of  a  pregnant  woman,  estab- 
lished also  a  College  of  Augurs,  who,  from  the  flight  of  birds  and  the 
entrails  of  animals,  predicted  health  or  the  reverse,  even  as  late  as  the  time 
of  Cicero,  when  they  could  scarcely  look  each  other  in  the  face  without 
smiling.  Distinguished  men,  nominated  especially  for  this  purpose,  inter- 
rogated the  Sibylline  books,  and  in  epidemics  magic  songs,  learned  from  the 
Etruscan's,2  were  universally  sung.  In  order  to  propitiate  the  gods  solemn 
processions  were  also  instituted  (as  at  a  later  period  in  papal  Rome,  which 
adopted  much  of  its  pageantry  from  the  heathen),  or  a  nail  was  driven  into 
the  right  door-post  of  the  temple  of  Jupiter  Capitolinns.  On  the  occasion 
of  a  dreadful  plague  in  the  year  B.  C.  400,  the  Romans  solemnized  the  first 
lectisternium  ;  that  is,  the  images  of  the  gods  were  placed  upon  couches, 
borne  through  the  streets,  and  finally  feasted  with  the  best  viands  of  the 
season. 

Marcus  Porcius  Cato,  the  Censor  (B.  C.  234-149),  opposed  the  gradual 
introduction  of  Grecian  civilization,  as  he  did  eveiything  not  originally  of 
Roman  growth  ;  for  he  was  perfectly  acquainted  with  that  phenomenon 
which  has  recurred  so  often  in  history  —  the  deterioration  resulting  from 
the  contact  of  a  more  highly  cultivated  and  correspondingly  effeminate 
people  with  a  nation  of  lower  intellectual  development,  but  physically  more 
vigorous — and  hence  he  desired  to  preserve  Roman  popular  medicine  to  the 
exclusion  of  Grecian  science.  Accordingly  he  himself  practised  medicine 
after  an  old  receipt-book,  and  recommended  senseless  magic  songs  (carmina). 
e.  g.  in  dislocations,  "Huat,  hanat,  ista,  pista  sista  damniato  damnaustra." 
Like  the  Pythagoreans  he  considered  the  cabbage  —  probably  under  the 
form  of  ambrosial  sauerkraut  —  especially  health)',  as  was  also  wine.3     He 

1.  Compare  Horace's 

"Montium  custos  nemorumque,  Virgo, 
Quse  laborantes  utero  puellas 
Ter  vocata  audis,  adimisque  leto, 
Diva  triformis." 

2.  The  Etruscans  were  an  aboriginal  Italian  race,  who  possessed  a  very  high  civiliza- 

tion long  before  the  Romans  came  into  Italy.  In  ceramics,  technics  and 
architecture  they  occupied  a  high  position,  and  carried  on  an  extensive  com- 
merce with  Egypt  and  the  Orient  in  general,  as  well  as  with  the  north  of  Europe. 
Their  written  language,  however,  has  never  been  deciphered. 

3.  How  coarse  was  the   mode  of  life,  even   among  the  old  Romans  of  rank,  maj-  be 

inferred  from  the  kitchen  receipts  of  Cato,  in  which  flour-dumplings  play  the 
Mime  role  that  thej"  do  among  the  Bavarians  of  the  present  da}r. 


—  133  — 

likewise  understood  surgical  matters,  and  was  a  veterinarian  to  boot. 
Thus  he  had  sick  cows  placed  upon  their  hind-legs  and  drinks  poured  down 
them  by  men  —  but  not  for  the  world  by  women  ! 

In  this  early  period  physicians  formed  a  class  despised  by  the  better  order  of 
Romans,  for  medicine,  down  to  the  time  of  Caesar  and  even  later,  was  considered  an 
occupation  unworthy  of  one  of  the  Quirites,  in  fact  as  "dishonorable.  '  Old  Roman 
physicians,  therefore,  (all  the  physicians  seem  to  have  been  foreigners)  are  never 
mentioned  by  name,  though  we  have  accounts  of  greater  or  lesser  epidemics, 
especially  camp-epidemics.1  By  degrees,  however,  many  Greek  physicians  of  the 
lower  order  (equivalent  to  the  so-called  "itinerants"  of  the  Middle  Ages)  wandered 
to  Rome,  in  order  to  turn  their  knowledge  into  money  in  the  wealthy  metropolis  of 
the  world.  In  this  respect  we  may  draw  a  not  uninteresting  historical  parallel 
between  the  mutual  relations  of  Greece  and  Home,  and  those  of  Europe  and  America 
at  a  later  period.  The  older,  civilized  people  fertilized  the  rising  republic  with  their 
spiritual  treasures  and  acquirements;  the  new  state,  in  return,  offered  to  the.adherents 
of  the  old  a  better  material  existence  here  than  at  home.  Another  point  of  similarity 
may  also  be  found  in  the  fact  that,  in  the  beginning,  chiefly  the  lower  and  impure 
elements  of  the  Grecian  medical  profession  travelled  from  Greece  to  the  Roman 
capital,  just  as,  after  about  2000  years,  the  same  thing  occurred  with  respect  to 
Europe  and  America.2  The  Greek  aliptae,  bath-keepers  and  slaves,  who  claimed  in 
Rome  to  be  physicians  and  worked  for  pay,  prepared  for  succeeding  and  competent 
physicians  in  Rome  the  same  doubts  and  the  same  burden  of  scorn  that  their  modern 

1.  Epidemics  of  a  nosological  character  not  definitely  determined  raged  in  the  years 

B.  C.  451,  4:J>6\  430,  412,  405,  395  (in  the  reports  of  this  so-called  "Pest  of 
Diodorus "  mention  is  made  of  "the  physicians"),  383,365,331,314  294,276, 
212  (before  Syracuse),  205,  182  (in  Rome).  163,  142  (in  Rome),  55  etc.  On 
these  occasions  aid  was  sought  in  lectisternia,  auguries  etc.,  and  at  one  time, 
when  men  particularly  succumbed  beneath  the  plague,  370  old  women — a  class 
of  whom  many  in  the  .history  of  the  world  have  fallen  victims,  even  among  the 
heathen,  to  mistaken  belief  and  superstition,  —  were  condemned  to  death.  Thus 
the  "Christians"  do  not  stand  alone  with  their  belief  in  witches! 

2.  The  fanciful   analogy   here   assumed  is  impaired  b}'  the   consideration   that  while 

the  Greek  medicasters  went  to  the  metropolis  of  the  world  to  make  money  and 
enjoy  its  pleasures,  the  pioneer  physicians  of  America  came  to  an  untrodden 
wilderness,  for  the  most  part  from  very  different  motives.  Nor  do  I  know  any- 
thing in  the  history  of  the  American  medical  profession  which  warrants  the 
implication  of  the  text  that  its  early  representatives  were  inferior,  mentally  or 
morally,  to  the  overage  of  their  European  colleagues.  Of  course  the  most  pros- 
perous and  able  European  practitioners  felt  no  temptation  to  exchange  the 
comforts  and  luxuries  of  civilization  for  the  trials  and  dangers  of  colonial  life  in 
America.  Of  course  quacks  and  other  adventurers  abounded,  and  it  may  even 
be  (though  1  know  nothing  to  establish  the  fact)  that  some  of  our  pioneer 
physicians  belonged  to  that  class  of  whom  the  poet  wrote  : 
"  True  patriots  all;  for  be  it  understood 
They  left  their  country  for  their  country's  good." 

But  an  a<£e  and  hemisphere  which  produced  a  Fludd,  a  Greatrakes  a  Digbj-, 
a  Butler,  with  other  notorious  charlatans,  can  scarcely  rebuke  the  American 
colonies  for  harboring  a  few  less  famous,  and,  therefore,  less  dangerous,  quacks. 
We  shall  see  hereafter  that  the  early  physicians  of  the  United  States  have  left 
behind  no  reputation  over  which  their  successors  need  blush.     (H. ) 


—  134  — 

compeers  occasioned  for  a  Ions!  time  among  the  more  intelligent  Americans.  Greek- 
physicians,  therefore,  were  extremely  disagreeable  to  the  better  Roman  circles,  and 
passed  for  charlatans  and  alchemists.1  The  first  Greek  surgeon  who  was  attracted 
to  Rome,  or  rather  the  first  whose  name  lias  been  preserved  to  us,  was  a  certain 
Archagathus,  from  Peloponnesus,  who  B.  C.  219  even  received  Roman  citizenship. 
The  story  goes,  however,  that  lie  was  banished  from  the  city  as  a  "carnifex" 
{ "butcher'  is  the  vulgar  expression  to-day ),  because  he  used  the  knife  and  fire  too 
freely. 

Not  long  after,  however,  the  Greek  physicians  won  an  honorable  position. 
Indeed  the  most  distinguished  Greek  physicians  of  later  times  practised  chiefly  in 
Rome  and  the  great  provincial  cities  of  the  empire,  to  which  rank  even  Athens  had 
sunk.  Here  began  a  period  in  which  a  complete  separation  of  Greek  and  Roman 
medicine  is  no  longer  possible,  for  both  were  continually  jostling  each  other  on  one 
and  the  same  field,  the  Roman  Empire.  Yet  the  leading  views  and  the  actual  sub- 
stance of  the  science  were  always  borrowed  from  the  Greeks,  though  Roman  physi- 
cians, from  this  time  rorth,  cultivated  medicine  in  various  ways.  Still  we  may  say, 
in  general  terms   that  there  was  no  longer  any  original  Roman  medicine! 

III.     GREEK  MEDICINE  DOWN  TO  THE  TIME  OF  THE  ROMAN  EMPIRE. 
AND    UNTIL    THE    PERIOD    OF    ITS    OVERTHROW. 

(GR.ECO-ROMAN  MEDICINE.) 

* 

In  spite  of  the  subjection  of  the  Greeks  to  the  political  power  of  the 
Romans,  in  spite  of  the  loss  of  their  political  independence  —  a  condition 
united  among  other  people  with  their  spiritual  power,  their  inmost  being 
and  their  capacity  for  action  —  still  this  unique  Greek  people  preserved  its 
old  creative  activity  and  power,  ruled  the  Romans  through  these  in  the 
field  of  science,  and  thus  vanquished  their  political  conquerors  in  the  sphere 
of  intellect.  Upon  all  people  with  whom  the  peculiar  Greek  spirit  has  ever 
come  into  contact,  it  has  at  least  impressed  its  stamp.  But  it  brought  the 
Romans  so  completely  under  its  power  that  the}'  imitated  its  works,  and, 
indeed,  the  rich  and  (what  is  ordinarily  the  same  thing)  the  educated, 
especially  after  the  age  of  Sylla  (B.  C.  138-78),  chose  the  Greek  as  their 
colloquial  tongue. 

So  much  was  this  the  case  that  not  only  were  Greek  schools  sought  after  very 
much  like  our  universities,  but  the  Latin  language  itself  assumed  a  Greek  structure. 
Children  were  expected  to  learn  to  speak  Greek,  and  for  this  purpose  Greek  nurses, 
teachers  etc.  were  invited  to  Rome,  and  in  the  works  of  the  most  important  Roman 
writers  of  the  izolden  age  of  Latin  literature  we  meet  not  infrequently  scraps  of  Greek, 
upon  which  the  authors  pride  themselves  as  openly  as  we  did  with  French  in  the  18th 
century.     This  we  observe  even  in  Cicero! 

Roman  culture  was  so  little  independent  that  it  can  lay  no  claim  to  originality 
in  anything  save  agriculture,  jurisprudence2  and  architecture.  For  even  the  first 
Latin  poets  were  Greeks  i  Livius  Andronicus,  Cnteus  Naevius,  Quintus  Ennius,  all  in 
the  Md  century   B.  C. ),  or  wrote  after  Greek  models,  as  Plautus   (died   B   C.   ISO), 


1.  Juvenal  writes : 

"  Graeculus  esuriens  in  caelum,  jusseris,  ibit." 

2.  As  the  Greeks  were  the  authors  of  public  law,  so  the  Romans  created  private  law, 

both  in  contrast  to  the  theocratic  law  of  other  ancient  peoples. 


—  135  — 

Publius  Terentius  Af'er  (died  B.  C.  193),  Pacuvius,  Cheilitis  Statius,  Atticus, 
Horatius,  Yergilius,  Ovidius  and  Lucretius  (died  A.  D.  55).  Jn  philosophy,  oratory 
and  historical  writing  too,  the  Romans  followed  the  Greeks,  as  is  manifest  from 
Cicero,  Livius  ( B.  C.  58-17),  Seneca  and  others.  In  like  manner  the  most  important 
statesmen,  like  Sylla,  Caesar,  Lucullus,  and  Pompey,  embraced  the  Grecian  culture. 
The  latter  statesman  also  transplanted  Greek  medical  literature  to  Rome,  and  is  of 
special  importance  from  the  fact  that  he  had  his  freedman  Lenams  translate  some 
of  these  writings  into  Latin.1  Whatever  great  works  in  sculpture  and  painting  the 
Romans  possessed  were  also  the  creations  of  Greek  artists.  Even  in  the  sciences  of 
mathematics,  mechanics,  botany  etc.,  the  Greeks  were  likewise  the  teachers  of  the 
Romans.  In  these  subjects  the  latter  accomplished  as  little  original  work  as  they  did 
in  philosophy,  which  owes  to  them  not  one  single  original  system.  On  the  whole 
the  Romans  believed  that  the  higher  sciences  were  brought  to  perfection  by  the 
Greeks,  a  significant  idea,  which  seems  to  have  been  transmitted  to  the  Middle 
Ages.2 

In  accordance  with  this  creative  faculty  of  their  spiritual  being  and 
their  great  power  of  intellectual  amalgamation,  the  Greeks,  even  after  the 
loss  of  their  native  nursen-  and  home,  planted  among  the  foreign  Romans 
a  new  doctrine,  whose  substance  was  largely  furnished  by  the  acquisitions 
of  the  Alexandrian  school,  and  which  completely  supplanted,  and  checked 
the  development  of,  the  scanty  germs  of  Roman  medicine  proper.  The}7 
gave  to  ancient  medicine  a  new  theoretical  foundation  ;  in  place  of  the 
humoral  pathology  which  had  prevailed  since  the  days  of  Hippocrates,  the}' 
called  into  existence  its  rival  Solidism,  destined  henceforth  to  struggle  with 
Humorism  for  the  precedence,  and  thus  they  awakened  between  the  two 
ideas  a  strife  which  after  long  centuries  is  not  yet  fought  to  a  conclusion. 
A  temporary  exchange  of  the  one  for  the  other,  as  the  weight  of  the  spirit 
of  the  age  has  borne  down  the  scale  to  either  side,  has  been  the  only  result. 

The  author  of  this  new  medical  theoiy,  which  in  the  sequel  became 

the  occasion   of  a  school  long  influential  in  medicine,  and  known  by  the 

name  of 

1,    THE  SCHOOL  OF  METHODISM, 

was  Asclepiades,  of  Prusa  in  Bithynia  (B.  C.  128-56). 

He  studied  under  Cleophantus  at  Alexandria,  sojourned  also  at  Athens,  where 
he  devoted  himself  to  medicine  and  rhetoric,  and  practised  then  at  Parion  in  the 
Proponfis  and  on  the  Hellespont.  After  such  extensive  travels  he  came  to  Rome, 
where  at  first  he  taught  rhetoric.  Subsequent]}-  he  practised  medicine  with  such  suc- 
cess— a  result  to  which  his  philosophical  education,  as  well  as  his  adroit  conduct  and 
pompous  behavior,  greatly  contributed  —  that  the  Romans  considered  him  an  angel 
sent  from  heaven.  He  was  also  on  friendly  terms  with  the  most  distinguished  men, 
such  as  Cicero,  Crassus  the  Orator,  and  others.  Besides  the  advantages  of  such  an 
acquaintance,  he  increased  his  fame  in  the  eyes  of  the  masses  by  the  revival  of  a  man 
apparently   dead,    as  well    as   by  bis    vehement    repudiation   of  Hippocrates,  whose 


1.  Many  of  the  more  important  Latin  authors  belonged  to  the  class  offreedmen. 

2.  Another  weighty   fact  may  be    mentioned.     The   Romans  liberated  woman  from 

the  almost  haremdike  social  position  whicli  she  held  among  the  Greeks,  and 
thus  prepared  for  her  complete  emancipation  under  Christianity  and  her  equality 
in  the  family. 


—  136  — 

teachings  he  named  "a  study  of  death".  He  censured  the  earlier  physicians 
generally,  and  may  be  regarded,  mutatis  mutandis,  as  a  kind  of  antique  Paracelsus. 
His  bold  assertion  that  he  who  rightly  understood  medicine  would  never  become  sick 
may  have  impressed  many  persons,  in  accordance  with  Goethe's  approved  maxim  •. 
"  Trust  yourself  and  the  people  will  trust  you."  This  assertion  was  verified  at  least 
in  his  own  person,  since  he  did  not  die  a  natural  death,  but  succumbed  to  the  results 
of  a  fall,  which  he  suffered  in  extreme  old  age. — Asclepiades  wrote  in  the  Greek  lan- 
guage many  works,  of  which  fragments  alone  are  preserved. 

Judged  by  his  teachings  Asclepiades  was  a  man  of  uncommon  mental 
power  and  boldness  ;  in  his  practice  his  methods  were  in  part  excellent. 
The  reputation  of  great  charlatanism  —  a  little  of  it  is  found  in  all  practice 
— which  he  enjoys  in  history  is  due  to  the  hatred  of  the  Romans  (who  felt 
their  intellectual  subjection  to  the  Greeks),  and  to  that  of  his  ancient  col- 
leagues :  for  it  is  not  conceivable  that  such  important  services  would  have 
been  possible  in  association  with  gross  charlatanism,  nor  is  it  to  be  assumed 
that  an  open,  bare-faced  quack  could  have  enjoyed  the  stead}-  friendship  of 
the  great  men  named  above  !  He  is  not  free,  however,  from  a  straining 
after  originality,  especially  in  his  principles  and  methods  of  treatment,  and 
in  this  he  went  so  far  as  to  turn  upside  down  almost  everything  heretofore 
current.  Hence  he  drew  upon  himself  the  hatred  of  those  who  clung  to 
antiquity,  and  Pliny,  openly  and  chauvinistically  enough  to  render  his 
motives  perfectly  clear,  says  : 

"  This  only  can  annoy  us,  that  a  man  of  this  most  fickle  race,  without  any  exter- 
nal aid,  simply  for  the  sake  of  his  own  profit,  should  have  suddenly  given  the  laws  of 
health  to  the  human  race,  though  many  persons  have  since  abrogated  them." 

Be  this  as  it  may.  Asclepiades  was  an  intellectual  pioneer  and  a  man 
possessed  of  an  extremely  fine  knowledge  of  human  nature  ;  one  who 
merely  used,  perhaps  a  little  too  openly,  that  phrase,  which  in  antiquity, 
and  alas,  to-day  too,  is  often  current  or  tolerated  in  practice. — "Mundus  wit 
decipi!  " — His  fundamental  ideas  (and  still  more  those  of  the  Methodists, 
who  claimed  him  as  their  founder),  and  particularly  his  therapeutics,  which 
were  modeled  very  little  upon  theory,  have  maintained  themselves,  though 
in  a  modified  and  somewhat  masked  form,  even  down  to  the  present  time. 

His  doctrines  are  founded  theoretically  upon  the  views  of  Heraclides  of  Pontus, 
and  the  philosophy  of  Leueippus  and  Demoeritus,  completed  by  Epicurus.  Practi- 
cally, however,  they  are  based  on  the  teachings  of  the  Stoa. —  Heraclides  of  Pontus,  l 
a  pupil  of  Plato  and  Aristotle,  assumed  dissimilar,  formless  and  changeable  atoms  as 
the  basis  of  all  things.  Epicurus  (  B.  C.  341-270),  on  the  other  hand,  whose  egotistic 
rule  of  life,  to  seek  only  after  comfort  and  pleasure  as  the  end  of  existence,  has 
unjustly  given  him  a  bad  name  for  all  time,  held  the  world  to  consist  of  innumerable 
most  minute  atoms,  which,  however,  (and  in  this  they  are  distinguished  from  the 
atoms  of  Demoeritus)  meet  not  from  necessity,  bul  rather  spontaneously.  In  this 
meeting  self  determination  is  also  called  into  play. 

The  atoms  are  indivisible  and  cognizable  by  the  spirit,  but  not  by  the  senses. 


1.  He  taught  the  daily  revolution  of  the  earth  from  west  to  east,  and  the  absence  of 
motion  in  the  fixed  stars.  He  was  the  author  of  the  so-called  Egyptian  (but 
actually  Greek)  system  of  motion  of  the  heavenly  bodies. 


—  137  — 

The  latter  faculties  lie  held  to  be  capable  only  of  discerning  the  truth  by  means  of 
•experience.  With  how  unprejudiced  an  eye  he  regarded  experience  may  be  inferred 
from  the  fact  that  he  declared  religion  to  be  a  product  of  fear.  For  this  he  was  taxed 
■with  heresy — no  harmless  charge  even  among  the  heathen,  who  had  their  own  inquis- 
itors. The  soul,  as  well  as  the  body,  he  considered  a  substance  compounded  of  atoms 
(but  of  the  finest  and  roundest  atoms  only),  and  not  a  simple  substance.— The  Stoics, 
■of  whom  Zeno  ( B.  C.  340-2(S0)  was  the  first,  laid  stress  upon  a  ''natural"  mode  of 
life  as  the  chief  means  of  happiness. 

In  his  philosopkico-mechanical,  general  pathological  and  physiological 
•views  Asclepiades  conceives  matter  to  consist  of  extreniel}*  small,  but  still 
divisible  and  fragile,  formless  and  mutable  collections  of  atoms,  the  "  Con- 
cretions "  ((Tuy/.i/ifTs'.c),  cognizable  indeed  by  the  understanding,  but  not  by 
the  senses.  These  originally  moved  about  uncontrolled  in  the  general 
vacuum  of  Democritus,  and  burst  in  pieces  through  accidental  collisions. 
By  union  of  the  finest  fragments  thus  engendered,  the  "  Leptomeres ", 
originate  the  visible  bodies,  whose  differences  of  form  and  varying  peculiar- 
ities have  their  foundation  in  the  different  association  of  the  leptomeres 
into  different  bodies.  The  particles  also  leave  between  them  little  empty 
tubes,  the  poroi,  in  which  move  a  multitude  of  the  finest  particles,  which 
occasion  sensation  and  correspond  to  the  pneuma  of  others,  here  considered 
only  atomically.  If  the  motion  of  these  particles  is  quL-t  and  regular  it  is 
called  health,  but  if  it  is  irregular,  feeble  or  boisterous,  sickness  arises. 
Sickness  also  originates  in  the  air  received  in  respiration  and  in  the  food, 
and  enters  our  bodies  in  respiration  and  digestion,  by  both  of  which  it 
passes  through  the  poroi  into  the  heart  and  the  blood,  and  through  this 
finally  into  the  whole  body  which  it  nourishes.  The  pulse  originates  in 
an  influx  of  the  particles  into  the  vessels  ;  animal  heat,  sensation,  secretion, 
in  a  similar  way,  hunger  and  thirst,  however,  originate  in  emptiness  of  the 
pores  of  the  stomach,  which,  in  accordance  with  our  varying  conditions, 
ma}*  be  either  empty,  full,  or  contracted. 

In  surgery  Asclepiades  has  won  great  reputation  by  his  practice  of  tracheotomy 
in  angina.  He  also  recommended  scarilication  of  the  ankles  in  drops}*,  as  well  as 
paracentesis  with  the  smallest  possible  wound.  He  observed  too  spontaneous  luxa- 
tion of  the  hip-joint. 

According  to  him  the  proximate  cause  of  disease  is  stagnation  of  the  atoms;  on 
the  other  hand  he  finds  in  the  humors  only  a  procatarctic  cause. 

In  pathology  lie  was  the  first  to  distinguish  definitely  acute  and  chronic  diseases 
(for  example  dropsy).  The  special  forms  of  disease  are  based  upon  the  greater  or 
less  disproportion  of  the  atoms  to  the  poroi,  and  the  grade  of  stagnation  thus 
occasioned.  Thus  e.  g.  quotidian  fever  originates  through  the  largest  atoms,  tertian 
through  the  medium-sized,  quartan  through  the  finest. 

Upon  the  size  of  these  atoms  depends  also  the  grade  of  the  fever:  larger  atoms 
occasion  severe,  smaller,  less  dangerous  fever.  Fever  heat  originates  in  active  move- 
ments of  the  atoms:  the  chilliness  is  due  to  their  quiescence.  Haemorrhage  is  a  result 
•of  putridity  or  of  laceration,  and  does  not  depend  upon  synanastomoses. — Crises,  in 
opposition  to  Hippocrates,  Asclepiades  totally7  denied,  a  denial  which  excited  the 
special  wrath  of  Galen.  What  is  said  in  therapeutics  of  the  activity  of  nature  is, 
.according  to  Asclepiades,    pure   sophistry  !     The  physician   alone   cures,  and  nature 


—  138  — 

simply  supplies  opportunities.  In  disease  nature  as  often  works  injuriously  as 
beneficially.  The  fundamental  principle  of  his  tliercapeutics,  as  famous  as  it  is  im- 
practicable, is  expressed  in  the  maxim:  "The  physician  should  cure  tuto,  celeriter 
ac  jucunde." 

In  all  this,  and  especially  in  his  doctrine  of  indications,  Asclepiades  was  the 
restorer  of  pathology  and  therapeutics. — Fever  he  regarded  as  a  curative  agency.  In 
the  beginning  he  denied  both  food  and  drink,  "so  that  he  did  not  allow  the  mouth  to 
be  rinsed  even  once" — a  fatal  principle,  which  maintained  currency  until  the  time  of 
Van  Helmpnt,  and  even  until  late  in  the  present  century.  In  this  stage  he  recom- 
mended clear  light.  At  a  later  period,  however,  he  allowed  good  food.  Certain 
methods  of  treatment  were  followed  at  certain  definite  periods,  and  thus  arose  the 
doctrine  of  cyclical  cures.  Thus  on  the  third  day  of  fever  he  would  give  an  enema; 
on  the  fifth,  an  emetic;  on  the  sixth,  rest  in  bed.  He  discarded,  however,  the  use  of 
medicines,  and  especially  of  strong,  debilitating  remedies,  and  rejected  violent  purga- 
tives and  emetics,  counselling,  on  the  contrary,  dietetic  and  hygienic  treatment, 
enemata,  cold  baths,  drinking  cold  water,  and  especially  the  use  of  wine  in  convales- 
cence. The  shower-bath,  exercise,  riding,  even  music,  singing  and  declamation  were 
also  employed  therapeutically  by  Asclepiades.  He  often  practised  bleeding,  but 
cautioned  against  the  use  of  cups,  while  strongly  favoring  frictions  (massage).  The 
latter  were  frequently  employed  in  the  gymnasia  of  the  ancients  (even  to  excite 
sexual  desire),  and  especially  in  the  Oriental  gymnasia,  whence  Asclepiades,  as  a 
native  of  Asia  Minor,  may  have  taken  them.  They  became  very  popular  at  that 
period  (like  massage  in  the  present  day),  and  were  submitted  to  by  even  queens  and 
empresses.  They  were  to  be  continued  until  sleep  supervened,  which  latter  Ascle- 
piades considered  wholesome.  In  "  Phrenitis"  (a  term  which  he  is  the  first  to  use  in 
the  sense  of  mental  disturbance)  he  utterly  discarded  the  use  of  the  dark  chamber 
and  bleeding,  but  recommended  decoctions  of  poppy  and  henbane,  wine  and  sea-water. 
In  tetanus  he  administered  warm  baths1   and  inunctions  of  oil,  while  in  epilepsy  he 


I.  The  Roman  baths  were  arranged  as  follows:  1.  The  hypocaustum  or  hot-air 
chamber  in  the  basement:  2.  The  vasarium,  an  apartment  with  three  basins 
placed  one  above  the  other,  which  supplied  by  means  of  pipes,  hot,  tepid  or  cold 
water,  according  to  their  distance  from  the  first,  or  hot-air  chamber:  3.  The 
balneum,  with  a  basin  (alveus),  upon  whose  border  (labrum)  or  upon  special 
benches  (solia)  the  bathers  seated  themselves:  t.  The  laconicum  with  a  steam 
boiler,  which  could  be  opened  by  a  valve  to  let  the  steam  out,  and  perforated 
stools  or  benches:  5.  The  tepidarium  for  warm-air  baths :  6.  The  frigidarium 
for  cooling  off  by  sprinkling  from  a  tub  (baptisterium)  and  in  a  cold  bath  :  7.  The 
eheotheriuin,  a  room  for  keeping  the  vessels  of  oil  and  ointment,  and  for  inunc- 
tion : — The  balnea  pensilia  (invented,  according  to  Pliny,  by  Sergius  Grata,  but 
ordinarily  ascribed  to  Asclepiades)  were  similar  to  our  shower-baths  of  the  present 
day,  though  probably  produced  by  condensation  of  the  steam  upon  the  ceiling  of 
the  bathroom,  and  its  subsequent  precipitation. 

We  may  also  remark  here  that  not  only  artificial  baths,  but  natural  baths 
likewise  (sea-bathing  at  Baiae  etc.),  were  commonly  used  among  the  Romans, 
especially  the  indifferent  warm-baths  e.  g.  Baden-Raden,  Wiesbaden,  Padenweiler, 
Baden  im  Aargau,  Aachen  etc.  in  Germany.  The}'  also  had  their  seasons  for 
bathing,  and  traveled  to  the  baths  cornme  chez  nous.  The  fact  that  the  Ancients 
had  no  body-linen,  and  wore  only  woolen  outer  clothing,  rendered  necessar}'  the 
use  of  daily  baths.  The  same  thing  is  true  of  the  whole  Middle  Ages,  and  this 
circumstance  explains  the  existence  and  general  diffusion  of  bathing-hom.es  even 
in  small  places  and  in  the  camps. 


—  139  — 

advised  sexual  intercourse.  In  regard  to  cold  baths,  Asclepiades  exercised  upon  his 
own  time  an  influence  similar  to  that  of  the  Silesian  peasant  Vincenz  von  Priessnitz 
( 1799— 1>S5 1 )  upon  ours.  Asclepiades,  however,  differed  from  Priessnitz,  as  his  friends 
Cicero  and  others  differed  from  the  artless  nobles  who  suffered  themselves  to  be 
macerated  by  Priessnitz.  —  At  that  time  the  cold-water  and  hardening  mania  was  so 
strong  among  the  blase  aristocracy  of  Rome,  that  even  a  Seneca  on  the  first  day  of 
January  bathed  in  clear  running  water:  "  I,  as  a  pronounced  cold-bather,  on  the  first 
of  January  sought  the  canal,  and  began  each  new  year  by  jumping  into  the  aqueduct, 
instead  of  reading,  writing  or  rehearsing  something."  (See  Marx. )  Therapeutics  corre- 
sponds at  all  times  to  the  physical  and  intellectual  condition  of  a  people  :  from  this  the 
science  originates,  and  to  this  it  accommodates  itself.  The  science  of  therapeutics  too 
is  not  born  in  the  heads  of  physicians  alone,  but  is  the  offspring  of  all  the  circum- 
stances of  a  period! 

If  in  the  therapeutics  of  Asclepiades  we  separate  the  chaff  (of  which 
there  is  quite  enough  in  all  systems)  from  the  wheat,  we  must  admit  that  in 
this  branch  of  medicine  too  he  was  the  pioneer  of  eminent  improvements. 

His  scorn  for  anatomy  and  physiology  deserves  all  reprobation.  Yet  he  experi- 
mented in  the  latter  branch,  as  we  learn  from  Tertullian  : 

"  Asclepiades  may  investigate  goats,  which  bleat  without  a  heart,  and  drive 
away  flies,  which  fly  without  a  head  " 

This  scorn  for  anatomj"  he  shared  too  with  famous  practitioners  of  a  later  age! 

Followers  and  pupils  of  Asclepiades  (Asclepiadists)  were  : 
Philonides  of  Dyrrhaciiium  (about  B.  C.  42),  Nicon  of  Agrigenti  u 
(about  B.  C.  49),  Titus  Aufiditjs  of  Sicily,  (about  B.  C.  44),  who  wrote  on 
chronic  diseases  and  recommended  in  the  treatment  of  melancholia  whip- 
ping, hunger,  thirst  and  occasional  coitus,  which  latter,  according  to  Hensler, 
was  at  that  time,  curiously  enough,  counted  among  the  bodily  or  gymnastic 
exercises.  Marcus  Artorius  (about  B.  C.  31),  who  saved  the  life  of 
Augustus  at  the  battle  of  Philippi  ;  Clodius  and  Niceratus,  who  wrote 
on  catalepsy,  and  left  us  some  recipes  (about  B.  C.  42)  ;  Ciirysippus, 
who  wrote  on  intestinal  worms  ;  Miltiades  Elaiusius,  who  wrote  on 
chronic  diseases  ;  Sextius  Niger,  a  friend  of  the  physician  next  mentioned 
and  a  laborer  on  the  subject  of  simple  medicines  (about  A.D.  50)  ;  Julius 
Bassus,  a  Roman,  who  wrote  in  the  Greek  language  a  work  on  drugs 
(about  A.  1).  44)  ;  Petronius  Musa  and  Petronius  Diodotus,  writers  on 
medicines,  and  Alexander  of  Laodicea.  Antonius  Musa1  (A.  D.  10) 
cured  Augustus  (B.  C.  63-14  A.  D.),  whose  slave  he  had  been,  of  a  disorder 
of  the  liver  by  means  of  cold  poultices  and  baths.  He  was  also  the 
physician  of  Horace.  Euphorbus,  a  brother  of  Musa,  was  physician  to 
Juba  of  Numidia  (died  B.  C.  40),  and  is  said  to  have  been  the  godfather 
of  the  Eupho/biaceae. 

The  most  important  pupil  of  Asclepiades,  and  one  who  in  his  old  age 
changed  and  corrupted  his  master's  doctrines,  as  a  basis  for  the  system  of 
•  Methodism  "  was 

1.    An  "  Instructio  de  bona  valetudine  conservanda  ",  assigned   to  the   pen   of  Musa. 
is  still  extant. 


—  140  — 

Themison  of  Laodicea,  (B.  0.  50). 

He  was  the  author  of  a  work  on  chronic  diseases ;  wrote  on  the  plantain,  elephan- 
tiasis (on  which  he  was  the  first  writer),  and  some  medical  letters,  and  would  have 
written  also  on  rabies  canina,  but  gave  it  up,  because  in  his  earlier  life  the  sight  of  a 
case  had  sufficed  to  sicken  him  with  the  same  disease,  and  he  feared  a  relapse  should 
he  undertake  to  write  about  it.  From  quite  comprehensible  causes  he  was  a  poor 
practitioner,  in  spite  of  his  invention  of  famous  remedies,  like  the  diacodium,  the 
diagrydium  etc. 

He  left  the  atoms  of  Asclepiades  entirely  out  of  consideration,  but 
classified  diseases  all  the  more  strictly  in  accordance  with  the  condition 
of  the  poroi.  Accordingly  "disease"  consists  in  either  a  contraction  or 
relaxation  (status  strictus  or  laxus)  of  the  latter. '  to  which  Mnaseas 
subsequentl}'  added,  as  a  third  characteristic,  a  mixed  condition  (status 
mixtus).  Subsequentl}'  another  "  community  "  (as  these  general  charac- 
teristics were  called)  was  added,  the  "community  of  time  or  course"  in 
acute  diseases,  according  as  these  were  in  the  stadium  of  increase,  of 
maximum,  or  of  decrease  of  the  symptoms  ;  hence  proceeded  the  invention 
by  the  Methodists  of  the  "three  day  periods"  (diatritus),  of  which  the  first 
seven  days  contained  three. 

The  system  thus  formed  passed  as  "a  method"  intermediate  between 
the  strong  Dogmatism  and  the  Empiricism  of  the  foregoing  physicians,  and 
was  opposed  to  both.  At  a  later  period  the  subject  received  a  scientific 
dress  and  was  spoken  of  as  a  "  method  of  science  "  which  sought  "the  com- 
munities ",  in  order  to  base  upon  them  the  cure  of  diseases.  Everything 
except  the  supposed  general  condition  of  the  body  in  question  lost  its  im- 
portance. Such  was  the  fate  of  diagnosis,  the  anatomical  seat  of  disease 
(the  better  Methodists  were  not  ignorant  of  anatomy),  symptomatology, 
aetiology,  constitution  etc.  Upon  the  recognized  community  the  physician 
built  up  his  "indications"  for  the  treatment,  whether  to  relax  or  astringe  • 
or  —  in  mixed  conditions  —  to  remove  the  most  prominent  community. 
As,  however,  these  three  indications  did  not  suffice  for  all  cases,  in  course 
■of  time  the  " surgical  indications "  and  the  "  proph}lactic  indications  " 
were  added.  The  former  were  directed,  1.  to  the  removal  of  all  foreign 
matter  which  had  obtained  entrance  into  the  bod}'  e.  g.  foreign  bodies  ;  or 
2.  the  removal  of  such  foreign  structures  as  had  originated  in  the  body 
without  external  agency,  e.  g.  tumors  ;  or  3.  the  correction  of  changes  of 
position,  as  in  fractures  of  bones  ;  or  4.  the  repair  of  defiencies  of  sub- 
stance, e.  g.  in  ulcers,  arrest  of  development,  like  hare-lip  etc.  The  "  pro- 
phylactic indications  "  related  to  conditions  which  would  not  fit  any  of  the 
old  "communities",  e.  g.  poisoning,  the  lutes  of  poisonous  beasts,  in  which 
the  poison  must  first  be  removed. 

Thessalus  made  a  further  addition  to  this  theoretically  imperfect 
structure  in  the  "  metas}-ncrisis  "  (incorporation),  which  was  to  be  directed 
especially  against  chronic  constitutional  diseases,  where  the  other  methods 
of  treatment  were  of  no  benefit.  This  name  can  be  found  even  as  early  as 
Hippocrates.     The  object  of  the  metasyncrisis  was  to  bring  the  atoms  into 


—   141   — 

different  position — here  too  the  "  cyclical  cures  "  were  of  service — and  it 
consisted  of  the  "  recorporative-'  part,  through  which,  notwithstanding  it 
contained  a  depletive  treatment,  the  forces  might  be  restored,  and  the 
"  regenerative  "  part,  which  was  designed  to  change  the  whole  bodily  con- 
dition. 

The  -community  was  diagnosticated  especially  from  the  condition 
of  the  evacuations  and  secretions,  from  the  circumstance  whether  they  were 
restrained  or  profuse  etc. 

For  example:  the  status  strictus  prevails  in  putrid  fever,  in  which  the  heat  is 
restrained  1)3"  'soot''  (fuligo):  the  status  laxus  exists  in  swooning  from  loss  of  blood, 
in  too  frequent  alvine  evacuation,  in  sudden  joy  :  the  status  mixtus,  in  epilepsy, 
paralysis,  lethargy,  catarrh  etc. 

The  crises  and  critical  da}-s  were  discarded.  Since  the  physician,  not 
nature,  cured  disease,  the  maxim  of  Hippocrates  "  Life  is  short,  art  is  long" 
might  have  been  exactly  reversed. 

Remedies  for  certain  "communities"  were,  e.  ir.  in  the  status  strictus,  warm  baths. 
warm  lotions,  warm,  moist  air,1  warm  poultices,  diaphoretics,  diuretics,  caihartics,  ex- 
pectorants, emetics,  bleeding  (which  the  Methodists  practised  upon  the  side  opprsite 
to  that  affected),  cupping,  scarification,  leeches  (which  Themison  was  the  first  to 
introduce  into  practice!) — measures  employed  as  well  in  stricture  in  general  as  in 
that  of  an}7  special  organ,  since  in  the  latter  case  too  we  can  only  act  upon  the  whole 
body.  Dietetic  measures  are  withdrawal  of  nourishment,  pure,  warm  and  clear  air, 
sleep,  since  it  not  infrequently  occasions  perspiration,  moderate  joy,  bodily  exercises 
in  affections  of  the  head,  asthma,  running  in  corpulency,  hunting  on  foot  and  on 
horseback,  moderate  coitus,  since  it  warms  and  evacuates  the  semen  (retaining  it 
occasions  headache,  melancholy)  etc. 

Against  relaxation:  pomegranate,  sanguis  draconis,  absinthium,  myrrh,  verbas- 
cum,  chalybeate  and  alum-water,  cold  baths  etc.  Dietetically :  cold  air,  abundant 
food,  red-wine,  rest,  fright  etc. 

In  mixed  conditions  the  suitable  remedy  was  selected  in  accordance  with  the 
most  striking  community. 

As  regards  the  three  day  periods:  in  pneumonia,  during  the  first  three  days  no 
food  and  no  drink  were  given,  and  living  in  tolerably  warm  air  with  the  horizontal 
position  were  recommended.  At  the  height  of  the  disease  the  chest  was  rubbed  and 
enveloped  in  cloths  dipped  in  oil,  and  sleep  was  forbidden.  After  the  crisis  of  the 
disease  sleep  was  again  permitted,  and  a  venesection  was  instituted  !  Barley-water, 
fresh  eggs,  or  a  drink  of  anise,  honey-  and  oil  were  given  for  nourishment,2  and  cups 
and  steam  baths  were  employed  externally,  a  mixture  of  honey7  and  the  yolk  of 
eggs  etc.  was  used  as  an  expectorant — and  finally  a  blistering  plaster  was  applied  to 
the  chest! 

Example  of  a  "cyclic  cure":  preparation:  first  day — little  food  and  water,  or, 
with  the  robust,  total  withdrawal  of  both  :  on  the  second  day — little  exercise,  rubbing 
with  oil,  the  third  part  of  some  specially7  prescribed  nourishment,  or  of  the  ordinary 
food,  and  so  on  for  two  or  three  days  :  then  in  addition  a  second  third  of  this  food, 

1.  They  taught  that  more  attention  should  be  directed  to  the  air,  which  we  are  forced 

to  inspire  constantly,  than  to  our  meat,  which  we  indulge  in  much  more  sparingly. 

2.  It  may  be  remarked  here  that  Greeks  and  Romans  down  to  the  time  of  the  Empire 

knew  nothing  of  bolted  flour,  and  used  universally  rye-flour  (Liehig).     Accord- 
ingly the  sole  bread  of  classical  antiquity  was  pumpernickel  ! 


—   142  — 

and  after  3  or  4  days  for  the  first  time  a  full  portion.  In  a  similar  way  they  gradually 
increased  the  exercises  and  the  wine!  Metasyncrisis  :  first  day — fast;  second  day — 
exercises,  inunction  or  bathing,  moderate  use  of  wine,  one-third  of  a  portion  of  roast 
meat,  salt  meat,  with  capers  or  mustard,  or  preserved,  unripe  olives;  alter  2  or  ?>  days 
two-thirds  of  a  portion  of  food:  after  the  same  number  of  days  a  full  portion.  The 
diet  was  changed,  and  this  process  repeated,  until  at  last  a  new  cycle  was  introduced 
with  emetics  of  radish  etc.  The  injurious  effects  of  the  emetic  were  prevented  by 
sleep — on  the  whole  a  thoroughly  "  methodistic  "  treatment  ' 

It  is  manifest  from  the  preceding-  account  that  the  fertile  ideas 
of  Asclepiades  were  merely  reduced  to  the  dead  level  of  a  system  by 
"Methodism",  and  that  even  his  therapeutic  methods  gained  nothing  in 
the  hands  of  the  Methodists,  although  their  therapeutics  (a  science  in 
which  they  even  formulated  certain  enduring  rules)  was  certainly  their  best 
contribution  to  medicine.  That,  however,  distinguished  physicians  of  that 
and  a  later  period  —  for  we  can  feel  no  surprise  at  the  characterless  Roman 
people  of  later  times,  who  judged  everything  by  superficial  appearances  — 
adhered  to  this  "  most  practical  "  of  all  systems,  is  only  to  be  explained 
by  the  strong  ebb  which  had  begun  to  manifest  itself  in  the  higher  in- 
tellectual departments,  and  which  the  rapidly  sinking  wave  of  ancient 
culture  introduced  and  brought  with  itself.  Fortunately,  however,  some 
few  good  spirits  shunned,  or  at  least  endeavored  to  shun,  the  headlong 
current ! 

Among  the  other  Methodists,  Thessalus  of  Tralles  (A.  D.  60),  the  son 
of  a  weaver,  was  at  all  events  one  of  the  most  talented. 

He  was  a  sort  of  antique  "  natural"  doctor,  for  Methodism  recalls  in  many  ways 
the  so-called  "natural  medicine"  of  modern  times.  Thessalus  was  entirely  without 
any  school  education,  and  was  compelled  to  rely  solel}-  upon  his  untutored  and 
natural  genius.  He  scorned  all  science  and  the  educated  physicians  of  antiquity, 
and  boldly  trod  the  road  of  charlatanry  and  rodomontade.  He  fawned  upon  the  rich, 
and  became  the  leader  of  a  medical  mob  which  followed  him  on  account  of  his  birth 
and  bringing  up,  and  he  has  thus  become  for  posterity  the  model  of  a  medical  charla- 
tan. He  called  all  the  physicians  of  earlier  times  bunglers  (a  thing  which  has  been 
done  too  by  otherwise  reputable  physicians  of  modern  times),  protested  that  he  could 
teach  the  whole  of  medicine  in  half  a  year,  and  called  himself  the  "Conqueror  of 
physicians"  !  He  was  always  surrounded  by  pupils  of  a.  station  similar  to  his  own, 
and  with  them  he  used  to  visit  his  patients,  a  custom  which,  as  we  know,  found  official 
acceptance  in  the  17th  century.  Thessalus  was,  so  to  say,  the  original  founder  of  the 
"  Poliklinik  ".  He  enriched  Methodism  with  the  "  metasyncritic  treatment '",  which 
he  employed  in  ulcers. 

Among  the  followers  of  Thessalus  were  :  Menemachus  of  Aphrodisia, 
Olympicus  of  Miletus  (A.  D.  70),  Mnaseas  (A.  D.  80),  Apollonides  of 
Cyprus  (A.  J).  100),  Julian  the  elder  (A.  D.  140),  who  opposed  Hippocrates 
and  wrote  an  introduction  to  medicine.  He  had  studied  with  Galen  in 
Alexandria,  but  subsequentl}'  became  his  enemy. 

Other  Methodists  were  :  Eudemus  (B.  C.  15),  who  wrote  on  hydropho- 
bia, and  Vectius  Valens  (about  A.  D.  23), 

both   infamous  for  their  scandalous  relations,  the  former  with  Livilla,  the  daughter- 
in-law  of  Tiberius   (B.  C.  42-A.  D.   37),  whose  husband,  Drusus,  he  poisoned;  the 


—  U'S  — 

second  with  Messalina  (murdered  A.  D.  48),  who  had  Li  villa  executed.  Livilla  herself 
was  a  daughter  of  the  no  less  infamous  Agrippina,  who,  with  the  aid  of  the  physician 
Xenophou  of  Cos  made  away  with  her  husband,  the  emperor  Claudius,  by  means  of 
a  dish  of  poisonous  mushrooms — a  nice  party  of  ladies  and  physicians ! 

Scribonius  Largus  (*A.  D.  -15), 
a  compiler  of  medicines,   especially  those  of  a  popular  character,  who  was  also  the 
first  to  recommend  the  electricity  of  the  electric  ray  in  cases  of  headache  : 

Meges  (B.  C.  20), 
a   surgeon  who  observed  tumois  of  the   breast  and   forward  dislocation  of  the   knee 
joint,  and  invented  instruments  for  lithotomy: 

Philumencs  (about  A.  I).  80), 
a  very  famous  physician,  who  mentions  podalic  version,  contracted  and  oblique  pelves, 
uterine  polypi,  points  out  too  great  youth  and  too  advanced  age  as  causes  of  difficult 
laoor,  teaches  the  treatment  of  disturbances  of  health  during  pregnancy,  determined 
the  treatment  of  the  different  forms  of  diarrhoea,  composed  the  remedy  "Anthora" 
used  for  ulcers  of  the  mouth  etc. : 

Andromachus,  The  Elder  (A.  D.  60), 
inventor  of  the  "Theriaca",  a  universal  remedy  composed  of  more  than  lit)  drugs  and 
said  to  be  efficacious  even  against  wounds.  He  was  also  the  first  "  Archiater"  (though, 
according  to  Brian,  the  notorious  Xenophon,  who  poisoned  Claudius,  and.  according 
to  others,  a  certain  Eutychus,  bore  the  title  before  him),  and  the  physician-in-ordinary 
of  Nero. 

SORANUS  Of  EPHESUS. 
was  an  unprejudiced  and  sharp-sighted  observer  and  diagnostician,  whose  ability, 
erudition  and  experience  as  a  practitioner  were  not  fully  recognized  from  his  own 
writings  until  the  present  century.  He  was  the  son  of  ]\Ienander  and  Phcebe,  and 
lived  in  Rome  in  the  time  of  Trajan  (A.  D.  98-117)  and  Hadrian  (A.  D.  117-138]. 
He  enjoyed  great  reputation  as  a  physician  and  obstetrician,  wrote  on  many  subjects 
of  medicine,  surgery  and  "midwifery,  and  passed  among  the  ancients  as  the  best  and 
most  learned  of  the  "  Methodists".  Fourteen  of  his  writings  have  been  enumerated, 
of  which  his  famous  work  "On  Diseases  of  Women  "(in  the  original  Greek),  a  work 
on  "Chronic  Diseases"  (translated  into  Latin  by  Cajlius  Aurelianus).  a  treatise  on 
medicines  (translated  into  Latin),  and  one  on  the  etymology  of  the  names  of  the 
parts  of  the  human  body,  are  still  extant.  The  first  is  the  only  gynaecological 
work  preserved  from  antiquity  written  for  the  use  of  midwives.  Its  contents  furnish 
evidence  that  gynaecology  and  obstetrics,  both  ordinary  and  operative,  as  well  as  the 
management  of  the  child,  belonged  among  the  most  perfect  branches  of  ancient 
medicine.  The  work  is  quite  full  of  surprising  and  acute  remarks,  which  prove  that 
it  is  only  in  our  late  day  that  the  perfection  of  the  ancient  Soranus  has  been  in  many 
respects  regained  !  For  example  :  in  coitus  and  menstruation  the  os  uteri  opens — a 
statement  recently  confirmed,  as  regards  coitus,  by  the  observation  of  an  American 
physician.  He  distinguishes  the  vagina  from  the  uterus,  and  compares  the  latter  in 
form  to  a  cupping-glass. — Extirpation  of  the  uterus  (which  was  performed  also  in 
antiquity)  is  not  necessarily  fatal. — Virginity  prolongs  life. — Coitus  at  the  close  of 
menstruation  is  most  readily  fruitful. — Artificial  abortion  in  the  third  month  is  least 
dangerous;  yet  it  majr  be  dangerous  from  the  production  of  tetanus  etc. — Careless 
manual  removal  of  the  adherent  placenta  majr  produce  inversion  of  the  uterus. — If 
the  placenta  is  not  separated,  both  ends  of  the  cord  (cut  with  a  sharp  instrument) 
must  be  tied. — The  parturient  woman  sits  upon  the  lap  of  another  woman,  or  better 
upon  the  labor-stool   recommended  and  carefully  described  by  him. — He  gives  an 


—  144  — 

extremely  careful  description  of  the  requisites  for  a  good  wet-nurse,  and  of  the  bath- 
ing, and  general  bringing-up  of  children.  They  should  never  be  weaned  before  the 
sixth  month,  and  then  their  food  should  be  thin  pap  and  soft  eggs.  Remarks  on  the 
artificial  feeding  of  children  (without  a  nurse)  are  entirely  wanting,  as  is  the  case 
with  all  other  ancient  physicians.  (Biedert.)  This  fact  may  be  explained  by  the 
supposition  that  the  Ancients  may  have  had  sufficient  nurses  in  their  female  slaves. 
Incision  of  the  gums  in  difficult  teething  Soranus  mentions,  but  rejects.  In  ophthal- 
mia neonatorum  he  recommends  instillation  of  oil. — Amulets  and  the  like  are  per- 
mitted in  metrorrhagia,  since  they  maintain  hopefulness  (!).- — Percussion  and  hiccus- 
sion  serve  to  distinguish  between  moles  and  tj'tnpanites.  An  account  of  a  vaginal 
speculum  is  given,  and  directions  for  reducing  the  vagina  to  virginal  size  by  the  intro- 
duction of  tampons  saturated  with  a  decoction  of  galls — a  cosmetic  practice  very 
common  among  Roman  ladies  !  : — He  displays  a  knowledge  of  internal  investigation 
with  the  oiled  finger,  of  the  knee-elbow  position,  evacuation  of  the  bladder  by  the 
catheter,  and  rupture  of  the  membranes  to  aid  in  difficult  labor. — Version  may  be 
performed  by  either  the  head  or  feet  (and  indeed  in  living  children). — The  hand 
should  be  introduced  into  the  uterus  with  the  fingers  formed  into  a  cone.- — Mention  is 
made  of  dismembering  of  the  child,  craniotomy  etc. 

Attalus 

was  a  pupil  of  Soranus,  and  a  practising  physician  about  the  end  of  the  second 
century 

AlOSCHlON  UlORTHOTES 
(Muscio,  probably  in  the  6th  century  according  to  Val.  Rose)  also  wrote  on  diseases 
of  women.  His  manual  for  midwives  was  first  translated  into  Latin,  and  then  from 
this  back  again  into  the  Greek,  and  is  taken  from  the  work  of  Soranus;  at  least  it 
varies  very  little  from  the  latter  treatise.  He  opposes  the  theory  of  the  origin  of  the 
male  embryo  in  the  right,  and  of  the  female  in  the  left  side,  gives  correct]}-  the 
symptoms  of  incipient  abortion,  and  is  acquainted  with  face  presentations.  He  gives 
as  the  cause  of  fluor  albus  too  violent  sexual  desire,  and  teaches  that  the  umbilical 
cord  should  be  cut  with  a  knife  or  scissors,  instead  of  separating  it  (as  had  been  done 
from  antiquity  down)  with  a  piece  of  wood  or  a  hard  crust  of  bread.  The  menstrual 
blood  serves  during  pregnancy  as  nourishment  for  the  child  ;  hence  it  ceases  to  flow 
during  this  period,  and  is  secreted  during  the  intervals  of  pregnane}7.  After  severe 
diseases  it  also  ceases  to  flow,  and  is  devoted  to  strengthening  the  patient. 

The  following  passage  displays  close  observation  :  "  Sterilitj-  is  a  disease  common  to 
both  women  and  men  "  (in  the  latter  it  has  not  been  thoroughly  studied  until  recently). 
"In  men  it  is  occasioned  by  prolonged  bodily  weakness  etc.  ;  in  women,  when  they 
are  too  lean  or  too  fat,  when  the  mouth  of  the  womb  is  closed  or  too  narrow"  (this 
has  no  reference  to  Sims'  uterine  surgery,  for  by  the  mouth  of  the  womb  the  Ancients 
understood  the  introitus  vaginas)  "  or  beset  with  callosities,  indurations  or  ulcers." 

CJELIUS  Al'RELIANTJS, 

who  lived,  practised  and  taught  at  Rome  at  the  close  of  the  4th  or  the  beginning  of 
the  5th  century  A.  D.  ("though  Rohlfs  places  him  about  the  time  of  Galen),  was  a 
native  of  Sicca  in  Numidia.  His  writings  "On  chronic  diseases",  Questions  and 
answers  on  materia  medica.   and   "  On  diseases  of  women  ",  which  are  in  part  (espe- 

1.  It  may  be  remarked  here  that  an  historical  study  of  the  sexual  relations  and 
customs  of  different  people  and  ages  is  yet  to  be  written  ;  and,  disgusting  as  the 
subject  and  the  results  of  the  investigation  would  often  prove,  it  would  still  form 
an  important  chapter  of  the  history  of  humanity.  Dufour's  "  Histoire  de  la  Pros- 
titution" and  other  works  furnish  materials. 


—  145  — 

cially  the  latter)  translations  of  the  works  of  Soranus,  are  still  extant.  Gout  is  par- 
ticularly well  analysed  and  described,  and  the  same  may  be  said  of  hydrophobia. 
He  also  describes  a  kind  of  condensed  milk,  and  knows  of  additions  to  prevent  its 
becoming  sour  (limestone).  He  is  the  first  who  distinguishes  priapism,  satyriasis  and 
phthiriasis  as  special  diseases.  (Rohlfs.)  He  especially  advanced  differential  diag- 
nosis. Even  auscultation  is  hinted  at  in  his  works.  He  also  is  the  representative  of 
excellent  therapeutic  principles:  e.  g.  lie  does  not  wish  to  cure  the  fit  of  gout,  but  to 
guard  against  its  return;  he  mentions  the  benefit  of  nutritive  tnematn,  and  of  the 
exhalations  of  forests  in  diseases  of  the  chest  (recognized  also  by  Galen).  His  ideas 
on  diseases  of  the  nerves  and  mind  are  especially  important.  He  discarded  restraint, 
and  desired  isolation  of  the  patients.  We  are  chiefly  indebted  to  him  for  our  know- 
ledge of  the  views  and  principles  of  the  Methodists,  and  during  the  Middle  Ages  his 
books  served  as  the  guide  of  the  medical  study  and  practice  of  the  monks.  Bei.mcus 
and  Lucretius  were  his  pupils. 

Tli£_  following  ph}*sicians,  like  the  last  two,  are  known  by  name  only 
as  -Methodists":  Xenopiion  (he  named  the  different  parts  of  the  bod}*), 
Mhius  Promotus,  Dionysus.  Proculus,  Antipater,  Apollonius  of 
Cyprus.  Rhegintjs  etc. 

The  Methodists  were  finally  merged  into  the  following  schools,  but 
their  views  and  writings  continued  popular  until  far  into  the  Middle  Ages, 
and  have  appeared  with  some  changes  even  in  modern  times.  Inasmuch 
as  important  changes  in  the  social  position  of  physicians  in  the  Roman 
empire  were  connected  with  some  of  the  Methodists,  it  seems  most  appro- 
priate to  unite  with  what  precedes  the  consideration  of 

2.    THE  MEDIOAL  PROFESSION  A^D  MEDICAL  REGULATIONS  UNDER 
THE  ROMAN  EMPIRE. 

The  Romans  no  more  bred  a  medical  profession  than  they  created  a 
medical  science  of  their  own.  unless  we  include  under  this  head  the  Augurs, 
Haruspices  and  similar  ministers  of  superstition.  The  latter,  however,  did 
not  (as  among  other  people)  transform  themselves  in  course  of  time  into 
active  physicians.  In  the  medico-social  department  likewise  the  Romans 
remained  under  the  guidance  of  the  Greeks.  The  earliest  (and  most  of 
the  later)  regular  physicians  in  the  Roman  state  belonged  to  the  latter  peo- 
ple. They  were  accommodated  with  so-called  '•  medicinae",  public  shops,  in 
which  they  both  prescribed  and  prepared  and  sold  medicines.  These  shops 
corresponded  to  the  Greek  Tatreia,  and  in  some  respects  to  the  "  offices " 
of  American  physicians.  Unfortunately,  however,  in  the  beginning  the 
best  representatives  of  medical  science  did  not  come  to  Rome,  and  the 
innate  contempt  of  the  Romans  for  professional  medicine,1  together  with 
their  strong  national  hatred  for  the  Greeks,  was  only  promoted  by  the 
despicableness  of  the  first  so-called  Greek  physicians  (bathers,  barbers, 
and  the  like),  who  immigrated  into  their  state.     For  both  these  reasons, 

I.    Among  the   Romans   as   well    as   the    Greeks  (and    later   slave-holding  people   in 
general)  all  earning  of  money  by  either  !>.  dily  or  mental  labor  was  regarded  as 
plebeian,  or  suited  onlv  for  slaves 
10 


—   146  — 

therefore,  the  free  Roman  found  little  reason  to  ehoose  the  medical  profes- 
sion, which  was  among  the  Romans  always  a  completely  free  occupation. 
This  is  manifest  from  the  following  declaration  of  the  learned,  but  intensely 
Roman,  Pliny  : 

"The  dignity  (!)  of  the  Roman  does  not  permit  him  to  make  a  profession  of 
medicine,  and  the  few  Romans  who  begin  to  study  it  are  venal  renegades  to  the 
(Greeks." 

As,  however,  the  practical,  sober  thinking  Roman  learned  to  see  the  ad- 
vantage of  ph3'sicians  for  the  maintenance  and  increase  of  his  possessions, 
and  especially  of  his  slaves,  he  bought  in  foreign  lands  slaves  who  had  been 
alread}-  educated  as  phj-sicians,  or  he  allowed  his  own  slaves  to  be  brought 
up  as  ph}sicians  at  home  (medici  servi),  and  these  slaves,  in  consequence 
of  the  expense  bestowed  upon  them  and  the  profit  to  be  obtained  from 
them,  were  valued  above  all  other  living  possessions. 

"  Since  we  estimate  a  notary  as  worth  50  solidi  l$"J(50),  we  will  assume  physicians 
and  mid  wives  to  be  worth  60  solidi  (3FB15).1 

As,  however,  such  slaves  might  die  natural  deaths,  or  might  be  manu- 
mitted, the  close-fisted  old  Roman,  like  the  parsimonious  Italian  of  the 
present  da\T,  gladly  made  use  of  hired  slaves  of  this  kind,  among  whom 
there  must  have  certainly  been  some  magnificent  specimens  !  One  of  these 
e.  g.  served  his  master  first  as  compounder  of  poisons  ;  then  he  became  a 
thief  and  a  murderer,  so  that  his  tongue  was  finally  cut  out  and  he  was 
crucified  !  How  Liighly  (taken  as  human  beings)  such  servile  physicians 
were  valued,  and  how  far  they  were  considered  pure  wares  and  pieces 
of  movable  property,  is  proven  by  the  classico-economical  advice  of  the 
slave-breeding  Cato  : 

"Sell  the  old  cattle,  infirm  oxen,  worthless  sheep,  wool,  hides,  wagons,  old 
furniture — old  slaves,  sick  slaves — and  suchlike  things!" 

Freedmen  physicians  (medici  liberti)  were  employed  in  the  public  ser- 
vice (servi  vel  liberti  publici),  and  these  were  held  in  greater  esteem  than 
the  private  medical  slaves.  These  freedmen  were  frequently  manumitted  by 
their  masters  under  the  conditions  that  they  must  treat  their  friends  gratu- 
itously, and  in  case  of  necessity  support  the  masters  themselves  by  their 
practice. 

The  physicians  of  the  lower  class  were  also  frequently  emplo3'ed  as 
assistants  by  the  very  busy  higher  practitioners. 

1.  This  valuation  is  from  the  period  of  the  later  emperors.  Servile  physicians  were 
placed  under  the  control  of  an  overseer  (superpositus  medicorum).  The  position 
and  treatment  of  these  sl.ives,  however,  among  the  Ancients  was  entirely  different 
from  that  of  the  negro  slaves  of  modern  times,  and  in  the  later  times  of  the 
empire  they  became  so  numerous  as  to  far  exceed  in  number  the  free  citizens. 

(Baas.) 

The  same  law   estimated   the    value   of  an   ordinary   slave,   possessed  of  no 

trade,  at  20  solidi;  if  possessed  of  a  trade  (notaries  and  physicians  excepted),  at. 

SO  solidi.     But  an  ordinary  eunuch  was  valued  at  f>0  solidi,  and  if  possessed  of  a 

trade  his  value  rose  at  once  to  70  solidi.     (  H.) 


—   147  — 

A  few  only  of  the  Quirites  occupied  themselves  professionally  with 
medicine.  Most  of  the  physicians,  even  under  the  Empire,  were  Greeks 
(slaves)  and  Egyptians.  The  contempt  of  the  Romans  for  medical  men 
was  not  lost  even  when  better  physicians  came  from  Greece  and  received 
citizenship.  These  too  were  driven  away  !  This  feeling  changed  somewhat 
at  a  later  period,  when  citizenship  was  granted  by  Caesar  (B.  C.  100-44. 
Antistius  was  the  name  of  the  phj'sician  who  examined  his  death-wounds.) 
to  all  physicians.  Asclepiades.  and  Musa  especially  exercised  the  most 
permanent  influence  in  increasing  the  public  estimation  of  physicians.1 
From  this  period  forward  under  the  Empire  physicians  (in  glaring  contrast 
to  the  contempt  under  which  they  at  an  earl}'  period  labored)  were  favored 
almost  beyond  bounds.  For  the  physically  depraved  Romans  compre- 
hended tkeir  advantage  and  necessit}-  for  their  own  sickly  bodies.  Hadrian 
in  the  year  133  even  granted  them  immunity  from  taxes,  military  service 
etc.,  and  they  were  also  free  the  dut}'  of  supplying  post-horses  in  the  travels 
of  the  higher  officials.     (See  Ritter  von  Rittershain). 

The  emperors  created  court-physicians  and  physicians-in-ordinary 
(archiatri  palatini),2  as  well  as  city  and  district  physicians  (archiatri 
populares).  Municipal  physicians  with  a  salary  already  existed  in  imita- 
tion of  Greek  institutions.     The}'  were  called  archiatri  municipales. 

The  court-physicians  belonged  to  the  court  officials  of  the  second  rank,  and 
were  addressed  as  "prsesul  spectabilis".  The  honorary  titles  of  vir  perfeetissimus, 
vicarius,  conies,  and  even  of  dux  (a  ducal  or  princely  title)  were  assigned  to 
them,  proof  enough  that  the  Romans  since  the  days  of  the  Republic  had  lost  an 
immense  share  of  their  earlier  rustic  simplicity  and  vigor!  A  few  of  these  court  and 
ordinary  physicians  received  an  annual  salary  of  many  thousands,  exclusive  of  other 
emoluments.  Others  were  the  ordinary  physicians,  and  frequently  the  favored  lovers 
of  the  empresses.  When  thej'  withdrew  from  service  they  became  "ex-archiatn". 
Often,  however,  they  took  the  position  of  archiatri  populares  (or  voluntarily  permitted 
themselves  to  lie  transferred  thither),  since  this  office  seems  to  have  been  more  lucra- 
tive.— The  archiatri  populares  were  neither  purecommunal  physicians,  nor  Physikatf- 
arzte,3  nor  yet  professors  in  our  modern  sense,  but  in  one  and  the  same  person  repie- 
sented  all  these  three  offices  alternately.  They  were  chosen,  not.  by  the  government, 
but  by  the  citizens  and  the  municipality.  Antoninus  Pius  decreed  that  10  should 
be  chosen  for  large  cities,  7  for  medium-sized  cities  and  5  for  small  cities. 

The  Collegium  Archiatrorum.  which  was  composed  of  all  the 
archiatri  of  a  city,  received  the  candidate  into  the  ordo  (guild)  archiatro- 
rum, if  an  absolute  majority  of  voices  (in  Rome  7  out  of  12)  in  the  college 
voted  for  his  worthiness,  and  then  assigned  to  him  the  position  of  junior 
fellow  of  the  college. 


1.  Musa  by  his  successful  treatment  of  Augustus  earned  his  freedom,  Roman  citizen- 

ship, much   money,  and  the   knight's  ring,   the  latter  the   prototype  of  the  ring 
subsequently  placed  upon  the  finger  of  the  graduating  doctor. 

2.  Nero  employed   them   to  treat  the   bruises  contracted  during   his   Dightly   revels 

incognito  in  the  streets. 
X  .District  health  officers  with  extensive  powers  and  duties.     (H.) 


—   148  — 

The  choice  and  reception  were  to  he  made  solely  on  the  ground 
of  capacity,  and  not  through  the  recommendation  and  favor  of  the  influen- 
tial. In  a  similar  manner  the  vacancies  resulting  from  misfortune  or  death 
were  filled  anew.  If  all  these  formalities  had  been  fulfilled,  the  imperial 
confirmation  was  required  for  the  archiatri  palatini  only. 

The  archiatri  populares,  whose  numher  was  first  fixed  by  law  under  Antoninus 
Pius,  in  return  for  a  fixed  position  and  salary  (payable  semi-annually),  were  required 
to  treat  the  poor  gratis.  They  had  the  right,  and  it  was  their  duty,  to  teach  medicine, 
and  they  instructed  poor  students  without  pay.  They  received  from  the  municipali- 
ties an  extra  allowance  in  the  shape  of  the  products  of  nature,  and  both  portions  of 
their  pay  were  to  be  delivered  without  deduction  so  long  as  they  held  the  office.  In 
their  private  practice,  however,  they  could  also  accept  fees  and  donations. 

"  They  shall  have  an  annual  salary,  in  order  that  they  may  honorably  serve  the 
poor,  rather  than  basely  grovel  before  the  rich.  We  also  decree  that  they  may 
accept  something  for  their  services  from  those  who  have  recovered  and  offer  it  to 
them,  but  not  from  those  who  are  yet  in  danger  from  disease."     (A.  1).  370). 

The  archiatri  populares  (who  were  similar  in  functions  to  our  Physikatsarzte, 
except  that  they  were  not  legal  physicians  to  furnish  judicial  opinions)  might  also  lie 
removed  on  obtaining  the  opinion  of  reputable  colli  ges.  Any  insult  offered  them 
exposed  i he  offender  to  a  fine  not  to  exceed  $;">000. 

The  colleges  of  the  archiatri  had  the  oversight  of  the  ordinary  practis- 
ing physicians  (artifices),  among  whom  there  were  Jews,  even  in  Rome  as 
early  as  the  first  century.  The  income  of  these  practising  physicians  de- 
pended upon  their  fees  alone.  These,  provided  the  physician  belonged  to 
the  freeborn.  could  also  be  sued  for  at  law.  From  this  rule  was  excepted, 
however,  whatever  fees  a  sick  person,  in  danger  of  dying,  had  promised  to 
pay,  or  had  left  to  the  physician  in  his  will.  The  number  of  these  ph}'- 
sicians  must  have  been  large.  At  first  the}-  enjoyed  almost  equal  privileges 
with  the  archiatri  At  a  later  period,  however,  their  rights  were  more  cir- 
cumscribed, 3"et  there  was  always  guaranteed  to  them  an  honorable  posi- 
tion, particularly  to  those  who  settled  in  their  native  city. 

"  We  ordain  that  physicians,  and  above  all  archiatri  and  ex-archiati  i,  together 
with  their  wives  and  children,  as  well  as  their  property,  shall  be  free  from  every 
payment  of  taxes,  and  from  all  offices  both  public  and  civil;  and  that  they  shall  not 
be  compelled  to  entertain  public  guests  in  the  provinces,  nor  in  any  way  to  administer 
a  public  office;  nor  shall  they  be  summoned  to  defend  themselves  in  court,  nor  cited 
before  the  Imperial  court  outside  of  their  province;  nor  shall  they  he  insulted  in 
any  way,  but  whosoever  insults  them  shall  be  punished  according  to  the  special 
judgment  of  the  magistrate  alone.  We  command  that  a  stipend  and  salary  he  given 
to  them,  in  order  that  many  of  them  may  the  more  readily  devote  themselves  to  the 
liberal  studies  and  the  beforeineutioned  arts.'' 

Hence  the  rush  for  the  lucrative  medical  profession  was  immense, 
particularly  as  from  the  outset  it  fell  under  the  laws  of  free-trade,  and  thus 
the  door  was  widely  opened  to  the  ignorant  and  impure  elements  of  society. 
The  latter  availed  themselves  too  so  freely  of  their  opportunities,  that  in 
(ialen's  day  many  so-called  physicians  could  not  even  read  perfectl}-. 

That  the  number  of  physicians  in  ancient  times  was  generally  very 
large  is  rendered  certain  from  the  following  considerations.     If  the  conclu- 


—   149  — 

sion,  that  in  times  when  there  are  many  physicians,  much  will  also  be  writ- 
ten on  medical  subjects,  is  as  just  (and  it  is  verified  by  our  experience 
to-day)  as  that  other  conclusion,  also  depending  upon  direct  daily  obser- 
vation, that  when  there  are  man\'  physicians  there  will  be  also  much  '•  doc- 
toring" and  medication,  then  it  follows  from  the  number  of  medical  authors 
known  by  name  from  the  period  of  the  School  of  Alexandria  down  to  the 
time  of  Galen,  that  there  must  have  been  at  that  period  a  very  considerable 
number  of  physicians— a  number  quite  as  considerable  in  proportion  to  the 
population  of  the  period  as  it  is  to-day. 

According  to  Strabo  (  B.  C.  66-A.  D.  2;!),  there  were  district  physicians,  even  in 
the  country,  in  Gaul  about  the  time  of  Christ  (Haeser),  and  consultations  (always  a 
sign  of  too  much  of  a  good   thing)   became 'at  an   early   period  so  great  a,  nuisance 

*r-  .  .  .     . 

that  Hadrian  conceived  the  idea  thai  th?  number  of  physicians  called  in  as  counsel  in 
his  illness  contributed  to  his  mill ! 

Accordingly  there  appeared  a  phenomenon  which  always  manifests  it- 
self when  the  profession  is  overstocked.  Among  these  physicians  were 
many  specialists,  numerous  oculists,  aurists,  surgeons,  dentists,  uroscopists, 
specialists  in  bleeding,  catheterization  and  clysterization,  herb-doctors, 
milk-doctors,  gynaecologists  (paints,  tooth  powder  etc.,  of  which  the  ladies 
made  great  use,1  belonged  in  their  department),  movement-curers.  special- 
ists in  private  diseases,  in  the  treatment  of  h'stuhe,  in  the  cosmetic  art, 
hair-doctors,  wine-doctors  (in  the  style  of  the  cider  and  perry-doctors 
appearing  in  the  German  capital),  hernia-doctors  etc..  etc. 

Among  the  oculists  we  may  mention  the  famous  Cbarmis  'about  A.  I).  33),  who 
was  paid  for  the  cure  of  a  single  patient  about  $10000:  P.  Decimius  a  clinical 
physician  and  oculist,  who  left  a  fortune,  although  he  had  been  a  slave:  Gaius  and 
Euelpides  (about  A.  D.  54 I:  Zoilus  (about  A.  D.  G9).  Their  ointment-pots  and 
business-stamps  have  been  found  almost  everywhere  where  Roman  legions  were 
stationed.'2 


1.  Martial  says: 

"  When  thou  at  home  and  absent,  borrowed  hay  re 
And  tyres  for  thee  the  shops  doe  still  prepare  ; 
When  teeth  as  cloaths,  at  sleeping  times  layd  by, 
Thj'  face  at  night  doth  never  with  thee  lye; 
Locked  up  in  hundred  boxes;  whence  i'  the  morne, 
That  looke  they  bring  thee  out  is  next  day  worne." 

(Old  translation.)     (H. ) 

2.  If  from    remedies   one   may  infer  the  diseases    for   which    they   were    employed, 

trachoma  must  have  been  very  frequent-among  the  Roman  soldiers;  for  sulphate 
of  copper  is  one  of  the  remedies  most  frequently  found.  That  the  stamps  of  so 
many  oculists  have  been  preserved  depends  upon  the  fact  that  all  ophthalmic 
troubles  (myopia,  presbyopia  etc. )  in  antiquity  were  treated  solely  by  medication, 
for  glasses  were  unknown.  From  the  expression  "Ad  claiitatem"  sc.  visas,  it 
may  be  inferred  that  remedies  supplied  with  this  label — chiefly  balsamic  prepara- 
tions, which  are  employed  even  to-day  to  "  strengthen  "  the  eyes,  when  glasses 
are  really   required- — were  used  for  defects  of  vision.      The   "oculists"   whose 


._  150  — 

False  teeth,  and  sets  of  teeth  constructed  of  ivory  fastened  with  gold  wire, 
existed  as  early  as  the  Laws  of  the  Twelve  Tables. 

"  In  Rome  this  evil" — and  the  decay  of  science  and  practice  which  accompanies 
it  and  is  always  one  of  the  symptoms  of  the  decline  of  the  moral  power  of  all  national 
spirit,  —  "reached  its  acme,  and  a  condition  was  developed,  which,  in  all  its  repulsive- 
ness,  stands  at  the  present  day  daily  and  hourly  before  our  eyes."  (Haeser.)  The 
hereditary  vices  of  the  medical  profession,  vices  depending  upon  the  uncertainty  of 
therapeutic  skill  and  the  associated  precariousness  and  uncertainty  of  external 
existence,  upon  which  the  laity  at  that  time  poured  out,  their  contempt,  and  con- 
cerning which  physicians  raised  loud  lamentations  —  colleagueship,  even  then,  as 
to-day,  often  a  synonym  for  professional  jealousy,  reciprocal  open  and  secret  dis- 
paragement, envy,  want  of  esprit  du  corps,  flattery  of,  and  fawning  upon  patients 
and  their  friends,  open  and  secret  dishonesty,  greed  and  covetousness,  abandonment 
of  scientific  effort,  forgetfulness  of  the  humane  side  of  the  profession  etc.,  etc.  — arose 
to  frightful  proportions;  so  that  Galen,  who  had  a  just  and  noble  conception  of  his 
calling  (doubtless  influenced  by  a  feeling  of  sickness  springing  from  his  love  for  his 
profession),  complains  :  "There  is  no  distinction  between  robbers  and  physicians, 
except  that  the  former  commit  their  misdeeds  in  the  mountains,  the  latter  in  Rome." 
The  satirists  even  accused  some  physicians  of  theft  while  visiting  their  patients,  e.  g. 
of  breaking  out  the  precious  stones  forming  the  eyes  of  statues  etc. 

Of  course  the  dear  public  bore  then,  as  it  bears  now,  a  great  share  of  the  blame 
of  these  lamentable  errors;  for  Galen  says  further:  "The  public  call  not  the  best 
physicians,  but  rather  those  who  humor  their  caprices.  Where  no  thought  is  given 
in  the  choice  of  a  physician  to  any  difference  in  individuals,  but  the  good  and  bad 
pass  for  equals,  there  each  physician  keeps  mainly  in  view  what  he  may  acquire 
without  labor,  and  what  offers  a  prospect  of  gain."  The  public  loved  too  what  it 
could  not  understand  :  "People  who  understand  no  Greek  place  no  confidence  in  a 
physician  who  does  not  practise  his  art  in  the  Grecian  style;  indeed  they  have  less 
confidence  when  they  understand  what  serves  to  cure  them''  (Pliny.)- — just  as 
with   us! 

How  the  public  of  that  day  was  cajoled  may  be  inferred  from  the  following 
account  of  the  same  author,  who  was,  however,  by  no  means  a  cool  and  unprejudiced 
judge:  "  Under  the  reign  of  Nero  the  whole  world  went  over  from  Vettius  Valens 
to  Thessalus,  who  discarded  all  preceding  prescriptions  and  wrathf'ully  inveighed 
against  the  physicians  of  every  age;  with  what  discretion  and  talent  may  be  seen 
from  the  fact  that  he  called  himself  upon  his  tomb-stone  the  "Conqueror  of  physicians." 
No  charioteer  or  play  actor  had  so  great  a  following  upon  the  streets.  Tl  en  Crinas 
of  Marseilles  got  the  start  of  him,  while,  under  the  guise  of  greater  carefulness,  he 
combined  medicine  and  astrology,  and  devoted  attention  to  the  hours.  These  men 
guided  Rome,  until  suddenly  Charmis  of  Marseilles  invaded  the  city,  and  not  only 
condemned  the  earlier  physicians,  but  also  their  warm  baths,   and    prescribed   cold 


stamps  have  been  found  were  mostly  dealers  in  ophthalmic  remedies,  probably 
the  agents  of  physicians.     (Baas.) 

The  "collyria"  of  the  Ancients  were  of  the  consistencj'  of  our  extracts  or 
soaps,  and  bore  like  our  toilet  soaps,  the  stamp  of  the  proprietor  or  inventor. 
The  vessels  in  which  these  collyria  and  eye-salves  were  stored,  and  even  the 
remedies  themselves  bearing  the  stamps  in  question,  have  been  found  in  great 
numbers  in  Germany,  England  and  France,  most  frequent]}*  in  localities  where 
permanent  camps  of  the  Roman  legions  are  known  to  have  been  situated.  As 
an  example,  I  quote  from  Haeser:  C.  CINTVSMINI  BLANDI  EVVODES  AD 
ASPR.     (Caii  Centusminii  Blandi  Euodes  ad  aspritudinem).     (H.) 


—  151  — 

lotions  even  in  the  middle  of  winter,  having  the  sick  dipped  into  the  lakes.  And 
there  is  no  doubt  that  all  these  physicians  desired  to  gain  reputation  by  novelties,  and 
thus  tampered  with  our  lives.  Hence,  too,  their  lamentable  quarrels  at  the  sick  bed, 
where  none  of  them  hold  the  same  opinion  for  fear  of  appearing  the  follower  of  some 
one  else.  Daily  is  this  art  changed''  (as  was  said  also  by  Gutzkow),  "  and  it  is  <eriain 
that  as  soon  as  one  of  them  is  skilled  in  oratory,  he  becomes  at  once  the  arbiter  of 
life  and  death  among  us." 

Besides  the  persons  already  mentioned,  doctresses  and  midwives  also 
practised  medicine,  and  the  latter  at  an  early  period  even  exercised  official 
functions  as  experts  before  the  courts.  In  this  event  five  midwives  were 
summoned  as  a  jury,  and  three  brought  in  a  verdict.  In  difficult  cases 
physicians  might  also  be  called  in,  but  as  a  rule  the  midwives  alone 
attended  even  the  worst  cases.  In  later  times  the  latter  formed  a  guild. 
Innumerable  bath-keepers  (to  whom  the  physicians  not  infrequently  aban- 
doned entirely  chronic  cases),  barbers,  gladiatorial  physicians  (iatroliptse, 
aliptse),  theatrical  physicians,  magicians  and  exorcists  (who  were  not.  how- 
ever, considered  physicians)  etc.,  dabbled  in  medicine  in  all  possible  and 
impossible  ways  —  exactly  as  the}-  do  with  us. 

Ignorant  physicians  decorated  their  shops  and  boxes  with  all  sorts  of  trifles  in 
order  to  attract  the  masses;  others  even  invited  patients  in  from  the  streets  (hired 
servants  attend  to  this  business  now-a-days).  Charlatans  operated  upon  a  kind  of  stage 
(as  is  done  to-day  in  Italy  by  the  itinerant  successors  of  these  lower  physicians),  and 
carried  these  stages  about  with  them,  as  was  done  as  late  as  the  last  century  by  Dr.  Eysen- 
barth  &  Co. — an  evidence  that  antiquity  furnished  the  classical  model  for  this  custom. 

The  honorarium  of  the  physician  for  an  ordinary  visit  amounted  to 
about  29  cents,  though,  according  to  Pliny,  competition  frequently  reduced 
the  fee.  Still  distinguished  physicians  in  special  cases  received  such  fees 
as  Pope  Pius  IX.  was  able  to  pa}*  out  of  his  Peter's  pence,  but  are  not  met 
with  to-day  among  private  individuals  even  in  England  and  America.  Thus 
Galen  for  a  single  case  received  a  fee  of  $2100,  while  others,  like  Crinas  of 
Marseilles,  were  able  to  acquire  such  wealth  that  they  furnished  cities  with 
walls  —  such  parties  with  us  would  provide  themselves  rather  with  fire- 
proof safes —  and  yet  retained  more  than  half  a  million  dollars!  The 
surgeon  Alcon  under  Claudius  was  able,  and  was  compelled,  to  pay  a  fine 
of  more  than  half  a  million  dollars,  and  yet  soon  made  up  the  sum  again. 
From  such  instances  (which  were,  however,  quite  exceptional)  the  old  saying 
"Galenus  dat  opes  !"  may  have  had  its  origin.  A  large  number  of  phy- 
sicians, however,  must  have  lived  in  poverty  and  even  absolute  want.  This 
may  be  inferred  from  the  system  of  robbery  which  Ulpian  was  forced  to 
oppose  in  his  ordinance  providing  that  a  physician,  who  by  his  treatment 
had  exposed  any  one  to  the  danger  of  losing  his  sight  or  similar  injury,  and 
should  then  persuade  the  patient  to  sell  him  any  of  his  property  below  its 
actual  value,  on  condition  that  he  should  cure  him  again,  should  be  com- 
pelled to  disgorge  all  his  plunder  !  The  wealthy  had  their  family  physicians 
who  enjoyed  a  high  salary,  payable  usually,  like  medical  fees  in  general,  on 
the  first  of  January. 


-  152  — 

The  deportment  of  physicians  wus  the  same  that  it  has  ever  been, 
even  down  to  our  own  day.  Some  cringed  in  apparent  humility,  others 
strutted  in  ostensation  ;  some  behaved  rudely  and  smelt  of  wine  and 
onions,  as  e.g.  Quintus  ;  others,  and  undoubtedly  many,  behaved  worthy  of 
their  high  calling.  Yet  of  these  latter  history  always  takes  less  notice  than 
of  the  excesses  of  the  bad  ! 

Each  cohort  (420  men)  employed  four  military  physicians,1  whose  pay 
consisted  partly  of  monej',  partly  of  natural  products.  According  to  other 
authorities,  however,  each  legion  often  cohorts  had  one  legionary  physician, 
and  only  ten  cohort  physicians.  The  latter  ranked  as  subalterns.  In  the 
navy  also  there  was  one  plnsician  to  each  trireme.  A  few  of  these  navy 
physicians  (and  probably  of  the  cohort  physicians  also)  received  a  double 
salary,  as  a  distinction  and  reward  of  merit.  The  administration  of  the 
army  hospitals  was  assigned  to  proper  officials  (prtefectus  castrorura, 
tribunus,  comes),  to  whom  the  physicians  were  subordinate.  Still  there 
were  no  field-hospitals  in  our  sense  of  that  term.  The  badly  wounded  were 
placed  in  tents  in  the  camps  <  valetudinarium),-'  and  there  were  also  bathing 
establishments  for  the  soldiers.  The  wounded,  when  it  was  possible,  were 
carried  to  the  neigboring  cities,  after  having  been  borne  immediately  into 
camp.  Each  soldier  carried  with  him  the  most  necessary  bandages  already 
prepared  for  use,  an  arrangement  which  we  have  only  recently  adopted. 

The  Ronians  had  already  observed   that   military  service  contributed  to  health : 
Expert  military  men   are  of  the  opinion   that   daily  exercise   contributes   more  to 
health  than  all  physicians.' 

In  early  times  medical  instruction  was  imparted  by  individual  phy- 
sicians in  return  for  a  certain  specified  honorarium.  Subsequently  the  in- 
struction was  given  chiefiy  by  the  archiatri,  and  in  their  (guild)  colleges, 
which  served  as  the  model  of  the  guilds  of  the  surgeons  etc.  in  mediaeval 
times.  Students  were  also  educated  in  the  higher  schools,  which  first  arose 
in  Rome  during  the  reign  of  Nero,  but  existed  too  at  an  early  period  in  the 
provinces  (at  Marseilles  in  Gaul  etc.).  Pure  medical  schools,  however,  did 
not  exist  among  the  Romans.  Alexander  Severus  gave  a  salary  and  lecture 
rooms  to  the  medici  scholares  (professors).  The  latter  often  took  their 
pupils  with  them  to  their  bedside,  and  this  custom  gave  occasion  for  the 
satirical  complaint  to  which  Martiai  gave  utterance  : 

"  Languebam,  sed  tu  comitatus  protinus  ad  me 
Venisti,  centum,  Symmache,  discipulis; 
Centum  me  tetigere  manus  Aqnilone  gelatae. 
Non  habui  febrem,  Symmache,  nunc  babeo."3 

1.  Not,  however,  until  the  beginning  of  the  Empire. 

2.  Valetudinaria  were  established  as  soon  as  five  or  six  legions  were  associated  in 

service.     They  were  placed   on   the   left  of  the  porta  praetoria,   and  were  60  feet 
square.     Bathing  facilities  were  only  exceptional.     (H.) 
3. —  "Faint  was  I  only,  Symmachus,  till  thou, 

Backed  by  ati  hundred  students,  throng'dst  my  bed; 

An  hundred  icy  fingers  chilled  my  brow; 

I  had  no  fever;   now  I'm  nearly  dead!"     (H.) 


—  153  — 

As  a  rule  the  physicians  visited  their  patients,  though  the  slightly  indis- 
posed also  went  to  the  offices  of  their  medical  advisers.  Famous  physicians 
gave  consultations  in  writing,  and  even  furnished  medicine  to  patients  in 
foreign  countries,  as  we  shall  see  done  also  at  a  later  period.  The  phy- 
sicians often  publicly  defended  their  views  and  prescriptions  when  these 
were  attacked  by  their  good  colleagues,  a  custom  which  depended  upon  the 
general  publicity  of  ancient  life  as  compared  with  our  own.  which  is  passed 
so  largely  within  the  limits  of  four  walls.  Thus  Galen  e.  g.  and  his  pupil 
Teuthras  catechised  each  other  on  such  occasions,  and  our  modern  journal- 
ism would  have  made  brilliant  use  of  these  medical  discussions.  Among 
the  Arabians  too  at  a  later  period  physicians  and  savants  furnished  striking 
examples  of  this  learned  logomachy.. 

Hospitals  for  slaves  only  (valetudinaria  and  veterinaria)  were  to  be 
found  upon  farms,  and  probably  also  in  the  city,  in  the  days  of  the  Republic 
and  the  first  emperors.  These,  however,  were  maintained  simply  for  the 
purpose  of  protecting  their  proprietors,  as  far  as  possible,  from  pecuniary 
loss,  and  not  from  motives  of  charity,  a  sentiment  which  first  manifested 
itself  in  the  erection  of  such  institutions  during  the  times  of  Christianity.1 
Upon  the  estates  the  "  Vilicus"  or  "Vilica"  had  the  oversight  and  the 
distribution  (if  the  sick,  though  the  proprietor  himself  was  often  the 
physician.  During  the  decline  of  the  empire  no  physicians,  of  course,  took 
care  of  the  many  children  who  were  exposed.  Nerva  ( A.  1).  96-98),  how- 
ever, had  inaugurated  antique  foundling  asylums,  in  which  the  annual  cost 
of  individual  maintenance  amounted  to  about  $7.50.  Antoninus  too  had 
constructed  a  hospital  for  parturient  women,  a  sort  of  lying-in-hospital  and 
home  for  convalescents  combined.  This  was  located  in  Argolis.  (See 
Lerch,  "Geschichte  der  Balneologie  ",  p.  118.)  Hospitals  proper,  therefore, 
in  our  sense  of  the  term,  did  not  originate  until  Christian  times  ;  for  the 
Romans  — probably  with  some  justice,  in  consequence  of  the  violent  separa- 
tion of  the  sick  from  their  ordinary  relations  and  conditions  of  life — regarded 
such  institutions  as  inhuman,  even  in  periods  when  epidemics  prevailed. 
Public  hygiene,  as  we  designate  it  to-day,  was  placed  in  charge  of  the  sedi- 
les,  who  were  provided  with  the  most  absolute  authority.  It  was  their  duty 
to  look  after  the  aqueducts,  drainage  (e.  g.  of  the  Pontine  marshes,  where 
remains  of  works  supposed  to  have  been  constructed  before  the  Roman 
age  have  been  recently  discovered),  the  building  of  cloacae  or  sewers  and 
their  preservation,  the  sanitary  condition  of  the  streets  and  houses  etc.,  for 
which  objects  they  provided  immense  means,  chietiy  from  their  own  private 
purses.  We  have  no  information  as  to  whether  they  called  in  physicians 
for  advice,  but   it  is   improbable,  for  no  employment  of  physicians  by  the 


1.  Christian  institutions  of  charity  and  hospitals,  though  actually  originating  in  the 
later  periods  of  Antiquity,  we  shall  present  in  our  description  of  the  Middle  Ages. 
For  in  spirit  they  belong  entirely  to  this  period,  and  are  absolutely  without  any 
intimate  relation  to  Gneco-Roman  antiquity.  Even  in  point  of  time,  it  is  only 
their  earliest  development  that  can  be  assigned  to  Antiquity. 


—  154  — 

state  for  sanitary  or  legal  purposes,  as  experts  before  the  courts  etc,  was 
introduced  among  any  of  the  nations  of  antiquity.  The  baths,  which  were 
in  almost  daily  use  among  all  the  Ancients,  and  were  also  retained  through- 
out the  whole  Middle  Ages,  must  be  considered  institutions  of  public 
hygiene,  inasmuch  as  their  building  and  maintenance  were  chiefly  provided 
for  by  the  treasury  of  the  state  or  municipality,  and  they  were  therefore 
under  governmental  oversight  (except  in  the  matter  of  morality).  This  is 
true  especially  of  the  time  when  oriental  manners  had  not  yet  corrupted 
the  Romans,  as  they  did  under  the  Empire,  and  when  the  baths  retained 
their  simple  character,  instead  of  being  artistically  decorated  places  of  ren- 
dezvous for  men  and  women.     A  bath  cost  about  half  a  cent. 

Pharmacies  and  apothecaries  equivalent,  or  similar,  to  ours  of  the 
present  day  did  not  exist  among  the  Romans.  Even  the  most  distinguished 
physicians  prepared  their  own  medicines,  or  at  least  kept  them  on  hand. 

These  medicines  bore  labels,  which  made  known  the  name  of  the  drugs,  the 
directions  for  their  use,  the  diseases  for  which  they  were  designed,  and  the  name  of 
the  inventor,  in  which  respect  they  filled,  in  some  degree,  the  place  of  our  modern 
advertisements.  The  physicians  had  too  their  own  boxes  for  medicines  and  medical 
weights,  which  were  often  beautifully  decorated. 

Indeed  they  often  collected  drugs  for  themselves  (as  e.  g.  Galen),  in 
order  to  have  them  genuine.  The  selection  and  preparation  of  drugs  was 
indeed  one  of  the  most  important  duties  of  the  earlier  physicians.  The 
most  expensive  drugs  were  then  too  regarded  as  most  efficacious.  The 
Seplashe  and  Seplasiarii1  dealt  only  in  drugs  and  the  ointments  used  in 
the  daily  baths.  The  ordinary  simple  internal  remedies  were  prepared  at 
home.  In  the  later  da}-s  of  the  Roman  Empire,  however,  special  formulae 
like  electuaries  (electuaria),  eye-salves  and  lotions  (collyria),  plasters 
(emplastra)  and  emollient  poultices  (malagmata),  were  kept  and  adulter- 
ated (for  there  was  no  oversight  of  the  matter  b}T  the  state)  in  the  officinae 
of  the  Seplasiarii.  "Apotheca  "  at  this  period  signified  a  wine-room,  though 
not  in  the  euphemistic  sense  of  the  term  employed  to-day.'2 

"The  physicians  —  many  scarcely  know  the  names  of  the  drugs  —  trust 
to  the  Seplasiarii,  who  always  adulterate  their  medicines  and  sell  old  plas- 
ters and  collyria  and  drugs  spoiled  by  age." 

Even  the  same  Pliny,  who  had  a  genuine  hatred  for  physicians  and 
tradesmen,  and  is  not  therefore  a  reliable  witness,  but  seems  rather  to  have 
been  a  scandal-monger,  names  the  latter  class  flatly — poison  mixers  (medi- 
camentarii).  The  same  statements  apply  to  the  terms  Pharmacus  and 
Pharmaceutria,  which  designated  male  and  female  poisoners,  sorcerers 
and  sorceresses. 

1.  The  grocers  and  sellers  of  toilet-articles  among  the  Romans. 

2.  The  "apotheca"  was  a  room  in  the  upper  part  of  the  house,  in  which  the  amphorae 

were  stored.  No  Roman  kept  his  wine  in  a  cellar,  as  we  employ  the  term.  Even 
the  "  cella  vinaria"  was  above  ground,  and  an  ancient  Roman  brought  down  his 
wine,   instead  of  bringing  it  vp,    as  we  do.      (H.) 


—  155  — 

Pharmaceuta,  on  the  other  hand,  was  the  title  of  one  who  occupied 
himself  with  the  healing  art  and  the  preparation  of  drugs.  The  Pbarmaco- 
polse  (who  may  be  considered  as  about  equivalent  to  our  apothecaries)  sold 
simple  drugs  and  also  put  up  prescriptions.  The}*  travelled  about  from 
place  to  place,  and  among  the  Romans  passed  for  charlatans  and  mounte- 
banks "  to  whose  words  we  listen,  but  to  whom  no  invalid  trusts  himself." 

Besides  the  persons  already  mentioned,  the  so-called  Herbarii  also 
furnished  physicians  and  the  public  with  drugs.  Under  this  title  were 
understoo(j_those  who  gathered  and  dried  the  drugs  in  question,  or  reduced 
them  to  a  salable  form.  On  the  other  hand,  the  Pharmacotritae  corres- 
ponded to  our  drug-powderers  of  to-da}T,  but  were  in  ancient  times  an  in- 
dependent trade. 

The  price  of  drugs  was  in  some  cases  very  high:  thus  500  grammes  of  the 
balsam  of  Gilead  cost  at  the  place  of  collection  nbout  $54,  in  Rome  $187:  500 
grammes  of  nard  leaves,  $7. 30-$14:  500  grammes  of  spike  of  nard,  $19  :  500  grammes 
of  oil  of  the  folia  malabathri,  $75:  500  grammes  of  pepper,  $0.75-3.00  etc.  (Mar- 
quardt,  Roem.  Privatalterthiimer,  1867.) 

On  the  whole,  the  reputation  of  all  the  last-mentioned  branches  of 
business  was  very  equivocal,  since  all,  without  exception,  dabbled  occasion- 
ally in  the  sale  of  poisons  etc.,  and  especially  in  those  abortive  remedies 
which  prevented  Roman  wives  and  maidens  from  becoming  mothers, 
whether  within  or  without  the  bonds  of  matrimony.  In  addition,  they  had 
a  monopoly  of  the  treatment  of  secret  diseases.  The  annual  income  of 
some  of  these  fellows  frequenth*  amounted  to  as  much  as  $12,000-24,000. 
The  position  of  the  true  ph}-sician,  in  contrast  with  that  of  such  characters, 
Galen,  however,  considers  quite  regal,  for  he  compares  the  former  to  an 
architect,  while  the  latter  are  placed  in  rather  disreputable  company. 

"As  he  stands  in  comparison  with  the  carpenters,  laborers  and  tradesmen,  so  the 
physician  stands  in  comparison  with  his  servants,  the  rhizotomists,  ointment-mal  <  rsr 
cooks,  plaster-spreaders,  poultice-makers,  administrators  of  clysters,  bleeders  and 
cuppers." 

The  worst  sort  of  drug-sellers  in  Rome,  however,  were  without  doubt 
the  "Medicae",  usually  old  prostitutes,1  and  the  "  Sagaa  ",  who  treated  the 
diseases  of  women  and  prepared  love-philters  and  abortive  drinks,  and  mur- 
dered and  exposed  children. 

In  times  of  the  greatest  corruption  their  commissions  for  the  latter  business  were 
especially  frequent.  Among  the  Greeks  and  Romans  the  life  and  death  of  children 
rested  upon  the  authority  of  the  parent,  a  barbarity  which  Christianity  was  the  first 
to  set  aside.  Gangs  of  these  medicas  and  saga?  were  especially  numerous  in  the 
degenerate  age  of  the  empire,  and  pandered  to  the  most  shameless  and  vicious  d(  sires 
of  the  corrupt  circles  of  the  court  world.  They  practised  the  introduction  of  tampons 
for  the  prevention   of  conception  (a  custom   recently  preached  up  among  us  on   neo- 

1.    The  number  of  meretrices  in  the  later  days  of  Rome  was  very  great.     They  were 
to  be  enjoyed  at  rates  varying  from   one  cent  up  to  $:->75  pro  dosi,   according  to 
their  beauty,  youth  etc.      From   the  time  of  Caligula  a  tax  was  laid  upon   this 
rofession,  a  fact  which  the  popes  in  later  times  recalled  to  remembrance. 


—  156  — 

Malthusian  grounds);  indeed  the  depravity  of  the  time  went  so  tar  tint  even  as 
emperor's  daughter  (Julia)  exposed  her  person  in  the  forum,  and  some  emprtsses 
roved  about  the  city  at  night  like  ordinary  nymphes  dn  pa\e,  si  eking  oppoilunities 
for  prostitution  (  Messalina).  Occasionally,  too,  crowned  debauchees  and  prostitutes 
ruled  the  world,  and  for  the  honor  of  humanity  we  must  consider  them  insane  victims 
of  satyriasis  and  nymphomania! 

3.    THE  FUNDAMENTAL  AMD  ACCESSARY  SCIENCES.    COMPILATIONS  IN 
PHYSICS  AND  MEDICINE. 

The  external  existence  of  the  Romans  under  the  Empire  was  entirely 
changed  from  what  it  had  been  in  earlier  days.  Canals,  military  roads  (a 
map  of  which  still  exists  unter  the  title  Tabula  Peutingeriana),  postal 
arrangements,  institutions  for  the  care  of  the  sick,  for  the  education  of 
youth  and  the  support  of  the  needy,  police  protection  and  regulation,  as 
well  as  a  care  for  law  and  justice  extending  to  every  quarter  of  the  Empire, 
were  at  this  period  —  the  beginning  of  the  Christian  era  —  the  chief  sub- 
jects to  which  the  activity  of  the  government  was  directed/'  (Schlosser.) 
But  the  old  force  was  gone.  Wealth,  avarice,  the  unbounded  enjoyment  of 
pleasure  and  sensualit}-,  had  introduced,  as  Livy  complains,  the  desire  to 
ruin  everything  with  luxury  and  lust. 

Hence  the  higher  problems  of  science,  even  in  the  early  days  of  the 
Empire,  after  the  time  of  Augustus,  began  to  lose  their  attractiveness  for 
the  Quirites,  who,  through  their  subjugation  of  the  then  known  world,  had 
become  wealthy  without  actual  labor,  and  were  ruined  b}T  slavery.  They 
were  introduced  b\'  the  influence  of  the  numerous  Greek  immigrants  to 
unwonted  luxury,  and  to  a  refinement  of  spirit  and  necessities  heretofore 
unknown. 

Besides  the  Romans  never  possessed  a  creative  talent  for  the  depart- 
ment of  medicine,  and  among  the  Greeks,  robbed  of  their  native  land  and 
maintaining,  therefore,  only  a  moribund  spiritual  life,  it  fell  likewise  gradu- 
ally into  a  decline. 

After  the  time  of  Asclepiades,  the  founder  of  ancient  Solidism  (as 
among  the  Greeks  after  Hippocrates,  the  father  of  Humorism,  and  in  the 
almost  purely  Grecian  city  of  Alexandria),  there  began,  therefore,  in  Rome, 
upon  a  foreign  soil  and  intermixed  with  Roman  and  foreign  elements, 
though  under  Grecian  guidance,  the  invention  of  medical  systems  with  all 
their  follies,  —  dialectic  subtilt}-,  literary  wrangling  and  mental  hair- 
splitting. The  spirits  of  the  better  class,  indeed,  sought  their  reputation 
in  struggling  against  this  tendency,  often  by  astonishing  displays  of  erudi- 
tion and  by  most  comprehensive  compilations  (the  offspring  of  erudition), 
but  they  thus  fell  into  Eclecticism,  in  which  creativeness  is  always  wanting. 
Moreover  the  majority  of  physicians  busied  themselves  with  a  subject  easy 
under  all  circumstances  and  often  ridiculous  and  even  absurd  —  the  inven- 
tion of  compound  remedies  and  the  resulting  miraculous  and  superstitious 
specifics,  with  which,  then  as  now,  medical  art  deluded  the  unreasoning- 
mass  of  the  educated  and  uneducated.     Thus  the  productive  scion  of  the 


—  157  — 

ancient  sciences,  engrafted  by  the  over-refined  Greeks  upon  the  rude  but 
sturdj'  Roman  stock,  began  to  decay  again  more  rapidly  than  we  should 
expect  in  so  vigorous  a  people.  But  public  and  private  morals,  and  with 
them  physical  strength,  sunk  into  the  foul  slough  of  common  and  universal 
luxuriousness,  in  which  all  purely  spiritual  interests  were  likewise  neces- 
sarily and  gradually  suffocated. 

En  medicine  even  anatomy  won  no  acquisitions  of  importance,  though 
it  does  not  seem  to  have  been  neglected  in  the  "  Schools  "  (e.  g.  of  the 
Methodists)  so  completely  as  we  might  expect  among  such  doctrinaires 
But  this  fact  cannot  be  wondered  at ;  for  the  only  true  path  of  the  great 
Alexandrian  anatomists  had  been  necessarily  abandoned  in  obedience  to 
popular  prejudice,  to  be  replaced  by  the  dissection  of  the  lower  animals. 
New  subjects  for  dissection  had,  however,  been  found  in  apes,  and  these 
animals  were  frequently  utilized.  Physiology,  which  is  entirely  based  upon 
anatomy,  was,  like  the  latter  science,  almost  stationary,  or  at  least  it  ex- 
perienced no  enrichment  of  importance. 

The  following  physicians  acquired  reputation  as  anatomists  :  ' 

Rufus  of  Ephesus  (about  A.  D.  50), 
who  lived  most  probably  shortly  sifter  Celsus,  find  practised  dissection  on  apes  and 
other  of  the  lower  animals.  He  discovered  the  decussation  of  the  optic  nerves  and 
the  capsule  of  the  crystalline  lens,  and  gave,  for  the  time,  a  very  clear  description  of  the 
membranes  and  parts  of  the  eye.  He  taught  that  the  nerves  originated  from  the 
brain.  Physiologically  he  divided  them  into  nerves  of  motion  and  nerves  of  sensa- 
tion, and  ascribed  to  them  all  the  functions  of  the  body,  since  he  did  not  distinguish 
them  accurately  from  muscles  and  tendons.  The  heart,  whose  left  cavity  he  declares 
to  be  thinner  and  smaller  than  the  right,  he  considers  the  organ  which  gives  origin  to 
the  pulse,  and  he  associates  the  latter  also  with  the  pneuma.  He  describes  the  pulse 
carefully  in  its  varieties,  'dicrotic,  suppressed,  innumerable,  intermittent  etc.  The 
heart  is,  in  his  view,  the  seat  of  life  and  of  animal  heat,  while  the  spleen  is  a  useless 
organ.  He  discovered  the  oviduct  in  the  sheep.  He  was  also  an  alienist,  and  wrote 
on  the  subject  of  melancholia.  A  sick  man  who  believed  that  he  had  no  head  was 
convinced  of  its  existence  by — a  leaden  hat.  Moreover  he  studied  diseases  of  the 
urinary  bladder  and  kidneys,  and  medicines  the  latter  of  which  he  discussed 
in  verse ! 

Marinus  (about  A.  I).  100) 
admitted    the   existence  of  7   cranial    nerves,    and   discovered   the   inferior   laryngeal 
nerves  and  the  intestinal  glands.      He  is  considered   one  of  the  greatest  anatomists 
of  antiquity. 

One  of  his  pupils  was  Quintus,  whose  pupils  Pelops  and  Satyrus  have 
been  already  mentioned.  As  anatomists  of  this  period  we  must  also  notice 
Numesianus  of  Corinth  and  Lycus  of  Macedon,  as  well  as  Martialis,  who 
has  been  already  mentioned.     To  these  we  ma}7  add  Julius  Pollux  (2nd 


J.  The  physicians  of  this  ''Period  of  Schools"  were  assigned  sometimes  to  one 
school,  sometimes  to  another,  especially  among  the  Methodists,  while  some  of  them 
belonged  to  no  special  school.  Hence  their  classification  in  one  school  or  the 
other  is  uncertain  and  unreliable.  For  many  of  them  even  the  period  in  which 
they  lived  is  not  satisfactorily  settled. 


—  158  — 

century  A.  1).),  whose  treatise  :'On  the  Parts  of  the  Human  Body'. 
according  to  E.  J.  Zarncke,  is  taken  from  Rufus,  the  first  chapter,  with  the 
exception  of  a  few  passages,  being  the  entire  work  of  the  latter. 

The  fewer  the  new  discoveries  made  at  this  period  in  the  department 
of  anatoni}',  the  more  were  novelties  invented  in  materia  medica  and  phar- 
maceutics, always  a  sign  that  a  true  comprehension  of  the  essentials  and 
capabilities  of  practical  medicine  has  been  lost.  Medical  art  was  looked 
upon  as  a  matter  of  business,  promoted  especially  by  new  remedies  —  just 
as  it  is  now.  At  this  period  all  therapeutic  efficiency  was  denied  to  nature 
and  transferred  to  the  province  of  art ;  for  the  golden  saying  of  Hippocra- 
tes, "  Natures  alone  heal ",  had  been  long  forgotten,  and,  indeed,  never  had 
any  deep  significance  save  to  a  few  !  The  thougthless  crowd  either  quietly 
accepted  the  "new  remedies",  or  a  venal  band  of  claqueurs  disseminated 
them  or  trumpeted  abroad  their  merits,  exactly  as  they  do  to-day,  save  that 
at  this  period  this  could  not  be  done  by  grandiloquent  advertisements  in 
the  columns  of  the  political  and  medical  journals,  which,  as  we  all  know, 
can  deny  their  responsibility  in  virtuous  and  precise  terms,  without,  how- 
ever, renouncing  the  profit  accruing  from  their  want  of  principle.  To  add 
to  this  lack  of  insight  and  judgment  the  further  element  of  stupidity,  the 
descriptions  of  these  remedies  are  often  presented  in  verse,  as  to-day  they 
are  displayed  in  special  forms  of  type.  Such  practices  brought  honorable 
science,  then  as  now,  into  contempt,  with  the  difference  again  that  this 
feeling  then  found  its  expression  not  in  the  Imperial  Diet,  but,  as  we  shall 
see,  in  learned  compilations  by  the  laity. 

A  few  persons  among  the  Romans  wrote  at  an  earl}*  period  on  the 
subject  of  medicines,  either  in  special  treatises,  or  incidentally  in  other 
works.  Among  these  may  be  mentioned  Lenaeus,  a  freedman  of  Pompey; 
C.  Valgius  Rufus  (B.  C.  12)  ;  JEmilius  Macer.  senior  (died  B.  C.  15);  M.  T. 
Varro  (B.  C.  116-27);  Menius  llufus(who  invented  a  favorite  "  Hiera",  an 
antique  counterpart  of  our  Vienna  potion),  a  contemporary  of  Celsus  ;  and 
Apuleius  Celsus  under  the  reign  of  Augustus.  In  the  time  of  Pliny  a  phy- 
sician by  the  name  of  Castor  also  possessed  a  botanical  garden.1 

Other  more  important,  or  rather  more  famous,  pharmacologists  of  this 
period  were  : 

Pamphilus  Migmatopoles  (between  A.  I).  14-38). 
author  of  a  book  "  On  plants",  displaying;  neither  originality  nor  critical  acumen,  and 
full  of  superstition.      However,  lie  acquired   jrreat  wealth  by  a  remedy  for  mentagra. 

Herennius  Philo  of  Tarsus  (about  A.  1).  20), 
inventor  of  the  "famous"  Philonium  (for  colicky  pains),  the  description  of  which   in 
verse  is  still  extant.     Under  Nero  lived 


Amonjr  the  physicians  already  mentioned,  the  following,  as  we  have  seen,  occupied 
themselves  with  the  subject  of  pharmacology:  Sextius  Niger,  Julius  Bassus, 
Andromachus  the  Elder,  Petronius  Diodotus,  and  Petronius  Musa,  Niceratus, 
Scribonius  Largus  and  Antonius  Pacchius  (about  A.  D.  20),  a  physician  men- 
tioned by  Scribonius. 


—   15!)  — 

Servilius  Damocrates  (about  A.  D.  25), 
who  described  in  iambic  verse  many  compound  remedies,  such  as  malagmata,  acopa, 
antidota,  tooth-powder,  plasters  etc. 

The  most  important  pharmacological  writer  of  antiquit}-,  who,  like 
Galen,  Ptolemreus  and  other  historically  important  characters  among  the 
Ancients,  enjoyed  the  highest  esteem  as  an  unsurpassed  scientific  "author- 
ity" among  the  Romans,  as  well  as  during  the  whole  Middle  Ages  and 
even  into  modern  times,  was,  however, 

Pedanius  Dioscoripks  (A.  D.  40-90)  of  Anazarba  (later  Caesarea 
Augusta  in  Cilicia), 

an  independent  investigator  and  writer  upon  the  medicines  employed  at  that  time, 
drawn  from  either  the  animal,  vegetable  or  mineral  kingdom.  Ancient  physical 
science  embraced  little  but  these  three  branches:  for  the  Ancients  knew  very  little 
of  physics,  inasmuch  as  they  did  not  experiment  (except  in  physiology  ) — Dioscorides 
•recognized  about  400  plants.  Galen  as  many  as  600,  Ebn  Beithar  800,  Linnaeus  about 
9,000-10,000,  and  to-day  we  know  more  than  100,000  species.  Dioscorides  had 
travelled  extensively  in  Italy,  Gaul,  Spain,  Germany,  Greece  etc.  Many  of  his 
medicines  are  still  in  use  to-day.  while  others  have  become  obsolete,  and  still  others 
belong  to  the  superstitions  which  were  current  in  the  author's  age.  We  may  mention 
as  examples:  whey,  ox-gall,  aloes,  fern,  cinnamon,  castor  oil,  sugar  (a  favorite  remedy 
later  with  the  Arabians),  quicksilver,  white  lead,  blue  vitriol  (the  chemical  preparation 
of  which  in  special  apparatus  is  partially  given),  rennet,  mandragora  (as  an  anaesthetic) 
bugs  (in  intermittent  fever),  the  grimy  sweat  of  gladiators  and  bathers  etc.  He  makes 
known  also  the  current  adulterations  of  the  medicines  of  that  time 

Tiberius  Claudius  Menecrates  (about  A.  D.  34),  of  Zeophleta, 
was  physician-in-ordinary  to  the  emperor  Tiberius,  and  inventor  of  the  diachylon 
plaster  (the  name,  though  not  the  precise  composition,  of  which  is  preserved  in  our 
plaster  of  to-day),  and  many  other  compounds.  His  recommendation  to  employ 
actual  figures  in  the  designation  of  weights  in  prescriptions,  instead  of  arbitrary  signs, 
was  very  judicious,  though  it  was  not  complied  with  until  the  middle  of  the  present 
century.  He  wrote,  besides  many  (155)  other  works,  a  treatise  on  pharmacology  with 
a  bombastic  title,  dedicated  to  the  emperor. 

Andromachus  the  Younger  (about  A.  D.  54), 
like  his  father  physician-in-ordinary  to  Nero,  gave  an  account  of  many  drugs  ;  among 
others  of  24  remedies  for  ear-ache,  remedies  for  bleeding,  tooth-ache  etc.,  and  plasters 
with  high-flown  titles. 

Xenocrates  of  Aphrodisias  (about  A.  B.  70), 
was  author  of  a  treatise  on  food  drawn  from  the  class  of  fishes,  and  (like  the  Isopaths 
a  short  time'ago,  and  Prof.  Yeager  at  the  present  time)  introduced  disgusting  filth  as 
"medicines";  e.  g.  ear-wax,  menstrual  blood,  human  flesh,  bat's  blood  etc. 

Apollonius  Archistrator  of  Pergamus  (about  A.  D.  80), 
was  the  inventor  of  some  remedies  for  the  hearing  and  the  like,  and  observed  cases  of 
cerebral  inflammation   resulting  from  insolation. 

Asclepiades  Pharmacion  (about  A.  D.  100) 
recommended  even  animal  excrement  as  a  medicine,  and  many  other   "  remedies." 

On  the  other  hand  Krito 
more  elegantly  occupied    himself  with  the    invention  of  cosmetic   preparations,    to 
which  he  (as  is  customary  too  to-day)  gave  magnificent  names,  such  as  "The  incom- 
parable remedy  "  etc. 


—   1(50  — 

As  an  author  on  subjects  of  natural  history  and  the  healing  art  we 
must  at  least  mention  here  the  panegyrist  of  medicine  and  friend  of  physi- 
cians Lucius  Annaeus  Seneca  (A.  D.  3-65),  who  has  often  interwoven  in 
his  writings   maxims  relating  to   physical   and    mental  diet,   remedies  and 

diseases.1 

Caius  Pliny  the  Elder,  of  Como  (born  A.  1).  23,  died  at  Stabiae,  in  an 

eruption  of  mount  Vesuvius,  Aug.  22d.,  A.  D.  79). 

that  scorner  of  doctors  and  thorough-bred  aper  of  Romanism  of  the  type  of  Cato, 
deserves,  however,  special  mention.  Like  Celsus,  a  savant  and  encyclopasdist  of 
enormous  endurance,  he  was  not  always,  like  him,  correct  in  liis  judgment.  As  a 
writer  lie  has  little  command  of  language,  a  defect  which  he  strives  to  replace  by 
far-fetched  and  obscure  modes  of  expression.  This  latter  defect  is  also  manifest  in 
Sail  us  t  and  Quintilian,  a  sign  of  the  declining  taste  and  intellectual  exhaustion  of  the 
Romans.  .Mannerisms  of  expression  and  enigmatical  obscurities  were  sought  after, 
to  serve  as  a  kind  of  pepper  and  impart  savor  to  the  intellectual  diet.  Pliny  too  was 
one  of  the  few  ancient  authors  who  was  zealously  studied  in  the  Middle  Ages,  and 
his  work  formed  the  sum  arid  substance  of  all  knowledge  of  the  natural  sciences 
during  this  period.  He  wrote  his  Historia  Naturalis,  which  is  compiled  from  2000 
different  works,  in  two  years  (A.  D.  77  &  7S).  It  contains  nothing  original  relative 
to  the  drugs  and  medicines  which  are  discussed.  It  is  worth  mentioning  that  he  knew 
cataract,  ineinbrana  papillaris,  coloboma  and  mydriatic  remedies.  (Panas).  The 
following  passages  may  serve  as  examples  of  his  hatred  against  physicians.'-  "And 
there  is  no  doubt  that  the}'  all  busy  themselves  with  our  lives,  in  order  by  the  dis- 
covery of  some  new  thing  or  another  to  win  reputation  for  themselves.  Hence  How 
those  pitiable  disputes  over  the  sick  ;  for  no  one  has  the  same  views  as  another  ;  hence 
also  that  inscription  upon  the  tombstone  of  the  unfortunate  victim  :  "He  died  by  reason 
of  the  confusion  of  the  doctors."  This  spurious  art  is  changed  so  often  and  so  lament 
ably,  and  we  are  driven  to  and  fro  by  the  breath  of  the  spirits  of  Greece."  "  There  is 
alas,  no  law  against  incompetency'  no  striking  example  is  made.  They  learn  by  our 
bodily  jeopardy,  and  make  experiments  until  the  death  of  the  patients,  and  the  doctor 
is  the  only  person  not  punished  for  murder." 

Examples  of  what  he  discovered  and  handed  down  to  posterity  :  "  As  regards  the 
menstruation  of  females,  rarely  can  anything  be  found  more  peculiar  and  dreadful  in 
its  results."  Wine  which  has  not  ceased  fermenting  becomes  sour  (a  maxim  firmly 
believed  by  the  common  people  to-day  in  France  and  on  the  Rhine!).  Dogs  who  lick 
up  menstrual  fluid  become  mad.  Ants  cast  away  their  store  of  food  if  a  menstruating 
woman  comes  in  their  neighborhood" — clear  evidence  that  Pliny  himself  was  no 
observer,  but  related  what  he  read  without  "criticism.  Of  course  he  does  better  in 
medicine,  especially  as  regards  plants  and  medicines.  The  description  of  a  kind  of 
spectacles  has  been  also  claimed  for  him  ("  Nero  princeps  gladiatorum  pugnas  spec- 
tabat  in  smaragd"),  but  in  our  opinion  the  passage  merely  implies  that  the  blase 
tyrant  looked  at  the  proceedings  through  colored  glass.  Pliny  must  have  been 
acquainted  with  the  treatment  of  corpulence,  for  he  snys  that  he  who  wishes  to 
become  stouter  and   more  corpulent    should  drink  during  his  meals,    while   he   who 


I      He   already   made  use  of  the  expression   that   the  Romans  were  perishing  of  too 
much  literature.     What  would  he  say  of  us? 

2.  Yet  when  he  himself  was  sick  he  called  in  a  physician,   and   even   recommended 

him  to  Trajan  as  a  candidate  for  citizenship. 

3.  Dr.  Theodor  Clemens,  of  Frankfort  on  the  Main,  considers  menstruating  women 

disseminators  of  bacilli 


—  1G1  — 

desires  to  become  thinner  should  not  drink  either  during  or  after  meals.  He  prefers 
sea  voyages  (common  even  in  that  day),  with  subsequent  residence  in  Egypt,  in  the 
treatment  of  diseases  of  the  chest,  to  a  residence  in  the  resinous  atmosphere  of  pine 
woods,  an  opinion  in  which  he  is  opposed  to  Celsus. 

The  most  important  Roman  author  on  medical  subjects,  and  a  compiler 
of  a  much  higher  order  in  his  eight  books  :' De  Medicina",  was  Aulus 
Cornelius  Celsus  (between  B.  C.  25-30  and  A.  D.  45-50).  He  had  also 
written  on  philosoph\',  oratory,  jurisprudence,  history  etc.,  and  was  in  fact 
an  encyclopaedist.  Though  not  a  physician  by  profession,  he  was  able  to 
write  and  to  think  on  medicine  quite  like  a  regular  practitioner,  so  that  his 
work  may  claim  the  value  of  an  original  treatise  on  medicine.  In  this  he 
was  aided  b\'  a  rich  experience  in  practice,  acquired  in  his  own  valetudi- 
naria.  This  too  placed  in  his  hand  (which  a  healthy  skepticism  well  suited) 
a  guide  for  the  exercise  of  criticism  on  physicians  and  medical  art — a 
faculty  which  he  exercised  with  much  more  justice  than  Pliny.  ]n  addition 
to  such  excellencies  he  enjoyed  also  the  command  of  a  language,  which 
differed  but  little  from  the  best  examples  of  Latinity. — How  nicely  he 
weighed  even  single  words  is  shown  sufficientry  by  the  one  sentence : 
"  Ut  alimenta  sanis  corporibus  agricultura,  sic  sanitatem  aegris  medicina 
promittit." 

His  judgment  as  to  the  power  and  the  limits  of  medical  art,  as  well  as 
his  knowledge  of  human  nature,  stamp  him  a  born  physician. 

"The  failings  of  those  who  practice  medicine  are  not  to  be  charged  to  the  art 
itself"  —  "It  is  their  confidence  in  medicine  which  is  very  frequent]}',  indeed  most 
frequently,  of  advantage  to  the  sick." — "It  is  the  sign  of  a  prudent  man  not  to  under- 
take the  treatment  of  one  who  cannot  be  cured,  lest  he  gain  the  reputation  of  slaying 
him,  whom  his  own  fate  is  dragging  down."  -  "  The  physician  of  experience  is 
recognized  by  his  not  at  once  seizing  the  arm  of  his  patient  as  soon  as  he  comes  to 
his  side,  but  he  looks  upon  him,  and,  as  it  were,  sifts  him  first  with  a  serene  look,  to 
discover  how  he  really  is ;  and  if  the  sick  man  manifests  fear,  he  soothes  him  with 
suitable  words  before  proceeding  to  a  manual  examination." — "  Little  minds  confess 
nothing  disgraceful  to  themselves,  for  they  have  nothing  to  lose:  But  to  a  great  mind 
it  is  befitting  to  acknowledge  even  mistakes,  especially  when  the  results  of  medical 
practice  are  handed  down  for  the  benefit  of  posterity."     (See  Haeser.) 

His  descriptive  and  operative  surgery  (including  also  operative  dentis- 
try) is  considered  the  best  contribution  of  Celsus  to  medical  art.  It 
must  still  be  regarded  as  a  "masculine"  branch,  in  comparison  with  the 
salve-surgery  which  came  into  vogue  at  a  later  period.  It  gives  us  too  the 
best  idea  of  the  eminent  services  of  the  Alexandrians,  who  furnished  the 
substance  of  surgical  art. 

The  qualifications  of  the  surgeon,  according  to  Celsus,  are  a  firm,  steady  hand, 
the  ability  to  use  either  hand  equally  well,  youth,  or  at  least  an  approximation 
thereto,  a  sharp  eye,  lack  of  timidity  and  compassion,  so  as  not  to  be  moved  by  the 
outcries  of  his  patient,  not  to  hurry  more  than  the  case  admits,  and  not  to  cut  less  than 
may  be  necessary,  but  to  manage  to  the  very  end  as  if  entirely  unaffected  by  his  cries. 

He  describes,  on  the  one  hand,  a  large  number  of  surgical  ailments,  such  as 
diseases  of  the  joints  and  the  bones,  wounds,  tumors,  burns,  fistula,  abscess,  sprains 
11 


—  162  — 

and  luxations,  for  which  he  recommends  reduction  before  the  development  of  inflam- 
mation; fractures,  in  which,  when  they  fail  to  unite,  he  recommends  extension  and 
rubbing  together  the  ends  of  the  bone,  and  even  cutting  down  upon  the  bone  so  that 
it  heals  as  an  open  wound;  hernia,  which  he  thinks  originates  in  laceration  of  the 
peritoneum;  strangulated  hernia,  where  he  cautions  against  cathartics;  the  radical 
operation  for  reducible  hernia  by  turning  up  and  casting  a  ligature  about  the  neck  of 
the  sack,  or  compression  of  the  latter  until  necrosis  takes  place  (in  large  and  strangu- 
lated hernias  he  does  not  approve  of  any  operation) ;  foreign  bodies  in  the  ears  etc.  ; 
on  the  other  hand  he  notices  many  operations  of  the  Ancients,  some  of  them  handed 
down  to  us  by  him  alone,  among  others:  bleeding,  double  ligation  of  bleeding  vessels 
and  division  of  the  vessels  between  the  ligatures,  lithotomy  (he  recommends  bimanual 
examination  from  the  belly  and  rectum  to  determine  positively  the  diagnosis  of  stone) 
even  in  women,  castration,  amputation  in  the  sound  flesh  with  a  single  circular  cut 
(in  gangrene  only,  a  rule  which  prevailed  throughout  the  whole  Middle  Ages  down  to 
the  17th  century),  which  he  is  the  first  among  the  Ancients  to  describe  unequivocally, 
catheterization,  repair  of  defects  of  the  nose,  lips,  auricles  and  prepuce1  (including 
the  not  easily  explained  infibulation,  so-called),  trepanning,  the  operative  treatment 
of  goitre,  scleroticonyxis  in  cataract  (which  he  ascribes  to  coagulation  of  the  humors 
in  the  pupil),  resection  of  the  ribs,  enemata  (with  the  view  too  of  artificial  feeding), 
diseases  of  the  ears  (which  he  only  among  the  Ancients  discusses,  and  in  which  he 
recommends  the  ear  syringe),  extraction  of  teeth  by  means  of  forceps,  fastening  teeth 
with  gold  wire,  bursting  hollow  teeth  by  peppercorns  pressed  into  them  etc.  The 
results  of  extraction  in  cases  of  anchylosis  of  the  teeth  and  alveoli,  caries  and  necrosis, 
are  known  to  him,  and  the  tooth  was  accordingly  shaken  loose  most  painfully  before 
application  of  the  forceps.  In  the  treatment  of  wounds  he  recommends  ripening, 
styptic  and  caustic  remedies,  but  declares  rest  the  best  remed}'  of  all. 

His  operative  midwifery  (discussed  together  with  surgery)  is,  on  the  other  hand, 
meager,  and  his  method  of  extraction  by  means  of  hooks,  after  the  employment  of  ver- 
sion by  the  head  or  foot  (in  dead  children),  is  rude.  The  latter  operation  he  employed 
in  transverse  presentation,  and  aided  the  subsequent  extraction  by  external  manipula- 
tion, a  method,  which  quite  recently  has  been  commended  as  very  effective  and  good. 
He  was  also  acquainted  with  the  conversion  of  breech  into  footling  presentations.  In 
presentation  of  one  foot  he  cuts  this  off.  He  was  also  acquainted  with  decapitation! 
Celsus  distinguishes  among  mental  diseases  three  varieties  of  phrenesis.  He  also 
speaks  in  favor  of  coercive  measures  in  the  case  of  the  violently  insane,  but  says  that 
each  case  must  be  individualized.  Sleep,  which  is  usually  absent,  must  be  compelled, 
if  necessary,  by  narcotics.  Raving  maniacs  he  considers  more  difficult  of  cure  than 
those  more  quietly  insane.  In  the  treatment  of  diseases  of  the  eyes  he  advises  the 
employment  of  the  milder  remedies,  instillations,  salves,  etc.,  the  more  severe  the  in- 
flammation may  be. 

Tnat  he  was  also  well  versed  in  practice  may  be  inferred  from  his  remark,  that 
it  is  the  part  of  a  theatrical  performer  to  display  great  activity  in  small  matters,  in 
order  to  give  the  impression  of  having  been  of  great  service.  He  recommends  the 
physician  to  wait  a  few  moments  before  feeling  the  pulse,  and  meanwhile  to  quiet  the 
patient  by  a  cheerful  air.  His  pictures  of  internal  diseases  are  clear,  and  some  of 
them  are  preserved  to  the  present  day  (area  Celsi,  kerion  Celsi).  He  is  also  the  first 
to  distinguish  hallucinations  of  vision.  His  natural  dietetic  prescriptions  and  simple 
therapeutic  measures  (in  which  he  often  mentions  Asclepiades),  as  well  as  his  semei- 
ology  and  prognostics,  both  of  which  are  based  upon  Hippocratic  principles,  have 

1.    Among  the  Jews  who  desired  to  evade  the  taxes  imposed  upon  them,  or  to  obtain 
office  among  the  Romans,  which  they  could  not  do  without  a  prepuce. 


—  163  — 

especial  value.  As  an  example  of  his  clear  method  of  description  we  quote  the  fol- 
lowing passage:  "This  instrument  (the  catheter)  is  necessary  not  only  in  men,  but 
also  occasionally  in  women.  In  order  that  it  may  fit  everybody,  whether  small  or 
large,  the  physician  should  have  three  sizes  for  men,  and  two  for  women.  The 
largest  size  for  men  should  be  lf>  inches  in  length,  the  medium  12  inches,  and  the 
smallest  9  inches.  For  women  the  larger  size  should  be  9  inches  and  the  smaller  6 
inches  in  length.  The  instrument  should  be  curved  slightly  (especially  the  male 
variety),  and  as  smooth  as  possible,  and  neither  too  thin  or  too  thick.  The  patient 
should  be  placed  supine  upon  a  bench  or  couch,  as  in  the  treatment  of  diseases  of  the 
anus.  The  physician  standing  upon  his  right  side  grasps  with  his  left  hand  the  penis, 
and  with  the  right  introduces  the  instrument  into  the  urinary  passage.  When  the 
catheter  has  reached  the  neck  of  the  bladder,  it,  with  the  penis,  is  to  be  depressed 
and  the  point  pushed  into  the  bladder,  and  after  the  evacuation  of  the  urine  it  is  to 
be  withdrawn." 

In  this  work  of  Celsus  much  of  the  substance  of  the  lost  writings  of  ancient 
physicians,  and  especially  those  of  the  Alexandrian  age,  is  preserved.  He  has  mani- 
festly selected  from  these  with  ripe  judgement  onty  what  is  reasonable,  useful  and 
valuable,  and  accordingly  has  paid  comparatively  little  attention  to  opinions  and 
theories,  a  point  in  which  he  contrasts  strongly  with  Galen,  and  which  impresses 
upon  his  work  the  stamp  of  practicality  and  usefulness.1 

4.    THE  PNEUMATIC  SCHOOL, 

in  opposition  to  the  humoral  theory  of  the  "  Dogmatists  "  and  the  solidism 
of  the  "  Methodists  ",  introduced  the  aeriform,  spiritual  principle  of  the 
"  pneuma  "  (the  world-soul  of  the  Stoics,  especially  of  Zeno,  their  chief) 
into  their  general  pathology.  Yet  they  also  left  the  elementary  qualities 
(warmth,  coldness,  moisture  and  dryness,  which  according  to  their  doctrine 
may  be  seen  and  felt,  and  not  recognized  simply  by  their  effects)  a  place  in 
their  "  System  ".  The  pnenma  comes  by  the  wa}-  of  the  respiration,  as 
a  part  of  the  creative  "  World-soul  ",  into  the  heart,  and  is  driven  thence 
into  the  vessels  and  the  whole  body,  in  which  it  effects  in  a  passive  wa}" 
the  diastole  of  the  pulse,  while  the  contraction  of  the  arteries  is  an  active 
process.  When  it  works  regularl}*  and  is  united  with  warmth  and  moisture, 
it  occasions  health  ;  under  contrary  circumstances,  and  mixed  (crasis)  with 
warmth  and  dryness,  it  occasions  the  acute  diseases  ;  while  mixed  with  cold 
and  moisture  it  produces  the  phlegmatic  diseases,  and,  finally,  with  cold 
and  dryness  —  melanchol}'.  This  latter  condition  in  its  acme  introduces 
death,  a  state  in  which  everjthing  becomes  dry  and  cold.  Moreover  the 
Pneumatists  assume  predisposing  and  transient  causes  of  disease,  and  for  all 
febrile  diseases  a  corruption  of  the  humors,  which  they  named  "  putrefac- 
tion.*'3    The  hard   pulse  is  inseparable  from  all  fevers.     They  also — as  is 

1.  The  phj-sician   Celsus  must  not  be  confounded,  as  has  been  done  occasionally. 

with  the  Epicurean  Celsus,  who  lived  under  Hadrian  and  was  stigmatized  b}- 
Origen  as  an  enemy  of  Christianity. 

2.  The  putrefactive  process  during  all   antiquity,  and  even  into  modern  times,  was 

regarded  as  the  cause  of  origin  of  organized  or  living  beings.     Conversely  we 
nowadays  regard  organized  beings  as  the  cause  of  putrefaction. 


—  164  — 

conceivable"  in"  such  a  system —  held  dialectics  to  be  a  necessary  part 
of  the  medical  art.  In  fact  so  firm  was  their  faith  in  this  branch,  that  in 
their  practice  treason  to  their  native  land  was  to  be  expected  rather  than 
an  abandonment  of  their  dogmas.  B}'  means  of  dialectics  they  built  up  in 
the  most  subtile  way  the  doctrine  of  the  pulse,  which,  as  we  have  already 
said,  they  referred  to  the  influx  and  efflux  of  the  pneuma  into  and  out  of 
the  heart  (or  lungs)  into  the  vessels. 

According  to  the  doctrine  of  the  Stoics  force  and  matter  are  inseparable.  God 
controls  the  world,  and  is  present  in  the  whole  universe.  He  permeates  this  as  a 
warm  halitus,  which,  in  the  formation  of  the  world,  separated  into  air  and  water. 
The  soul  is  God,  or  the  warm  halitus  within  ns,  and  is  mortal,  but  survives  the  hodj' 
until  the  conflagration  of  the  world.  It  is  divisible  into  the  five  senses,  the  faculties 
of  speech  and  generation,  and  the  controlling  force  in  the  heart,  to  which  the  presi- 
dency belongs.  Experience  arises  out  of  numerous  reminiscences.  The  idea  01  in- 
itiates in  advancing  from  perceptions  to  the  general,  which  is  an  abstraction,  for  the 
individual  alone  has  existence — a  view  affirmed  also  b}*  the  Nominalists  and  Scholas- 
tics.    (Ueberweg). 

The  founder  of  the  Pneumatic  school  (whose  representatives  lived 
between  Vespasian  and  Antoninus  Pius,  about  A.  D.  70-100),  as  well  as 
its  only  powerful  representative,  was 

ATHENiEUS  of  Attalia,  in  Cilicia.  He  was  a  famous  physician  at  Rome, 
about  A.  D.  09,  and  turned  his  weapons  first  against  the  views  of  Asclepiades, 

but  soon  fell  into  hair-splitting  refinements,  especially  with  respect  to  the  pulse.  To 
the  latter  he  assigned  eight  qualities:  rythm,  fullness,  regularity,  irregularity, 
uniformity  and  uneveness,  slowness,  frequency,  size,  force,  and  named  also  several 
subordinate  divisions  of  these  qualities.  He  split  up  the  pneuma  into  the  psychical, 
the  physical  and  the  generative,  conformably  to  the  chief  functions  of  the  body,  but 
fell  into  contradiction  of  his  Pneumatic  principles  in  adding  to  his  system  the  elemen- 
tary qualities,  of  which  he  distinguished  warmth  and  cold  as  "formative",  while 
dryness  and  moisture  were  'plastic".1  The  same  may  be  said  of  his  assumption 
of  causes  of  disease  in  the  Hippocratic  sense.  In  conformity  with  the  idea  of  Aris- 
totle, that  substance  and  form  were  derived  from  different  individuals,  he  declared 
the  menstrual  blood  to  be  the  substantial,  and  the  male  semen  the  formative  principle 
in  generation  and  development.  Women  have  no  semen.  He  concluded  further  that 
the  female  testicles,  the  ovaries,  inasmuch  as  the  woman  has  no  semen — the  fluid 
secreted  by  the  female  sexual  organs  was  a  sort  of  local  perspiration,  the  result  of  the 
violent  movements  and  friction  during  coitus — are  superfluous  organs,  exactly  like  the 
male  breasts,  and  like  the  latter  exist  merel}-  for  symmetry.  In  dietetics  he  followed 
good  principles.  He  recommends  its  remedies,  cold  and  warm  baths;  amulets  in 
headache;  human  milk  in  consumption.  The  "Hiera:'  of  Archigenes  was  partic- 
ularly famous  as  a  remedy  to  purify  the  head,  stomach  and  all  the  humors,  and 
consisted  of  colocynth,  squill,  euphorbium,  gentian,  opoponax,  and  theriaca,  u'a  20 
grammes,  and  about  (500  other  drugs!  Venesection  he  performed  only  in  diseases 
attended  with  too  much  blood,  and  in  these  he  never  pushed  it  to  syncope.  Moreover 
he  was  solicitous  for  public  hygiene,  published  methods  for  the  filtration  of  drinking 
water,  and  made  observations  on  the  situation  of  dwellings,  particularly  as  to  its  in- 
fluence on  health  and  disease. 


1.    ra  TtoirjTixa  and  ■:<).   dltxd,     I  H.  ( 


—  1G5  — 

Among  the  famous  pupils  of  Athenaeus  the  very  first  departed  from 
his  doctrines,  and  was  the  founder  of  the  so-called 

6.    SCHOOL  OF  ECLECTICS, 

whose  principles  are  distinguished  by  its  title.  The  different  phj-sicians 
belonging  to  this  school  followed  widely  differing  views.  The  originator 
of  this  so-called  "  school "  was 

Auathinus  of  Sparta  (about  A.  D.  90),  who  endeavored  to  combine 
the  views  of  his  master  with  those  of  the  Methodists  and  early  Empirics. 
By  this  process,  in  the  course  of  time,  the  "  Eclectics "  (Episynthetics, 
Hectics)  were  formed,  a  sect  which  numbered'among  its  members  some  of 
the  most  brilliant  medical  men  of  later  antiquity. 

Of  his  doctrine  of  the  pulse,  which  he  constructed  with  much  subtility  on  Pneu- 
matic principles,  we  Know  that  he  ascribed  the  full  pulse  to  the  volume  of  the  inflowing 
pneuma,  while  he  maintained  that  one  could  not  perceive  the  contraction  of  the 
vein,  and  explained  the  pulsation  of  the  veins  by  the  existence  of  concealed  veins. 
He  spoke  earnestly  against  the  abuse  of  warm  baths,  prevalent  in  his  day,  and  advo- 
cated the  employment  of  cold  baths,  as  most  beneficial  to  the  health. 

A  pupil  of  Athenaeus  was  a  certain  Theodoris  (the  17th  of  this 
name),  whose  name  has  been  preserved  to  us  by  some  remedies  for  tetter. 
The  most  famous  pupil  of  Agathinus,  however,  was 

x\rchigenes  of  Apamea  (A.  D.  48-117),  a  physician  of  unusual  acute- 
ness  of  mind,  which  manifested  itself  in  his  observations,  though,  alas,  it 
also  degenerated  into  obscure  subtilities.  He  distinguished  himself  also  as 
a  surgeon. 

In  surgery  he  described  amputation  with  preliminary  ligation  of  the  main  vessel 
and  subsequent  cauterization  of  the  smaller  ones;  wounds  of  the  head;  taught  the 
practice  of  bleeding  upon  the  healthy  side,  and  the  employment  of  caustics,  particu- 
larly in  sciatica.  In  order  to  obviate  haemorrhage  as  far  as  possible  in  amputations, 
he  had  the  skin  retracted  and  then  bound  a  bandage  about  the  limb  above  the  point 
of  operation,  something  in  the  style  of  Esmarch.  He  warns  against  operations  in 
patients  from  whose  great  feebleness  one  anticipates  an  unfavorable  result.  He  does 
not  limit  the  indications  for  amputation  to  gangrene  alone,  but  extends  them  to  such 
shattering  of  the  limb  as  will  probably  result  in  gangrene,  to  extensive  wounds,  cancer 
and  ulcers  (Wernher).  His  disputatiousness  may  be  inferred  from  his  saying  that  a 
man  should  rather  betray  his  country  than  the  opinion  of  his  sect.  His  admirable 
gift  for  analysis  appears  most  brilliant  in  his  divisions  of  the  pulse  and  of  pain.  Of 
the  former  he  assumed  eight,  depending  upon  the  size,  strength,  rapidity,  frequency, 
fullness,  order,  equality  and  rytlim  of  the  pulsations,  and  in  each  of  these  classes  he 
distinguished  three  varieties:  the  strong,  the  weak  and  the  intermediate.  Pain  he 
divided  into  dragging,  severe,  itching,  stinging,  writhing,  dull,  immoderate,  cramping, 
and  also  falsely'  professed  to  determine  from  these  characters  the  seat  of  disease.  In 
the  doctrine  of  fever  he  introduced  the  so-called  epialos1  and  the  semi-tertian  fever. 
He  also  enriched  nosognosy  by  distinguishing  sharply   sympathetic   from   primary 

1.    A   form  of  fever  in  which,  together  with  febrile  symptoms,  the  patient  also  suffers 
with  rigors.     (H) 


—  166  — 

diseases.  In  all  diseases  he  assumed  two  stadia  only,  that  of  the  acme  and  that  of 
resolution.  He  was  the  first  to  divide  mineral  waters,  in  accordance  with  their  chemi- 
cal composition,  into  nitrous,  sulphurous  and  aluminous.  In  therapeutics  he  managed 
empirically,  and  invented  many  compound  remedies,  among  others  also  a  so-called 
hiera.1 

Aret.eus  of  Cappadocia  (about  A.  D.  30-90),  shows  himself  a  great 
physician  by  his  conception,  even  thus  early,  of  the  duties  of  his  profes- 
sion : 

"  When  he  can  render  no  further  aid,  the  pl^sician  alone  can  still 
mourn  as  a  man  with  his  incurable  patient :  This  is  the  physician's  sad 
lot",  beyond  which  modern  medicine  ought  certainly  to  go,  since  for  us.  in 
cases  where  our  technical  art  fails  us,  our  profession  represents  a  humane, 
if  you  will,  a  Christlike,  mission  ! 

But  in  his  observations  and  the  naturalness  of  his  pictures  of  disease 
Aretaeus  also  stands  high  among  the  ancient  ph3*sicians  ;  indeed  in  this 
respect  he  resembles  greatl}-  Hippocrates,  whose  dialect,  and  even  manner- 
isms he  adopted.  But  instead  of  the  simple  style  of  Hippocrates,  Aretaeus 
adopted  a  pomposity  and  studied  conciseness  of  expression,  which  corres- 
ponded to  his  age,  so  intolerant  of  Hippocratic  simplicity.  The  greater 
clearness  of  his  pictures  of  disease,  too,  was  undoubtedly  due  in  great 
measure  to  improved  views  and  methods  of  observation,  the  result  of  lapse 
of  time.  The  appearance  of  consumptive  patients  he  sets  forth  in  the  fol- 
lowing clear  words  : 

"  The  voice  is  hoarse,  the  neck  slender,  the  fingers  thin,  but  their  joints  thick. 
The  bones  alone  seem  to  exist,  for  the  flesh  is  consumed,  the  finger-nails  are  curved — 
for  the  flesh,  which  is  supplied  so  plentifully  to  the  fingers,  serves  as  a  support  to  the 
nails.  Those  who  have  a  slender  build,  a  breast  like  two  boards  joined  together, 
shouHer-blades  projecting  like  a  bird  and  a  prominent  pomum  Adami,  have  a  predis- 
position to  this  disease." 

In  this  pointed,  though  plastic  style,  he  distinguishes  many  diseases, 
so  that  even  to-day  their  diagnosis  is  eas}7,  a  remark  which  is  not  true  of 
many  of  the  ancient  pl^-sicians. 

So  he  describes  e.  g.  diphtheria  (ulcera  Syriaca),  paralysis,  in  which  he  distinguished 
the  paralysis  of  sensation  (anaesthesia)  from  that  of  motion  (para^sis  proper),  and 
called  the  mixed  condition  paraplegia.  He  knew  that  injuries  of  the  brain  occasion 
paralysis  of  the  opposite  side.  He  also  described  haemoptysis,  migraine  and  cephal- 
algia, diabetes,  diseases  of  the  bladder,  aortitis,  pneumonia,  diarrhoea,  gonorrhoea, 
fluor  albus,  elephantiasis,  jaundice  (which  he  ascribed  to  stoppage  of  the  biliary 
ducts),  epilepsy  (even  that  occasioned  by  lead  poisoning).  Mental  disturbances  he 
divided  into  mania,  melancholia  and  settled  insanity,  a  division  which  all  following 
ages  have  not  essentially  improved.  In  all  his  delineations  of  disease  he,  after  the 
example  of  Hippocrates,  takes  into  consideration  the  constitution,  the  age,  the  season, 
and  the  situation  of  the  place.     To  each  section  of  his  work  he  prefixes  an  anatomico- 

1.  A  physician  Hermogenes  also  belongs  to  this  sect.  Martial  (A.  D.  40-100)  says 
of  him:  "Andragoras  bathed  and  dined  with  me  cheerfully,  but  the  next  morning 
lie  was  found  dead.  Can  you  teli  me,  Faustina,  the  cause  of  his  death?  He  saw 
in  his  dreams  Hermogenes,  the  physician.'' 


—  167  — 

physiological  introduction  concerning  the  part  of  the  body  whose  diseases  are  to  be 
considered  (in  the  style  of  many  of  our  modern  text-books),  and  exercises  a  sharp 
criticism  founded  upon  his  own  observations.  In  anatomy  he  does  not  differ  greatly 
from  the  views  of  his  time.  Still  we  find  in  his  work  intimations  of  the  tubes  of  Bellini, 
while  he  may  possiblj-  have  had  a  correct  idea  of  the  decussation  of  the  nerves  and  of 
the  Hunterian  decidua  also.  He  knew  that  the  tongue  was  composed  of  muscles.  In 
physiology  he,  with  Aristotle,  regarded  respiration  as  the  process  b}r  which  the 
pneuma  reached  the  lungs,  and  thence  the  heart,  the  seat  of  life.  The  blood  was  pre- 
pared in  the  liver,  the  bile  in  the  gall-bladder;  in  the  large  intestine  a  seconda^ 
digestion  takes  place;  in  the  spleen  is  to  be  found  thick,  coagulated  blood;  the  seat 
of  the  soul  is  in  the  heart.  He  knew  that  the  contents  of  the  arteries  was  light-colored, 
that  of  the  veins  dark.  In  therapeutics  he  recommended  in  general  proper  dietetic, 
and  mild  (medical,  treatment,  but  did  not  shrink  also  from  more  powerful  drugs,  like 
elaterium,  hellebore  etc.,  and  he  employed  without  hesitation  emetics,  bleeding  (upon 
the  diseased  side  in  the  outset  of  the  disease — pleurisy — ),  leeches,  blisters,  and  even 
the  actual  cautery.  The  slight  success  of  tracheotomy  was  known  to  him,  and  he 
defended  good  principles  in  his  treatment  of  the  insane.  In  chronic  diseases  he  was 
fond  of  giving  castoreum.  Two  of  his  works  are  still  extant,  viz:  "De  causis  et  signis 
acutorum  et  diuturnorum  morborum,"  and  "  De  curatione  acutorum  et  diuturnorum 
morborum." 

Herodotus  (about  A.  D.  100), 
a  pupil  of  Agathinus,  wrote  on  certain  acute  infectious  exanthemata,  which  have  been 
interpreted  as  small-pox  (also  measles,  petechia?),  and  also  upon  verminous  diseases. 
He  is  the  first  to  mention  pomegranate  root  as  a  remedy  for  tapeworm.  In  thera- 
peutics he  laid  especial  weight  on  the  diaphoretic  method,  and  recommended  hot 
sand-baths,  oil-baths  and  baths  in  sea  and  mineral  water.     A  famous  surgeon  was 

Heliodorus  (about  A.  D.  100), 
who  has  left  some  fragments  upon  amputation  without  ligation  of  vessels.  He  recom- 
mends the  division  of  the  skin  of  the  leg  in  front,  and  the  sawing  through  of  the  bones, 
before  dividing  the  vascular  soft  parts  on  the  back  of  the  leg.  The  haemorrhage  is 
then  to  be  stopped  by  a  firm  bandage.  He  discards  chopping  off  limbs,  and  declares 
amputation  through  and  above  the  knee  and  elbow  joints  very  dangerous,  an  idea 
which  maintained  currency  down  into  the  17th  century.  Supernumerary-  members  he 
removed  by  double  circular  section.  (Wernher).  He  describes  trepanning  and  its 
after-treatment,  caries  and  necrosis,  injuries  of  the  head,  exostoses  and  fissures  of  the 
skull,  and  their  treatment. 

Cassius  the  Tatrosophist  (about  A.  D.  130) 
discusses  in  84  sections,  eclectically  and  in  accordance  with  various  "s3"stems", 
his  "Medical  Questions".1  Some  of  these  are  treated  with  considerable  judgment, 
e.  g.  those  relating  to  metastatic  abscess  of  the  parotid,  sympathetic  affections  of 
both  eyes,  the  erysipelas  of  wounds,  the  secondary  swelling  of  glands  (for  instance 
those  of  the  axilla  following  ulcers  upon  the  hand),  the  formation  of  callus  etc. 
Other  questions  receive  a  comical  treatment,  e.  g.  sneezing,  which,  according  to 
Cassius,  takes  place  twice  in  succession — because  man  has  two  nostrils  !) 

Philip  of  (Lesarea  (about  A.  D.  117) 
is  considered  a  zealous  follower  of  Archigenes.     He  wrote  about  medicines,  cataleps}' 

and  consumption,  in  the  treatment  of  which  he  discarded  the  use  of  baths. 

_ 

1.     "  Questiones   et    Problemata",    or    in    the  original   Greek   'Iarptxai   aizopiai   xai 
TtpoftXrj'j.ara  (foar/.a.      (H.) 


—  168  — 

The  greatest  of  the  Eclectics,  however,  was 
Claudius  Galeu 

of  Pergamus1  (A.  D.  131-201  or  210),  who,  though  he  did  not  consider  him- 
self an  Eclectic,  and  is  not  usually  classed  as  such,  yet  distinguished  himself 
above  all  others  Irv  advancing  a  complete  "Eclectic  System  "  of  his  own — 
a  system  which  for  more  than  a  thousand  years  enjoyed  undisputed  swa}\ 
Galen  was  in  the  medical,  as  Aristotle  in  the  philosophical,  department 
the  leading  lawgiver  of  both  Christians  and  Arabians  during  the  whole 
Middle  Ages,  and  he  has  therefore  attained  the  widest  importance  of  all 
the  ancient  physicians.  "  He  belonged  ",  as  Schlosser  sa}Ts,  "  to  a  period, 
in  which,  as  in  all  times  of  laxity  and  over-refinement,  the  institutions  of 
instruction  were  excellently  arranged,  instruction  was  learned  and  profound, 
and  the  struggle  for  those  branches  of  knowledge,  which  every  man 
of  breeding  was  expected  to  possess,  was  generally  diffused.  Hence  much 
attention,  indeed,  more  attention  than  at  other  times,  was  bestowed  upon 
those  branches  which  demand  no  flight  of  fancy,  no  independence  of  mind, 
but  which  offer  immediate  profit.  These  branches,  as  we  know,  are  the 
mathematical,  medical,  physical,  geographical  and  legal  sciences.  In  after 
ages  Galen's  influence,  not  only  as  a  medical,  but  also  as  a  rhetorical  and 
philosophical,  writer  was  exercised  most  beneficially  on  a  class  which  des- 
pised the  ancient  sources  of  genuine  wisdom,  and  while  it  continually 
preached  about  supersensible  things,  of  divine  revelations  and  of  the 
renunciation  of  humanity  through  monastic  discipline,  was  yet  incapable 
of  any  genuine  enthusiasm.  This  influence  of  Galen  shows  itself  particularly 
in  that  treatise  which  bears  the  title  "  Suasoria  ad  artes  oratio  "  and  was 
most  frequently  read."' 

Galen  was  the  son  of  Nicon,  an  architect,  whom  he  paints  as  the  most  excellent 
of  fathers,  while  he  has  fixed  upon  his  mother  the  stain  of  a  .second  Xantippe.2  The 
former  instructed  him  at  first  himself,  as  was  the  rule  among  the  Ancients;  for  in  a 
few  places  only  were  there  any  arrangements  like  our  primary  and  intermediate 
schools.  He  then  had  him  in  his  15th  year  instructed  in  the  most  prominent  philos- 
ophical systems,  and  later  devoted  him  to  the  medical  profession  in  consequence  of  a 
dream,  a  superstitious  tendency  which  explains  the  same  peculiarity  in  the  son. 
Galen  received  instruction  in  anatomj-  from  Satyrus  at  Pergamus,  and  in  pathology 
from  Stratonicus  the  Hippocratist,  Ennius  Meccius,  and  ^Eschrion  the  Empiric. 
After  the  death  of  his  father,  however,  he  went  in  his  21st  year  to  Smyrna  where  he 
received  further  anatomical  instruction  from  Pelops ;  thence  he  went  to  Corinth, 
where  he  had  Numesianus  as  his  teacher.  In  order  to  improve  himself  also  in 
pharmacology  by  his  own  observation,  he  made  long  tours  in  Asia  Minor  und  Pales- 
tine, and  sought  e.  g.  the  jet-stone  3  in  in  a  boating  expedition  along  the  entire  Lycian 


1.  In  Mysia,  one  of  the  educational  and  artistic  centers  of  the  world  at  that  time. 

2.  The  mothers  of  great  men   among  the   Ancients,  in  consequence  of  their  want 

of  education,  did  not  and  could  not  have  that  influence  upon  the  career  of  their 
sons,  which  is  so  common  among  modern  peoples. 

3.  Latin    "gagates",   Greek  yaydreq,  a  stone  said  to  be  found  in  Lyoia  or  Cilicia, 

which,  when  exposed  to  the  fire,  burns  and  emits  a  bituminous  odor.     It  was  re- 
commended in  epilepsy,  hysteria  and  gout.     (H.) 


—  169  — 

coast.  After  studying  anatomy  especially  for  a  long  time  at  Alexandria, —  he  names 
as  his  teacher  a  certain  Heraclianus,  and  mentions  as  a  piece  of  good  fortune  that  he 
saw  there  a  human  skeleton — he  returned  in  his  28th  year  to  his  native  city,  and 
began  to  practice  as  a  gladiatorial  physician.  At  the  age  of  34  he  went  to  Rome, 
where  he  speedily  acquired  reputation,  especially  by  his  physiological  lectures  and 
his  practice.  Galen  fought  especially  against  the  school  of  Methodism,  which  was  the 
most  influential  in  his  day,  and  in  behalf  of  Hippocrates,  who  was  not  in  fashion,  and 
he  relates  how  some  of  his  "colleagues"  even  poisoned  each  other — a  matter  limited 
to  glances  at  the  present  day !  The  envy  of  these  fellows  drove  him,  however, 
from  Rome,  and  with  disgust  for  the  practice  of  his  profession  in  his  heart,  in  the 
37th  year  of  his  age  he  went  again  upon  his  travels,  and  returned  to  his  home.  After 
a  year,  however,  he  was  recalled  to  Rome  bjr  Marcus  Aurelius,  and  retnrned  to  the 
metropolis  on  foot.  When  he  arrived,  he  was  requested  to  accompany  the  emperor  in 
the  war  against  the  Marcomanni,  but  declined  the  position,  superstitiousl}'  influenced 
by  a  dream,  and  so  became  physician-in-ordinary  to  Commodus.  Of  his  subsequent 
life  nothing  is  known,  though  he  is  supposed  to  have  lived  to  the  age  of  70-80  years. 

Galen  was  an  author  of  immense  fertility  (and  not  alone  in  the  field 
of  medicine),  a  fact  only  partially  explained  by  the  circumstance  that  he 
began  to  write  in  very  early  youth.' 

1.   Of  Galen's  works  there  were  on  philosophical,  grammatical,  mathematical 

and  legal  subjects         .  .  .  .  .  .  .125 

Of  independent  medical  works  still  extant :  genuine         .  .  83 

doubtful  .  .  19 

lost      ...  48 


275 


Add  thereto  : 

Commentaries  on  Hippocrates     .....  15 

Fragments        .  .  .  .  .  .  .  .  19 


.109 
Still  un printed      ........  80 

Total  .     .  389 

Under  Galen's  name  there  exist  45  other  writings   distinguished  as  "spurious". 

The  most  complete  edition  of  Galen's  works  is  that  of  Kuhn  in  22  volumes. 
The  most  important  treatises  are  :  'De  usu  yartium  corporis  humani' ';  "De  motu 
musculorum";  "Delocis  affectis  ";  "De  differentiis  morborum  '';  "Depuhibus"' 
" Ars  \iarva ';  " De  ratione  medendi  ";  "Methodus  medendi";  " De  crisibus " ; 
"De  differentiis  fibrillin" ;  "De  sanitate  tuenda";  "  De  compositione  medica- 
mentorum";   '"  De  morborum  causis";   The  commentaries  etc. 

Those  treatises  of  the  preceding  list  whose  titles  are  printed  in  italics  have  been 
distinguished  as  the  "canonical"  writings  of  Galen,  and  during  the  Middle  A^es 
these  were  first  expounded  to  the  students.  A  complete  translation  from  the 
Greek  of  the  entire  works  of  Galen  has  never  been  made. 

In  spite  of  the  facility  with  which  he  wrote,  Galen  received  but  slight  honoraria 
from  the  booksellers.  Martial  for  the  first  book  of  his  epigrams  received  only 
about  75  cents.  On  the  other  hand  large  bids  were  made  by  private  individuals: 
e.g.  Pliny  was  offered  $<i0,000  for  his  work.  Shorthand  writers  received  about  10 
cents  for  each  of  our  pages  of  the  present  daj",  or  the  same  sum  per  hour.  At 
that  period  there  were  booksellers  in  England,  Spain  etc.,  and  of  course  book- 
fanciers,  as  well  as  waste  paper  (for  dealers  in  fish  and  sausage). 


—  170  — 

The  philosophico-physiological  and  general  pathological  views  of  Galen  are 
founded  upon  the  four  elements,  to  which  are  attached  the  primary  qualities:  to  air, 
coldness,  to  fire,  warmth,  to  water,  moisture,  to  earth,  dryness.  To  these  correspond 
four  cardinal  humors,  among  which  latter  the  element  water  predominates  in  the 
mucus,  which  is  secreted  by  the  brain;  fire,  in  the  yellow  bile,  which  has  its  origin  in 
the  liver;  earth,  in  the  black-bile  formed  by  the  spleen;  while  in  the  blood,  which  is 
prepared  in  the  liver  (an  important  error,  not  discarded  until  the  17th  century),  the 
elements  are  uniformly  mixed.  Mucus  is  cold  and  moist;  yellow  bile,  warm  and 
dry;   black-bile,  cold  and  dry  ;  the  blood,  warm  and  moist. 

This  coincidence  of  the  primary  qualities  is  the  cause  of  the  secon- 
daiy,  so  that  the  latter  arise  from  the  mixture  of  the  former.  The 
primary  qualities  are  not  cognizable  by  the  senses,  but  only  the  secondary. 
The  life-giving  principle  is  the  soul,  understood  as  a  primitive  force,  which 
as  "  spiritus  ",  "  pneuma  ",  is  taken  from,  and  constantly  renewed  by,  the 
general  world-soul  in  the  respiration,  taken  in  its  widest  sense.  Arrived  in 
the  bod\'  the  pneuma  becomes  in  the  brain  (to  which  it  penetrates  through 
the  nose)  and  the  nerves  the  "  animal  spirits "  (nvPu/xa  (pu^ixov,  spiritus 
animalis);  in  the  arteries  and  the  heart  (to  which  it  comes  by  way  of  the 
lungs)  the  "  vital  spirits  "  (nvsu/xa  £u>tu6v,  spiritus  vitalis)  ;  and  in  the 
liver  and  the  renal  veins,  the  ;'  natural  spirits  "  (jtveu/xa  yuatzov,  spiritus 
naturalis).  The  three  fundamental  faculties  (duvd/tets,  facilitates),  the 
'■'animal"  (<pu%urj),  "  vital "  (£wTtzyj)  and  '-'natural"  (<pu<rur}),  which  bring 
into  action  and  keep  in  operation  the  corresponding  functions,  originate 
as  an  expression  of  the  primal  force,  "soul"  (pneuma),  existing  in  these 
three  modalities  within  the  body.  Besides  these,  there  are  for  special 
functions  of  the  body  other  faculties,  subordinate  to  these  three  and  act- 
ing occasionally,  as  tbe  "  attractive"  (<5.  iXxrtxij),  the  '■  propulsive "(5.  -po- 
wT-r/.rj),  the  "retentive"  (8.  /.aOzy-t/^)  and  the  "secreting"  [8.  axaxpiTtxTJ). 

Upon  these  depend  nutrition,  assimilation,  secretion,  muscular  contraction,  in 
general  all  the  ordinary  functions  of  the  body,  in  which  each  organ  has  the  property 
of  appropriating  to  itself  by  means  of  these  faculties  that  which  is  necessary  for  its 
own  existence.  There  are,  besides  these,  "special  forces",  which  are  not  derived 
from  the  three  already  named,  and  which  are  therefore  supernatural.  Everything, 
however,  which  exists  and  displays  activity  in  the  human  body,  originates  in,  and  is 
formed  upon,  an  intelligent  plan,  so  that  the  organ  in  structure  and  function  is  the 
result  of  that  plan.  Thus  the  human  frame  is  adapted  to  the  solution  of  a  teleological 
problem.     Indeed  Galen  is  the  father  of  teleology  in  medicine. 

"  It  was  the  Creator's  infinite  wisdom  which  selected  the  best  means  to  attain  his 
beneficent  ends,  and  it  is  a  proof  of  his  omnipotence  that  he  created  every  good  thing 
according  to  his  design,  and  thereby  fulfilled  his  will",  an  expression  which 
accords  with  the  Christian  ideas  that  were  then  forced  by  the  spirit  of  the  age  upon 
the  very  heathen.      (Schlosser. ) 

As  in  what  precedes  we  find,  besides  views  peculiar  to  Galen,  a  mixture  of  Hip- 
pocratic,  Platonic,  Aristotelian  and  Stoic  ideas,  so  in  what  follows  we  observe  a 
similar  selection  from  the  older  views,  besides  those  of  purely  Galenic  origin. 

Health  is  to  be  regarded  as  that  condition  in  which  all  the  functions  of  the  body 
are  performed  without  pain  and  without  disturbance  (effecting  thereby  the  so-called 
euexia),  the  possibility  of  which  depends  upon  the  proper  proportion  of  the  solid  and 
fluid  constituents,  and  the  correct  mixture  (crasis,  eucrasis)  of  the  humors.     Conse- 


—  171  — 

quently  disease  is  that  "  unnatural"  condition,  in  which  a  contrary  state  exists.  Now 
diseases  may  affect: 

1.  The  four  elements  and  their  corresponding  cardinal  fluids  (general  diseases), 
in  the  form  of  dyscrasiae,  of  which  there  may  consequently  be  eight,  while  one  or  two 
are  especially  conspicuous. 

2.  The  similar  parts  (general  tissues:  muscles,  nerves,  bones,  ligaments  etc.),  in 
which  either  abnormal  tension  or  relaxation  (views  of  the  Methodists!),  or  disturbance 
of  the  fundamental  qualities  (warmth,  cold,  moisture,  dryness — Hippocratic!)  through 
abnormal  predominance  of  the  one  or  the  other,  arises. 

3.  The  organs  (local  diseases),  in  which  the  number,  form,  mass  or  position  of  the 
parts  ma}-  be  disturbed. 

To  the  two  latter  classes  of  disease  the  abolition  of  the  constant  performance  of 
the  functions  of  the  undisturbed  condition   is  common. 

Galen  divides  the  causes  of  disease  into  the  proximate  and  the  remote,  the  latter  of 
which  again  are  subdivided  into  the  external  (occasional),  and  internal'  (predisposing) 
causes.  The  predisposing  causes  consist  for  the  most  part,  in  an  overflow,  or  corruption, 
of  the  humors,  for  which  latter  condition  Galen  retained  the  "putrefaction"  of  the 
Pneumatists.  This  he  considered  a  general  cause  of  fever  (the  essential  phenonenon 
of  which  was  an  elevation  of  the  temperature — as  it  is  to-day- — more  rarely  moisture), 
with  the  exception  of  ephemeral  fever,  which  arises  from  injur}*  of  the  pneuma. — The 
influx  of  the  blood  into  unusual  places  (error  loci  of  Erasistratus ! )  is  the  cause  of 
inflammation,  with  its  cardinal  symptoms,  redness,  heat,  swelling  and  pain.  Galen 
divides  inflammation  into  the  following  curious  classes,  some  of  which  are  still  current : 
a.  erysipelatous,  where  the  yellow  bile  mingles  with  the  misplaced  blood  ;  b.— pneu- 
matous,  where  the  pneuma  unites  with  the  misplaced  blood;  c. — phlegmatous,  where 
mucus  mixes  with  the  blood;  d. — phlegmonous,  when  it  depends  purely  on  misplace- 
ment of  the  blood;  e. — scirrhous,  when  black  bile  meets  with  the  blood.  The 
results  of  inflammation  are  resolution,  exudation  and  suppuration. 

Symptoms  (epigenemata)  are  the  visible  results  of  disease.  They  are  distributed 
(in  opposition  to  the  theoretical  view  of  crudeness,  coction  and  crisis,  of  Hippocrates) 
over  the  four  stadia  of  disease  recognized  by  Galen:  the  stadium  initiale,  increment!, 
acmes  and  decrementi. 

The  course  of  disease  becomes  chronic  through  the  influence  of  mucus  and 
black  bile,  acute,  through  blood  and  yellow  bile. 

Galen,  like  Hippocrates,  taught  the  doctrine  of  crises,  but  associated  therewith 
the  course  of  the  sun  and  moon. 

Galen  is  of  peculiar  importance  in  special  pathology  from  the  fact  that  he  first, 
designedly,  and  extensively  employed  experiment  for  its  basis.  He  was  the  first 
physiologist  (if  we  except  the  accounts  of  the  Hippocratists  in  embryology)  to  experi- 
ment and  vivisect  upon  scientific  principles.  Thus  he  founded  the  physiology  of  the 
nervous  system  by  section  of  the  fifth  cervical  nerve,  after  which  he  saw  the  motility 
of  the  supra-  and  infraspinatus  muscles  cease;  similarly,  after  section  of  the  recur- 
rent, nerve,  (together  with  the  intercostal  muscles),  and  after  destruction  of  the 
spinal  marrow,  he  observed  loss  of  the  voice.  Nerves  of  motion,  which  as  such  are 
"hard",  are  represented  by  the  60  spinal  nerves;  those  of  sensation  ("soft")  by  the 
nerves  of  the  brain.  Of  the  latter  he  recognized  seven:  the  optic;  oculomotorius 
and  trochlearis ;  1st.  branch  of  the  trigeminus;  2d.  and  3d.  branches  of  the  trigem- 
inus; acoustic  and  facial :  vagus,  and  glossopharyngeus.  The  nerves  of  the  medulla 
oblongata  were  of  mixed  function. — Galen  was  acquainted  with  the  movement  of  the 
brain,  and  assumed  that  by  it  the  impurities  of  the  "animal  spirits",  brought  to  the 
brain  by  the  carotids,  were  expelled  through  the  lamina  cribrosa,  while  its  more 
refined  portions,  the  nervous  spirits,  were  prepared   in  the  plexus  of  the  ventricles, 


—  172  — 

and  thence  borne  by  the  nerves  throughout  the  body. — The  great  sensibility  of  the 
intestines  depends  upon  the  sympathetic  nerve.  The  perception  of  light  he  locates  in 
the  retina. — According  to  Galen  the  secretion  of  milk  depends  upon  pressure  of  the 
pregnant  uterus  upon  the  vessels  of  the  abdomen,  with  which  those  of  the  breast  anas- 
tomose—Respiration and  the  pulse  serve  one  purpose,  the  reception  of  air.  The 
latte;-  in  inspiration  comes  first,  into  the  lungs,  and  thence  into  the  left  heart  and 
arteries.  On  the  other  hand,  during  the  diastole  of  the  arteries  air  is  sucked  into 
them  through  the  pores  of  the  skin.  During  the  systole  of  the  lungs  and  arteries  the 
"soot"1  escapes.  The  air  or  pneuma  received  by  the  lungs  is  not  sufficient  by 
itself  to  cool  the  heart;  hence  air  is  also  received  through  the  skin.  The  diastole  of 
the  heart  and  arteries  and  inspiration  also  conduct  pneuma  to  the  blood,  while  the 
systole  and  expiration  discharge  the  "soot"  from  the  blood.  Respiration  has  its 
origin  in  the  vital,  the  pulse  in  the  animal  sphere.  In  this  consists  their  essential 
difference,  not  in  their  function.  Respiration  is  effected  by  means  of  the  diaphragm 
and  the  intercostal  muscles  The  physiological  route  of  the  pneuma  (the  respiratory 
process  is  one  of  combustion  ! )  is  developed  within  the  body  or  the  vessels  as  the 
circulation,  which  takes  place  as  follows:  from  the  stomach  the  food,  which  lias 
undergone  "coction",  proceeds  to  the  liver,  where  it  is  converted  into  blood.  This 
blood  is  now  carried  to  the  heart,  and  the  latter  organ  (whose  various  parts  all  con- 
tract simultaneously)  drives  into  the  lungs,  through  the  pulmonary  artery,  so  much 
of  this  blood  as  may  be  required  for  their  nutrition.  At  the  same  time  the* remainder 
of  the  blood  is  driven  through  the  veins  into  the  body,  and  a  minute  portion  passes 
through  the  pores  of  the  septum  into  the  left  ventricle,  where  it  is  mixed  with  the 
pneuma  drawn  into  the  heart  through  the  pulmonar}'  veins  in  diastole.  No  blood 
returns  from  the  lungs  to  the  heart,  for  all  of  it  is  consumed  in  the  nutrition  of  those 
organs.  From  the  left  heart  the  blood  (mixed  with  the  pneuma)  proceeds  through  the 
aorta  to  be  communicated  to  the  veins  finally  by  means  of  the  pore-like  anastomoses  at 
the  terminations  of  this  vessel.  To  the  veins  all  the  nutrition  of  the  body  is  due.  The 
blood  conveyed  to  the  body  b}-  the  veins  is  principally  used  up  in  nutrition;  but  what 
little  remains,  together  with  the  new  blood  formed  in  the  liver,  returns  to  the  right  heart 
by  a  sort  of  ebb-tide  in  the  venous  circulation.  Dilatation  and  diastole  of  the  heart,  as 
well  as  of  the  arteries,  are  the  active  factors  in  the  motion  of  these  parts,  while  systole 
is  the  passive  element.  The  venous  portion  of  the  circulation  is  the  seat,  as  we  have 
seen,  of  nutrition;  the  arterial  of  the  "vital  spirits".  Galen's  explanation  of  the  cir- 
culation is  by  no  means  clear.  King  Alfonso  judged  of  the  Ptolemaic  system  of  the 
motion  of  the  universe,  that  it  was  not  sufficiently  simple  to  be  true.  Singularly 
enough,  however,  no  physician,  down  to  the  time  of  Harvey,  formed  a  similar  opinion 
of  the  theory  of  circulation  of  the  Ancients  !  The  blood  is  perfected  in  the  heart  and 
supplied  with  the  calidum  innatum,  and  then  passes  on  into  the  body.  The  pulse 
arises  from  an  active  dilating  force,  pulse-force,  communicated  to  the  arteries  from 
the  heart.  The  heart  has  no  nerves,  but  is  the  seat  of  passion  and  courage.2  The 
brain  is  the  seat  of  the  rational  soul,  and  an  organ  for  the  secretion  of  mucus  and  for 

1.  Or.  /.ip'i:  or  to  zamiodss,  Lat.  fuligo:  the  excrementitious  waste  of  the 
body.     (IT.) 

2  It  is  interesting  to  observe  how  this  idea  has  engrafted  itself  upon  our  very 
language,  courage  coming  down  to  us  from  the  Latin  cor,  heart,  through  the 
mediaeval  Latin  coraticum  and  the  old  French  corage.     So  Chaucer  says: 

"So  priketh  hem  Nature  in  hir  corages". 
The   venereal   function   of  the  liver   is   at   least  as  old   as    Plato,  and   descends 
certainly  as  late  as  Shakespeare.     To  Ford's  question  "Love  my  wife?"     Pistol 
replies  "  With  liver  burning  hot !  "     (H.) 


—  173  — 

cooling  the  heart.  The  lungs  also  serve  to  cool  off  the  heart.  The  liver  is  the  place 
for  the  preparation  of  the  blood — and  the  seat  of  love!  The  "animal  spirits"  are  the 
cause  of  the  soul's  activity.  They  originate  from  the  blood,  and  are  also  originally 
"vital",  but  in  the  brain  become  the  "animal"  spirits.  From  the  origin  of  the 
"animal  spirits"  the  dependence  of  mental  expressions  and  disturbances  upon  the 
bodily  condition  is  also  explained.  Galen  divides  these  mental  disturbances  into 
mania,  melancholia,  imbecility  and  dementia.  In  direct  opposition  to  what  has  been 
said  concerning  mental  activity  and  its  cause  and  seat,  he  explains  the  tempera- 
ments by  the  mixture  of  the  elements,  and  therefore  divides  them  into  I. — the  dry 
and  warm  (choleric);  '1. — dry  and  cold  (melancholic);  3. — moist  and  warm  (sanguine); 
4. — moist  and  cold  (phlegmatic).  The  sensations  again  are  dependent  upon  the 
animal  spirits.  The  sight  is  effected  through  that  portion  of  these  spirits  which  is  found 
between  the  lens  and  the  choroid,  and  which  intercepts  the  rays  of  light  in  order  to 
conduct  them  to  the  optic  nerve.  The  pneuma  likewise  occasions  the  smell  by  forcing 
its  wajr  into  the  anterior  ventricles  of  the  brain,  which  are  the  seat  of  this  sense.  The 
hearing  originates  in  the  penetration  of  the  pneuma,  in  the  form  of  waves,  into  the 
course  of  the  nerve  of  hearing. — The  natural  spirits  are  the  final  cause  of  the  natural 
functions,  as  well  as  of  generation.  In  the  latter,  the  man  and  the  woman  are  equally 
concerned,  since  both  have  entirely  similar  organs,  only  the  female  organs,  in  ac- 
cordance with  the  greater  "coldness  of  the  woman",  are  situated  in  the  inner  parts  of 
the  body.  Both  produce  semen,  the  woman,  a  very  fluid  seed  in  the  ovaries  (whose 
excretory  ducts  are  the  Fallopian  tubes),  the  man  in  the  testicles,  and  the  two  are 
uniformly  mixed  during  and  after  coition.  In  this  process,  according  to  Galen  also, 
the  right  testicle  supplies  boys,  the  left,  girls.  In  the  development  of  the  brain  the 
"semen  "  alone  is  concerned,  but  in  that  of  the  intestines  the  blood,  which  the  embryo 
sucks  from  the  placenta,  and  in  that  of  the  vessels,  both  the  blood  and  pneuma.  The 
membranes  originate  in  the  colder  female  semen  only;  the  heart  is  not  completely 
formed  at  first  etc.  The  stomach  and  intestines  possess  peristaltic  movements,  and 
from  the  former  the  dissolved  mass  of  food  only  passes  through  the  pylorus  into  the 
intestines. 

Much  more  original  is  the  knowledge  of  Galen  in  anatomy,  which  from  his  youth 
up  he  studied  with  enduring  fondness.  His  observations  were  confined  entirely  to 
the  lower  animals,  except  in  regard  to  the  bones,  which  he  had  been  able  to  study 
upon  two  human  skeletons  at  Alexandria.  One  of  these  skeletons  had  been  cleaned 
by  birds,  the  other  by  the  Nile,  and  Galen  considered  it  a  piece  of  special  good- 
fortune  that  he  had  been  able  to  study  their  structure.  His  anatomical  works —  the 
best  among  the  Ancients  —  continued  text-books  down  into  the  16th  century.  He  is 
in  main-  points  the  first  discoverer,  and  always  a  very  careful  describer,  the  latter 
especially  in  regard  to  osteology,  the  central  and  peripheral  nervous  system,  the 
larynx,  the  intestines  (he  was  acquainted  with  Wharton's  duct)  and  the  genital 
organs,  though  he  too  is  not  free  from  the  confusion  and  errors  of  the  Ancients,  and 
readily  falls  into  teleological  speculations.  He  was  the  first  to  describe  the  structure 
of  the  tendo  Achillis,  the  popliteus  muscle,  8  muscles,  of  which  two  were  situated 
upon  the  upper  arm  and  two  were  masticatory  muscles;  the  platysma  myoides ;  the 
three  coats  of  the  arteries;  very  thoroughly  also  the  eye  (including  the  puneta 
lachrymalia  and  lachrymal  ducts  and  glands.  The  tears,  which  up  to  this  time  had 
been  looked  upon  as  an  exudation  of  the  aqueous  humor,  he  considered  the  secietion 
of  the  latter  glands);  the  heart,  which,  by  the  way,  he  does  not  consider  a  muscle; 
the  aorta,  the  jugular  vein,  the  ductus  Botalli,  the  foramen  ovale,  the  muscles  of  the 
spine;  six  muscles  of  the  eye  and  those  of  the  larynx  etc.  He  wrongly  assigns  to 
the  heart  a  position  in  the  center  of  the  thoracic  cavity,  but  knew  that  it  was  com- 
posed of  straight,  oblique  and  transverse  fibres,  and   had  a  force  of  its  own,  which 


—  174  — 

kept  it  beating  after  it  was  cut  out  of  the  body.  He  also  holds  that  the  veins  arise 
from  the  liver  and  the  arteries  from  the  heart,  but  he  does  not  (like  Aristotle)  derive 
the  nerves  from  the  latter  organ,  but  from  the  brain.  The  spleen,  in  contrast  to  the 
liver,  has  arteries  alone. 

The  services  of  Galen  to  descriptive,  as  well  as  to  operative,  surgery  stand  far 
behind  those  to  pathology.  Among  the  comparative^  few  observations  marie  by  him 
is  found  one  of  forward  dislocation  of  the  thigh.  He  mentions  in  an  operative  view 
trepanning,  wounds  (which,  in  opposition  to  Hippocrates  and  Celsus,  he  treats  not 
with  cold  water,  but  with  warm  water  and  oil,  a  practice  followed  far  into  the  Middle 
Ages,  and  even  as  late  as  the  18th  century),  diseases  of  bone  etc.,  but  devotes  himself 
extensively  to  bleeding,  the  only  operation  which  he  regularly  performed  himself, 
while  he  abandoned  the  others  to  the  "specialists".  This  "beneficent  division  of 
labor"  was  a  real  disadvantage  to  science,  even  at  that  time,  for  it  prevented  Galen, 
the  trusty  transmitter  of  ancient  medicine,  from  sajing  much  about  the  surgery  of 
the  Ancients,  and  induced  him  to  confine  himself  in  this  department  to  salves, 
poultices  etc.  Yet  he  handled  the  subject  of  bandaging  in  detail,  and  introduced  the 
methods  known  even  today  as  the  accipiter,  the  sling,  the  testudo,  the  f=pica  etc. 

In  like  manner  he  has  written  little  on  midwifery,  though  the  birth  of  the  child  is, 
in  his  view,  the  result  of  the  contraction  of  the  muscular  fibres  of  the  uterus  under 
active  dilatation  of  the  os  uteri,  aided  by  abdominal  pressure.  He  says  very  little  of 
gynaecology,  and  as  little  on  diseases  of  the  ears,  and  teeth,  while  he  devotes  more 
attention  to  diseases  of  the  eyes.  He  is  the  first  to  mention  keratonyxis  or  para- 
centesis corneas,  and  he  is  acquainted  with  the  removal  of  staphyloma  and  tattooing 
the  cornea. 

Galen  did  not  greatly  advance  semeiology,  with  the  exception  of  the-doctrine  of 
the  pulse,  which  he  elaborated  so  extensively  that  he  wrote  many  treatises  on  this 
subject  alone.  He  distinguished  the  following  altogether  too  refined  (and  therefore, 
during  life  mostly  entirely  useless)  classes,  to  which  the  sphygmography  of  to-day 
can  probably  still  add  a  few  varieties. 

I.  Absolute  Differences  of  the  Pulse. 

A.  Simple  Relations. 

1.  In  respect  to  the  kind  of  progression  of  single  pulse-waves  =  pulsus  celer,  moder- 

atus,  tardus. 

2.  In  respect  to  the  dimensions  of  the  artery  during  diastole. 

a)  In  respect  to  the  length  of  the  pulse-wave  =  p.  longits,  moderatus,  brevis  ; 

b)  "  "         breadth     "  =  p.  latvs,  moderatus,  auguslus ; 

c)  "  "         depth  =  p.  alius,  moderatus,  humilis ; 

3.  In  respect  to  the  strength  of  the  pulse  =  p.  validus,  moderaius,  imbecillus  ; 

4.  In  respect  to  the  condition  of  the  artery  =  p.  diirus,  moderaius,  mollis ; 

5.  In  respect  to  the  intermission  =  p.  rants,  moderatus,  creber. 

B.  Combined  Relations. 
These  arise  from  combinations  of  the  varieties  of  pulse  already  named. 

II.  Relative  Differences 

of  one  pulsation  from  another  =  pulsus  ryihmicus,  arythmicus,  cequalis, 
incequalis,  regularis,  irregularis  etc."     (Wunderlich.) 

Galen  advanced  diagnosis  chiefly  by  his  sharper  systematic  definition  of  the 
phenomena  of  disease,  while,  so  far  as  the  means  of  investigation  are  concerned,  he 
did  not  go  beyond  the  Hippocratists  and  earlier  physicians.  His  "hissing  sound"  in 
perforating  wounds  of  the  thorax  is,  however,  worth}7  of  mention. 


—  175  — 

In  prognosis  Galen  prided  himself  upon  surpassing  the  physicians  of  his  day,  and 
on  equalling  Hippocrates,  whose  principles  he  followed  in  this  science.  "I  have 
read  the  Prognostics  of  Hippocrates  as  well  as  you.  Why  can  I  not  prognosticate 
as  well  as  you?"  said  one  to  him;  he  replied  at  once,  "That  by  God's  help  he  had 
never  been  deceived  in  his  prognosis." 

In  special  pathology  Galen  added  little  of  importance  to  the  material  already 
existing,  though  he  constructed  his  pictures  of  disease  more  perfectly  through  a 
better  analysis  of  single  symptoms;  as  e.  g.  in  phthisis  (its  different  forms  and  infec- 
tious (?)  character),  pneumonia,  and  pleuritis,  gout,  rheumatism,  intermittent  fever, 
varieties  of  spasm  etc.  Cancer  he  regards  as  a  parasitic  being,  which  occasions  both 
local  and  general  disturbances.  In  special  therapeutics  he  seems,  in  opposition  to 
his  general  therapeutic  principles,  to  have  given  too  much  medicine,  and  particularly 
to  have  been  too  free  with  his  favorite  remedies,  e.  g.  bleeding,  cathartics  and 
emetics,  capers,  pepper  etc.  He  rightly,  however,  laid  great  weight  on  so-called 
climatic  cures,  of  which  he  seems  to  have  been  the  founder.  But  even  in  the  treatment 
of  disease,  he  was,  as  we  should  express  it,  less  a  practitioner,  than  a  skilful,  theorist. 
The  number  of  drugs  used  by  Galen  is  very  large.  Moreover  his  inclination  to, 
and  use  of,  the  numerous  (animal  and  vegetable)  compound  remedies  of  "  hoary 
theory"  became  extremely  prejudicial  to  future  ages,  which  could  swear  by  nothing 
higher  than  Galen.  Metallic  remedies  he  rejected,  regarding  mercury  as  the  greatest 
of  poisons.  Not  infrequently  open  superstition  plajed  a  role  in  his  treatment.  The 
effect  of  drugs,  according  to  Galen,  is  based  upon  the  harmony  or  disagreement  of 
their  "qualities"  with  the  behavior  in  diseases  of  the  "elementary  qualities".  These 
'"qualities"  were  cognizable  by  the  senses,  and  upon  them  depended  the  use  of  rem- 
edies. When  the  character  of  the  disease  was  known,  the  remedy  was  chosen  to  cor- 
respond therewith.  Hence  drugs  were  divided  theoretically  into  grades.  If  e.  g.  a 
drug  is  slightly  heating,  it  is  "warm  in  the  first  degree",  if  it  is  stronger,  it  is  "warm 
in  the  second  degree";  if  still  more  heating,  it  is  called  "warm  in  the  third  degree"; 
if  it  disturbs  the  condition  of  the  body,  it  is  called  "warm  in  the  fourth  decree".  In 
toxicology  he  divides  poisons  into  1.  refrigerants  (narcotics),  and  2.  calorifacients, 
the  latter  subdivided  again  into  corrosives  and  septics.      (Marx.) 

His  general  princples  of  treatment,  in  contrast  to  these  incomprehensible  specu- 
lations and  his  practical  polypharmacy,  are  simple  and  natural.  He  lays  great 
weight  on  correct  diet;  exercise,  when  practicable;  reliance  upon  nature;  care  to 
benefit,  or  at  least  in  bad  cases  to  do  no  harm,  and  to  cure  without  pain, — in  all  of 
which  he  follows  Hipprocates.  "Nature  is  the  overseer  b}r  whom  health  is  supplied 
to  the  sick.  .  .  .  Nature  lends  her  aid  on  all  sides,  she  decides  and  cures  diseases. 
....  No  one  can  be  saved  unless  nature  conquers  the  disease,  and  no  one  dies 
unless  nature  succumbs."  He  also  strengthened  the  doctrine  of  "  indications  and 
contraindications",  founded  by  the  Methodists  on  false  principles,  by  a  natural  con- 
sideration of  the  constitution  and  strength  of  the  patient,  the  character,  symptoms  and 
course  of  the  disease,  the  external  conditions  under  which  the  invalid  finds,  or  found 
himself,  the  cause  of  the  disease,  and  finally  also,  in  accordance  with  his  own  super- 
stitious disposition  and  the  tendencies  of  his  age,  b}T — dreams.  He  was  at  home  too 
in  professional  policy.  One  should  be  neither  too  obsequious  nor  too  gruff  at  the 
bedside;  he  should  entertain  the  patient  with  serious  or  cheerful  stories  (as  a  suitable 
subject  he  suggests  the  proposition  of  Hipprocates  that  medical  art  is  based  upon 
disease,  the  patient  and  the  physician  —  how  pedantic!);  he  must  yield  to  fashion 
e.  g.  in  regard  to  the  style  of  wearing  the  hair,  but  not  as  to  pomatums!  etc. 

Galen  was  a  man  of  universal  education,  versed  especially  in  philoso- 
phy and  rhetoric,  and  of  an  enormous  technical  knowledge,  which  enabled 


—  176  — 

Mini  to  comprehend,  historically  and  critically,  the  whole  pre-existing 
science  of  medicine.  This  knowledge  was  the  result  of  a  marvellous 
capacity  for  labor,  devoted,  from  a  precocious  \-outh  onward  to  literary 
pursuits,  in  which  respect  he  was  equalled  by  scarcely  any  physician  of 
any  age.  Thus  he  became  one  of  the  greatest,  medical  savants,  most  emi- 
nent scholars  and  most  fruitful  authors  of  all  time.  If  he  was.  on  the 
whole,  rather  a  great  compiler  and  savant,  he  was  yet  an  independent  in- 
vestigator also,  particularly  in  the  departments  of  anatomy  and  physiology, 
—  he  was  the  creator  of  experimental  physiology  —  and  by  reason  of  his 
acuteness  of  mind  and  his  great  skill  in  dialectics  he  was  a  born  system- 
atist. 

As  an  author  —  not  infrequently  he  wrote  down  hastily  out  of  com- 
plaisance to  his  hearers  and  friends,  lectures  just  delivered — he  was  a 
master  of  language,  and  he  took  such  delight  in  this  gift  that  he  often 
lapsed  into  prolixity  and  pompous  diction.  Thus  his  works  lost  in  force 
and  consequence  what  they  gained  in  number  and  volume. 

As  a  critic  Galen  was  acute,  but  not  always  impartial. 

As  the  result  of  his  whole  education  and  his  natural  disposition,  he 
was  better  adapted  for  a  teacher  and  savant  than  for  a  practitioner  In  the 
latter  capacity  he  seems  never  to  have  been  very  active,  for  his,  reported 
cases  are  very  few  ;  at  least  they  are  much  less  numerous  than  with  Hip- 
pocrates. Moreover  he  is  self-complacent  and  desirous  of  fame  (however 
much  he  ma}'  deny  such  charges),  and  in  many  things  fanciful  and,  indeed, 
superstitious,  in  all  of  which  he  was  unlike  the  unprejudiced   Hippocrates  ! 

Galen  possessed  a  high  conception  of  the  profession  of  medicine,  which 
may  have  tempted  him  into  bitterness  and  harshness  against  the  weakness 
and  faults  of  the  physicians  of  his  day,  though  he,  doubtless,  in  many  things 
had  the  correct  view,  and  spoke  the  truth,  in  this  respect.  Marcus  Aure- 
lius  gave  him  such  a  character  as  Napoleon  gave  Larrey,  that  he  was  the 
only  upright  man  whom  he  knew.  Great  physicians  have  in  all  ages  been 
noble  minds  ! 

Taken  all  in  all,  Galen  was  rather  a  gifted  savant  than  a  pre-eminent 
practitioner  like  Hippocrates. 

He  lacked  the  practical  glance  of  the  latter,  though  not  the  gift  of  observation, 
which  in  Galen  was  directed  to  the  so-called  scientific  branches.  With  him  all 
science  and  thought  was  applied  to  the  theoretical  elucidation  of  medicine;  with 
Hippocrates,  only  to  its  practical  employment  and  utilization.  Even  where  tialen  is 
original,  it  is  only  in  the  theoretical  departments  of  medicine!  Even  during  his  life- 
time Galen  enjoyed  great  reputation  as  a  philosopher,  and  a  medical  teacher  and 
law  giver.  Through  the  whole  Middle  Ages  this  reputation  continued  undisputed, 
and  by  it  he  was  the  lord  and  master  of  medicine  for  fifteen  hundred  years!  And 
yet  Boerhaave  summed  up  the  result  of  his  rule  in  the  words:  "Galen  has  done  more 
harm  than  good"    -a judgment  which,  however,  seems  too  harsh. 

Marcellus  ok  Sida  (about  A.  D.  138) 
treated  medical  suhjects  in  hexameter  verse,  an  offence  against  common-sense  and 
taste   which   forestalled   the   Middle    Ages.      Of  this  poem   in   42   books,   fragments 


—  177  — 

"On  remedies  derived  from  the  fisli  kingdom"  and  on  lykantluopia  have  been  pre- 
served to  ns.  The  latter  disease  was  an  ancient  psychical  plague,  in  which  the 
sufferers  left  their  houses  by  night,  howling  like  wolves  and  roaming  about  among  the 
graves,  wan,  with  sunken  cheeks  and  hollow  eyes,  dr\-  tongues  and  tormented  by 
thirst,  dicers  upon  the  legs  were  the  results  of  wounds  received  from  thorns.  The 
disease  prevailed  especially  in  February  and  March  of  each  year.  Marcellus  himself 
is  an  evidence  of  the  declining  condition  of  medicine  as  early  as  his  day. 

Magnus  of  Ephestjs  (about  A.  P.  150) 

was  archiater  at  Rome  in  the  time  of  Galen,  explained  the  pulse  as  an  alternate 
swelling  and  sinking  of  the  veins,  and  placed  the  seat  of  hydrophobia  in  the  stomach 
and  diaphragm. 

Leonides  of  Alexandria  (about  A.  P.  200),  -'the  Episynthetic ", 

was  one  of  the  most  important  of  the  great  surgeons  of  the  imperial  period.  He 
amputated  limbs  and  cancerous  breasts  with  the  knife,  even  cutting  through  the 
healthy  tissues,  but  treated  haemorrhage  with  the  actual  cautery.  Tn  operating  for 
empyema  be  resorted  to  incision,  as  well  as  to  burning  through  the  chest-wall  with 
the  redhot  iron.  In  hydrocele  be  first  cauterized  and  then  made  an  incision;  he 
practised  scarification  in  anasarca,  recommended  puncture  in  hydrocephalus,  and 
found  the  reduction  of  hernia  not  very  difficult.  He  assumes,  like  the  earlier  physi- 
cians, laceration  of  the  peritoneum  as  the  cause  of  hernia,  and  in  large  hernias  this  is 
accompanied  with  laceration  of  the  coverings  of  the  testicle.  Fistula,  especially 
fistula  in  ano,  be  operated  upon  with  a  blunt-pointed  knife,  which  he  called  a 
syringotome.  He  mentions  callous  ulcers,  waits  and  excrescences  on  the  genital 
organs,  which  do  not  originate  of  themselves,  though  he  did  not  recognize  coitus  or 
infection  as  their  cause,  and  he  considered  the  actual  cautery  necessarj-  for  their 
removal.  He  also  mentions  buboes,  fissures  of  the  anus,  orchitis,  gonorrhoea  etc.  He 
was  the  most  important  syphilographer  of  antiquity,  though  he  did  not  select  the 
designations  in  use  to-day,  nor  did  he  recognize  general  syphilis,  which,  according  to 
all  accounts,  first  made  its  appearance  at  a  later  period. 

Alexander    of    Aphrodisias    in    Caria   (about  A.  P.   200),   "the 
Exegete  ", 

so  named  from  his  interpretations  of  Aristotle,  was  a  favorite  of  Septimius  Severus 
and  a  patron  of  Galen.      He  wrote  a  treatise  "  On  fever". 

Antylltjs  (3d  century) 

was  one  of  the  most  distinguished  surgeons  of  antiquity,  and  the  first  who,  in  addition 
to  depression,  described  the  extraction  of  small  cataracts.1     He  also  described  the 

1.  Perhaps  this  operation  was  also  practised  earlier  by  the  eminent  oculists  of  the 
days  of  the  Empire,  Theodotius  (?)  Severus  and  Latyrion  (or  Satyrion).  The 
cataract  extraction  of  the  Ancients  had  nothing  in  common  with  the  operation  of 
the  present  day.  It  was  performed  with  the  smallest  possible  wound  of  the 
cornea,  more  like  our  operation  for  hypopyon.  About  the  time  of  Antyllus  the. 
modification  of  removing  the  lens  by  suction  was  likewise  introduced  (Magnus). 
In  cases  of  ectropium  Antyllus  recommended  the  removal  of  a  triangular  piece, 
extending  through  the  whole  thickness  of  the  lower  lid.  Severus  recognized  the 
layers  of  the  cornea,  and  located  onychion  (in  contradistinction  to  hypopyon) 
between  them.  He  also  described  the  changes  of  the  conjunctiva  in  the  blen- 
orrhoea,  so  prevalent  in  his  day,  and  in  trachoma.  In  the  latter  disease  he 
recommended  the  operation  of  periscintbismus,  a  semicircular  incision  of  the 
scalp  down  to  the  bone,  extending  from  one  temple  to  the  other,  but  avoiding  the 
12       . 


—   ITS  — 

so-called  Antj'llie  method  of  operation  on  aneurism  (ligation  of  the  vessel  both  above 
and  b -low  the  sack,  followed  by  opening  of  the  sack  itself  in  order  to  remove  its  con- 
tents without  cutting  out  the  sack.  Albert.)  He  was  the  first  to  describe  aneurism 
precisely,  as  well  as  the  method  of  practising  venesection,  cupping,  scarif  cation, 
arteriotomy,  subcutaneous  section  of  the  ligaments  in  stiff  joints,  and  of  the  ligaments 
of  the  tongue  in  stammering.  He  practised  incision  of  the  inner  layer  of  the  prepuce 
without  injury  of  the  skin  in  phimosis.  He  also  discussed  the  different  forms  of 
hydrocephalus  acutus  (the  seat  of  which  he  located  between  the  skin  and  pericranium, 
or  between  the  latter  and  the  bones,  or  finally  between  the  bones  and  the  membranes 
of  the  brain.)  He  also  described  tracheotomy.  As  a  physician  Anfylliis  coiifidered 
in  his  treatment  the  influence  of  air  of  different  temperatures:  of  various  bathing 
waters  containing  sulphur,  alum  and  soda;  of  herb-baths,  bathing  and  swimming 
(especially  in  chronic  diseases  >:  of  gymnastic  exercises;  of  residence  ;  of  the  position 
of  the  sick;  even  of  songs  and  declamation;  and  besides  dietetic  prescriptions,  he 
gave  also  directions  for  the  preparation  of  plasters,  ointments  etc.  He  advised  that 
when  leeches  had  fixed  themselves  upon  the  skin,  their  tails  should  be  cut  off,  so  that 
they  might  suck  the  more  blood. — The  brothers 

Philagrius  and  Posidonius 
lived  about  A.  D.  860-375,  and  were  sufficiently  enlightened  to  protest  earnestly 
against  the  employment  of  mystic  words  in  the  preparation  of  medicines,  an  abuse 
which  prevailed  even  at  this  period.  The  former  removed  a  stone  by  an  incision 
made  from  above  into  the  neck  of  the  bladder,  and  oe.-irihed  the  operation  for  aneur- 
ism resulting  from  the  unskilful  performance  of  bleeding.  He  laid  bare  the  artery, 
applied  two  ligatures  above  the  sack,  and  then  divided  the  artery  between  the  two. 
Then  he  opened  the  sack  by  a  longitudinal  incision,  removed  the  coagulated  blood, 
and  tied  the  lower  end  of  the  artery,  as  had  been  done  with  the  upper.  The  artery 
was  then  also  divided  between  the  lower  ligatures.  The  sack  was  left  to  suppurate. 
Posidonius  was  a  distinguished  neuro-pathoiogist  and  psychiater,  who  wrote  on 
"phrenitis" — the  phenomena  of  which  lie  referred  to  the  anatomical  seat  of  the 
disease.  The  anterior  parts  of  the  brain,  as  the  seat  of  the  imagination,  when 
diseased,  produce  only  distorted  images,  but  leave  the  reason  free,  while  in  injuries  of 
the  middle  ventricle  of  the  brain  reason  is  disturbed.  In  disease  of  the  posterior 
ventricle  recollection  is  destroyed,  and  with  it  the  other  faculties.  He  also  well 
described  mania,  night-mare,  hydrophobia,  catalepsy  etc.  etc. 

muscles.  He  likewise  recommended  anthiology,  i.  e.  double  suture  of  one  of  the 
veins  of  the  eye,  division  of  the  vein  between  the  ligatures,  and  finally  tying  the 
vein  after  sufficient  blood  had  escaped.  The  first  of  these  two  terrible  and  useless 
barbarities  (both  of  which  were  practised  long  after  this  period)  was  designed  to 
prevent  diseases  of  the  eye  by  the  long  continued  suppuration  of  such  a  ghastly- 
wound.  In  the  same  way  the  operation  of  hypospathismus,  which  consisted  in 
making  three  incisions  through  the  skin  of  the  forehead,  followed  by  moxas  to 
the  temples,  was  supposed  to  act.  Diseases  of  the  eye  in  general,  and  especially 
cataract,  were  supposed  to  be  due  to  a  materia  peccans  descending  from  the 
brain,  to  which  such  horrible  methods  of  treatment  were  designed  to  give  an 
outlet.  In  cataract  a  cataract-space  between  the  lens,  located  in  the  middle  of 
the  eye,  and  the  iris  was  assumed  (Magnus.)  Severus  explains  that  staphyloma 
of  the  cornea  arises  from  ulcers  of  the  cornea,  which  may  also  result  in  prolapse 
of  the  iris.  Staphyloma  is  treated  by  ligatures,  doubled  and  crossed.  Of 
Latyrion  nothing  is  known  but  his  name,  and  the  fact  that  he  and  Severus 
probably  lived  in  the  3d  century,  prior  to  Antyllus. 


—  179  — 

6.   MYSTICISM  AND  MAGIC  IN  ANCIENT  MEDICINE. 

It  is  an  innate  characteristic  of  the  human  mind  that,  with  all  its 
efforts  after  rational  knowledge,  there  still  clings  to  it  in  all  ages  a  certain 
amount  of  mysticism.  This  mysticism  manifests  itself  chiefly  (though  by 
no  means  exclusivel}')  among  the  uneducated  ;  and  yet  its  highest  grades 
appear  in  people,  as  in  individuals,  whose  minds  are  excited  and  their 
bodies  enervated  by  over  education  and  miseducation,  among  whom  mysti- 
cism wins,  frequently  and  for  long  periods,  the  supremacy  over  reason. 
This  is  the  result  of  that  fatal  inclination  to  explain  the  sum  of  all  physical 
phenomena  and  appearances  (which  from  the  inadequacy  and  imperfection 
of  human  reason  must  ever  remain  unfathomable  in  their  nature  and  cause) 
by  associating  them  with  supernatural  powers,  whether  we  call  these  God, 
angels,  demons,  or  by  some  other  title.  By  a  mystical  influence  upon  these 
beings,  or  b}'  prayer  to  such  creations  of  the  fancy  or  personified  conceptions, 
it  is  sought  to  obtain  aid  of  a  supernatural  kind  for  time  or  for  eternity. 
This  inclination  has  always  led  (as  it  leads  to-da}'),  on  the  one  hand,  to  the 
founding  of  religious  sects,  from  the  lowest  order  to  the  highest,  and,  on 
the  other,  —  and  often  in  close  connection  with  these  religions  —  to  the 
awakening  of  all  kinds  of  delusions,  with  their  terrible  and  most  unhappy 
results  to  the  life  of  nations  as  well  as  individuals. 

Both  of  these  phenomena,  in  the  life  of  individuals,  as  in  history,  ad- 
vance step  by  step  beside  each  other.  Childhood,  the  most  robust  maturity, 
as  well  as  hoaiy  and  deca}'ing  age  the  first  and  the  last  especially  —  of 
nations  as  of  individuals,  are  not  free  from  such  efforts  to  comprehend  the 
mystical,  and  that  which  will  ever  remain  a  secret  to  us.  The  search  after 
the  secrets  of  creation  leads  to  faith,  faith  almost  alwa}'s  to  superstition, 
and  at  last  to  absurdities  of  action,  when  the  power  of  reason  fails,  or  is 
set  aside. 

This  side  of  intellectual  life  from  the  ver}T  beginning  won  a  place  in 
ancient  medicine,  as  it  holds  one  among  us  to-day. 

Hence  arose  the  theurgic  treatment  of  the  priests,  which  precedes  all 
medicine  proper,  and  is  found  among  all  people.  Hence  at  a  later  pericd 
arose,  by  the  aid  of  inquisitive  reason,  those  half  philosophical  half  medical 
systems,  which  subsequently,  in  the  golden  age  of  most  people,  developed 
into  a  genuine  medical  art.  But  beside  this  moved  quietly  but  steadily  that 
mystic  medicine,  which  finally,  in  the  periods  of  intellectual  decay  of  the 
race,  appropriated  once  more  the  mastery. 

Among  some  people  this  original  medicine,  indeed,  continued  to  exist, 
and  developed  only  into  systems  and  theories  of  magic,  which  then  trans- 
ferred their  evil  effects  to  other  nations  of  higher  qualifications  and  greater 
refinement,  in  the  day  of  their  decaying  mental  power.  Among  the  systems 
just  named  belongs,  above  all,  the  system  of  emanations  of  Zoroaster,  which 
is  to  be  regarded  as  the  original  source  of  all  those  which  followed.  In  the 
time  of  their  national  weakness,  after  the  Babylonian  captivit}-,  the  Jews  in- 


—  180  — 

corporated  a  portion  of  this  system  into  their  religious  views  and  their  system 
of  medicine,  always  theurgic  in  its  character.  After  the  entire  loss  of  their 
independence,  however,  a  complete  sect  was  formed  among  them  in  Alexan- 
dria (to  which  even  Christ  is  said  by  some  to  have  belonged),  the  Essenes 
or  Therapeutse  (B.  C.  150),  in  which  a  mixture  of  Jewish,  and  Zoroastrian, 
with  a  lesser  portion  of  Pythagorean,  views  formed  the  rule  of  life.  They 
believed  the  worship  most  acceptable  to  God  consisted  in  seclusion,  con- 
stant contemplation,  purity  of  morals  (sought  especiall}-  in  abstinence  from 
sexual  love),  holy  silence  and  a  separation  from  other  men,  manifested  ex- 
ternally  by  their  white  clothing  etc.  By  these  means  they  thought  the}' 
could  come  into  close  relation  with  "  The  Emanation  of  God  ",  the  "  Word 
of  God",  the  "Son  of  God  ",  and  with  the  angels,  so  that  a  portion  of  their 
power  might  overflow  upon  them.  Thus  they  expected  to  receive  power  to 
perform  miracles  and  to  cure  diseases.  They  offered  no  sacrifices,  but 
labored  with  their  own  hands  at  all  kinds  of  work,  and  lived  extremely 
sober  and  retired  lives.  Their  chief  business,  speculative  contemplation 
and  the  interpretation  of  the  sacred  books,  degenerated,  however,  by  de- 
grees, into  a  nonsensical  study  of  words  and  letters.  Hence  originated 
the  Cabala  ("oral  tradition"),  which  called  itself  a  science,  but  was  really 
a  web  of  nonsense  of  the  worst  kind,  clothed  in  mysticism.  Acibah  (died 
A.  D.  120)  was  called  its  founder1  and  the  author  of  the  "Book  of  Crea- 
tion "  (Sepher  Jezirah),3  from  which,  with  the  much  later  book  Zohar  of 
Simeon  Ben  Joehai.  our  knowledge  of  this  absurdity  is  derived. 

According  to  the  doctrine  of  the  Cabala,  ten  angels  emanated  from  the 
"Eternal  God",  as  the  "first  world",  of  whom  the  first  three  were  knowl- 
edge, understanding  and  wisdom.  Besides  this  first  world  there  werer 
however,  three  others,  emanating  in  continuall}'  widening  concentric  cir- 
cles from  Ihe  "  Eternal  "  :  a  "  created  ",  an  "  improved  "  and  a  -completed  ". 
The  models  of  each  of  these  exist  already  in  the  "  first  world  ".  As  regards 
the  treatment  of  the  sick,  it  was  substantially  this,  that  the  corresponding 
powers  of  the  "  higher  world  "  were  to  be  set  into  activity,  and  that  this 
was  brought  about  by  those  persons  who,  through  the  Cabala,  had  acquired 
knowledge  of  these  powers.  Such  nonsense  at  a  late  period  affected  even  the 
Greeks,  whose  important  spirits  (Democritus,  Aristotle,  the  Stoics  etc.), 
especially  in  the  time  of  their  political  and  intellectual  decay,  almost  all 
believed  in  dreams.  But  among  the  Bomans,  who  chei'ished  numerous  and 
dense  superstitions,  it  was  more  readily  lighted  up.  Thus  the  sorcerers  and 
swindlers  Simon  and  Apollonius  of  Tyana  in  Cappadocia  (A.  D.  2-98).  and 
their  companion.  Iarchas.  the  g^vmnosophist,  bloomed  forth  as  rivals  of  the 
Christian  miracle- workers  (in  the  form  of  bishops  etc.).  The  doctrines 
of  Zoroaster  and  these  impostors  were  united  with  Platonic,  and  partially 
Christian  views  into  a  system  which  is  distinguished  as  "  New  Platonism  " 

1.  One  of  the  spiritual  fathers  of  this  work  was  Philo  of  Alexandria  (born  A.  D.  25), 

a  contemporary  of  the  Jewish  historian  Flavius  Josephus. 

2.  According  to  other  authorities,  however,  it  dates  from  the  7th  century. 


—  181  — 

(the  Neo-Platonic  or  second  Alexandrian  school),  the  founder  of  which  was 
Ammonius  Saceas  (about  A.  D.  175-250).  Plotinus  (205-270  A.  D.)  — 
bythewa}-,  a  vegetarian  on  religious  grounds  — and  his  three  pupils,  Heren- 
nius,  Aurelius  and  Porphyrias  (A.  D.  233-304).  Janiblichus  (about.  A.  D. 
300)  and  Proclus  (A.  P.  411-485)  built  up  and  extended  this  system  to  all 
branches  of  science,  while  a  certain  Andreas  Chiysaris,  a  physician,  first 
introduced  the  Neo-Platonic  philosophy  into  medicine.  The  whole  uni- 
verse, both  above  and  below,  was  filled  with  emanations  of  God,  with  demons 
of  higher  and  lower  degree,  and  through  a  special  grade  of  immersion  in 
God,  called  ecstasy,  the  government  over  these  demons  was  acquired  by 
witchcraft.  The  lower  demons,  the  authors  of  disease,  suffered  tliemselves 
to  be  managed  by  offerings  and  exorcism,  by  all  sorts  of  symbols  and  mys- 
tic words,  like  Adonai,  Sabaoth.  Abraham,  Isaac  and  Jacob,  by  the  stam- 
mering words  of  newborn  children  etc.  "  Such  words,  of  no  signification  to 
the  reason,  are  undoubtedly  the  most  powerful,  especial ly  the  sacred  words 
of  the  East,  which  spring  from  the  oldest  tongue,  and  therefore  that  best- 
known  and  most  agreeable  to  the  gods  "  —  There  arose  too  various  grades 
of  the  mystic  treatment  of  the  sick  !  Theosophy  (Theocras}-)  was  founded 
•on  a  union  with  the  "Source  of  Light",  and  treated  disease  through  God 
himself;  theurgy  worked  b}"  the  aid  of  good  demons  ;  goety,  by  that  of  the 
■evil ;  magic  accomplished  its  ends  by  means  of  material  demons  and  spirits 
of  high  degree  :  while  pharmac}'  was  a  species  of  influence,  through  which 
the  demons  were  subdued  by  means  of  drugs.  To  fill  the  measure  of  ab- 
surdity, with  these  follies  were  incorporated  all  the  errors  by  which  the 
pure  germ  of  the  doctrine  of  Christ  had  been  transformed,  errors  from 
which  even  to-da}-  we  are  not  entirely  free. 

According  to  this  patchwork  system,  which  ruled  the  Middle  Ages 
down  to  the  time  of  Luther,  the  power  of  Christ,  and  consequently  of  God, 
was  transferred  by  sprinkling  or  inunction  to  the  priests  (a  favorite  supersti- 
tion from  that  day  to  this),  and  thus  was  presented  a  Christian  system  of 
emanations.  Accordingly,  even  at  this  time,  the  priests  possessed  the  power 
of  curing  diseases  by  the  imposition  of  their  hands,  or  by  prayer  and  in- 
unction (chrisma),  as  well  as  the  power  of  raising  the  dead,  though  all 
these  claims  were  not  fully  erected  until  the  Middle  Ages.  In  course 
of  time  the  relics  of  martyrs  were  employed  as  the  therapeutic  agents, 
e.  g.  the  bones  of  Cosmas  and  Damianus,  both  of  whom,  under  the  pretext 
of  introducing  medicine,  devoted  themselves  to  prosetytism,  and  were 
accordingly  executed  as  martyrs  under  the  reign  of  Diocletian.  Subse 
quentl}'  they  were  honored  with  a  temple  as  medical  saints.  Exorcism 
too,  by  which  Christ  himself  was  evoked,  was  called  in  to  drive  out  the 
evil  spirit  of  disease.1  Finally  all  these  absurdities  were  heaped  together 
by  the  later  Gnostics  under  the  lead  of  Basilides  (in  the  reign  of  Hadrian), 

1.  In  the  year  1884  appeared  li  Die  Yerwaltung  des  Exorcistats  etc.',  by  Dr.  Chr. 
Bischo0>erger,  a  priest,  2d  edition,  Leutkirch,  the  venerable  formula?  of  which 
work-spring  from  the  age  of  the  apostles! 


—  182  — 

who  collected  365  "  aeons  "  with  Christ  at  their  head,  and  whose  numbei 
was  expressed  I13'  the  rmTstic  word  Abraxas,  which  was  endowed  with  mys- 
tical power.     Now  arose  talismans  inscribed  with  words  and  symbols  like 

IAi2,  (PPH,  M  |j|  xfX  (the  diagram  of  the  Gnostics,  now  a  sign  for  lager- 
beer).  Another  unfortunate  delusion  -  alchemy,  the  mother  of  chemistry,1 
grew  up  in  these  dark  ages  out  of  the  effort  to  make  gold.  Such  was  the 
object  of  the  "  philosopher's  stone  ",  and  the  art  of  finding  this  wonderful 
stone  was  taught  in  forged  books  of  the  so-called  Hermes  Trismegistus, 
e.  g.  in  the  "  Tabula  Smaragdina ",  and  particularly  in  the  book  called 
Cyranides2  (about  A.  D.  400),  of  Greek  origin.  Besides  these  follies  astrol- 
ogy was  also  industriously  cultivated. 

This  wonderful,  disgusting  and,  indeed,  dismal  mixture  of  superstition, 
folly,  delusion  and  every  dark  abortion  of  the  human  mind,  borrowed  from 
all  "  religions  "  and  brewed  up  with  the  old  Greek  philosophy  (which  it  also 
disgraced),  is  explicable  only  by  considering  it  the  last  flicker  of  the  ancient 
spirit,  when,  confused  and  fantastic,  it  confounded  earth  and  heaven,  men 
and  spirits,  impostors  and  demons,  priests  and  gods,  nonsense  and  reason, 
in  the  visions  of  death's  delirium,  and  united  them  into  a  caricature 
of  human  thought  and  human  feeling. 

7.   MEDICINE  DURING  THE  LAST  PERIOD  OF  THE  ROMAN  EMPIRE,  BOTH  BEFORE 

AND  AFTER  ITS   DIVISION   (A.  D.  395),   AND   DOWN   TO  THE 

OVERTHROW"  OF  THE  WESTERN  EMPIRE. 

It  is  difficult  to  say  whether  it  was  chiefly  its  deep  offences  against  the 
old  religion  and  the  mental  acquisitions  of  the  past,  as  we  have  been  able 
to  indicate  them  briefly  in  the  preceding  section,  or  the  physical  decay 
of  the  Romans,  associated  as  it  was  with  vice  of  every  form,  —  and  the 
vices  of  old  age  are  worse  than  those  of  3-outh —  or,  finally,  whether  it  was 
the  moral  and  social  corruption  of  slavery,  which  admitted  no  middle  class, 
and  through  intermixtures  of  blood  destroj'ed  the  ancient  families,  which 
introduced  and  occasioned  the  overthrow  of  the  well-knit  Roman  Empire, 
and  the  downfall  of  the  most  powerful  of  nations.  It  is  difficult  to  prove 
which  of  these  phenomena  was  the  cause,  and  which  the  effect  of  the  other. 
To  us  it  seems  that  the  cause  la}-  in  the  manifest  corporeal  decay  of  the 
nation,  accelerated  by  intermixture  with  all  sorts  of  degraded  or  entirely 
uncivilized  people,  as  well  as  in  the  coarseness  of  physical  life,  as  it  mani- 
fested itself  in  the  last  ages  of  the  Romans  (and  specially  in  Rome,  the  sink 
of  all  vice),  from  the  highest  dignitary  down  to  the  common  people  and  the 
soldiers,  and  against  which  the  better  emperors  and  statesmen,  as  well  as 

1.  Originating  in  Egypt,  which  is  called  Kemi  bjr  the  Egyptians. 

2.  Liber    physico-medicus    Kiranidum    Kirani,    i.   e.    Regis    Persarum,    vere    aureus 

gemmeusque  etc.,  a  sort  of  mystic  materia  medica  in  which  numerous  vegetable 
and  animal  remedies  are  enumerated,  with  theosophic  and  absurd  directions  for 
their  preparation  etc.      (H.) 


—  183  — 

poets  and  philosophers,  vainl}-  strove  with  all  their  power.  During  and 
after  physical  decay  there  comes  almost  always  and  everywhere  a  mental 
decay,  and  only  a  degenerate  and  perishing  people  enslaves  itself  to 
mammon,  to  appetite,1  to  insane  luxury,  to  the  government  of  mis- 
tresses with  its  many  consequences,  to  prostitution,  and,  after  all  these, 
to  the  most  shameless  debauchery  practised  by  the  Romans  of  later 
times. 

Interest  in  science  decayed  more  and  more,  and  with  it,  of  course, 
medicine  also  declined  in  these  times  of  dissolution.  No  law  against  the 
prevalence  of  alchemy,  magic  and  astrology  (though  one  was  promulgated 
b}*  the  enlightened  Diocletian  in  the  year  A.  D.  296)  could  avail,2  when  his 
predecessors  upon  the  throne,  Alexander  Severus,  Marcus  Aurelius,  Anto- 
ninus Pius.  Vespasian.  Hadrian  etc.  had  cultivated  this  most  absurd  ten- 
dency of  the  age,  and  lent  it  their  aid.  Even  Julian,  the  gifted  and  en- 
thusiastic Apostate  (A.  D.  360-363),  b}-  his  restoration  of  the  schools 
at  Athens  and  Alexandria  and  his  solicitude  for  pagan  science  and  its 
representatives,  could  not  put  a  stop  to  that  decay.  As  little  too  was 
accomplished  by  the  improvement  of  the  external  position  of  phj-sicians 
under  Valentinian  I.  and  Valens  (A.  D.  364-378).  To  an  orthodoxy  which 
hated  everything  pagan  was  added  the  passion  for  rapine  und  destruction 
of  the  Arian  hosts  of  the  Goths,  who,  under  the  lead  of  Alaric,  for  the  first 
time  extended  their  incursions  into  Greece.  What  benefit  then  could  result 
from  the  foundation  of  a  new  university  at  Rome2  in  the  beginning  of  the 
5th  century  by  Theodosius,  who  in  426  ordered  the  destruction  of  the 
heathen  temples  —  so  low  had  sunk  the  taste  for  ancient  art  ?  The  mental 
weakness  rooted  in  the  loss  of  the  cheerfulness  of  the  Ancients  lent  its  aid 
to  the  birth  of  all  superstition,  and  there  began  in  this  period  to  develop 
a  monstrous  state  of  affairs  —  the  whole  world,  after  a  period  of  atheism, 
sunk  for  long  centuries,  more  than  before,  into  the  hands  of  a  self-deceived 
or  deceitful  priesthood,  or  into  the  worst  forms  of  Theurgy. 

Thus  even  the  pagan  physicians  of  this  period  either  drifted  into  magic 
medicine  or,  at  best,  were  compilers  of  more  or  less  originalit}',  or  rude 

1.  Apicius,  under  Augustus  and   Tiberius,  had   guzzled   down    more  than  three  and  a 

half  millions  of  dollars. 

2.  This  edict  prohibited  the  practice  of  alchemy,  and   ordered  all  books  on  this  sub- 

ject in  Egypt  to  be  collected  and  burned.  Magic  was  also  subjected  to  a  rigorous 
inquisition  at  Rome  and  Antioch  under  Valentinian  and  Valens  (A.  D.  374),  in 
which  many  innocent  persons  were  falsely  accused  of,  and  executed  for,  its  prac- 
tice.     (H.) 

3.  Theodosius  II.  about  A.  D.  425  established  an  Academy  at  Constantinople,  with  a 

corps  of  31  professors.  The  "Athenaeum"  at  Rome,  founded  by  Hadrian  (A.  D. 
117-1381,  enlarged  and  endowed  by  Severus  (A.  D.  222-235),  subsequently  de- 
clined, but  was  restored  by  Valentinian  (A.  D.  364-375),  who  published  for  its 
discipline  the  "Eleven  Academic  Laws".  It  was  again  reorganized  by  Athalaric 
(A.  D.  526-532),  after  which  period  I  am  unable  to  trace  it.  I  know  of  no  educa- 
tional institution  founded  by  Theodosius  at  Rome.     (H.) 


—  184  — 

empirics,  none  of  whom  accomplished  anything  permanent  and  new.  Under 
the  name  of 

Quintits  Serenus  Samonicus  (died  A.  I).  211) 
there  is  still  extant  a  medical  poem  in  hexameter  verse.1  Which  of  the  two  physi- 
cians of  this  name,  the  father  (who  was  put  to  death  under  Caracalla,  A.  D.  211,  prob- 
ably for  his  recommendation  of  amulets,  which  the  emperor,  crack-brained  as  he  was 
himself,  had  interdicted),  or  the  son  (teacher  of  the  younger  Gordian  A.  D.  2o7),  is 
the  author  of  this  work  is  unknown.  In  it  the  most  ludicrous  and  disgusting  reme- 
dies are  recommended,  e.  g.  mouse-dung  dissolved  in  rainwater  as  a  poultice  for 
swelling  of  the  female  breast ;  goat's  urine  internally  for  stone  in  the  bladder;  earth 
and  dung  from  a  wagon-rut  for  the  pains  of  colic,  used  externally;  as  well  as  amulets 
with  magic  words  arranged  in  curious  forms,  as  2- 

A  B  R  A  C  A   D  A  15  R  A 

BRA  GAD  A  BRA 

RACADABRA 

A  C  A  D  A  B  R  A 
C  A  D  A  B  R  A 

A   D  A   B  1!  A 

D  A   B  R  A 

A  B  R  A 

BRA 

R  A 

A 

adoration  of  the  numbers  o,  7  and  !•  etc.3  Besides  these  we  find,  however,  a  few  rea- 
sonable counsels,  e.  g.  animal  baths4  for  gout,  the  recommendation  of  cheap  drugs. 
A  contemporary  of  Samonicus  was 

Gargilius  Martialis  (A.  D.  220-240), 

who  wrote  on  the  subject  of  plants  and  their  use. 

Of  a  different  class  from  the  physicians  just  named  were  the  teachers 
and  physicians  supported  and  salaried  b}-  Julian  at  Alexandria : 

Zeno  of  Cyprus  (A.  P.  830) 
was  one  of  the  partisans  of  Gregorj'  banished  from  Alexandria,  and  a  famous  teacher, 
who  was  recalled  again  with  honor  by  .Julian.     Among  his  pupils  were  Oribasius  and 

Magnus  of  Alexandria,  the  Iatrosophist. 
an  acute,  litigious  professor  of  the  art  of  healing,  who  wrote  a  lost  work  on  uroscopy. 
For  reasons  easily  comprehended    he  was   not    liked  by   the   physicians  of  his  time, 
since  he  always  doubted  whether  a  patient  had  ever  been  cured  hy  them  ! 


1.  "  De  Medicina  Prajcepta".     ill.i 

2.  The  "Abracadabra"  was  to  be  written  on  cloth  or  parchment  and  suspended  from 

the  neck  in  intermittent  fever.     ( 11.  ) 

3.  Two  of  his  highly  poetical  verses  run  : 

"  Si  vero  horrendum  vulnus  fera  fecerit  aspis, 

Urinam  credunt  propriam  conducere  potu." 
"  Siquis  hyoscyamum  gustarit,  lacte  capella- 

Exhausto,  rabidos  poterit  mulcere  furores." 

4.  "  Seminecisve  hirci  reserato  pectore  calces 

Insere:     sic  dirre  reprimes  primordia  pestis."      (H.) 


—  185  — 

Ionicus  or  Sardis  in  Lydia  (A.  D.  360) 
•was  a  famous  physician  and  savant,  the  son  of  an  equally  famous   physician,  and  an 
-eminent  anatomist,  pharmacologist  and  surgeon,  though  he  was  no  operator. 

Theon  of  Alexandria,  the  Archiater, 

lived  in  Gaul  at  the  close  of  the  fourth  century,  and  was  the  author  of  a  work  "  On 
man  ",  which  was  not  lost  until  after  the  ninth  century.  It  is  a  striking  historical 
fact,  that,  while  very  many  important  medical  works  have  been  lost,  the  much-abused 
compilations  prepared  from  them  have  been  preserved.  This  may  depend  upon  the 
■circumstance  that,  even  in  ancient  times,  the  extent  of  literature  did  not  permit  most 
physicians  to  find  leisure  for  the  study  of  the  whole,  and  thus  the  demand  for  compila- 
tions was  greater  than  for  the  original  works  themselves.  The  higher  price  of  a 
collection  of  original  works  was  also  to  be  considered,  so  that  the  purse  of  most  phy- 
sicians might  not  suffice  for  their  purchase.  Perhaps  too  the  scientific  interest  of 
most  physicians  then,  like  those  of  the  present  day,  extended  no  further  than  the  pos- 
session of  the  books  necessary  for  their  business,  and  thus  these  have  been  preserved 
to  posterity  because  they  existed  in  greater  numbers.  All  these  circumstances  com- 
bined may  have  preserved  the  works  of  the  following  physician,  while  most  of  the 
authors  who  formed  the  sources  of  his  compilation  have  perished. 

Oribasius  of  Pergamus  (or  Sardis,  A.  D.  326-403)  is  very  important 
as  the  transmitter  of  the  lost  views  of  the  old  medical  authors  in  excellent 
compilations,  like  his  "  Medical  Compendium",1  "  S3"nopsis  for  Eustathius", 
"  Euporista  "  etc. 

He  was  ordinary  physician  to  Julian  the  Apostate,  with  whom  he  became  ac- 
quainted in  the  year  S55  at  Athens.  He  accompanied  him  from  Gaul  after  his  nom- 
ination as  the  "Cassar",  and  at  his  request  made  an  epitome  of  Galen  (now  lost),  and 
prepared  the  material  for  his  other  compilations.  Educated  for  a  physician  under 
Zeno,  at  Alexandria,  he  possessed  a  very  good  general  education,  and  was  of  noble 
descent.  Besides  this,  beiris  versatile,  fond  of  intrigue  and  useful  in  all  kinds  of  bus- 
iness, he,  b3*  virtue  of  these  qualities,  aided  Julian  to  the  throne,  and  was  accord- 
ingly made  by  the  emperor  "Qutvstor"  of  Constantinople.  During  the  short  period 
of  Julian's  reign  he  composed  his  still  extant  works.  On  Julian's  Persian  campaign 
he  filled  the  office  of  ordinary  physician  in  attendance.  He  was  not  able,  however, 
to  cure  the  wound  of  his  friend  and  master,  and  the  new  authorities,  in  consequence 
of  the  position  which  he  had  held  near  Julian,  deprived  him  of  his  property  and  ban- 
ished him  among  the  barbarians.  Here  he  enjoyed  very  great  esteem  as  a  physician, 
but  was  speedily  recalled  with  honor  to  Constantinople,  where  he  lived  to  a  great 
age. 

Besides  the  excellent  selection  of  authors  upon  which  his  work  is  based,  several 
of  whom  are  known  solely  from  this  work  (he  made  use  of  Hippocrates,  Galen  es- 
pecially, Dioscorides,  Diodes,  Erasistratus,  Antyllus  Soranus,  Zopyrns,  Mnaseas, 
Ctesias,  Rufus,  Archigenes,  Herodotus,  Philotinius,  Marcellus,  Lycus,  Philumenus, 
Heliodorus,  Philagrius,  Dieuches,  Mnesistheus  etc.),  he  has  also  the  merit  of  present- 
ing his  personal  views  and  judgment,  particularly  in  regard  to  dietetics  and  gymnas- 
tics. He  was  well  acquainted  with  syphilis  and  gonorrhoea,  and  recommended 
urethral  and  vaginal  injections  in   the  treatment  of  the   latter  disease.     He  gives  de- 


1.  Oribasius  wrote  in  Greek.  The  Latin  titles  of  his  works  are  "Collecta  medici- 
nalia",  "  Synopsis  ad  Eustathium"  and  "Euporista  ad  Eunapium".  Bussemaker 
and  Daremberg  edited  an  excellent  edition  of  the  works  of  Oribasius  in  Greek 
and  French,  4  vols.,  Paris,  1851 -G2.    (H.) 


—  18G  — 

tailed  directions  regarding  venesection,  which,  in  his  opinion,  should  be  practised  as- 
close  as  possible  to  the  diseased  point,  and  with  an  eye,  not  to  the  period  of  the  dis- 
ease, but  simply  to  the  condition  of  the  patient  etc.  He  also  gives  us  a  treatise  on 
bandaging,  with  views  on  diseases  of  the  liver,  on  the  treatment  of  sterility  etc. — 
From  the  age  of  Oribasius  we  have  an 

"  Introduction  to  Anatomy",  based  upon  the  anatomical  investigations  of  Aris- 
totle, from  whom  it  differs  very  little,  save  that  it  specially  denies  any  pulsation  in 
the  veins.  The  membrana  tympani  and  the  peritoneum  are  well  discussed,  while,  on 
the  other  hand,  the  Platonic  view  of  the  entrance  of  a  portion  of-  the  drink  into  the 
air-passages  is  declared  tenable. — The  converted  Jew, 

Adamantius  of  Alexandria,  "the  Iatrosophist ",  (about  A.  D.  350), 
wrote  on  physiognomonies,  in  imitation  of  the  similar  work  of  Polemon,  who  lived 
under  Hadrian.  He  likewise  wrote  on  the  treatment  of  the  teeth,  on  pharmacology 
and  the  winds.  Adamantius  was  a  professor  of  medicine  at  Alexandria,  for  this  is 
the  signification  of  the  title  "  Iatrosophist". 

Sextus  Placitus  of  Papyra  (A.  D.  370) 
wrote  on  "  Drugs  derived  from  the  animal  kingdom"1    in  the  style  of  an  old  woman. 
Thus  e.  2.  he  employs  cooked  puppy  to  relieve  colic,  and  breaks-up  fever  by  cutting 
a  splinter  from  a  door,  through  which  a  eunuch  has  just  passed,  and  saying:    "I  take 
thee  that  N.  N.  ma}-  be  freed  from  fever  !  "     Somewhat  more  intelligent  is 

Vindician  (about  A.  D.  370),  the  friend  of  St.  Augustine,2 
and  ordinary  physician  of  the  emperor  Valentinian  I.     He  has  left  to  us  a  poem  on 
the  preparation  of  theriaca.3    The  bishop 

Nemesius  (about  A.  D.  400),  of  Eraesa  in  Phoenicia, 
in  his  book  "On  the  nature  of  man",4  devotes  more  attention  to  philosophy  and 
psychology  than  to  medical  matters.  A  knowledge  of  the  circulation  of  the  blood 
has  been  ascribed  to  him  ;  but  his  other  physiological  views  differ  too  little  from 
those  of  his  age  to  permit  us  to  find  in  his  statements  relative  to  this  subject  adequate 
data  for  a  clear  exposition  of  his  ideas.  Thus  he  maintains  e.  g.  that  the  semen 
originates  in  the  brain,  is  conducted  to  the  testicles  by  the  veins  behind  the  ears,  and 
is  stored  up  in  these  organs.  Sensation  he  located  in  the  anterior  ventricle,  thought 
in  the  middle,  and  recollection  in  the  posterior.  Nemesius,  however,  strongly  pro- 
moted the  prevalent  faith  by  his  prohibition  of  the  use  of  astrology. 

1.  "  De  medicamentis  ex  animalibus."     (H.) 

2.  Some  legislative  enactments,  e.  g.  the  Alemannic,  were   based   upon  the  medical 

views  of  St.  Augustine.  He  taught  that  the  blood  is  inspissated  during  the  first 
month  of  pregnancy  ;  in  the  second  the  tendons  and  vessels  originate;  in  the 
fourth  the  sex  becomes  determined;  in  the  fifth  the  soul  is  formed  and  the  child 
raises  itself  up;  in  the  sixth  the  skin  and  medulla  are  developed;  in  the  seventh, 
the  intestines,  and  in  the  eighth,  the  nails  and  the  heart.  The  doctrine  of  quick- 
ening in  the  second,  and  of  sexual  determination  in  the  fourth  month,  were  of 
importance  in  aggravating  or  lightening  the  penalty  in  cases  of  injury,  abortion 
etc.  of  pregnant  women.     (Oesterlen.) 

3.  The  78  hexameter  lines  referred  to  here  scarcely   constitute  a  poem,  nor  do  they 

probably  belong  to  Vindician.  Meyer  ascribes  them  to  Marcellus  Empiricus. 
Vindician,  however,  wrote  a  treatise  entitled  "  De  expertis",  which  has  been 
utterly  lost.     (H.) 

4.  Tlepi  (fixretos  (h()/)U>-ou,  De  natura  hominis.     This  treatise  served  in  the  schools 

as  a  physiological  text-book  for  many  ages.     (H.) 


—  187  — 

Theodorits  Priscianus1  (called  also  Octavius  Horatianus,  about  A.  D. 
380),  ordinary  physician  of  the  emperor  Gratian, 

made  a  comparative  catalogue  of  indigenous  and  foreign  drugs,  rejecting  the  latter  in 
practice.  He  also  recommended,  besides  magic  remedies,  many  useful  drugs,  e.  g. 
semen  Santonici  tor  worms  etc.  Werlhof  classes  his  son  Eusebius  and  his  brother 
Timotheus  among  the  Methodists.     Priscianus  was  a  pagan. 

Under  the  name  of 

Pliny  (Pseudo-Plinius,  also  Plinius  Valerianus,  probably  lived  in  the 
beginning  of  the  4th  century) 

tiiere  is  still  extant  a  "  Medicina  Plinii ",-  a  probably  spurious  collection  of  curious 
remedies,  the  authorship  of  which  has  been  assigned  to  this  period.     We  have  also  by 

Lucids  Apuleius  (probably  the  beginning  of  the  5th  century) 
an  Herbarium  containing  all  sorts  of  inviting  and  uninviting  popular  remedies. 
This  author,  however,  must  not  be  confounded  with  the  poet  Lucius  Apuleius  Madau- 
rensis  (i.  e.  of  Madaura  in  Africa),  who  was  born  under  Hadrian  and  looked  upon  as 
a  magician  because  he  dissected  animals.  The  non  plus  ultra  of  nonsense  in  tlie 
form  of  medicine  was  recommended,  however,  by  the  Christian, 

Marcellus  Empiricus5  of  Bordeaux,  ordinary  physician  of  Theodo- 
sius  I.  (345-395) 

In  case  of  a  splinter  in  the  eye,  for  instance,  this  should  be  touched  three  times, 
while  the  physician  repeats  as  often  the  unmeaning  words  "  Tetune  resonco  bregan 
gresso'',  expectorating  each  time.  A  stye  may  be  removed  from  the  eyelid  by  touch- 
ing it  nine  times  with  the  poii.t  of  nine  barley-corns,  repeating  each  time  u(p£uye, 
fsuys,  /.piOrj  as  diatxst",  or,  if  the  abscess  is  situated  on  the  right  eye,  by  touching 
it  with  three  fingers  of  the  left  hand,  expectorating  and  saying  thrice:  "The  mule 
brings  into  the  world  no  young,  nor  does  the  stone  produce  wool ;  so  may  this  disease 
come  to  no  head,  or,  if  it  comes  to  a  head,  may  it  wither  awaj*."  Marcellus  further 
recommends  as  natural  pills" — rabbit's  dung  etc.,  and  says  certain  remedies  should  be 
prepared  e.  g.  on  Thursday  only,  and  when  taking  them  the  patient  should — turn 
toward  the  east. — The  two  phj-sicians  last  mentioned  are  historically  important  (as 
Daremberg  has  emphatically  shown),  because  they  transmitted  to  the  Middle  Ages  a 
large  part  of  the  popular  medicine  of  the  Romans.  (With  us  on  the  Rhine  e.  g.,  the 
"  Hasenpillen  "  are  used  even  to-day  in  consumption). 

1.  Priscian  wrote  in  Greek,  but  translated   his  own   writings   into  Latin.     These  con- 

sisted originally  of  six  or  seven  books,  of  which  we  possess  only  five.     (H.) 

2.  According  to  Hajser  there  are  no  less  than  three  works   which  pass  under  the  title 

of  Pseudo-Pliny  :  1.  A  compilation  of  the  4th  century  extracted  chiefly  from  the 
Historia  naturalis  of  the  elder  Pliny,  but  containing  also  extracts  from  Gargilius 
Martialis,  Vindician  and  Caelius  Aurelianus:  2.  A  treatise  of  the  rtth  or  7th  cen- 
tury, containing  the  three  books  of  the  original  Pseudo-Pliny  of  the  4th  century 
together  with  two  others  taken  from  other  sources :  and  3.  a  compilation 
of  the  10th  century,  entitled  "Liber  de  remediis",  which  contains  also  the 
three  books  of  the  Pseudo-Pliny  of  the  4th  century,  but  is  yet  different  from 
No.  2.     (H) 

3.  "  De  medicamentis   empiricis,  physicis  ac  rationalibus  liber."     Marcellus  was  not 

a  physician,  and  his  work  was  probably  written  for  the  use  of  his  son  in  visiting 
the  sick,  or  in  emergencies.  Of  course  then  Marcellus  was  not  ordinarj'  physician 
to  Theodosius,  but  he  was  an  Ex-ma>rister  officiorum  under  this  emperor,  an> 
office  supposed  to  be  about  equivalent  to  our  Minister  of  the  Interior.     (H.) 


—   188  — 

After  the  division  of  the  empire  (A.  D.  395)  there  lived  in  Constanti- 
nople a  highly  celebrated  physician,  Hesychius  of  Damascus  in  Coele- 
Syria  (about  A.  D.  430),  the  father  of 

Jacohis  "  PSYCHRESTUS 

who  enjoyed  still  greater  fame  than  his  father,  and  came  to  Constantinople  in  the 
reign  of  Leo  the  Thracian  (A.  D.  -lo7-47ti  From  his  erudition,  his  cures  and  par- 
ticularly his  success  in  prognosis,  Psychrestus  attained  such  estimation  that  lie  was 
styled  'Savior"  and  "/Esculapius  ",  and  a  statu e  in  his  honor  was  erected  at  Athens. 
On  the  whole  he  must  have  been  a  skilful  charlatan,  though  lie  likewise  defended 
some  rational  views;  otherwise  he  would  not  have  dared  to  rebuke  the  physicians 
of  his  day  because  in  choosing  their  remedies  they  conformed  too  much  to  the  luxury 
of  their  patients  ;  nor  would  he  have  been  satisfied  with  prescribing  simple  watery 
diet  in  chronic  troubles,  a  treatment  from  which  he  derived  his  sobriquet  of  "  Psy- 
chrestus".1 

To  this  period  belong  also 

Palladius  of  Alexandria,  called  the  "  Iatrosophist "  (a  title  no 
longer  uncommon),  and 

Asclepiodotus  of  the  same  city,  who,  like  Palladius,  whom  he  took 
for  his  model,  wrote  commentaries  on  Hippocrates  in  the  Alexandrian 
fashion. 

Cassius  Felix  (5th  century)  wrote  a  treatise  on  pathology  a  capite 
ml  calcem,  and 

Severus,  the  "  Iatrosophist", 
likewise  composed  about  this  time  his   book   "  On    Clysters ",   a  remedy 
with  which  he  was  very  fond  of  treating  colic. 

Medicine  now  fell  rapidly  into  a  new  phase  of  development,  the  Grseco- 
Arabic  and  Christian,  and  thus  the  old  pagan  medical  science  migrated  to 
other  peoples  and  passed  over  to  a  different  principle  of  culture  and  to 
nations  of  another  civilization,  an  epoch  which  begins  historically  the  real 
Middle  Ages  of  medicine.  The  slow  process  of  decay  in  the  Eastern 
Empire  during  the  Middle  Ages  received  only  a  feeble  glimmer  from  the 
brilliant  radiance  of  the  ancient  medicine — a  glimmer  which,  like  the 
nocturnal  brightness  of  decaying  wood,  served  but  to  render  more  visible 
the  surrounding  darkness.  Arabian  medicine  (to  say  nothing  of  monastic 
medicine)  in  its  meteoric  rise  and  disappearance  brought  no  true  light  into 
the  twilight  of  the  Middle  Ages. 

8.    EPIDEMICS  DURING  THE  CLOSING  AGES  OF  ANTIQUITY. 

To  the  causes  already  mentioned,  which  accelerated  the  downfall  of  the 
Roman  Empire  and  speedily  destroyed  its  western  half,  were  added  un- 
successful, and  most  unfortunate,  wars,  with  their  consequences,  want 
of  population,  neglect  of  agriculture  and  continual  military  impressment, 
resulting    in    poverty    and    famine.       Unusual    misfortunes,    independent 


3.    From  Greek  (pu%poq,  cold,  a  reference  to  his  fondness  for  "cooling"  remedies.   (H. 


—  189  — 

of  human  co-operation,  were  added  in  the  devastation  of  earthquakes, 
floods  and  droughts,  as  well  as  the  ravages  of  grasshoppers  etc., 
calamities,  which  often  extended  over  large  districts  of  the  empire. 
To  misfortunes  of  this  nature  succeeded  (each  preceding  evil  always 
producing  another  new  and  worse)  the  blows  of  man  and  nature,  delivered 
more  and  more  rapidly  and  effectively  against  the  ancient  people  and  the 
mature  and  gradually  withering  stem  of  their  civilization,  culminating 
at  last  in  terrible  and  destructive  plagues.  There  were  three  especially 
fatal  general  plagues,  which,  however,  singularly  enough,  are  not  described 
by  physicians.  The  so-called  plague  of  Orosius,  that  of  Antoninus  and  that 
of  Cyprian.  Other  lesser  epidemics  preceded,  intervened  between,  or  fol- 
lowed after,  these  more  general  visitations. 

On  the  cessation  of  the  eruption  of  Vesuvius,  which  began  on  the  23d 
of  August,  A.  D.  78,  and  which  buried  Herculaneum,  Stabise  and  Pompeii 
in  ashes,  there  arose  such  a  destructive  plague,  which  for  many  da}'s  in 
succession  slew  10,000  men  daily. 

The  plague  of  Orosius  (who  described  it  most  fully.  He  lived  in  the  5th  century.) 
began  in  the  year  A.  D.  125.  "As  immense  masses  of  grasshoppers  collected  together 
throughout  all  Africa,  and  not  only  withdrew  all  hope  of  the  harvest  b}-  devouring  all 
vegetables,  with  a  part  of  the  roots,  the  leaves  of  the  trees  and  the  tender  parts  of  the 
branches,  but  also  gnawed  through  the  bitter  barks  and  even  the  dry  wood,  they  were 
suddenly  swept  away  by  the  wind,  collected  into  swarms,  driven  through  the  air  by 
day,  and  finally  drowned  in  the  African  sea.  As  the  tides  threw  immense  heaps, 
through  the  force  of  the  waves,  upon  the  exter.ded  shore,  the  putrefying  and  corrupt 
mass  exhaled  an  exceedingly  disagreeable,  and  incredibly  pernicious  odor,  from 
which  proceeded  so  great  a  pestilence  among  all  living  creatures,  that  they,  without 
distinction,  perished  from  infection  of  the  air;  and  then  the  putrefying  bodies  of  birds 
and  tame  and  wild  beasts  still  increased  the  evils  of  the  putrescence.  How  very  great 
the  plague  was  among  men,  I  shudder,  however,  to  relate;  for  in  Numidia,  where  at 
that  time  Micipsa  was  king,  800,000  men  perished,  while  in  the  region  which  lies  most 
contiguous  to  the  sea-shore  of  Carthage  and  Utica,  more  than  200,000  are  said  to 
have  been  cut  down.  In  the  city  of  Utica  itself  HO, 000  soldiers,  who  had  been  ordered 
here  for  the  defence  of  all  Africa,  were  destroyed.  This  visitation  occurred  so  sud- 
denly and  so  heavily  that  at  Utica,  in  a  single  day,  more  than  500  of  these  young 
men,  it  is  related,  were  borne  forth  from  one  gate  of  the  camp,  dead."     (Haeser. ) 

The  plague  of  Antoninus  (A.  D.  164-180)  visited  the  whole  Roman 
Empire,  from  its  most  eastern,  to  its  extreme  western  boundaries,  beginning 
at  the  former,  and  spreading  thence  by  means  of  the  troops  who  returned 
from  putting  down  a  rebellion  in  Syria.  In  the  year  166  it  broke  out  for 
the  first  time  in  Rome,  and  returned  again  in  the  year  168.  In  its  pro- 
gress, which  by  degrees  involved  the  whole  Roman  Empire,  the  plague 
depopulated  entire  cities  and  districts,  so  that  forests  sprung  up  in  places 
before  inhabited.  It  raged  so  fierceh',  that  in  some  places  wagon-loads  of 
corpses  were  borne  at  once  to  the  grave,  since  individual  burial  was  no 
longer  possible.  The  loss  of  human  life  produced  by  this  plague  could 
not  be  even  approximateby  estimated.  In  Rome  many  thousands  died, 
especially  soldiers  and  "nobles".     In  its  last  }*ear  it  appears  to  have  raged 


—  190  — 

again  with  especial  fury,  so  that  in  Home  ( which  was  even  then  known  to 
be  very  unhealthy  in  summer)  2000  men  often  died  in  a  single  day. — With 
regard  to  the  character  of  this  plague,  it  has  been  considered  sometimes 
small-pox,  sometimes  petechial  typhus,  and  again  the  bubo-plague. 

The  third  so-called  plague,  that  of  Cyprian,  raged  about  A.  D.  251-206. 
Like  the  foregoing  it  displayed  very  marked  contagiousness.  The  disease 
began  with  an  indescribable  feeling  of  heat,  vomiting  and  redness  of  the 
eyes,  to  which  were  added  sore-throat  and  colicky  pains.  These  were 
followed  by  diarrhoea  and  gangrene  of  the  limbs,  of  the  organs  of  sense, 
and  of  the  sexual  organs.  Genuine  horrors  or  maniacal  symptoms  often 
manifested  themselves  in  the  sick. — The  epidemic,  in  the  "regions  visited 
by  it  with  the  greatest  severity  (for  a  long  time  500  died  a  day  in  Rome), 
began  mostl}*  in  the  autumn,  and  continued  with  equal  violence  until 
August. — Before  its  final  extinction  it  again  attained  a  very  great  in- 
tensity, and  after  its  disappearance  Italy  was  almost  deserted,  while  great 
swamps  occupied  the  place  of  lands  heretofore  cultivated. — It  has  been 
assumed  that  this  plague  should  be  considered  either  a  true  bubo-plague, 
or  small-pox. 

In  the  year  312  appeared  anew  an  epidemic  disease,  which  was  desig- 
nated ''Anthrax",  but  from  its  symptoms  might  be  considered  small- 
pox. 

In  England,  after  the  famine  year  of  440,  and  in  spite  of  the  suc- 
ceeding years  of  abundance,  there  appeared  a  "  pest "  so  fatal,  that  the 
dead  could  scarcely  be  buried.— In  Asia  Minor  especially  there  raged 
again  in  the  }"ear  455  a  frightful  pestilence,  which  was  distinguished  by 
swelling  and  redness  of  the  skin,  with  severe  cough,  and  death  following 
generally  on  the  third  day.  Possibly  it  may  be  explained  I13-  the  assump- 
tion of  scarlet  fever,  or  pernicious  measles.  The  loss  of  human  life 
suffered  by  the  Roman  Empire  towards  its  close  by  pestilence,  famine,  war, 
earthquakes  etc.,  was  so  great  that  one  of  the  Church  fathers  cried  out : 
"  The  human  race  is  extirpated,  the  earth  is  returning  to  uncultivated 
wastes  !" 

Though  not  so  general  and  fatal  as  that  form  of  the  disease  which  prevailed 
among  the  Jews  and  in  the  Middle  Ages,  still  the  leprosy  in  its  milder  forms  belongs 
among  the  plagues  which  visited  the  Greek  and  Roman  people.  Hippocrates  knew 
its  mild  forms,  and  Aristotle  also  described  elephantiasis  (Satyria),  as  did  iEschines 
and  others.  The  disease  came  to  Italy  and  the  southwest  of  Europe  in  general  in 
the  latter  half  of  the  last  century  before  Christ.  A  description,  now  lost,  mentioned 
it  as  a  disease,  rare  in  Italy,  but  frequent  in  other  regions.  At  a  later  period  it  ap- 
peared more  frequently',  and  in  the  age  of  Galen  it  was  known  as  a  wide-spread  dis- 
ease (extending  even  into  Germany).  Serenus  Samonicus  and  Marcellus  Empiricus 
considered  it  a  generally  known  disease,  and  in  the  fourth  century  after  Christ 
horoscopes  were  taken,  to  determine  whether  a  person  would  have  the  leprosy* 
or  not. 


—  191  — 


9.    VETERINARY  MEDICINE  OF  THE  ROMAN  PERIOD  OF  ANTIQUITY. 

This  art  occupied  relatively  as  high  a  position  as  human  medicine. 
The  occupation  of  even  noble  and  educated  Romans  with  "agriculture  and 
cattle-breeding'"  was  favorable  to  its  development  and  improvement.  Their 
ready  perception  of  their  own  pecuniary  interest  led  them,  as  they  devoted 
attention  to  their  slaves  in  their  valet udinaria,  so  also  to  give  special  care 
to  their  sick  cattle  in  their  veterinarin.  The  medical  treatment  of  cattle, 
like  that  of  slaves,  was  considered  a  portion  of  the  agricultural  department, 
and  was  discussed  in  contemporary  works  on  agriculture,  e.  g.  by  Celsus. 
whose  treatise  has  been  lost;  by  M.  Porcius  Cato1,  and  by  L.  Junius 
Moderatus  Columella  (about  A.  D.  20),  the  famous  agricultural  writer,  who 
studied  well  the  diseases  of  horned  cattle,  and  in  epidemic  diseases  recom- 
mended the  separation  of  the  sick  cattle  from  the  sound,  a  measure  of 
which,  in  the  plagues  of  the  human  race,  nothing  seems  to  have  been 
known  at  that  period.  Even  before  his  time,  probably,  wrote  the  Greek 
Paxamos,  who  made  use  of  the  works  of  the  Carthaginians  Mago  (middle 
of  the  2nd  or  3d  century  B.  C.)  and  Hamilcar. — Eumelus  of  Thebes,  in  the 
third  century  after  Christ,  did  good  service  as  a  special  veterinary  author, 
and  among  his  contemporaries  were  Gargilius  Martialis,  Stratonicus,  and 
Hieronymus  of  Lybia.  A  much  more  important  writer,  however,  was 
Apsyrtus  (in  the  first  half  of  the  fourth  century  after  Christ),  a  veterinarv 
physician  descended  from  a  veterinary  family,  under  Constantine  I.  the 
Great  (274-337).  He  described  glanders  and  farcy,  the  strangles,  founder, 
the  distemper,  as  well  as  diarrhoea,  grease,  heaves,  broken-wind,  shoulder- 
strain,  stag-evil,  wind-gall,  spavin,  the  toad,  the  scab,  "kidney  disease"' 
and  the  staggers,  and  gives  instruction  in  the  castration  of  horses,  the 
practice  of  bleeding,  trepanning  of  the  sternum,  paracentesis,  the  treatment 
of  fractures,  the  removal  of  worms  etc.  Even  hints  for  determining  the 
beauty  and  health  of  the  horse  were  given,  and  the  hereditary  character  of 
certain  diseases,  particularly  defects  of  the  eye,  was  taught.  That  horses 
have  no  gall-bladder  was  known  to  Apsyrtus.  Contemporaries  of  Apsyrtus 
were  the  "  Hippiatri "  Hippocrates  and  Hemerius.  To  the  same  century 
belong  too  the  superstitious  Pelagonius,  and  Theomnestus,  so  devoted  to 
odd  remedies,  and  ordinary  veterinarian  of  the  first  king  of  the  Ostrogoths, 
Theodoric  the  Great  (455-520),  while  the  period  of  the  Spaniard  Pisterius, 
Litorius  of  Beneventum,  ^Emilius  of  Spain,  Beretius,  Hiero,  Nepho, 
Agathothychus  and  others,  some  of  whom  are  known  by  name  only,  is 
uncertain. 

1.  M.  Terentius  Varro  ( B.  C.  117-2G),  the  greatest  of  the  Romans  savants,  indeed 
wrote  on  the  subject  of  agriculture,  but  omitted  all  reference  to  medicine.  Yet 
he  mentions  minute  creatures,  invisible  to  the  eye,  which  penetrate  through  the 
mouth  and  nose  into  the  body  and  occasion  diseases  of  a  severe  character.  Was 
this  a  presage  of  our  modern  bacteria  ? 


—  102  — 

The  works  of  Apsyrtus  were  made  use  of  by  Hierocles,  the  lawyer 
(a  sort  of  antique  Bourgelat  of  the  4th  or  5th  century),  and  P. 
Vegetius  Renatus  of  Volterra  (about  A.  D.  380)  borrowed  likewise  from 
other  Greek  authors  his  "Four  Books  on  Veterinary  Medicine",1  in  which 
the  diseases  of  horned  cattle  especially  are  comprehensively  treated. — To 
"small  cattle",  like  sheep,  hogs,  dogs  etc.,  little  care  was  devoted  in 
Antiquity. 

That,  besides  practising  veterinary  physicians,  there  were  also  among 
the  Romans  army  veterinarians,  follows  from  the  founding  of  a  veterinarium 
for  wounded  and  sick  horses  about  A.  D.  100.  Even  a  kind  of  tariff  for 
the  "  Mulomedici ",  as  veterinary  ph}rsicians  were  called,  is  found  in  an 
edict  of  Diocletian  (284-313). 


1.    Mulomedicina  seu  ars  veterinaria. 


S  E  C  ONI)    P  E  R  I  O  I). 


THE  MIDDLE  AGES. 


13 


MEDICINE  FROM  THE  DOWNFALL  OF  THE  ROMAN  EMPIRE 

TO    THE    DISCOVERY    OF    AMERICA. 

A.   D.   476-I492. 

MEDLEVAL     MEDICINE. 


THE  MIDDLE  AGES. 


"Man  sieht  wie  in  der  truben  und  dunkelen  Zeit  der 
Menschengeist  ist  immer  geschiiftig  gewesen." 

Gothe,  Ital.  Reise. 

The  Middle  Ages  are  frequently  underrated  and  misunderstood,  or  at 
least  misjudged,  as  regards  their  importance  to  the  history  of  civilization, 
their  necessity  in  the  development  of  humanity.  Filled  with  classic  re- 
grets, we  would  fain  consider  them  the  dark  epoch  of  absolute  barbarity  or 
semi-barbarism  ;  the  period  of  historj-  during  which  the  glorious  bloom  of  a 
by-gone  civilization  fell  into  the  sere  and  yellow  leaf  and  utterl}T  withered 
away.  This  view,  however,  is  but  partially  justifiable;  for  the  Middle 
Ages  —  and  from  their  latter  half  onward  this  fact  is  in  every  department 
plainly  evident  —  served  not  to  repress,  nor  even  simply  to  maintain  un- 
disturbed, but  actually  to  advance,  the  development  of  humanity  and 
civilization,  and  thus  promoted  also  the  development  of  medicine. 

When,  indeed,  we  regard  only  the  sublime  greatness,  the  dazzling 
pomp  and  high  lustre,  of  the  golden  age  of  the  ancient  peoples  (especially 
the  Greeks),  but  overlook  their  gradual  senescence  and  infirm  decay1; 
when  too  we  contemplate  the  Middle  Ages  with  a  glance  directed  too  ex- 
clusivel}'  toward  the  past,  that  first  impression  strikes  us,  undoubtedly, 
with  a  perfectly  irresistible  force  ;  for  then  the  fall  appears  almost  instanta- 
neous, and  the  damage  almost  irreparable2!  This  view,  however,  changes 
as  soon  as  we  turn  our  eyes  away  from  the  past  and  towards  the  rising 
future.  To  the  dusk  of  the  evening  of  Antiquity  succeeded  a  night  ever 
lightened  by  individual  stars,  until  the  dawn  developed  as  a  harbinger  of 

1.  Even  at  the  very  beginning  of  the  Middle  Ages,  Athens  and  Rome,  the  centres  of 

the  ancient  world,  had  declined  into  ruined  and  decaj'ing  provincial  cities. 

2.  Historical  writing  too  is  influenced,  in    not  a  few   cases,  by   the  very  human  pecu- 

liarity of  representing  the  evil  in  the  darkest,  the  good  in  the  brightest,  colors. 
Hence  we  frequently  find  ourselves  in  the  dilemma  of  having  before  us  either  a 
pessimist  or  an  enthusiast.  It  has  thus  become  customary  to  represent  the 
Middle  Ages  too  darkly.  Undoubtedly  medicine  especially  found  itself  in  bad 
hands  during  this  period,  and  we  meet  on  every  side  popes,  bishops  —  even  in  the 
discussion  of  brothels! — priests,  monks,  nuns  etc.;  for  every  one  who  could 
merely  cross  himself  dabbled  to  his  heart's  content  in  the  medicine  of  the  period. 
Hence  it  resulted  that,  besides  the  superstition  descended  from  the  olden  time,  a 
perfectly  enormous  mass  of  new  superstition  was  crammed  into,  and  (through  the 
tradition  of  a  future  life)  received  by,  the  heads  of  the  people,  superstition  to 
which  they  have  clung  so  tenaciously,  that  ver}'  frequently,  even  to-day,  we  meet 
in  ordinary  practice  mediaeval  ideas  and  medicaments,  which  it  is  difficult  to  set 
aside.  We  must  always  remember  too  that  superstition  has  at  all  times  clung 
tenaciously,  and  still  clings,  to  mankind. 

(195) 


—  196  — 

the  day  of  the  modern  era.     Thus  onl}-  does  the  importance  of  the  Middle 
Ages  to  the  future  show  itself,  even  in  the  field  of  medical  culture. 

The  trough  of  the  descending  wave  of  civilization  did  not  reach  very  far  into  the 
Middle  Ages.  It  had  attained  its  greatest  depth  in  the  west  of  Europe  as  early  as 
the  6th  and  7th  centuries.  At  this  time  onhy  a  few  of  the  clergy  could  read  and  write, 
and  the  learned  among  them  (in  case  they  possessed  the  capacity)  no  longer  occu- 
pied themselves,  like  the  Church  fathers  and  early  clergy,  with  the  great  Ancients, 
for  these  were  great  —  heathen,  and  they  dreaded  the  commission  of  a  deadly  sin  in 
consulting  their  works.  Hence  this  was  done  only  in  the  rarest  of  cases,  and  even 
then  the}'  were  satisfied  with  the  inferior  nuthors,  and  particularly  with  the  Romans. 
Accordingly  the}-  composed  and  read  with  so  much  the  more  zeal  le*gends  of  the 
saints  and  similar  superstitious  fables  full  of  religious  fancies.  Historical  writing, 
above  all,  decayed  almost  entirely,  and  dry  chronicles  of  the  monasteries  etc.  took  its 
place,  though  of  course  without  making  good  its  loss.  Probably  nothing  demonstrates 
the  complete  enervation  of  all  higher  intellectual  life  in  the  Middle  Ages  so  com- 
plete^7 as  this  lack  of  historical  writing.  As  early  as  the  8th  century7,  however,  a 
revival  appeared,  and  from  the  countries  and  people  of  the  south,  about  the  time  of 
Charlemagne,  advanced  the  ascending  wave  of  civilization  in  the  West.  To  this  the 
Arabians  of  Spain  and  the  English  gave  the  chief  impulse.  The  dawn  of  civilization 
had  begun ! 

Forwards,  therefore,  lies  the  peculiar  importance,  indeed  the  necessity,  of  the  so- 
called  Middle  Ages  to  the  advancement  of  humanity.  The  Ancients  had  so  utterly 
exhausted  their  physical  and  mental  activity;  they  had  become  so  utterly  powerless, 
that  to  their  unmixed  and  unrefreshed  existence  nothing,  save  a  general  valetudina- 
rianism and  decay,  was  longer  possible.  And  in  this  existence  only  a  ray  of  the  old 
spirit  could  stream  forth  fitfully  here  and  there,  like  an  ignis  fatuus,  in  the  general 
night  of  undisturbed  stagnation,  as  the  eastern  Grasco-Roman  Empire- — that  mourn- 
ful memorial  of  the  frailt}7  and  transitoriness  of  the  spiritual  greatness  of  nations  — 
actually  showed. 

Christianity,  with  its  doctrine  of  the  "renunciation  and  mortification"  of  the 
flesh,  opposed  itself  to  the  cultivation  of  sensuality  and  the  senses  b}*  the  later 
Ancients.  It  was,  indeed,  an  ethical  reaction,  but  in  its  consequences  it  effected  also 
the  physical  elevation  of  the  race.  Humanity  was  compelled  to  begin  once  more,  as 
it  were,  from  the  beginning,  in  both  the  spiritual  and  corporeal  directions. 

A  refreshing  of  bodj7  and  spirit  was  required,  and  for  this  purpose  even  the 
slaughter  an  1  death  of  that  which  no  longer  possessed  a  capacity  for  life  (provided  it 
did  not  and  would  not  die  of  itself),  in  order  to  make  room  for  that  which  was  fresh 
and  vigorous.  The  irruption  of  a  definite  mass  of  robust,  even  violent,  barbarit}-,  of 
natural  growth  and  based  upon  energy,  healthy  in  character  and  apt  for  develop- 
ment; an  irruption,  I  say,  into  the  sickly,  characterless  and  enervated,  as  well  as 
vicious,  over-refinement  of  the  too  highly  cultured  people  of  Antiquity,  was  indis- 
pensable to  the  execution  of  that  decree  of  universal  history — the  maintenance  of 
mankind  in  a  condition  suitable  for  further  development.  The  law  providing  for  the 
conservation  of  vigor  in  humanity  prevailed  with  all  its  inexorable  power,  and  to  that 
law  individual  nations,  j"es,  even  entire  races,  from  that  day  to  this,  have  been  ruth- 
lessly sacrificed. 

The  creation  of  a  new  civilization  in  place  of  the  deca3'ed  and  stagnant 
culture  of  the  Ancients  was  then  the  difficult  task  of  the  Middle  Ages  —  a 
task  which,  at  the  expense,  indeed,  of  the  utmost  travail,  it  completely 
accomplished. 


—  197  — 

The  re-casting  of  humanity  took  place  in  two  wa}-s  :  in  a  physical 
point  of  view,  through  the  migration  of  whole  peoples,  the  violent  commix- 
ture of  a  great  part  of  the  members  of  all  the  then  known  races  of  the 
earth;  then  through  famine,  terrible  plagues,  constant  wars  and  endless 
strife.  In  a  spiritual  point  of  view  it  was  the  result  of  unprecedented 
struggles  concerning  the  new  feelings  and  thoughts  awakened  bv  a  new 
and  Christian  philosophy  and  a  new  faith. 

These  surfings  and  struggles  of  the  various  barbarous  and  semi-barbarous 
peoples,  Goths,  Germans,  Vandals,  Huns,  and  later  the  Saracens,  Sclaves  (6th  cen- 
tury), Hungarians  (9th  centurj-)  etc.,  during  the  Middle  Ages,  the  particulars  of 
which  are  but  imperfectly  known  to  us,  introduced,  with  youthful  blood  and  new  seed, 
new  strength  of  both  will  and  action.  Accordingly,  as  the  result  of  this  robust  inter- 
mixture, the  Ancients  for  the  most  part  either  perished,  or,  in  favorable  cases,  united 
with  the  more  youthful  elements  to  form  new  nations.  Yet  in  this  crossing  of  blood 
with  the  over-civilized,  in  this  contact  with  the  over-refined  forms  of  life,  many  of 
these  semi-barbarous  peoples  also  perished  utterly,  as  among  consumptives  mixture 
with  the  diseased  infects  and  destroys  the  healthy. 

B}T  this  continual  crossing  arose  vigorous  mixed  stocks,  the  Roman 
races,  which  still  exist  to-day  and  reach  back  in  their  origin  to  the  earliest 
period  of  the  Middle  Ages.  On  the  other  hand  e.  g.  the  Goths,  Vandals 
and  Huns  perished.  It  was  another  task  of  the  Middle  Ages  to  introduce 
and  effect  the  association  of  different  people  and  races  in  the  support  and 
advancement  of  civilization,  a  thing  entirel}-  foreign  to  Antiquity.  For 
during  Antiquity  one  people  only  relieved  another ;  one  civilized  people 
only  exercised  a  controlling  influence  at  any  one  period.  Hence  the  Middle 
Ages  fulfilled  a  cosmopolitan  mission.  During  Antiquity,  even  down  to 
its  very  close,  there  was  always  one  overshadowing  empire  ;  at  the  end  of 
the  Middle  Ages,  on  the  contrary,  the  powerful  nations  of  the  present  day 
were  alread}'  in  existence.  The  Middle  Ages  inaugurated  the  empire  of 
nationalities,  and  put  a  close  to  the  period  of  universal  empire. 

In  the  prime  of  youth,  with  uncorrupted  vigor,  and  full  of  independence, 
the  German  peoples  (to  whom  belong  so  peculiarly  the  later  Middle  Ages 
and  our  modern  times)  seized  upon  the  youthful  career  of  humanit}-,  to  pass 
through  an  adolescence  more  protracted  and  more  romantic  than  other  races  ; 
an  adolescence  during  which  they  were  strengthened,  at  least  spiritually,  by 
their  struggles,  }'et  also  squandered  therein  much  of  their  national  force, 
especially  in  the  crusades  and  the  struggles  with  the  popes. 

A  new  leaven  of  civilization  was  the  doctrine  of  the  carpenter's  son  of 
Nazareth,  that  man  of  the  largest  and  warmest  heart  the  world  has  ever 
seen,  yet  whose  teachings  were  at  once  corrupted  and  falsified  b}-  the 
Roman  mediaeval  priesthood  (which  of  all  professions  has  brought  most 
evil  upon  mankind),  instead  of  being  freed  from  the  dross  of  the  time  and 
the  people  of  their  founder.  Yet  through  this  corruption  (so  historj' 
teaches)  the  "  Religion  of  love  "  has  resulted  in  more  dark  delusion  and 
horrors  of  all  kinds  than  any  other  religious  belief.  It  has  been  the 
bloodiest  of  all  religions  designed  to  bless  mankind. 


—  198  — 

Man  was  perverted  into  God;  faith,  into  superstition  and  delusion  ;  benevolence 
and  charity,  into  persecution  of  unbelievers;  peace,  into  war,  the  natural,  iuto  the 
unnatural.  At  once  it  appeared  how  closely  related  were  the  faith,  thus  rank  in  its 
luxuriance,  and  unnatural  phantasy,  and  how  both  in  alliance  lent  aid  to  the  senses 
and  to  sensuality,  with  all  their  evil  consequences,  never  greater  than  during  the 
"faithful"  Middle  Ages.  Mournful,  indeed,  would  be  the  reflection,  that  from  the 
ethical  seed  sown  by  Christ  proceeded  such  great  evils,  evils  perhaps  even  the  greaiest 
that  mankind  has  ever  suffered,  were  it  not  true,  on  the  other  hand,  that  by  the  aid 
of  a  very  small  portion  of  that  doctrine  of  loving  mercy,  happily  conve3-ed  into  life, 
were  accomplished  those  lofty  deeds  of  charity,  which  certainly  exercised  upon  the 
medicine  of  the  Middle  Ages  an  influence  of  especial  importance  :  for  through  them 
the  practice  of  that  period  received  its  peculiar  character  and  impress. 

If  the  medicine  of  Antiquity  was  par  excellence  the  pupil  of  philosophy, 
theolog}-,  or  perhaps  it  were  better  to  say  faith  in  general,  stamped  its  seal 
on  the  medicine  of  the  Middle  Ages,  so  far  as  the  latter  did  not  (as  with 
the  Byzantines  and  Arabians)  follow  almost  absolutely  the  Ancients.  If 
too  the  medicine  of  the  Ancients  was  pre-eminently  a  medicine  of  phil- 
osophic thought,  and  if  modern  medicine  is  a  science  of  thoughtful  obser- 
vation, the  medicine  of  the  Middle  Ages  was  the  pupil  of  authority  and 
faith,  clinging  slavishly,  on  the  one  hand,  to  the  works  and  views  of  the 
Ancients  and  adopting  particularly  popular  beliefs  in  order  to  Christianize 
them  ;  on  the  other,  striving  after  and  instituting  works  of  Christian 
charit}'  (whose  spirit  and  practice  were  ever  more  active  in  medicine  than 
in  theolog}),  which  had  in  view  chiefly  eternity,  but  concerning  which 
ordinaiy  medical  knowledge  and  thought  had  for  a  long  time  manifested  no 
interest  whatsoever. 

It  is  the  fatal  characteristic  of  the  whole  intellectual  life  of  the  Middle  Ages  that 
it  remained  without  any  productive  philosophy,  and  above  all,  without  any  nctive 
skepticism.  Even  to  scholastic  philosophy,  all  direct,  and  almost  all  indirect,  pro- 
ductive force  was  lacking.  When,  however,  true  philosophy  once  more  came  to  be 
studied,  above  all  when  in  the  16th  century  a  vigorous  skepticism  began  to  act,  the 
Middle  Ages  were  injured  at  the  root,  so  that  the  stem,  blind  faith  and  unreasoning 
repetition,  was  forced  to  wither  away.  (Ueberweg).  Observation,  which  the  Ancients 
cultivated  occasionally  and  partially,  was  shut  out  for  the  same  period. 

The  number  of  writers  too,  whom  the  Middle  Ages  chose  for  guides  out  of  the 
great  wealth  of  Antiquity,  was  trifling.  The  following  are  those  whose  works  were 
chiefly  utilized:  Pliny  (Hist.  Nat.),  Seneca  (Quaestiones  Nat.),  Galen  and  a  few 
books  of  Hippocrates;  Ptolemy  in  astronomy  and  geography;  iElius  Donatus  in 
grammar;  Vergil:  the  Arabic  version  of  Aristotle;  Dioscorides ;  Dion  Cassius; 
Caslius  Aurelianus;  Celsus  (rarely);  Marcellus  Empiricus  (more  frequently);  Lucius 
Apuleius;  Sextus  Placitus  Papyriensis  and  others.  At  a  later  period  Paul  of  ^Egina, 
Alexander  of  Tralles,  Oribasius  and  a  few  others. 

As  regards  medical  science,  and,  indeed,  the  sciences  in  general,  the  Middle  Age 
can  at  least  display  meritorious  service  in  the  preservation  of  the  works  of  the 
Ancients.  In  this  respect  the  Byzantine  Greeks  occupy  the  first  rank;  then  the 
Arabians;  and  finally  the  monasteries  merit  consideration,  though  the  latter,  indeed, 
are  of  less  importance  than  has  been  commonly  taught.  In  the  monasteries,  as 
almost  all  productive  and  animating  art  was  wanting,  so  too  there  was  no  productive 
investigation  :  indeed  the  latter  seemed  no  longer  necessary,  since  the  sciences  were 


—   199  — 

believed  to  have  been  perfected  by  the  Ancients.  To  collect  from  their  knowledge, 
to  appropriate  what  was  thus  collected,  often  without  any  critical  research,  was  re- 
garded in  the  Middle  Ages,  at  least  in  the  first  half  of  this  period,  as  science.  Purely 
mechanical  work  filled  the  place  of  the  art  of  the  Ancients  even  down  to  their  close. 
And  it  was  the  revival  of  genuine  science  and  art,  that  is  science  and  art  in  the  sense 
of  the  Ancients,  which  renewed  the  spiritual  leaven,  that  in  the  last  centuries  of  the 
Middle  Ages  excited  in  medical  affairs  the  mighty  fermentation  of  mind,  which  finall}' 
called  into  life  a  medicine  of  observation.  In  practice  too  the  Middle  Ages  intro- 
duced the  institution  of  hospitals,  so  beneficent  in  iuany  points  of  view. 

Among  the  historical  phenomena  which  compose,  in  the  main,  the 
medical  Middle  Ages,  we  must  first  consider  Byzantine  medicine,  founded 
entirely  upon  Antiquity,  or  perhaps  more  truly  a  wretched  continuation  of 
that  period  ;  then  the  transplanting  of  Greek  medicine  among  the  Arabians, 
also  the  work  of  the  Byzantine  school ;  next  the  Christian  labors  in  behalf 
of  the  care  of  the  sick,  including  monastic  medicine ;  and  finally  the 
vigorous  impulse  toward  the  founding  of  a  new  science  of  medicine  in  the 
last  half  of  the  Middle  Ages. 


IV.  THE  GREEK-CHRISTIAN  MEDICINE  OF  THE  EASTERN  EMPIRE. 

Grecian  science,  fortunately,  ruled  almost  exclusively  the  medicine  of 
the  Eastern  Empire,  though  in  the  long  period  which  preceded  its  downfall 
it  contributed  to  it  nothing  of  importance. 

This  Empire  itself,  feeble  from  its  foundation,  sunk  gradually  during  the  Middle 
Ages  so  low,  that  for  the  greater  portion  of  the  thousand  years  of  its  existence  during 
this  period  it  lived  solely  by  the  grace  of  other  nations.  From  time  to  time,  however, 
it  started  up  with  apparent  vigor,  animated  bj-  the  fortuitous  and  unwonted  talents 
of  the  ruling  emperor  or  his  generals,  or,  perhaps,  inspired  by  the  energy  of  the 
reigning  empress,  but  never  impelled  by  a  genuine  outburst  of  national  power.  Its 
vitality  in  the  sphere  of  intellect  corresponded  with  its  political  existence,  and  forms 
one  of  the  most  wearisome  and  repulsive  pictures  of  all  history.  It  was  an  emascu- 
lated and  mongrel  life,  which  from  heathen  art  and  science  had  adopted  little  but 
their  image  and  their  forms,  from  Christianity,  only  its  weaknesses. 

Art  (if  we  except  archilecture,  which  created  some  masterpieces ),  though  still  in 
many  ways  following  the  antique,  had  lost  its  necessary  character  of  freedom,  and 
was  subordinated  entirely  to  dogma  and  to  faith.  It  degenerated  into  rigid  and  in- 
flexible formalism,  lost,  like  science,  its  creativeness,  and  exercised  an  evil  influence 
upon  the  art  of  the  West,  which  followed  the  lead  of  the  Byzantine,  even  down  to  the 
time  of  Charlemagne.  Besides  architecture,  mosaic  and  miniature  painting  were 
best  cultivated.  Sculpture  and  music  received  less  attention,  though  instrumental 
music  was  admitted  into  the  churches,  while  in  the  West  vocal  music  only  was  allowed. 
Yet  these  relics  at  least  preserved  artistic  effort,  until  in  Italy  a  new  art  was  able  to 
develop  in  the  13th  century. 

The  trade  in  court-offices,  titles  and  matters  of  etiquette,  the  mania  for  imaginaiy 
positions  of  state,  absurd  factiousness,  iconoclasm,  the  offspring  of  Christian  fanati- 
cism, the  search  after  theological  dogmas  and  other  crotchets,  sectarianism  and  all 
such  nonsense,  filled  the  heads  of  emperors,  priests  and  savants  at  times  when  it  was 
not  absolutely  necessary  to  defend  themselves  against  the  numerous  enemies  of  their 
very  life.  And  often,  even  when  a  struggle  was  going  on  before  the  very  gates  of  the 
city  for  the  existence  of  the  empire,  whose  limits  not  infrequently  extended  no  further 


—  200  — 

than  the  walls  of  Byzantium,  they  fairly  wearied  themselves  out  in  the  most  exas- 
perating disputes  over  miserable  subtilties  of  the  Christian  theology. 

Yet  this  infirm  Eastern  Empire,  involuntarily,  indeed  in  spite  of  itself,  performed 
services  of  inestimable  value  to  humanity.  Here  the  ancient  Greek  language,  the 
mother-tongue  of  science,  continued  to  survive,  and  here  were  collected  and  preserved 
a  large  part  of  its  literary  treasures.  In  jurisprudence  the  services  of  the  Byzantine 
empire  were  especially  valuable  :  in  medicine  they  were  less  important,  yet  very 
considerable.  Here  originated  some  medical  works  of  importance  (even  though  they 
were  mere  compilations),  and  various  other  treatises,  of  secondary  importance  in 
medicine,  yet  precious  for  the   insight  which  the}-  give  us  into  the  spirit  of  the  times. 

Greek  mental  and  moral  culture  continued  to  exercise  its  influence  upon  the 
West,  even  high  up  into  northern  latitudes.  Vikings  and  Normans,  in  the  ranks  of 
the  army,  long  supported  the  decaying  empire.  But,  disregarding  this  and  the  com- 
mercial intercourse  with  the  West,  the  visits  of  eastern  physicians  to  Salerno  and  the 
kingdom  of  the  Franks  bear  witness  to  this  Byzantine  influence,  especially  in  the 
■department  of  medicine. 

Imperishable  and  inestimable,  however,  was  the  value  to  humanity  of  that  em- 
pire, even  in  her  death  struggles;  for  from  her  borders  came  to  the  West  those  men1 
who,  through  the  revival  of  the  study  of  the  ancient  Greek  authors,  gave  the  im 
pulse,  which  finally  awakened  mankind  from  the  romantic  twilight  of  mediaeval  faith 
to  the  dawn  of  a  period  of  freshened  and  renewed  thought.  And  here  the  spirit  of 
the  ancient  Greeks  in  later  hours  celebrated  a  greater  triumph  than  it  could  have 
ever  won  or  celebrated  in  its  own  narrow  home.  It  gleamed  like  an  oriflamme  on  the 
standard  of  the  spiritual  liberators  of  mankind,  and  its  works  served  as  weapons  with 
which  these  heroes  won  at  last  a  free  road  to  the  light;  for  indirectly  it  was  the 
creator  of  a  new  scientific  epoch  in  general,  and  of  the  new  medicine  in  particular. 
Here  also  approved  itself  again — and  not  for  the  last  time — the  fertile  spiritual  power 
©f  that  peculiar  old-Greek  spirit-life,  to  which  mankind  owes  the  most,  and  above  all 
the  greatest,  of  its  attainments!  The  writings  to  which  it  gave  birth,  by  this  influence 
of  the  past  upon  the  future,  laid  the  cable,  by  means  of  which  the  past,  and  the  future 
of  medicine  eame  into  a  living  and  speaking  union. 

Below  we  mention  certain  Greek  physicians  of  mediaeval  times,  who 
belonged  to  the  Eastern  Empire,  or  were  at  least  intellectually  connected 
with  it,  though  they  were  not  all  Christians.  They  no  longer  belonged  to 
anj*  special  "school",  but  where  Eclectics,  and  frequently  collected  into 
manuals  (after  the  style  of  our  modern  physicians)  the  experiences  of  others, 
together  with  additions  of  their  own,  and  hence  were  better  or  worse  com- 
pilers or  encyclopaedists.     Interesting  and  remarkable  too  is  the  fact  that 

1.  The  most  famous  of  these  were  Barlaam  (A.  D.  1339),  the  friend  of  Petrarch; 
Leontius  Pilatus,  the  first  professor  of  the  Greek  language  in  the  West,  for  whom, 
at  the  instance  of  Boccacio,  a  chair  was  created  at  Florence,  A.  D.  1360;  Manuel 
Chrysoloras,  who  taught  Greek  literature  at  Florence,  Pavia,  Venice  and  Rome 
(A.  D.  1396-1415);  George  of  Trebizond  (1430),  Philelphus  (1440),  Theodorus 
-Gaza  (1450),  George  Gemistus  Pletho  (1440),  Cardinal  Bessarion  (A.  D.  1450), 
Pope  Nicholas  V.  (1447-1455),  Lascaris  (1470).  The  first  Greek  book  printed 
in  Italy  was  a  Greek  grammar  composed  by  Lascaris,  and  published  at  Milan  in 
1476.  The  press  of  Aldus  Manutius  was  established  at  Venice  about  A.  D.  1494. 
He  printed  more  than  60  works  of  Greek  literature,  most  of  them  for  the  first 
time.  Guarini  (1395),  Aurispa  (1423)  and  Philelphus  (1440)  also  imported  nu- 
merous Greek  works  into  Italy.     (H.) 


—  201  — 

Christianity,  so-called,  though  so  constantly  fostered  and  nurtured  in  the 
Eastern  Empire,  remained  almost  without  any  apparent  influence  on  the 
scientific  substance  of  medicine.  Medicine,  as  a  science,  remained  Greek, 
beside  a  development  of  civilization  in  other  respects  entirely  Christian  and 
Pseudo-Christian.  In  therapeutics  only  did  Christian  influences  show 
themselves  prominently  in  the  form  of  all  kinds  of  new  superstition. 

The  earliest  of  these  eastern  physicians  (he  lived  in  the  first  three 
quarters  of  the  6th  century,  about  A.  D.  502-575)  was 

Aetius  of  Amid  a  (now  Diarbekir)  in  Mesopotamia  or  Armenia,  who 
pursued  his  studies  at  Alexandria,  even  then  the  first  university  of  Anti- 
quity. Thence  he  came  to  B}zantium,  where  he  spent  the  greater  portion 
of  his  life.  He  was  a  follower  of  the  Christian  superstition,  and  held  the 
office  of  a  comes  obsequii  (lord  high  chamberlain)  at  the  betitled  court  of 
Byzantium.  As  such  he  was  also  ordinaiy  physician  of  the  '•  Great " 
Justinian  I.  (A.  D.  527-565),  who  closed  the  pagan  schools,  and  thereby 
inflicted  upon  his  empire  injuries  similar  to  those  inflicted  upon  France  by 
Louis  XIV.  in  his  revocation  of  the  Edict  of  Nantes.  He  had  also  this  in 
common  with  the  French  king,  that  his  former  mistress,  the  actress 
Theodora,  afterwards  as  his  spouse  exercised  a  great  —  and  in  truth  a 
good  —  influence  upon  the  government. 

His  16  books  on  medical  science1  form  a  text-book  of  general  medicine,  and  aie 
based  upon  the  teaching  of  many  important  ancient  physicians,  which  without  him 
would  have  been  lost.  They  were  subsequently  divided  into  4  "  Telrabilia  ",  each  of 
which  comprises  4  "Sermones".  The  value  of  the  compilation  of  Aetius  is  naturally 
measured  by  that  of  the  original  writers  (Archigenes,  Philagrius,  Leonides,  Philu- 
menns,  Soranus,  Aspasia  etc.).  Much,  however,  belongs  to  Aetius  himself,  much  to 
his  time,  the  stamp  of  which  is  impressed  especially  upon  his  therapeutic  counsels. 
For  therapeutics  generall}"  furnish  a  relatively  better  barometer  of  the  fallen  condition 
of  the  science  than  the  other  branches  of  medicine, —  a  truth  of  which  the  whole 
Middle  Ages  furnishes  numerous  examples.  In  fact  the  bad  for  the  most  part  long 
outlasts  the  beginning  of  improvement. 

In  surgical  therapeutics  Aetius  recommended  a  great  number  of  salves  and 
plasters,  but  also  the  seton,  and  even  lithotomy  in  women.  Moreover  he  mentions 
ligation  and  torsion  as  means  for  controlling  haemorrhage,  and  recommends  irrigation 
with  cold  water  in  the  treatment  of  wounds.  The  preparation  of  salves  must,  how- 
ever, take  place  with  certain  superstitious  ceremonies.  Thus  e.  g.  one  should  con- 
tinually repeat,  in  a  loud,  but  solemn,  tone,  the  charm  "The  God  of  Abraham,  the 
God  of  Isaac,  the  God  of  Jacob,  give  virtue  to  this  medicament",  until  the  consist- 
ency of  plaster  is  obtained!  If  a  bone  is  stuck  in  the  throat  the  patient  should 
swallow,  and  then  draw  out  again,  a  piece  of  raw  meat,  to  which  a  pack-thread  has 
been  fastened,  —  or  the  physician  should  grasp  him  by  the  throat  (unfortunately  the 
results  of  this  treatment  are  not  given!)  and  cry  in  a  loud  voice,  "As  Jesus  Christ 
drew  Lazarus  from  the  grave,  and  Jonah  out  of  the  whale,  thus  Blasius,  the  martyr 
(A.  D.  316)  and  servant  of  God,  commands  "Bone  come  up  or  go  down!  '.  In  lith- 
otomy he  recommends  the  use  of  a  knife  guarded  by  a  tube,  to  avoid  wounding  the 

1.  Bi^Ua  tarpi/.a  i y./.aOh /.a  ^=h\bvi  medicinales  sedecim.  The  Greek  text  of  the 
first  eight  books  only  has  been  published.  A  Latin  translation  of  the  whole  work, 
however,  was  published  by  Cornarius  and  Montanus  (Basil.  1533-35).     (H.) 


—  202  — 

internal  organs  of  generation,  which  might  result  in  impotence.  He  practises  vene- 
section on  both  the  diseased  and  the  sound  side,  and  in  cerebral  congestion  advises 
also  to  stick  a  straw  into  the  nose  of  the  patient,  that  the  double  haemorrhage  may 
render  the  cure  more  certain.  —  He  further  commends  the  pimpernel1  in  hydrophobia, 
pomegranate  bark  for  worms,  and,  on  the  other  hand,  castration  in  leprosy.  To  de- 
tect poison  in  a  wound  he  makes  use  of  a  poultice  of  walnuts  laid  upon  it  and  after- 
wards thrown  to  a  fowl:  if  the  fowl  eats  the  poultice,  the  wound  is  free  from  poison  ;  if 
not,  it  is  not!  Moreover  he  defends  the  Hippocratic  maxim  that  nature  should  be 
permitted  to  have  her  own  way,  a  precept  to  which  very  different  explanations  have 
been  given  from  Hippocrates'  time  down  to  our  own  day,  since  it  is  usually  "the 
masters'  own  nature"  which  they  ask  others  to  follow.  In  hectic  fevers  he  advises 
nutritious  food;  in  febrile  diseases  generally,  coolness  of  the  apartment.  "Lipyria", 
a  febrile  disease  of  the  stomach  accompanied  with  loss  of  speech  and  external 
chilliness,  lie  cures  b}-  drinking  cold  water  and  the  use  of  opium.  Typhoid  fever 
manifests  as  its  chief  sjmptoms  stupor  and  delirium;  febris  algida,  however,  an  icy 
coldness.  The  former  depends  upon  inflammation  of  the  liver,  the  latter,  upon  that 
of  the  lung.  Erysipelatous  inflammation  of  the  intestines  occasions  especially  hyper- 
pyrexia (causus)  and  hectic  fever.  He  speaks  further  of  a  superficial  inflammation, 
of  the  brain  (erysipelas  cerebri),  of  an  inflammation  of  the  brain  in  children  (siriasis), 
of  an  itching  of  the  bladder  (scabies  vesicae),  and  of  intestinal  softening  in  children 
(chordapsus).  He  also,  like  Aretaeus  and  Archigenes,  mentions  diphtheria,  and 
evidently  has  an  idea  of  the  paralysis  of  the  palate  which  follows  the  disease. 

The  condition  of  obstetrics  at  that  time  may  be  inferred  from  the  fact  that,  in 
faulty  positions  of  the  child,  he  recommends  the  following  procedure:  to  cut  off  the 
upper,  and  if  necessary,  the  lower,  extremities  also;  then  to  decapitate,  and  after- 
wards drag  out  with  sharp  hooks  first  the  trunk  and  then  the  head — a  style  of 
management  which  prevailed  down  into  the  18th  century.  Aetius  was,  however, 
acquainted  with  podalie  version,  and  also  inculcated  protection  of  the  perineum.  (It 
is  remarkable  that  he  nowhere  mentions  the  great  plague  of  his  time.) 

In  the  general  night  of  ignorance  Alexander  of  Tralles  (525-605), 
in  consequence  of  his  relative  independence,  his  excellent  powers  of  obser- 
vation and  his  skill  in  exposition,  ma}"  be  called  comparatively  a  star  of  the 
first  magnitude.  Yet  even  he  is  not  free  from  the  dense  mental  obscurity 
of  his  century.  His  native  city2  was  in  Lydia,  where  first  his  father r 
Stephen,  and  subsequently  his  brother,  Dioscurus,  were  physicians.  Both 
came  to  Constantinople  and  occupied  important  positions.  The  same  may 
be  said  of  the  other  sons  of  Stephen,  Metrodorus,  the  grammarian,  Olym- 
pius,  the  jurist,  and  Anthemius  (with  Isidorus  of  Miletus  and  Ignatius), 
the  architect  of  the  church  of  St.  Sophia.3  Alexander's  father  at  first,  and 
his  patron,  the  father  of  a  certain  Cosmas,4  supplied  his  early  education, 
and  they  were  succeeded  by  the  most  famous  teachers  of  medicine  of  that 

1.  Anagallis   Phoenicea.     A  decoction   of  this  plant  in  beer  is  said  to  be  the  chief 

ingredient  of  "  Stoy's  medicine  for  hydrophobia.''     (H.) 

2.  Tralles  was  also  the  birthplace  of  other  famous  men,  e.  g.  Apollonius  and  Tauris- 

cus,  the  sculptors  of  the  Farnese  Bull. 

3.  He  was  also  acquainted  with  the  power  of  steam,  and  bjr  its  aid  exemplified  an 

earthquake  for  one  of  his  neighbors. 

4.  Probably  the  Indian   traveller,  who  thought  the  earth  to  be  a  flat   surface  sur- 

rounded b}'  four  walls,  upon  which  rested  the  heavens. 


—  203  — 

day.  On  the  completion  of  his  studies  he  travelled  extensively  to  Cyrene, 
Spain,  Gaul,  Italy  and  Greece,  and  finally  settled  down  in  Rome,  where  he 
died  at  an  advanced  age.  Before  his  death,  when  no  longer  able  to  practice, 
he  wrote  his  "Twelve  Books  on  Medicine",1  the  fruit  of  a  long  life.  In 
these,  beginning  (in  the  style  of  the  da}-)  with  injuries  of  the  head  and 
terminating  with  the  feet,  he  has  left  us  a  compendium  of  the  pathology  of 
his  period. 

His  views  give  evidence  of  independent  thought,  in  proof  of  which  he 
binds  himself  to  neither  Hippocrates,  nor  the  schools,  nor  yet  to  Galen  (the 
idol  of  his  own  and  later  times),  but,  like  a  good  eclectic  and  compiler,  he 
makes  use  of  them  all.  Yet  he  ventures  (rank  heresy  in  that  day  !)  to  re- 
prove even  Galen  for  his  frequently  incorrect  methods  of  treatment. 

His  doctrine  of  fever,  according  to  which  the  seat  of  fever  is  in  the  heart  (he 
has  no  conception  of  an  essential  fever),  is  most  complete.  Fever  results  chiefly  from 
diseases  of  the  stomach  and  intestinal  canal. —  The  general  vitality  suffers  in  diseases 
of  special  organs  only  so  far  as  it  functionates  through  these  organs.  Thus  epilepsy 
depends  upon  disease  of  tHe  brain,  and  he  uses  the  seat  of  the  aura  as  an  indication 
of  the  point  where  a  chronic  suppuration  should  be  maintained. —  On  mania  and 
diseases  of  the  mind  in  genera!  he  makes  some  admirable  observations. —  1  nflammations 
of  the  throat  he,  like  his  predecessors,  divides  into  cynanche  (inflammation  of  the 
larynx),  and  para-cynanche  (inflammation  of  the  external  parts  of  the  larynx);  then 
into  synanche  (inflammation  of  the  pharynx),  and  para-synanche. —  His  methods  of 
diagnosis  are  comparatively  perfect.  Thus  he  employs  the  pressure  of  the  fingers  for 
the  detection  of  anasarca  (the  frequent  inflammatory  nature  of  which,  indeed,  he  first 
recognized);  palpation  in  enlargements  of  the  spleen;  inspection  in  the  investigation 
of  urinary  sediments,  which-  he  discusses  fully;  percussion  in  tympanites  and  sue- 
cussion  in  ascites. —  The  diseases  occasioned  by  worms  he  describes  very  well,  and 
he  also  recognizes  lung-stones,  so  that  he  had  evidently  made  dissections. —  His 
views  on  the  place  where  venesection  should  be  practised  give  evidence  of  a  freedom 
from  prejudice  far  in  advance  of  his  time.  He  bled  from  all  parts  of  the  body,  and 
held  the  opinion  that  it  was  perfectly  immaterial  whether  the  operation  was  performed 
in  the  vicinitj'  of  the  diseased  part  (as  Hippocrates  preferred),  or  (as  the  Methodists- 
directed)  on  the  opposite  side,  since  all  the  veins  in  the  body  communicate. —  He 
admonishes  his  colleagues  not  to  be  dazzled  by  the  glare  of  "  The  Authorities".  Of 
drugs  he  is  the  first  to  mention  rhubarb,2  but  he  discards  opium  in  many  diseases  (a 
remed3r  in  his  time  used  in  all  painful  cases),  since,  as  he  correctly  observes,  it 
frequently  occasions  cerebral  congestion.  In  gout  he  recommends  blisters;  in 
diarrhoea  he  warns  against  astringents,  and  instead  of  them,  advises  mild  laxatives. 
In  nervous  fever  he  recommends  the  use  of  wine;  in  hectic  fever,  with  circumscribed 
flushing  of  the  cheeks,  he  especially  advises  milk-diet  (goat's,  asses',  mare's  milk). 
Alwaj's  and  above  all,  however,  he  lays  stress  upon  consideration  of  the  constitution, 
the  mode  of  life,  and  the  age  and  vigor  of  the  patient,  and  he  defines  the  task  of  the 


1.  lhflXia  iazfiv/.d  dooxacosxa,  libri  duodecim  de  re  medica.     The  work  is  dedicated 

to  his  friend  Cosmas,  though  the  dedication  is  found  at  the  beginning  of  the 
twelfth  book.     It  was  not  completely  translated  into  Latin  until  1549.     (H.) 

2.  Rhubarb  is  said  to  be  mentioned  in  the  herbal  Pen-king,  ascribed  to  the  Chinese 

emperor  Shen-nong,  B.  C.  2700.  The  6a  or  fyov  of  Dioscorides,  the  radix  Pon- 
tica  of  Celsus  and  Scribonius  Largus  and  the  rhacoma  of  Plinj'  are  supposed  to 
be  the  rheum  Rhaponticum,  our  garden  rhubarb  or  pie-plant.     (H.) 


—  204  — 

physician  in  the  following  words:  "It  is  the  duty  of  the  physician  to  combat  diseases 
with  remedies  which  are  opposed  to  their  nature,  to  provide  with  circumspection 
everything  necessary,  and  to  rescue  the  patient  with  all  art  and  caution,  as  one 
beleaguered  in  war".  In  striking  contrast  with  these  and  similar  sound  principles, 
however,  are  his  peculiarities  and  his  superstition,  in  which  qualities  he  was  a  true 
son  of  his  time.  Thus  in  gout  he  recommends  a  very  complicated  antidote,  the  use 
of  which  is  to  be  begun  in  January,  and  continued  for  a  year  and  a  day.  It  is  to  be 
taken  100  days,  then  suspended  for  30  days,  then  resumed  for  100  days,  then 
suspended  15  days,  then  it  is  prescribed  ajiain  every  second  day  for  260  days,  after 
which  SO  similar  doses  follow1  !  He  cures  the  pains  of  colic  by  a  stone,  upon  which 
is  engraven  the  figure  of  Hercules  strangling  the  serpent,2  or  bj"  an  iron  ring,  upon 
one  side  of  which  is  exhibited  an  incantation,  on  the  other,  the  diagram  of  the  Gnostics. 
In  gout  he  orders  also  the  mystic  words  //£/,  Opzu,  /xnp,  (f<>j>,  rsu^  etc.  to  be  written 
upon  a  golden  leaf  during  the  wane  of  the  moon!  In  intermittent  fever  he  advises  one 
to  carry  an  olive  leaf,  upon  which  are  written  the  mystic,  because  senseless,  syllables 
ka,  ra,  a,  or  to  drink  menstrual  blood  (?),  or  to  put.  on  the  dress  of  a  lyinjr-in  woman  ! 
—  Another  medical  treatise  '"  Problemata  '.3  which  follows  the  humoral  pathology 
with  Methodistic  and  Pneumatic  views,  and  goes  under  the  name  of  Alexander  of 
Aphrodisias,  is  probably  from  the  pen  of  Alexander  of  Tralles.  Thus  e.  g.  the  sparks 
seen  after  a  blow  upon  the  ear  depend  upon  an  inflammation  of  the  spiritus  visorius; 
hemeralopia,  upon  arrest  of  the  advance  of  a  loo  thick  pneuma  to  the  organ  of 
sense  &c. 

Far  less  important  are  the  following  physicians  of  this  period  : 

John  Philoponus, 
one  of  the  earliest  bishop-physicians,  wrote  commentaries  on  Galen,  and  lived  in  the 
sixth  century. 

John  of  Alexandria4 

(about  the  end  of  the  6th,  or  beginning  of  the  7th,  centurj')  wrote  commentaries  on 
Hippocrates  and  Galen,  which  were  translated  into  Arabic,  and  again  from  this 
tongue  into  Latin,  as  was  afterwards  often  done  with  other  works. 

Theophilus  (Philotheus,  Philaretus), 
who  lived  under  Heraclius  (610-641),  was  distinguished  by  his  investiture  with  the 
titular  rank  of"  Protospatharius  "  that  is  Colonel  of  the  Guard,  a  dignity  with  which 

1.  Probably  this  nonsense  is  hardly  worthy  of  correction.     In  the  interests   of  ac- 

curacy, however,  it  may  be  said  that,  according  to  the  Latin  translation  of 
Giinther  von  Andernach,  the  antidote  was  to  be  taken  daily  for  100  da}rs,  then 
suspended  for  HO  days;  then  resumed  every  day  for  100  days  and  again  suspended 
for  15  days.  When  260  days  had  passed  and  200  doses  had  been  taken,  it  was  to 
be  administered  every  second  day  for  160  days,  or  until  80  doses  had  been  taken. 
Then  in  the  next  260  da}-s  80  more  doses  were  to  be  taken  every  third  day 
(duobus  diebus  interpositis),  until  in  all  365  doses  should  have  been  taken.  It 
will  be  seen  that  the  method  of  administration  of  this  antidote  was  about  as  com- 
plex as  its  composition.      (H.) 

2.  A  lion,  not  serpent.     (H.) 

3.  Not  to  be  confounded  with  a  work  of  similar  title  ascribed  to  Cassius  the  Iatro- 

sophist  and  noticed  on  page  167.     (H.) 

4.  John  Philoponus  and  John  of  Alexandria  are  often  confounded,  especially  by  the 

Arabians.  The  former  is  said  to  have  been  a  Jacobite  bishop  in  Alexandria  in 
the  6th  century.  John  of  Alexandria  is  also  known  as  John  the  Gramma- 
rian.    (H. ) 


—  205  — 

the  addresses  of  "  Magnificence  "  and  "Most  Illustrious"  were  associated.  He  was 
one  of  the  most  popular  physicians  and  medical  authors  during  the  Middle  Ages,  and 
his  work  "  On  the  Structure  of  the  Body"  was  often  made  the  basis  of  instruction  in 
the  universities.  In  it,  among  other  things,  the  olfactory  nerves  are  first  mentioned 
as  a  special  pair  of  cerebral  nerves ;  attention  is  directed  to  the  dependence  of  the 
development  of  the  skull  and  vertebral  column  upon  that  of  the  brain  and  spinal 
cord,  and  reference  is  made  to  how  the  wisdom  and  goodness  of  God  have  ordained 
everything  so  infinite!}'  perfect,  as  to  give  e.  g.  to  the  hand  precisely  five  fingers,  and 
to  the  skull  a  spherical  form  !  In  general  he  follows  Galen,  as  well  in  his  treatise 
"  On  alvine  dejections",  as  in  those  "  On  fever  ",  "  On  the  urine  "  and  "  On  the  pulse", 
part  of  which  were  composed  in  conjunction  with  the  author  next  mentioned. 

Stephen  of  Athens1 
(who  also  appears  as  Stephen  of  Alexandria,  a  name  shared  by  other  and  later 
writers)  was  a  pupil  of  Theophilus.  and  is  said  to  have  been  the  author  of  works 
"  On  medicines  ",  "  Commentaries  on  the  aphorisms  of  Hippocrates"  and  treatises  on 
alchemy  and  astrology.  By  reason  of  the  latter  he  was  also  distinguished  as  "The 
Philosopher",  a  title  held  in  those  times  by  all  persons  who  busied  themselves  with 
such  arts.  In  his  treatise  "On  the  Signs  of  Virginity"  he  mentions  the  Egyptian 
superstition,  already  noticed,  that  a  reliable  diagnostic  sign  of  virginity  may  be  found 
in  the  fact  that  peas  upon  which  a  virgin  has  urinated,  germinate,  while  the  contrary 
condition  of  sexual  purity  may  be  proven  by  the  failure  of  the  peas  to  sprout — appar- 
ently a  very  accommodating  doctrine  when  we  consider  the  germinative  power  of  peas! 

A  man  of  entirely  different  spirit,  standing  alone  among  the  Byzantine 
physicians  as  a  great  surgeon  and  obstetrician,2  was  Paul  of  ^Egina  (about 
A.  D.  625-690).  He  lived  therefore  under  the  emperors  Heraclius  (610- 
641),  Constantius  (642-668)  and  Constantine  IV.,  Pogonatus  (668-685). 
Paul  had  studied  in  Alexandria  before  this  city  had  been  captured  by  the 
caliph  Omar  (634-644)  in  December  A.  D.  641. 3  Concerning  the  rest  of 
his  life  we  know  little  more  than  that  as  an  itinerant  physician  (periodeutes 
it  was  called  at  that  period)  and  teacher  (iatrosophist),  without  smy  per- 
manent residence,  he  passed  most  of  his  life  in  Egypt  and  Asia  Minor,  and 
enjoyed  great  reputation  even  during  his  lifetime,  so  that  his  advice  was 

1.  He  flourished  about  A.  D.  640.     The  treatise  itepi  nupwv,  De  urinis,  commonly 

ascribed  to  Theophilus,  is  probably  the  work  of  his  diciple  Stephen,  and  is  the 
earliest  treatise  on  uroscopy  which  has  been  preserved  to  our  day.     (H.) 

2.  Hence  surnamed  by  the  Arabians  "  Alkawabeli  ",  i.  e.  the  obstetrician. 

3.  The  noble  library  had  been  long  before  destroj'ed  by  Christian  fanatics,  like  bishop 

Theophilus  (under  the  reign  of  Theodosius  I.,  who  in  379  formally  interdicted  the 
pagan  religion)  and  others.  (Baas.)  The  credibility  of  the  testimony  of  Abul- 
faragius  as  to  the  destruction  of  the  Alexandrian  librarjr,  on  the  capture  of  that 
city  by  Amrou,  has  been  fiercely  debated,  but,  on  the  whole,  seems  to  be  fairly 
well  established.  (See  Milman's  note  on  this  subject  in  his  edition  of  Gibbon's 
"  Decline  and  Fall  of  the  Roman  Empire",  chapter  li).  Dr.  Baas  himself  seems 
to  admit  the  fact  on  a  preceding  page  (120).  It  will  also  be  noticed  that  if  the 
date  assigned  by  the  author  for  the  birth  of  Paul  is  correct,  he  could  have  been 
but  sixteen  years  old  when  Alexandria  was  captured- — an  age  when  his  medical 
education  at  least  could  have  been  scarcely7  begun.  Haeser  says  he  flourished  in 
the  first  half  of  the  7th  century,  probably  under  the  reign  of  Heraclius,  an 
opinion  which  accords  with  that  of  Meyer  (Geschichte  der  Botanik).     (H.) 


—  206  — 

sought  from  long  distances.  His  work  ("Seven  Books,  an  epitome  of  the 
healing  art';1  the  6th  book  contains  his  surgery)  enjoyed  the  greatest 
esteem  among  the  Arabians,  who  translated  it  and  metamorphosed  it,  with 
genuine  oriental  bombast,  into  <:  The  Collection  of  the  Pleiades", — a 
reference  to  the  septenary  of  its  divisions. 

Minor  surgery. —  Cupping  with  glass  cups  is  considered  inferior  to  the  use  of 
large  metallic  cups,  because  the  former  break  easily,  while  the  latter  permit  greater 
rarefaction  of  the  air. 

Scarification,  arteriotomy,  injection  of  the  bladder  ("mechanical"  local  treat- 
ment, or  washing  out  a  hollow  organ)  etc.  belong  to  the  procedures  practised  by 
Paul,  and  on  the  other  hand  venesection,  and  especially  the  actual  cautery  —  in  the 
use  of  which  the  Arabians,  his  pupils  in  surgerj",  even  surpassed  him  —  were  recom- 
mended. Venesection  was  practised  by  him  in  the  neighborhood  of  the  diseased 
organ  —  in  diseases  of  the  e}7es  e.  g.  on  the  jugular  or  frontal  vein  —  and  its  applica- 
bility was  limited  to  the  ages  between  14  and  GO  years,  before  and  after  which  ages  he 
did  not,  in  general,  approve  of  it.  Paul  employed  the  actual  cautery  freely  in  ab- 
scesses of  the  liver,  empyema,  old  luxations  etc  ,  and  allows  it  to  act  e.  g.  upon  the 
head  down  to  the  bones,  which  he  then  scrapes  in  order  to  obtain  cicatrization.  In 
affections  of  the  teeth,  besides  numerous  dentifrices,  he  also  employs  the  forceps. 

In  herniology  he  distinguishes  between  ordinary  herniae  depending  on  mere 
stretching  of  the  peritoneum,  and  scrotal  hernia,  which  arises  from  a  laceration  of 
that  membrane.  The  first  form  only  is  adapted  to  operative  interference..  He  was 
acquainted  with  taxis  b}r  pressure  while  the  abdomen  is  elevated.  Varicocele  he 
cures  by  the  application  of  two  ligatures,  and  the  sloughing  of  the  intermediate 
portion  of  the  veins.  Hydrocele  he  treats  by  incision.  He  recognizes  also  astringent 
poultices,  the  actual  cautery  and  trusses  (which  he  applied  immediately  after  taxis),  as 
remedies  for  hernia,  the  seat  of  which  he  locates  in  the  sheath  of  the  spermatic  cord. 

His  syphilidology — if  we  can  speak  of  such  a  science  in  a  physician  who  did  not 
know  the  specific  character  and  contagiousness  of  syphilitic  lesions — is  tolerably  com- 
plete. He  recognizes  phagedenic  ulcers  of  the  genitals  in 'man  and  woman,  non-in- 
flammatory ulcers,  moist,  dry  and  excavated  ulcers,  and  excrescences  of  the  labia 
and  foreskin,  which  he  either  excises  or  destroys  with  the  hot  iron.  Gonorrhoea  he 
describes  in  accordance  with  its  symptoms,  and  distinguishes  it  from  spermatorrhoea, 
but  ascribes  it  to  an  ulceration  of  the  urethra,  the  cause  of  which  he  does  not  recog- 
nize.    On  the  other  hand  he  considers  the  leprosy  contagious. 

In  gynaecology  he  zealously  employed  the  speculum  vaginae,2  on  the  use  of  which 
depended  his  excellent  knowledge  of  diseases  of  the  uterus  (atresia  of  the  os  uteri, 
fissures,  excrescences,  prolapsus  etc.).  In  using  the  speculum  the'woman  sat  upon 
a  high  stool,  and,  grasping  with  her  own  hands  the  bend  of  the  knees,  raised  the 
thighs;  while  a  support  was  placed  under  the  feet.3     That  the  speculum  might  have 

1.  'E-cro/j.^  larpu^q  j3tflAia  i-ra,  compendii  medici  libri  septem.     Paul  also  wrote 

a  work  on  midwifery,  which  has,  however,  been  lost.  The  "  Compendium  "  was 
translated  into  Arabic  by  Joannitius  (Honain  ebn  Ishak)  about  K50.     (H.) 

2.  These  specula  were  either  single-  or  many-bladed,  and  of  various  forms,   (coni- 

cal etc.). 

3.  This  is  not  quite  accurate,  at  least  if  I  may  trust  the  translation  of  Cornarius  in 

the  "  Collectio  Stephaniana".  The  woman  was  placed  on  her  back  upon  a 
bench  (supina  in  sella),  the  thighs  drawn  up  against  the  abdomen  and  separated. 
The  forearms  were  then  passed  through  the  popliteal  spaces  and  tied  by  bandages 
to  the  neck.     (H.) 


—  207  — 

the  proper  length,  the  vagina  was  first  measured,  and,  after  the  introduction  of  the 
speculum,  a  dilating  apparatus  was  employed.  He  recognizes  the  causes  of  hysteria 
and  sterility,  recommends  clitorideetomy  in  nymphomania,  ligation  of  the  limbs  in 
metrorrhagia,  and  limits  the  ordinary  duration  of  menstruation  to  the  years  between 
14  and  50,  more  rarelj*  between  12  and  (>U.  His  remarks  on  obstetrics  relate  to  the 
diseases  of  pregnancy,  the  alimentation  of  children,  extraction  of  the  dead  child,  em- 
bryotomy and  delivery  of  the  placenta.  Very  fat  women  were  placed  upon  the 
abdomen  with  the  legs  raised  up  behind,1  one  of  the  most  singular  of  the  many  par- 
turient positions  invented  in  the  course  of  ages.  Podalic  version  was  already  un- 
known to  Paul. 

The  treatise  on  fractures  and  dislocations  lays  stress  on  the  immediate  applica- 
tion of  splints  and  their  infrequent  change,  even  in  complicated  fractures  of  the  leg. 
He  recommends  re  fracture  in  badly  united  fractures,  even  with  the  use  of  the  chisel, 
and  likewise  thinks  well  of  pressure  and  straightening  of  the  callus.  Fractures  of  the 
patella  and  femur  are  the  rarest.  Fractures  of  the  skull  require  immediate  trepan- 
ning: complete  dislocations  of  the  vertebra?  are  mortal,  incomplete,  produce  scoliosis. 
He  recognizes  dislocations  of  the  elbow  and  clavicle,  admits  the  possibility-  only  of 
luxation  of  the  arm  downwards,  describes  machines  for  straightening  in  cases  of 
crooked  growth  etc. 

Some  of  the  remedies  in  his  treatise  on  ophthalmolog.v  are  odd  enough;  e.  g. 
crocodile's  dung  in  opacity  of  the  cornea,  bed  bugs'  and  frogs'  blood  in  trichiasis  etc. 
His  advice  in  strabismus,  to  wear  a  special  apparatus  with  suitable  openings  to  cor- 
rect the  direction  of  vision,  is  judicious.  He  was  the  first  to  consider  the  contracti- 
bility  of  the  iris  in  cataract  a  means  of  distinction  between  cataract  and  amaurosis, 
and  says  that  pterygium  often  returns  after  operation.  The  cataract  extraction 
which  he  mentions,  like  that  of  the  Ancients  in  general,  is  a  kind  of  operation  for 
hypopyon.      (Magnus.) 

The  military  surgery  of  Paul  is  very  complete,  clear,  and  suited  to  the  weapons 
of  the  period.  It  is  evidently  based  upon  a  rich  experience,  for  he  had  seen  even  the 
worst  injuries  do  well,  and  in  operations  he  desires,  above  all,  that  the  wounded  part 
should  occupy  the  same  position  which  it  had  occupied  at  the  moment  of  injury.  In 
order  to  remove  sling-stones,  darts,  arrow-heads  etc.,  he  cuts  or  draws  them  out  or 
pushes  them  through,  and  he  gives  judicious  precautions  to  avoid  the  injur}-  of  any 
important  parts.  Thus  he  pushes  a  tube  over  the  barbed  heads  of  arrows  etc. 
(Frolich.) 

His  treatise  on  operations  mentions  bandaging,  scraping  off  polypi  of  the  nose 
and  ear;  the  removal  of  foreign  bodies  from  these  passages  and  from  the  oesophagus; 
paracentesis  below  the  navel  (on  the  right  side  in  ascites  from  disease  of  the  liver,  on 
the  left  side  of  the  abdomen  where  the  ascites  is  due  to  disease  of  the  spleen);  trach- 
eotomy, bronchotomy,  tonsillotomy,  staphylotomy  and  cauterization  of  the  uvula; 
puncture  in  hydrocephalus,  lithotomy  ;  herniotomy  with  removal  of  the  testicles, 
which  continued  to  be  the  normal  operation  among  the  Arabians  and  mediaeval 
surgeons  until  the  time  of  Pierre  Franco  and  still  later.  He  also  mentions  double 
ligation,  and  even  extirpation  of  the  uterus,  together  with  the  removal  of  cancer  of 
the  breast;  the  operation  for  imperforate  anus;  adhesions  of  the  pudenda  and  vagina; 
castration;   amputation,  dilatation  of  rectal  strictures  by  bougies  etc.2 

1.  "  Genibus  ad  femora  inclinatis,  quo  uterus  ad  abdomen  delatus,  e  directo  osculi 

sit,"     (H.) 

2.  The  instrumental  apparatus  of  the  ancient  surgeons,  both  as  regards  the  number 

of  instruments  and  their  form    was  very  complete.     Even  a  kind  of  antique  in- 
strument-case has  been  discovered.     Among  the   various  instruments  we   may 


—  208  — 

Pathology  he  treats  from  head  to  foot,  after  the  method  customary  in  his  day. 
He  also  describes  specially  diseases  of  the  skin  and  heart  (without,  however,  differ- 
entiating the  individual  diseases),  epidemic  colic,  and  ascribes  gout,  verjr  properJy, 
to  an  inactive  life,  with  too  rich  food  ivc. 

His  toxicology  and  pharmacologj'  are  based  upon  Dioscorides.  Among  special 
therapeutic  measures  he  recommends  opium  in  tetanus,  venesection  in  apoplexy  etc. 
From  the  foregoing  we  may  infer  that  Paul  must  have  been  one  of  the 
most  capable,  if  not  the  most  important,  of  the  surgeons  among  the  Greeks, 
and  certainly  the  most  daring  operator  among  them.  His  appearance  in 
this  department  of  the  healing  art,  and  particularly  at  this  time,  seems  the 
more  surprising,  since,  for  centuries  before  him,  surgeons  had  made  shift 
with  an  apparently  inoffensive  surger}*  of  plasters  and  salves,  rather  than 
resort  to  operative  measures. 

Like  Alexander  of  Tralles,  he  furnishes  proof  that  genius,  united 
with  assiduity  and  experience,  rise  superior  to  the  wretchedness  of  their 
age,  and  are  able  to  shed  light,  even  in  the  darkest  periods  of  science,  a 
light  which  depends,  however,  upon  the  individual  alone,  and  is  extinguished 
with  him.  The  same  fact  is  proven  b}*  the  Greek  physicians  and  medical 
writers  to  be  named  hereafter,  but  who  in  ability  rank  far  beneath  Paul. 

The  Christian  priest-physician,  •''  Presbyter "  Ahrtjn  (7th  centuiy), 
who  lived  at  Alexandria  and  was  a  contemporary  of  Paul  of  ./Egina, 
is  especially  important  for  having  first  carefully  described  the  small-pox,  its  cause 
(heat  and  inflammation  of  the  blood,  with  effervescence  of  yellow  bile),  symptoms, 
prognosis  and  treatment.  His  "Pandecta?",  originally  written  in  Greek,  were  trans- 
lated into  Syriac  b}'  Gosius,  or,  according  to  others,  by  Maserjawaih  ebn  Joljol,  a  Jew 
of  Bassnra.1  In  regard  to  prognosis  he  lays  down  the  golden  rule  never  to  make  it 
at  the  outset  of  the  disease.  Hypochondria  and  epilepsy  he  ascribes  to  their  proper 
causes,  and,  with  respect  to  the  latter,  prognosticates  speedy  death  when  the  attacks 
occur  daily.  In  like  manner  he  rightly  observes  that  petechia;  in  epidemic  diseases 
are  of  evil  omen.  He  justly  ascribes  scrofula  to  bad  food  and  habits  of  life,  but  gives 
incorrectly  the  prodromes  of  different  forms  of  intermittent  fever,  and  in  surgery 
makes  shift  with  external  medication. 

To  the  8th  century,  probably,  belongs  the  treatise  "  On  the  Nature  of 
Man  '*,  which  had  for  its  author  a  Phrygian  Monk,  Meletius  ;  to  the  first 
half  of  the  9th  century,  the  "  Synopsis  of  Medicine  ",  bj'  Leo,  the  Iatros- 

enumerate  different  kinds  of  knives,  lancets,  straight  and  curved  needles,  male 
and  female  catheters,  sounds,  sharp  and  smooth  pincers  for  pushing  and  hooking, 
sharp  and  blunt  hooks,  forceps  etc.  etc.  A  forceps  found  in  Pompeii  is  con- 
jectured to  be  an  obstetric  forceps.  Tubes  with  holes  at  the  end  and  sides  for 
vaginal  injection  (?),  rods  with  flat  plates  at  the  end  at  an  angle  of  135  (laryng- 
oscope?), trocars,  spatulas,  2,  3  and  4  bladed  specula  vagina?,  spoons,  cauteries 
etc.  have  also  been  found.  The  instruments  were  made  of  bronze,  some  of  them 
gilded  or  silvered,  or  of  iron  etc. 
1.  Ahrun  lived  under  Heraclius  (610-641).  His  "Pandecta?  medicina?",  in  thirty 
books,  are  known  only  by  extracts  found  in  Rhazes  and  Haly  Abbas.  They  were 
translated  into  Syriac  by  Gosius,  an  Alexandrian  (about  680),  and  thence  into 
Arabic  by  Maserjawaih  (Al  Yehudi),  a  Jewish  physician  of  Bassora  in  the  reign 
of  the  caliph  Merwan  I.  (683).     (H.) 


—  209  — 

ophist  ;  a  flittle  later,  under  Michael  III.  (842-867),  the  Constantino- 
politan  patriarch,  Photius,  equally  at  home  in  Greek  and  Latin  literature, 
composed  his  "  Bibliotheca",  consisting  of  279  books,  and  containing  also 
some  medical  extracts.1 

To  the  period  of  the  Macedonian  d}-nasty  (867-1056),  under  which 
Byzantine  literature  was  considerably  promoted,  especially  by  the  literary 
compiler,  savant  and  patron  of  learning,  the  emperor  Constantine  VII. , 
Porphyrogenitus  (911-951),  belongs  an  "Epitome  of  general  medicine"  by 
Theophanes  Nonnus  (a  work  which  begins  with  the  creed  and  ends  with 
the  culinary  art  —  Marx),  as  well  as  "Two  anonymous  books  on  Hippia- 
trics  ",2  from  which  is  derived  our  information  of  the  veterinarians  men- 
tioned in  the  section  on  Ancient  Medicine. 

Michael  Psellus  (1020-1105)  is  of  less  importance  for  his  medical 
works  —  "  On  the  healing  power  of  precious  stones  ",  "  On  the  bath  ",  a 
medical  poem,  a  treatise  on  dietetics,  a  lexicon  of  the  nomenclature  of  dis- 
eases, a  treatise  on  the  influence  of  demons,  an  encyclopaedia  embracing 
everything  from  heaven  to  the  kitchen,  in  which  works,  however,  Arabian 
remedies  (e.  g.  rose-water)  are  first  mentioned  —  than  for  his  revival  of  the 
Platonic  and  Aristotelian  philosophy.  The  latter,  which,  from  its  origin, 
contained  within  itself  the  germ  of  decay,  degenerated  in  the  West  too  into 
dialectic  subtilties  and  definitions.  By  it  was  inaugurated  the  foll^y  known 
as  mediaeval  Scholasticism,  which,  as  is  well  known,  influenced  medicine 
most  injuriously.  Michael  Psellus  himself,  however,  kept  free  from  it. 
Animated  b}T  the  greatest  love  of  science,  to  which  in  his  }'Outh  he  was 
destined  by  his  distinguished,  but  poor,  parents,  he  pursued  it  with  the 
greatest  success,  even  so  far  as  external  position  is  concerned,  for  he  became 
"  Chief  of  the  Philosophers  ".  But  his  pupils  corrupted  his  teachings  and 
brought  matters  to  such  a  pass,  that  he  left  Constantinople  and  ended  his 
life  in  a  cloister. 

The  above  mentioned  views  of  Psellus  are  of  importance  in  consideration  of  the 
superstition  as  to  the  efficacy  of  precious  stones  in  disease,  which  persisted  clear 
through  the  Middle  Ages  down  to  modern  times.  He  recommends  e.  g.  the  amethyst 
in  mania  a  /iota  and  in  headache;  the  external  use  of  amber  in  fever  and  in  urinary 
disorders;  the  jasper  in  epilepsy;  the  berj-l  in  jaundice,  spasms  and  inflammation  of 
the  eyes;  the  magnet  with  milk  internally  in  melancholy  &c. 

Simeon  Sethi,  who  lived  at  court  under  Constantine  IX.  (1042-1054) 
and  dedicated  his  chief  work  to  Michael  VII.  (1071-1078),  though  he  was 
compelled  to  withdraw  from  court  before  the  Comnenus  famil}-  ascended 
the  throne  (1057),  is  a  man  of  importance  in  another  view.  The  title-mad 
Byzantine  emperors  (like  the  German  potentates  of  the  18th  century)  were 

1.  Photius   was   patriarch   of  Constantinople    (858-886).      His   work   was   entitled 

Muf>iufSi(jh>c,  and  was  a  critical  summary  of  the  readings  of  the  learned  author, 
with  occasional  extracts  from  the  originals.     (H.) 

2.  Twv  'I--uiTf)cxu»  fttftkta  oud).     They  were    collected,  by  order   of  Constantine 

Porphyrogenitus  about  A.  D.  940,  from  the  writings  of  preceding  authors.     (H.) 
14 


—  210  — 

fortunate  enough  to  be  able  to  stamp  him  "  Master  of  the  Wardrobe  "  and 
"  Superintendent  of  the  Palace  of  Antiochus  ".  He  affords  us  the  first 
evidence  that,  by  this  time,  Arabians  (in  reversal  of  the  relation  heretofore 
existing)  exercised  great  influence  on  Greek  medicine.  For  instance,  he 
translated  a  ;'  Dream-book  "  from  Arabic  into  Greek,  and  in  his  chief  work 
<c  On  the  Virtues  of  Aliments  "  mentions  a  great  mass  of  Arabian  remedies, 
such  as 

syrups,  juleps,  oils,  camphor  (which  he  considers  "dry  and  cold  in  the  third  degree", 
recognizing  also  its  anaphrodisiac  virtue),  musk,  ambergris,  balsam,  nutmeg,  cloves, 
hashish,  the  juice  of  lettuce,  cinnamon  (of  which  there  were  7  kinds),  asparagus 
(a  kitchen  herb  in  Rome  1000  years  before)  etc.  Besides  the  above  works  he  wrote  a 
"Synopsis",  and  a  treatise  "On  Taste,  Smell  and  Feeling",  evidence  that  he 
employed  his  muse  assiduously  in  the  monastery  founded  by  him  on  mount  Olympus, 
whither  he  had  retired  from  the  court. 

Nicetas,  who  lived  in  the  service  of  the  emperors  Constantine  X. 
Ducas  (1059-1067),  Romanus  IV.  Diogenes  (1067-1071),  Michael  VII. 
Ducas  (1071-1078),  and  probably  also  Alexius  I.  Comnenus  (10S1-1118), 
compiled  out  of  Hippocrates,  Soranus,  Galen,  Rufus,  Oribasius,  Paul,  and 
other  writers  his  surgical  work,  "  Books  of  Greek  Surgery  ",  adorned  with 
gilded  plates  (at  that  time  still  a  rarity)  of  bandages  and  machines,  while 

Stephanus  Magnetes, 
probably  at  the  beginning  of  the  12th  century,  furnished  an  "Alphabetic  catalogue 
of  remedies". 

A  certain  Synesius,  under  Manuel  I.  Comnenus  (1143-1180), 
translated  from  Arabic  into  Greek  the  "Viaticum"  (Zad  el  Mosafer)  of  Abu  Jafar 
Ahmed  Ibn  el-Jezzar,  the  Arabian  Bredecker,1    in  which  work   the   small-pox  and 
measles  are  mentioned. 

In  the  12th  century  there  also  lived  at  Constantinople  the  distinguished  physicians 
Nicholas  Cai.lici.es,  Pantechnes  Michael,  ordinary  physician  to  the  emperor 
Alexius  I.  Comnenus,  and  Michael,  a  eunuch.  Others  of  this  class  of  mutilated 
physicians,  are  also  mentioned  at  this  period,  e.  g.  Thomas  of  Lesbos  (under  Manuel 
I.  Comnenus),  who  acquired  great  wealth  by  the  practice  of  venesection,  but  finally 
ended  his  life  in  prison. —  The  much  lauded  but  peevish  blue-stocking,  Anna 
Comnena  (1083-1148),  daughter  of  the  emperor,  also  understood  something  of  the 
medicine  of  her  day,  and  even  held  the  presidential  chair  at  a  council,  in  which,  or 
rather  by  which,  the  pulmonary  disease  of  her  father  (Alexius  I.)  was  no  better 
recognized  or  determined  than  it  had  been  under  her  male  predecessors. 

The  emperor  Manuel  I.  Comnenus2  (1143-1180)  was  not  entirely  lacking  in 
medical  skill,  for  he  performed  venesection  and  applied  bandages  well,  and  even 
invented  mixtures  and  ointments,  which  imperial  compounds  were,  doubtless,  especially 
efficacious — as  long  as  the  noble  inventors  lived. 

1.  He  was  a   native  of  Cairoan,   and  a  pupil  of  Ishak   Ibn   Soleiman.     El-Jezzar 

practised  in  his  native  city  until  his  death  A.  D.  1004,  and  left  a  librar}-  of 
medical  and  other  works  valued  at  24  talents.  The  Zad  el  Mosafer  was  translated 
into  Latin  under  the  title  "  Viaticum  perigrinantis''  by  Constantine  Africanus  of 
the  School  of  Salernum,  about  1075.     (H.) 

2.  The  Comneni  reigned  in  Constantinople   1057-1204,  and  from  that  time  to  1161  in 

Trebizond. 


—  211  — 

In  the  }Tear  1204  Baldwin,  Count  of  Flanders,  with  his  rude  hosts  took 
Constantinople,  and  founded  the  Latin  Empire,  the  duration  of  which, 
however,  extended  011I3-  to  1261.  He  gave  the  decaying  Eastern  Empire  a 
first  and  almost  mortal  blow,  which  was  repeated  with  absolutely  fatal 
effect  in  1453.     During  this  period,  however,  lived 

Demetrius  Pepagomenos,  ordinary  physician  of  Michael  Palseologus 
(1261-1283),  the  first  emperor  of  the  family  of  Paheologus1  (1261-1453), 
who  wrote  "On  Gout"  and,  as  a  sporting  author,  "On  the  Rearing  and  Diseases  of 
Falcons".     He  is  also  the  first  to  mention  senna.2 

Nicholas  Myrepsus, 

who  lived  at  Nicrea,  and  was  "  Actuarius"  (i.  e.  physician-in-ordinary,  a  title  which 
his  contemporary  Cabasilas  first  bore,  instead  of  the  earlier  title  "  Comes  Archiatro- 
ruin")  under  John  Ducas  Vataces  (1222-1255),  wrote  a  formulary  in  48  sections, 
intermingled  with  Arabic  remedies.  It  contains  2656  prescriptions  against  every 
disease  which  could  befall  a  human  being,  e.  g.  lice,  the  itch  &c.  He  mentions  as 
remedies  cooking-salt,  quicksilver  and  sal  ammoniac.  Nicholas  had  studied  at 
Salernum,  an  evidence  both  of  the  reputation  of  that  school  and  of  its  connexion 
with  the  East. 

The  last  to  be  mentioned,  though  b}-  no  means  the  least  as  regards 
worth,  is  John  Actuarius  (died  1283),  son  of  Zachariah,  and  ordinary 
physician  at  the  court  of  the  Palaeologi. 

He  wrote  a  good  '"  Materia  Medica",  a  treatise  "  On  the  Urine",  in  which  many 
kinds  of  sediments  are  named  in  accordance  with  their  colors,  and  graduated  glasses  for 
measuring  the  depth  of  these  deposits  are  recommended;  a  physiological  work  "On 
the  Animal  Spirits",  full  of  remarkable,  though  not  always  original,  ideas,  and  a 
"  Therapeutics",  which  contains  no  mention  of  surger}7  and  the  diseases  of  women, 
but  otherwise  exhibits  a  good  abstract  of  Galenico-Arabic  medicine.  He  ranks  as  a 
genius  worthy  of  a  better  age. 

With  Actuarius,  therefore,  Graeco-Christian  medicine  bids  adieu  to 
histoiy  more  honorably  than  was  to  be  expected  from  the  past  and  future 
political,  physical,  moral  and  intellectual  wretchedness  of  the  Eastern 
Empire  ! 

THE  CONDITION  OF  MEDICAL  INSTRUCTION  AND  PRACTICE  IN  THE 
EASTERN  EMPIRE. 

This,  like  the  political  condition,  deteriorated,  when  compared  with 
that  which  had  prevailed  in  the  undivided  empire. 

In  this  statement,  however,  (if  we  regard  the  question  from  the 
"  modern "  standpoint)  we  must  not  include  the  life  and  actions  of  the 
eastern  students,  who,  at  the  school  of  Athens,  enlisted  scholars  for  their 
own  favorite  teachers  from  among  the  newl}-  arrived  students,  and  drummed 
up  recruits  for  their  societies.  Through  the  influence  of  these  societies, 
even  at  this  earl}'  period,  the  students  fell  into  frequenting  drinking  houses, 

1.  The  last  member  of  this  famity  died  in  distress  in  Italy,  and  his  wife  died  of  star- 

vation in  Rome  in  1878.     Sic  transit  splendor  et  gloria  mundi ! 

2.  Senna  is  mentioned,   however,  by  the  elder  Serapion  and   Ishak   Ibn  Soleiman 

(Isaac  Judaeus),  both  of  whom  flourished  abcut  A.  D.  900.     (H.) 


—  212  — 

and  ran  into  debt.  Like  their  ancient  Roman  predecessors,  however,  they 
were  not  compelled,  under  any  circumstances,  to  submit  to  disgrace.1 

The  better  physicians  of  the  Eastern  Empire  were,  as  a  rule,  educated 
in  Alexandria,  though  at  a  later  period,  during  their  travels  as  students, 
they  also  attended  the  Asiatic  schools.  Many  simply  received  private 
instruction  from  certain  famous  physicians,  and  at  most  went  to  Alexandria 
to  finish  their  education. 

It  is  more  than  probable  that,  from  the  very  origin  of  the  Eastern 
Empire,  the  lower  and  uneducated  elements  of  the  medical  profession  pre- 
dominated, and  finall}T  formed  the  majority.  The  individual  exceptions 
which  we  have  already  considered,  and  which  occurred  then,  as  they  do 
under  an}'  and  all  circumstances,  prove  nothing  to  the  contrary,  nor  do 
the}'  contradict  the  general  low  condition  of  the  profession.  These  few 
exceptions,  here,  as  in  all  other  cases,  merel}-  prove  the  rule. 

In  accordance  with  the  Byzantine  customs  numerous  titles  and  "dis- 
tinctions "  of  all  sorts  were. given  to  the  court  physicians  and  ph}-sicians-in- 
ordinary,  who,  though  not  always  the  best  physicians,  yet,  as  they  have 
"  destiny  "  often  on  their  side,  at  all  times  more  easily  attain  prominence  in 
history,  while  it  is  ever  the  lot  of  the  ordinary  practitioner  to  wear  out  his- 
life  in  honorable,  but  unhonored,  labor,  and  to  die  unnoticed.  To  these 
court  physicians  (besides  the  worthless  and  even  venal  titles  of  the  old 
empire)  were  assigned  new  and  strange  titles,  which  frequentl}'  had  no  re- 
lation to  the  medical  profession,  and  were,  therefore,  simply  ridiculous. 
Among  these  titles  were  "Superintendent  of  the  Palace",  "Master  of  the 
llobes",  "Savior"  etc.  Some  of  these  higher  physicians  too  were  even 
employed  in  diplomatic  missions,  e.  g.  Stephen  of  Edessa,  who  was  a  sort 
of  oriental  Struensee  or  Baron  Stockmar.  and  was  sent  to  Chosroes  because 
he  had  been  at  an  earlier  period  an  active  teacher  in  Persia,  and  had  won 
reputation  by  his  success  in  medicine.2  At  a  later  period  the  physicians- 
in-ordinary  received  the  title  of  "Actuarius  ".  This  office  was  even  filled 
by  eunuchs,  an  evidence  that  general  luxur}*  and  boundless  corruption  had 
degraded  even  the  medical  profession.  The  same  fact  is  established  b}'  the 
statement  that  physicians  were  expected  to  castrate  boys  and  men  —  an 
expectation  too  which,  as  Paul  of  iEgina3  half  admits,  was  actually  fulfilled. 
Yet,  as  the  result  of  rude  methods  of  operation  or  bad  after  treatment,  96 

1.  We  read  that  the  ancient  students  formed  cliques  and  societies,  tossed  objectionable 

tutors  in  blankets.,  cultivated  wine  and  women  and  forgot  to  pay  their  bills  etc., 
tout  comme  chez  nous.     (H.) 

2.  Some   years   latter  Chosroes   concluded    a   treaty   of  peace  for  five  years  with 

Justinian,  one  of, the  conditions  of  which  was  that  Tribunus,  a  physician  of 
Palestine,  should  be  sent  to  the  Persian  monarch.  A  charlatan  Uranus  also 
accompanied  the  embassy  from  Edessa,  and  imposed  upon  the  confidence  of 
Chosroes,  by  whom  he  was  held  in  high  esteem.     (H.) 

3.  Paul  says  "  Verum  quandoquidem  sa?pe  etiam  inviti  aliquibus  praeeminentibus  ad 

castrationem  faciendam  cogimur  etc.     (H.) 


—  213  — 

per  cent,  of  the  castrated  died  !  In  fact  this  abuse  became  so  glaring  that 
it  became  necessary  to  put  a  stop  to  it  b}"  law,  and  castration  was  punished 
by  castration  and  banishment  to  a  desert  island. 

The  number  of  regular  physicians  too  in  the  Eastern  Empire  must 
have  gradually  diminished,  as  it  did  in  the  West,  since  the  clergy  speedily 
usurped  the  chief  share  of  practice.  This  conclusion  is  supported  too  by 
the  fact  that  the  number  of  lay  medical  authors  is  so  small  in  itself,  and 
decreases  in  the  same  proportion  as  the  empire  enters  upon  the  later 
Middle  Ages  and  verges  toward  its  close. 

A  noble  acquisition  to  the  cause  of  military  h}'giene  in  the  Eastern 
Empire  was  due  to  the  emperor  Maurice  (582-602),  who  was  himself  an 
author  on  military  subjects  and  military  hygiene.  This  prince  ordered 
that,  from  every  division  of  200-400  cavalry,  8-10  stout  fellows  of  the 
same  command  should  be  selected,  whose  duty  it  should  be  to  bring  to  the 
rear  those  who  were  severely  wounded,  to  refresh  them  with  water  from 
their  canteens  (phlaskion),  and  to  collect  together  the  weapons  lying 
about  and  encumbering  the  field.  Such  mounted  bearers  of  the  sick  and 
wounded  (deputati)  received  as  a  reward  for  each  person  rescued  about 
'$2.40. 

This  arrangement  was  confirmed  by  Leo  VI.,  the  Philosopher 
(886-911).  —  What  was  the  rule  with  regard  to  the  infantry,  and 
whether  similar  arrangements  generally  existed  for  these,  is  entirely 
unknown. 

Of  military  physicians  proper  we  have  no  express  information,  though 
in  the  code  of  Justinian  such  physicians  were,  indeed,  mentioned,  whose 
duty  it  was  to  examine  soldiers  as  to  their  incapacity  after  diseases.  Still 
these  ma}'  have  been  civil  physicians,  employed  for  the  occasion  only.  It 
is  probable  however  that,  at  least  in  the  beginning,  the  old  Roman 
arrangements  continued  in  force,  until  medicine  was  entirely  transferred 
into  the  hands  of  the  monks  and  the  Christian  attendants  upon  the  sick, 
who  were  not  permitted  to  practice  surgery.  The  example  of  Paul  of 
iEgina,  who,  at  all  events,  possessed  sufficient  militar}-  experience  to  write 
on  military  surgery,  speaks  in  favor  of  this  hypothesis.  The  wounded 
might  readily  be  cared  for  by  the  monks  in  the  numerous  hospitals  of  the 
Eastern  Empire  subject  to  their  control,  and  which  too,  from  the  little 
extent  of  the  empire,  could  be  easily  reached.  Certainly  at  a  very  earl}' 
date  hospitals  where  introduced  into  Byzantine  medical  practice,1  in  which 
only  monks,  nuns  and  similar  ignorant  people,  nursed  the  sick,  in  order  to 

1.  The  first  hospitals  were  probably  instituted  soon  after  the  decree  of  Constantine 
which  directed  the  closure  of  the  Asclepieia  and  other  pagan  temples  about  A.  D. 
335.  Helena,  the  mother  of  Constantine,  was  very  active  in  founding  such 
institutions  at  Constantinople,  Jerusalem  and  other  cities  A  hospital  was  also 
founded  at  Antioch  during,  or  short!}'  after,  the  reign  of  the  emperor  Julian 
(361-363).  The  famous  "  Basilides"  hospital  was  established  at  Cassarea  as  early 
as  A.  1).  378.     (H.) 


—  214  — 

merit  a  place  in  heaven.  That  this  was  confessedly  their  chief  object,  and 
that  their  remedies  belonged  mainly  among  the  Christian  superstitions, 
does  not  prove,  however,  (as  has  been  assumed  by  most  writers)  that  the 
results  of  their  treatment  must  have  been  particularly  bad  ;  for  Nature,  the 
friend  of  doctors  and  scorner  of  apothecaries,  may  have  come  promptly  to 
the  aid  of  simplicity  and  superstition,  as  she  is  compelled  to  do,  even  at  the 
present  day,  with  the  numerous  drugs  of  doubtful  efficacy,  prescribed  in 
accordance  with  all  the  rules  of  art.  Holy-oil,  prayer,  laying-on  of  hands, 
application  of  the  bones  of  so-called  saints,  preserved  as  relics  &c,  and  the 
harmless  remedies  of  the  monastic  gardens — savine  excepted,  which  seems 
to  have  been  cultivated  rather  for  cases  of  mishap  on  the  part  of  celibates 
and  nuns  of  reputed  chastity — at  least  permitted  nature  to  work  undisturbed, 
and  were,  at  all  events,  not  less  ineffective  than  the  mouse-dung  &c.  of 
Serenus  Samonicus.  Indeed,  from  a  therapeutic  standpoint,  the}"  are  not 
worthy  of  such  severe  condemnation  as  many  curative  methods  and  poly- 
phartnic  compounds  of  the  actual  physicians  and  medical  amateurs  of  that 
(and  the  present)  da}*.  On  the  whole,  the  monks  seem  to  have  done  more 
injury  to  the  minds  and  morals  of  mankind,  than  to  their  bodies,  and  to 
have  harmed  science  and  art  more  through  the  promotion  of  delusions  and 
mental  indolence,  than  they  shortened  the  lives  of  their  fellow-men  by  their 
"  practice  ". 

The  class  of  medical  men  who  occupied  themselves  with  the  preparation 
of  drugs  was  also,  in  the  Byzantine  empire,  very  extensive,  in  both  the 
cities  and  the  country.  Among  them  were  already  some,  who,  as  genuine 
apothecaries,  devoted  their  time  to  the  prescriptions  of  physicians.  These 
were  called  pementarioi  (pigmentarii),  and  held  in  such  light  esteem,  that 
the  law  absolutely  denied  to  them  even  civil  offices.  Their  formulae  were 
manifold:  besides  the  numerous  drinks  (the  later  official  decocta  and  in- 
fusa),  they  also  prepared  pills,  troches,  electuaries,  collyria  etc.  The}" 
existed  up  to  the  very  end  of  the  Byzantine  empire,  practised  medicine 
themselves,  and  had  as  competitors  a  great  number  of  peddling  dealers, 
Jews  and  adventurers.  This  latter  class  of  dealers  in  drugs  seems,  even  at 
that  time,  to  have  found  its  chief  customers  among  the  lower  class,  as  was 
the  case  also  with  us,  in  respect  to  similar  individuals,  until  a  few  decennia 
ago.  The  regular  physicians  at  that  period,  as  it  seems,  commonly  pre- 
pared their  own  drugs.  At  least  they  often  wearied  themselves  out  in  the 
search  for  proprietary  remedies,  a  practice  in  which  they  were  imitated  by 
even  imperial  pretenders  —  proof  enough  how  little  these  latter  had  to  rule, 
or  how  badly  they  ruled  what  they  had  !  Thus  the  eastern  emperors  were, 
so  to  speak,  the  only  apothecaries  of  imperial  rank  which  have  ever  existed. 
Some  of  them  also  dabbled  in  practical  medicine ;  indeed,  even  their 
daughters  did  the  same.  What  must  have  been  the  general  condition  of 
medicine  in  that  day  may  be  judged  from  the  fact  that  frequently  the  entire 
and  extensive  reputation  of  a  Byzantine  physician  depended  singly  and 
solely  upon  some  nostrum  invented  by  him. 


—  215  — 

Veterinary  physicians  existed,  at  all  events,  in  the  Byzantine  empire. 
The  veterinary  compendiums  made  at  the  instanceof  the  emperors  prove  this. 
Their  social  position  seems  to  have  been  analogous  to  that  which  they 
occupy  at  the  present  da}-. 


V.     GR.ECO-ARABIAN  MEDICINE. 

Europe,  in  the  East  as  well  as  the  West,  finally  preserved  little 
but  the  ignis  fatuus  of  the  deceptive  Groeco-Roman  civilization,  popular 
superstition  in  its  thousand  varied  forms.  Wherever  even  a  respectable 
remnant  of  intellectual  enlightenment  remained  at  the  disposal  of  the 
perishing  race,  this  depended  upon  the  imitation  and  servile  explanation 
of  the  views  of  the  great  physicians  of  an  earlier  age,  and  especially  those 
of  Galen.  Darkness  and  superstition,  from  which  arose  the  ancient  medical 
culture,  likewise  accompanied  it  to  its  grave. 

How  powerful  were  the  effects  of  even  the  sad  relics  of  a  civilization 
so  lofty  as  that  which  the  Greeks  had  attained,  is  manifest,  however,  in  the 
fact  that  from  the  slow  decay  in  the  East  a  single  germ  of  sound,  though 
feeble,  vitality,  could  transfer  itself  to  an  Asiatic  people,  and  excite  them 
(as  if  by  magic)  to  a  bloom  and  a  fruitfulness,  without  its  aid  quite  un- 
attainable. This  was  what  happened  to  the  Arabians  in  philosoph}'  and 
mathematics,  and  in  a  less  degree  as  regards  the  natural  sciences,  but 
specially  and  chiefly  in  the  medical  sciences.  Thus  they  were  enabled  to 
offer  a  new  field  for  the  civilization  of  mankind.  Yet  it  was  not  the 
Arabians  alone  who  created  a  new  life  out  of  the  Ancients.  Almost  all  the 
Orientals,  Persians,  Syrians.  Christians  and  Jews  under  Arabic  names,  took 
part,  indeed,  in  this  new  phase  of  the  development  of  civilization  :  so  that 
it  is  not  strictly  correct  to  speak  of  Arabian  science  and  medicine  alone. 

We  are,  however,  justified  in  speaking  of  a  mediaeval  Semitic  medical 
culture,  as  one  of  the  most  interesting  episodes  in  the  history  of  civilization. 
For  at  this  time,  long  after  the  first  great  Semitic  leadership  in  culture,  a 
Semitic  people  again,  and  apparently  for  the  last  time,  entered  as  a  con- 
trolling factor  into  the  history  of  the  world  and  of  civilization.  It  probably 
sounds  paradoxical  (though  it  is  not)  to  affirm  that,  throughout  the  first 
half  of  the  Middle  Ages,  science  made  its  home  chiefly  with  the  Semites  and 
Graeco-Romans  (its  founders),  while,  in  opposition  to  the  original  relations, 
faith  and  its  outgrowths  alone  were  fostered  by  the  Germans.  In  the 
sterile  wastes  of  the  desert  the  Arabians  constructed  a  verdant  oasis  of 
science,  in  lands  to-day  the  home  once  more  of  absolute  or  partial  bar- 
barism. A  genuine  meteor  of  civilization  were  these  Arabians,  a  meteor 
which  arose  from  the  long  darkened  Orient,  and  in  its  course  toward  the 
West  lightened  once  more  the  whole  Occident  before  its  final  extinction. 

The  Arabian  physicians  were  almost  all,  and  certainly  the  most  im- 
portant of  them,  doctors  of  all  the  faculties,  as  we  would  call  them.  The 
individual  studies  were  not  yet  separated  from  each  other  so  strictly'as 


—  216  — 

with  us,  and  in  practice,  therefore,  the  savant  could  become  as  well  a  jurist 
as  a  theologian  and  physician,  according  to  the  occasion.  Medicine,  as  well 
as  philosophy,  theology,  mathematics,  the  natural  sciences  and  jurispru- 
dence, belonged  to  general  education  —  a  peculiarity  of  Arabian  civilization, 
observed  elsewhere  only  in  the  earliest  grades  of  culture.  This  gives  to 
Arabian  medicine  its  stamp.  It  was  based  only  upon  science  in  its  widest 
sense,  and  in  the  division  of  individual  force  which  arose  from  the  idea 
just  mentioned,  medicine  could  not  be  productive,  or  could  be  fertile  in 
special  directions  only,  and  was  compelled  too  to  assume  chiefly  the 
character  of  compilation. 

Accordingly  the  Arabians  built  their  medicine  upon  the  principles  and 
theories  of  the  Greeks  (whose  medical  writings  were  studied  and  copied 
mostly  in  translations  only),  and  especially  upon  those  of  Galen,  in  such  a 
way,  that,  on  the  whole,  they  added  to  it  very  little  matter  of  their  own,  save 
numerous  subtle  definitions  and  amplifications.  But  Indian  medical  views 
and  works,  as  well  as  those  of  other  earlier  Asiatic  peoples  (e.  g.  the 
Chaldeans),  exercised  demonstrably,  but  in  a  subordinate  degree,  an  in- 
fluence upon  Arabian  medicine.  The  Arabians  interwove  too  into  their 
medical  views  various  philosophical  theorems,  especialby  those  of  Aristotle, 
already  corrupted  by  the  Alexandrians  and  still  further  falsified  by  them- 
selves with  portions  of  the  Xeo-Platonic  philosophy  :  and  finally  they  added 
thereto  a  goodly  share  of  the  absurdities  of  astrology  and  alchemy.  Indeed 
it  is  nowadays  considered  proven  that  the}*  even  made  use  of  ancient 
Egyptian  medical  works,  e.  g.  the  papyrus  Ebers. 

Thus  the  medicine  of  tbe  Arabians,  like  Grecian  medicine  its  parent, 
did  not  greatly  surpass  the  grade  of  development  of  mere  medical  phil- 
osophy, and,  so  far  as  regards  its  intrinsic  worth,  it  stands  entirely  upon 
Grecian  foundations.  The  chief  reputation  of  its  physicians,  therefore, 
depended,  for  the  most  part,  upon  their  great  and  comprehensive  erudition  ; 
in  the  practice  of  medicine  upon  their  perfect  knowledge  of  the  pulse,  their 
uroscopy,  their  medical  combinations,  amulets  etc.  Yet  the}'  constantly 
advanced  novelties  in  the  sciences  subsidiary  to  medicine,  materia  medica 
and  pharmacy,  from  the  latter  of  which  chemistry,  pharmacies  and  the  pro- 
fession of  the  apothecary  were  developed.  These  very  acquisitions  in  the 
subordinate  departments  supplied  the  fruitful  seed  —  no  germ  possessed  of 
genuine  vitality  for  the  intellectual  development  of  humanity,  is  ever 
entirely  lost  —  to  which,  at  a  later  period,  medicine  was  greatly  indebted. 
Moreover  the  Arabians  increased  our  nosological  knowledge  by  the  first 
description  of  several  epidemic,  and  other,  diseases  of  the  skin,  and.  in  this 
respect,  accomplished  even  more  original  work  than  the  Byzantine  physi- 
cians. Finally  they  enriched  the  cosmetic  art,  an  art  which  seems  a  field 
of  medical  labor  for  only  a  moderate  number  of  our  " specialists"  of  to-day. 
but  has  mostly  fallen  into  the  hands  of  barbers  and  female  hair-dressers. 

Obstacles  to  higher  advances  on  the  part  of  the  Arabians,  as  of  most 
Semitic  peoples,  were  in  general  their  speculative  and  receptive,   rather 


—  217  — 

than  productive,  disposition,  which  rendered  them  more  men  of  learning 
than  independent  originators  in  the  department  of  medicine  ;  their  talent 
for  observation,  efficient  only  in  minute  details  ;  their  predominant  imagin- 
ation ;  their  inclination  to  subtilties,  distinctions  and  speculation ;  and, 
greatest  of  all,  their  religious  belief,  to  which  e.  g.  the  simple  thought  of 
dissection  of  the  human  body  would  have  been  a  mortal  sin,  as  it  is  to-day 
with  their  descendants  (and  the  Turks).  For  the  same  reason  they  were 
unable  to  advance  surgery,  while  their  backwardness  in  midwifery  was  due 
to  their  exclusion  of  male  obstetricians. 

On  the  whole,  however,  the  Arabians  were,  in  spite  of  all  this,  of  more 
importance  intellectually  than  the  Christians  of  the  Middle  Ages.  They 
had  a  national  poes}*,  architecture  and  music  (they  were  the  inventors  of 
the  violin),  as  well  as  a  system  of  historical  composition,  and  they  cultivated 
the  sciences  of  chemistry,  botany,  optics,  mathematics  and  astronomy.  In 
the  latter  science  they  surpassed  even  the  Greeks,  and  laid  the  foundation 
of  the  advances  of  the  10th  and  17th  centuries.  We  need  recall  merely  the 
Toledo  tables  of  the  11th  century,  those  of  Ilek  Khan  and  the  contempo- 
rary Alphonsine  tables  of  the  13th  century  (particularly  perfected  b}*  the 
Arabians),  without  which  modern  astronom}*  would  have  been  impossible. 
Last,  but  not  least,  there  was  among  them  even  a  certain  irreligiousness, — 
a  superiority  in  the  sense  of  opposition  to  so-called  religion,  e.  g.  Ahmed 
ben  Jahja  (el  Rawindi,  the  heretic,  about  900),  Averroes  etc.  In  cases  of 
sickness  too  they  sought,  when  possible,  a  rational  physician,  at  a  period 
when  the  Christians  (as  some  of  them  do  to-day)  ran  to  a  wooden  or  stone 
idol,  or  to  the  bony  or  ragged  relics  of  some  saint,  in  order  to  pray  before, 
or  even  to,  them  for  health. 

The  mode  of  transfer  of  Greek  medicine  to  the  Arabians  was  probably 
as  follows  : 

The  inhabitants  of  the  neighboring  parts  of  Asia,  including  both  the 
Persians  and  Arabians,  as  the  result  of  multifarious  business  connexions 
with  Alexandria,  came,  even  at  an  early  date,  in  contact  with  Grecian 
science,  and  by  degrees  a  permanent  alliance  was  formed  with  it.  In  a 
more  evident  way  the  same  result  was  accomplished  b}-  the  Jewish  schools 
in  Asia,  the  great  majority  of  which  owed  their  fouudation  to  Alexandria. 
Such  schools  were  established  at  Nisibis,  at  Nahardea  in  Mesopotamia,  at 
Mathae-Mechasja  on  the  Euphrates,  at  Sura  &c,  and  their  period  of  prime 
falls  in  the  5th  century.  The  influence  of  the  Nestorian  universities  was 
especiall}'  favorable  and  permanent,  particularly  the  school  under  Greek 
management  founded  at  Edessa1  in  Mesopotamia,  where  Stephen  of  Edessa, 
the  reputed  father  of  Alexander  of  Tralles,  taught  (A.  D.  530). 

1.  The  school  of  Edessa  was  founded  at  an  early  period,  but,  falling  under  the  influ- 
ence of  Nestorianism,  it  was  broken  up  in  431.  Revived  under  bishop  Ibas 
(4:55-457),  after  his  death  it  was  again,  and  finally,  dissolved  by  the  emperor 
Zeno  A.  D.  489.  Most  of  the  teachers  of  this  school  fled  into  Persia  and  united 
themselves  with  the  school   of  Jondisabur.     Some,  however,  under  the  lead  of 


—  118  — 

The  college  of  Jondisabur  (Gondisapor,  Nishapoor),  which  had  Greek 
teachers  even  as  early  as  the  time  of  Sapor  (SchapurL,  240-270,  founder 
of  the  dynasty  of  the  Sassanides,  226-630),  was  already  very  influential 
under  Chosroes  I.  Nushirvan  (A.  D.  531-579),  but  did  not  attain  its  greatest 
importance  until  the  7th  century. 

The  Jews  and  Xestorians  (as  we  have  already  seen  in  the  example  of 
Ahrun),  by  their  translations  of  Greek  works  into  Syriac,  first  made  the 
Arabians  acquainted  with  the  Greeks.  Translations  were  then  made,  by  far 
most  commonl}-,  from  the  Syriac  into  the  Arabic,  which  explains  the  frequent 
corruptions  of  the  sense,  particularly  in  the  works  of  Aristotle. 

Bv  rhe  term  "  Nestorians"  are  to  be  understood  the  followers  of  Nestorius,  who 
exist  in  considerable  numbers  even  in  these  modern  times,  especially  in  Asia,  and 
even  in  China  and  India.  Nestorius  was  made  patriarch  of  Constantinople  in  428, 
and,  after  a  life  of  vicissitudes  in  upper  Egypt,  died  in  exile  440.  He  was  one  of  those 
quarrelsome,  obstinate,  priests,  devoted  to  the  sifting  of  words  and  dogmas,  who  brought 
t lie  Byzantine  empire  to  confusion  and  disgrace.  He  taught,  for  instance,  the  correct 
doctrine  that  Mary  should  be  called  not  "  Mother  of  God"',  but  "Mother  of  Christ", 
and  that  in  Christ  the  two  natures,  human  and  divine,  must  be  careful^-  distinguished. 
This  doctrine,  however,  was  disputed  so  obstinately  and  pertinaciously  bj-  the  still 
more  quarrelsome  and  litigious  Monophysite,  Cyril,  that  even  numerous  extra 
councils,  held  one  after  another  especially  to  settle  this  controversy  (Synod  of  Rome 
430,  Council  of  Ephesus  431,  Council  of  Chalcedon  432),  as  well  as  the  interference 
of  the  emperor  Theodosius  IT.1  (408-450)  produced  no  agreement,  and  the  empire, 
through  such  trifles,  fell  into  confusion.  The  Xestorians  were,  therefore,  banished  in 
439,  and  in  439  their  school  at  Edessa,  where  the  Arabians  also  were  educated  as 
pfn-sicians,  was  dissolved.  The  teachers  scattered  themselves  throughout  all  Asia, 
and  founded  in  490  a  new  school  at  Nisibis  in  Mesopotamia,  an  impregnable  Persian 
frontier  fortress,  which  in  the  8th  century  fell  into  the  hands  of  the  Arabians.2 

Still  more  influential  in  the  transfer  of  Grecian  science  to  the  Arabians 
was  the  banishment  of  the  "heathen"'  philosophers  of  the  last  so-called 
Platonic  school  of  Athens,  by  the  "Christian  :'  despot  Justinian  I.  (529). 
These  philosophers  were  well  received  at  the  court  of  the  infidel  Chosroes,* 

Barsumas,  founded  a  new  school  at  Nisibis  in  Mesopotamia.  The  school  of 
Edessa  had  contained  many  excellent  teachers,  and  possessed  a  public  hospital 
in  which  the  pupils  were  instructed  in  the  details  of  medical  practice.  Ibas,  with 
the  aid  of  Cumas  and  Probus,  translated  into  Syriac  the  works  of  Aristotle.    (H.) 

1.  Under  his  reign  the  temple  of  ^Esculapius,  on  the  southern  slope  of  the  Acropolis,. 

"  to  which  the  old  faith  clung  most  obstinately"  (Gregorovius),  was  destroyed. 

2.  These  Nestorian  schools  were  the  first  to  require  an  examination  before  granting 

a  certificate  to  practice,  and  also  the  first  to  separate  pharmaceutics  from  medi- 
cine proper.     (H. ) 

3.  Chosroes    was    also    acquainted    with    Indian    savants.      His    ordinary-    physician 

Barzoi  i  Burzweih)  introduced  the  game  of  chess  into  Persia.  (Baas.)  Burzweih 
also  translated  into  the  Pehlevi  dialect  the  Indian  work  Panchatantra,  known  in 
modern  times  as  the  "Fables  of  Pilpay".  This  popular  work  was  translated 
into  the  Arabic  by  Ibn  el-Mocaffa  (died  762),  under  the  title  '■  Calila  and  Dimna", 
and  thence  into  most  of  the  languages  of  Europe.  The  first  English  version 
appeared  in  1570.      i  H. ) 


—  219  — 

and  in  return  manifested  their  gratitude  by  the  propagation  of  Grecian- 
science.  The  latter  and  its  representatives  were  at  that  period  more  highly 
esteemed  by.  the  tolerant  "Barbarians",  than  by  the  fanatical  Christians 
- — indeed  so  highly  that  Chosroes  offered  a  suspension  of  hostilities  for  the 
single  physician  Tribunus. 

From  all  these  causes  it  resulted  that,  even  as  earl}'  as  the  time  of 
Mohammed1  (571-032),  physicians  educated  in  the  Grecian  doctrines  lived 
among  the  Arabians.  One  of  these,  Haraph  ben  Kaldaht,  of  Takif  (who 
studied  at  Jondisabur,  settled  in  Tayef,  was  the  ordinary  physician  of  Abu 
Bekr,  and  died  of  poison  A.  I).  634),  was  recommended  by  even  the 
vigorous  and  uxorious  prophet.  Indeed  Greek  physicians  themselves  were 
permitted  to  sojourn  as  practitioners  among  the  Arabians,  as  did  e.  g. 
Theodunus  and  Theodocus2  in  the  7th  century  —  certainly  a  fine  example 
of  Arabian  toleration  !  Finally  it  should  be  stated  with  all  commendation,- 
that  the  caliphs,  in  contrast  to  most  of  the  B}zantine  emperors,  vied  with 
each  other  in  the  promotion  of  science,  and  some  of  them  even  took  part  in 
the  course  of  instruction.  Arabian  culture  (and  of  course  Arabian  medicine) 
reached  its  zenith  at  the  period  of  the  greatest  power  and  greatest  wealth 
of  the  Caliphate  in  the  9th  and  10th  centuries.  At  that  time  intellectual 
life  was  rooted  in  the  schools  of  the  mosques,  i.  e.  the  Arabian  universities, 
which  the  great  caliphs  were  zealous  in  founding.  Such  Arabian  univer- 
sities arose  and  existed  in  the  progress  of  time  (even  as  late  as  the  14th 
century)  at  Bagdad,3  Bassora,  Cufa,  Samarcand,  Ispahan,  Damascus,. 
Bokhara.  Firuzabad  and  Khurdistan,  and  under  the  scholastic  Fatimides 
(909-1171)  in  Alexandria.'   Under  the  Ommyiades  (755-1031),  after  the 

1.  Mohammed  himself,  like  all  prophets,  dabbled  in  medicine  also;  for  in  the  case  of 

a  friend  suffering  from  angina,  instead  of  resorting  to  silly  prayers  and  cere- 
monies, as  a  "  Christian  "  priest  at  that,  time  would  certain!}-  have  done,  he  is 
said  to  have  judiciously  applied  the  actual  cautery.  Still  in  his  time  prayers 
and  exorcisms  naturally  passed  among  the  Arabians  as  remedies  for  disease, 
bodily  injuries  and  the  "evil  eye"'  of  demons  and  spirits  (a  subject  of  dread  even 
to-day  in  the  whole  Orient).  This  is  proven  by  a  papyrus  of  the  9th  century  in 
the  noble  collection  of  the  archduke  Rainer  (a  unique  MS.,  adorned  already  with 
ornamental  cuts  in  wood),  in  which  are  found  prayers  for  protection  by  Abu 
Dudschana  (died  633),  a  companion  of  Mohammed. 

2.  Two  Greek  physicians  in  the  service  of  Hejaj  ben  Yusuf,  prefect  of  Irak  (about 

689),  a  sanguinary  and  deformed  monster.  Theodunus  is  said  to  have  written 
some  Pandectse  medicina?.  Leclerc  considers  the  two  names  to  represent  the 
same  person.     (H.) 

3.  The  most  famous  of  the  Arabian  universities.     It  was  founded  by  Almansor  (754- 

775),  whose  still  more  famous  successors,  Harun  al  Raschid  (786-808)  and  Al 
Mamun  (812-833),  were  also  patrons  of  science.  Motawakkel  (847-861)  restored 
the  university  and  its  library.  The  annual  budget  of  the  caliphs  allowed  these 
universities  a  large  stipend.  Under  Harun  it  amounted  to  $57,812,500,  for  that 
period  an  immense  sum.  (It  may  be  of  some  interest  in  the  question  of  medical 
fees  to  remark  that  in  the  West  a  silver  standard,  and  in  the  East  a  gold  standard,, 
prevailed.) 


—  220  — 

settlement  of  the  Arabians  in  Spain  in  the  beginning  of  the  8th  century, 
were  founded  the  famous  universities  of  Cordova1  (possessing  in  the 
10th  century  a  library  of  250,000  volumes),  Seville,  Toledo,  Almeria  and 
Murcia  under  the  three  caliphs  named  Abderrahman  and  Al  Ilakem.  Less 
important  were  the  universities  of  Granada  and  Valencia,  and  least  import- 
ant of  all,  those  founded  by  the  Edrisi  dynasty  (800-9,86)  in  the  provinces 
of  Tunis,  Fez  and  Morocco.-  In  spite  of  all  these  institutions  the  Arabians 
possessed  no  talent  for  productive  research  ;  still  less,  like  the  ancient 
Semites,  did  they  create  any  arts,  save  poesy  and  architecture.  Their 
whole  civilization  bore  the  stamp  of  its  foreign  origin.  Even  their  very 
religion  was  a  mixture  of  Jewish,  Christian  and  all  other  sorts  of  ideas. 

These  so-called  Academies  of  the  Arabians  were  true  imitations  of  the  school  of 
Alexandria  (which,  as  we  have  already  pointed  out,  exercised  the  greatest  influence 
upon  Arabic  culture),  and  indirect  successors  of  the  old  Egyptian  and  Jewish  sacer- 
dotal schools  in  Asia,  as  well  as  forerunners,  and  probably  also  models,  of  our  modern 
universities,  which  must  according]}'  be  referred,  at  last,  to  ancient  Egyptian  models. 
The}-  often  included  large  blocks  of  buildings,  indeed  miniature  cities,  as  must  have 
"been  the  case  e.  g.  at  Bagdad.  Here  were  collected  (as  was  the  case  with  the  western 
universities  at  their  origin  only)  at  one  time,  and  from  all  portions  of  the  world,  6000 
savants  and  students,  while  the  most  popular  German  university  of  to-day  cannot 
exhibit  half  of  this  number.  These  Arabian  academies,  however,  included  not  only 
the  lecture  rooms,  but  also  —  part  of  them  at  least  —  hospitals  and  pharmacies,  and 
especially  the  residences  of  the  teachers  and  many  of  the  students.  Besides  these 
there  were  rooms  for  the  reception  of  the  libraries,  which  by  themselves  alone  must 
have  been  considerable,  since,  as  we  have  just  mentioned  e.  g.  at  Cordova,  they  are 
said  to  have  contained  a  great  mass  of  books.  Some  of  these  institutions,  especially 
the  later  Spanish  universities,  enjoyed  such  reputation  as  scientific  schools,  that  many 
students  went  to  them  from  even  Christian  countries,  in  order  to  acquire  a  higher 
education.  This  was  particularly  the  case  with  the  Jewish  physicians  scattered  every- 
where throughout  Europe.  By  them  also,  as  is  well  known,  was  indirectly  introduced 
again  into  the  West,  especially  into  lower  Italy,  a  portion  of  the  science  of  the 
Ancients.  These  medical  institutions  were,  however,  only  secondary  affairs,  since 
theology,  philosophy,  mathematics,  physics,  astronomy  and  astrology  were  the  chief 
subjects  of  the  Arabian  educational  course,  and  medicine  was  nowhere  taught  sepa- 
rately from   these  branches.     When  a  student  had  passed   his  examination  he  also 

1.  This  city  [founded  by  Abderrahman  111.  (912-7-961)  and  Al  Hakim  II.  (961-976)] 

contained  under  Arabian  rule  300  mosques,  200,000  houses,  1,000,000  inhabitants, 
and  was  called  "The  Center  of  Religion,  the  Mother  of  Philosophers,  the  Light 
of  Andalusia  ".  To  such  an  elevation  was  it  raised  by  the  Arabians.  The  indo- 
lent and  most  Catholic  Spaniards,  however,  converted  it  into  a  neglected  den  ! 
Yet  no  state  had  so  influential  a  priesthood  ! 

2.  Schools  were  also  founded  at  Herat,  Ispahan,   Bassora  and  Bagdad  by  Nizam  el 

Moulk,  the  famous  minister  of  Alp  Arslan  (1068-1072)  That  of  Bagdad  was 
called  Medressat  Ennizamia,  and  soon  became  one  of  the  most  famous  of  its  day. 
Schools  were  founded  at  Bassora  and  Cufa  by  Schurfel  Dowlat,  emir  of  Irak, 
about  988.  The  university  of  Bagdad  was  reorganized  by  Al  Mostanser  (1226- 
1240),  who  provided  regular  salaries  for  its  professors,  collected  a  new  library, 
established  a  new  pharmacy,  and  even  took  part  himself  in  the  instruction  of  the 
students.     (H.) 


—  221   — 

received  the  venia  legendi  (igaze,  liberty  to  teach).  Among  the  special  medical 
branches,  practical  anatomy  was  utterly  excluded  by  religious  belief,  and  midwifery 
and  gynaecology  were  then  (as  almost  universally  in  the  East  to-day)  forbidden  to 
men.  The  practice  of  operative  surgery  too  was  considered  unworthy  of  a  man  of 
honor,  and  was  permitted  only  to  the  despised  lithotomists  and  similar  persons  of  the 
lower  class,  who,  in  conseqnence  of  the  fatalism  of  the  Arabians  (in  spite  of  the 
remarkable  tolerance  of  the  Orientals,  even  to-day,  for  painful  operations),  were  very 
rarely  allowed  to  have  recourse  to  the  knife. 

"  Operations  performed  by  the  hand,  such  as  venesection,  cauterization,  and  incis- 
ion of  arteries,  are  not  becoming  a  physician  of  respectability  and  consideration. 
They  are  suitable  for  the  physician's  assistants  only.  These  servants  of  the  physician 
should  also  do  other  operations,  such  as  incision  of  the  eye-lids,  removing  the  veins 
in  the  white  of  the  eye  and  the  removal  of  cataract.  For  an  honorable  physician 
nothing  further  is  becoming  than  to  impart  to  the  patient  advice  with  reference  to 
food  and  medicine.  Far  be  it  from  him  to  practise  any  operation  with  the  hands! 
So  say  we!"  Even  the  extraction  of  teeth  was  avoided,  and,  although  dentistry  was 
cultivated,  as  among  the  Ancients,  it  was  practised  only  by  the  lower  class  of  physi- 
cians, the  assistants  etc.  Yet  the  higher  physicians  —  Thabit  ebn  Senan  e.  g.  cured 
the  stump  of  a  hand  that,  had  been  cut  off — seem  always  (though  not  frequently)  to 
have  practised  surgical  operations,  and  it  even  appears  that  they,  as  among  the 
Greeks,  probably  operated  in  person  as  obstetricians  in  very  difficult  cases  of  labor. 
They  certainly  watched  over  the  practice  of  midwifery  by  the  lower  surgeons  and 
midwives,  just  as  the  physici  puri  did  among  us  until  the  present  century. 

Medicine  proper  was  chiefly  taught.  Chemistry,  pharmacy  and  materia  medica 
and,  indeed,  the  history  of  medicine  were  also  well  cultivated. 

The  teachers  (Rabban)  were  installed  in  their  offices  with  a  certain  ceremony,  a 
custom  transmitted  from  the  Jews  to  the  Syriac  Christians  and  later  Nestorians  of 
Nisibis,  from  these  to  the  Arabians,  and  from  the  latter  to  the  Christian  schools  of  the 
West,  which  found  in  the  Arabian  academies  their  models.  The  teachers  also 
enjoyed  private  practice,  or  were  physicians-in-ordinary.  Moreover  they  received  a 
salary  from  the  state,  which  was  raised  by  some  of  the  rulers  to  a  considerable  sum. 
Abd  el  Letif  e.  g.  received  a  salary  of  $240  per  month  —  a  large  sum  when  we  con- 
sider the  value  of  money  in  that  day.  Many  of  them  belonged  to  the  Nestorian  sect, 
and  their  audience  was  composed  of  Christians,  .lews,  Arabians  and  Persians.  The 
text-books  which  formed  the  basis  of  their  lectures  were  Galen,  Hippocrates,  Oribasius, 
Dioscorides,  Aetius,  Paul  &c  the  reading  and  explanation  of  which,  with  exercises 
in  dialectics,1  were  the  chief  objects  of  instruction.  Personal  observation  was  less 
cultivated,  though  clinical  instruction  was  also  imparted.  Indeed  Rhazes  writes: 
"A  thousand  physicians,  for  probably  a  thousand  years,  have  labored  on  the  improve- 
ment of  medicine;  he  who  reads  their  writings  with  assiduity  and  reflection  discovers 
in  a  short  life  more  than  if  he  should  actually  run  after  the  sick  a  thousand  years." 
Yet,  on  the  other  hand  (like  Paracelsus),  he  confesses  that  "Reading  does  not  make 
the  physician,  but  a  critical  judgment,  and  the  application  of  known  truths  to  special 
cases". 

Before  students  (who  were  forced  to  gain  their  own  living  in  part  and  were 
partially  supported  by  stipends)  were  received,  they  were  compelled  —  at  least  this 
fact  is  known  as  regards  the  school  of  Jondisabur —  to  exhibit  their  proficiency  in 
certain  branches  of  knowledge,  and  to  pass  a  kind  of  Arabian  examination  for 
matriculation ! 

1.    Dialectic  tournaments,  similar  to  those  of  the  later  Scholastics,  were  customary 
among  the  students  and  between  the  teachers,  even  in  the  presence  of  the  caliphs. 


Daring  their  attendance  U]  on  the  universities  the  Arabian  students  made  botan- 
ical excursions,  just  as  in  the  German  universities  of  a  later  period.  Finally,  they 
were  compelled,  at  least  occasionally  and  in  certain  cities  like  Bagdad  etc.,  to 
pass  an  examination  (our  examination  for  the  Doctorate)  before  an  examining 
board.  This  examination  (as  has  been  the  case  for  a  long  time  too  in  some  of  our 
Christian  institutions)  seems  occasionally  to  have  been  made  very  light.  Of  course 
the  Arabian  professors  had  not  only  sons  and  daughters,  but  also  a  whole  harem,  to 
provide  for. 

"An  old,  but  well-clad,  Arabian  applied  for  a  medical  examination  to  the  Presi- 
dent of  the  college  of  Bagdad.  At  the  very  first  question  of  the  President  the  old 
man  drew  forth  his  purse  and  shook  out  its  contents.  Although  he  could  neither  read' 
nor  write,  this  jingling  answer  was  sufficient,  and  he  was  given  a  diploma,  with  the 
conditions  that  he  should  never  administer  either  active  purges  or  emetics,  nor  per- 
form venesection,  but  merely  employ  with  his  patients  oxymel  and  syrup,"— a  degree, 
therefore,  about  equal  to  our  doctor  externus,  which,  until  a  short  time  ago,  was 
granted  upon  similar  principles. 

Besides  these  institutions  (especially  in  the  early  period  of  Arabian  culture) 
physicians  were  also  instructed  by  their  elder  professional  brethren.  It  is  character- 
istic of  the  inheritance  of  medical  knowledge,  and  a  fact  which  we  notice  also  among 
the  Greeks,  that  there  were  entire  families  devoted  to  medicine,  who  flourished  for 
long  periods.  If  we  draw  our  conclusions  as  to  the  number  of  physicians  among 
the  Arabians  from  the  number  of  the  teachers  and  students  of  a  few  schools,  and  from 
the  number  of  their  medical  authors  (a  mode  of  computation  well  authorized),  this 
number  must  have  been  great.  Indeed  Oseibiah  alone  enumerates  as  many  as  S99 
of  considerable  distinction,  and  in  the  middle  of  the  10th  centurj-  in  Bagdad  alone 
there  were  8(50  physicians — about  as  manj-  as  in  Berlin  in  1876.  Thejr  were  especi- 
ally devoted  to  internal  diseases,  and  the  Arabians  have  been  reproached  with  having 
•especially  promoted  the  division  of  the  profession  into  physicians  of  internal  diseases 
and  surgeons.  Among  the  latter  were  specialists  (including  oculists)  who  busied 
themselves  only  with  the  disreputable  operation  of  lithotomy,  or  with  operations  upon 
the  eyes  etc.  A  regular  physician  would  rarel}'  meddle  with  surgery.  Yet  opera- 
tions seem  to  have  been  performed  occasionall}-  by  even  the  most  distinguished 
physicians.  The  Arabian  physicians  were  great  savants,  mathematicians,  botanists, 
chemists  or  alchemists,  zoologists,  translators,  philologists  and  philosophers.  Many 
were  also  poets,  others  praised  and  glorified  by  poets  —  a  characteristic  piece 
of  amiability  among  the  Arabians;  for  among  Ancients  as  well  as  Moderns  it  is  cus- 
tomary to  write  satirical  poems  only  upon  physicians. 

The  pictures  which  have  been  drawn  of  physicians,  as  a  class,  make  them  appear 
in  a  rather  unfavorable  light.  In  order,  however,  to  judge  matters  more  mildly  and 
with  greater  justice,  we  must  always  remember  that  Arabian  circumstances  and  cus- 
toms are  not  to  be  squared  with  our  rule.  In  this  way  many  things  will  appear  in  a 
more  tolerable  light.  The  relations  of  medical  colleagues  to  each  other  among  the 
Arabians  were  not  always  particularly  good.  Besides  the  detraction  and  calumnia- 
tion customary  from  all  time  (medicus  medicum  odit),  they  had  recourse  in  some 
cases  to  actual  poisoning  in  order  to  get  rid  of  a  colleague,  a  practice  of  which  we 
have  no  examples  in  the  most  recent  times! — Physicians  visited  the  sick  at  their 
homes  and  had  "office  hours"  in  their  residences,  which  appointments  seem,  however, 
to  have  been  less  confined  to  precise  hours  than  with  us.  In  some  institutions  there 
was  a  sort  of  "  Policlinic  ".  As  regards  Arabian  practice  it  strikes  us  above  all  that 
even  the  great  Arabian  physicians  were  not  free  from  a  straining  after  effect  and  a 
passion  for  surprises.  Thus,  on  one  occasion,  a  man  fell  down  in  the  street  when  a 
(physician  of  undoubted  reputation  was  in  the  vicinity.     The  physician,  taking  in  his 


—  223  — 

band  a  cane  and  summoning  the  bystanders  to  follow  his  example,  began  to  beat  ihe 
.sick  man  upon  the  soles  of  his  feet  and  upon  his  body,  until  he  was  somewhat 
.aroused.  Thereupon  the  others  were  encouraged  and  followed  the  physician's  exam- 
ple, and,  when  the  sick  man  finally  came  to  himself,  everybody  among  the  Arabians 
praised  the  cleverness  of  the  doctor.  Another  physician  promised  to  cure  the  favorite 
-wife  of  the  caliph,  who  had  paralysis  of  the  arms.  Having  collected  the  whole  court, 
he  directed  the  young  woman  to  enter,  immediately  ran  up  to  her  and  —  threw  her 
■clothes  over  her  head!  She  on  the  instant  (in  the  hope  of  helping  herself  some- 
what!), moved  her  arms  to  put  them  down  again.  Again  the  Arabian  physicians  had 
recourse  to  mysterious  procedures  and  busied  themselves  specially  and  immoderately 
with  uroscopy  and  astrology,  branches  which  were  subsequently  transmitted  by  them 
to  the  West.  In  accordance  with  the  first  mentioned  tendency  they  wrote  with  a  pur- 
gative ink  (perhaps  prepared  with  the  juice  of  colocynth,  scammony  etc.)  certain 
charms  in  cups,  in  order  to  purge  the  faithful  mysteriously,  just  as,  even  in  the  present 
•century,  we  used  to  employ  quassia  cups,  in  order  to  have  a  stomach  bitters  always 
at  hand,  or  to  prepare  it  for  ourselves  by  pouring  into  the  cup  a  little  spirits,  as 
Daubitz  said,  as  often  "as  any  one  believed  it  necessary  to  take  it".  From  the 
urine  pregnancy  was  diagnosticated,  and  even  the  sex  of  the  child  foretold. 

Much  swindling,  and  charlatanry  too  may  have  crept  in,1  perhaps  in  consequence 
of  a  surplus  of  phj'sicians.  Possibl}'  also  self-deception  through  ignorance  or  exces- 
sive imaginativeness,  or  intentional  deception  with  the  design  of  producing  an  im- 
pression, may  have  had  its  share  in  the  peculiarities  of  Arabian  practice.  Tims  the 
physicians  promised  to  the  caliph  YVatek  Billah,  who  suffered  from  dropsy,  fifty  years 
more  of  life,  and  shoved  him  several  times  into  a  heated  oven,  until  (far  beyond  their 
original  promise)  he  was  cured  forever!  —  Moreover  the  Arabian  physicians  enjoyed 
a  good  reputation  as  prognosticians  and  diagnosticians.  What  kind  of  diagnoses  they 
sometimes  made  maybe  inferred  from  the  following  anecdote :  Thabet  ebn  Korra 
diagnosticated  a  disease  between  the  ribs  and  the  pericardium,  not  at  all  from  the 
local  phenomena,  but  as  follows  :  "  I  showed  him  my  urine  glass,  and  he  saw  in  it 
what  was  hidden  between  my  ribs  and  my  pericardium."  And  without  needing  to 
trouble  himself,  like  us  poor  doctors,  with  anatomy,  pathological  anatomy,  ausculta- 
tion and  percussion,  and  even  the  post  mortem,  "the  concealed  disease  appeared  to 
him  as  a  stain  on  a  polished  sword  looks  to  the  eye",  —  a  better  result  than  we  can 
attain  with  all  our  accessories!  Their  fee  seems  always  to  have  been  stipulated  in 
advance  —  a  point  in  which  the  Arabians  were  ahead  of  us  until  recently'.  When  a 
patient  declared  that  he  was  only  growing  worse,  the  physician  demanded  at  least 
half  the  stipulated  fee,  since  he  had,  at  all  events,  converted  an  originallj-  tertian  fever 
into  a  semi-tertian,  and  Isaac  Judasus  gives  the  discreet  counsel  to  stipulate  the  fee 
during  the  course  of  the  disease,  and  to  fix  it  as  high  as  possible  ;  for  after  recovery 
recollection  of  the  service  rendered  declines  rapidly.  He  also  advises  against  gratu- 
itous treatment,  because  one  gets  no  thanks  for  it  —  an  experience  which  the  Ara- 
bians had  alreadj-  made.     Physicians-in-ordinary  and  court-physicians  enjoyed  high 

1.  Under  this  head  belong  the  medical  prescriptions  regarding  the  daily  use  of 
laxatives  and  the  enjoyment  of  coitus  but  once  a  month — prescriptions  which  must 
certainly  have  been  observed  less  strictl}'  among  the  polygamous  and  nervously 
uxorious  Arabians,  than  among  the  Egyptians.  The  Christian  princess  Isabella 
I.  of  Aragon  published  in  1496  a  law  for  the  protection  of  "married  women", 
according  to  which  the  latter  need  not  permit  coitus  oftener  at  most  than  six 
times  a  day  (what  men!).  Luther,  on  the  other  hand,  is  said  to  have  recom- 
mended it  twice  a  week;  so  that  either  he  puts  to  blush  the  Arabians,  or  the 
Arabians  him  ! 


—  224  — 

salaries,1  and  often,  as  the  result  of  a  few  successful  cases,  attained  to  great  wealth. 
In  case  of  ill  success  in  their  treatment,  however,  or  bad  humor  in  their  masters,  they 
were  exposed  to  abrupt  reverses  of  fortune.  Sometimes  they  were  subjected  to  im- 
prisonment and  even  whipping,  just  as  the  German  military  physicians  down  to  the 
middle  of  the  18th  century  were  put  into  the  stocks.  For  the  existence  of  military 
physicians  in  the  Arabian  armies  we  have  in  evidence  the  circumstance  that  they 
were,  without  doubt,  provided  with  field  apothecaries  and  field  pharmacies  at  least, 
the  latter  of  which  were  often  inspected  by  the  Generals  themselves.  Moreover  there 
were  veterinary  physicians  among  ihe  Arabians  (at  least  we  may  so  conclude  from 
their  veterinary  authors),  and  finally  there  must  have  been  a  kind  of  female  physicians, 
since  certain  operations  on  women,  such  as  lithotomy,  replacing  the  prolapsed  uterus 
etc.,  could  be  performed  by  women  only.  Besides  all  the  covered  portions  of  the 
female  body  were  prohibited  from  being  stripped  hj  strange  men,  and  of  course  least 
of  all  could  the  sexual  organs  be  touched  by  them.  Possibly,  however,  these  female 
physicians  were  merely  midwives.  The  latter  were  the  only  obstetricians  (as  with  us 
until  the  18th  century),  and  they  performed  the  bloodiest  operations,  such  as  embry- 
otomy, even  lithotonry  etc.  It  must  still  be  mentioned  that  there  were  apothecaiies  in 
the  hospitals,  as  well  as  others  unconnected  with  those  institutions,  and  that  male  and 
female  nurses  were  also  employed.  The  better  physicians  existed  for  the  rulers  and 
the  wealthy  only;  the  common  people,  in  the  great  majority  of  cases,  employed  sim- 
ple popular  physicians  (tubib),  conjurors,  jugglers  etc.,  for  according  to  the  Koran 
actual  medical  treatment,  as  well  as  the  study  of  medicine,  was  simply  tolerated,  while 
to  the  most  devout  believers  it  was  regarded  an  infringement  upon  the  sphere  of 
Allah.  Even  from  the  better  physicians  of  the  rulers  miraculous  cures  were  expected, 
rather  than  regular  medical  treatment.  —  Besides  the  hospitals  of  the  Arabians  con- 
nected with  their  academies,  there  also  existed  in  many  places  others,  which  (in  con- 
trast to  the  Christian  monastic  hospitals  of  the  Middle  Ages)  were  always  managed 
by  physicians.  Such  was  e.  g.  that  founded  by  the  caliph  Abd  el  Melik  in  the  year 
707.  Similar  lay-hospitals  existed  at  Misr,  Fez  etc.  Cordova  had  40  such  hospitals, 
but  the  greatest  was  at  Cairo,  and  was  endowed  with  genuine  luxury,  both  as  regards 
its  arrangements  and  its  medical  staff.  It  was  founded  in  1283  by  El  Melik  al  Mansur 
Gilavun,  and  might  serve  in  many  respects  as  a  model  institution  even  to-day.2  It 
possessed  a  physician-in-chief  (who  held  lectures  in  a  special  room),  male  and  female 
nurses,  special  wards  for  wounds,  diseases  of  the  eye,3  diarrhceai  diseases,  fevers  (this 

1.  In  the   Arabic  states  of  the  present  day  these  are  arranged  upon  a  lower  scale. 

Thus  in  Morocco  Gerhard  Rohlfs  received,  as  physician-in-ordinary,  a  daily 
salary  of  about  six  cents,  though  he  treated  his  patients  on  native  principles,  i.  e. 
he  wrote  amulets  and  amulet-like  recipes,  to  be  taken  in  water  etc.  There  are 
no  longer  any  regular  physicians  there  now,  though  apothecary -shops  exist  and 
are  supplied  with  the  "latest  novelties".  Even  in  the  loth  century — in  the  time 
of  Leo  Africanus  (Alhassan),  the  geographer — the  great  native  and  foreign  phy- 
sicians of  the  meridian  of  Arabic  culture  were  entirely  forgotten,  and  physicians 
and  surgeons  no  longer  existed  there. 

2.  The  hospital  "Moristan"'.     According  to  Leclerc  it  was  founded  by  the  Fatimite 

caliph  Moez  Ledinillah  (953-975),  and  was  originally  designed  for  the  insane  only, 
but  was  afterwards  thrown  open  to  the  sick  of  all  classes.  It  was  restored  by  the 
Mameluke  sultan  El  Munsoor  Eelaoun  (1279-1290)  in  1286,  and  a  school  of 
medicine  was  added  thereto.  Under  the  auspices  of  the  sultan  Kelaoun  also 
appeared  a  treatise  on  hippiatrics  and  hippology,  entitled  "Nacery".     (H.) 

3.  Separate    ophthalmic    wards   were    not    introduced    among    us    until    the    present 

century.  Oseibia's  uncle  Reschid-ed-din-Abul-Hassan  Ali  was  the  director  of 
such  a  ward  in  Cairo. 


—  225  — 

ward  was  cooled  by  fountains),  a  room  for  women,  another  for  convalescents,  and 
rooms  for  the  storage  of  food,  drugs  and  other  stores  etc.  The  house  was  arranged 
for  the  sick  of  all  conditions,  and  the  number  of  the  patients  was  not  determined  be- 
forehand. Inasmuch  as  it  was  united,  however,  to  a  mosque  (in  which  the  Koran  was 
read  and  expounded  day  and  night),  and  contained  a  law-school,  library,  orphan 
asylum  etc.,  it  was  quite  similar  to  the  academies.  The  general  condition  of  public 
hj-giene  among  the  Arabians  may  be  inferred  from  the  picture  of  Cairo  given  by  the 
Egj'ptian  historian  Al  Makrizi  (15th  centurj') :  "The  inhabitants  make  it  a  habit  to 
throw  out  into  the  streets  all  dead  animals,  like  cats  and  dogs,  that  die  in  their  houses, 
together  with  the  refuse  of  their  dwellings,  remnants  of  food,  dirty  water  etc.  All  this 
calls  forth  in  the  narrow  streets,  into  which  no  currents  of  air  can  force  their  way,  an 
insupportable  and  very  unhealthy  stench.  Then  they  all  drink  the  water  of  the  Nile, 
into  which  their  sewers  (so  they  had  sewers!)  empty,  and  in  which  the  bodies  of  ani- 
mals are  everywhere  floating.  If  you  go  out  of  a  morning  in  a  clean  caftan  and  tur- 
ban to  attend  to  your  business,  your  clothing  is  soiled,  your  beard  and  eyes  are  full 
of  dust:  for  no  draughts  of  air  make  their  way  into  the  streets  to  disperse  the  dust 
raised  by  men  and  beasts.  If,  however,  you  go  out  in  the  evening  to  take  a  walk, 
from  all  the  houses,  and  particularly  from  the  large  fireplaces,  ascends  a  smoke,  which 
darkens  the  heavens  and  makes  the  atmosphere  appear  black  and  murky.  Besides 
all  this,  the  bad  fish,  which  in  the  winter  and  spring  are  brought  from  the  sea  for  sale, 
diffuse  an  abominable  and  very  pernicious  odor.  The  wealthy,  therefore,  prefer  to 
live  in  Higelesch-Scharaf,  situated  to  the  south  of  the  city,  because  there  they  drink 
the  water  of  the  Nile  before  it  has  been  defiled  by  the  city.  From  all  this  I  think  it 
explicable  why  the  inhabitants  of  Cairo  fall  sick  easily.  For  this  reason  too  the 
Ancients  placed  the  capital  of  the  country  at  one  time  at  Memphis,  and  then  at 
Alexandria.  The  healthiest  place  in  Fostat  is,  undoubtedly',  that  in  which  thej-  bury 
their  dead."   In  the  conservative  Orient  affairs  are  in  the  same  condition  exactly  to-day  ! 

The  so-called  Arabian  physicians,  whose  golden  age  falls  between  the 
8th  and  13th  centuries,  were  also  the  instructors  of  the  physicians  of  the 
West  in  Grecian  medicine.  Even  as  late  as  the  17th  century  their  writings 
were  the  text-books  for  lectures  in  the  universities.  The  earliest  Arabian 
physicians  to  distinguish  themselves  were  members  of  the  Nestorian  family 
of  Bachtishua  (i.  e.  Servants  of  Christ,  flourished  750-1050),  all  of  whom 
were  famous  translators.     Of  these 

Jurjis  (George) 
was  called  in  772  by  the  caliph  Almansor  from  Jondisabur  to  Bagdad.     His  sov; 

Bachtishua  ben1  Jurjis 


1.  In  Arabic  proper  names  Abu  or  Ebu  signifies  father;  Ben,  Ebn,  Ibn,  son  or  des- 
cendant; al,  el,  er,  il,  is  the  article,  and  the  name  following  gives  the  native 
country,  place  of  birth,  father's  occupation  etc.  The  Arabic  sounds  are  not  so 
sharply  defined  to  our  ears  that  variations  in  the  mode  of  writing  cannot  arise. 
In  the  West,  Arabic  proper  names  often  undergo  such  changes  that  the  original 
and  correct  orthography  is  no  longer  recognizable.  As  examples  we  may  quote 
Rambam,  Abimeron,  Avicenna  etc.  These  changes  are  noticed  in  their  appro- 
priate places.     (Baas.) 

[In  the  English  translation  an  effort  has  been  made  to  replace  the  (to  the 
English  eye)  rather  uncouth  combinations  of  German  orthography  by  a  simpler 
mode  of  spelling,  where  such  changes  would  not  occasion  mistake.  Thus 
the  German  Dschordschis  has  been  changed  into  Jurjis ;  Dschabril,  into 
Jabril  etc.  (H.)] 
15 


—  226  — 

cured  the  caliph  Harun  al  Raschid  of  an  attack  of  headache  by  bleeding  bim; 
■while  his  grandson  Jabril  (Gabriel,  died  828)  saved  the  life  of  the  same  caliph  in  an 
apoplectic  attack.  The  latter,  in  his  earlier  successes  and  later  and  sudden  mis- 
fortunes, was  a  genuine  type  of  the  Oriental  pbysician-in-ordinary.  The  later  des- 
cendants of  this  family. 

JuRjis  ben  Bachtishua  (9th  century), 

Bachtisiiia  hen  Jabril  (died  870), 

Jahjah  (John)  ben  Bachtishua  (about  900), 

Bachtishua  ben  Jahjah  (died  940), 

Obeidallah  ben  Jabril  (about  040), 

Jabril  ben  Obeidallah  (died  1006)  and 

Abu  Said  Obeidallah  (died  1058). 
only  partially  attained  the  reputation  of  their  ancestors. 

Another  Nestorian,  and  physician  of  Harun,  was  Jahjah  ebn  Maseweih 
(780-857,  Mesne  the  Elder,  Janus  Damascenus), 

distinguished  as  a  translator  and  teacher,  lie,  like  all  the  later  Arabians,  discarded 
the  strong  purgatives  of  the  Greeks  (scammony,  Nile-corn  etc.),  recommending  in 
their  stead  the  mild  Arabian  laxatives  (tamarinds  etc.).  He  also  declared  that  the 
small-pox  was  a  fermentation  of  the  blood  necessary  for  all  men.      His  pupil 

Honain  ebn  Ishak  of  Hira  (809-873),  called  in  the  West  Joannitius, 

was  a  Nestorian  teacher  at  Bagdad  and  a  court  physician,  equally  famous  with  his 
master  for  his  translations,  for  each  of  which  he  received  the  full  weight  of  the 
manuscript,  told  down  in  gold.  He  distinguished  himself  by  subtle  elaboration  of 
the  Galenic  doctrine  of  forces  and  humors  (assuming  4-6  chief  forces  and  the  neces- 
sary secondary  forces,  as  well  as  five  kinds  of  bile  of  all  colors,  as  red,  greenish- 
yellow,  lemon-yellow  etc.),  and  followed  m  part  the  Methodists.  With  Plato  he  con- 
sidered the  uterus  a  wild  beast,  possessed  with  a  sore  longing  for  semen.  He  also 
-.assumed  that  it  wandered  about  in  the  body,  and  proposed  by  the  use  of  pleasant 
odors  and  ointments — introduced  into  the  vagina — to  entice  it  downwards,  or  with  bad 
odors  to  drive  it  away.  The  odor  of  garlic  or  of  burnt  hair  serves  the  latter  purpose, 
and  is  considered  useful  even  to-day  for  hysterical  persons,  whose  emotions  (though 
not  their  uteri)  are  well  known  to  be  very  unstable.  Normal  presentations  are  those 
of  the  head  or  feet,  in  fleshy  persons  he  advises  the  knee-elbow  position,  and 
suggests  the  same  in  instrumental  cases  and  in  the  introduction  of  suppositories  into 
the  vagina,  in  order  to  entice  the  child  downwards.  Midwives  alone  should  operate. 
In  respect  to  therapeutics  he  was,  in  the  main,  a  follower  of  Hippocrates,  and  he  Was 
:also  a  good  oculist.  His  sons  Ishak  (died  !.)10)  and  David  were  also  translators. — 
About  the  same  period  lived 

•Jahjah  ebn  Serabi  (Serapion  the  Elder)  of  Damascus  (802-849), 
author  of  a  compilation  written  originally  in  Syriac,  and  afterwards  translated  into 
Arabic.  It  was  entitled  "Aggregator",  and  contained  descriptions  of  a  disease  of 
the  head  called  "Soda",  meningitis  =  Karabitos,  rachitis  =  Hada,  and  of  an 
eruption  =  Essera.  Hysteria  he  ascribes  to  a  want  of  sufficient  sexual  intercourse, 
— hence  its  frequency  in  widows  and  old  maids. 

Abul  Abbas  Ahmed  ben  Muhammed  ben  Merwan  ebn  el  Tajjib 
el  Serachfi  (died  899), 

physician  to  the  caliph  el-Motadhed,  by  whose  order  he  was  put  to  death,  translated 
into  Arabic  a  book  of  Hippocrates  and  also  wrote  an  "Introductio  in  artem 
medicain." 


While  Galen  classified  simple  medicines  into  grades  and  qualities, 

Yacub  ebn  Ishak  el  Kindi  (Aleuindus,  813-873), 

an   Arabian  who  equalled    him   in  fertility   as   a  writer    (he  composed  more  than  200 

treatises),  employed  the  doctrines  of  geometrical  proportion  and  musical   harmony 

in  explanation  of  the  effect  of  compound  remedies.    His  example  was  followed  almost 

down  to  our  modern  times,  crude  and  preposterous  as  it  appears.     Thus, 

Cardamon  is  1°    warm,     \°  cold,     h°  moist,  ]°  dry, 

Sugar  is         2°        "       1°       "      1°        "     2°     " 

Indigo  is  A°    ,    "        1°       "         1°       "      1°     " 

Emblicais     1°        "    .  2°      "      1°        "     2°     " 


Sum  4\°  warm,  -il°  cold,  3°  moist,   li°  dry. 

As  the  warm  and  cold  are  equal,  and  the  dry  twice  as  much  as  the  moist,  the  above 
prescription  gives  us  a  compound  dry  in  the  first  degree. 

An  equally  fruitful  writer  was  the  contemporary  of  Aleuindus 
Thabit  ebn  Corra  (836-001)  ;  whose  sons 

Ibrahim  ebn  Thabit  ben  Corra  and 

Abu  Said  Sinan  ben  Thabit  ben  Corra  (died  942),  and  grandson 

Thabit  ebn  Sinan  (died  073) — all  of  them  were  called  -l  The  Sabians  " 
— were  presidents  of  the  medical  college  at  Bagdad. 

Another  later  (Spanish)  Arabian  physician  Ebn  Wafid  (Abenguefit, 
097-1075), 

in  his  treatise  "On  the  powers  of  Drugs  and  Aliments",  and  in  similar  specu- 
lations on  the  action  of  drugs,  shows  himself  a  partisan,  as  we  have  seen  in  the 
case  of  Aleuindus.  —  One  of  the  most  distinguished  Arabian  physicians  was  the 
Persian 

Mohammed  Ebn  Zakarijah  Abu  Bekr  er  Razi  (Rhazes,  also  cor- 
rupted into  Abubertus,  Abubater,  Bubikir,  Abubeter),  originally  a  cithern- 
player,1  born  A.  D.  850  at  Rai  (hence  Arrasi,  el  Razi),  later  an  active 
teacher  at  Bagdad,  who  finally  died,  poor  and  blind,  in  his  native  city  in 
923  (932  ?,  1010  ?). 

Equally  great  as  a  philosopher  and  a  medical  writer,  the  "  el 
Ha wi  "  (Liber  Continens)  passes  for  the  masterpiece  of  his  (237)  works, 
while  his  "  Aphorisms  "  were  used  for  an  extremely  long  period  as  a  vade 
mecum. 

In  surgery  and  the  treatment  of  diseases  of  the  eves,  especially  in  the  operative 
branches,  his  knowledge  is  considerable.  He  is  acquainted  whh  the  operative  pioee- 
dures  in  trichiasis,  en- and  ec-tropion,  the  extraction  of  cataract  (suction?),  tracheot- 
omy, tonsillotomy,  the  operation  for  fistula  lachrymalis,  the  reduction  of  fractures 
and  dislocations  by  means  of  machines,  the  treatment  of  abscessts,  burns  (in  which 
he  advises  a  mixture  of  snow  and  water),  necrosis,  caries,  hare-lip,  fistula,  recognizes 
fracture  of  the  penis  etc.,  while  his  gynaecological  and  obstetrical  remarks  relate  to 
retroversion  of  the  uterus,  hydrotnetra,  mole  pregnancy,  shaking  the  parturient 
woman,  and  finally  embryotomy  for  the  relief  of  labor,  the  well  known  culbute  etc. 
In  dietetics  he  advises  against  the  weaning  of  children  in  summer.     Like  a  genuine 

1.  Other  physicians  besides  Rhazes  were  famed  for  playing  upon  the  flute  etc. — 
evidence  that  among  the  Arabians  music  stood  in  high  esteem  at  a  period  when 
in  the  West  this  art  was  almost  unknown,  or  at  least  disregarded. 


—  228  — 

Arabian  he  thought  he  could  determine  in  primiparae  the  number  of  future  children 
by  the  number  of  abdominal  wrinkles !  In  pathology  he  follows  Galen  almost 
entirely,  "  since  otherwise  the  widely  differing  opinions  of  the  Ancients  lead  to  em- 
harassment" — a  statement  which,  however,  may  be  still  more  truly  made  of  our 
modern  authors.  On  the  other  hand,  he  is  one  of  the  earliest  and  most  important 
dermatologists,  and  his  famous  description  of  the  small-pox  (first  mentioned  in  a  lost 
work  of  Ahrun,  presbyter  in  Alexandria  in  the  7th  century)  and  measles  is  new  and 
original,  though  in  the  therapeusis  he  follows  Hippocratic  principles.  A  proof  of  his 
therapeutic  insight  is  found  e.  g.  in  his  preference  of  food  to  drugs,  whenever  the 
former  may  suffice,  and  among  drugs,  his  preference  of  the  simple  to  the  compound. 
With  respect  to  venesection  he  gives  the  rule  to  open  the  vein  longitudinall}-,  and  re- 
commends in  hepatitis  opening  the  vein  of  the  right  arm,  in  haematemesis,  the  veins 
of  the  foot  etc.  Purgatives  he  rejects.  His  Semeiology  and  Prognostics,  with  the 
exception  of  the  indications  to  be  derived  from  the  urine  and  the  planets,  are  famous, 
while  his  anatomical  and  physiological  knowledge  never  exceeds  that  of  Galen.  Yet 
he  mentions  the  double  recurrent  nerves,  the  infra-trochlear  branch  of  the  nasal,  the 
trigeminus  etc.  Children,  he  holds,  originate  from  a  mixture  of  male  and  female 
semen  (male  children,  in  case  the  male  semen  is  more  vigorous,  female,  when  the 
female  semen  is  the  stronger)  etc.  In  respect  to  Materia  Medica  he  teaches  the  ex- 
ternal use  of  the  preparations  of  arsenic,  mercurial  ointment  and  sulphate  of  copper, 
and  the  internal  employment  of  brandj',  saltpeter,  borax,  red-coral  and  precious  stones 
(the  prescription  of  which  induced  the  utmost  fraud  in  pharmaceutics),  as  well  as  the 
chemical  preparation  of  oil  of  ants.  Moreover  he  does  not  consider  it  superfluous  to 
write  (in  addition  to  many  other  subjects)  upon  the  characteristics  of  the  charlatan 
(a  character  of  specially  frequent  occurrence  among  the  Orientals)  and  the  skilful 
physician,  a  subject  upon  which  lectures  ought  to  be  given,  or  rather  revived,  in  our 
universities,  for  this  was  done  during  the  last  century  almost  everywhere.  That  it 
is  done  no  longer  is  due  probably  to  the  fact,  that  to-day  we  are  often  in  doubt 
where  the  charlatan  ends  and  the  true  phj-sician  begins. 

A  veiy  short  time  after  Rhazes  lived  the  Persian  physician  Ali  ben 
el  Abbas  (Ali  Abbas,  died  994), 

who  in  his  "el-Maliki"  (Royal  Book)  treats  in  a  scientific  manner  the  whole  subject 
of  medicine,  out  according  to  his  own  statement,  follows  the  Arabians  in  materia 
medica  only,  while  in  all  other  respects  he  is  an  imitator  of  the  Greeks.  He  very 
properly  demands  of  the  physician  that  (as  he  himself  had  done)  he  should  control 
the  accuracy  of  the  pictures  of  disease  found  in  the  books  by  his  own  observations 
at  the  bedside.  He  gives  muscles  to  the  eye,  but  occupies  himself  with  teleological 
reflections  as  ro  the  value  of  its  different  parts.  In  his  dietetics  (where  he  commends 
sugar  as  food  for  infants)  he  furnishes  also  an  Arabian  regulation  as  to  clothing  con- 
sidered in  a  hygienic  point  of  view,  and  notices  likewise  the  necessity  of  taking  into 
account  the  demands  of  habit.  He  is  prominent  among  the  Arabians  as  an  obstet- 
rical and  ophthalmological  writer.  Yet  he  also  considers  the  uterus  a  veritable  beast, 
which  longs  for  semen  as  its  food.  The  extraction  of  the  child  and  embryotomy, 
according  to  Ali  Abbas,  are  allowable  for  midwives  alone.  His  work  was  translated 
into  Latin  under  the  title  "Pantegni"  by  Constantinus  Africanus,  the  first  author  to 
introduce  the  Arabian  writings  into  the  West. 

The  treatise  on  materia  medica  and  diet  of  Alhervi,  and  the  compen- 
dium of  pathology  of  Abu  Jafar  Ahmed  ebn  el  Jezzar  (Algazirah,  died  100-4) 
are  also  to  be  referred  to  this  period. 

"The  Prince  of  Physicians"  (el  Sheik  el  Reis  —  he  was  also  a  poet) 
was  the  title  given  bv  the  Arabians  to 


—  229  — 

Abu  Ali  el  Hossein  ebn  Abdallah  ebn  Sina  (Ebn  Sina,  Avicenna, 
980-1037),  in  recognition  of  his  great  erudition,  of  which  the  chief  evi- 
dences are  stored  in  his  "  Canon  ". 

This  work,  though  it  contains  substantially  merely  the  conclusions  of  the  Gieeks, 
was  the  text-book  and  law  of  the  healing  art,  even  as  late  as  the  first  century  of 
modern  times.  It  includes  anatomy,  physiology  and  materia  medica.  Jn  it  are 
mentioned  camphor,  iron  in  various  forms,  amber,  terra  eigilhata,  sublimate  (he 
differs  from  Galen  in  the  use  of  chemical  remedies),  cubebs,  aloes,  manna  and  many 
other  drugs.  He  considers  gold  and  silver  as  "blood-purifiers";  hence  gilded  and 
silvered  pills  are,  in  his  view,  specially  efficacious.  He  also  recommends  urine  and 
similar  substances  as  remedies,  while  he  advises  bleeding  at  the  outset  of  disease  at 
a  remote  point  from,  towards  the  end,  at  a  point  contiguous  to,  the  seat  of  the  disease. 
Epileptics,  according  to  him,  should  eat  heartily  at  midday,  less  at  evening.  For 
patients  suffering  from  consumption  he  prescribes  venesection,  and  then  gives  sugar 
and  milk;  in  diarrhoea  he  prescribes  gentle  laxatives.  He  also  discusses  compound 
remedies,  and  knows  many  "cordials"  etc.,  in  all  which  matters  he  shows  himself  a 
genuine  Arabian. 

His  pathology  makes  prominent  mention  of  mental  diseases,  and  notices  tic 
douloureux  (described  also  by  other  Arabians),  tetanus,  "blueing  of  the  eyes' ,  three 
forms  of  inflammation  of  the  chest — pleuritis,  muscular  rheumatism  and  mediastinitis 
— measles,  the  purples,  albaras  nigra  etc.  He  is  also  said  (according  to  Leichten- 
stern)  to  have  been  the  first  (?)  physician  to  teacli  the  contagiousness  of  phthisis. 

In  his  general  pathology  and  therapeutics  he  distinguishes,  among  other  matters, 
fifteen  kinds  of  pain,  assumes  four  peripathetico-scholastic  causes  of  disease  (the 
material,  efficient,  formal  and  final  causes),  preserves  the  Galenic  humoral  pathologj" 
etc.  In  great  coldness  and  in  great  heat  he  gives  no  medicines,  and  considers  the 
same  remedy  good  in  one  locality,  which  would  be  injurious  if  employed  in  another. 
In  surgery  he  calls  the  extraction  of  cataract  a  dangerous  operation,  but  speaks 
in  favor  of  depression;  declines  to  operate  on  strangulated  hernia;  describes 
puncture  of  the  bladder;  the  method  of  direct  reposition  of  the  head  of  the  os  brachii 
in  dislocation,  the  method  by  which  leeches  and  other  foreign  bodies  when  swallowed 
may  be  removed  from  the  oesophagus,  hardened  wax  removed  from  the  meatus  etc., 
while  he  prefers  to  loosen  the  teeth  by  means  of  the  fat  of  tree-toads,  rather  than  to 
pull  them  out.  In  obstetrics  he  follows  the  views  of  the  earlier  writers.  In  military 
surgery  (according  to  Frohlich)  he  taught  only  very  little,  and  this  he  borrowed  from 
the  Greeks,  without  giving  his  own  experience. 

The  history  of  Avicenna's  life  is  as  follows.  His  father,  a  reputable 
official,  who,  at  the  time  of  Avicenna's  birth,  resided  at  Afschena  in 
Bokhara,  supplied  to  him  very  early  the  foundation  of  all  Oriental  instruc- 
tion, i.  e.  the  knowledge  of  the  Koran,  which  work  he  knew  by  heart  as 
early  as  his  tenth  year.  After  this  he  studied  grammar,  dialectics,  astron- 
omy and  geometry,  learned  from  a  merchant  the  Indian  figures  and  arith- 
metic, then  devoted  his  time  to  the  Aristotelian  philosophy,  and  finally 
turned  his  attention  to  the  study  of  medicine,  under  the  direction  of  the 
Nestorian  Abu  Sahel  Mosichi  and  Abu  Nasr  Alfarabi  at  Bagdad.  As 
early  as  the  age  of  sixteen  he  was  qualified  to  teach  and  practise  this  pro- 
fession also.  At  a  later  period  he  became  vizier  at  Hamadan,  but  was 
deprived  of  this  office  and  even  thrown  into  prison,  where  he  wrote  many 
of  his  medica]  works.     He,  indeed,  recovered  his  freedom  and  his  office, 


—  230  — 

but,  having  fresh  occasion  to  be  apprehensive  for  his  liberty,  he  kept  himself 
concealed  for  a  long  time  in  the  house  of  an  apothecary.  Finally,  however, 
he  was  discovered  and  imprisoned  in  the  castle  of  Berdawan.  Again,  in 
the  garb  of  a  monk,  he  fled  to  Ispahan,  where  he  enjoyed  renewed  dis- 
tinction, but,  undermined  in  health  b}*  women  and  wine,  he  died  during  a 
journey  to  Hamadan,  in  the  58th  j-ear  of  his  age. 

His  views  as  to  what  is  allowable  to  a  physician  are  characteristic  of  Arabian 
modes  of  thought  and  ideas.  As  a  priest  he  could  never  employ  reason;  in  his 
character  as  a  philosopher,  however,  it  was  permissible  to  make  some  use  of  it  When 
e.  g.  it  is  asserted  that  jaundice  is  removed  by  looking  at  yellow  objects,  he  will  not, 
as  a  physician,  question  the  fact,  yet,  as  a  philosopher,  he  cautions  against  super- 
stitious remedies. 

For  the  fact  that  Avicenna  became  at  once  the  ruling  "  Authority  " 
among  the  Arabians,  and  at  a  later  period  among  the  Christians  also,  the 
circumstance  that  commentaries  upon  his  works  appeared  immediately 
(though  he  was  himself  only  a  commentator  and  compiler;  speaks  volumes. 

Ishak  ben  Amran  (about  900)  of  Bagdad  was  the  founder  of  Arabian 
medicine  in  Africa  and  was  crucified. 

Ishak  ben  Soleiman  (830-940)  wrote  on  dietetic  subjects  and  the 
deportment  and  conduct  of  the  physician. 

Using  as  a  iruide  the  elementary  qualities,  he  determines  the  value,  not  only  of 
the  different  kinds  of  flesh,  but  also  of  the  special  parts  of  one  and  the  same  animal. 
Although  he  was  a  Jew  (hence  called  el-Israili  and  Isaac  Judseus),  he  declares  pork 
to  be  very  healthy.  He  was  the  first  (?)  to  introduce  senna.  Very  properly  also  he 
decides  upon  the  qualities  of  spring  water  in  accordance  with  its  source,  or  in  consid- 
eration of  the  climate,  and  gives  directions  for  the  baking  of  bread,  a  subject  which, 
as  we  know,  Liebig,  in  recent  times,  did  not  consider  it  superfluous  to  explain. 

About  the  same  period  Abul  Hassan  Garib  ben  Said  (about  830-930) 
composed  some  obstetrical  treatises  (the  only  specimen  of  his  works  which  has  been 
preserved  to  us),  in  which  were  considered  the  diseases  of  childbed  and  children,  the 
means  for  increasing  the  semen,  the  method  of  recognizing  the  sex  of  the  foetus  in 
utero,  labor,  suckling,  the  rearing  of  children  etc.,  while 

Ebn  Serapion  the  Younger  (died  1070), 
in  his  work  "On  Simple  Remedies"  collected  all  the  knowledge  of  the  Greeks  and 
Arabians  on  this  subject.  Spinach,  nutmeg,  music,  liquid  amber,  senna,  asafcetida 
etc.  are  minutely  described,  while  wonderful  accounts  are  given  of  the  procuring  of 
asphalt,  bezoar,  diamonds  and  the  magnetic  stone.  On  materia  medica  and  pharma- 
ceutics (subjects  in  which  his  "Grabadin"  served  for  along  period  as  the  chief  guide),' 
as  well  as  upon  pathology,  he  wrote  numerous  treatises,  which  were  used  as  text- 
books in  the  Christian  schools  as  late  as  the  16th  century. 

Jaiija  ben  Masewaih  ben  Ahmed  (Mesue  the  Younger,  died  1015) 
of  Maradin  on  the  Euphrates, 

was  a  pupil  of  Avicenna,  and  ordinary  physician  of  Alhakem  II.  (1)61-976)  at  Cairo, 
and  is  said  to  have  been  a  Christian.  He  taught  the  so-called  correction  of  drugs, 
the  preparation  of  extracts  etc. 

The  Christian  physician  Jahjah  ebn  Jesla,  of  Bagdad  (died  1100), 
composed  treatises  on  drugs  and  diseases  in  a  tabular  form,  which  were  entitled 
"Takuim  elabdan".     He  apostatized  to  Mahommedanism  in  order  to  be  able  to  hear 


—  231   — 

the  lectures  of  Abu  AH  ben  Walid,  and  afterwards,  abused  both  Jews  and  Christians, 
like  a  true  renegade. 

A  rival  of  Avicenna  in  the  fame  won  in  the  department  of  surgery  is 
the  Spanish-Arabian  physician, 

Chalaf  ben  Abbas  Abul  Casim  el-Zahrewi  (Abulcasem.  Alzaha- 
ravius,  Albucasis)  of  Elzahra  (Zahera)  near  Cordova  (936-1013). 
His  medico-surgical  text-book,  entitled  "  Altasrif"  (Compendium),  much  of  which, 
like  the  works  of  many  of  the  Arabians,  is  simply  copied  from  the  Greeks  (Paul  of 
Aegina  and  others),  had  until  a  late  period  almost  undisputed  sway.  Tbis  is  especi- 
ally true  of  the  tenth  chapter  on  surgery.  The  indications  for  the  actual  cautery 
form  the  longest  section  of  the  work.  This  may  be  considered  the  Arabian  national 
instrument,  though  it  was  also  used  almost  exclusively  by  the  later  Greeks,  who 
shrunk  from  the  knife.  It  was  recommended  in  numerous  diseases,  from  feebleness 
of  memory  to  spontaneous  luxations  and  hernia,  as  well  as  for  the  staying  of  arterial 
haemorrhage,  when  complete  division  of  the  vessel  and  styptics  failed.  'J  he  form  of 
the  instruments  varied  with  the  locality  and  object  of  the  operation.  His  treatise  on. 
operations  includes  very  numerous  procedures,  as  ligation  of  arteries  in  their  contin- 
uity, amputation  amputations  above  the  knee  and  elbow  he  was  probably  the  first  to- 
interdict  as  too  dangerous  —  Wernher) ;  suture  of  the  intestine  with  threads  scraped 
from  the  intestinal  coat;  the  operations  for  hare-lip,  ranula,  exsection  of  necrosed 
bone,  cutting  of  fistula  (also  the  use  of  the  ligature  and  the  cautery),  operations  for 
goitre  and  aneurism,  ligation  of  staphyloma,  operation  for  cataract,  puncture  of  the 
cornea,  different  forms  of  suture,  lithotripsy  (by  implication),  use  of  the  silver  cathe- 
ter (instead  of  the  copper  ones  used  heretofore)  exploring  trocar,  artificial  teeth  of 
beef-bone  etc.  Lithotomy  in  women  should  be  performed  by  midwives  under  the 
direction  of  the  physician,  as  follows: 

"The  finger  should  be  introduced  into  the  rectum  of  virgins,  into  the  vagina  of 
married  women;  then  an  incision  should  be  made,  in  virgins  to  the  left  and  below 
into  the  labium,  in  married  women  between  the  urethra  and  cs  pubis,  so  that  in  both 
cases  the  wound  is  oblique.'' 

He  performs  venesection,  after  the  manner  of  the  Arabians,  upon  the  sound  side, 
and  recommends  the  employment  of  the  same  with  the  view  of  prophylaxis,  an  idea 
from  which  subsequently  originated  a  pernicious  custom.    (Stahl.) 

Besides  the  surgical  diseases  already  noticed  from  his  treatise  on  operations,  he 
recognizes  a  gangrenous  epidemic  erysipelas,  warty  excrescences,  fractures  (which, 
after  the  manner  of  his  aye,  he  rectifies  by  means  of  machines — a  cruel  procedure 
of  which  reminiscences  still  exist  among  the  public)  ami  wounds.  His  operative 
midwifery  knows  nothing  outside  of  the  same  art  among  the  Greeks,  save  the  recog- 
nition of  an  abdominal  pregnancy  discharging  by  external  suppuration.  Plates  of 
instruments  adorn  the  work.  He  valued  anatomy  as  an  important  aid  in  the  practice 
of  surgery. 

In  his  pathology  he  recognizes  crusta  lactea,  and  the  results  of  the  use  of  mer- 
cury in  the  form  of  affections  of  the  mouth  and  salivation,  but  follows  in  the  main  the 
teachings  of  Rhazes. 

Abd  el  Malik  Abu  Merwan  ebn  Zoiir  (1113-1162,  1196?,  Abim- 
eron,  Avenzoar),  son  of  a  physician,  and  probably  a  Jew,  was  also  born  in 
Spain,  at  Pentaflor,  near  Seville.  He  died  honored  as  "  The  "Wise  and 
Illustrious",  titles  which  he  won  b}'  a  freedom  from  prejudice,  so  extensive 
that  he  ventured  to  contradict  even  Galen,  a  hazardous  undertaking, 
especially  for  an  Arabian,  at  that  period. 


232   

In  his  time  too  it  was  considered-  disgraceful  to  practise  operative  surgery. 
Nevertheless  he,  like  Albucasis,  practised  it  with  marked  distinction,  excepting,  how- 
ever, lithotomy,  which  was  also  considered  so  excessive]}-  disgraceful  among  the 
Greeks.  He  even  performed  experimental  operations  on  the  lower  animals,  and, 
indeed,  the  first  total  extirpation  of  the  uterus  is  ascribed  to  him,  though  his  opera- 
tion arose  from  confounding  the  uterus  with  an  accidental  abscess.  In  general,  how- 
ever, he  was  satisfied  with  plasters  etc.,  and,  indeed,  proposed  to  remove  stone  in  the 
bladder  by  the  internal  use  of  the  oil  of  dates,  and  exostoses  by  the  magnet. —  In 
physiology,  on  the  subject  of  the  relative  importance  of  organs,  he  calls  attention  to 
the  fact  that  no  organ  can  perform  its  functions  properly  without  the  aid  of  another 
(e.  g.  the  brain  or  lungs  without  the  liver),  and  that  one  cannot,  therefore,  distinguish 
any  one  organ  as  the  most  important.  Further,  in  opposition  to  Galen,  he  assigns 
sensibility  to  the  teeth  and  the  bones,  and  holds  that  the  continuance  of  life  depends 
upon  a  correct  crasis  of  the  humors.  In  a?tiological  matters  he  lays  stress  upon  the 
deleterious  qualities  of  the  air  of  swamps.  His  special  pathology  mentions  pericarditis 
and  pericardial  exudation,  consumption  from  abscess  of  the  stomach,  mediastinitis, 
growths  in  the  stomach,  salivary  concretions  under  the  tongue,  quinsy  from  paralysis 
of  the  pharyngeal  muscles  etc.  Therapeutically  he  recommends  in  inflammations 
venesection  always  on  the  sound  side,  the  milk  cure  in  consumption,  considers  — 
again  in  opposition  to  Galen  —  amaurosis  curable  etc.  It  is  important  to  observe 
also  the  fact  that  his  book  "Tai'sir",  in  which  he  records  the  foregoing  results  of  his 
experience,  avoids  all  subtilties,  and  lays  down  experience  as  the  sole  guide  of  the 
physician. 

A  pupil  of  Avenzoar  was 

Abul  Welid  Muhammed  ben  Ahmed  ebn  Roschd  (Averroes)  of 
Cordova,  the  Mohammedan  "Spinoza"  (Sepp),  a  man  who  exercised  the 
greatest  influence  upon  his  own  time  and  succeeding  ages.  He  was  a 
religious  free-thinker,  who,  hiding  himself  behind  the  precepts  of  philoso- 
phy, awakened  doubts  as  to  the  creed  of  the  church,  and  the  church 
accordingly  hated  him  bitterly.  He  died  at  a  good  old  age,  in  Morocco  in 
the  year  1198,  after  having  suffered  bitter  persecution  at  the  hands  of  his 
fellow-believers,  in  consequence  of  the  pantheistic  views  awakened  in  him 
by  the  stud}'  of  Aristotle,  whose  trustiest  follower  he  was  among  all  the 
Arabians.  He  was  chief!}'  a  philosopher,  like  almost  all  the  Arabian 
ph}'sicians,  but,  b}'  reason  of  his  opposition  to  Galen,  and  of  a  few  peculiar 
views  preserved  in  his  "  Collijat"  (Compendium),  he  deserves  also  a  place 
in  medicine. 

With  Aristotle  (whom,  as  we  know,  the  Nestorians  had  made  accessible  to  the 
Arabians),  he  claimed  sensibility  for  the  heart,  while  in  other  respects  he  held  it 
merely  the  place  of  origin  of  the  arteries.  He  considered  the  ethereal  principle 
inherent  in  the  semen  the  onl}-  essential  agent  in  generation,  and  declared  the  possi- 
bility, by  means  of  this,  that  a  woman  might  be  impregnated  in  a  bath,  in  which  a 
short  time  before  a  man  had  had  a  seminal  emission.  He  was  prompted  to  the  adop- 
tion of  this  opinion  by  the  oath  of  a  cunning  wife,  who  had,  at  all  events,  got  in  a  bad 
condition  w-ithout  the  aid  of  her  husband.  The  sense  of  sight  he  sought  in  the  lens 
of  the  eye.  The  small-pox,  according  to  his  teaching,  never  befalls  the  same  indi- 
vidual more  than  once.  In  therapeutics  he  rejects  the  employment  of  mathematical 
formulas  in  the  compounding  of  remedies,  and  holds,  instead,  that  the  duty  of  the 
physician  consists  chiefly  in  the  application  of  general  principles  to  special  cases. 


—   233  — 

The  distinguished  Jewish-Arabian  theologian,  philosopher,  mathema- 
tician, astronomer,  jeweler  and  physician,  Abu  Amran  Musa  ben  Meiinun 
el  Cordobi  (Rabbi  Moses  ben  Maimon,  Maimonides,  Rambam),  during  the 
persecutions  which  Averroes  had  to  endure,  even  at  the  hands  of  his  earlier 
patron  Al  Mansur  Yacub  (died  1198),  king  of  Morocco  and  Spain,  showed 
himself  a  generous  pupil  of  that  savant  by  supporting  him  and  obtaining 
for  him  a  refuge  among  the  Jews.  Maimonides  was  born  at  Cordova  (1135 
or  1139),  and  died  ordinary  physician  to  the  sultan  Saladin  in  Egypt 
A.  D.  1204  or  1208. x 

He  composed  so-called  "Aphorisms",  in  ihe  style  of  Hippocrates  and  Galen 
(whom  he  carefully  followed),  wrote  on  dietetics,  haemorrhoids,  the  causes  and 
symptoms  of  disease,  and  furnished  an  improved  method  of  circumcision.  As 
examples  of  his  dietetic  prescriptions  we  may  quote  the  following:  "Honey  and 
wine  are  injurious  for  children,  but  beneficial  for  the  old,  particularly  in  winter.  In 
summer  a  third  less  quantity  should  be  taken."  "  During  sleep  one  should  neither 
lie  upon  the  face  nor  the  back,  but  only  on  the  side;  during  the  early  part  of  the 
night  upon  the  left  side,  towards  its  close  upon  the  right.  One  should  not  yield  to 
sleep  until  3-4  hours  after  supper,  and  should  not  sleep  in  the  day-time."  "  Coitus  is 
not  fruitful  when  one  is  surfeited  or  hungry,  but  only  when  digestion  is  completed. 
Nor  is  it  successful  in  the  sitting  posture  or  standing"  (Oppler.)  All  of  this  is  char- 
acteristic of  the  Arabico-Jewish  fashion  with  its  subtle  refinements! 

About  the  same  period  lived 

Abd  el  Letif  ben  Jussup  ben  Muhammed  (1162-1231),  a  native  of 
Bagdad. 

He  studied  medicine  in  his  native  city  and  is  famous  for  his  description  of  his 
travels  undertaken  for  the  sake  of  studying  the  natural  sciences.  He  composed  166 
treatises  relating  to  philosophy,  medicine,  history  and  philology  —  an  exquisite 
example  of  the  erudition  and  fertility  of  the  Arabians.  His  "Improved  Anatomy  " 
is  no  longer  extant  This  work  contained,  as  the  sole  Arabian  contribution  to 
anatomy,  the  statement  that  the  lower  jaw  (and  the  os  sacrum  usually)  consisted  of  a 
single  bone  only. 

Equall}*  famous  as  a  scientific  traveller  and  learned  botanist  is  Abd, 
Allah  ben  Ahmed  ebn  el  Beithar  (Ebn  Beitar),  who  was  "Teacher  of 
Medicine  "  and  vizier  at  Cahirah  and  died  in  Damascus  in  1248. 

His  work  on  "Simple  Medicines"  is  founded  upon  the  writings  of  Galen, 
Dioscorides  etc.,  together  with  his  own  observations.  The  latter  enabled  him  to 
correct  some  mistakes  of  Dioscorides,  whom  in  the  main,  however,  he  follows.  His 
knowledge  of  plants  surpassed  considerably  that  of  Theophrastus  and  Dioscorides 
(about  200). 

The  most  famous  medical  historian  among  the  Arabians  was 
Abul  Abbas  ebn  Abu  Oseibia  Muwaffik  ed  Din  (Oseibia,  1203- 
1273)  of  Damascus, 

who,  however,  wrote  also  on  medical  subjects  and  mentions  e.  g.  the  chorda  venerea, 
which  he  cures  by  laying  the  penis  upon  a  stone  support  and  striking  it  violently 
with  the  fist.  His  "Biography  of  Distinguished  Physicians"  treats  of  Arabian. 
Persian,  Indian,  Egyptian,  Christian  and  other  medical  men. 

1.    The  precise  dates  of  many  of  these  Arabian  physicians  vary  according  to  different 
authorities.     (H.) 


—  234  — 

( )f  less  reputation  than  the  foregoing  physicians  were  : 

Ebn  Badschdsch  (Avempas,  Aven  Pas,  died  1138),  who  was  poisoned 
by  his  ••  Colleagues  "; 

Abraham  ben  Meir  (Avernezel,  1093-1168)  of  Toledo,  who  died  in 
Rome  ; 

Abul  Hassan  el  Mtjktar  ebn  Botlan  or  Eluchasem  Elimithar 
(died  1 052) ; 

Hossein  el  Tsterabadi  (about  1155): 

Ebn  Dschemi  Hibetallaii  1 12th  century;,  a  Jew.  his  pupil  ; 

Ebn  el  Ainzarbi  (died  1153); 

Ebn  Dschemi  ; 

Ali  Rodwan  (died  1061  or  1068); 

Mechitar  (about  1150),  an  Armenian  ; 

Fakr-ed-Din  el  Razi  (1140-1210).  a  philosopher  and  physician  ; 

The  gynaecologists  ; 

Abd  er  Rahman  (about  1 160),  a  physician  of  Haleb,  author  of  an 
"  Exposition  of  the  Mysteries  of  Women  "; 

Ebn  Hobal  Muhaddib  ed  Din  of  Bagdad  (1117-1203); 

GlJAT  EL  G-eith  (about  1335),  "On  general  medicine"; 

Ahmed  ben  Jusuf  el  Jafedi  (about  1341),  author  of  a  medical 
compendium  : 

Nefis  ben  Audh,  a  physician  of  Samarcand  (about  1424); 

Dawud  el  Antaki  i.  e.  "the  Blind"  of  Misr,1  (died  at  Mecca  1596); 

The  oculists  : 

Ali  ben  Isa  (11th  century)  el  Kahal,  i.  e.  the  oculist,  wrote  a  treatise 
entitled  Tedhkireth  el  Kahalin,  or  '•  Admonition  to  Oculists  "; 

Abul  Kasem  Omar  ben  Ali  el  Musly  of  Mosul  (11  century)  wrote 
a  ••  Manthekel  "  or  "  Epitome  of  Ophthalmology  "; 

Kotb-ed-Din  el  Schirazi  (1236-1311)  of  Shiraz,  at  once  an  astrono- 
mer, philosopher  and  physician  ; 

Ebn  el  Nefis  (Annafis,  died  1288  or  1296,  aged  nearly  80),  a  famous 
jurist  and  juristic  author  of  Damascus  ;  the  Armenian 

Alcanami  sali  (about  1258),  probably  identical  with  Abulkasem  Omar 

1.  In  the  Oriental  universities  (medrese;  professor  =  muderris ;  study  =  dsirs ; 
student,  especially  of  theology,  =  softa)  there  are  many  blind  students  even  at 
the  present  day.  (These,  however,  are  usually  destined  to  be  mueddins  (who 
announce  the  hours  of  prayer).  In  1875  the  university  Azhar  had  321  professors 
and  10, 7S0  students  from  all  the  countries  of  the  East.  They  are  divided  into 
special  riwaks.  corresponding  to  the  mediaeval  "  Bursa.'",  and  the  latter  owe  their 
origin,  doubtless,  to  the  Arabian  models.  The  most  populous  riwak  was  the 
Egyptian;  that  of  the  Syrians  numbered  250  students;  of  the  Turks  60;  of 
Bagdad  '.)  students  etc.  The  proportions  are  the  same  as  in  the  golden  a>:e  of 
Arabian  learning.    (Kleinpaul.)    (Baas). 

The  mosque  el  Azhar  at  Cairo  was  built  by  the  vizier  of  the  Fatimite  caliph 
Moez-ledinillah  in  972.  In  connection  with  it  was  established  a  school  which 
speedily  grow  into  a  Mussulman  university.      (  H. ) 


—  235  — 

ben  Ali,  a  philosopher  and  physician  of  Bagdad,  who  collected  everj'thing 
written  on  Ophthalmology  by  the  Chaldeeans,  Indians,  Jews  and  Arabians. 
However  the  Arabians  produced  nothing  new  in  ophthalmology,  although 
it  was  a  department  in  which  they  frequently  labored. 

Abu  Bekr  ben  el  Bedr,  (died  1290)  an  equerry  by  profession  ;  and 
Muhammed  ben  Jakub  el  Cheili. 

In  the  pharmacies,  first  introduced,  as  noticed  above,  by  the  Arabians 
(the  first  public  pharmacy  was  erected  by  Al  Mansur  in  the  year  745),  the 
students  —  those  of  medicine  as  well  —  learned  pharmaceutical  preparations 
and  manipulations,  according  to  the  Arabian  pharmacopoeias  and  dispen- 
satories (Krabadin,  Grabadin),  under  the  direction  of  teachers  and  masters. 
These  works  contained  a  list  of  the  drugs  to  be  kept  in  store,  and  directions 
for  the  preparation  and  preservation  of  medicines.  The  state,  however, 
watched  to  see  that  the  proper  medicines  were  always  kept  plentifully  on 
hand,  and  were  not  sold  at  too  high  a  price  —  arrangements  which,  as  we 
know,  exist  even  to-day  and  with  the  very  best  results. 

We  will,  therefore,  in  this  place  add  the  names  of  those  authors,  who 
rendered  special  service  in  the  department  of  pharmaceutical  science, 
whose  practical  work  in  pharmaceutics  and  the  institutions  subservient  to 
that  art  has  rendered  them  meritorious,  and  who  have,  therefore,  without 
doubt,  mediately  or  immediately,  great!}-  advanced  practical  medicine  also. 

The  most  famous  of  these  names  is  that  of  a  certain  Geber,  concerning 
whose  life  and  circumstances,  in  spite  of  his  fame,  reports  differ  very 
widely.  Sometimes  e.  g.  he  passes  for  a  native  Greek,  apostatized  to 
Islamism,  sometimes  for  an  Arabian  of  Haran  in  Mesopotamia,  whose 
proper  name  was  Abu  Musa  Jafer  el  Sufi,  and  again  even  two  different 
persons  are  included  under  the  one  name,  viz  :  Jafer  el  Sadik  and  his  pupil 
Jafer  el  Tarsufi  (699-765). 

Under  his  name  are  still  extant  some  chemical  treatises  (one  under  the  title 
" Alchemia"),  in  which  are  described  the  preparation  of  lapis  infernalis,  sublimate, 
burnt  alum,  milk  of  sulphur,  artificial  cinnabar  etc.  Unfortunately,  however,  he 
defends  that  idea  which  has  caused  so  much  mischief  in  the  minds  and  life  of  many 
of  mankind,  viz.  that  by  certain  methods  the  baser  metals  may  be  converted  into  the 
nobler,  and  that  the  latter  (since  the  baser  ingredients  of  the  metal  have  been  re- 
moved) possess  also  the  faculty  of  removing  the  uncleanness,  that  is  the  diseases,  of 
the  body.  He  also  forwarded  alchemistic  delusions  by  the  assumption  that  sulphur 
and  mercury  were  the  basis  of  all  the  metals.  The  theory  of  the  transmutation  of 
metals  depended  upon  correct,  but  falsely  interpreted,  observations.  "By  expulsion 
of  sulphur,  galena  —  everything  which  possessed  lustre  was  a  metal  —  was  changed 
into  lead.  From  the  lead  by  further  treatment  with  fire  we  get  (by  reduction)  a 
certain  quantity  of  silver  and  from  the  silver  we  separate  gold.  Alchemy  regarded 
these  separations  as  productions,  and  the  lead,  silver  and  gold  as  products  of  its 
manipulations."  "Gold  by  heating  with  sal  ammoniac  took  on  a  red  color.  What 
was  more  natural  then  to  the  inexperienced  mind  than  to  believe  that  the  properties 
of  the  metals  depended  upon  certain  constituents,  and  that  by  the  abstraction  or 
addition  of  certain  substances  the  properties  of  silver  and  gold  might  be  attained  ?  The 
imperfect  tincture  produced  the  color,  a  more  perfect  tincture  might  give  the  lacking 


—  236  — 

qualities."  (Liebig.)  The  first  phase  of  chemistry  too  was  chiefly  synthetic,  and  it 
was  not  until  the  17th  century  that  this  science  entered  upon  the  analytic  method. 
In  fact  all  the  natural  sciences  (including  medicine)  in  their  early  grades  0f  devel- 
opment pursue  chiefly  the  synthetic  route.  To-day  the  synthetic  method,  as  we  know, 
is  revived  in  chemistry,  but  only  on  the  basis  of  preceding  analysis. 

Among  other  authors  of  pharmaceutical  treatises 

Sabur  ebn  Sahel,  (died  864),  president  of  the  school  at  Jondisabur, 
published  the  first  "  Grabadin  "x  in  the  middle  of  the  9th  century  ; 

Abul  Solt  Omaja  (1068-1134)  wrote  "On  Simple  Medicines '',  a 
text-book  of  anatomy  etc. ; 

The  Christian  physician 

Amin  ed  Daula  ebn  el  Talmid  (1070-1164)  left  us  an  "  Antidot- 
arium  "; 

Abu  Jafer  el  Gafiki  (died  1075)  also  wrote  "On  Simple  Remedies  "; 

Nedschib  ed-din  el  Samarkandi  (died  1222)  composed  an  "Alphabetic 
Catalogue  of  Medicines  ",  a  treatise  "  On  Cordials  "  etc.,  "  On  the  Symptoms 
and  Causes  of  Disease  ";  and 

Ebn  el  Kotbi  (about  1311),  a  physician  of  Bagdad,  was  the  author 
•of  a  treatise  entitled  "  What  the  Physician  should  know  ". 

In  1236  Cordova  fell  before  Ferdinand  III.,  the  Saint  (1139-1252), 
of  Castile  ;  in  1258  Bagdad  succumbed  to  the  Tartars,  and  with  these 
two  chief  seats  of  Arabian  science,  that  science  itself  was  overthrown. 
Only  the  extermination  of  the  industrious,  high-bred,  but  over  refined  and 
effeminate,  Moors  of  Spain  (1492),  practised  under  the  veil  of  the  doctrines 
of  Christ,  and  by  the  "  Most  Catholic  "  Ferdinand  the  Catholic  (1452-1516), 
was  needed  to  remove  the  Arabian  people  entirely  out  of  the  rank  of 
the  nations  advancing  in  civilization.  It  must  be  remembered  too  that  the 
Arabians,  even  in  the  meridian  of  their  power,  planted  Iry  their  wantonness 
the  germ  of  their  own  decline  and  overthrow.  As  conquerors,  through 
their  luxury,  immorality  (harems,  paederasty)  and  intermixture  with  the 
subjugated  peoples  etc.,  they  rather  plundered  than  utilized  the  wealth  upon 
which  they  seized.  All  these  are,  doubtless,  vices  which  accornpaivy  the  acme 
■of  scientific  and  artistic  cultivation  among  other  nations,  and— the  statement 
is  as  sad  as  true — occasion  and  accelerate  its  transfer  to  different  hands. 

Arabian  medicine,  entirely  independent  of  its  introduction  into  nos- 
ology of  a  few  new  and  important  diseases,  rendered  itself  of  essential 
service  to  general  medicine  in  the  following  directions  : 

1.  It  cultivated  the  stud}'  of  the  Greeks  and  made  them  accessible  to 
the  West  (though  in  a  corrupted  form),  until,  through  the  revival  of  learn- 
ing, the  Greek  writers  could  be  once  more  studied  in  the  original.  This 
transfer  of  Greek  science,  including  medicine,  to  the  West  was  accomplished 
through  Italy  and  Spain,  and  even  as  early  as  the  age  of  Charlemagne, 
though   it  became  more  marked  in  the  following  centuries.     By  it  the 

1.   This  work  continued  in  general  use  amonjr  the  Arabians  until  superseded  bj'  the 
"  Antidotarium"  of  Amin  ed-Daula  ebn  el-Talmid  about  1125.     (H.) 


—  237  — 

Arabians  acquired  very  high  importance  in  the  intellectual  development  of 
the  West,  and  particularly  in  its  medical  culture.  Hence  the  popular  scorn 
of  the  Arabians,  manifested  by  those  who  proclaim  only  "  new  facts  as 
acquisitions  "  in  medicine,  seems  entirely  out  of  place. 

Indirectly  Arabian  civilization  and  culture  was  of  further  advantage 
in  that  it  awakened,  by  its  own  too  servile  imitation,  an  opposition  against 
its  teachers,  and  even  against  itself. 

2.  It  introduced  a  great  number  of  new  and  active  remedies  from  the 
vegetable  kingdom,  and  especially  from  the  department  of  chemistry  (a 
science  which  it  fairly  created),  and  brought  to  life  the  pharmacies,  as  an 
advance  in  practice. 

3.  It  contributed  directly  to  the  reform  of  practical  medicine  by  the 
exhibition  of  chemical1  remedies  :  indirectly  by  the  union  of  the  natural 
sciences  with  medicine,  which  (on  the  advice  of  Aristotle,  indeed)  had  its 
origin  with  them. 

4.  It  first  entered  upon  the  clinical  method  of  instruction,  though  it 
reaped  for  itself  very  little  advantage  therefrom. 

5.  It  preserved  a  lay  medicine  at  a  time  when,  as  in  the  West,  priests 
and  monks  only,  in  Christian  ignorance,  treated  the  sick  with  supernatural 
and  superstitious  remedies  —  a  period  which,  without  the  Arabians,  would 
have  lasted  at  least  longer  than  it  actually  did. 

Such  are  the  services  which  secure  to  the  Arabians,  for  all  time,  an 
honorable  position  in  the  histor}'  of  medical  culture.  The  Arabians,  how- 
ever, did  not  fade  from  the. ranks  of  the  great  cultured  nations  until,  after 
a  relatively  short  period  of  bloom,  the}'  became  historically  senescent,  and 
when  other  and  more  powerful  races  (in  conjunction  with  whom  they  had 
themselves  labored  in  part)  were  able  to  assume  the  burden  of  further 
development,  even  in  medicine.  Histoiy  teaches  also  the  teleology  of 
national  life,  and  in  this  case,  as  with  the  Greeks  and  Romans,  we  are  able 
to  determine  the  existence  of  that  law  of  development,  in  accordance  with 
which  nations,  after  attaining  the  meridian  of  their  intellectual  and  social 

1.  The  Arabians  were  extremely  well  versed  in  chemistry  and  technology.  They 
were  acquainted  e.  g.  with  the  use  of  powder  and  of  artillery  before  the  West. 
Even  as  early  as  the  11th  century  it  is  said  of  them  that  "  The  ship  of  the  king 
of  Tunis  carried  with  it  a  number  of  iron  tubes,  from  which  was  thrown  much 
thundering:  fire"  (Pedro  de  Leon's  chronicle  of  Alfonso  VI).  They  derived  from 
China  a  knowledge  of  paper,  and  as  earl}'  as  650  made  silk  paper  for  themselves 
in  Samarcand,  and  cotton  paper  in  Mecca  in  706.  The  latter  was  introduced  into 
Spain  in  the  12th  century.  (In  Egypt  papyrus  was  still  employed  in  the  begin- 
ning of  the  9th  century,  although  other  paper  was  known.  A  piece  two  metres 
long  and  80  centimetres  broad  cost  about  68  cents.)  At  the  same  period,  and 
about  500  years  before  the  West,  they  also  made  woodcuts  for  the  ornamentation 
of  paper  MS.  (Linen  or  rag  paper  is  not  mentioned  in  the  West  before  about 
1400.)  The  Arabians  also  received  from  China  the  compass,  which  they  im- 
proved and  employed  as  early  as  the  12th  century  on  sea  voyages  and  journeys 
across  the  deserts.  They  are  said  too  to  have  constructed  the  pendulum  clock 
as  early  as  about  1300. 


—  238  — 

culture,  decay  physically  and  mentally  —  a  law  whose  inexorabilit}- we  may 
humanly  deplore,  but  whose  grandeur  in  sustaining  the  active  course  of 
history  must  fill  us  with  astonishment.  From  the  grounds  of- the  past  and 
fertilized  by  the  good  remains  of  decaying  culture,  new  and  fruitful  races 
must  be  transplanted  and  cultivated.  Ancient  civilizations  never  pass 
away  until  the  germs  of  the  new  are  already  planted  so  widely,  and  are 
become  so  vigorous,  that  they  can  continue  to  grow  independently.  So  in 
early  antiquity  Egyptians  and  Assyro-Babylonians,  at  a  later  period  Greeks 
and  Romans,  withdrew  from  the  scene.  After  them  came  the  Arabians, 
and  when  these  had  disappeared,  new  races  began  at  once  to  assume  their 
role.  Lack  of  progress  and  activity  in  any  people  furnishes  the  cue  for 
the  development  of  power  in  another.  Such  is  the  law  for  the  conservation 
of  foi'ce,  even  in  the  life  of  the  human  race  ! 

EPIDEMICS  OF  THE  BYZANTINE  AND  ARABIAN  EPOCHS  OF  MEDICINE^ 
The  medical  culture  of  the  Byzantine  empire  and  of  the  Arabians, 
discussed  in  the  preceding  pages,  has  vanished,  as  such,  from  the  stage  of 
history.  The  same  fate  has  likewise  befallen  a  form  of  disease  distin- 
guished as  "The  Plague  of  the  Ancients".  The  case,  however,  is  different 
with  respect  to  the  epidemic  diseases  of  the  skin,  first  introduced  into 
nosology  by  the  Arabians,  and  which  have  impressed  upon  their  medicine 
a  stamp  so  definite  that,  independent  of  this  connexion  the}-  could  not  be 
suitably  treated  historically.  Here,  therefore,  is  the  most  suitable  place  (in 
the  completion  of  the  picture  of  these  two  forms  of  civilization)  to  consider 
the  epidemics  and  the  new  epidemic  diseases,  which  either  actually  occurred 
within  their  period,  or  were  first  described  by  representatives  of  that  period. 
The  Middle  Ages  was  the  period  for  the  forcible  remodelling  of 
humanity  in  both  a  spiritual  and  corporeal  view.  In  the  latter  direction 
the  causes  already  partially  considered  in  the  preceding  pages  were  active, 
and,  in  addition  thereto,  especiall}'  the  numerous  and  frightfully  murderous 
epidemics ;  so  that,  from  a  medical  standpoint,  we  might  name  this  period 
the  age  of  epidemic  diseases.  The  beginning  and  the  end  of  this  period 
were  particularly  ravaged  by  them.  None  can,  therefore,  wonder  that  the 
Middle  Ages  left  to  succeeding  times  only  one-half  the  population  which 
they  had  themselves  received  at  their  beginning  ! 

One  of  the  most  frightful  visitations,  which,  in  the  form  of  disease, 
have  ever  befallen  mankind,  bears  in  history  the  name  of  The  Plague  of 
Justinian,  since  it  raged  throughout  almost  the  whole  reign  of  that 
emperor  (527-565).  But  it  also  continued  beyond  this  period,  prevailing 
nearby  70  complete  years  (from  about  531  to  about  600),  touching  in  its 
devastating  march  the  whole  of  the  then  known  world,  and  not  sparing- 
even  the  most  remote  barbarians,  the  Persians  and  the  Germans. 

As  is  the  case  with  all  epidemics  of  ancient  times,  many  forerunners  and  attend- 
ants of  the  Justinian  plague  are  mentioned.  Their  connexion  with  these  epidemics 
is,  however,  partially  inexplicable  (though  the  credulity  of  mankind  knows  readily 
how  to  explain  it),  e.  g.  that  of  comets,  earthquakes,  eclipses  of  the  sun;  in  part  they 


—  239  — 

stand  in  reciprocal  relations  as  cause  or  effect,  like  drought,  famine  etc.  Thus  there 
occurred  before  the  plague  of  which  we  are  speaking  an  earthquake,  which  in  a  few 
moments  destroyed  the  greater  part  of  the  populous  city  of  Antioch,  and,  from  the 
resulting  conflagration,  laid  the  rest  in  ashes,  so  that  25,000  persons  were  buried  in 
the  ruins  and  the  flames.  Then  comets  of  wonderful,  and,  to  the  superstitious,  of 
frightful,  form,  appeared,  and  throughout  a  whole  year  there  was  a  remarkable 
darkening  of  the  sun,  which  is  ascribed  to  the  numerous  volcanic  outbreaks  of  the 
same  period. 

From  the  year  538,  however,  there  raged  for  a  year  or  more  a  general  famine, 
which  in  Italy  alone  brought  to  a  miserable  end  an  innumerable  host  of  men — among 
the  Piceni  alone  50.000  peasants  perished.  Marks  of  various,  but  always  remarkable, 
colors,  appeared  likewise  upon  houses,  stones,  clothing  and  even  food, —  everything, 
and  their  significance  was  magnified  by  Christian  superstition,  then  in  the  bloom  of 
youth,  into  all  that  is  frightful  and  terrible. 

With  such  harbingers  and  attendants,  and  after  a  destructive  conflagration  which 
hail  reduced  to  ashes  the  great  hospital  in  that  city,  there  appeared  in  Constantinople 
in  the  year  5151  a  form  of  death  (if  I  may  use  that  expression),  which  was  originally 
only  local.  The  general  plague,  however,  originated  in  the  year  542  in  lower  Egypt. 
Thence  it  spread  its  devastation  up  the  Nile  and  away  from  that  stream  into  Asia 
Minor,  at  first  confining  itself  to  the  coast,  but  gradually  bearing  into  the  interior  of 
the  continents  similar  devastation  and  equal  misery.  Constantinople  was  speedily 
attacked,  and  (according  to  the  almost  incredible  accounts)  in  the  time  of  its  greatest 
severity  5,000-10,000  human  beings  perished  there  daily.  In  the  next  year,  however, 
the  plague  striding  over  Greece  to  the  West  reached  Italy.  In  545  it  extended  into 
Gaul,  and  in  540  reached  the  Rhine,  whose  bordering  cities  (at  that  time  in  the  bloom 
of  prosperity ),  from  Bingen  over  Mayence,  the  metropolis,  to  Schlettstadt,  it  depopu- 
lated with  its  ravages.  After  this  first  ''period"  of  fifteen  years  (which  it  is  said  to 
have  afterwards  also  uniformly  maintained),  the  disease  became  milder,  though  it  did 
not  entirely  disappear,  until  in  558  it  visited  Constantinople  for  the  second  time,  with 
horrors  onlj-  heightened  by  comparison  with  its  first  assault.  So  fiercely  did  it  rage 
that  the  towers  upon  the  walls  were  unroofed,  filled  to  the  brim  with  corpses,  and 
then  again  covered  in,  since  hands  were  wanting  to  assist  in  their  burial,  while  many 
of  those  who  lent  aid  in  this  horrible  labor  of  heaping  up  the  dead  fell  down  them- 
selves and  expired  in  the  midst  of  their  task.  Thus  new  causes  of  death  in  the  form 
of  the  horrible  gases  of  decomposition  were  stored  up,  as  it  were,  in  these  fearful 
store-houses.  In  other  cases  the  dead  were  treated  more  judiciously  and  hygienieally 
by  sinking  the  corpses  in  the  open  sea  with  the  aid  of  a  ship  specially  appointed  for 
that  purpose,  though  some  bodies  were  carried  by  the  waves  back  to  the  shore  — 
dreadful  tokens  of  warning  to  those  who  yet  survived. 

In  this  plague,  however,  the  general  imminence  of  death  broke  down  all  the 
barriers  of  custom  and  shame  to  such  a  degree  that  only  the  worst  of  mankind  seem 
to  have  survived.  In  the  j'ear  565  this  unprecedented  plague  visited  Italy  a  second 
time  so  severely  that  the  Romans  could  not  advance  against  their  enemies. 

For  long  years  this  plague  endured,  intermixed  at  the  close  with  the  small-pox, 
sweeping  away  in  its  devastating  course  the  bloom  of  manhood  and  youth,  and 
destrojnng  the  greater  part  of  women,  maidens  and  children  in  all  the  then  known 
world.  It  loosened  too  almost  all  the  rootlets  of  the  ancient  civilization,  so  that  the 
withered  stem  was  able  to  maintain  for  centuries  onlj'  a  feeble  and  sickly  existence. 

No  medical  author  has  left  us  a  description  of  the  phenomena  of  this  plague. 
The  profane  historians  report  upon  it  in  the  following  words  (vid.  Hasser): 

"Here,  however,  it  began  in  the  following  manner.  To  many  persons  appari- 
tions appeared  under  the  form  of  some  human  being  or  another.     Those,  however, 


—  240  — 

who  met  them  were  seized  by  the  disease,  while  they  believed  that  they  had  received 
a  blow  from  the  spectre.  In  the  beginning  many  sought  b}'  prayers  and  expiatory 
offerings  to  prevent  these  horrors,  but  in  vain;  for  even  in  the  temples  destruction 
overtook  them.  Others  shut  themselves  up  in  their  apartments,  but  then  there 
appeared  visions  in  a  dream,  or  they  heard  a  voice  which  called  to  them  that  they 
too  belonged  to  the  number  of  those  devoted  to  death.  Most  persons  were  attacked 
without  anything  of  the  kind  having  happened  to  them,  either  awake  or  asleep. 
Some  were  seized  with  fever,  others  had  none.  The  disease  in  some,  after  beginning 
in  the  head  and  occasioning  redness  of  the  eyes  and  swelling  of  the  face,  descended 
into  the  pharynx  and  carried  off  those  whom  it  had  seized.  In  others  a  diarrhoea 
existed;  in  others  still  buboes  broke  out,  followed  by  a  pernicious  fever.  Such 
patients,  however,  died  on  the  2d  or  3d  day.  Some  breathed  their  last  in  a  state  of 
unconsciousness.  Anthrakes  (phryctasnae  of  the  size  of  a  lentil)  also  broke  out  and 
proved  fatal  to  many." 

The  disease  seldom  visited  the  same  individual  a  second  time  (if  he  was  not 
killed  by  the  first  attack),  though  here  and  there  exceptions  occurred.  Sometimes  — 
in  fact  this  was  the  rule  —  the  disease  appeared  to  be  called  forth  by  epidemic  influ 
ences  only  ;  sometimes  it  seemed  also  a  contagious  affection,  against  which,  however, 
certain  ]  ersons  possessed  the  most  remarkable  immunity,  "so  that  they  might  almost 
wallow  with  the  sick  "  without  being  attacked.  Pregnant  women  were  exposed  to 
special  dangers.  If  the  buboes  suppurated,  recovery  ordinarily  followed.  Certain 
parts  of  a  city  often  remained  perfectly  exempt  from  the  disease,  and  in  the  affected 
portions  again  certain  houses  were  spared  in  a  remarkable  way,  while  others  beside 
them  were  utterly  depopulated. 

The  fact  that  buboes  showed  themselves  clearly  and  generally  for  the  first  time 
in  this  epidemic  proves  that  a  transformation  of  the  earlier  form  was  taking  place,  by 
which  the  disease  was  converted  into  the  more  modern  plague.  From  this  period 
also  the  names  "pestis  inguinaria  ",  "bubo-plague",  which  remain  to  us  to-day,  made 
their  appearance  for  the  first  time. 

About  the  same  time  that  the  bubo-plague,  just  described,  was  developed  from 
the  plague  of  the  Ancients,  and  was  winning  for  itself  a  place  among  the  permanent 
epidemics,  the  same  thing  occurred  also  with  regard  to  a  series  of  other  contagious 
diseases,  to  wit,  the  small-pox  and  the  measles  (scarlet  fever?) * 

Small-pox  was  most  probabl}-  known  at  a  verjr  early  period  to  the  Indians  and 
Chinese,  as  well  as  to  the  Greeks,  only  (it  would  seem  as  the  result  of  that  peculiarity 
of  the  medicine  of  the  Ancients — the  investigation  of  the  individual  disease,  rather  than 
forms  of  disease)  it  was  not  sufficiently  described  in  accordance  with  its  symptoms. 
The  latter  was  first  done  in  a  tolerably  satisfactor}-  manner  by  the  Arabian  writers 
who  report  on  the  siege  of  Mecca  by  the  Abyssinians,  about  the  year  570.  According 
to  the  latter,  the  small-pox  seems  to  have  been  introduced  among  the  Arabians  b}-  the 
Africans  —  small-pox  is  even  to-day  the  special  epidemic  disease  of  the  African  race 
and  the  African  continent.  (The  Koran  also  mentions  the  disease.)  The  same 
statement  is  true  of  the  measles.  At  exactly  the  same  period,  however,  and  singu- 
larly in  the  West  also,  there  was  observed  a  new  epidemic  disease,  distinguished  as 
pustulag,  pusulse  (Marius  of  Avenches  already  calls  it  variola2),  and  described  by  the 

1.  Diphtheria  was  also  mentioned  at  this  period,  and  prevailed   under  the  name 

"Equinancie"  at  St.  Denys  in  580. 

2.  According  to  Cnrschmann  the  term  "variola"  originally  included  any  disease  of 

the  skin  accompanied  by  the  formation  of  papules  and  pustules.  The  first  physi- 
cian who  used  the  term  specifically  for  small-pox  appears  to  have  been  Con- 
stantinus  Africanus  of  Salernum  about  1075.     (H.) 


—  241  — 

famous  chronicler  Gregory  of  Tours.  The  first  medical  description  of  tlie  two 
diseases,  however,  was  furnished  in  the  7th  century  bjT  the  Graeco-Arabic  author 
Ahrun.  The  first  distinct  division  into  two  separate  forms  of  disease  is  due  to  Rhazes, 
who  described  the  schedrij  (small-pox)  and  the  hasbah  (measles).  This  distinction 
was  again  obliterated,  however,  by  the  introduction  of  a  form  of  disease  styled  luimak 
(blaccia?  =  variola  vel  exanthemata  iis  similia). 

Moreover  the  Arabian  physicians  held  these  diseases  as  mere  varieties  of  one  and 
the  same  morbid  process,  the  beginning  of  which  they  placed  in  foetal  life.  They 
ascribed  this  process  to  general  anomalies  of  nutrition  acting  during  the  fcetal  period, 
and,  therefore,  also  declared  that  every  one,  as  a  rule,  must  undergo  these  diseases. 
They  pointed,  indeed,  to  the  fact  that,  during  the  period  when  the  woman  is  "  preg- 
nant", the  blood  of  the  monthly  "purification"  does  not  flow  (following  in  this  the 
Grecian  idea),  as  an  evidence  that  the  certainly  impure  materials  of  the  menses  were 
applied  to  the  nutrition  of  the  foetus.  Now  these  unclean  humors  must  be  iigain 
removed  from  the  body  ;  whence  it  results  that  every  one  is  "disposed"  (as  we  vaguely 
express  ourselves  to-day)  to  the  above-named  diseases,  but  is  also  attacked  by  ihem 
once  only. 

Of  the  symptoms  of  these  diseases  the  so-called  Arabian  phj-sicians  had  quite  a 
satisfactory  knowledge  —  they  were  acquainted  even  with  eruptions  in  the  internal 
organs  —  and  in  the  treatment  they  followed  more  judicious  principles  than  we  see 
always  pursued  even  at  the  present  day  ! 

Concerning  the  further  course  of  small-pox  and  measles  during  the  Middle  Ages 
our  knowledge  is  not  very  precise.  This  much,  however,  is  certain,  that  these 
diseases  —  and  the  "holy  fire" — from  the  sixth  century  onward  spread  more  and 
more  widely  over  Europe,  and  gained  great  diffusion  particularly  by  the  aid  of  the 
Crusades.  After  this  —  about  the  12th  and  13th  centuries  —  they  prevailed  epidemic- 
ally in  England,1  and  even  in  Iceland  (1241-42)  and  Greenland.  Indeed  these 
latter  countries  were  so  depopulated  by  them,  that  the  civilization,  which  they  pos- 
sessed at  that  time  in  a  high  degree,  perished  almost  entirely.2 

1.  Small-pox  is  said  to  have  first  appeared  in  England  in  1241,  and  to  have  n  ached 

Germany  via  the  Netherlands  in  1493.  The  disease  was  conveyed  from  Europe 
to  America  at  an  early  date,  and  appeared  first  in  Mexico  in  1527.  Thence  it 
spread  gradually  over  the  whole  continent.  According  to  Toner  it  prevailed 
among  the  Indians  of  New  England  as  earlj'  as  1618,  and  its  ravages  were  ielt  by 
the  white  settlers  of  this  section  in  1622  and  1638.     (H.) 

2.  It  is  worthy  of  remark  that  in  the  extreme  north  a  notable  medical  culture  pre- 

vailed during  the  Middle  Ages.  The  most  famous  northern  physician,  surgeon 
and  lithotomist,  Rafn  Sveinbjornsen  (died  1289),  according  to  the  detailed  account 
of  Ludw.  Faye  of  Christiania,  was  an  Icelander.  He  had  travelled  extensively 
in  France,  Italy  and  Spain,  and  had  also  visited  England,  but  died  in  Denmark. 
He  practised  the  bimanual  manipulation  of  Celsus  in  the  diagnosis  of  vesical 
calculus.  We  should  here  make  the  general  remark  that  in  the  three  northern 
kingdoms  civilization  had  attained  a  very  respectable  position,  even  during  the 
early  part  of  the  Middle  Ages.  Icelanders  in  877  discovered  Greenland,  and 
about  A.  D.  1000  also  discovered  the  coasts  of  North  America  and  practised 
barter  with  the  natives.  Even  several  centuries  earlier  the  Northlanders, 
Norwegians  and  Swedes,  carried  on  a  lively  trade  in  furs  and  amber  with  the 
Roman  and  Mohammedan  inhabitants  of  the  coasts  of  the  Mediterranean  as  far 
as  Byzantium.  Indeed  between  the  7th  and  13th  centuries  they  were  even  hired 
as  soldiers  by  the  Byzantine  emperors. 
16 


B.      MEDICINE   UNDER   THE   INFLUENCE   OF  CHRISTIANITY. 


I.     MEDICINE  UNDER  THE  DIRECTION  OF  CATHOLIC  IDEAS 
(THE  MEDICINE  OF  FAITH). 

1.    CONDITION  OF  PROFANE  SCIENCE  AND  PRACTICE  IN  THE  STATES  OF  THE  WEST 
DURING  TBE  FIRST  HALF  OF  THE  MIDDLE  AGES. 

Of  the  relations  of  medical  science,  and  the  conditions  of  practice  (so 
far  as  medicine  was  cultivated  and  practised  by  the  lait}-)  in  the  states 
which  arose  after  the  downfall  of  the  "Western  Empire,  we  know  very  little. 
Medical  works,  particularly  translations,  were,  indeed,  in  use,  but  we  have 
only  scanty  evidence  of  the  extent  of  this  branch  of  literature,  and  the 
information  which  we  can  draw  from  other  sources  is  also  exceedingly 
meager.  Hence  it  is  that  very  little  mention  is  made  at  this  period  of  a 
lay  medicine  and  of  lay  phj'sicians  —  in  contradistinction  to  clerical  or 
monkish  physicians ;  yet  quite  enough  to  establish  at  least  the  fact  that 
such  lay  physicians  were  never  entirely  wanting,  even  among  the  Germanic 
and  Frankish  nations.  They  must  have  existed,  though  in  a  condition  of 
deep  degradation  when  compared  with  their  earlier  position.  We  might 
infer  this  too  from  the  simple  fact,  that  in  the  later  days  of  the  Western 
Empire,  there  were  still  very  many  educational  institutions,1  as  well  as 
numerous  ph}Tsicians  of  pagan,  though  inferior  education,  whose  occupation 
could  not  have  terminated  at  once,  nor  passed  immediately  into  the  hands 
of  the   monks.      It  may   be  readily  imagined   from   the  rank  growth  of 

1.  In  the  4th  and  5th  centuries  famous  schools  existed  in  the  East  at  Constantinople, 
Berytus,  Cassarea,  Alexandria,  Laodicea,  Pergamus,  Antioch,  Athens  etc.;  in 
the  West  at  Rome  (Athenaeum),  Ravenna,  Marseilles,  Autun,  Bordeaux,  Treves, 
Toulouse,  Poitiers,  Lyons,  Narbonne,  Aries,  Vienne,  Besancon  etc.  These 
schools  were  mostly  under  the  direction  of  pagan  teachers,  and  their  curriculum 
comprised  philosoph}-,  medicine,  law,  literature,  grammar  and  astrology.  By 
the  close  of  the  Gth  century  most  of  these  secular  schools  had  disappeared,  to  be 
replaced  by  the  monastic  and  cathedral  schools.  The  earliest  monastic  school 
in  the  West  seems  to  have  been  that  of  Nismes,  founded  by  St.  Castorius,  bishop 
of  Asst,  A.  D.  422.  Others  soon  followed  at  Lerens,  Luxeuil,  Fontenelle,  Sithier, 
St.  Medard  etc.  Monasteries  were  first  founded  in  England  by  St.  Germain 
about  430,  and  a  monastic  school  was  established  by  him  at  Bangor-Iscoed  in 
north  Wales  a  few  years  later.  Iltutus,  one  of  St.  Germain's  companions,  also 
established  a  school  at  Llanyltad,  or  St.  Iltad's,  in  Glamorganshire,  about  the 
same  period.  Monastic  schools  were  also  founded  at  Iona  (565),  Lindisfarne 
(635),  Oxford  and  Cambridge  (about  670),  Peterborough  (670),  Whitby  (about 
675),  Jarrow  (678)  etc.  In  Ireland  monasteries  and  monastic  schools  were 
introduced  by  St.  Patrick  about  440.  Among  the  most  famous  monastic  schools 
of  Europe  were  those  of  Fulda,  Hirschau,  Corvey,  Prum,  Weissenburg,  St.  Gall, 
Reichenau  etc.     (H.) 

(242) 


—  243  — 

Christian  (amalgamated  with  pagan)  superstition,  as  it  manifested  itself 
even  during  the  closing  ages  of  Antiquity,  and  likewise  from  the  Christian 
scorn  for  science 1  and  the  deficiencies  of  profane  scientific  efforts  and 
impulses,  that  no  great  weight  was  an}'  longer  laid  upon  ordinary  medicine, 
especially  that  descended  from  the  Ancients.  There  still  survived,  how- 
ever, from  the  closing  da}*s  of  Antiquity  a  higher  class  of  schools  in  which 
medicine  was  taught,  as  e.  g.  at  Marseilles.  Lyons,  Autun,  Bordeaux, 
Toulouse,  Narbonne,  Aries  in  Gaul ;  at  Treves  on  the  borders  of  Germany  ; 
at  Aventicum  (Avenches)  in  Switzerland  ;  at  Rome,  and  subsequent^  at 
Ravenna.  At  these  schools,  which  were  attended  not  simply  by  youths 
desiring  to  obtain  an  education,  but  also  by  grown  men,  grammar,  rhetoric, 
philosophy,  jurisprudence  and  medicine  were  taught.  The  teachers  were 
appointed  by  the  cities  and  were  exempt  from  the  duty  of  quartering 
soldiers  and  other  public  burdens.  Some  of  their  salaries  were  very  high. 
Thus  Eumelus,  a  famous  teacher  at  Autun  (about  300),  had  a  salary  of 
$5500.  (Schlosser.)  Accordingly  Goths  and  Franks,  even  when  Rome 
had  sunk  to  the  position  of  a  little  city  with  not  more  than  500  inhabitants,2 
for  the  most  part  copied  both  the  public  and  private  regulations  of  the 
Romans.  The  two  peoples  were  also  connected  in  culture  and  traditions 
by  family  descent  and  family  alliances.  Hence  many  students  went  for 
their  general  education  to  Italy,  or  even  to  the  capital  of  the  Eastern 
Empire.  We  know  too  that  some  acquired  at  Constantinople  medical  skill 
and  information,  which  they  subsequently  employed  in  their  own  homes, 
and  that  translations  of  the  Greek  authors  (e.  g.  Hippocrates,  Galen, 
Alexander  of  Tralles  etc.)  into  Latin  were  made  after  the  downfall  of  the 
empire. 

Of  the  public  and  private  position  of  physicians  in  those  dark  ages  we 
know  more  than  of  the  condition  of  science  itself,  and  of  its  attributes. 

Those  persons  to  whom  the  legislatures  of  the  Ripuarian  and  Salic 
Franks,3  in  the  years  422  and  496,  assigned  the  duties  of  state  physicians, 
must  certainly  have  been  superior  physicians  of  lay  rank.     Among  these 

1.  The  Church  at  that  period  (and  it  does  the  same  to-day  !)  held  science  in  general 

as  the  seed  of  the  devil ! 

2.  Rome,  especially  under  the  first  emperors,  had  become,  as  we  know,  a  magnificent 

city.  It  began  to  suffer  in  repair  severely  during  its  occupation  by  Alaric  (410), 
and  again  under  the  Vandals  (455),  who  plundered  it  particularly  of  its  treasures 
in  metal,  though  they  still  left  more  than  3000  statues  in  bronze.  The  city,  how- 
ever, suffered  most  severely  at  the  hands  of  Totila  (546).  Thenceforth  it  remained 
impoverished  and  decaying,  so  that  from  the  8th  century  onward  the  most 
expensive  marble  fragments  were  burned  for  lime,  and  the  remnants  of  master- 
pieces in  architecture  and  sculpture  were  employed  in  the  construction  of  ordi- 
nary walls.  In  this  way  much  has  been  preserved  to  us.  It  was  not  until  the  loth 
and  14th  centuries  that  a  beginning  was  made  in  the  removal  of  the  rubbish, 
which  had  become  an  unendurable  nuisance. 

3.  The  Salic  Franks  were  those  living  on  the  Moselle,  the  Maas  and  the  Yssel.     The 

Ripuarian,  those  on  the  banks  of  the  Rhine.     (H.) 


—  244  — 

duties  e.  g.  were  the  determination  of  virginity  (certainly  not  done  by  the 
clergy,  who  could  not,  or  at  least  should  not  confessedly,  understand  such 
a  question  ! ).  arbitration  in  cases  of  bodily  injur}^,  poisoning  etc.  The 
history  of  juristic  science  also  gives  us  here  some  light  on  the  beginning  of 
state  medicine,  as  well  as  on  the  history  of  the  medical  profession  — 
subjects  upon  which  special  information  is  lacking  in  medical  works. 
Hence  these  legislative  enactments  are  of  considerable  importance  and 
value  in  the  consideration  of  our  present  subject.  Moreover  there  certainly 
existed  hospitals  under  lay  administration,  e.  g.  at  Lyons  in  542,1  and  at 
Merida  in  580.'2  Besides  this  there  were  also  physicians-in-ordinary  with 
the  ancient  title  of  "Archiater';  (a  title  undoubtedly  given  at  a  later  period 
to  clerical  physicians  also),  and  therefore  an  official  position  (modelled 
after  the  Romans),  definite  functions  and  an  honorable  office  for  them. 
Indeed  more  of  the  Roman  arrangements  and  institutions  were  handed 
down  to  the  Middle  Ages  than  we,  as  a  rule,  emphasize  in  our  histories. 
Thus  mention  is  made  of  a  Byzantine  physician  Anthimus,3  who  was 
physician  to  Theodoric  the  Great  about  the  close  of  the  5th  century,  and 
wrote  for  his  master  a  Latin  treatise  on  dietetics,  which  has  been  recentl}' 
discovered  ;4  of  a  certain  Mareleif,  "  The  first  among  the  physicians  of  the 
royal  court"  of  the  Prankish  king  Chilperic  (561-58-4);  of  the  archiater 
Peter,  "  who  sat  joking  with  Protadius,  majordomo,  at  the  table  in  the  tent 

1.  The  "Hotel-Dieu  "  of  Lyons  was  founded  in  542  by  Cbildebert  I.,  king  of  Paris 

(511-558),  and  his  queen  Ultrogothe.     (H.) 

2.  Merida,  the  Augusta,  Emerita  of  the  Romans,  is  situated  on  the  Guadiana  River  in 

Spain.  It  was  founded  by  Augustus  B.  C.  25  for  the  settlement  of  his  veteran 
troops  {emeriti),  and  subsequently  became  the  capital  of  Lusitania.  It  fell  into 
the  hands  of  the  Moors  A.  D.  713,  and  was  finally  attached  to  tbe  kingdom  of 
Castile  in  1228.  Many  remains  (circus,  theater,  baths  etc.)  of  the  Roman  period 
srill  exist  in  this  city.      (H.) 

?>.  This  is  an  example  of  a  visit  (probably  merely  temporary)  by  a  Byzantine  physi- 
cian to  the  West.  Together  with  the  concordant  fact  that  very  early  —  even  in 
the  7th  century  —  Greek  clergy  came  to  England  as  teachers  (even  of  medicine), 
it  makes  it  seem  probable  that  Byzantine  physicians  and  savants  ma}'  have 
visited  the  West  more  frequently  than  has  been  reported,  and  that  a  peaceful 
commerce  and  scientific  relations  prevailed  between  the  East  and  the  West. 
The  instance  of  the  royal  veterinary  physician  Theomnestus  is  a  proof  that 
eastern  veterinarians  also  existed  in  the  West.     (Baas.) 

Theodorus  of  Tarsus  was  sent  to  Oswy,  king  of  Northumberland,  by  the  Pope 
A.  I).  668,  and  rendered  efficient  service  in  the  organization  of  the  Church  of 
England.  He  was  Archbishop  of  Canterbury  A.  D.  668-693,  and  a  warm  friend 
of  all  the  sciences.  Theomnestus  was  the  veterinary  physician  of  Theodoric  the 
Great,  king  of  the  Ostrogoths,  and  accompanied  the  army  of  the  latter  into  Italy 
in  488.    Some  fragments  of  his  writings  are  preserved  in  the  "  Hippiatrica".    (H.) 

4.  Anthimus  emphasized  the  fact  that  a  judicious  diet  was  the  fundamental  condition 
of  health.  He  directs  bread,  meat,  bacon,  mead,  beer,  spiced  wine,  the  inner 
parts  of  animals  (the  uterus  was  a  delicacy  among  the  Ancients!),  birds,  eggs, 
fish,  oysters  and  muscles,  roots  and  vegetables,  legumes  and  various  sorts  of  flour, 
milk  (fresh  and  warm  in  phthisis),  butter,  cheese,  fruit  etc.     (J.  Uffelmann.) 


—  245  — 

of  a  later  Frankisb  king  named  Theodoric"  (605),  and  the  archiater 
Keovalis  (about  590),  who  related  :  "  When  he  was  a  small  boy  and  had  a 
disease  of  his  thigh,  he  was  given  up  for  lost.  Then  I,  having  made  an 
incision  into  the  testicles  (hernial  tumor?),  as  I  had  once  seen  done  in  the 
city  of  Constantinople,  restored  the  boy  sound  to  his  sorrowing  mother." 
This  anecdote  speaks  in  favor  of  the  existence  at  this  time  of  a  higher  class 
of  lay  physicians,  possessed  even  of  a  certain  knowledge  of  surgery  and 
dexterity  in  that  art,  the  practice  of  which  was  from  the  beginning  for- 
bidden to  monkish  physicians,  and  at  a  later  period  was  still  more  strictly 
interdicted.  The  so-called  Alemannic  code,  arranged  between  the  years 
613  and  628,  argues  in  support  of  the  same  conclusion  and  upon  similar 
grounds.  This  code  says  :  "  When  the  skull  is  perforated  so  that  the  brain 
comes  into  view,  and  the  physician  touches  the  brain  with  a  feather  or  a 
probe."  .  .  .  "After  their  feet  were  cutoff  they  walked  with  stilts"  —  an 
example  of  "artificial"  limbs,  such  as  are  used  even  at  the  present  da}'. 
Among  the  Alemanni  also  physicians  were  employed  in  medico-legal 
duties,  as  we  should  call  them  to-day,  and  they  cannot  have  been  very 
scarce,  for  in  all  the  Germanic  codes  mention  is  made  of  the  fee  to  be 
granted  the  physician  in  the  determination  of  the  penalty  for  bodily 
injuries.  Hence  we  may  safely  assume  that  medical  aid  was  everywhere 
employed.  (S.  Venedey,  "Deutsche  Geschichte").  That  the  physicians 
were  not  reckoned  among  "The  learned"  (a  class  which  included  onl}' 
those  who  had  been  duly  instructed  in  the  monastic  schools,  whose  cur- 
riculum did  not  admit  the  "illiberal"  art  of  medicine1  until  a  later  period), 
is  evident  from  the  Langobard  code,  arranged  in  650.  This  ordains : 
"  Whosoever  has  inflicted  wounds  upon  any  one,  he  shall  supply  him  with 
attendance  and  likewise  pa}T  the  fee  of  the  physician,  at  a  rate  to  be 
estimated  by  learned  men."  This  estimate,  like  the  medical  assizes  of  the 
present  day,  was  not  made  by  the  physician  himself,  but  by  "The  learned." 
It  does  not,  however,  follow  from  the  above  passage  that  the  physicians  of 
that  da}-  could  not  fix  their  own  claims  because  they  were  considered 
unworthy  of  such  a  trust,  nor  because  they  did  not  enjoy  sufficient  con- 
fidence in  their  character.  From  the  story  of  king  Gram  too,  who,  in  order 
to  remain  unrecognized  during  a  festival,  put  on  the  dress  of  a  physician 
and  took  the  lowest  seat  at  the  board,  we  cannot  infer  that  the  position  of 
the  physician  was  considered  disreputable.  On  such  occasions  this  seat 
was  left  vacant  for  casual  travellers,  and  itinerant  physicians  often,  probably, 
occupied  it  as  guests,  so  that  the  disguise  of  such  an  individual  was  least 
calculated  to  awaken  suspicion.  That  there  were,  even  in  the  seventh 
centur}-,  lay-physicians,  who  had  studied  in  the  ancient  st}de  under  another 
physician,  is  manifest  from  the  public  ordinances  ("Fuero  Judzgo"2 —  the 

1.  The   "Liberal  Arts"   included  grammar,   rhetoric  and   logic    (the   trivium),   and 

arithmetic,  music,  geometry  and  astronomy  (the  quadrivium,).     (H.) 

2.  The  "Fuero  Judzgo"  is  properly  a  Spanish  translation  of  the  original  code  of  the 

Visigoths  entitled  "Forum  judicium".     This  translation  was  made  by  order  of 
Ferdinand  III.  in  1241,  and  formed  the  basis  of  Spanish  mediaeval  law.     (H.) 


—  246  — 

title  of  the  Fueros  of  the  Basques)  of  Chindaswind  (6-41-652)  and  Reces- 
wind  (652-672),  kings  of  the  Visigoths.1 

Such  la}'  physicians  were,  accordingly,  regarded  as  mechanics  and  trades- 
men, and  as  inferior  in  birth  to  the  learned.  It  does  not  follow,  however, 
from  the  ordinances  hereafter  cited,  that  these  physicians  of  the  Visigoths 
were  necessarily  regarded  with  especial  disrespect.  These  ordinances,  like 
all  similar  laws  from  the  beginning  of  time  to  the  present  day,  were  insti- 
tuted chiefly  to  provide  against  transgressions  and  to  meet  exceptional 
cases,  and  may  best  be  compared  with  our  Draconian  vaccination  statutes 
of  the  present  day.  That  physicians  were  then  made  responsible  for  their 
want  of  skill  is  too,  in  itself,  a  regulation  in  no  respect  disgraceful  to  their 
profession — otherwise  the  same  thing  would  hold  true  to-day.  The  furnish- 
ing of  security  was  a  precautionar}-  regulation,  which  sprung  probably  simply 
and  naturally  from  the  fact  that  the  lay  physicians  of  that  period,  who  were 
not  settled  in  fixed  residences,  could  in  no  other  way  be  made  responsible  for 
the  conscientious  treatment  of  their  patients,  nor  constrained  to  complete 
their  cure.  That  they  were  compelled,  however,  to  stipulate  their  fee  in 
advance  certainly  points  to  a  low  and  purely  juristic  conception  of  the 
medical  profession  and  its  functions  ;  and  3'et  it  is  quite  similar  to  the 
conception  which  prevails  in  the  eye  of  the  law  in  the  German  Empire 
to-day.  Nor  can  it  be  regarded  as  offensive  except  to  a  more  refined  idea 
of  the  profession,  an  idea  foreign  to  the  legislators  of  that  day  as  well  as 
to  those  of  the  present,  while  the  perception  of  its  offensiveness  cannot  be 
presupposed  in  the  public  of  the  Middle  Ages. 

These  ordinances,  which,  accordingly,  we  need  not  understand  ex- 
clusively  as  a  portion  of  the  penal  code,  but  which,  in  consequence  of  the 
protective  clauses  therein  contained,  we  may  better  regard  as  a  kind  of 
medical  assize  and  ordinance  (doubtless  very  imperfect,  3-et  partially 
agreeing  with  even  the  "Most  modern  standpoint  "),  run  as  follows  : 

1.  "  No  physician  may  undertake  to  bleed  a  woman  in  the  absence  of  her  rela- 
tives: if  he  has  done  so,  he  shall  pay  10  solidi  2  to  the  relatives  or  to  the  husband, 
since  it  is  not  impossible  that  occasionally  some  sport  may  be  associated  with  such 
an  opportunity."  In  all  Germanic  legal  codes  (Salic,  Ripuarian,  Bavarian)  carnal 
offences  were  very  severely  punished.  Perhaps  this  was  an  expression  of  the  high 
respect  of  the  race  for  women  (a  sentiment,  as  we  know,  of  great  strength  among  the 
Germans);  perhaps  (and  more  probabky)  it  was  designed  to  remove  or  overcome  the 
sexual  rudeness  of  a  lack  of  civilization  or  laxity  of  morals.  "Whoever  touched  the 
hand,  arm,  or  breast  of  a  maiden  was  fined  15,  HO,  35  solidi.  The  servant  who 
became  too  intiinate  with  the  maid  of  another,  if  she  died  of  the  natural  results,  was 

1.  How  greatly  many  ideas  had  changed  under  the  influence  of  Christianity  immedi- 

ately after  the  downfall  of  the  Western  Empire  is  shown,  among  other  evidences, 
by  the  fact  that  in  the  laws  of  the  Visigoths  artificial  abortion,  effected  b}'  a 
physician  (a  crime,  as  we  know,  at  least  tolerated  by  the  Romans),  was  punished 
by  loss  of  sight. 

2.  Such  a  solidus  was  in  value  about  $2.2.3,  while  two  solidi  was  the  price  of  an  ox. 

Hence  the  value  of  money  was  at  that  time  at  least  thirty,  and  probably  sixty 
times  as  great  as  it  is  to-day,  and  this  fine  for  a  private  venesection  is  very  high. 


—  247  — 

castrated."  Hence  it  follows  that  this  unchristian  operation  was  still  in  vogue  and 
was  performed  by  way  of  punishment.  It  was  likewise  done  from  motives  of  revenge, 
as  the  case  of  Abelard  (who  was  castrated  by  the  friends  of  Heloise  in  consequence 
of  his  love  for  her)  proves.  The  same  vengeance  too  is  common]}-  taken  at  the  pres- 
ent day  among  the  southern  Sclaves,  Arabs,  Abyssinians,  Negroes,  Turcos,  Indians  etc. 

2.  "No  physician  shall  visit  any  person  confined  in  prison  without  the  presence 
of  the  jailer,  lest  the  prisoner,  throujrh  fear  of  his  punishment,  majr  seek  the  means 
of  death  at  his  hands." 

3.  'When  any  one  has  called  a  physician  to  see  a  sick  person,  or  to  heal  a  wound, 
the  physician,  when  he  has  seen  the  wound  or  recognized  the  pains,  shall  at  once  take 
charge  of  the  patient  under  definite  security."  1 

4.  "When  a  physician  has  assumed  charge  of  a  patient  under  security,  he  must 
cure  him.  If  death  ensues,  he  shall  not  demand  the  stipulated  fee,  nor  shall  a  suit  be 
instituted  for  it  by  either  party."  2 

5.  "  If  a  physician  has  removed  a  cataract"  from  the  eye  and  restored  the  patient 
to  his  former  health,  he  shall  receive  a  fee  of  five  solidi." 

6.  "If  a  physician  injures  a  nobleman  in  bleeding  him,  he  shall  pay  150  solidi. 
If,  however,  the  patient  dies,  the  physician  (how  equitable!)  shall  be  delivered  up  at 
once  to  his  relatives,  to  be  dealt  with  as  they  may  see  fit.4  When,  however,  the 
physician  has  killed  or  injured  a  slave,  he  must  return  a  slave  of  the  same  kind."  5 

7.  "When  a  physician  has  accepted  a  student,  he  shall  receive  a  fee  of  twelve 
solidi." 

8.  "No  one  shall  cast  a  physician  into  prison  without  a  hearing,  except  in  case 
of  murder." 

From  this  last  ordinance  it  is  manifest  that  the  lay  physician  and  sur- 
geon, even  in  these  barbarous  times,  was  still  considered  worthy  of  a  certain 
respect ;  otherwise  he  would  not  have  been  expressly  protected  from  an 
arrest,  which  was  both  allowed  and  approved  in  the  case  of  other  less 
respectable  and  less  respected  persons. 

It  should  be  noticed  too  that  tbere  was  a  distinction  made  between  a 
call  to  visit  the  sick  and  to  treat  a  wound.6 

The  high  remuneration  (see  ordinance  5)  and  the  high  penalties  may, 
however,  indicate  a  relatively  good  social  position  in  the  lay  physicians  of 

1.  Latin  "statim  sub  certo  placito  eautione  emissa  infirmum  suscipiet." 

2.  Latin  "nee  ulla  hide  utrique  parti  calumnia  moveatur".     (H.) 

3.  Latin  "ypocisma".     (H.) 

4.  The  physicians,  however,  in  doubtful  cases  guarded  themselves  against  these  and 

similar  ordinances  by  having  the  patients  declared  dead  in  proper  legal  ibi  m, 
and  in  advance  of  treatment,  so  that  if  death  actually  ensued  it  could  not  be 
ascribed  to  their  treatment  at  all  events. 

5.  Nicholas  and  Donatus,  physicians  of  Austrigilde,  wife  of  Gontram,  king  of  1'ur- 

gundy  (561-593),  were  so  unfortunate  as  to  lose  their  royal  patroness  by  small- 
pox (581),  and  in  compliance  with  her  d}"ing  injunction  were  slain  upon  her  tomb 
by  her  faithful  spouse.     (H.) 

6.  If  we  consider  the  comparative  condition  of  medicine  in  those  days,  the  demands 

made  upon  the  practice  of  such  mediaeval  lay  physicians  will  seem  by  no  means 
trifling.  This  is  evident  from  the  fact  that  in  Sweden  (laws  of  Sudermania,  com- 
piled in  1327)  the  lawful  physician  was  expected  to  understand  the  treatment  of 
fractures,  incised  wounds,  wounds  of  the  skin,  stabs  through  the  bod}-  and  finally 
even  that  of  amputated  limbs. 


—  248  — 

that  day,  although  the}'  might  all  be  considered  members  of  the  so-called 
lower  class.  In  fact  such  was  the  estimation  of  even  the  best  surgeons 
down  almost  to  the  19th  century. 

In  addition  to  the  monkish  practitioners,  there  also  existed  in  the  first 
half  of  the  Middle  Ages  many  Jewish  physicians,  who  had  been  educated 
at  Alexandria,  or  still  later  in  the  so-called  Arabian  schools,  and  Arabians 
themselves  officiated  in  the  West  as  lay  physicians  of  the  higher  order. 

The  ordinary  physicians  of  princes,  and  even  of  the  popes,  at  that  time 
were  often  Jews,  who  had  been  educated  in  the  schools  of  the  East  and 
were  scientific  physicians.  They  held  these  positions  in  spite  of  the  fact 
that,  since  the  da}-s  of  Theodosius  II.  (as  well  as  under  the  earlier  empe- 
rors), Christian  fanaticism  had  excluded  them  by  law  from  all  state  and 
municipal  offices,  because  they  had  crucified  the  Saviour.  The  consultation 
of  Jewish  ph}'sicians  was  also  prohibited  by  the  Church  on  many  occasions. 
Yet  in  the  eleventh  centuiT  Jews  were  almost  the  only  authorized  lay 
physicians  of  the  higher  order.  Whether  they  were  compelled  to  wear  a 
yellow  mark  (Judenfleck)  upon  their  clothing,  like  the  other  Jews  of  the 
Middle  Ages,  is  not  stated,  but  is  quite  probable.  It  would  certainly  agree 
with  the  ''spirit"  of  mediaeval  fanaticism. 

Even  during  the  first  half  of  the  Middle  x\ges  monkish  or  clerical 
medicine  had  almost  entirel}-  overgrown  all  higher  la}'  practice,  and  herni- 
otomists,  lithotomists,  oculists  etc.,  uninterrupted  successors  of  the  lower 
itinerant  medical  profession  of  the  Ancients,  alone  survived.  Such  phy- 
sicians or  rather  empirics,  were  probabl}'  the  men  who  practised  the  few 
reported  cases  of  Cesarean  section  upon  dead  mothers  in  the  earlier  portion 
of  the  Middle  Ages.  The  lives  of  a  subsequent  bishop  of  Constance  and  an 
abbot  of  St.  Gall  e.  g.  were  saved  by  such  physicians  in  the  10th  century. 
These  so-called  "  Yolksarzte  "  of  the  Germans,  accordingly,  are  to  be  con- 
sidered the  uninterrupted  successors  of  the  lower  itinerant  physicians  of 
the  Greeks  and  Romans.  These  alone  survived,  while  the  higher  class  of 
lay  physicians,  who  still  existed  among  the  Goths  in  the  beginning  of  the 
Middle  Ages,  disappeared,  or  at  least  took  a  position  far  in  the  background, 
until,  by  the  foundation  of  the  school  of  Salerno  and  the  European  uni- 
versities, they  came  once  more  into  prominence. 

In  the  Niebelungenlied,  a  poem  which  in  its  present  form  dates  from 
the  12th  centur}-  (the  minnesinger  Kiirenberger,  about  1140,  is  said  to  have 
arranged  it),  though  its  substance  concerns  a  still  more  remote  German 
antiquity,1  physicians  (though  none  of  the  clerical  profession)  are  found, 

1.  The  use  of  the  magic  cap  (Tarnkappe),  which  rendered  one  invisible,  and  there- 
fore invulnerable,  may  be  regarded  as  a  theurgic  measure.  The  same  may  be 
said  of  Siegfried's  baptism  in  dragon's  blood,  by  which  he  became  vulnerable 
only  in  a  place  about  the  size  of  a  leaf  between  the  shoulders,  as  Achilles  was 
only  in  the  heel.  In  "  Tndrun"  (manifestly  in  imitation  of  the  Iliad)  we  first  find 
the  "Heilkunst  Meister"  Wate  employing  roots,  salves  and  powerful  herbs  in  the 
cure  of  wounds.     He  had  learned  his  art  from  a  rude  old  woman  (druidess?). 


—  249  — 

although  in  other  passages,  often  in  close  proximity  to  medical  procedures, 
priests  are  spoken  of.     Thus  in  the  battle  with  the  Saxons  it  is  said  : 
"  To  those  who  pin-sic  knew  was  offered  rich  reward, 

Silver  un  weighed,  and  with  it  too  the  shining  gold  (to-day  nickel !), 

To  heal  the  heroes  when  the  battle's  rage  was  o'er." 

Beside  this  intimation  of  surgical  aid  stands  the  simple  domestic 
treatment  of  the  loud-wailing  Chriemhilde,  after  the  murder  of  Siegfried  : 

"  The  faithful  spouse  so  writhed  in  pain  and  inward  woe, 
That  she  was  often  freely  sprinkled  from  the  spring." 

Although  by  means  of  this  certainly  simple  therapy 
"  It  was  great  wonder  she  recovered  from  her  grief", 
she    was   yet   able    at    once,    and    in    person,    to   open    the    medico-legal 
investigation  for  the  murderer  :  for 

"  Denying  they  persist.     Then  spake  Chriemhilde  thus  : 
Let  him  who  guiltless  stands  approve  the  fact  to  me 
By  going  to  the  bier  before  the  people  all, 
Whereby  we  rnajr  at  once  the  honest  truth  perceive." 

'  This  is  a  wonder  great,  yet  often  is  it  seen, 
When  one  with  murder  stained  hard  by  the  dead  appears, 
The  wounds  do  bleed  afresh.     So  happened  it  too  now  ; 
And  from  this  ver}"  sign  was  Hagan's  guilt  disclosed !  " 

a  superstition  long  prevalent,  and  which  even  found  a  place  in  much  later 
medico-legal  works  of  all  seriousness. 

On  the  manner  of  transporting  the  wounded1  and  their  care  (according 
to  Frohlich,  even  wounded  enemies  were  carefully  nursed),  we  find  also  a 
few  notices.     Besides  other  hostages,  there  are  brought  : 

"  Of  wounded  to  the  death,  know  thou  our  princess  high, 
Full  eighty  stretchers  red  with  blood  are  in  our  land. 
He  begged  for  the  sore  wounded  all  the  best  of  care, 
Rest  suited  for  their  wounds  he  sought,  and  gentle  heed." 

This  was  much  more  than  is  customaiy  among  other  uncultivated 
people,  who,  as  a  rule,  abandon  their  own  wounded  to  their  fate. 

In  the  earliest  ages  too  women  only  seem  to  have  practised  medicine  among  the 
Germans  and  Celts,  as  they  do  to-day  e.  g.  in  southern  Russia.  Probably,  as  in 
the  latter  country,  medicine  was  regarded  as  unworthy  of  the  attention  of  men. 
At  least  in  old-German  writings  (as  well  as  in  those  of  Tacitus)  medical  women 
alone  are  mentioned,  and  it  is  not  until  the  12th  century  that  phj-sicians  are  also 
spoken  of.  Their  remedies,  as  is  the  case  with  all  uncultivated  nations,  consisted 
chiefly  of  charms,  runic  characters,  and  the  natural  domestic  remedies.  St.  Hilde- 
garde  too  was  acquainted  with  no  other  remedies  than  the  aboriginal,  domestic 
drugs  of  the  Germans  and  their  methods  of  preparation.  It  was  not  until  the 
12th  century  that  old-Greek  medicine  and  Arabian  remedies  reached  German}'. 
(Among  the  ancient  Germans  Eir  was  the  goddess  of  physicians.) 
1.  The  Norwegian  king,  Magnus  the  Good  (1042-1047),  after  a  battle,  selected  for  the 
handling  of  the  wounded  twelve  of  his  warriors  who  had  the  softest  hands.     (H.) 


—  250  — 

2.    CHRISTIAN  MEDICINE  WITH  A  PRACTICAL  TENDENCY.    (NURSING,  MONKISH 
PHYSICIANS),    MONTE  CASSINO,  SALERNO,  MONTPELLIER, 

Religion  and  medicine,  in  the  early  ages  of  civilization,  are  ever  closely 
connected  as  the  effect  of  one  and  the  same  impulse  —  the  impulse  of  self- 
preservation.  The  former  serves  for  the  period  after  death  ;  the  latter,  for 
the  present  world.  The  Middle  Ages,  however,  were,  as  we  have  seen,  in 
many  respects  an  epoch  in  which  civilization  arose  anew. 

Through  Christianity,  which  during  this  latter  period  became  widely 
diffused,  the  original  union  of  religion  and  medicine  was  once  more 
revived,  to  endure  for  a  long  period.  More  especially  was  this  true  from 
the  third  century  after  Christ.  This  reunion  was  begun  by  even  Christ 
himself,  who,  like  almost  all  founders  of  religion,  found  it  necessary  to 
establish  his  claims  as  an  embassador  of  God  by  the  performance  of 
theurgic  cures.  It  resulted  more  especially  from  his  inculcation  of  an 
active  charit}T,  which  placed  the  oppressed,  the  poor,  and  the  hitherto  des- 
pised and  forsaken,  prominent  in  the  foreground  of  life.  Marvellous  !  This 
most  effective,  socialistic  doctrine  of  the  son  of  the  most  egotistic  people 
known  to  history,  planted,  in  an  age  which  appeared  hostile  and  inaccess- 
ible to  all  culture,  the  germ  of  that  humanity,  which  subsequently  devel- 
oped into  a  vigorous  and  fruitful  plant  —  a  humanity  of  which  intimations 
only  existed  among  the  Ancients,  and  to  the  maturing  of  which  the 
Germanic  peoples  were  called  !  Thus  Christianity  preserved  and  displayed 
in  practical,  daily  life  its  loft}'  power  and  its  mission,  almost  in  spite  of 
those  who,  in  nearly  every  other  direction,  corrupted  into  a  curse  the 
sublime  germ  of  the  doctrine  of  Christ,  and  by  avarice  and  abuse  prosti- 
tuted to  their  own  ends  even  compassion  itself;  while,  through  the  over- 
grown superstition  of  its  "  ministers  ",  it  occupied  a  position  hostile  to 
science  and  to  reason.     While  monks1  and  priests  in  general — of  course 

1.  Too  much  stress,  as  a  rule,  has  been  laid  upon  the  cultivation  of  the  sciences  by 
the  monks,  while,  on  the  other  hand,  their  activity  in  the  arts,  architecture^ 
sculpture,  the  art  of  the  goldsmith,  wood-carving,  writing,  the  illumination  of 
manuscripts  etc.,  has  not  received  deserved  attention.  That  the  monastic  scribes- 
for  the  most  part  were  ignorant  of  what  they  wrote,  is  well  known.  With  them 
it  was  a  mere  question  of  caligraphy,  miniature  painting  etc.,  i.  e.  a  matter  of 
pure  manual  dexterity.  Indeed  throughout  the  whole  Middle  Ages  writing  (like 
printing  at  a  later  period)  was  regarded  as  an  art,  so  rare  was  a  knowledge  of  it. 
An  eminent  scribe  at  that  period  was  a  man  much  sought  after,  very  much  like  the 
scribes  of  the  Orient  to-day,  and  the  distinguished  Thoraschreiber  among  the  Jews. 
Many  of  the  monks  devoted  their  whole  lives  to  the  completion  of  a  single  manu- 
script, a  fact  which  serves  to  explain  the  smallness  of  mediaeval  libraries,  most  of 
which  consisted  of  a  few  works  only.  These  caligraphists  were  connected  with 
medicine  also  by  their  preparation  of  medical  MSS.,  some  of  which  were  illustrated 
in  miniature  in  the  style,  and  after  the  example  of  the  Alexandrians  and  Byzantines. 
Their  concluding  words,  found  quite  regularly  at  the  end  of  the  MS.,  are  often 
characteristic  of  the  men  :  e.  g.  "0  God!  of  thy  goodness  bestow  upon  me  caps  and 
hats,  cloaks  and  coats,  she-goats  and  a  he-goat,  sheep  and  cattle,  and  a  handsome- 
wife  without  children!"   Ah,  how  joyous  was  I  when  I  said:   "Deogratias"  etc. 


—  251  — 

there  were  exceptions  —  servants,  though  unwittingly,  of  that  development 
which  bade  the  rejection  of  the  ancient  civilization,  destroyed,  or  at  least 
scorned,  the  science  of  the  Ancients,  the}-  yet  called  into  existence  institu- 
tions and  works  of  beneficence,  which  at  a  later  period  supplied,  at  least 
partially,  opportunity  and  occasion  for  the  restoration  of  that  science  and 
for  the  foundation  of  a  new  science  of  medicine. 

In  point  of  time  (though  the  idea  itself  is  characteristic  of  the  Middle 
Ages  only),  the  origin  of  Christian  benefaction  reaches  back  to  the  very 
foundation  of  Christianity.  Its  followers  were  necessarily,  indeed,  the 
benefactors  and  the  guardians  of  their  needy  brethren,  and  especially  of  the 
sick.     For  this  Christ  himself  had  set  the  example. 

Almost  from  the  first  the  church  officials,  deacons,  subdeacons  and  deaconesses, 
constituted  a  regular  body  for  the  care  of  the  Christian  distressed  and  the  sick. 
Afterwards  the  widows  (though  the  latter  were  not  required  always  to  be  widows  in 
the  genuine  sense  of  that,  term)  performed  the  same  duties  All  these  officials  how- 
ever speedify  degenerated  and  fell  into  the  worst  vices,  particularly  the  deacons,  who 
even  contracted  "carnal"  diseases  in  the  course  of  their  pious  duties.  But  as  soon 
as  special  institutions  for  the  care  of  the  needy  were  founded,  there  arose  also  a 
special  class  of  nurses,  who  were  expected  to  search  out  and  convey  to  these  institu- 
tions those  who  were  sick,  just  as  the  monks  of  St.  Bernard  seek  out  and  collect  their 
beneficiaries  to-day.  These  "Parabolani",1  as  they  were  called,  soon  degenerated 
too,  and,  forming  a  kind  of  body-guard  for  quarrelsome  and  factious  bishops,  allowed 
themselves  to  be  precipitated  into  revolutionary  acts.  Hence  both  their  number  and 
their  duties  were  soon  curtailed.  Besides  these  ordinary  professional  nurses  (male 
and  female),  there  were  also  pious  souls,  who,  in  order  to  secure  salvation  (the  desire 
for  which,  then  as  now,  lay  at  the  foundation  of  many  deeds  of  Christian  charity), 
voluntarily  devoted  themselves  to  the  care  of  the  sick. 

Some  of  these  volunteers,  in  order  to  be  truly  acceptable  to  God,  occasionally 
caressed,  and  (regardless  of  bacteria)  even  kissed  the  unwashed  feet  of  filthy  beggars. 
Such  follies  were  a  special  source  of  delight  to  delicate  ladies — and  male  blockheads, 
some  of  whom  by  such  services  fairl}-  won  the  title  of  saints.  Monachism  proper  did 
not  make  its  appearance  in  the  East  before  A.  D.  300,  and  it  reached  the  West  still 
later.  That,  after  its  establishment,  monks  and  nuns  were  active  in  caring  for  the  sick 
was  a  matter  of  course  ;  nor  is  it  very  surprising  that  plysicians,  in  the  proper  sense 
of  that  term,  were  not  placed  at  the  head  of  most  of  these  Christian  institutions. 
Their  duties  too  fell  to  the  clergy,  who  possessed  at  most  a  rude  sort  of  medical  art 
handed  down  from  the  Ancients,  or  a  pastoral  medicine — a  branch  of  medical  science 
taught  in  our  seminaries  even  to-day,  and  doubtless  modelled  after  that  of  the  monks. 
Yet  there  was  a  few  of  the  clergy  also  (especially  among  the  Benedictines),  who 
studied  the  ancient  physicians,  and  who  were  representatives  of  a  practice  worthy,  in 
some  degree,  of  being  called  medical.  At  a  later  period,  especialty  after  the  Crusades, 
special  orders  of  nurses  developed,  such  as  the  Brothers  of  St.  Anthony,  the  Ale.xians, 
the  Beguins  and  Beghards,  the  Black  Sisters,  the  Lollhards,  Cellites,  Lazarists, 
"  Kalandsbriider ",  the  Hospitallers  (Sisters  of  St.  Elizabeth,  Brothers  of  the  Holy 
Spirit,  Sisters  of  St.  Catharine  and  of  Christian  Love,   of  Our  Blessed  Lady,  Knights 

1.  Probably  so  called  in  consequence  of  the  hazardous  duties  (jzapafiohw  epyov) 
which  they  were  expected  to  perform.  Gibbon  says  the  Parabolani  of  Alexandria 
were  first  instituted  during  the  plague  of  Gallienus  (A.  D.  253-268),  but  they  are 
first  mentioned  officially  A.  D.  415.     (FI.) 


—  252  — 

of  the  Cross  etc.),  the  Sisters  and  Brothers  of  Charity,  the  Knights  of  St.  John, 
Ladies  of  St.  John,  the  German  Order  etc.  A  number  of  these  orders  are  still  active, 
and  in  some  small  degree  realry  beneficent. 

Originally  there  existed  no  separate  institutions  for  the  exercise  of  Christian 
aidance,  but  it  was  carried  on  in  private  dwellings,  as  is  done  by  a  few  physicians  at 
the  present  day.  In  process  of  time,  however,  there  arose  separate  houses  of  enter- 
tainment for  the  poor,  for  orphans,  travelers  etc.,  connected  usually  with  the  churches, 
the  residences  of  the  bishops  or  the  monasteries,  and  these,  in  addition  to  the  persons 
mentioned  above,  received  also  the  sick.  Such  was  particularly  the  case  with  the 
monasteries  of  the  Benedictines.  Among  these  Xenodochia  belonged  the  Hospices, 
some  of  which  are  in  existence  to-day,  as  e.  g.  those  of  Mt.  Cenis  (founded  825),  and 
the  Great  St.  Bernard  (founded  980).  In  the  same  class  also  should  be  reckoned 
•certain  magnificent  foundations  in  the  East,  as  that  of  Constantine  II.  (337-361)  in 
Constantinople,  that  of  St.  Basil  (370)  at  Cassarea,  those  erected  by  Justinian  and  by 
Alexius  1.  (1081-1118,  an  orphan  asylum).  Here,  too,  must  be  mentioned  the 
"  Seelbader  ",1  where  the  baths  in  general  use  since  the  time  of  the  Ancients,  were 
given  gratis  to  the  sick  and  the  poor,  and  where  the  "  Seelschwestern  ",  in  addition  to 
the  "Bader",  furnished  aid  to  the  beneficiaries.  Subsequentlj',  however,  this  aid  on 
the  part  of  the  sisters  was  bjT  no  means  always  limited  to  the  higher  offices  of  charily. 
Indeed  so  little  was  this  the  case  that  certain  secret  diseases,  the  result  of  unbridled 
sexual  indulgence,  occasioned  finally  the  closure  of  these  institutions.  For  the 
majority  of  monks  and  nuns  in  the  Middle  Ages  were  verj'  corrupt  in  their  sexual 
conduct,  since  the  spiritual  castration  of  their  vows  could  at  last  only  increase  the 
physical  impulse  of  sexuality.  The  so-called  "  Houses  of  Mercy"  (Elendshauser) 
likewise  belong  in  the  class  of  which  we  are  speaking.  Besides  such  institutions 
there  also  existed  at  a  very  early  period  special  hospitals  (nosocomia),2  whose  sole 
object  was  the  reception  and  treatment  of  the  sick.  Among  these,  those  of  the 
Nestorians  were,  as  we  have  seen,  the  most  important.  The  golden  age  of  such 
■establishments,  however,  began  after  the  Crusades,  by  which  the  leprosy  in  particular 
was  very  widely  distributed  throughout  the  West,  and  we  find  them  thenceforward  in 
every  land.  Many  of  them  bore  the  title  of  "Hospital  of  the  Holy  Spirit"  (Guteleut- 
hauser,  Siechenhauser).  Here  and  there  they  stood  under  lay  administration  down 
to  the  13th  century,  at  which  period  they  were  first  withdrawn  from  such  management, 
and  a  number  of  these  hospitals  still  exist  under  the  same  names  to-day.  The 
"leper-hospitals",  so  numerous  in  the  Middle  Ages  (in  the  13th  century  there  were 
about  19000  of  them  !),  belong  to  the  same  class. 

All  these  institutions   were  under  the  direction  of  the  Church,  and 
their  corps  of  assistants   was  composed  of  the  clerg}-,  especially  members 

1.  These  were  free  bathing  establishments  for  the  poor,  instituted  by  the  wealthy  or 

their  heirs  in  behalf  of  the  souls  of  their  founders.  They  were  quite  numerous 
in  Europe  during  the  Middle  Ages.     (H.) 

2.  The  statutes  of  the  Hospital  of  St.  John  of  Jerusalem,  which  took  their  origin  in 

1181,  provided  that  four  phj-sicians  (fisicien,  mire,  miege)  should  always  be 
employed  upon  a  salaiy,  and  that  these  should  be  skilled  in  uroscopy  etc.  The 
patients  were  to  receive  fresh  pork,  mutton  or  poultry,  thrice  a  week  etc.  Sur- 
geons (serorgien)  were  also  appointed.  The  manumission  of  the  slaves,  which  re- 
sulted from  the  introduction  of  Christianity,  necessitated  the  establishment  of 
these  Nosocomia  and  similar  institutions,  since  the  slaves  did  not  of  course  at 
once  acquire  material  independence,  but  depended  upon  charity.  Christian 
•beneficence  towards  the  poor  too  was  not  simply  a  matter  of  ethics,  but  de- 
pendent also  upon  the  necessities  of  the  new  social  relations. 


—  253  — 

of  the  religions  orders,  to  whom  their  erection,  like  benefaction  in  general, 
was  a  tolerably  easy  matter,  since  the  faithful  furnished  the  means,  by 
which  they  frequently  cared  for  themselves  first  —  and  then  for  others. 
In  a  few  cases  onby  were  regular  physicians  emplo}'ed.  Thus  in  the  course 
of  the  Middle  Ages  —  from  the  sixth  century  onward  —  everything  which 
could  be  called  medicine  in  the  Christian  West  fell  by  degrees  into  the 
hands  of  the  ministers  of  the  Church,  especially  the  monks,  who  looked 
upon  themselves  as  great  scholars,  and  were  entitled  to  higher  pretensions 
if  they  could  read,  an  art  which  —  even  reading  at  that  time  was  regarded 
as  an  "art" — had  been  quite  lost  by  the  laity  in  the  first  half  of  the  Middle 
Ages . 

What  was,  in  the  main,  the  nature  of  the  so-called  medical  practice  of  the  higher 
and  lower  orders  of  priests,  who,  though  destitute  of  any  special  knowledge  of  medi- 
cine, disported  themselves  as,  and  even  received  the  title  of,  "physicians"  in  the 
Middle  Ages  (many  monasteries  had  entire  divisions  for  their  "Medici"),  may  be 
sufficiently  determined  from  the  fact  that  prayer,  the  imposition  of  hands,  exorcisms, 
rings  and  amulets  engraved  with  sacred  symbols,  holy  oil,  bones,  rags  and  similar 
relics,  conjurations,  crossings,  consecrated  herbs,  consecrated  salt,  special  saints  lor 
wounds,  toothache,  poisoning,1  and  the  three  or  four  most  sacred  names  etc.,  were 
employed  generally  and  openly  for  the  cure  of  every-day  diseases  by  the  clergy  in 
their  simple  faith  and  gross  superstition,  as  the  same  thing  is  done  to-day  in  secret. 
Indeed  at  that  time  diseases  were  generally  regarded  as  a  chastisement  from  God,  or 
a  visitation  of  the  devil — as  in  fact  they7  are  to-day  in  the  eyes  of  manj"  of  the 
"faithful".  Severe  acute  diseases  were  generally  held  to  be  the  result  of  poison  ; 
pestilences,  the  effect  of  poisoning  of  the  springs  (charged  especially  upon  the  Jews) 
etc.  The  monks  frequently  held  the  principle  of  similia  similibus,  and  e.  g.  treated 
the  poisoning  occasioned  bj7  swallowing  a  toad  by  directing  the  eating  of  another 
toad  etc.  (Not  only  Hippocrates  and  Paracelsus,  but  the  monks  too,  were  predeces- 
sors of  the  Homceopathists  and  Isopathists !)  Besides  the  misuse  of  the  numerous 
saints,  other  and  grosser  abuses,  such  as  gluttony,  extortion,  lasciviousness  etc.,  seem 
to  have  prevailed  among  the  monks,  so  that  finally  their  actions  appeared  too  wicked 
and  disgraceful  even  in  the  eyes  of  the  indulgent  Church.  Accordingly,  the  practice, 
and  in  fact  the  study7  and  teaching,  of  medicine,  were  forbidden  to  the  higher  clergy 
by  the  Councils  of  Rheims  1181,  the  Lateran  1189,  Montpellier  1162,  Tours  1163, 
Paris  1212,  and  the  second  Lateran  1215.  Finally  the  lower  monks  were  also  re- 
stricted, and  especially  by  the  Council  of  Le  Mans  1247  all  burning  and  cutting 
(surgery7)  were  forbidden  them,  on  the  principle  "The  Church  shuns  bloodshed" — a 
maxim  which  was  not  followed  even  in  surgery,  to  say  nothing  of  questions  of  faith  ! 
Long  after  this  prohibition,  however,  the  practice  of  surgery  was  still  carried  on  by 
the  monks;  in  fact  we  observe  it  even  to-day  in  less  enlightened  countries,  and  among 
the  specially  faithful  with  us! 

Of  the  large  number  of  clergy  who  practised  medicine  at  this  period,  and  who, 
though  of  little  merit  in  medical  matters,  were  yet  very  worthy  medicasters  in  other 
branches,  the  following  are  known  at  least  by  name.  Though  chiefly7  active  in  the 
science  of  pharmacology,  they  are  of  historical  importance  as  a  bond  of  union  be- 
tween the  medical  culture  of  Antiquity  and  that  of  the  Middle  Ages. 

Paulus,  bishop  of  Merida  (530-560).  is  said  to  have  performed  the  first  Caesarean 
section  upon  a  living  female,  so  that  this  honor  is  due  to  a  bishop,  and  not  to  a  swine- 

1.    The  latter  was  a  very  frequent  crime  during  the  devout  Middle  Ages,  and  was  even 
practised  by  means  of  the  poisoned  Host. 


—  254  — 

gelder;  Theodoras  (died  690),  a  Greek  of  Tarsus,  bishop  of  Cambridge,1  and  a  teacher 
of  medicine,  who  forbade  venesection  during  the  increase  of  the  moon  ;  Cuthbert,  of 
the  same  country;  Tobias,  bishop  of  Ross  in  England;  Ursus,  physician  of  pope 
Nicholas  I.  ;  Sigoald,  bishop  of  Spoleto;  Hugo,  abbot  of  St.  Denis;  Campo,  a  monk 
of  the  monastery  of  Tarfa  in  Italy;  Dido,  abbot  of  Sens  and  physician  to  St.  Louis; 
John  of  Ravenna,  abbot  of  Dijon;  Milo,  archbishop  of  Beneventum ;  Benedictus 
Crispus  (died  725),  archbishop  of  Milan;  Dominico,  abbot  of  Pescara;  Wigbert, 
bishop  of  Hildesheim  (880);  the  more  important  personages,  venerable  Bede2  (673-735), 
as  a  specimen  of  whose  medical  knowledge  we  may  quote  the  following  prescription: 
in  June,  of  a  morning,  one  may  drink,  fasting,  a  cup  of  cold  water;  the  same  in  July; 
but  in  October,  for  sweetening  the  blood,  for  the  expulsion  of  stone,  and  for  healing 
the  lungs,  instead  of  water,  one  should  take  the  milk  of  goats  or  of  sheep,  and  should 
not  wash  very  often;  in  February  one  should  foment  the  limbs;  in  August  he  should 
not  refresh  himself  in  cold  water,  but  in  January  he  should  plunge  his  body  into  warm 
water  etc.:  then  Isidore  of  Seville  (died  636),  who,  in  his  book  "  De  natura  rerum, 
sive  de  mundo",  treats  of  medicine  among  other  things;  Rhabanus  Maurus3  of 
Mayence,  bishop  of  Fulda,  and  finallj-  archbishop  of  Mayence  (774-856),  who,  in  his 
work  on  "  Physic",  which  begins  with  God  and  ends  with  the  stone,  discusses  man 
and  his  parts,  medicine  and  diseases;  Walafrid  Strabo  (807-848),  abbot  of  the  monas- 
tery of  Reichenau,  founded  by  Charles  Martel  in  714  on  lake  Constance,  and  author 
of  the  first  Latin  poem  composed  by  a  German,  a  "Hortulus"  in  hexameter  verse 
(a  similar  Latin  poem,  entitled  "  De  virtutibus  herbarum",  which  goes  under  the 
name  of  Macer  Floridus,  and  maintained  great  influence*  for  a  long  period  during 

1.  Theodorus  of  Tarsus  was  not  bishop  of  Cambridge,  but  archbishop  of  Canterbury, 

and  Primate  of  all  England.  He  was  sent  to  England  b}-  pope  Vitalian  in  669, 
and,  in  conjunction  with  his  companion  Hadrian,  an  African  abbot,  established 
schools'  at  Oxford,  Canterbury,  and  many  other  places.  In  these  schools  the 
Greek  and  Latin  languages,  arithmetic,  astronomy,  and  the  rules  of  versification 
were  taught,  and  it  is  written  of  their  pupils  that  many  of  them  were  as  familiar 
with  Greek  and  Latin  as  with  their  own  mother  tongue.  The  practice  of  chant- 
ing the  service  was  first  introduced  by  Theodorus  into  the  English  Church. 
Cuthbert  was  a  famous  abbot  of  Melrose,  and  subsequently  (A.  D.  684)  bishop  of 
Lindisfarne,  while  Tobias  was  the  ninth  bishop  of  Rochester,  appointed  to  that 
see  in  693.      (H.) 

2.  Bide  mentions  a  Saxon  leech  Cynifrid  or  Cyneferth,  who  opened  a  tumor  (abscess :) 

for  the  queen  and  abbess  iEtheldryth,  in  679.  The  Saxon  "leech-books"  also 
mention  the  leeches  Bald,  Cild,  Oxa  and  Dun.  That  the  surgeiy  of  these  leeches 
was  not  confined  entirel}-  to  the  use  of  salves,  poultices,  plasters  etc.,  is  evident 
from  the  following  extract:  "  For .  hair-lip,  pound  mastic  very  small,  add  the 
white  of  an  egg,  and  mingle  as  thou  dost  vermilion:  cut  with  a  knife  the  false 
edges  of  the  lip,  sew  fast  with  silk,  then  smear  without  and  within  with  the  salve, 
ere  the  silk  rot.  If  it  draw  together,  arrange  it  with  the  hand.  Anoint  again 
soon."    (H.J 

3.  The  first  German  popular  author  on  medicine  and  the  natural  sciences.     He  is 

also  worthy  of  notice  for  his  efforts  to  have  sermons  delivered  in  German,  an 
object  not  effected  until  the  time  of  Luther.  Even  medical  lectures  (those  of 
Paracelsus  and  Thomasius  excepted)  were  delivered  in  Latin  in  almost  all  the 
universities  down  to  the  present  century.  Maurus  was  a  pupil  of  Alcuin,  and 
active  in  the  effort  to  introduce  the  Greek  language  into  the  West. 

4.  Felt  especially  in  the  popular  materia  medica  of  the  Germans,  since,  towards  the 

close  of  the  Middle  Ages,  and  even  in  the  beginning  of  modern  times,  the  poem 
was  translated  into  German  (and  also  into  Danish). 


—  255  — 

the  Middle  Ages,  is  ascribed  to  Odo  von  Mendon,  who  died  in  1161);  Marbodus,  who 
wrote  on  precious  stones  and  died  bishop  of  Rennes  in  1123;  Notker  (9th  century) 
of  St.  Gall,  famous  as  the  greatest  savant  of  his  age,  a  musician,  astronomer,  mathe- 
matician, poet  and  theologian,  well  versed  in  the  Greek  and  Latin  languages  (at  that 
time  a  great  rarity),  and  well  known  also  for  his  cures  and  his  Uroscopy;  Thiedegg 
of  Prague,  pl^-sician  of  Boleslaw,  king  of  Bohemia  (died  1017);  and  finall}"  the 
famous  abbess  Hildegarde,  of  the  convent  of  Ruppertsberg,  near  Bingen,  eminent  in 
her  day  as  a  phj'sician  and  naturalist,  who  has  left  us  a  "  Physica"  or  Materia  Medica, 
(recommending,  among  many  other  popular  German  remedies,  herring  for  the  cure 
of  the  itch,  fern  against  the  wiles  of  the  devil,  gnat's  ashes  for  eruptions,  watermint 
for  asthma  etc.),  and  is  said  (therewith?)  to  have  performed  nianj-  miraculous  cures. 
"It  is  worthy  of  remark  that  Hildegarde,  with  rare  independence,  was  the  first  in  the 
West  to  separate  entirely  her  pictures  of  disease  frem  her  methods  of  treatment, 
relegating  them  to  two  different  sections  of  her  work.  This  was  due  partly  to  the 
plan  of  her  writings,  and  partly,  probably,  to  the  fact  that  she  avowedly  adopted  from 
the  popular  practice  many  stereotyped  and  detailed  prescriptions  without  any  change, 
while  she  was  compelled  to  discuss  and  explain  the  prevalent  views  regarding  the 
phenomena  of  disease  in  accordance  with  her  theory.  The  remedies  employed  were 
(in  addition  to  the  common  aromatics)  entirely  of  German  origin.  Their  mode  of 
preparation  was  far  different  from  the  methods  of  the  old  Greek  physicians,  which 
had  at  this  period  been  revived  in  southern  Europe.  Her  enveloping  the  remedy  in 
flour,  which  was  then  made  into  pancakes  and  eaten,  is  quite  peculiar  to  St.  Hilde- 
garde, and  takes  the  place  of  the  sugar,  syrups  etc.  now  introduced  among  us  from 
the  South."     (Jessen.) 

Within  the  religious  order  of  the  Benedictines,  to  which  many  of  the 
persons  just  mentioned  belonged,  medicine  enjoyed  a  regular  and  constant 
cultivation,  and,  under  their  hands  (in  contrast  with  those  of  the  rude 
clerical  empirics),  it  even  preserved  in  some  degree  the  appearance  of  a 
science.  Aurelius  Cassiodorus  (480-573),  the  famous  private  secretary  of 
Theodoric  the  Great  (reigned  493-526),  on  entering  this  order  founded  by 
St.  Benedict  of  Nursia  (480-544),  recommended  to  his  associates  the  study 
of  medicine.  The  statutes  of  the  order  indeed  made  the  cultivation  of  the 
science  a  part  of  its  rule,  but  the  cure  of  diseases  by  pra}-er  and  conjuration1 
was  alone  permitted,  and  the  study  of  medicine  was  prohibited.  However 
Cassiodorus  recommended  the  reading  of  certain  of  the  writings  of  Hippo- 
crates translated  into  Latin,  of  similar  translations  of  Galen  and  Dioscori- 
des,  of  the  works  of  Caelius  Aurelianus,  of  an  anonymous  author  and 
several  other  writings,  which  constituted  his  own  inherited  library  —  a  re- 
commendation which  bore  fruit  in  the  preservation  of  the  remembrance  of 
the  ancient  physicians.     From   the  Benedictines  of  England,2   where,  as 

1.  The  use  of  exorcisms  in  disease  was  general  until  as  late  as  the  last  century,  and 

even  now  is  frequently  practised  by  the  clergy. 

2.  England,  unlike  Germany,  was,  as  we  know,  a  Roman  province,  and  thus  came 

early  and  remained  long  under  the  influence  of  the  civilization  of  the  Ancients. 
She  sent  into  Germany  the  first  teachers  of  agriculture  in  the  form  of  mission- 
aries (Columba,  about  600,  for  Bavaria;  Gallus,  for  Switzerland;  Winifred,  for 
the  Franks),  so  that  the  first  impulse  to  the  higher  civilization  of  Germany  pro- 
ceeded from  her  borders,  and  in  this  roundabout  way  the  ancient  civilization 
began,  though  not  till  a  late  period,  to  influence  our  native  countrj-. 


—  256  — 

earl}-  as  the  7th  century,  there  were  teachers  of  the  Greek  language,  pro- 
ceeded too  Albin  Alcuin1  (730-80-4).  the  preceptor  of  mediaeval  Germany. 
It  was  he  who  prompted  the  foundation  of  cathedral  schools  by  Charle- 
magne" (742-814),  in  which  (as  in  the  schools  of  the  Egyptian  temples- 
and  Arabian  mosques)  from  the  year  800  forward  medicine  was  expected 
to  be  taught.  Indeed,  it  is  said  that  medical  instruction  was  begun  here 
in  childhood,  as  in  the  schools  of  the  Asclepiadse.  These  institutions  of 
Charlemagne,  who,  as  we  know,  was  a  patron  of  classical  studies  and  chose 
the  economy  of  the  Roman  empire  and  the  Christian  papacy  as  the  basis 
of  his  new  political  system,  were  important  not  only  in  the  development 
of  general  education,  but  also  especially  in  the  cultivation  of  medicine, 
though  their  influence  upon  the  latter  science  was  not  everywhere  asserted 
and  manifested  in  the  same  way  as  it  was  e.  g.  in  the  monaster}'  of  Monte 
Cassino  and  the  school  of  Salerno.  Such  schools  existed  at  Paris,  Fulda, 
Paderborn.  Wurzburg,  Hirschau.  Reichenau.  Metz,  Osnabriick,  Lyons,  Cremo- 
na. Pavia.  Florence  etc.  The  Othos  also  in  the  10th  century  took  an  interest 
in  educational  matters,  while,  with  the  help  of  their  Italian  and  Byzantine 
consorts,  they  introduced  (what  Charlemagne  essayed  in  vain)  more  refined 
culture  and  manners  into  their  court,  and  favored  luxury  and  art.  In  this 
way  they  became  prominent  in  the  development  of  civilization  in  Germany. 

The  curriculum  of  these  cathedral  schools  embraced  originally  the  Trivium, 
arithmetic,  grammar,  music),  and  the  Quadrivium  (dialectics,  rhetoric,  geometry, 
astronomy).  Charlemagne,  in  the  Capitulary  of  Thionville  (805),  ordained,  however, 
that  medicine  also  should  be  taught  (as  already  stated)  under  the  name  of  Physic. 
How  far  the  Arabian  schools  land  the  Roman  higher  schools)  served  as  patterns  and  a 
stimulus  in  this  matter,  it  is  not  easy  to  determine.  That  both  exercised  some  in- 
fluence, seems  probable,  when  we  remember  that  Charlemagne  had  dealings  with  the 
Arabians,  and  frequently  built  upon  Roman  foundations.  In  the  monastic  gardens 
medical  herbs,  such  as  althaea,  water-mint,  squill,  savine  etc.  were  always  to  be  planted. 
In  the  monastic  garden  of  St.  Gall3  e.  g.  in  the  year  820  the  following  herbs  were 
cultivated:  lilium.  rosa.  salvia,  sisymbrium,  rata,  cuminum.  gladiola.  lubestico, 
pulegium  etc.  Still  more!  This  monastery  possessed  a  chamber  for  very  sick 
persons,  a  pharmacy,  and  a  house  for  the  physicians,  with  a  residence  for  the  regular 
physician  of  the  monastery. 

1.  Flaccus  Albinus  Alcuinus,  a  native  of  York,  England,  and  educated  in  the  famous 

school  of  that,  city,  over  which  he  subsequently  presided.  He  was  one  of  the 
most  learned  men  of  his  age.  and  was  invited  by  Charlemagne  to  his  court  in 
783  and  invested  with  authority  to  establish  schools  throughout  his  kingdom. 
The  "  Schola  Palatii",  the  pupils  of  which  wftre  the  sons  of  Charlemagne  and 
other  young  noblemen  of  his  kingdom,  was  presided  over  by  Alcuin  for  several 
years,  until  he  finally  retired  to  the  monastery  of  St.  Martin  of  Tours.     (H) 

2.  The  physicians  of  Charlemagne  were  Wintarus,  and  a  Jew,  Abul  Faradsch.     The 

latter  must  not  be  confounded  with  the  Arabian  historian  of  the  same  name, 
called  also  Bar-Hebra?us  (1226-1286). 

3.  St.  Gall   was   an    Irishman,   a  pupil   and  a  companion  of  St.  Columbanus   in   his 

missionary  tours.  He  founded  the  monastery  of  St.  Gall,  near  Constance  in 
Switzerland,  about  A.  D.  612.  The  monastic  school  at  this  place  in  later  years 
became  very  famous.     (H.) 


—  257  — 

An  excellent  influence  upon  mediaeval  medicine  and  its  development  was 
exercised,  however,  b}T  the  monastic  infirmary  at  Monte  Cassino,  and  still 
more  eminently  and  effectively  by  the  school  of  Salerno.  The  former  was 
situated  in  Campania,  and  was  intimately  connected  with  the  monastery  of 
Monte  Cassino  ;  the  latter  was  in  the  province  of  Naples. 

The  monaster}-  of  Monte  Cassino  was  founded  by  St.  Benedict  himself  on  the  site 
of  an  ancient  temple  of  Apollo.  In  violation  of  the  rule  of  its  founder,  heretofore 
mentioned,  but  in  compliance  with  the  advice  of  Cassiodorus,  its  abbot  Bertharius 
(died  883)  taught,  medicine  both  orally  and  in  his  writings.  Nevertheless  the  monas- 
tery continued  to  be  rather  a  school  of  practice  than  of  instruction,  and  miraculous 
cures  seem  to  have  played  a  prominent  part  in  its  activity.  After  Bertharius,  an 
abbot  Alphanus  I.  distinguished  himself,  and  then  Desiderius  (born  1027  at  Monte 
Cassino,  succeeded  in  108fi,  under  the  title  of  Victor  III.,  pope  Gregory  VII.,  who  died 
in  Salerno  in  1085),  who  left  "four  books  on  the  miraculous  cures  of  St.  Benedict" 
and  founded  a  hospital,  which  was  enlarged  by  his  successor  Odorisius,  and  afterwards 
enjoyed  important  privileges.  Here  monks  from  foreign  lands  came  to  study,  and 
eminent  invalids  to  receive  treatment.  Among  the  latter  was  Henry  II.,  emperor  of 
Bavaria  (972-1024),  from  whom  St.  Benedict  himself  removed  a  stone  by  lithotomy 
during  his  sleep,  placed  the  stone  in  the  emperor's  hand,  and  finally  also  healed  the 
wound — a  storj-  from  which  (as  well  as  from  the  books  of  Desiderius)  we  may  infer  that 
in  this  instance,  at  all  events,  a  magnificent  pious  fraud  was  practised.  The  most 
famous  and  important  of  all  the  monks  of  this  monastery,  however,  was  Constantinus 
Africanus1  (1018-1087  or  1085)  of  Carthage,  who  introduced  Arabian  science  into 
Europe,  or  rather  into  Italy.  By  his  travels  through  all  lands  (he  acquired  his 
education  in  the  school  of  the  mosque  at  Cairo)  he  won  the  title  of  "  Orientis  et 
occidentis  doctor".  Constantinus  was  at  first  for  a  short  time  a  teacher  in  Salerno. 
Having  then  become  a  monk  in  Monte  Cassino,  he  translated  into  barbarous  Latin  and 
recast  many  works  from  the  Arabic  ("De  chirurgia",  "Pantegni",  Viaticum",2  De 
pulsibus",  "Decoitu" — a  genuine  monkish  subject — "  De  febribus  ",  "Deurinis" 
etc.).  His  pupil,  Hetto  or  Atto,  again  converted  his  wretched  translations  into 
Romaic  doggerel. 

The  glory  of  Monte  Cassino,  however,  speedily  faded  away,  a  result  to  which  the* 
increased  reputation  of  the  school  of  Salerno  most  largely  contributed.  The  latter 
school  attained  its  highest  position  in  the  12th  century,  so  that  even  among  the 
German  poets  of  that  period  a  physician  of  Salerno  was  regarded  as  the  best  of  all, 
outranking  even  those  of  Montpellier.  In  the  13th  century  the  school  still  retained 
considerable  importance,  but  from  this  time  forward  it  declined  more  and  more, 
though  it  maintained  its  existence  until  the  present  century.3    The  time  and  manner 

1.  He  was   called   by   Berthold  von  Regensburg   (13th  century)   the   "Inventor  of 

Medicine",  and  associated  with  Hippocrates,  Galen,  Avicenna,  Macer  Floridus- 
and  Bartholomaeus. 

2.  The  "  Viaticum  "  is  a  translation  of  the  Zad  el-Mosafer,  "Provision  for  the  Voyage  " 

of  Ebn  el-Jezzar;  the  "Pantegni",  a  translation  of  the  el-Maliki  of  AH  Abbas. 
Constantinus  was  the  first  to  appropriate  the  term  "variola"  to  the  special 
disease  small-pox,  though,  as  already  stated,  the  term  originated  with  Marius  vou 
Avenches  in  the  6th  century. 

3.  Its  existence  as  a  university  was  terminated  by  a  decree  of  Napoleon,  Nov.  29, 

1811,  though  the  Collegium  medicum  was  not  discontinued.      The  university  of 
Salerno  was  revived  by  the  Bourbons  and  still  exists  (Haeser),  but  it  is  now  an 
institution  of  very  little  importance.     (H.) 
.    17 


—  258  — 

of  the  founding  of  the  school  of  Salerno  are  unknown  and  uncertain,  and  on  this 
subject  conjectures  only  can  be  advanced. 

Salerno  was  founded  by  the  Romans  as  early  as  B.  C.  200.  and,  in  consequence 
of  its  charming  situation  and  climate,  enjoyed  among  them  the  reputation  of  a 
climatic  health-resort,  with  many  of  which  they  were  acquainted.  It  is  therefore 
probable  that  physicians  were  always  located  here,  and  we  know  that  among  the 
Romans  all  physicians  might  be  teachers  also.  After  the  establishment  of  Christian- 
ity, however,  Salerno  became  likewise  a  resort  for  pilgrims,  as  well  as  a  kind  of 
medical  establishment,  in  consequence  of  the  fact  that  in  its  cathedral  were  to  be 
found  the  bones  and  other  relics  of  St.  Matthew  and  the  three  saints  Thecla,  Susanna 
and  Archelais.  To  these  bones  a  bishop  Adalberon  made  a  pilgrimage  in  (J84,  but 
without  receiving  any  benefit.  The  city  of  Salerno  at  an  early  date  received  also  a 
Benedictine  monastery.  Charlemagne,  as  early  as  the  year  802,  is  said  to  have 
founded  a  school  here,  as  he  did  in  so  many  other  places — Subsequently  the  city  fell, 
as  we  know,  into  the  possession  of  the  Normans,  whose  reign  is  important  in  the 
history  of  civilization  through  its  cultivation  of  the  sciences  in  the  schools  of  lower 
Italy.  Famous  schools  existed  at  Amain  and  Naples,  as  well  as  in  Salerno.  In 
Amain  the  Norman  jurisprudence  (which  was  entirely  independent  of  the  clergy)  was 
taught;  in  Naples  Graeco-Italian  law. — From  the  peculiar  fact  that  Salerno  was  both 
a  watering-place  and  a  resort  for  pilgrims  it  is  possible  that  a  more  lively  interest  in 
medicine  proper  may  have  alwajs  prevailed  there,  especially  as  many  Benedictines, 
under  the  guise  of  monkish  physicians,  followed,  and  inculcated  in  others,  the  advice 
of  Cassiodorus  to  read  Hippocrates  and  Galen.  Perhaps  too  they  saw  that  miracles 
alone  were  insufficient  to  retain  their  reputation,  and  that  the  cure  of  disease  brought 
emolument.  Besides  this  the  Greeks  of  neighboring  Sicily  may,  and  subsequently  the 
Arabians  of  the  same  island  must,  have  exercised  some  influence:  for  as  early  as  the 
11th  century  Arabian  physicians  were  studied  in  Salerno,  while  up  to  this  time  the 
Greek  writers  alone  were  employed  as  the  basis  of  instruction.  The  "  Hippocratic 
Union" — "Collegium  Hiupocraticum  " — may  have  been  instituted  in  order  to  study 
and  expound  the  ancient  writers,  for  at  this  period  (indeed,  in  the  Carlovingian  age) 
the  first  impulse  toward  the  study  of  the  classics  had  developed,  to  be  followed  by  an 
interruption  until  it  burst  into  bloom  in  the  15th  and  16th  centuries.  By  degrees  this 
association  acquired  the  greatest  fame,  until  it  gained  for  the  city  itself  the  title  of 
"  Civitas  Hippocratica."  Ordinary  citizens  of  the  latter  might  become  fellows  of  the 
college.  Pupils,  teachers  and  fellows  were  exempt  from  taxation,  as  in  the  schools  of 
Rome,  an  arrangement  which,  at  all  events,  furnished  an  inducement  to  join  the 
-college.  Among  the  earliest  members  of  this  society  belonged,  probabty,  a  Jew  Elinus, 
a  Roman  Magister  Salernus,  an  Arabian  Adala  and  a  Greek  Pontus,  who  are  men- 
tioned as  the  first  teachers  of  medicine  in  Salerno.  Each  is  said  to  have  taught  his 
own  countrymen,  and  each  in  his  native  tongue;  for  all  these  languages,  besides  the 
lingua  volgare,  were  met  with  in  lower  Italy  and  Sicily.     (Gregorovius.) 

Now,  as  Salerno  lay  upon  a  mediasval  thoroughfare  and  military  high-road,  the 
■"Studium  Salernitanum "  (Lyceum,  Gymnasium),  through  the  influence  of  an 
acquaintance  with  the  arrangement  of  the  Arabian  academies  —  an  acquaintance 
easily  made  by  reason  of  the  propinquity  above  noticed  —  may  have  assumed  the 
functions  of  a  college,  modelled,  perhaps,  after  similar  institutions  among  the  Arabi- 
ans. Accordingly  Jurisprudence,  Philosophy,  Theology  and  Medicine  were  all  finally 
taught  there,  as  in  the  Arabian  academies.  The  fact  that  the  institution  was  never 
properly  a  school  of  monks,1  but  from  its  very  origin  possessed  married  teachers, 

1.    Hence  too  its  tolerance  of  Jews,  which  was  likewise  great  among  the  Arabians. 
The  Jews  were  the  "  Kammerknechte"  (slaves)  of  the  emperor. 


—  259  — 

points  also  to  an  Arabian  origin.  Indeed  even  women,  genuine  mediaeval  female 
professors  (like  the  species  recently  revived  in  Pavia),  taught  here — a  purely  western 
innovation.  Of  Arabian  or  Nestorian  origin  was  also  most  probably  the  title  of 
"  Magister"  or  "  Doctor"  (a  translation  of  the  title  Rabbi1  or  Rabban)  introduced  at 
Salerno,  and  solemnly  bestowed  on  graduation.  This  title  made  its  appearance  in 
the  middle  of  the  12th  century,  but  did  not  become  common  until  later,  because  the 
granting  of  it  being  a  privilege  of  the  universities,  its  frequency  increased  with  the 
number  of  the  latter.  The  cetemonj'  of  graduation  or  promotion  was  performed  in 
public,  and  demanded  of  the  candidate  the  fulfilment  of  the  following  preliminary 
conditions:  seven  years'  study,  the  attainment  of  the  age  of  21  years,  a  satisfactory 
examination  in  the  Hippocratic,  Galenic,  and  Arabian  writings,  legitimate  birth,2  a 
promise  to  teach  correctly,  and  in  accordance  with  the  received  doctrines,  to  administer 
no  poisons,  and  to  treat  the  poor  gratuitously — some  of  which  conditions  are  required 
of  our  candidates  to-day.  These  requirements  all  fulfilled,  the  candidate  received  a 
ring,  a  wreath  of  laurel,  a  kiss,  and  finally  the  benediction  —  and  thereafter  he  could 
teach  and  practise  wherever  he  wished.  After  graduation  the  office  of  teacher  was 
open  to  all,  as  it  was  later  in  the  first  universities.  Some  of  the  teachers  received  a 
salary  of  twelve  ounces  of  gold. 

The  tendency  of  the  school  or  university  of  Salerno  (which,  according  to 
Marx,  dates  back  into  the  6th  century,  though  first  definitely  mentioned  in 
846)  was  entirel}'  and  eminently  practical.  Hence  it  laid  great  stress  on 
S3'mptomatology,  dietetics,  treatment  and  materia  medica,  and  less,  in  accord- 
ance with  the  age,  upon  physiolog}'  and  human  anatom}-.  Still  the  latter  was 
even  then  estimated  of  such  consequence  that  Salerno's  patron,  Frederick  II. 
(1194-1250),  introduced  a  special  provision  with  respect  to  its  study  there 
into  his  medical  code.  From  this  provision  too  the  statement  that,  by  the 
emperor's  direction,  a  dissection  was  made  ever}*  five  years,  gains  great 
probability.  Probably  too  this  regularly  recurring  dissection  took  place  in 
Salerno  itself.  The  practical  bent  of  the  school  ma}'  also  be  inferred  from 
the  fact  that  considerable  importance  was  laid  upon  the  manner  of  the 
physician,  an  apparently  subordinate  matter  which  is  also  of  considerable 
weight  in  the  life  of  our  practising  physicians  to-da}'.  What  craftiness 
was  then  recommended  we  may  judge  from  the  precept  that  the  physician 
should  say  to  the  patient  that  he  will  recover  ;  to  the  relatives,  that  he  is 
very  ill.  If  he  dies,  it  will  then  be  said  that  the  physician  foresaw  the 
result ;  if  he  recovers,  his  reputation  will  likewise  be  increased.  It  sounds 
curious  (and  is  a  sign  of  the  times)  to  read  that  the  physician  should  not 

1.  Steinschneider  has  recentl}-  (1868)  published  a  Hebrew  treatise  on  pharmaceutics, 

written  about  the  middle  of  the  10th  century  by  a  Jew  who  styles  himself  "  Sab- 
batai  ben  Abraham,  called  Donnolo,  the  Physician".  The  author  was  born  near 
Otranto,  probably  about  913,  and  with  his  familj-  made  prisoner  by  the  Arabians 
in  925.  Donnolo  was  subsequent!}'  released  and  applied  himself  to  the  stud}-  of 
medicine  and  astrology.  His  work  consists  of  an  enumeration  of  120  drugs, 
almost  exclusively  from  the  vegetable  kingdom,  with  directions  as  to  their  prepar- 
ation for  internal  use  or  for  plasters  and  salves,  and,  according  to  Bajser,  it  bears 
throughout  tie  stamp  of  originalit}'.     (H.) 

2.  Legitimate  birth  was  demanded  in  our  universities  down  to  modern  times;  indeed 

it  is  required  even  to-day  for  the  attainment  of  military  grades. 


—  260  — 

pa}'  too  much  regard  to  the  wife,  daughter  or  female  servant  of  the  patient ; 
that,  when  invited  to  take  a  meal,  he  should  be  modest  and  temperate,  and 
should  look  after  the  patient  frequently  during  the  meal,  that  he  ma}-  not 
seem  to  forget  the  latter  in  the  pleasures  of  the  table  etc. 

The  two  chief  works  of  this  school  are  the  "  Compendium  Salernita- 
num  "  and  the  "  Regimen  Sanitatis  "  (Flos  vel  Lilium  Sanitatis). 

The  "  Compendium  "  is  the  first  example  of  a  complete  text-book  of  medicine, 
like  our  modern  encyclopaedias  of  medicine  and  surgery,  in  which  many  experts  work 
under  the  direction  of  a  single  responsible  editor.  The  six  following  writers  were 
co-laborers  on  the  standard  text-book  of  Salerno :  Pontus,  Petronius,  or  Petrocel- 
lus  (about  1035),  Copho,  John  of  Milan  (Johannes  Afflacius,1  Joh.  Medicus,  Joh. 
Magister),  Barthol.  Ferrarius  and  Joh.  Platearius.  Especially  prominent  are  the 
doctrines  relative  to  venesection,  the  pulse,  the  urine  and  fever,  all  of  which  are 
treated  chiefly  on  Hippocratic  principles.  The  second  work  is  a  Latin  poem,  con- 
sisting of  verses  rhyming  at  the  end  and  frequently  also  in  the  middle.  The  poetic 
form,  however  admirably  it  may  be  handled  in  itself,  and  however  true  a  model  it 
may  be  of  mediaeval  versification,  is  badly  suited  to  the  medical,  by  no  means  poeti- 
cal, and  often  quite  commonplace,  topics  of  the  work.  Such  verse-making  became  a 
genuine  mediaeval  fashion  among  Christian  writers  from  the  days  of  Gregory  Nazian- 
zen  (328-390),  who  lived  under  the  emperor  Julian.  The  object  was  often  simply 
to  facilitate  the  learning  of  the  text  by  heart,  as  in  the  Latin  grammars  from  the 
Middle  Ages  down  to  the  present  day.  We  must  not  infer  from  the  example  of  these 
grammars,  however,  that  all  poetic  inspiration  was  lacking  in  these  mediaeval  poems. 
Even  the  passion  of  Christ  was  described  in  verse  and  dramatised,  a  mediaeval  custom 
from  which  the  modern  drama  took  its  origin,  just  as  the  Greek  drama  was  in- 
vented by  the  priests  as  a  change  in  their  religious  services.  Remains  of  these  plays 
are  preserved  to  us  in  the  carnival  plays  and  "  Passionspiele"  of  Oberammergau. 
The  whole  school  was  originally  named  as  the  author  of  the  poem.  "  The  whole 
school  of  Salerno  writes  to  the  King  of  England"  (to  wit  Robert,  son  of  William  the 
Conqueror,  who  was  cured  of  a  wound  at  Salerno  in  1101  ).3 

As  examples  of  the  contents  of  this  poem  we  quote: 

"  Anglorum  regi  scribit  schola  tota  Salerni :  " 
"  Si  vis  incolumem,  si  vis  te  vivere  sanum," 
"  Curas  tolle  graves,  irasci  crede  profanum;  " 
"  Parce  mero,  camato  parum ;   non  sit  tibi  vanum  " 
"  Surgere  post  epulas  ;   somnum  fuge  meridianum  ;  " 
"  Ne  mictum  retine,  ne  comprime  fortiter  anum." 
"  Haec  bene  si  serves,  tu  longo  tempore  vives." 
"  Si  tibi  deficiant  medici,  medici  tibi  fiant 
Haec  tria :  mens  laeta,  requies,  moderata  diaeta." 

[Translated  by  Prof.  Ordronaux  : 

"  Salerno's  school  in  conclave  high  unites 
To  counsel  England's  king,  and  thus  indites: 

1.  Johannes  Afflacius,  a  pupil  of  Constantinus  Africanus  and  author  of  two  treatises 

entitled  "  De  febribus"  and  "Curae  Afflacii",  is  not  usually  indentified  with  John 
of  Milan,  though  undoubtedly  a  contemporary  of  the  latter.     (H.) 

2.  John  of  Milan  (about  1100),  president  of  the  school  of  Salerno,  is  also  named  as 

the  sole  author  of  this  long  poem,  consisting  of  more  than  2000  lines. 


—  261  — 

If  thou  to  health  and  vigor  wouldst  attain, 

Shun  mighty  cares,  all  anger  deem  profane; 

From  heavy  suppers  and  much  wine  abstain  ; 

Nor  trivial  count  it  after  pompous  fare 

To  rise  from  table  and  to  take  the  air. 

Shun  idle  noonday  slumbers,  nor  delay 

The  urgent  calls  of  nature  to  obey. 

These  rules  if  thou  wilt  follow  to  the  end, 

Thy  life  to  greater  length  thou  may'st  extend."     H.] 

"Sex  horis  dormire  sat  est  juvenique  senique," 
"  Seplem  vix  pigro,  nulli  concedimus  octo." 

"Ex  magna  ccena  stomacho  fit  maxima  poena:" 
"Ut  sis  nocte  levis,  sit  tibi  coena  brevis." 

"Post  ccenam  stabis,  aut  passus  mille  meabis." 

"  Non  sit  acetosa  cerevisia,  sed  bene  elara," 

"De  validis  cocta  granis  satis  ac  veterata:  " 

"De  qua  potetur,  stomachus  non  inde  gravatur." 

"  Grossos  humores  nutrit  cerevisia;  vires" 

"  Prasstat,  et  augmentat  carnem,  generatque  cruorem  ;  " 

"Provocat  urinam,  ventrem  quoque  mollit  et  inflat." 

[This  poem,  under  the  various  titles  of  Regimen  Sanitatis  Salerni,  Schola  Salerni- 
tana,  Medicina  Salernitana,  De  Conservanda  Bona  Yaletudine,  Flos  Medicinse  etc., 
enjoyed  the  most  unexampled  popularity  during  many  succeeding  ages,  and  was  in 
fact  the  vade  mecum  of  every  well-educated  physician  for  centuries.  Zach.  Sylvius, 
in  an  edition  of  the  Schola  published  at  Rotterdam  in  1649,  declares  "Nullus  medico- 
rum  est,  qui  carmina  Seholae  Salernitanai  ore  non  circumferat,  et  omni  occasione  non 
crepet."  M.  Baiidry  de  Balzac  counts  from  1474  to  1846  no  less  than  240  different 
editions  of  the  poem,  and  Haeser  says  that  81  manuscripts  of  the  work  are  now  known 
to  exist.  It  has  been  translated  into  English,  French,  German,  Italian,  Irish,  Polish, 
Provencal,  Bohemian,  Hebrew  and  Persian.  Choulant  mentions  four  English  trans- 
lations1 of  the  Schola,  and  a  fifth  was  published  by  Prof.  John  Ordronaux  in  1871. 

The  poem  iu  its  present  form  is  undoubtedly  a  composite  work,  enlarged  by  the 
accretions  of  ages.  The  first  edition,  published  probably  in  1474  with  a  commentary 
of  Arnold  of  Villanova,  contained  onty  364  lines  and  was  purely  dietetic  in  its  char- 
acter. De  Renzi  has  collected  from  the  various  MSS.  and  editions  no  less  than  3526 
verses,  many  of  them  of  comparativelj'  modern  origin,  though  others  borrowed  from 
Macer  Floridus,  ^Egidius  of  Corbeil  etc.  may  equal  in  antiquity  those  of  the  original 
poem.  It  is  curious  in  this  connection  to  observe  the  reference  to  inoculation  con- 
tained in  the  following  verses  of  a  later  edition: 

1.  By  Thomas  Paynell,  an  English  clergyman,  in  1530;  a  metrical  translation  by 
John  Harington  entitled  "The  Englishman's  doctor  or  the  schoole  of.  Salerne", 
1607;  Regimen  sanitatis  Salernitanum,  or  the  schoole  of  Salerne's  regiment  of 
health",  text  and  metrical  English  translation  by  P.  H(olland),  London,  1649; 
an  edition  by  Alex.  Croke,  Oxford,  1830,  Latin  text,  an  old  English  translation, 
historical  introduction  and  notes.  Ordronaux  also  speaks  of  a  translation  made 
in  1575,  the  MS.  of  which  exists  in  the  library  of  Corpus  Christi  College,  Oxford, 
but  has  never  been  published,  and  of  another  version  made  and  published  in  1617. 
.  Of  the  latter  I  know  nothing.     (H.) 


—  262  — 

Adversus  Variolas. 
"  Ne  pariant  teneris  variolae  funera  natis, 
lllorum  venis  variolas  mitte  salubres; 
Seu  potius  morbi  contagia  tangere  vitent 
^Egrum,  aegrique  halitus,  velamina,  lintea,  vestes, 
Ipseque  quae  tetigit  male  pura  corpora  dextra." 

Everyone  will  also  recognize  in  the  following  lines  the  source  of  one  of  our  com- 
mon proverbs : 

De  Potc. 
"  Si  tibi  serotina  noceat  potatio  vini, 
Hora  matutina  rebibas,  et  erit  medicina."     H.] 

As  early  as  the  ninth  century  teachers  were  active  in  the  school  of 
Salerno,  and  among  these  we  find  the  names  of  Josua.  Josep  medicus  and 
Ragenfrid,  yet  even  the  circumstances  of  life  of  the  following  physicians 
are  not  satisfactorily  settled. 

In  the  11th  century  (he  died  before  1056)  lived  Gariopontus  (also 
called  Warimpotus,  Raimbotus), 

who,  in  a  work  entitled  "  Passionarius  Galeni "  and  compiled  from  Galen  and  other 
Greek  writers,  as  well  as  in  a  lesser  degree  from  the  Arabians,  advanced  measures 
and  views  conformable  to  the  age:  e.  £.  "On  the  island  of  Delphi  a  painful  molar 
tooth,  which  was  extracted  bjT  an  inexperienced  physician,  occasioned  the  death  of  a 
philosopher;  for  (!)  the  marrow  of  the  tooth,  which  originates  from  the  brain,  when 
lacerated,  ran  down  into  the  lungs  and  killed  the  philosopher."1  (Extraction  of  teeth 
at  that  time  and  long  after  was  considered  by  regular  ph_ysicians  a  frightfully  dangerous 
operation,  though  itinerant  quacks  drew  them  out  without  hesitation.)  We,  however, 
find  in  Gariopontus  the  first  intimation  of  the  inhalation  of  narcotic  vapors,  while  the 
Ancients  were  acquainted  only  with  anaesthesia  by  compression  and  the  Arabians  with 
the  internal  use  of  mandragora  and  belladonna!2      (Corradi.) 

Not  long  afterwards  Copho  the  younger  (first  quarter  of  the  12th 
century  ;  the  elder  Copho  is  mentioned  by  Trotula) 

wrote,  in  accordance  with  views  of  Hippocrates,  Galen  and  the  Arabians,  an  "Ars 
Medendi"  and  an  "Anatomia  Porci "  —  the  latter  in  spite  of  the  fact  that  he  was, 
probably,  a  Jew.  The  "Anatomia"'  also  mentions  the  connexion  between  the  lym- 
phatics and  veins. 

Better  known,  however,  is  Nicholas  Propositus,  President  of  the 
School  of  Salerno  during  the  first  half  of  the  12th  century  (about  1140), 
whose  "Antidotarium  "  acquired  great  popularity  as  a  pharmacopoeia  in  the 
Middle  Ages,  though  (or  perhaps  rather  because)  among  its  remedies  cer- 

1.  Probably  the  tooth  itself  was  drawn  into  the  trachea  during  inspiration.    (Baas.) 

The  Latin  text  runs:  "Apud  Delphos  enim  insulam  molaris  dens  tantum  dolens 
ab  imperito  medico  avulsus  causa  fuit  mortis  philosophi,  quia  medulla  dentium  a 
cerebro  principatum  habens,  dum  crepuit,  in  pulmonem  descendens  occidit  philos- 
ophum."     (H.) 

2.  Herodotus  tells  us  that  the  Scythians  were  accustomed  to  intoxicate  themselves  by 

inhaling  the  vapor  of  hemp-seed,  and  both  Dioscorides  and  Pliny  mention  the 
anaesthetic  power  of  the  mandragora  and  its  use  preparatory  to  surgical  opera- 
tions.    (H.) 


—  263  — 

tain  prescriptions  of  St.  Paul,  and  others  handed  down  even  from  the 
prophet  Elias,  are  introduced.  The  same  work  contains  our  recently 
obsolete  apothecaries'  weight : 

20  grana         .         .         1  scrupulus, 

3  scrupuli  .         .     1  drachma. 

1^  drachmae.         .         1  hexagium, 

6  hexagia  .         .      1  uncia, 
12  uncia        .         .  1  libra, 

2\  librae  .         .      1  sextarius, 

and  also  brings  forward  the  anaesthetic  mentioned  at  a  later  period  by  Hans 
von  Gersdorf. 

Nicholas  was  also  the  author  of  a  "  Quid  pro  Quo  ",  that  is  an  alphabet- 
ically arranged  catalogue  of  equivalent  drugs,  capable  of  replacing  each 
other,  when  for  any  reason  one  or  the  other  drug  was  wanting  —  an  event 
which  must  have  frequently  occurred,  especially  with  foreign  drugs,  in  con- 
sequence of  the  imperfect  commercial  relations  of  the  period.  (From  the 
title  of  this  work  sprang  our  common  expression  "  Quid  pro  Quo".) 

In  the  middle  of  the  12th  century  Matkleus  Platearius  (son  of  Jo- 
hannes Platearius,1  who  composed  a  "  Practica  Brevis  "  in  accordance  with 
the  views  of  the  old  physicians)  wrote  "  Glossae  "  or  commentaries  on  the 
preceding  work,  and  a  treatise  "De  Simplici  Medicina  "  (called  also  from  its 
initial  words  "  Circa  Instans  "). 

Maurus,  Urso,  Petrus  Musandinus  the  teacher  of  ^Egidius,  Salo- 
mon and  Joh.  Castalius  were  also  famous  teachers  at  Salerno  during  the 
12th  century. 

To  the  last  half  of  this  century,  in  which  physicians  were  ever  poet- 
ically disposed,  belongs  yEoimus  "  Corboliensis  ",  so  named  because  born 
at  Corbeil  near  Paris. 

On  his  return  from  Salerno  he  became  ordinary  plrysician  to  King  Philip  Augus- 
tus (11 65—121 H),  and  sang  in  verse  "  De  Urinis",  "De  Pulsibus',  and  "  De  Laudibus 
et  Virtntibus  Compositorum  Medicaminurn  ".  In  this  latter  poem  he  already  laments 
the  decline  of  Salerno,  and  ascribes  the  retrogression  of  medicine  to  the  circumstances 
that  physicians  pushed  aside  as  useless  all  books  which  did  not  contain  recipes, 
and  that  the  right  to  teach  in  the  school  had  been  granted  to  youthful  "  sprigs  and 
immature  boys". 

Alcadinus  of  Syracuse  (12-13th  centuries),  physician  to  Frede- 
rick II.  and  a  teacher  in  Salerno, 

composed  a  poem  in  elegiac  measure  "  De  Balneis  Pnteolanis"  :  Otho  Cremonensis, 
who  belonged  to  the  beginning  of  the  13th  century,  wrote  a  similar  poem  in  simple 
hexameters  "  De  Electa  Medicamentorum  Simplicium". 

1.  Johannes  Platearius  was  the  inventor  of  the  term  "cataracta"  in  place  of 
the  old-Egyptian  term  signifying  "ascent"  and  the  Greek  "  hypochysis ",  in 
classical  Latin  "suffusio  humorum  ".  (Hirsch.)  Much  confusion  exists  with 
reference  to  the  precise  period  of  the  Platearii  and  their  relationship  to  each 
other. 


—  264  — 

Among  the  female  physicians  who  proceeded  from  the  school  of  Salerno 

Trotula  de  Ruggieri1  (or  Eros) 
wrote,  with  other  works,  a  treatise  entitled  "  De  passionibus  mulierum  ante,  in  et  post 
partum",  in  which  she  gives  directions  for  perimeorraphy.  To  determine  the  sex 
of  the  foetus  she  advises  to  drop  three  drops  of  blood  or  milk  from  the  right  side 
into  water:  if  the  foetus  is  a  female  the  drops  will  float  on  top;  if  a  male  they  will 
sink. 

Abella, 
without  prejudice  to  the  lovely  modesty  of  her  sex,  and  as  a  still  unattained 
ideal  for  our  "  doctresses "  of  the  present  day,  who  for  the  sake  of  decency  are 
forced  to  confine  their  attention  to  the  heart,  bubbled  over  with  poetic  enthusiasm  in 
some  verses  "  De  natura  seminis  hominis",  and  also  wrote  a  treatise  "  De  atra  bile". 
The  most  famous  among  the  female  physicians,  however,  was 

COSTANZA  CALENDA 
(distinguished,  like  most  of  the  ladies  of  Salerno,  for  her  beauty),  who  lived  under  the 
equally  beautiful  and  notorious  Joan  II.  of  Naples  (1414-14H5),  but  left  no  writings. 

Mercuriadis  (15th  century) 
composed  treatises  "  De  crisibus  ",  "  De  unguentis"  and  "  De  curatione  vulnerum  ". 

Rebecca  Guarna  (15th  century) 
wrote  works  entitled  "  De  febribus",   "  De  urinis"  and  "  De  embryone". 

These  doctresses  all  lived  between  the  12th  and  14th  centuries,2  and,  as  we  have 
seen,  wrote  on  all  medical  subjects,  but  particularly  on  gynaecology  and  midwifery. 
Later  Salernian  physicians,  who  translated  and  followed  the  lead  of  the  Arabian 
writers  on  medicine,  and  thus  laid  the  foundation  of  the  subsequent  decline  of  the 
school  of  Salerno,  were  : 

Romuald  II.  bishop  of  Salerno  (1153-1181), 
who  died  in  the  office  of  physician  to  the  pope; 

Franciscus  Alphanus, 
who  wrote  "On  the   plague,    pest^ever,   malignant   fever,  small-pox   and    measles"; 

JOH.  NlCOLAUS  DE  RoGERIIS, 
a  physician  of  Venice  in  the  beginning  of  the  13th  centuiy,  and 

1.  According  to  Handerson   ''Trotula"  is  merely  the  title  of  the  book,  which  was 

written  by  a  man,  while  Trotula  is  always  mentioned  in  the  third  person.  (Baas.) 
The  translator,  while  not  insensible  to  the  delicate  flattery  of  the  author  in  quo- 
ting him  as  an  authority  on  a  question  which  may  perhaps  be  called  the  pons 
asinorum  of  medical  historians  —  the  identity  of  Trotula  and  the  authenticity  of 
the  work  which  bears  her  name — feels  called  upon,  in  the  interests  of  truth,  to  say 
that  his  opinion  (expressed  in  the  "School  of  Salernum')  was  based  entirely 
upon  the  results  of  an  examination  of  two  earl}"-  MSS.  by  Malgaigne,  and  was, 
quite  naturally,  substantially  the  opinion  of  that  eminent  surgeon.  As  Darem- 
berg  and  De  Renzi,  after  a  similar  examination  of  various  MSS.  of  the  work 
ascribed  to  Trotula,  arrived  at  conclusions  diametrically  opposite  to  those  of 
Malgaigne,  affirming  the  undoubted  identity  of  Trotula  and  the  substantial  authen- 
ticity of  her  work,  the  translator,  in  imitation  of  the  example  of  the  pious  and 
puzzled  Ibn  Khallikan,  can  only  exclaim,  "  God  knows  best  which  of  these  state- 
ments is  true! "     (H.) 

2.  Trotula  is  believed  by  Daremberg  to  have  been  the  wife  of  John  Platearius  the 

elder,  who  flourished  in  the  11th  century,  while  several  of  the  other  "doctresses", 
as  the  author  himself  states,  lived  in  the  15th.     (H.) 


—  265  —  . 

Johannes  Vincentius,  and 
Johannes  Vitus  de  Rooeriis. 

[Other  writers  of  the  school  of  Salerno,  who  deserve  mention,  were: 

Magister  Salerncs,  who  flourished  about  the  middle  of  the  12th  century  and 
wrote  the  "Tabula?  Salerni",  a  short  treatise  on  the  virtues  and  effects  of  medicine, 
and  a  "  Compendium". 

Berxardus  Provincialis,  who  wrote  about  1155  an  interesting  commentary  on 
the  "  Tabulae"  of  Salernus,  in  which  he  endeavors  to  simplify  the  materia  medica  by 
eliminating  foreign  drugs,  as  far  as  possible;  and 

Farraguth  (Farragius,  Farragus),  a  learned  Jew,  educated  at  Salerno,  who 
translated  into  Latin  the  "  Continens ''  of  Rhazes  in  the  latter  part  of  the  13th 
century. 

The  Salernian  surgeons  Roger,  Roland  and  the  "  Fpur  Masters",  the  famous 
oculist  Benvenuti  Graphteus,  and  the  pharmacist  Saladino  d'  Ascoli,  are  noticed 
hereafter.     (H.)] 

The  profound  importance  of  Salerno  as  regards  medical  culture  de- 
pends not  upon  any  memorable  contributions  to  science  which  proceeded 
from  her  school,  but  rather  upon  the  fact  that  within  her  "  Hippocratic 
Society  "  the  principles  of  the  great  ph}'sicians  of  antiquit}*  were  at  first 
cultivated  independently,  and  subsequently,  when  received  through  the 
medium  of  the  Arabians  (though  in  a  corrupted  form),  were  carefull}T  pre- 
served. Her  school  too  (again  after  the  example  of  the  Arabians)  main- 
tained and  secured  the  influence  of  the  laity  upon  the  progressive  develop- 
ment of  medicine  at  a  time  when  the  priests  especiall}'  were  again  active 
in  passing  off  their  stale  devices  for  a  science  of  healing.  It  promised  to 
free  work  a  field  of  action,  since,  so  far  as  was  possible  at  that  day,  it  held 
itself  aloof  from  the  fetters  of  the  fanatical  Church.  Thus  her  school  at- 
tained an  extended,  and  even  an  international,  importance  ;  for  here  taught, 
studied  and  interchanged  ideas,  Arabians  and  Jews  as  well  as  Christians. 
It  was,  like  Alexandria,  one  of  the  historic  bridges,  over  which  ancient 
culture,  and  particularly  ancient  medical  culture,  took  its  way  during  the 
Middle  Ages  from  East  to  West.  Salerno  was  also  the  medium  by  which 
Arabian  pharmacy  and  therapeutics  were  introduced  into  the  medicine 
of  the  West.  It  is  also  in  the  highest  degree  probable  that  she  borrowed 
from  the  Arabians  the  principle  of  arrangement  of  her  school,  to  transmit 
it  again  in  the  sequel  to  the  European  universities.  The  latter  may,  there- 
fore, be  considered  offshoots  of  Oriental  civilization,  matured  and  natural- 
ized among  us. 

If,  however,  Salerno  may  be  considered  the  forerunner  and  model  of 
the  later  universities,  the  same  holds  true  in  a  greater  degree  of  the 

School  of  Montpellier, 
so  important  not  only  in  medicine,  but  in  the  entire  culture  of  the  West, 
and,  possibly,  a  direct  continuation  of  a  Roman  institution  of  learning. 
Montpellier  also  resembles  Salerno  in  this  respect,  that  here  too  the 
Ancients  (especially  Hippocrates)  and  their  principles  found  still  some  cul- 
tivation, though  Galen  and  the  Arabians  were  the  chief  authorities.  Another 


—  26G  — 

point  of  comparison  between  the  two  is  found  in  the  fact  that  the  physi- 
cians who  proceeded  from  her  school  did  not  lapse  unconditionally  to  the 
Ohurch  or  to  its  mediaeval  philosophy  (though  according  to  our  views 
they  certainly  suffered  strongly  therefrom),  and  preserved,  in  part  at  least, 
reasonably  practical  principles.  Finally  Montpellier  resembles  Salerno  in 
the  fact  that  the  reputation  of  her  school  was  so  great,  that  to  have 
studied  there  also  lent  a  special  halo  of  glory  to  the  physician.  Besides, 
though  her  teachers  were  compelled  to  be  unmarried  clerg}',  she  preserved 
a  small  portion  of  reasonable  pagan  thought,  and  demonstrated  the  prac- 
tical scientific  tendency  of  her  school  by  the  fact  that  from  1376  onward  an 
annual  dissection  of  the  corpse  of  a  criminal  took  place  here. 

Montpellier,  "  Lovely  Montpellier",  —  Mons  Pessulanus  ■ — which,  like  Salerno, 
occupies  a  charming  position  not  far  from  the  sea  and  in  the  vicinity  of  baths,  wasr 
as  early  as  the  jear  1153, l  so  famous  and  successful  as  a  school  of  medicine,  that 
many,  "  who  only  intended  to  study  philosophy  more  thoroughly,  became  her  pupils". 
Within  her  walls  sojourned  (doubly  praiseworthy  in  so  dark  an  ape)  both  Christians 
and  Jews,  the  latter  of  whom  were  subject  directly  to  the  civil  authorities.  The 
Jews  were  especially  important  as  translators  for  the  West.  One  of  the  most  famous 
of  the  Jews  of  Montpellier  was  Profatius  Judaeus  (Yacub  ben  Makir),  a  mathema- 
tician, astronomer  and  physician,  who  was  even  Rector  of  the  Faculty.  Until  1220 
(when  cardinal  Conrad,  a  German,  first  established  a  satisfactory  examination  as  the 
condition  of  entrance  upon  the  office  of  teacher)  every  graduate  could  teach  here,  as- 
at  Salerno.  Subsequently  Montpellier  (which  was  until  1870  subject  to  the  pope,  then 
to  the  kings  of  France)  received  a  faculty  of  philosophy  and  of  law,  and  a  rank 
similar  to  that  of  the  University  of  Paris.  Yet  even  to  this  day  the  school  of  medi- 
cine remains  her  chief  ornament. 

One  of  the  most  illustrious  and  famous  pupils  of  Montpellier  was  the 
religious  m3'stic  and  alchemistic  visionary, 

Raimond  Lull,  "Doctor  Illuminatissimus"  as  he  was  called,  a 
would-be  transmuter  of  metals  and  searcher  for  the  philosophers'  stone, 
which  in  this  century  began  to  be  extolled  as  a  means  for  the  preservation 
of  eternal  health. 

Born  in  a  high  station  at  Majorca  in  1285,  in  his  j'outh  he  served  Venus  (that  not 
entirely  heavenly  goddess,  though  a  deity  who  frequently  supplies  sons  and  daughters. 
of  heaven,  i.  e.  monks  and  nuns — after  they  reach  old  ape)  with  such  faithfulness,, 
that,  as  early  as  the  age  of  30,  he  received  visions,  and  became  wonderfully  pious. 
Accordingly  he  entered  the  order  of  Minorites,  learned  Arabic,  and  then  went  on  a 
journey  to  northern  Africa  to  convert  the  Saracens.  The  Saracens,  however,  declined 
to  learn  anything  from  him,  so  he  returned  again  to  Italy,  only,  however,  to  go  back 
to  Africa.  Once  more,  persecuted  and  harassed,  he  journeyed  back  to  Italy,  but,  in 
spite  of  his  earlier  and  double  unfortunate  experience,  ventured  once  again  to  Africa, 
and  was  there  stoned  to  death  in  1315  as  an  importunate  missionary  by  the  Saracens, 

1.    Montpellier  is  said  to  have  been  founded  in  738.     The  first  mention  of  the  study 
of  medicine  there  occurs,  however,  in  1137,  when  bishop  Adelbert  II.  of  Mayence 
visited  the  city  to  listen  to  its  medical  teachers.     At  this  period  it  is  said  : 
"  Hie  et  doctrina  praeceptaque  de  medicina 
A  medicis  dantur,  qui  rerum  vim  meditantur." 
The  Faculty  of  philosophy  was  added  in  1242,  and  that  of  law  in  1298.     (H.) 


—  267  — 

whose  patience  was  finally  exhausted.  Besides  alchemistic  and  philosophico-theolog- 
ical  works,  amonj;  which  is  his  "  Ars  magna",  he  wrote  also  on  medical  subjects,  viz.: 
"  De  pulsions  et  urinis"  ;  "  De  medicina  theorica  et  practica'" ;  "  De  aquis  et  oleis"  ; 
etc.  "  Like  all  great  minds  of  the  Middle  Ages"  (Heine)  Lull  passed  for  a  sorcerer 
in  league  with  the  devil.  Some  regard  liim  as  a  lunatic,  others  as  a  remarkable  man. 
He  was,  at  all  events,  a  notable  spirit.  His  important  chemical  works  undoubtedly 
owe  their  existence  to  his  acquaintance  with  the  Arabians.1 

Bernard  Gordon,2  a  Frenchman, 
who  wrote  a  famous  compendium  of  medicine  under  the  title  "  Lilium  medicinae"r 
was  a  teacher  at  Montpellier  from  128a  to  1307.  That  he  worked  under  Arabian 
influence  is  evident  from  his  statement  that  small-pox  and  measles  originate  from 
conception  occurring  during  menstruation.  On  the  other  hand  he  betrays  evidences 
of  scholastic  speculation  when  he  announces  that  the  bile  descends  in  the  third  hour, 
black  bile  in  the  ninth,  but  mucus  in  the  evening.  He  also  lays  great  weight  upon 
the  constellations,  but,  like  a  "  canny  Scotchman  ".  also  pays  especial  attention  to  the 
purse,  i.  e.  the  wealth  or  poverty  of  the  patient.  Gordon  is  the  first  medical  writer  to 
mention  the  use  of  spectacles,  but  praises  highly  his  own  eye-water,  by  the  use  of 
which  he  could  render  them  unnecessary. 

Still  better  known  is  the  compendium  of 

Gilbert  of  England  (1290), 
which,  with  the  lack  of  taste  characteristic  of  his  age,  he  has  entitled  "  Laurea 
Anglicana".3  In  this  work  he  embraces  Arabian  and  scholastico-Galenic  views,  but 
would  have  gladly  followed  Hippocratic  principles,  if,  as  he  sa3-s— he  had  been  willing 
to  pass  for  a  fool !  Leprosy,  the  results  of  impure  coitus,  the  exhibition  of  mercurial 
preparations  and  of  acetate  of  ammonia,  the  virtues  of  sulphurous  waters  etc.  are 

1.  Lull  wrote  his  works  in  the  Spanish  language.     Humboldt  calls  him  a  "  singularly 

ingenious  and  eccentric  man ",  and  ascribes  to  him  a  notice  of  the  mariner's 
compass  in  1286,  and  of  the  astrolabe  in  1295. 

2.  Gordon,  though  of  Scotch  descent,  seems  to  have  been  born  in  France  and  edu- 

cated at  Salerno.  The  "  Lilium  medicina?  "  was  written  in  1305.  Hasser  calls 
it  a  work  "thoroughly  independent,  and  rich  in  observations".     (H.) 

3.  It  is  probably  fair  to  say  that  Gilbert's  work  is  neither  better  nor  worse  than  those 

of  his  contemporaries.  We  find  the  same  scholastic,  speculative  nonsense,  the 
same  polypharmacy  and  the  same  superstition.  Little  else  could  be  expected  in 
a  work  compiled  largely  from  other  writers.  If  Gilbert  was  not  educated  at 
Salerno,  he  certainly  displays  an  intimate  acquaintance  with  the  literature  of  that 
school,  quoting  Copho.Gariopontus,  Constantinus,  Romuald,  Nicholas  Praepositus 
and  Maurus,  while  the  surgical  portions  of  his  work  coincide  too  closely  with  the 
writings  of  Roland  of  Parma  to  permit  us  to  think  the  agreement  accidental. 
Gilbert  also  quotes  Magister  Ricardus  "omnium  doctorum  doctissimus ",  but 
which  of  the  several  physicians  bearing  this  name  is  referred  to  it  is  difficult  to 
decide.  However,  there  was  an  English  physician  of  this  name,  residing  in  Paris 
(he  died  there  in  1252),  several  of  whose  works  still  exist  in  MS  ,  e.  g.  "  Micro- 
logus  inagistri  Ricardi  Anglici",  a  treatise  on  the  causes,  signs  and  cures  of 
diseases,  and  "  Tabula?  Ricardi  Anglici  medici.  cum  commentario  Joannis  de 
Sancto  Paulo  et  glossulis  in  eas".  Thus  Gilbertus  Anglicus  was  not  the  first 
English  writer  on  practical  medicine,  but  only  the  earliest  whose  works  have  been 
published.  The  work  of  Bartholomams  Anglicus,  an  English  Franciscan 
monk  (about  1250),  entitled  "  De  proprietatibus  rerum",  treats  of  a  few  medical 
subjects  incidentally.     (H.) 


—  268  — 

well  described  in  his  book.  How  much  nonsense  (besides  what  may  be  regarded  as 
reasonable  for  that  day)  was  then  classed  under  the  head  of  medical  science  may  be 
judged  from  the  following  statement :  lice  spring  partly  from  the  blood  and  mucus, 
partly  from  the  yellow  and  black  bile  ;  the  vital  spirits  in  the  body  take  a  direct,  the 
animal  spirits  a  circular  course ;  the  conscious  soul  is  no  bare  form,  like  the  vegeta- 
tive, hence  the  former  is  immortal.  In  cases  of  stone  he  administers  the  blood  of  a 
he-goat  which  has  eaten  diuretics;  lethargy,  however,  he  "treats"  by  tying  a  lusty 
sow  to  the  bedstead,  that  the  healing  influence  of  a  vigorous  grunt,  close  at  hand, 
may  be  felt  by  the  patient.  Still  more  absurd,  however,  than  this  ps3Tchical  drastic 
is  the  advice  in  sexual  debility  to  carry  a  scrap  of  paper  inscribed  with  arrant  non- 
sense! But  alas!  all  this  is  no  unheard-of  exception  in  the  history  of  the  treatment 
of  the  sick. 

Still  more  famous  was  the   "  Rosa  Anglica "  of  John  Gaddesden, 
which  appeared  between  1305  and  1314. 

Gaddesden  lived  at  Oxford,  was  (like  Gilbert1)  physician-in-ordinaiy  to  the  king 
of  England,  and  a  professor  in  Merton  College,  Oxford  (founded  1264),  the  same 
institution  in  which  Harvey  officiated  at  a  later  period. 

His  scholastic  subtilties,  mysticism  in  the  use  of  remedies,  nonsense,  taint  of 
medical  avarice,  superstition  and  charlatanry,  as  well  as  his  disgusting  therapeutics, 
may  be  charged  in  part  to  the  times.  Examples  of  the  latter  are  hogs  dung  in 
haemorrhage,  the  daily  insertion  of  one's  own  finger  into  the  anus  to  relieve  the  pain 
of  stone,  cathartics  for  crab-lice,  the  imposition  of  hands  by  the  king  of  England 
(which  included  also  the  king  of  France)  for  scrofula2  etc.  He  (like  our  law)  advises 
the  physician  to  stipulate  his  fee  in  advance,  gives  a  summary  of  those  diseases  in 
which  the  physician  earns  little,  and  distinguishes  between  the  medicines  for  the  poor 
and  the  rich.  Yet  he  remarks,  fairly  enough,  that  if  the  laity  were  well  versed  in  our 
best  arcana,  thejr  would  esteem  our  art  lightly,  and  despise  the  physician. 

Arnold  of  Villanova  (near  Montpellier), 
having  abandoned  theology,  studied  medicine  at  Montpellier.  He  lived  from  1235  to 
1313  a  very  stirring  life,  travelled  extensively,  and  at  the  close  of  the  13th  century 
was  a  teacher  at  Barcelona  and  ordinary  physician  of  Peter  III.  of  Aragon.  Thence 
he  fled  to  Paris,  after  falling  under  the  ban  because  of  his  sensible  declarations  that 
the  bulls  of  the  popes  were  human  works,  and  that  acts  of  charity  were  dearer  to  God 
than  hecatombs  etc.,  etc.  Accused  of  alchemy,  he  was  again  compelled  to  flee,  went 
thence  to  Montpellier,  Bologna,  Rome  and  Naples,  and  finally  perished  by  shipwreck 
as  he  was  sailing  from  Palermo  to  the  pope,  who,  personally,  held  him  in  high  esteem. 
Fanaticism  still  persecuted  him  after  death  in  his  very  works,  some  of  which  were 
•condemned  by  the  Inquisition.  Arnold,  however,  merits  no  less  esteem  for  his  views 
in  so  dark  an  age  on  religious  matters  (condemned  as  they  were  for  heresy)  than  for 
his  medical  and  surgical  knowledge  and  the  praise  which  he  bestows  upon  Hippocrates, 
Galen,  and  even  Rhazes  and  the  teachers  of  Montpellier,  because  they  promoted 
rather  experiment  than  mere  speculation.  Yet  he  was  given  to  the  Arabico-Galenic 
subtilties  of  his  time,  was  a  profound  devotee  of  astrology,  and  was  not  free  from  a 

1.  Gilbert  was  never  ordinary  physician  to  the  king.     Gaddesden  was  the  first  native 

Englishman  who  held  this  position.  The  latter  is  said  to  have  treated  the  son  of 
Edward  II.  of  England,  when  suffering  from  small-pox,  by  surrounding  him  with 
scarlet  wrappings  and  curtains.     See  p.  58,  note.     (H.) 

2.  This  ceremony  is  said   to  have   been   first  performed  by  Edward  the  Confessor 

(1042-1066).  A  special  "Service  of  Healing"  was  used  in  the  English  Church 
in  the  reign  of  Henry  VIII.  (1484-1509).     (H.) 


—  269  — 

belief  even  in  witchcraft.  Moreover  he  inculcated  the  use  in  practice  of  open  swind- 
ling and  fraud:  "  If  thou  canst  find  nothing  by  an  examination  of  the  urine,  declare 
that  an  'obstruction'  of  the  liver  exists.  If  again  the  invalid  says  he  suffers  from 
headaches,  thou  must  say  they  spring;  from  the  liver.  Particularly,  however,  use  the 
word  'obstruction',  since  it  is  not  understood,  and  it  is  of  great  importance  that 
people  should  not  understand  what  thou  sayest."  Let  us  compare  this  not  very 
honest  advice  (even  if  taken  as  a  joke)  of  a  Christian  with  the  precepts  imparted  to 
the  Indian  physician — and  we  must  praise  the  morality,  not  of  the  Christian,  but  of 
the  "  heathen  "  !  Arnold's  "  Parabolas  "  an  I  especially  his  "  Breviarium  ",  "  De  Vinis" 
etc.  were  very  famous.  He  was  also  the  first  to  administer  brand}',  which  he  regarded 
as  the  elixir  of  life. 

Similar  things  are  to  be  found  also  in  the  treatise  "  On  the  fistula  in 
ano " 1  by  the  physician  John  Ardern,  who  flourished  as  a  surgeon  in 
Newark  in  1349,  and  settled  in  London  after  the  middle  of  the  14th  century. 
Subsequently  he  served  as  an  army-surgeon  in  France.  Ardern  had  prob- 
ably studied  at  Montpellier,  as  well  as  the  Portuguese  Valescus  de  Taranta 
(1382-1417,  ordinary  physician  of  Charles  VI.  of  France),  who  also  wrote 
on  surgical  subjects,  and  among  other  things  was  acquainted  with  the  taxis. 
To  the  school  of  Montpellier  are  also  assigned  Gerardus  a  Solo,  professor 
there,  and  Gulielmus  de  Brescia  (Guil.  Corvi,  1250-1326),  ordinary  ph}*si- 
cian  of  Clement  V.  (died  1314).  Connected  with  this  school  were  also 
Raimond  Chalin  de  Vinario,  a  contemporary  of  Gui  de  Chauliac.  and,  like 
the  latter,  ordinary  physician  at  Avignon  ("  De  peste  libri  tres");  Johannes 
de  Tornamira  (about  1400),  ordinar}-  physician  of  several  popes,  and  for  a 
long  time  chancellor  of  Montpellier,  and  the  surgeon  and  anatomist 
Henricus  ab  Hermondavilla,  teacher  of  Gui  de  Chauliac  at  the  school  of 
Montpellier,  to  whom  we  shall  again  return.  The  last  mentioned  of  these 
physicians  should  stand  forth  with  other  prominent  spirits  as  the  light  of  a 
better  age.  And  such  an  age  must  come,  unless  all  science,  and  every 
moral  law  which  alone  supports  it,  should  utterly  perish  !  How  must  all 
the  good  taste  of  any  period  have  disappeared  (doubtless  a  trifling  matter 
compared  with  the  evils  mentioned),  when  most  writers  chose  titles  for 
their  works  after  the  style  of  ballad-singers,  and  treatises  describing  the 
plague,  gonorrhoea  and  chancre,  were  labelled  "  Flowers  and  Lilies  of 
Medicine "  !  Indeed,  even  men  of  science  no  longer  hesitated  to  teach 
confessed  superstition,  to  mingle  this  unblushingly  with  open  deceit,  and, 
in  opposition  to  the  interests  of  the  most  needy  of  their  fellow-creatures, 
the  sick  and  the  poor,  to  choose  the  measure  of  their  hoped-for  fee  as  the 
level  of  medical  extortion  ! 

3.  This  is  an  extract  from  a  large  work  written  by  Ardern,  and  entitled  "  Practica". 
It  was  written  in  Latin,  but  the  extract  on  fistula  was  translated  into  English  and 
published  by  John  Reed  in  1588.  Manuscripts  of  the  "Practica"  exist  in  Oxford 
and  London,  but  the  complete  work  has  never  been  published.     (H.) 


—  270  — 

3.    INFLUENCE  OF  THE  CRUSADES  (BETWEEN  1095  AND  1270),  OF  MEDICAL 
LEGISLATION,  OF  THE  UNIVERSITIES  AND  OF  CHRISTIAN 
PHILOSOPHY  (SCHOLASTICISM),  UPON  THE  MEDI- 
CINE OF  THE  LAST  CENTURIES  OF'THE 
MIDDLE  AGES. 

Faith,  though  not  the  sole  lever  b}-  which  the  Middle  Ages  were 
moved,  was  yet  almost  their  sole  rule  of  conduct.  That  wonderful  plant, 
for  which  the  ground  had  been  prepared  by  the  fallen  people  of  Antiquity 
and  the  Neo-Platonic  philosoph}*,  struck  its  roots  deeply  and  securely  in 
the  ancient  ages  of  persecution.  But  it  was  not  until  removed  entirely 
from  the  reach  of  sober  pagan  speculation  that  it  shot  up  luxuriant  and 
strong  in  sap  and  leaf,  and  finally  overspreading  all  other  spiritual  emotions, 
not  only  robbed  them  of  the  clear  light  of  day,  so  essential  to  their  glad- 
some growth,  but  absolutely  stifled  them  in  the  damp  gloom  of  delusion. 
Its  bloom,  like  the  famous  flower  of  night,  unfolded  itself  with  explosive 
force  in  the  "  God  wills  it "  of  the  Crusades,  and,  by  the  fascination  of  its 
magic  fragrance,  stupefied  with  religious  intoxication  the  whole  of  man- 
kind attuned  to  romance — an  intoxication  which  only  gradually  wore  off 
under  the  influence  of  long  and  destructive  military  expeditions. 

A  great  part  of  the  high  value  of  the  Crusades  in  the  development 
of  civilization  among  the  masses  depends  assuredly  upon  their  guidance 
towards  health  of  this  universal  and  insane  morbid  faith.  For  centuries 
the  bigoted  semi-activit}-  of  the  human  mind,  turned  ever  in  one  direction 
aud  occupied  soleh*  in  the  sphere  of  faith,  had  too  strongly  aroused  the 
imagination,  and  excited  unhealthy  yearnings  after  unattainable  happiness. 
"With  historic  necessit}',  therefore,  this  universal  morbid  tension  was  com- 
pelled to  relax  itself  in  those  expeditions,  which,  to  us  who  are  weaned 
from  the  faith  and  live  in  a  more  healthy  atmosphere,  appear  absolutely 
quixotic, — expeditions  in  which  even  children  joined,  and  which  had  no 
other  object  than  the  seizure  of  a  sepulchre  existing  only  in  the  eye  of  faith.1 

In  another  respect,  however,  the  historic  results  of  these  expeditions, 
which  seem  to  us  such  pure  ventures  of  the  faith,  were  extremely  impor- 
tant in  the  development  of  humanity  in  the  West.     They  brought  the  rude 

1.  Out  of  the  same  impulse  grew  the  cathedrals,  which,  since  that  period,  have  ex- 
isted everywhere,  and  by  the  size,  expensiveness  and  magnificence  of  which  it  is 
desired  to  honor  and  propitiate  God  and  the  Saviour — a  sign  how  greatly  the 
inner  spirit  of  Christianitjr  has  decayed,  and  how  greatly  the  power  of  the 
priesthood  has  grown.  If  a  new  epoch  and  stylf  of  art,  the  Christian,  was 
happily  thus  created,  yet  all  these  magnificent  structures  had,  on  the  other  hand, 
a  gloomy  side:  the  deepest  superstition  ruled  the  masses,  and  under  its  influence 
they  spent  their  means;  and  while  the  priests  served  God  with  show  within  the 
cathedrals,  the  poor  people,  for  whom  "salvation"  was  chiefly  designed,  starved 
outside.  The  ministers  of  God  preached  to  them  only  of  the  joys  of  the  future 
life,  while  they  appropriated  to  themselves  by  anticipation  in  this  life  a  great 
number  of  pleasures  offered  to  others  hereafter  as  the  reward  of  virtue.  If  this 
too  was  an  historical  mission  (as  some  affirm),  it  was  at  least  a  very  dubious  one! 


—  271  — 

inhabitants  of  the  West  (whose  emperors  could  not  all  even  read)  into  contact 
with  the  highly  cultivated  Saracens,  then  in  the  bloom  of  their  civilization, 
and  with  the  oriental,  though  mistaught,  Greeks,  and  in  this  way  awakened 
the  impulse  and  germ  of  civilization  deeply  slumbering  in  the  West.  More- 
over the}T  opened  the  way  for  the  crushing  of  the  political  and  spiritual 
supremacy  of  the  pope  and  the  clergy  in  general,  whose  mandates  there- 
after no  longer  preserved  absolute  and  unlimited  swa\',  and  whose  teach- 
ings and  lives  henceforth  suffered  sharp  criticism.  The  crusading  knights 
themselves  first  ventured  to  set  the  religious  authorities  at  defiance.  The 
bondmen,  in  common  danger,  learned  to  follow  their  example,  and  thus  a 
threefold  emancipation  of  mankind,  political,  social  and  spiritual,  was  in- 
troduced by  the  Crusades.  Again  the  Crusades  awakened  commerce  by 
the  wish  to  obtain  the  products  and  objects  of  luxury,  which  the  Crusaders 
had  learned  to  know,  and  extended  it  to  other  maritime  countries  than 
those  heretofore  frequented  (Venice).  Moreover  the  knowledge  of  remote 
lands  excited,  even  in  the  lower  classes,  curiosity  and  the  desire  for  dis- 
covery, or  rather  for  travel,  and  showed  likewise  that  the  despised  unbe- 
lievers and  their  wives  were  not  quite  so  bad  as  the  sermons  at  home 
painted  them,  so  that  the  credibilit}*  of  the  latter  received  a  shock.  In 
comparison  with  such  great  gains  to  posterit}*,  the  temporary  over-cultiva- 
tion of  eastern  astrolog}'  and  theosophy,  and  of  Oriental  sensuality,  besides 
the  free  intercourse  of  the  sexes  already  existing  in  the  West,  was  of  merely 
momentary  importance. 

The  evil  last  mentioned  was  maintained  in  a  great  degree  by  the  laxity  of  morals 
so  highly  developed  in  the  preceding  barbarous  ages  (a  laxity  which  was  probably 
only  a  simple  animal  conception  of  sexual  life),  and  which  by  the  excesses  of  the 
"  nobles  "  was  carried  down  into  the  otherwise  despised  and  dependent  ranks  of  society. 
As  early  as  the  days  of  Charlemagne  (who,  with  his  daughters  and  his  court,  as  well 
as  the  contemporary  clergy,  lived  by  no  means  in  sexual  chastity)  brothels  had  made 
their  appearance;  but  even  earlier  some  of  the  monasteries  were  not  much  better,  so 
that  even  St.  Boniface  (680-755)  strongly  recommended  to  the  episcopal  shepherds  to 
keep  an  eye  over  the  lambs  in  the  nunneries,  and  particularly  enjoined  upon  them  to 
see  that  the  abbesses  were  chaste  and  temperate.  About  the  year  1000  severe  lectures 
against  the  rude  drinking  and  plays  of  the  monks  (which  were  characteristic  of  the 
age)  and  against  their  filthiness  and  godlessness  were  more  frequent.  Similar  casti- 
gation  was  bestowed  upon  their  foppishness  in  dress,  which  was  adopted  certainly  not 
with  an  eye  to  please  God.  The  evil  was  increased  when  pope  Gregory1  made  a  class 
of  uncastrated  eunuchs  secular  and  parochial  priests,  and  their  unheard-of  excesses  to 
the  close  of  the  Middle  Ages  prepared  the  soil  for  the  reception  of  the  Reformation 
by  the  people.  To  this  was  added  a  general  and  "amiable"  service  of  the  ladies 
(of  which  the  poets  have  often  sung),  and  which  in  practice  was  not  limited  to  Platonic 
love — indeed  quite  the  contrary.  This  gallantrj-  extended  from  noble  ladies  and 
maidens  above  down  to  the  very  menials  below,  so  that,  as  is  well  known,  in  this  and 
succeeding  ages,  for  the  security  of  female  honor  and  the  matrimonial  state,  lock  and 
bar  were  frequently  applied  to  the  female  genitalia !     The  disproportion  between  the 

1.    I  presume  this  refers  to  the  prohibition  of  marriage  among  the  clergy  by  pope 
Gregory  VII.  (Hildebratid)  in  1064.     (H.) 


sexes— there  were  seven  women  to  one  man;  the  Crusades  had  swallowed  up  almost 
six  millions  of  men— contributed  to  the  same  result.  Celibacy  (obligatory  since  the 
time  of  pope  Calixtus  II.,  or  the  Council  of  Rheims,  1119,  and  the  Lateran,  1123)  and 
the  institution  of  monks  and  nuns,  with  its  innumerable  offences1  against  the  laws  of 
chastity,  only  fed  the  flame  of  immorality.  Moreover  the  imaginative  life  excited 
by  the  one-sided,  spiritual  tendency  to  faith  and  supersensible  matteis  —  a  life  which, 
as  we  know,  strongly  influences  the  sexual  impulse,  and  even  to-day  produces  erethitic 
female  onanists,  and  brings  about  mA'stic  marriages  with  Mar}-  and  Christ  among 
those  affected  by  ecclesiastical  influences — was  favorable  to  the  same  result.  To  this 
long  catalogue  must  be  added,  final!}-,  the  general  lack  of  occupation  and  unexampled 
indolence  of  the  period,  and  we  have  certainly  causes  enough  to  explain  the  founda- 
tion of  cloisters  even  for  "converted"  widows  and  "  maidens",  as  well  as  the  appear- 
ance of  the  religious  orders  of  "  Daughters  of  Magdalen  "  and  "  Penitential  Sisters". 
The  latter  order  was  recruited  from  "the  fallen",  who  not  infrequently  within  its  fold 
prosecuted  only  the  more  conveniently  and  with  "  more  gusto"  their  lamented  "fall". 
Besides  these  there  were  "itinerant  wives  and  maidens",  a  female  association,  which 
at  fairs  and  religious  councils  (there  were  1400  of  them  in  attendance  at  the  Council 
of  Constance)  and  on  similar  festive  occasions  sacrificed  themselves  at  request  upon 
the  altar  of  love,2  or  as  "schone  Frauen"  furnished  housekeepers  for  the  clergy.  The 
latter  regarded  these  females  as  animated  proplvylactics,  and  "not  as  sources  of 
pleasure,  lest  their  superabundant  substance  might  fall  into  corruption,  whereby  evil 
diseases  would  doubtless  be  increased  among  the  honorable  clergy" — an  Arabico- 
Galenic  theory  which  had  numerous  followers,  and  is  still  charitably  believed  by  the 
housekeepers  of  the  present  dajT.  Finally  there  arose  at  this  time  from  the  common 
street-prostitution  the  somewhat  more  respectable  brothel-system.  The  inmates  of 
these  latter  dark  places  even  chose  their  regular  female  superintendent.3  They  were 
subject  to  the  magistrate,  or  more  frequently  to  the  bishop  (less  commonly  to  the 
executioner),  and  formed  often  for  the  clergy,  with  the  pope  at  their  head,  a  favorite 

1.  On  the  site  of  an   early   monastery  in  Worms  was  found  a  whole  collection  of 

earthen  vessels  filled  with  the  skeletons  of  children.  In  many  places  monasteries 
and  nunneries  were  connected  with  each  other  by  subterranean  passages,  designed 
to  facilitate  the  spiritual  influence  of  the  respective  inmates  upon  each  other. 
The  ultimate  results  were  such  collections  of  skeletons — unless  these  consequences 
were  prevented  by  the  timely  use  of  the  numerous  remedies  ad  menstruum  provo- 
candum  (abortives),  quoted  so  frequently  in  the  mediaeval  books  on  medicine, 
and  certainly  not  designed  for  "the  people".  Doubtless  their  effect  was  antici- 
pated by  other  prescriptions  ad  coitum  provocandum.  The  monastic  remedj"-  for 
temptation  of  the  flesh — to  hold  the  index  finger  in  the  flame  of  a  candle  until 
the  temptation  was  banished — could  certainly  be  of  little  benefit  to  the  females  of 
the  cloister,  as  the  monks  might  hastil}- — blow  out  such  flames  of  chastity.  Then 
too  the  treatment  smacked  of  homoeopathy — to  banish  (internal)  fire  bjr  the  appli- 
cation of  external !  But  historic  justice  demands  the  statement  that  the  better 
clergy  and  the  Councils  strove  continually  against  the  general  demoralization  of 
the  monks,  nuns  etc.,  though  without  stopping  its  source,  the  unnatural  celibacy, 
which  manjr  of  the  popes  certainly  did  not  follow. 

2.  The  terms  were  reasonable  enough  to  suit  the  most  parsimonious,  viz:  a  package 

of  bodkins  (aiguillettes).  The  Latin  designation  for  these  housekeepers  was 
"focariae"  (quae  focum  curant,  kitchen-maids).     (H.) 

3.  They  formed  guilds  similar  to  those  of  other  occupations,  and  had  their  statutes  and 

judges.     (H.) 


—  273  — 

field  for  missionary  labor  and  a  fine  source   of  income,  as  thej*  were  taxed  one-tenth 
of  their  receipts.1 

In  London  e.  g.  there  were  eighteen  of  these  houses  under  the  jurisdiction  of  the 
bishop  of  Winchester  2  In  Nordlingen  the  authorities  found  it  necessary  to  recommend 
to  the  reverend  clergy  that  they  should  pursue  their  search  for  converts  in  the  brothels 
rather  b}T  day  than  by  night — an  indiscreet  official  recommendation,  which  to-day  at 
least  seems  no  longer  necessary.  How  very  widespread  evils  of  this  kind  must  have 
been  is  shown  by  the  fact  that  such  houses  were  considered  at  this  time  institutions 
of  prophylaxis  and  were  deemed  just  as  indispensable  as  ordinary  inns.  In  England 
(at  this  period  mostly  in  a  condition  of  semi-barbarit}')  the  institution  of  brothels 
under  episcopal  supervision  seems  to  have  been  in  its  prime,  and  to  have  been  very 
carefully  regulated.  These  houses  had  special  signs,  as  "The  Crane",  "The  Boar's 
Head"  etc.,  and  as  early  as  llfi2  certain  "ancient"  statutes  were  confirmed  by  act 
of  Parliament,  among  which  we  find  the  following  paragraphs  : 

1.  "  No  host  or  hostess  shall  suffer  a  maiden  to  go  out  and  come  in  at  pleasure. 

2.  No  such  maiden  shall  be  provided  by  the  host  with  board  and  lodging  out  of 
the  house. 

1.  Pope  Sixtus  IV.  (1472-1484)  is  said  to  have  licensed  a  brothel  at  Rome,  the  prosti- 

tutes of  which  paid  him  a  weeklj-  tax,  amounting  in  course  of  a  j'ear  to  20,000 
ducats.     (H.) 

2.  At  this  period  the  solution  of  the  prostitution  question  was  in  clerical  (especially 

episcopal)  hands,  rather  than  in  those  of  the  medical  profession,  and  it  seems  to 
have  enjoyed  in  that  da}'  a  verjr  fruitful  cultivation.     (Baas.) 

The  brothels  of  London  were  situated  on  the  Bankside,  Southwark,  and  were 
visited  weekly  by  the  sheriff's  officers.  They  were  privileged  by  patent  and 
regulated  by  statute  from  the  reign  of  Heni\y  II.  (1162)  until  the  last  year  of 
Henry  VIII.  (1547),  when  they  were  formally  suppressed.  The  statutes  quoted 
below  are  those  of  Henry  II.  In  1129  it  was  forbidden  to  grant  licenses  to  the 
"  Focarire"  in  London.  As  late  as  1321  an  English  cardinal  purchased  a  brothel 
in  London  as  an  investment  for  sacerdotal  funds!  In  France  the  barbers  quite 
generally  kept  houses  of  assignation.  The  quarter  assigned  to  prostitutes  in 
Paris  acquired  the  not  inappropriate  designation  of  "Clapier",  but  so  common 
was  it  for  them  to  reside  over  rooms  occupied  by  students  of  law  and  medicine, 
that  such  a  residence  was  regarded  as  prima  facie  evidence  of  the  debauched 
character  of  the  female  occupants.  Perhaps,  however,  the  most  damning  evidence 
of  the  immense  prevalence  of  prostitution  during  the  Middle  Ages  may  be  found 
in  the  facts,  that  in  1179  an  archbishop  of  Mayence,  a  man  of  extraordinary 
erudition  for  his  day,  was  charged  with  supporting  such  a  retinue  of  prostitutes 
that  their  maintenance  entailed  heavier  expense  upon  his  diocese  than  the  charges 
of  royal  representation:  that  in  1190  the  Danish  peasantry  joined  the  priesthood 
in  opposing  an  ordinance  of  the  bishops,  which  exacted  the  expulsion  of  concu- 
bines from  religious  houses,  on  the  ground  that  the  execution  of  the  ordinance 
would  endanger  seriously  the  chastity  of  their  own  wives  and  daughters;  that  in 
1291  the  Knights  Templar  are  said  to  have  supported  no  less  than  13000  prosti- 
tutes! It  must  not,  however,  be  forgotten  that  the  episcopal  supervision  of  the 
question  of  prostitution  was  designed  to  regulate  what  was  then  (as  often  now) 
regarded  as  a  necessary  evil,  and  that  the  facts  mentioned  were  abuses  of  an 
institution  designed  for  beneficent  purposes.  They  demonstrate  forciblj-  the 
danger  and  impotence  of  ecclesiastical  interference  with  a  dirt}'  subject  at  least. 
Whether  other  interference  would  be  more  successful  is  a  question  upon  which 
doctors  disagree.     (H.) 

18 


—  274  — 

3.  The  maiden  shall  pay  for  her  apartment  not  more  than  fourteen  pence  per 
week. 

4.  On  holidays  no  one  shall  be  permitted  to  enter  the  house. 

5.  No  maiden  shall  he  forcibly  detained  in  the  house. 

6.  No  host  shall  receive  a  female  from  ecclesiastical  institutions,  nor  shall  he 
receive  a  married  woman.     (What  filth  !) 

7.  No  maiden  shall  receive  pay  from  a  man  unless  she  has  passed  the  whole 
night  until  morning  with  him. 

8.  No  host  shall  keep  a  maiden  who  has  the  dangerous  burning  disease:  nor 
shall  he  sell  either  bread,  beer,  meat  or  other  victuals." 

During  and  after  the  Crusades  man  kind  began  (so  to  speak)  to  get  its 
eyes  open,  and  heresy,  mild  and  rare,  indeed,  but  gradually  acquiring 
strength,  began  to  undermine  the  deceit  of  priests.  In  the  Crusades  were 
developed  the  germ-shoots  of  the  seed  of  the  Reformation,  a  development 
which  the  priests  themselves  saw,  but  could  no  longer  repress  by  their 
opposition. 

To  medicine  especially  the  Crusades1  brought  an  extended  field  of 
activity,  particularly  in  the  innumerable  hospitals  founded  as  the  result  of 
these  military  expeditions,  and  over  which  the  laity  began  to  be  appointed 
physicians.  The  disposition  of  the  latter  to  investigation,  and  their  practi- 
cal impulses,  received  fresh  nutriment  in  the  new  diseases  resulting  from 
the  Crusades,  as  well  as  from  an  acquaintance  with  Byzantine  and  Arabian 
erudition  and  medicine,  and  their  drugs  and  methods  of  treatment  so  differ- 
ent from  those  of  the  West.  The  great  Hohenstaufer  Frederick  II.,  a 
"  free-thinker ",  enlightened  by  the  wisdom  of  the  Orient,  was  especially 
active  in  the  promotion  of  education,  and  above  all  in  the  elevation  of  the 
position  of  physicians.  He  paid  no  heed  to  the  triple  ban  of  pope 
Gregory  IX.  (1227-12-11)  —  a  freedom  from  prejudice  unheard-of  and  won- 
derful in  that  day,  and  often  lacking  even  in  our  rulers  of  the  present 
time — partly,  probably,  because  he  had  learned  to  exercise  unprejudiced 
observation  in  his  own  occupation  with  the  subjects  of  natural  science.2  By 
his  promotion  of  medical  studies  and  educational  institutions  he  became  a 
benefactor  of  mankind,  and  especially  of  Italy,  the  land  of  his  love.  Through 
his  medical  ordinance,  published  in  1224,  he  has  secured  for  himself  forever 
an  honorable  place  in  the  history  of  medical  culture. 

Roger,  king  of  Sicily,  and  grandfather  of  the  emperor,  had  already  before 
Frederick  (as  early  as  1140)  published  an  ordinance  providing  that  the  physician, 
before  entering  upon  practice,  must  present  himself  to  the  civil  magistrates  and  pro- 
cure their  permission,  "in  order  that  my  subjects  may  not  incur  danger  through  the 
inexperience  of  the  physicians".  For  violation  of  this  ordinance  the  penalty  of  im- 
prisonment and  confiscation  of  goods  was  established.  Frederick,  however,  completed 
and  enlarged  the  whole.  The  tenor  of  the  important  ordinances  of  the  latter  prince 
is  set  forth  in  the  following  paragraphs: 

1.  Physicians,  especially  Jews,  followed  the  crusading  hosts. 

2.  He  wrote  a  treatise  "  De  arte  venandi  cum  avibus". 


—  275  — 

I.     Of    Physician's    and    Surgeons. 

a.  To  practice  in  all  branches  of  medicine  (and  surgery  also),  and  to  bear  the 
title  of  a  physician,  was  permitted  only  to  him  who  had  passed  an  examination 
at  Salerno,  and  received  the  state-license  from  the  emperor  or  his  viceroy. 
Violators  of  the  law  were  punished  in  money  and  goods,  and  received  one  year's 
imprisonment. 

b.  Before  the  physician  was  admitted  to  an  examination,  he  must  have  attended 
lectures  on  logic  for  3  years,  and  on  medicine  and  surgery  for  5  years,  and  must  have 
practised  under  the  direction  of  an  experienced  physician  for  one  year.1 

c.  Physicians  were  examined  on  the  genuine  books  of  Hippocrates,  Galen, 
and  Avicenna. 

d.  The  surgeon  must,  in  like  manner,  bring  evidence  that  he  had  attended  the 
lectures  of  the  professors,  and  pursued  for  one  year  the  curriculum  which  surgeons 
hold  necessary,  especiall}-  human  anatom}-.  Surgeons  of  the  first  class  were  ex- 
amined by  three  professors,  of  whom  one  teacher  of  surgery  conducted  the  examina- 
tion in  the  Latin  language,  and  in  the  presence  of  the  prosyndic  and  prorector  of  the 
nation  of  the  candidate.  The  diploma  was  subscribed  by  all  these  persons,  accom- 
panied by  the  attestation  of  a  notary,  and  bore  the  seal  of  the  Faculty.  Surgeons 
of  the  second  class  were  examined  in  Italian  and  b}*  two  teachers  only,  and  the 
diploma  was  then  subscribed  bj"  the  two  examiners  alone.  The  candidates  must  take 
an  oath  never  to  treat  internal  diseases,  and  they  could  not  receive  the  title  of  doctor. 

e.  The  physician  must  give  information  of  the  fact  if  an  apothecar}-  sold 
adulterated  drugs. 

f.  The  physician  must  not  be  guilty  of  collusion  with  the  apothecary  as  regaids 
the  price  of  drugs;  still  less  might  he  keep  a  drug-store. 

II.     Tariff    of    Fees. 

a.  The  poor  must  be  treated  gratuitously. 

b.  The  physician  must  visit  his  patients  at  least  twice  each  day,  and,  if  re- 
quested by  the  latter,  once  also  at  night.  For  this  he  received,  for  every  day  of 
treatment : 

a.  In    the   city,   or   at  his   residence,     .     .     half  a  tarenus  =  SO.  14 
{i.  Away  from  his  residence,  when 

1.  The  patient  paid  his  travelling  expenses,  '.'>  tareni  =  SO. 85 

2.  The  doctor      "       "         "  "  1  tareni  =  $1.17  2 

III.    Of   Apothecaries,    Druggist  sand  their   Tariff. 
a.     The  druggists  (confectionarii)  must  keep  their  drugs  at  their  own  cost,  and  in 
the  prescribed  method,  which  fact  must  be  certified  by  physicians,  and  even  confirmed 
by  an  oath.     Contravention  of  this  regulation  was  punished  by  sequestiation  of  goods 
and  by  death. 

1.  I  do  not  understand  that  this  year  of  practice  under  the  direction  of  an  experienced 

physician  was  a  condition  for  examination,  but  for  a  license  in  practise  independ- 
ently. The  ordinance  runs:  "  Nee  tamen  post  completum  quinquennium  prac- 
ticabit,  nisi  per  integrum  annum  cum  consilio  experti  medici  practicetur."     (H.) 

2.  When  we   remember  that   at  this  period  9  eggs  e.  g.  cost  about  one  cent   in   the 

money  of  the  present  day,  we  may  understand  the  high  esteem  which  the  profession 
of  the  physician  must  have  enjoyed  in  that  day  —  and  may  long  for  its  return! 
Still  more  must  this  be  the  case  if  we  accept  the  calculation  of  Daremberg, 
according  to  which  the  tarenus  was  a  gold  coin  equal  in  value  to  half  a  Carolin, 
i.  e.  about  $2.40. 


—  276  — 

b.  The  apothecaries  (stationarii)  in  the  first  place,  for  such  drugs  and  simples 
as  were  preserved  commonly  not  longer  than  one  year  from  the  day  of  purchase, 
might  demand  86  cents  per  ounce  ;  secondly,  for  such  as  were  preserved  more  than 
one  year,  they  could  demand  f  1.73  per  ounce. 

c.  Apothecary-shops  could  be  kept  only  at  places  designated  throughout  the 
kingdom. 

IV.     Inspectors  —  Teachers. 

1.  Two  circumspect,  worthy,  sworn  men,  whose  names  are  well  known  to  the 
magistrates,  shall  be  appointed,  whose  duty  it  shall  be  to  testify  that  the  electuaries, 
syrups  and  other  preparations  are  prepared  in  conformity  to  the  requirements  of  the 
law.     This  shall  be  done  especially  by  the  teachers  of  medicine  at  Salerno. 

2.  No  person  may  teach  medicine  or  surgery  elsewhere  than  at  Salerno  or 
Naples,  nor  assume  the  title  of  teacher  unless  he  has  passed  an  examination  before 
the  teachers  of  the  same  branch  of  art,  and  before  the  magistrates. 

V.     Public    Hygiene. 

The  laws  on  this  subject  related  to  the  adulteration  of  food  and  delicacies,  the 
sale  of  poisons  and  love-potions,  infection  of  the  air  by  putrefying  animal  matters  etc. 

Spun  received  a  similar  medical  ordinance  about  1283,  and  Charles  IV.  (1347) 
in  lik  •  manner,  published  such  an  one  for  the  German  States,  to  which  that  of  Frederick 
served  as  a  model. 

Regulations  relating  to  the  practice  of  midwifery  by  physicians  are,  indeed,  not 
contained  in  these  laws,  since  the  operative  portion  of  that  art,  so  far  as  it  was  prac- 
tised in  general  by  men,  belonged  to  the  department  of  the  surgeon.  Midwives, 
however,  were  not  probably  classed  among  medical  persons. 

That  such  wise  ordinances  (which  certainly  appear  in  many  respects 
too  strict  to  us  of  to-day,  though  we  too  enjoy  some  Draconian  decrees 
— vaccination  laws)  effected  a  reformation  in  the  study  of  medicine,  and 
were  especially  calculated  to  rescue  the  medical  profession  from  its  mediaeval 
ruin  and  decay,  is  readily  apparent.  Accordingly  it  should  be  gratefully 
recognized  that  Joanna  of  Naples  confirmed  them  anew  in  1365.  Certainly 
they  must  at  least  have  tended  to  this  result,  that  clerical  medicasters,  with- 
out some  medical  knowledge,  were  less  common. 

Next  to  the  influences  already  noticed,  the  founding  of  the  Universities 
worked  a  further  reformation  in  the  sciences  and  intellectual  life  in  general, 
as  it  did  also  in  medicine.  They  were  often  causes  of  the  reaction  against 
the  faith,  though  designed  for  its  confirmation.  The  number  of  students 
became  speedily  very  great,  and  they  formed  among  themselves  a  kind 
of  "community",  which,  like  the  communities  among  citizens,  was  desig- 
nated Universitas.  (Kriegk.)  In  the  founding  of  universities  too,  that 
Frederick  the  Great  of  the  Middle  Ages  and  his  chancellor  Petrus  de  Vineis 
were  of  eminent  service.  The  former  called  into  being  the  universities 
of  Pavia  and  Padua  (1222),  Naples  and  Messina  (1224),  which  were  un- 
doubtedly preceded  by  those  of  Bologna  (1110),  Oxford,1  Montpellier  (1180), 

1.    As  early  as  872  there  were  three   Halls  founded  by  Alfred  the  Great  in   Oxford. 

University  College,  from  the  foundation  of  which  the  more  modern  writers  reckon 

the  founding  of  the  Universit}7,  was  not  established,  however,  until  1250.     (Baas.) 

The  legend   of  the  foundation  of  Oxford   University  by  king  Alfred  is  now 


—  277  — 

and  Paris  (1205). '  Bologna  and  Paris  became  the  models  for  many  of  the 
later  universities.  These  universities  originated  in  voluntary  associations  ; 
the  medical  departments  In  an  association  of  physicians,  from  whose  num- 
ber those  who  desired  to  study  medicine  selected  their  teachers.  It  was 
also  a  question  of  guilds,  whose  statutes  were  then  confirmed  by  the  Church. 
At  a  later  period  the  initiative  in  the  founding  of  universities  proceeded 
ordinarily  from  the  sovereigns,  who,  however,  were  required  to  obtain  per- 
mission for  the  erection  of  a  university  from  the  pope.  This  permission 
(often  after  long  negotiations  only)  was  granted  by  a  bull.  The  universities 
received  the  power  to  manage  their  own  affairs  and  other  privileges,  which 
formed  the  basis  of  university  rights.  Frederick,  however,  preserved  to 
the  state  the  absolute  right  to  found  such  institutions  and  to  grant  them 
statutes,  so  that  the  universities  through  him  began  to  pass  into  the  con- 
trol of  the  state. 

The  plan  of  instruction  and  organization  of  the  universities  of  that  period  tended 
less  to  free  investigation,  than  to  the  acquisition  and  illustration  of  existing  knowledge. 
Thus  philosophy  was  the  leading  study,  and  its  standard  bearers  were  Aristotle  and 
the  Arabians.  Under  the  head  of  philosophy  medicine  was  also  included.  In  the 
latter,  however,  very  few  authors  were  admitted  as  authorities;  in  Paris  e.  g.  Hippoc- 
rates (Aphorisms,  Prognostics,  "  De  victu  in  acutis"),  Theophilus  (De  corporis  humani 
fabrica),  Joannitius  and  ^Egidiws  of  Corbeil ;  in  other  schools  Galen  and  Avicenna 
also,  as  e.  g.  at  Tubingen,  where  in  1481  the  following  curriculum  was  in  force:  First 
year:  forenoon,  Galen's  "Ars  medica";  afternoon,  first  and  second  sections  of  Avi- 
cenna's  treatise  on  fever.  Second  year:  forenoon,  first  book  of  Avicenna  (anatom}- 
and  phj-siology) ;  afternoon,  ninth  book  of  Rhazes  (local  pathology).  Third  year: 
forenoon,  Aphorisms  of  Hippocrates;  afternoon,  Galen.  As  a  text-book  of  surgery 
Avicenna  or  some  other  Arabian  was  used,  although  practical  surgery  e  g.  was  almost 
entirely  foreign  to  these  authors.  Besides  the  ordinary  course  of  instruction,  lectures 
were  also  given  on  Mesue,  /Egidius  and  Constantine  Africanus.  The  professors  of 
medicine  were  classed  at  the  beginning  among  the  teachers  of  the  free  arts,  and 
required  neither  the  approval  of  the  state,  nor  a  special  examination  for  their  position. 
Any  one  who  had  studied  for  three  years,  and  had  attained  the  age  of  21,  might  act 
as  a  teacher.  Of  course  he  must,  however,  lecture  first  upon  the  preparatory  branches, 
and  was  now  called  Baccalaureus.  After  three  years'  further  study,  he  became  a 
Magister  in  Physica,  or  doctor,  though  for  the  latter  grade  a  further  term  of  study 

prett}'  well  exploded.  We  know,  however,  that  a  popular  school  existed  in 
Oxford  in  the  12th  century,  and  that  in  1209  no  less  than  3000  professors  and 
students  withdrew  to  Cambridge  and  other  schools,  in  consequence  of  dissatisfac- 
tion with  the  citizens  of  that  town.  In  our  modern  parlance  they  "  boycotted" 
the  town  of  Oxford  for  five  years.  Merton  College  was  founded  in  1264,  Baliol 
in  1263,  and  University  College  in  1253,  yet  the  latter  celebrated  its  alleged 
millenary  in  1872!  (H.) 
1.  Even  earlier  than  this  Obizo  (died  1138)  and  Hugo  Physicus  (died  1199)  were 
clerical  physicians  in  Paris  under  the  reign  of  Louis  VI.,  the  Fat,  and  the  latter 
physician  was  also  a  teacher  there.     (Baas.) 

It  is  impossible  to  fix  upon  an}-  definite  year  as  the  precise  date  of  founda- 
tion of  the  universities  of  Bologna,  Oxford,  Montpellier  and  Paris.  All  of  them 
were  flourishing  institutions  in  the  12th  century.  1205  is  the  v'ear  in  which  the 
university  of  Paris  received  the  papal  privileges  from   pope  Innocent  III.     (H.) 


—  278  — 

of  six  3'ears,  as  well  as  a  double  public  and  private  examination,  was  required.  After 
this  the  teacher  was  for  the  first  time  permitted  to  practise,  in  contrast  to  our  custom, 
where  the  venia  practicandi  precedes  the  venia  legendi.  What  kind  of  persons  some 
of  these  teachers  were  may  be  judged  from  the  following  extract :  "  They  make  a  great 
show  of  Hippocrates  and  Galen,  bring  forward  strange  words,  quote  their  aphorisms 
on  all  possible  occasions,  and  daze  the  minds  of  men  as  if  they  were  struck  I33*  a 
thunderbolt.  They  are  believed  to  be  able  to  do  everything,  because  they  boast  of 
everything  and  promise  everything.  .  .  Those  boys  of  yesterday  are  to-day 
Magistri:  they  who  yesterday  felt  the  rod,  to-day,  clad  in  the  stola,  teach  from  the 
rostrum".  Many  very  excellent  translations  of  the  ancient  authors  proceeded  from 
the  universities  of  this  period;  the  labor  lavished  by  them  upon  the  Arabian  writers 
deserves,  however,  less  praise.  They  clung  slavishly  to  the  Ancients,  and  even  as 
late  as  1603  the  Faculty  of  Paris  strongly  inculcated  the  importance  of  varying  in  no 
respect  from  the  doctrines  of  Hippocrates  and  Galen. 

These  first  universities  were  followed  in  the  course  of  the  Middle  Ages 
Irv  numerous  others,  which  on  the  whole  (like  culture  in  general)  advanced 
from  south  to  north,  and  almost  everywhere  occupied  the  most  charming- 
sites.  Their  organizations  differed  little  from  each  other,  and  their  libraries, 
gradually  increasing,  constituted  a  new  leaven  working  likewise  upon 
medicine.  Among  these  later  universities  were  those  of  Toulouse  1229. 
Salamanca  12-43,  Lisbon  (Coimbra)  1287,  Heidelberg  1386,  Cracow  1364, 
Prague  1318  (in  1883  the  medical  Faculty  was  divided  into  a  German  and 
a  Czech  branch),  Vienna  1365.  Fiinfkirchen  1382,  Culm  1387,  Cologne  1388, 
Erfurt  1392.  Wurzburg  1403,  Leipzig  1409,  Rostock  1419,  Louvain  1426, 
Greifswald  1456,  Freiburg  in  Baden  1457  (occupying  the  most  charming 
situation  of  any  of  the  German  universities,  founded  at  the  instance  of  the 
archduchess  Matilda  by  her  husband  Albrecht),  Basel  1460,  Ofen  1465 
(erected  by  John  of  Pannonia,  by  command  of  Matthew  Corvinus  ;  from 
this  period  until  1848  Latin  was  the  language  of  the  court  and  the  state), 
Ingolstadt  1472.  Munich  and  Treves  1472,  Tubingen,  Mayence  and  Upsala 
1477,  and  Gratz  1486. 

If  the  universities  of  the  Middle  Ages  for  the  most  part  served  mereby 
as  institutions  of  instruction,  and  developed  no  productive  activit}*  in  the 
department  of  mind  ;  if  they  were,  indeed,  in  man}'  respects  rather  a  check 
upon  intellectual  activity,  yet  they  still  promoted  the  advancement  of  medi- 
cine, since  within  their  walls  this  science  gained  once  more  a  scientific 
position  and  place  of  refuge.  That  the  course  of  instruction  was  stereotyped 
in  form,  and  carefully  watched  over  by  the  Church  and  subsequently  by 
the  state,  must,  indeed,  be  regarded  as  a  limitation  of  free  development  ; 
that,  however,  the  study  in  these  universities  gave  by  its  honors  a  certain 
higher  social  position  in  life  ;  finally  that  medicine  once  more  fell  into  the 
hands  of  thinkers  (albeit  of  false  thinkers  in  man}'  respects  when  compared 
with  our  present  standpoint  of  knowledge),  while  up  to  this  time  it  had  for 
its  guardians  for  the  most  part  mere  empirics  and  ignorant  clergy  —  these 
were  certainl}-  unquestionable  advantages. 

These  false  modes  of  thought  (yet  genuine  thought  instead  of  the 
pure  faith  heretofore  dominant)  were  introduced  by  the  so-called  scholastic 


—  279  — 

philosophy.  This  philosophy  was  originally  designed  —  an  impossible 
task  —  merely  to  establish  ecclesiastical  doctrine  on  the  basis  of  reason,  or 
rather  to  harmonize  it  with  the  ancient  philosoph}',  particularly  that  of 
Aristotle,  and  thus  to  bring  higher  thought  also  into  the  service  of  theology. 
But  alas,  the  subtilties  necessarily  resulting  from  such  an  expectation 
speedily  acquired  an  influence  upon  all  other  sciences.  Scholasticism,  in 
spite  of  the  prodigious  erudition  which  it  awakened,  was  substantially  noth- 
ing but  a  one-sided  and  deplorable  wandering  in  the  labyrinth  of  the  most 
hairsplitting  dialectics,  where,  however,  undoubtedly  great  intellectual  power 
and  versatility  were  united  in  activity  with  an  industry  often  wonderful. 
The  Arabians  furnished  its  impulse  and  its  models,  and  their  method  of 
philosophizing  the  scholastic  philosophy  continued  in  the.  West  and  trans- 
ferred to  Christian  theology  and  the  sciences,  in  which  the  same  philosophers, 
were  regarded  as  the  masters.  It  matured  the  first  skeptics,  and  thus  laid 
the  foundation  of  intellectual  advancement  in  opposition  to  the  will  of 
the  Church. 

The  founders  of  this  school  of  philosophy  were  Johannes  Scotus  Erigena  (died 
879),  who  affirmed  that  all  authority  came  from  reason,  but  reason  never  from 
authority,  and  Gerbert  (afterwards  pope  Sylvester  II.,  died  1003).  After  an  acquaint- 
ance had  been  formed  with  the  writings  of  Aristotle  and  his  Arabian  interpreters, 
by  means  of  the  Jews,  who  possessed  flourishing  schools  from  Toledo  to  Metz, 
Laufranc  (1005-1089)  and  Anselm  of  Canterbury  (1035-1109),  both  of  whom  were 
bishops  of  the  last  named  see  under  William,  the  Conqueror,  became  above  all  others 
important  promoters  of  the  scholastic  philosopy.  Alexander  of  Hales  (died  1245) 
possessed  the  whole  of  Aristotle,  and  was  the  first  to  make  philosophj"  subservient  to 
theolog}',  a  thing  which  had  not  been  done  by  the  generality  of  the  earlier  scholastics. 
What  subjects  some  of  these  scholastic  philosophers  selected  for  the  exercise  of  their 
"acuteness"  may  be  inferred  from  the  example  of  Petrus  Lombardus  (died  1164), 
bishop  of  Paris,  who  excogitated  whether  in  Paradise  the  bowels  moved,  and  how 
many  angels  could  comfortably  dance  upon  the  point  of  a  needle! 

With  the  name  of  Anselm  is  associated  the  founding  of  the  philosophical  sect  of 
"Realists",  who  taught  that  an  object  and  its  conception  were  one  and  the  same  thing 
and  originated  at  the  same  time,  while  their  opponents,  the  "Nominalists",  whose 
leader  was  the  monk  Roscellinus  (end  of  the  11th  century;  he  taught  that  three 
names,  but  not  three  persons,  were  to  be  found  in  the  Trinity)  affirmed  that  concep- 
tions were  obtained  solely  from  existing  objects,  and  that  the  perception  must  pre- 
cede conception.  Both  fought  like  philosophical  boxers  until  the  latter  succumbed. 
The  most  famous  champion  of  Realism,  who  considered  doubt  profitable,  since  it  leads 
to  the  proving  of  the  truth,  was  Pierre  Abelard  of  Palet  near  Nantes  (1079-1142), 
famous  for  his  amour  with  Heloise  (1105-1164),  which  finally  occasioned  his  castration 
by  his  inhuman  enemies. 

Similar  intellectual  polemics,  which,  indeed,  often  degenerated  into  bloody 
measures,  gave  birth  later  to  the  sects  of  "  Thomists"  and  "  Scotists",  the  former  be- 
longing to  the  Dominican,  the  latter  to  the  Franciscan  order,  and  so  called  after  their 
leaders,  Thomas  Aquinas  (1224-1274),  author  of  28  quartos,  and  Duns  (Dunstan) 
Scotus  (died  1308,  wrote  12  stout  folios).  What  was  the  nature  and  the  subjects  of 
the  philosophical  wrangles  of  both  parties  may  be  judged  e.  g.  from  the  fact  that  the 
Immaculate  (though  incredible)  Conception  furnished  for  them  so  inexhaustible  a 
subject,   that  each  week  in  Paris  a  Scotist  stood  ready  for  the  tongue-lashing  and 


—  280  — 

word-playing,  a  whole  day  through,  without  either  eating  or  drinking  !  The  fanatically 
pious  St.  Bernard  of  Clairvaux  (1091-1153)  opposed  the  subtilties  of  both  these 
earlier  parties.  After  his  death  his  fancies,  united  with  dialectics,  were  developed  into 
a  peculiar  kind  of  Christian  "  Neo  Platonism  "  (taught  especially  in  the  school  of  the 
monastery  of  St.  Victoire  at  Paris),  to  which  Thomas  a  Kempis  (1380-1471)  and  the 
earlier  Johann  Tauler  (1290-1361)  of  Strassburg,  subscribed.  Besides  this  there 
existed  at  the  same  period  still  another,  if  possible  even  more  fatal,  amalgamation 
viz.  that  of  scholastic  dialectics  with  poetical  mysticism,  which  Bonaventura  (died  1247), 
the  so-called  "  Dr.  Angelicus",  introduced.  According  to  him  temporal  and  eternal 
existence  lay  in  the  doubled  three,  and  the  unity  tending  thereto.  The  lower  life  has 
three  grades;  the  higher,  the  same.  The  number  7,  which  unites  the  three  and  con- 
tains the  unity,  has,  however,  no  corresponding  condition,  and  is  therefore  God 
himself. 

To  the  indirect  advantage  supplied  to  medicine  by  the  revival  of  thought, 
as  such,  through  the  scholastic  philosophy,  must  still  be  added  the  transla- 
tions and  explanations  of  the  old  Greek  medical  writers  (especially  Hippoc- 
rates and  Galen)  and  the  Arabians  effected  by  its  sectaries.  On  the  other 
hand  the  fashion  of  hair-splitting  dialectics,  transferred  also  into  medicine, 
and  thoroughly  perfected  by  the  "Authorities",  was  most  pernicious.  The 
unhappy  kindred  efforts  which  manifested  their  influence  in  medicine  as  the 
result  of  the  mystic  bent  of  individual  scholastics,  and  which  found  their 
expression  in  astrological  and  other  superstitious  opinions  and  procedures, 
and  prevailed  too,  as  we  have  seen,  among  the  later  physicians  of  Antiquity 
and  the  Arabians,  tended  to  the  same  unfortunate  conclusion. 

The  scholastic  philosoplrv  now  ruled,  with,  indeed,  a  gradually  decreas- 
ing power,  and  in  a  more  or  less  distinctly  marked  proportion,  the  different 
departments  of  medical  literature  to  the  end  of  the  Middle  Ages,  and  even 
into  modern  times.  Naturally  its  leadership  affected  least  those  branches 
founded  chiefly  upon  experience,  observation  and  matters  of  fact — I  refer 
to  anatomy  and  surger}-,  the  separate  and  independent  cultivation  of  which 
was  to  give  at  last  the  death-blow  to  the  medicine  of  faith,  in  order  to 
break  an  unobstructed  way  for  the  medicine  of  observation. 

4.    THE  CHRISTIAN  PHILOSOPHICAL  PERIOD  OF  MEDICINE,    SCHOLASTICS.     TRANS- 
LATORS AND  SCHOLASTIC  ELABORATORS  OF  GREEK  AND  ARABIAN  WORKS, 
AND  INDEPENDENT  WRITERS  IN  THE  DEPARTMENTS  OF  INTERNAL 
MEDICINE,  ANATOMY,  SURGERY,  PHARMACOLOGY 
PHARMACY  AND  VETERINARY  MEDICINE. 

Pagan  medicine  began,  as  we  know,  in  faith,  or  rather  in  theurgic  super- 
stition, and  finally  became  a  philosophical  science.  The  same  statement 
holds  true  with  regard  to  the  Christian  medicine  of  the  Middle  Ages,  which, 
indeed,  had  to  begin  a  new  course  in  the  development  of  humanity.  Its 
philosophical  phase  extended  through  the  scholastic  period,  and  here  too 
(in  opposition  to  the  religious  phase)  it  represents  a  real  advance,  while  the 
succession  of  the  two  phases  must  be  regarded  as  one  of  the  historical 
proofs  that  mediaeval  medicine  in  general  belongs  to  a  progressive  develop- 
ment ;  that  it  represents  no  halt  nor  retrograde  movement,  as  the  common 


—  281  — 

idea  (which  ever  regards  the  ancient  medicine  simply)  runs.  This  is,  how- 
ever, a  false  standpoint,  for  mediaeval  medicine  was  not,  and  did  not  remain, 
simply  the  medicine  of  the  Ancients,  but  began,  combined  with  popular 
medicine  and  clerical  medicine  (which  differs  little  therefrom),  a  new  phase 
of  development,  with  which,  of  course,  important  parts  of  the  ancient 
medicine  were  combined.  New  and  old,  indeed,  in  every  metamorphosis 
of  civilization,  join  hands  ever  with  each  other. 

The  long  line  of  medical  authors  in  the  last  half  of  the  Middle  Ages, 
who  directly  or  indirectly  felt  the  influence  of  these  scholastico-philosophi- 
cal  views,  contains  (with  the  exception  of  a  very  few  writers  who  belong  to 
the  last  period  of  this  division)  such  writers  onl}-  as  busied  themselves  with 
translations,  explanations  and  the  elaboration  of  the  old-Greek  and  Arabian 
physicians.  They  cherished  the  views  of  both  as  though  they  were  a 
Gospel,  in  which  one  might  change,  and  to  which  one  might  add,  nothing 
whatsoever  ;  which  one  ought  only  to  learn  to  understand  and  to  explain. 

The  spirit  of  the  age.  which  still  clung  to  by-gone  faith  and  supersti- 
tion, furnished  the  inevitable  mystic,  astrological,  alchemistic,  chiromantic 
and  fraudulent  ingredients.  On  the  other  hand  this  epoch  matured  a  few 
harbingers  of  the  future  phase  of  reflective  observation  ;  for  the  present 
ever  conceals  the  germs  of  the  future. 

The  adherents  of  the  Greeks  were  the  earlier  ;  those  of  the  Arabians 
followed  at  a  later  period.  From  the  mass  of  authors  of  both  nations, 
however,  a  few  onby  were  used  as  guides  for  these  authority-mad  times  ;  at 
first  Hippocrates,  Galen,  Dioscorides  and  Aristotle  ;  subsequently  Avicenna, 
Averroes,  Mesue  and  Rhazes.  But,  even  among  the  works  of  the  authors 
just  mentioned,  a  few  only  were  subjected  to  criticism.  Accordingly  there 
were  Grecists  and  Arabists,  and  besides  these  a  middle  part}*,  the  so-called 
Conciliators.  There  was  also  an  opposition  party,  small  in  numbers,  and 
composed  of  opponents  less  in  word  and  writing,  or  ex  professo,  than  de  facto, 
in  the  manner  and  the  result  of  their  investigations. 

Some  of  the  individuals  to  be  mentioned  here  belong  rather  to  the 
department  of  philosophy  than  to  that  of  medicine  (which  latter  science, 
however,  was  considered  a  branch  of  philosophy),  with  the  subjects  of  which 
they  busied  themselves  only  incidentally.  The}'  exercised,  however,  great 
influence  upon  the  development  of  the  natural  sciences,  to  whose  elabora- 
tion and  reestablishment  they  unquestionably  gave  the  impulse.  Through 
their  labors  the  13th  century  became  the  century  of  birth  of  the  modern 
investigation  of  nature.  The  chief  scholastics  were  men  who  desired  to 
investigate  the  whole  world,  the  visible  as  well  as  the  invisible.  At  the 
head  of  these 

a.    Philosophical  Students  of  the  Natural  Sciences  and  Medicine 

belongs  one  of  the  greatest  thinkers  and  savants  of  all  time,  a  mediaeval 
-'  coadjutor  of  Aristotle,  Leibnitz,  Haller  and  Alex,  von  Humboldt,  and  a  man 
beatified  "  in  spite  of  the  Catholic  Church, 


—  282  — 

Albert  von  Bollstadt,  of  Lauingen  in  Suabia. 
better  known  as  Albertns  Magnus  (1193—1280).  His  collected  works  (in  which  many 
of  his  writings  are  wanting)  fill  21  quarto  volumes  —  all  considerable  scholastics  wrote 
with  amazing  fecundity  —  and  among  them  his  "  De  animalibus  "  discusses  anatomical 
and  physiological  questions.  In  his  commentary  on  the  "  Textus  sententiarum  "  of 
Petrus  Lombardus  he  discusses  —  evidence  of  an  age  which  squandered  its  acuteness 
on  vain  and  paltry  subjects  —  the  question  whether  Adam,  in  the  removal  of  the  rib 
out  of  which  Eve  was  formed,  reall}-  experienced  pain,  and  whether,  at  the  day  of 
judgment,  that  loss  of  a  rib  would  be  compensated  by  the  gift  of  another.  In  conse- 
quence of  his  knowledge  of  physics  and  mechanics  —  he  is  credited  with  the  construc- 
tion of  automata  and  speaking  heads  —  he  was  in  his  day  regarded  as  a  sorcerer. 
Albert  made  a  great  number  of  experiments  in  these  branches,  and  was  such  an 
enthusiast  in  natural  science  that  he  even  interwove  it  in  his  treatise  "On  the  Virgin 
Mary".  He  discussed  botany  (from  the  standpoint  of  practical  agriculture),  chemis- 
try, physiology  (insensible  transpiration  etc.),  astronomy,  magnetism  (polarity  of  the 
magnet  i,  the  capacit}-  of  animals  and  plants  to  adapt  themselves  to  climate,  environ- 
ment etc.,  falconry,  as  well  as  the  doctrine  of  cognition  etc.  His  pupil,  Henricus  de 
Saxonia,  composed  a  secular  work  entitled  "  De  secretis  mulierum",  very  often  printed 
even  as  late  as  the  17th  century. 

Even  before  Albert  von  Bollstadt  his  fellow-monk  (Dominican) 

Vincent  de  Beauvais  (died  about  1264),  the  "  Pliny  of  the  Middle 
Ages  ", 

in  his  work  entitled  "Speculum  Majus"  (much  of  which  is  borrowed  from  the 
"  Quajstiones  naturales'  of  L.  Annaeus  Seneca),  supplied  an  encyclopaedia  which 
included  a  manual  of  popular  medicine  and  remarkable  intimations  of  the  polarity 
of  the  magnetic  needle.     He,  together  with  the  older 

Hugo  de  St.  Victoire  (died  1140), 
assumes  a  reasonable  and  a  vegetable  soul,  the  first  of  which  as  a  fiery  vapor  ascends 
from  the  heart  to  the  brain. 

Pupils  of  Albert  were  also  : 

Thomas  de  Cantimpre  (1201-1270), 
a  professor  in  Louvain,  who,  in  his  compendium,  entitled  "  De  naturis  rerum",  men- 
tions cephalic  version,  and 

Thomas  Aquinas  (1225  or  1227-1274). 

In  his  "  Summa  totius  theologia?"  the  latter  employed  medical  matters  as  collateral 
proof  of  his  subject.  He  held  the  heart  to  be  the  source  of  all  motion.  The  form 
and  powers  of  the  organs  were  entirely  independent  of  each  other;  yet  the  soul  was 
a  form  not  accidental  to  the  body,  but  substantially  united  with  it  This  form  was 
created  anew  in  each  conception,  though  not  from  the  semen,  which  contains  a  forma- 
tive principle  alone,  conveyed  to  the  uterus  and  passing  over  into  the  embryo.  For 
the  generation  of  an  individual,  moisture,  heat  and  aether  alone  are  necessary;  hence 
animals  originate  even  from  putrefying  matters. 

What  intellectual  power  existed  too  in  these  times,  under  all  the  super- 
stition and  the  subtilties  of  the  age.  is  shown  by  the  example  of  the 
English  Franciscan  and  "  Dr.  Mirabilis  ". 

Roger  Bacon  (1214-1292  or  1298), 

who,  surrounded  by  such  hindrances  and  by  an  unbounded  faith  in  authority,  insisted 
upon  independent  thought,  "  precision"  (the  modern  ideal,  observation,  measurement 


—  283  — 

and  calculation  as  the  means  to  clearer  knowledge.  Accordingly  he  was  by  some 
accused  of  rank  heresy,  though  in  fact  he  was  simply  an  opponent  of  scholasticism. 
But,  as  the  first  and  chief  skeptic  and  realist  in  our  modern  sense  of  the  terms  (and 
he  showed  himself  to  be  this  in  some  particulars  at  least),  he  was  looked  upon  by  his 
contemporaries  as  in  league  with  the  devil,  and  by  posteritj'  as  a  herald  of  the  modern 
spirit.  On  the  other  hand  his  merits  have  been  by  some  too  highly  extolled.  He  was 
acquainted  with  the  telescope,  lenses1  (he  called  attention  to  their  usefulness  for  old 
people,  and  ascribed  their  action  to  the  fact  that  objects  were  seen  under  a  greater 
angle),  microscopes,  the  burning-glass  and  camera,  but  their  invention  belongs  most 
probably  not  to  Bacon,  but  to  the  Arabians.  At  least  they  were  some  of  them  known 
to  Al  Hazen  in  the  11th  century,  and  as  Bacon  understood  Arabic,  Hebrew,  Greek 
and  Latin,  he  may  have  made  use  of  the  works  of  the  latter.  Talking-machines 
(ascribed  also  to  Albert  von  Bollstadt),  gun-powder  and  flying  machines  he  certainly 
did  not  invent.  His  principles,  his  freedom  from  prejudice,  his  zeal  for  practical 
aims  and  his  experimental  method,  however,  secure  to  Bacon  an  imperishable  place 
in  the  histor}"  of  the  development  of  the  natural  sciences,  chemistry,  physics, 
mechanics  and  mathematics  (which  he  was  one  of  the  first  to  adopt  from  the  Arabians 
and  to  transplant  into  the  West),  and  secondarilj'  thej-  merit  honorable  mention  also 
in  medicine.  On  the  other  hand  his  astrological  superstition,  which  led  him  to 
believe  in  the  influence  of  the  stars  on  therapeutic  measures  like  bleeding  and  the 
use  of  laxatives,  his  search  after  a  universal  remedy,  and  his  speculations  over  the 
question  whether  barley-water,  a  substance,  could  cure  fever,  an  accident,  —  all  these 
must  be  charged  to  his  time.  Through  the  machinations  of  the  monks,  who  began  at 
this  time  to  displa}-  their  mischievous  activity,  Bacon  was  accused  of  heresy,  and  even 
imprisoned  many  years  as  a  person  dangerous  to  the  faith.  For  in  this  century  the 
religious  orders,  through  that  centralization  which  the  later  Jesuits  adopted,  had 
acquired  still  greater  power  than  that  attained  in  the  11th  century  by  their  separation 
from  the  ecclesiastical  and  political  authorities.  This  separation  was  attained  by 
"'greasing"  the  popes  —  a  process  to  which  the  latter  were  by  no  means  averse! 
Bacon's  chief  work  was  entitled  "  Opus  majus  de  militate  scientiarum  ''.  Haifa  cen- 
tury later  Nicolaus  de  Autricaria  (d'  Audicours),  also  a  materialist  and  atomic  philoso- 
pher in  Paris,  a  city  still  devoted  absolutely  to  the  faith,  was  compelled  to  recant, 
among  other  things,  the  maxim  "that  in  natural  processes  nothing  is  active  save  the 
motion  of  union  and  separation  of  the  atoms".     (Lange.) 

Among  the  scholastic  encyclopaedias  belongs  also  the  "  Livres  dou  Tresor"  of 
Brunetto  Latini  (1220-1295).  the  teacher  of  Dante. 

1.  At  this  time  (1285  l  the  first  glasses  were  ground  for  optical  purposes,  spect;  cles 
and  simple  magnifying  glasses,  by  Salvino  degli  Armati  (died  1H17).  This  was 
the  foundation  of  our  modern  astronomy,  photography,  spectrum-analysis,  micro- 
scopy etc.,  and  one  of  the  most  important  inventions  in  regard  to  civilization 
which  has  ever  been  made.  Alexander  della  Spina  (died  1313),  a  monk  of  Pisa, 
is  also  associated  with  the  invention  of  spectacles,  an  invention  which  is  said  to 
have  withdrawn  a  large  portion  of  the  diseases  of  the  eye  from  treatment  in  the 
apothecary-shops.  At  a  still  earlier  period  Seneca  had  seen  letters  magnified  by 
means  of  glass  globules  filled  with  water  (just  such  as  are  used  by  cobblers  today 
to  improve  their  light).  In  a  picture  by  Jan  van  Eyck,  1436,  a  cleric  is  seen 
with  a  sort  of  eye-glass  in  his  hand  for  reading.  We  do  not  know  the  name  of  the 
inventor  of  rag-paper,  which  appeared  in  the  West  about  the  same  time,  and 
must  have  rendered  printing,  with  all  its  unforeseen  results  to  civilization,  if  not 
possible,  at  least  powerful  in  its  agencies.  Probably  both  inventions  were  of 
Chinese  origin.     The  first  glass  mirror  is  mentioned  in  1279. 


—  284  — 

b.    Laborers  on  Pathological  and  Therapeutical  Subjects. 

Were  the  conclusion  admissible  that  the  inner  state  and  intrinsic  worth 
of  medicine  at  any  particular  period  are  always  proportioned  to  the  number 
of  its  medical  authors,  and  not  (which  is  alone  the  correct  inference)  that 
a  great  number  of  authors  points  only  to  an  excessive  number  of  physicians 
existing  at  any  definite  time,  we  should  conclude  that  in  the  Scholastic 
epoch  the  healing  art  found  itself  in  an  internal  condition  so  flourishing  as 
happened  to  it  at  few  other  periods.  Nothing,  however,  is  less  the  fact ! 
On  the  contrary  we  may  affirm  that,  in  general,  medicine  had  at  no  other 
period  possessed  so  little  intrinsic,  productive  value  as  at  this  time.  An 
interesting  comparison  may  be  drawn  between  this  and  the  Alexandrian 
period.1  In  both  the  treatment  and  elaboration  of  existing  materials, 
commentaries  upon  the  earlier  physicians,  occupied  the  chief  position  in 
medical  art  ;  in  both  two  groups  of  physicians  must  be  distinguished, 
though  the  Grecists  and  Arabists,  more  distinct  in  their  periods,  did  not 
exist  beside  each  other.  We  find  in  both  the  overgrown  rule  of  the  subtil- 
ties  of  dialectics  ;  in  both  Aristotle  was  the  leader  of  philosophy  ;  in  both 
therapeutics  and  materia  medica  were  especiall}*  cultivated,  beside  an  erudi- 
tion often  perfectly  astonishing,  together  with  astrological  and  other  super- 
stitions. At  bottom,  an  advance  in  anatomy  and  surgeiy  only,  this  time, 
however,  destined  to  be  permanent,  because  an  outgrowth  of  the  spirit 
of  the  masses,  and  not  of  individual  rulers.  Both  epochs  too  were  of 
almost  equal  duration,  only  during  the  Alexandrian  period  more  currents 
of  thought  ran  beside  each  other.  It  is  striking  also  that  during  this 
period  Germany  did  not  at  an}T  time  exercise  an}-  considerable  influence 
upon  medical  culture,  and  was  even  almost  without  medical  representa- 
tives—  at  all  events  without  any  of  considerable  importance  —  so  that  the 
Roman  nations  ruled  medicine  without  interruption,  a  condition  which 
remained  substantiall}-  unchanged  until  the  following  century. 

a.     Twelfth  and  Thirteenth  Centuries. 
With  the  12th  century  begins  the  "Age  of  the  Arabists",  who  followed 
the  Arabians  in  science  and  practice,  and  whose  influence  continued  active 

1.  The  Alexandrian  epoch,  however,  was  a  descending,  the  Scholastic  an  ascending 
epoch,  and  the  latter,  therefore,  manifested  very  many  progressive  acquisitions  in 
the  scientific,  religious,  artistic  and  material  departments.  We  may  mention  the 
growth  of  religious  criticism  (Waldenses);  the  progressive  development  of  states 
and  associations;  the  discontinuance  of  all  slavery  from  the  13th  century,  to  be 
replaced  by  simple  vassalage;  the  founding  of  cities;  the  decline  of  chivalry; 
the  gradual  development  of  the  arts,  some  of  which  e.  g.  music  (which  began  to 
revive  in  the  11th  and  12th  centuries),  architecture,  painting  etc.,  had  entirely 
disappeared  since  the  days  of  Antiquity;  commerce  and  colonization  (Hanseatic 
league),  which,  like  the  arts,  proceeded  from  Italy;  banking,  which  originated  in 
the  same  eountr}-,  and  during  the  13th  century  spread  also  to  the  North;  the 
growth  of  trades  (guilds)  among  the  citizens;  the  beginning  ot  travels  for  learn- 
ing and  discovery  (Marco  Polo  died  1251),  etc. 


—  285  — 

down  into  the  17th  century.     The  earliest  among  the  considerable  authors  of 
this  period  (he  was  a  contemporary  of  Frederick  Barbarossa,  1152-1190)  was 
Gerhard  of  Cremona  (1114-1187), 

a  scion  of  the  school  of  Salerno,  who  translated  chiefly  the  writings  of  Hippocrates 
but  also  many  Arabian  physicians  and  the  whole  of  Galen.  He  had,  like  many  of  the 
very  numerous  and  zealous  translators  of  the  time  who  travelled  extensively,  betaken 
himself  in  the  first  place  to  Spain  (at  this  period  raised  by  the  labors  of  the  Arabians 
to  the  position  of  the  lauded  land  of  the  sciences  and  the  Mecca  of  numerous  savants 
and  students),  and  particularly  to  Toledo,  where  he  continued  to  reside  until  his 
death. 

The  Aphorisms  of  Hippocrates  and  the  writings  of  Galen  were  better  translated  by 
Bcjrgundio  or  Pisa  (died  119-tt.  a  lawyer. 

A  famous  teacher  at  Bologna  after  12(10  was 
Thadd.eus  of  Florence  (1215-1295), 
who  united  philosophy  and  medicine  with  a  display  of  all  scholastic  and  Arabian  erudi- 
tion, and  translated  and  explained  the  Hippocratic  writings  especially,  besides  those 
of  Galen.  He  also  wrote  a  treatise  entitled  "  De  regimine  sanitatis  secundum  quatuor 
anni  partes".  Although  the  Bolognese  had  relieved  him  of  all  taxes,  he  yet  made 
himself  notorious  by  his  costly  treatment  and  his  covetousness. 

The  Jew  Ferragius  (Ferraguth,  Farradsch  ben  Salem)  of  Agrigentum 
in  the  13th  century  acquired  some  dubious  credit  by  his  translations  of  the  Arabian 
physicians,  who  were  so  highly  esteemed  that  Charles  of  Anjou  (1266-1285)  procured 
a  copy  of  the  "Continens"  of  Rhazes  from  the  bey  of  Tunis  by  means  of  a  special 
embassy.  It  was  through  the  agency  of  the  school  of  Salerno  that  the  writings  of  the 
Arabians  were  first  made  known  to  the  West. 

The  famous  Peter  of  Abano  near  Padua  (lived  1250-1320), 

a  man  of  refined  views,  though  given  to  superstition  of  all  kinds,  was  a  master  of  the 
speculation  and  erudition  of  the  times.  Persecuted  for  his  heresy  originating  in  his 
devotion  to  the  writings  of  Ebn  Roschd,  he  was,  on  the  other  hand,  equally  admired, 
especially  for  his  knowledge  of  Greek  acquired  at  Constantinople  and  in  Greece.  He 
lived  a  long  time  at  the  university  of  Padua,  after  having  studied  medicine  and 
mathematics  during  his  educational  travels  and  in  Paris.  His  writings  —  proof  of  the 
estimation  in  which  their  author  was  held  —  were  among  the  first  impressions  of  the 
15th  century.1  His  "  Conciliator  "  in  its  very  title  expresses  his  mediation  between 
the  Arabists  and  the  Grecists.  The  scholastic  method  of  questions  and  answers 
followed  by  an  expression  of  his  own  views,  is  also  his,  and  the  questions  themselves 
are  subtle  speculations,  e.  g.  whether  air  is  b}'  nature  cold  or  hot,  whether  pain  is  a 
disease  or  an  accident,  whether  heat  and  pneuma  are  one  and  the  same  thing, 
whether  a  small  head  is  better  than  a  large  one  etc.  (Smallness  of  the  head  from 
narrowness  of  the  skull  is  pernicious;  from  a  deficiency  in  the  thickness  of  its  cover- 
ing it  is,  however,  very  good!).  Critical  days  he  ascribes  to  the  influence  of  the 
moon;  considers  venesection  especially  beneficial  in  the  second  quarter  of  the  moon  ; 
iron  is  the  most  serviceable  material  for  instruments  in  consequence  of  its  relation  to 
Mars,  and  of  the  latter  god  to  surgery,     in  the  latter  science  he  commends  the  "dry 

1.  The  "Conciliator  differentiarum  philosophorum  et  precipue  medicorum"  was  first 
published  at  Venice  in  1471.  Peter  was  aware  that  the  air  possessed  weight,  and 
he  calculated  the  duration  of  the  year  at  365  days,  6  hours  and  4  minutes. 
He  calls  the  brain  the  source  of  the  nerves,  the  heart  the  source  of  all  the 
vessels  etc.     (H.) 


—  286  — 

method"  in  the  treatment  of  ulcers,  recommends  bronchotomy,  but  desires  to  limit 
the  use  of  paracentesis  abdominis. 

During  the  same  period  lived  a  second  Peter  (he  died  1277),  known  as 
the  Spaniard, 

son  of  a  physician  Julian,  and  afterwards  pope  under  the  name  of  John  XXI.  He 
wrote  a  "Thesaurus  pauperum  ",  in  which  he,  indeed,  discards  the  charms  of  the 
monks,  but  is  of  the  opinion  that  one  ma}-  keep  free  of  epilepsy  if  he  suspends  about 
him  Sts.  Caspar,  Melchior  and  Balthasar,  i.  e.  their  names  written  on  a  scrap  of 
paper.  Filial^  he  believes  that  diarrhoea  may  be  excited  by  packing  fasces  of  the 
patient  in  hollow  human  bones  and  laying  the  latter  in  a  river.  As  long  as  these  lie 
in  the  stream  the  abdominal  flux  will  continue. 

Among  German  physicians  of  this  period  (in  which  family  names  were 
either  not  used,  or  employed  only  exceptionally;  we  may  mention  : 

Magister  Henricus,  physicus  in  Ruspach  1226  ; 

Eupertus  Medicus,  physicus  1248  ; 

Magister  Hermannus,  physicus  in  Bamberg  1248  ; 

Magister  Johannes,  physicus. 
whose  known  life  falls  between  1236  and  1249,  and  who  was  ordinary  physician  of  the 
bishops  Brunward  and  William  of  Schwerin  ; 

Magister  Hermannus 
was  chosen  city  physician  of  Wismar  in  1281  ;  besides  these  we  may  notice: 

Otho,  medicus  in  Nuremberg,  and  a  Jewish  physician,  Joseph,  of  the  same  city  ; 
.Magister  Andreas,  (died  1295),  physicus  in  Wimpfen,  and 

Magister  Bertholiius  (died  1295),  of  the  same  place. 

These  names  at  least  furnish  evidence  that  in  Germany  then,  and  even 
before  this  time,  medicine  occupied  a  recognized  position,  and,  above  all, 
was  held  in  esteem. 

,3.  The  Fourteenth  Century 
introduced  with  power  and  energ}-  the  might}'  leaven  of  a  more  modern 
period  into  both  social  and  intellectual  life.  In  regard  to  both  we  must 
emphasize  the  fact  that  commerce,1  business  and  manufactures,  as  well  as 
the  higher  arts,  took  a  lively  start,  particularly  in  Italy.  Dante  (1265-1320  ; 
by  the  bye  he  was  a  member  of  the  guild  of  physicians  and  apothecaries) 
had  produced  his  "  Divina  Commedia",  and  this  was  the  century  of  Petrarch 
and  Boccaccio  !  In  Germany,  on  the  other  hand,  the  Hanseatic  league  was 
in  its  bloom,  and,  for  the  first  time,  coined  money  came  into  common  use  as 
a  convenient  medium  of  exchange,  facilitating  commerce  and  stimulating 
production  which  had  hitherto  languished  under  an  almost  exclusive  system 
of  barter.  But  increased  prosperity  favored  intellectual  mobility  and  men- 
tal effort.  Progress  in  the  sphere  of  religion  had  been,  indeed,  invoked  by 
individuals  in  the  preceding  century,  but  mainly  in  secret :  now,  however, 
it  appeared  in  the  definite  shape,  and   upon  the  open  road,  of  anti-papal 

1.  In  Florence  e.  g.  15  millions  of  guilders  changed  hands  annual!}-  in  the  wool 
business.  The  invention  of  the  compass  (according  to  accounts  by  Flavio  Gioja 
of  Amain  in  1300)  was  a  powerful  agent  of  civilization  which  we  owe  to  the  close 
of  the  Middle  Ages,  so  rich  in  great  discoveries. 


—  287  — 

sectarianism  (Wickliffites).1  It  shook  the  infallibility  of  the  pope  (with 
which  human  reason  is  to-day  once  more  offended  !),  and  insisted  upon  an 
improved  education,  whose  higher  departments  Scholasticism  was,  however, 
still  for  a  long  time  to  control,  though  Petrarch  and  other  heralds  of  the 
great  Humanists  of  the  following  century  fought  against  it  with  all  firm- 
ness. Astrology,  theosophy,  miracle-working  and  clerical  quackery  likewise 
still  walked  openly  in  the  light  of  day,  while  alchemy  was  cultivated  in 
secret.  Yet  from  the  latter  art  the  elements  of  chemistry  began  to  develop, 
as  the  natural  sciences  in  general  began  at  this  time  to  spread  abroad. 
Kunrat  von  Megenberg  (1307-1374)  composed  his  "Buch  der  Natur",  the 
pioneer  natural  histoiy  in  the  German  language.  The  remarkable  invention 
of  gunpowder  by  Berthold  Schwartz  (1330),  so  important  in  the  history 
of  civilization,  reformed  surgery.  The  French  demonstrated  their  intellec- 
tual independence  particularly  by  genuine  national  historical  writings  and 
poetr}'  (troubadours),  while  such  essa}Ts  among  the  Germans  (of  course  for 
the  second  time,  but  with  greater  success  than  in  the  times  of  the  city 
chroniclers  and  minnesingers  and  meistersingers  of  the  13th  and  14th  cen- 
turies) did  not  appear  with  aivy  prominence  until  the  16th  century.  The 
sciences  accessory  to  medicine,  and  its  fundamental  branches,  arose,  and 
moreover  the  revival  of  human  practical  anatomy  as  an  openly  recognized 
department  of  medical  science  makes  this  centuiw  imperishable  in  the 
annals  of  medicine. 

The  most  famous  among  the  scholastic  physicians  of  this  period,  a 
man,  indeed,  distinguished  among  the  "  Conciliators  "  by  the  title  of  ;'  Plus 
quam  commentator",  was  the  pupil  of  Thaddseus, 

Torrigiano  Rustichelli,  a  teacher  at  Paris,  between  1306-1311. 

The  commentary'  of  this  Carthusian  monk  on  Galen's  "Ars  parva  "  brought  him 
the  title  mentioned  above,  and  helped  him  to  a  place  in  the  curriculum  of  the 
uuiversities  of  the  day.  In  many  points  he  deviates  from  Aristotle,  Galen  and 
Avicenna,  e.  g.  in  accepting  the  seat  of  sensation  in  the  brain  (instead  of  the  heart), 
the  identity  of  the  nerves  of  sensation  and  motion  etc. 

To  this  epoch  also  belongs 

Matthew  Sylvaticus  of  Mantua  (died  1342  ;  probably  the  Salernian 
Mazzeo  di  Montagno,  whom  Boccaccio  mentions  oh  the  occasion  of  a  case 
of  anaesthesia  of  the  lover  of  the  old  man's  young  wife), 

who  was  for  a  long  time  an  active  practitioner  in  Milan,  and,  in  like  manner,  desired 
to   mediate  between  the  Arabians  and  the  Greeks.     On  the  other  hand  the  cardinal 

Vitalis  Bufour  (Be  Ftjrno,  died  1327) 
composed  an  alphabetic  compilation,   after  the  style  of  the  Arabians  and  Arabists, 
entitled  "Pro  conservanda  sanitate"  etc.     In  the  same  year  with  him  died 

1.  Physicians  also  took  part,  as  pioneers  of  Luther,  in  the  efforts  for  reformation  of 
the  church.  The  most  influential  of  these  was  Marsilius  of  Padua,  who  was  for 
18  years  ordinary  physician  of  the  emperor  Lewis  of  Bavaria  and  author  of  the 
"  Defensor  pacis",  which  has  been  called  ''the  creed  of  the  anti-papal  party". 
Phyrsicians  have  ever  stood  in  the  foreground  wherever  there  has  been  a  question 
of  intellectual  progress! 


Dinus  a  Garbo  of  Florence, 
who  wrote  subtle  commentaries  on   the  treatises  of  Avicenna  and   Hippocrates  on 
generation  and  the  nature  of  the  embryo,  in  which  he  investigates  whether  the  semen 
originates  from  the  heart  only  of  the  father,  or  from  his  whole  body;  whether  intelli- 
gence resides  in  it  etc. 

Nicholas  of  Reggio  (about  1330) 
again  translated  the  whole  of  Galen,1   while 

Francesco  of  Piedmont  (about  1330).  near  Naples, 
explained  the  Arabian  Mesne.     He  recommended   the  Psalms  of  David  as  a  kind  of 
ergot  for  facilitating  difficult  labor,  is  acquainted   also  with   cephalic  version,   knows 
of  the  occurrence  of  superfcetation.  and  administers  serpents  internally  in  small-pox. 
Similar  curious  counsels  are  given  by 

Gentilis  of  Fuligno,2 

in  his  day  a  highly  famed  and  devoted  professor  at  Padua,  who  died  of  the  plague  at 
Perugia  in  1348.  He  composed  some  "  Consilia  "  and  commentaries  on  the  Arabians 
and  Galen.     He  is  said  to  have  been  the  first  to  observe  gall-stones. 

Thomas  a  Garbo  (died  1370).  the  son  of  Dinus, 

wrote  on  the  same  book  of  Avicenna  as  his  father.  A  famous  teacher  at  Perugia  and 
Padua,  he  merited  the  praise  of  Petrarch  (1304-1374),  who,  though  a  sworn  enemy 
of  the  physicians  of  his  time  and  of  their  medicine  in  general,  yet,  in  his  fiery  opposi- 
tion to  blind  faith  in  authority  and  to  hollow  dialectics,  promoted  this  science  indi- 
rectly, and  should  accordingly  be  mentioned  here  as  a  "herald  of  the  strife".  His 
idea  that  the  destruction  of  the  common  man  by  the  physicians,  is  not  much  to  be 
lamented,  however,  does  not  exhibit  him  in  a  very  estimable  light- 
To  this  century  belongs  also  the  medical  family  of  Santa  Sofia;  at  the  beginning 
of  the  century,  Nicor.o  Santa  Sofia,  professor  at  Padua;  then  his  sons  Marsilio  and 
Giovanni,  the  former  professor  at  Bolojrna,  the  latter  at  Padua;  and  at  the  end  of  the 
century  (1388)  Galeazzo,  professor  at  Vienna  and  Bologna.  They  wrote  on  practical 
subjects  with  some  commentaries. 

Another  commentator  on  the  Arabian  Mesue,  was  Christophorus  de  Honestis 
(died  1392)  of  Bologna,  where,  as  well  as  at  Florence,  he  was  a  professor. 
Among  the  German  clerical  physicians  of  this  century  belong  : 
Magister  Thomas   of  Breslau,  bishop  i.  p.  of  Sarepta,  the  earnest 
opponent  of  uroscopy  and  astrology,  and 

Sigmund  Albicus  (born  1347)  of  Moravia,  both  of  whom  were  follow- 
ers of  Arnold  of  Villanova. 

y.     The  Fifteenth  Century. 
Were  we  discussing  the  histoiy  of  world-moving  inventions,  we  should 
mention  here,  before  all  others,  that  of  printing,  1450,3  by  Joh.  Gansfleisch, 

1.  From  a  MS.  sent  to  king  Robert  I.  of  Sicily,  by  the  Byzantine  emperor  Adron- 

icus.     (H.) 

2.  Steinschneider  designates  by  the  title   "  Pseudo-Gentilis"   a  physician,  Bernard 

Alberti,  dean  of  Montpellier,  to  whom  he  ascribes  the  "Recepta"  which  pass 
under  the  name  of  Gentilis. 

3.  The  first  impressions  (42  line  Bible)  appeared  in  Mayence  in  1455  or  1456.     The 

art  extended  very  rapidly  throughout  Germany,  France  and  Itaky  etc.  The 
presses  at  first  supported  themselves  by  religious  and  theological  (scholastic) 
writings;  subsequently  by  humanistic,  and  still  later  by  those  relating  to   the 


—  289  — 

called  Gutenberg,  1397-1467,  of  Mayence) —  that  German  achievement  of 
the  fifteenth  century,  which  produced  such  incalculable  blessings  for  the 
intellectual  life  of  all  people.  Moreover  we  should  recall  as  its  antipode  in 
the  history  of  civilization  the  introduction  of  firearms  into  the  West.1  If, 
however,  we  desired  to  write  a  general  history  of  civilization,  or  even  simply 
an  introduction  to  the  imperishable  work  of  the  greatest  of  German  heroes 
■ — the  Reformation  —  we  should  be  compelled  to  discuss  in  detail  the  life 
and  labors  of  those  great  Humanists  who  gave  to  this  century  its  spiritual 
consecration  and  its  zeal.  We  should  speak  of  a  Georgius  Gemistus  Pletho 
(1355-1452).  of  a  cardinal  Bessarion  (1395-1472),  a  George  of  Trebizond 
(1396-1486),  Demetrius  of  Crete,  Demetrius  Chalcondyles  (1424-1511), 
Callinicus,  Joh.  Argyropulus  (died  1486)  ;  of  those  Platonic  philosophers 
like  Marsilius  Ficinus  (1433-1499),  the  Germans  Nicholas  Cusanus  (1401- 
1464)  of  Cusa  on  the  Moselle,  Conrad  Celtes  (Conrad  Pickel  of  Wipfeld, 
1459-1508),  and  Rudolph  Agricola  (properly  Rud.  Baumann  of  Wasserburg, 
1412-1485),  and  finally  the  noble  martyr  Huss,  and  many  other  equally 

Reformation.  Printer,  publisher  and  bookseller  were  originallj'  all  united  in  the 
same  person.  The  printers,  and  particularly  the  proof-readers,  were  often 
persons  of  learning'.  It  was  not  until  the  beginning  of  the  16th  century  that 
publishers  proper  arose,  who  employed  printers  and  agents  (Sartimenter)  in  all 
large  places  of  every  land,  in  order  to  facilitate  the  sale  of  the  books.  Originally 
the  Latin  language,  as  the  cosmopolitan  tongue,  was  employed,  and  it  was  not 
until  the  16th  century  that  bftoks  began  to  be  divided  more  and  more  according 
to  national  languages.  Of  course  the  fabrication  of  paper  was  greatly  increased 
by  the  invention  of  printing,  but  its  price  fell  in  consequence  of  overproduction. 
In  1484  twenty  books  cost  only  about  $2  50,  and  at  the  turn  of  the  century  200 
books  were  purchased  for  $3.60.  Woodcuts  and  decorative  printing  were  speedily 
introduced.  The  booksellers'  emporium  was  Frankfort-on-the-Main  until  the 
middle  of  the  18th  century,  when  Leipsic  developed  into  headquarters  of  the 
publishing  business.     (Oscar  Hase,  1886.)     (Baas.) 

The  first  book  printed  in  the  English  language  was  a  translation  of  "  Le 
Recueil  des  Histoires  de  Troyes",  set  up  and  printed  at  Cologne  in  1471  by 
William  Caxton.  Soon  after  Caxton  erected  his  press  in  the  monasteiy  of 
Westminster  Abbey,  where  in  1474  appeared  his  "  Game  and  Playe  of  the 
Chesse",  which  is  believed  to  be  the  first  book  printed  with  the  date  in  England. 
Printing  is  believed  to  have  been  introduced  to  the  western  continent  by  the 
Spaniards  as  early  as  1535.  At  all  events  the  "  Manual  de  Adultos  "  appeared 
from  the  press  of  Juan  Cromberger  in  Mexico  in  1540.  The  first  press  within 
the  limits  of  the  present  United  States  was  set  up  in  the  house  of  Rev.  Henry 
Dunster,  president  of  Harvard  College,  at  Cambridge,  in  1639.  It  was  placed  in 
charge  of  Stephen  Daye,  and  the  first  work  issued  was  "The  Freeman's  Oath", 
followed  by  "An  Almanack"'  in  the  same  year.  This  press  was  the  lineal  ances- 
tor of  the  present  famous  "University  Press".  The  "Bay  Psalm  Book",  a. 
metrical  version  of  the  Psalms  of  David  printed  by  Daye  in  1640,  was  the  first 
book  proper  printed  in  the  U.  S.  A  copy  of  this  work  in  the  "  Lenox  Library'", 
New  York,  is  reported  to  have  cost  $400.  (H.) 
1.  The  first  fire-arms  were  manufactured  in  Augsburg  in  1381.  (This  must  refer  to 
small-arms,  for  it  is  well  established  that  cannon  were  employed  by  the  English 
under  Edward  III.  at  the  battle  of  Crecy  in  1346.  (H.) 
19 


—  290  — 

great  men  !  Were  we  writing  a  histoiy  of  the  arts,  we  should  mention  here 
the  greatest  names  of  all  time.  For  painting  and  architecture,  music,  so 
long  undeveloped  (especially  among  the  Netherlander),  wood-engraving, 
wood-carving,  art-work,  goldsmithing,  ceramics  (majolica)  etc..  celebrated, 
as  we  know,  high  triumphs  in  this  century,  and,  indeed,  this  epoch  com- 
prehended or  engendered  the  greatest  geniuses  who  have  ever  lived  in  the 
service  of  the  Beautiful !  Mathematical  science  was  advanced  by  such  men 
as  G.  Peurbach  (1423-1461  ;  introduced  the  Arabic  or  Indian  figures  and 
the  decimal  system)  ;  Martin  Beheim  (about  1149-1507),  a  mathematician, 
geographer  and  navigator;  Joh.  Miiller  (Regiomontanus,  143G-1476)  of 
Konigsberg  in  Franconia.  author  of  the  first  German  almanac,  and  of  the 
ephemerides  which  rendered  possible  the  voyage  and  geographical  discov- 
eries of  Christopher  Columbus  (145G-150(J)  ;  historical  composition  was 
represented,  among  others,  by  Joh.  Turmair,  surnamed  'Aventinus  (1477- 
1534,  son  of  an  inn-keeper,  and  pupil  of  Celtes,  the  son  of  a  wine-grower), 
not  to  mention  numerous  others.  The  natural  sciences  were  likewise  pro- 
moted by  travels,  though  the  latter  were  undertaken  solely  with  the  object 
of  palpable  profit,  like  the  earlier  travels  of*  Marco  Polo.  But  self-interest 
worked  involuntarily  in  the  service  of  the  lofty  spirit  of  the  time.  The 
Orient  was  the  scene  of  the  travels  of  the  Nuremberg  patrician  Schillberger, 
of  the  great  Breidenbach  expedition  (1483-84-)  and  other's  ;  on  the  ever 
memorable  12th  of  October,  1492,  Columbus  discovered  a  new  world,  and 
five  years  later  Vasco  da  Gama  (1469-1524)  opened  a  new  route  to  the 
Indies.  In  a  history  of  medical  culture  these  deeds  must  be  at  least  pointed 
out,  and  these  men  mentioned,  if  only  cursorily.  Of  course  we  can  onl}- 
refer  to  the  historical  foundations  of  the  histoiy  of  medical  development, 
without  thoroughly  discussing  them  ;  otherwise  we  should  far  transgress 
the  limit  of  simple  "  Outlines".  But,  by  means  of  these  acquisitions,  medi- 
cine too  received,  directly  and  indirectly,  in  this  period  the  might}*  impulse 
which  led  it  forth  out  of  the  wilderness  of  the  Middle  Ages  and  the  swa}" 
of  Galen  and  the  Arabians,  though  here,  alas,  it  worked  with  far  less  energ}' 
than  in  the  emancipation  of  the  other  sciences.  Besides  the  renewed  study 
of  the  Ancients,  the  appearance  of  new  epidemics,  in  which  physicians 
could  not  pursue  the  treatment  of  Galen  and  the  Arabians,  but  must  per- 
force stand  upon  their  own  feet,  had  also  its  influence  upon  medicine. 
Still  astrology,  Neo-Platonic  mysticism  and  kindred  parasites  on  the  pure 
body  of  science,  especially  in  its  practical  portions,  maintained,  on  the 
whole,  their  open  and  secret  dominion.     Thus  even  the  great  Ficinus1  (1433- 


t.  Ficinus  wrote  a  book  entitled  "  De  studiosorum  valetudine  tuenda",  of  which 
Hseser  says  "Das  buch  des  lebens  zu  Kitsch  gemacht  durch  Joh.  Adelphi,  1505" 
is  a  German  translation.  He  adds  that  the  book  was  published  "sine  loco". 
Since  a  Joh.  Adelphus,  phjsicus,  is  named  as  corrector  of  the  book  of  Eueharius 
Roesslin,  edition  of  1513,  published  by  Martin  Flach  Jr.,  the  place  must  have  been 
Strassburg,  and  the  printer  M.  Flach,  for  whom  Job.  Adelphus  prepared  the 
translation. 


—  291  — 

1499),  a  physician  of  Florence,  recommended  gold  as  the  most  excellent 
elixir  of  life,1  and  specially  advised  pills  prepared  at  the  period  of  the  con. 
junction  of  Jupiter  and  Venus  ;  indeed  he  even  lauded  drinking  the  blood 
of  little  children  and  3*011  ng  persons  as  a  means  of  rejuvenation — means  by 
which  a  Constantine  and  Louis  X.I.  endeavored  to  recover  new  vital  energj- ! 
Other  great  spirits  of  that  time  defended  with  all  earnestness  the  Cabala. 
Thus  Pico  of  Mirandola  (1 463-149-4),  and  Francesco  Pico  of  Mirandola 
(died  1533),  his  nephew,  as  well  as  the  pupil  of  the  former  and  of  Ficinus> 
Johann  Reuchlin  (1455-1522),  the  son  of  a  messenger  of  Pforzheim  (most, 
of  the  great  minds  mentioned  sprung  from  the  class  of  citizens  or  farmers), 
cherished  the  dark  side  of  the  spirit  of  the  times,  which,  in  spite  of  its 
powerful  growth  toward  the  light,  could  not  disown  its  roots  buried  in  the 
soil  of  a  darker  age.  The}-  were  men  who,  indeed,  separated  mediaeval  and 
modern  times  from  each  other,  but  stood  with  their  feet  in  the  one  and  their 
heads  in  the  other  ;  in  a  word  men  of  two  epochs  of  civilization.  But 
when  such  was  the  condition  of  the  green  wood,  what  must  have  been  the 
state  of  the  more  or  less  feeble  spirits  of  that  period  ?  And  above  all 
what  the  condition  of  the  masses  ? 

Nicholas  Falcutius  (died  1412) 
gained  great  fame  in  his  day  for  his  "Sermones  medicinales  ".  He  already  displays 
more  independent  observation,  though  he  likewise  wrote  some  bare  commentaries 
(on  Hippocrates).  His  independence  must  probably  be  credited  to  his  occupying 
himself  with  anatomy  and  surgery.  On  the  other  hand  the  commentaries  on  Hippo- 
crates, Galen  and  Avicenna  of  the  Pad u an  professor 

Jacob  of  Forli  (died  1415), 
are  full  of  scholastic  subtilties.      He  denies  the  viability  of  children   born  in  the  8th 
month,  for  the  reason  that  Saturn  rules  in  the  uterus  during  this  month,  and  lie,  as  is 
well  known,  eats  up  children  ! 

Jacob  Ganivet  (about  1418) 
may  serve  here  as  an  example  of  the  way  in  which  the  pastoral  physicians  of  the 
period  rendered  service  to  medicine,  since  he  held  the  various  diseases  of  every  man 
to  depend  upon  his  nativity,  and  formed  his  prognoses  accordingly.  Moreover  he 
apportioned  to  each  city  a  special  planet,  and  derived  epidemics  from  the  conjunction 
of  these  bodies. 

The  Spaniard,  John  of  Avignon, 

composed  about  1419  a  medical  topography  of  Seville. 

Nicholas  Leonicenus  (1428-1524  ;  born  at  Lunigo,  and   hence  his 
name) 

was  not  only  a  physician,  but  also  a  shining  light  in  general  education.  A  famous 
humanist  and  professor  of  medicine  at  Ferrara,  he  translated,  among  other  works, 
the  Aphorisms  of  Hippocrates  and  was  the  first  to  restore  this  author  to  his  proper 
position.     He  also  worked  a  lasting  reformation  in  medicine  by  his  exposure  of  the 


1.   It  is  probably  scarcely  necessary  to  recall  to  the  English  reader  the  lines  of  our 
own  Chaucer: 

"For  gold  in  phisik  is  a  cordial, 
Therefore  he  lovede  gold  in  special."     (H.) 


292  

errors  of  Pliny  (a  bold  and  important  deed  in  that  age  still  so  faithful  to  authority). 
He  likewise  gave  currencj-  to  astrological  explanations  of  the  origin  of  syphilis  (a 
subject  upon  which  he  was  the  first  in  Italy  to  write  in  1497),  in  opposition  to  the 
theory  of  the  influence  of  inundations.  He  was  perfectly  acquainted  with  the 
symptoms  of  the  disease,  even  those  manifested  in  the  eye  and  the  joints  (Purjesz), 
and  regarded  it  as  epidemic  and  infectious.  He  also  held  to  the  opinion  that  it  had 
existed  in  Antiquity. 

Hermolaus  Barbarus  (145-1-1493) 

must  also  be  mentioned  here,  as  he  reveals  the  sources  of  information  of  Pliny. 

John  Concorregio  of  Milan  (1439) 

elaborated  in  the  style  of  the  Arabians  his  "  Practica  nova,  breve  lucidarium,  et  flos 
florum  medicinae  nuncupata".  A  few  good  observations  on  venesection  and  on  a 
mild  form  of  epilepsy  must  compensate  for  the  usual  lack  of  independence  of  an 
Arabist. 

Hugo  Bencio  (died  1439), 
professor,  one  after  another,    in  almost  all  the  Italian   universities  of  his  day   and 
finally  at  Padua,  was  a  commentator  upon  Hippocrates,  Galen  and  Avicenna    as  well 
as  the  author  of  1;  Consilia  saluberrima  ad  omnes  ajgritudines  a  capite  ad  calcem 
perutilia  '. 

The  "  Practica''  of  the  illiterate  professor  at  Padua, 

Antonio  GrUAiNERi1  (Gruainierio,  died  1447,  or  according  to  others  1440 ), 
who  also  wrote  on  diseases  of  women,  is  distinguished  by  its  relative  freedom  from 
the  superstition  of  the  day  with  respect  to  alchemy  and  treatment  by  exorcism,  as 
well  as  for  its  nice  observations.  He  e.  g.  mentions  affections  in  which  the  memory 
of  a  few  words  only  is  preserved  and  to  which  increased  attention  has  recently  been 
given.  He  also  notices  pregnancy  in  the  absence  of  menstruation,  ab.»ence  of  the 
hitter  except  during  the  period  of  pregnancy,  rectal  concretions  etc.  Still  he  also 
clings  to  empiricism  and  astrology. 

Mengo  Bianchelli  of  Faenza  (about  1441), 
on  the  other  hand,  was  a  subtle  scholastic  and  a  great  astrologist,  who  recognized  e.  g. 
a  pulse  high  in  the  middle  and  contracted  at  the  sides,  a  pulse  twisted  like  a  thread, 
and  distinguished  abnormal  heat  as  a  species  added  to  the  natural  warmth. 

Antonio  Cermisone  of  Padua, 
professor  at  Paris  (died  1441),  composed  "Consilia  medica  contra  omnes  fere  aegritu- 
dines  a  capite  usque  ad  pedes". 

Bartholom.eus  Montagnana,  professor  at  Padua. 
from   whom  descended  a  long  flourishing  family  of  physicians,  also  composed  some 
more  justly  celebrated  "Consilia  medica". 

Thomas  Linacre2  (1461-1524), 
the  pupil  of  Chalcondyles  and  Angelus  Politianus,  (1454-1494),  is  also  to  be  classed 


1.  According  to   Hasser,  Guaineri    is   the  first   physician  to  mention  the  use  of  wax 

bougies,  and  sounds  of  tin  and  silver,  in  the  treatment  of  urethral  stricture.  He 
does  not,  however,  speak  of  them  as  anything  novel.      (H.) 

2.  Linacre  was  born  in  Canterbury,   and  received  his  early  education  in  that  city. 

He  afterwards  studied  in  Oxford,  where  he  became  a  Fellow  of  All  Souls'  College 
in  1484.  Proceeding  thence  to  Italy,  he  studied  Greek  under  Demetrius  Chal- 
condyles at  Florence,  where  he  was  warmly  received  by  Lorenzo  de  Medici.  He 
also  perfected   himself  in  Latin,   under  the  direction  of  Angelo  Poliziano,   and 


—  293  — 

here  on  a  par  with  Leonicenus.  He  was  ordinary  physician  of  Henry  VII.,  and  of  the 
grossly  sensual  (like  so  many  bigots)  but  energetic  Henry  VIII.  (1509-1547).  Linacre 
performed  immortal  service  to  English  medicine  by  his  excellent  translations  of 
Hippocrates,  and  especially  by  his  foundation  of  chairs  of  Greek  medicine  at  Oxford 
and  Cambridge,  and  of  the  College  of  Physicians  (1518)  at  London.  His  grave  is  in 
St.  Paul's  Church  in  that  city.  It  was  he  who  introduced  Italian  Humanis-m  among 
the  physicians  of  England,  and  he  thus  belongs  among  the  reformers  of  education  in 
that  land. 

One  of  the  most  famous  Italian  professors  of  medicine  in  this  period  was 
Michael  Savonarola  (died  1462  as  professor  at  Ferrara), 
who  wrote  a  "  Practica  de  segritudinibus  a  capite  usque  ad  pedes".  He  follows  the 
Arabians,  but  is,  however,  not  without  independence  in  observation  and  practice,  in 
spite  of  his  faith  in  the  efficacy  of  precious  stones,  animal  monsters,  a  human  embryo 
etc.  He  observed  a  decrease  in  the  number  of  teeth  to  22,  as  a  rule,  in  the  period 
after  the  subsidence  of  the  plague,  the  development  of  new  ones  during  pregnancy  etc. 

Contemporary  with  him  was 
Sigmund  Polcastro  (died  1473)  of  Vicenza,  professor  at  Padua. 

Here  belong  also  Th.  Gaza  (died  1478),  who  translated   the   "Aphorisms"   of 
Hippocrates ; 

Marcellus  Vergilius  (died  1521) 
of  Florence,  who  promoted  the  science  of  botany,  atid 

Johannes  Manardus  (1462-1536)  of  Ferrara, 
at   first   ordinary  pli3'sician   of  the   count   of  Mirandola,  then  of  king  Ladislaus  of 

studied  philosophy  and  medicine  with  Hermolaus  Barbaras  in  Rome.  On  return- 
ing to  England  he  decided  to  complete  his  studies  in  medicine,  and  took  his  M.D. 
at  Oxford.  His  reputation  as  a  scholar  led  to  his  appointment  as  preceptor  of 
prince  Arthur,  son  of  Henry  VII.,  and  his  professional  attainments  procured  him 
the  position  of  ordinary  physician  to  that  sovereign,  and  subsequently  to 
Henry  VIII.  In  the  latter  office  his  salary  seems  to  have  been  £12  10s  quarterly. 
Linacre's  familiarity  with  the  Greek  language  induced  him  to  essay  the  revival 
of  classical  learning  in  England,  and  his  Latin  style  is  said  to  almost  rival  that 
of  Celsus.  He  translated  into  Latin  the  "Oath"  of  Hippocrates,  and  the 
"  Methodus  Medendi",  with  several  other  treatises  of  Galen.  His  interest  with 
Henry  VIII.  and  Cardinal  Woolse^v  procured  the  Grant  of  Incorporation  of  the 
"  College  of  Physicians",  London,  which  bears  date  Sept.  23,  1518,  and  is  recorded 
to  have  been  given  at  the  intercession  of  John  Chambers,  Thomas  Linacre  and 
Ferdinand  Victoria,  the  king's  phj-sicians.  It  provided  that  no  person  should 
practice  medicine  in  the  City  of  London,  or  within  seven  miles  of  it,  unless  he 
were  a  member  of  this  College.  The  first  meetings  of  the  College  were  held  in 
Linacre's  house,  No.  5,  Knight  Rider  St.,  and  at  his  death  this  house  was  be- 
queathed to  the  corporation.  Until  the  establishment  of  this  College,  medical 
practitioners  were  licensed  to  practise  by  the  bishop  of  London  or  the  dean  of 
St.  Paul's.  In  1524  Linacre  founded  three  lectureships  in  medicine,  two  at 
Oxford  and  one  at  Cambridge,  to  be  called  "  Lynacre's  lectures".  By  the  terms 
of  the  foundation,  these  chairs  were  to  be  occupied  by  professors  who  should 
expound  Hippocrates  and  Galen  to  the  students  of  the  University,  and  if  no 
person  could  be  found  in  the  University  capable  of  doing  this,  competent  teachers 
should  be  sought  for  in  other  societies.  Linacre  died  Oct.  20,  1524,  having 
been  ordained  a  priest,  in  the  English  Church  about  five  years  before  his 
decease.    (H.) 


—  294  — 

Hungary.  He  was  a  pupil  of  Leonicenus.  and  called  Avieenna  a  mere  compiler. 
His  services  in  the  study  of  Hippocrates,  and  his  recommendation  of  the  observation 
of  nature  after  the  manner  of  the  latter  physician,  should  Le  prominently  mentioned, 
as  well  as  his  critical  acumen  in  the  study  of  natural  history,  in  such  contrast  to 
the  method  of  the  Ancients. 

Jacobus  de  Partibus  (Despars), 

who  died  in  his  native  city  Tournay  in  1465,  is  worthy  of  mention  for  his  observations 
on  the  spotted  typhus  and  for  his  commentary  on  Avieenna,  as  well  as  for  his  in- 
troduction of  chapters  into  the  works  of  the  Greek  and  Arabian  writers. 

Wiliielm  Koch  (Copus,  1471-1522) 
must  be  noticed  here  as  a  translator  of  the  writings  of  Hippocrates,  Galen  and  Paul 
of  iEiina,  by  which  service  he  greatly  promoted  German   medicine   and  stands  on  a 
level  with   Leonicenus  and  Linacre.     He  was  a  professor  at  Basel. 

Matthias  Ferrari  de  Gradi  (died  1472), 
professor  at  Pavia  and  ordinary  physician  of  Bianca  Maria  of  Sforza,  composed  again 
some  "  Consilia". 

Johannes  Arculanus  (Giovanni  D'Arcoli.  died   14S4  at  Fcrrara)  of 
Verona 

was  a  follower  of,  and  commentator  on,  the  Arabians.  He  was  also  professor  at 
Bologna  and  Padua. 

Petri's  Bayrus  (Pietro  Bairo)  of  Turin  (1468-1518), 
ordinary  physician  of  two  dukes  of  Savoy,  in  his  compendium  entitled  "Veni  niecum" 
was  likewise  a  worshipper  of  the  Arabians.  In  difficult  labors  he  administers  inter- 
nally a  vinous  infusion  of  dittan}',  seats  the  parturient  woman  over  a  vessel  tilled  with 
an  infusion  of  herbs,  and  directs  the  surgeon  to  whisper  in  her  ear  '"  Sn,  Ca,  Midur". 
And  it  helps  ! 

Paolo  Magel\rdo  of  Fiume 
wrote  in    1472   a   treatise   entitled    "  De   asgritudinibus  et  remediis  infantum  '  ;   and  a 
year  later 

BARTHOLOM/EUS  Metlinger, 
in    his  work    "  Eyn   vast    nutzlich  regiment  der  jungen   kinder",    published  the  first 
German  treatise  on   this  subject.      By  these  two  works  the  diseases  of  childien  were 
inaugurated  as  a  distinct  department  of  medicine. 

Benyenutus  Grapheus  (properly  Benvennto  Grassi  or  Grasso), 
a  physician  of  Salerno,  developed  the  subject  of  ophthalmology.  He  prol  ably  belongs 
to  an  earlier  period.'  His  book  "  De  oculorum  adfectionibus ''  was  printed  as  early 
as  1174,  but,  like  the  first  impressions,  must  have  been  a  popular  and  much  used 
work  before  this  time.  His  "  Practica  oculorum"  was  published  bj-  A.  M.  Eeiger  in 
18S2.  Under  the  head  of  cataract  he  understands  not  only  gray  cataract,  but  also 
amblyopia  and  amaurosis — precisel}-  like  the  earlier  writers. 

Dietrich  Ulsen  of  Friesland 

was  in  1486  city  physician  of  Nuremberg,  and  became  in  1507  ordinary  phy.-ician  of 
the  duke  of  Mecklenburg. 

The  so-called  "Articella"2   of  the  Venetian  physician 

1.  He  is  quoted  by  Guy  de  Chauliac,  who  wrote  in  1363.      (H.) 

2.  The  Articella,  Artisella,  Artisela,  was  a  popular  compendium   of  medicine,  which 

included:   the  "  Isagoge  "  of  Joannitius  :   Philaretus  or  Theophilus  "Depulsibus" 
and  "  Liber  urinarum";   the  Aphorisms  of  Hippocrates,  with  Galen's  commentary 


—  295  — 

Gregorius  A.  Vulpe  (Vulpi), 
who  belongs  to  this  period,    consists  of  a  compilation  of  the  translated  writings  of 
Hippocrates,  Galen,  Theophilus  and  others. 

The  "  Fasciculus  medicina?"1  of  the  German  physician 

Johannes  de  Ketham  (living  at  Venice  about  14'.>2> 
is  worthy  of  mention  for  its  first  employment  of  woodcuts  in  a  medical  work. 

c.  Revival  of  Human  Anatomy. 

After  the  period  of  the  Alexandrian  anatomists  human  anatomy, 
especially  the  practical  portion  of  it,  had  again  almost  disappeared  from 
the  list  of  medical  studies,  though  here  and  there  probably  a  sort  of  dissec- 
tion may  still  have  been  practised,  as  e.  g.  by  the  Rabbi  IsmaeT  at  the  close 
of  the  first  century.  Even  Galen  dissected  only  animals,  and  he  considered 
it  one  of  the  great  advantages  of  Alexandria  that  human  skeletons  could 
there  be  seen.  In  the  early  Middle  Ages  the  Christian  priests  would  have 
tolerated  quite  as  little  as  the  Koran  a  violation  of  God's  image,  and  an 
impairment  of  the  capacitv  for  resurrection,  such  as  was  involved  in  anatom- 
ical dissection,  even  if  the  beatitude  of  faith  had  permitted  the  growth  of  an 
interest  in  knowledge  pure  and  simple.  They  made  shift  with  a  study  of 
the  anatomy  of  Galen  (since  it  was  the  popular  idea  that  the  Ancients  had 
perfected  ail  science),  or  dissected  swine,3  if  they  ever  desired  an}-  informa- 
tion be}-ond  that  simple  anatomy  of  the  books.  When  i.  e.  how  early,  and 
where  (whether  perhaps  at  Salerno  by  decree  of  Frederick  II.)  human  dis- 
sections in  aid  of  anatomical  studies  were  revived,  is  unknown.  This  much, 
however,  is  certain,  that  the  Senate  of  Venice  (in  spite  of  the  prohibition 
by  pope  Boniface  VIII.,  eight  years  before)  decreed  in  the  3-ear  1308,  that 
a  human  bod}-  should  be  dissected  annually.  From  this  express  decree  it 
would  seem  to  follow  that  this  had  alread\-  been  often  done  heretofore. 
At  all  events,  William  of  Salicet  and  Guilielmo  Var iguana  in  Bologna,  and 
Henricus  ab  Hermondavilla  (Mondeville,  about  1300)  had  performed  dissec- 

in  a  Latin  translation;  the  "  Prognosticon  "  of  Hippocrates;  the  "  De  regimine 
in  acutis"  with  Galen's  commentary  in  Latin;  Galen's  "Ars  parva"  with  the 
commentary  thereon  of  Ali  Rodwan.     (Marx.)     (Baas.) 

The  different  editions  of  the  "Articella  '  differ  somewhat  in  their  contents. 
The  first  edition,  without  place  or  date,  is  supposed  to  have  appeared  before 
1479.  The  first  edition  with  date  and  place  of  publication  was  that  of  Venice, 
1483.     (H.) 

1.  First  edition  1491.  The  wood-cuts  are  said  to  be  the  work  of  the  famous  painter 
Andrea  Mantegna  (1431-1506).  They  are  extremely  remarkable  plates  and  have 
the  names  of  Mondini  frequently  placed  upon  the  wrong  parts.      (Baas.) 

According  to  Hawser  the  first  edition  of  the  ''  Fasciculus"  appeared  at  Venice 
without,  any  date;  the  second  at  the  same  place  in  1491.     (H.) 

'1.  He  merely  boiled,  not  dissected,  the  corpse,  although  the  Talmudists  declare  that 
bodies  ma}-  be  opened  for  scientific  purposes. 

3.  Even  at  the  present  day  it  is  the  popular  belief  that  the  hog  is  constructed  inter- 
nally just  like  man,  an  ambiguous  compliment,  which  the  earlier  savants  have 
upon  their  conscience. 


—  296  — 

tions,  and  a  Magister  Ricardus,  likewise  a  surgeon  and  apparently  a  contem- 
porary of  Lanfrauc,  had  written  an  "Anathomia".  But,  as  a  matter  of 
historical  fact,  the  credit  of  the  revival  of  dissection  belongs  to  Mondino 
alone,  who  took  hold  of  the  subject  at  the  luck}r  moment,  and  in  the  happ}- 
way  which  calls  novelties  into  existence.     The  fact  too  that 

MONDINO  DE  LUZZI 

with  his  immortal  "Anatome  omnium  humani  corporis  interiorum  mem- 
brorum  "  (1316),  could,  without  endangering  his  life,  step  into  publicity, 
speaks  in  favor  of  an  earlier  unopposed  practice  of  dissection  (i.  e.  opening 
of  the  cavities  of  the  body).  All  such  deeds  are,  generally,  prepared,  indeed, 
long  before  they  are  raised  to  permanent  and  common  intellectual  posses- 
sions by  some  spirit,  perhaps  not  great,  but  (as  in  this  case)  fortunate  and 
bold  iu  its  grasp  of  the  possibilities  of  the  time. 

Mondino  de  Luzzi  (Raimondino,  born  1276)  was  the  son  of  the  apothecary  Nerino 
Franzoli  de  Luzzi  of  Bologna,  whose  business  he  himself  at  first  followed,  until  he 
became  a  professor  in  his  native  city  and  was  there  venerated  "as  a  god  by  the 
entire  association  of  students".  In  1316  he  went  as  a  deputy  to  king  Robert  at 
Naples,  and  died  in  1326. 

His  work  is  written  entirely  in  the  spirit  of  the  Arabians,  whose  nomenclature 
even  is  still  retained.  It  lies  too  in  the  teleological  bands  of  Galen,  so  that  e.  g. 
Mondino  considers  the  anterior  abdominal  walls  specially  constructed  without  bony 
supports  by  the  Creator,  in  order  to  stretch  sufficiently  in  cases  of  flatulence  and 
abdominal  dropsy,  if  perchance  these  diseases  should  befall  one.  Observations  on 
operative  surgery,  together  with  some  false  speculations  —  e.g.  the  ulerus  possesses 
seven  cells  to  facilitate  the  coagulation  of  the  semen  and  menstrual  blood,  when  they 
meet  in  that  organ.  The  female  testicles  (ovaries)  secrete  a  fluid  like  saliva,  which 
excites  the  sexual  organs  etc.  — are  also  found,  but  they  deprive  this  essay  of  anatomy 
(which  Mondino's  work  is  to  be  considered)  of  none  of  its  value  in  the  promotion 
of  medical  culture,  in  spite  of  the  still  undisturbed  and  controlling  mania  for  empty 
speculations,  even  among  the  anatomists.1 

The  dissections  of  the  following  period  —  Mondino,  to  escape  burdening  his  soul 
with  mortal  sin,  did  not  yet,  venture  to  open  the  skull  —  which  were  soon  so  popular 
that  bodies  for  dissection  were  stolen,  if  they  could  not  be  otherwise  obtained,  involved 
simplj'  the  cavities  of  the  body,  and  the  various  internal  organs  were  merely  pointed 
out,  without  the  performance  of  much  actual  cutting.  The  sections  were  made  by 
a  "disreputable"  barber,  and  in  an  unscientific  manner  by  means  of  a  razor.  The 
u  Demonstrator"  pointed  out  the  different  parts  with  a  staff,  while  the  professor  read 
the  description  from  the  book,  even  when  the  dissection  was  merely  that  of  one  of  the 
lower  animals.  The  professor  did  not  dream  of  soiling  his  fingers  by  actually  handling 
the  body.  Mondino's  work  was  designed  to  be  such  a  text-book  of  anatomy,  and  it 
maintained  general  acceptance  as  such  down  to  the  close  of  the  Middle  Ages.  Besides 
the  dissections  of  the  Italian  universities,  regular  dissections  were  also  made  at 
Prague  after  the  year  1348  (a  criminal  in  prison  was  first  "stabbed"  by  the  execu- 

1.  Hyrtl  gives  us  examples  of  his  anatomical  nomenclature  and  literary  style  in 
"  Das  Arabische  und  Hebraische  in  der  Anatomie  ",  Vienna,  1879.  "He  who 
takes  in  hand  an  anatomical  work  of  the  period  before  Vesalius,  will  find  whole 
pages  unintelligible  to  him  :  Ossa  sempsamanie,  quae  sunt  in  juncturis  abselamiat ; 
locus  inter  alchell  et  alchadam  vocatur  pocra ;  vena  chilis,  a  jocinore  ad 
anchas"   etc. 


—  297  — 

tioner,  and  the  corpse  was  then  brought  into  the  anatomical  theater),  and  after  1370 
at  Montpellier  (on  an  executed  criminal  also).  In  1517  a  first  dissection  was  also 
performed  at  Strassburg. 

After  Mondino  little  further  advance  was  made  until  the  lGth  century. 
Up  to  this  time  there  appeared  the  following  anatomists,  most  of  whom 
held  the  chair  of  surgery  in  those  universities  where  lectures  on  surgery 
were  delivered. 

Bertruccio  (Bertuccio,  Bertrutius,  Vertuzzo,  died  1347),  a  pupil 
of  Mondino. 

Nicolo  Bertrucci  1 ; 

Petrus  ab  Argelata  (de  la  Cerlata,  died  1423); 

Bartholom^eus  Montagnana2  (died  1460), 
who  had  dissected  fourteen  bodies,  and  has  been  already  mentioned; 

Alexander  Achillini  (1463-1525), 
author  of  "Annotationes  anatomica?  in  Mundinum",  1524,  and  a  professor  at  Bologna, 
who  described  first  the  ossicles  of  the  ear,  with  the  labyrinth,  the  patheticus,  olfactory 
nerves,  and  7  tarsal  bones; 

Gabriel  de  Zerbis  (1468-1505), 
author  of  a  "Liber  anathomie  corporis  humani  "  etc.,  who,  though  a  professor  at  Padua 
and  Rome,  was  forced  to  flee  from  a  charge  of  larceny,  and  was  subsequently  cruellj' 
sawn  asunder  by   the  slave  of  a  certain  pasha.     He  made  some  observations  on  the 
uterus  and  the  embryo. 

German  anatomists  of  this  early  period  were  : 

Johannes  Peyligk  of  Leipzig. 
About  the  same  time  lived 

Magnus  Hundt3  (1449-1519)  of  Magdeburg, 
professor  in    Leipzig,  who  wrote  an    "Antropologium  de  hominis  dignitate,  natura  et 
proprietatibus",    Liptzick,    Wolfs:.     Monacensis,   1501,    with    four  laige    and  several 
small  woodcuts.4     At  the  close  of  the  15th  century  also  lived 

1.  While  Tirabosehi  questions  the   Christian   name  Nicolo  applied  to  Bertrucci   or 

Bertuccio,  I  know  no  reason  to  suppose  that  there  were  two  physicians  of  this 
name,  as  the  text  would  seem  to  imply.  Bertuccio  was  one  of  the  teachers  of 
Guy  de  Chauliac,  and  a  professor  in  Bologna,  where  he  died  in  1342  or  1347. 
His  "  Collectorium  artis  medicae,  tam  practical  quam  speculativte '  appeared  at 
Lyons  in  1509.      (H.) 

2.  He  must  not  be  confounded  with   Bernardino  Montana  de  Monserrate,  who  lived 

after  Montagnana,  and  whose  book,  entitled  "  Libro  de  la  Anatomia  del  Hombre. 
Un  Coloquio  del  Marques  de  Mondexar  D.  Luis  Hurtado  de  Mendoza,  con  el  Autor, 
acerca  de  un  suenno  que  sonno  el  Marques  de  la  generacion,  nacimento  y  muerte 
del  Hombre",  Valladolid,  S.  Martinez,  1551,  fob,    appeared  in  1551. 

3.  Not  to  be  confounded  with  another  Magnus  Hundt  (II. ),  who  wrote  on  the  "  French 

disease"  and  the  English  sweating-sickness,  and  is  said  to  have  been  a  kinsman 
of  Magnus  I.     (Proksch.) 

The  work  of  the  latter  is  entitled  "  Nuetzlich  Regiment  sammt  dem  Bericht 
der  Arzney  wider  etliche  Krankheit  der  Brust"  (Leipzig,  1529).  The  two  writers 
are  not  usually  distinguished  from  each  other.     (H.) 

4.  The  art  of  wood-cutting,  a  German  invention  (though  known  long  before  to  the 

Arabians),  arose  in  its  rude  beginnings  at  the  close  of  the  14th  or  the  beginning 
of  the  15th  century. 


—  298  — 

Laurentius  Phryesen  (Frisen,  Fries,  died  about  1532), 
a  physician  in  Colmar  and  Metz,  who,  at  the  suggestion  of  the  Strassburg  physician 
Wendelin  Hack  of  Brachenau,  likewise  introduced  into  his  work  ("  Spigl  der  Artzny 
dessgleichen  vormals  nie  von  keinem  Doctor  in  Tutsch  ussgegangen,  ist  niitzlich  und 
gut  alien  denen,  so  der  Artz  Rath  begern,  auch  der  gestreifelten  Leyen")  woodcuts, 
drawn  from  nature  by  the  artist  Waechtlin.1  This  work  of  Fries  is  the  first  treatise 
on  patholog}'  written  in  German. 

Marc  Antonio  Della  Torre  (1473-1 50G), 

professor  at  Padua  and  Pavia,  for  whom  Leonardo  da  Vinci  (1452-1519),  the  greatest 
savant  and  investigator  among  the  eminent  painters  of  that  day,  designed  the  ana- 
tomical plates.  So  perfect  were  these,  that  it  is  difficult  to  determine  whether  the 
professor  or  the  painter  was  the  greater  anatomist,  especially  as  Da  Vinci  also  wrote'" 
on  anatomy.  At  a  later  period  Michael  Angelo  Buonarotti  ( 1474-1 5G4),  a  friend  of 
Machiavelli,  and  a  great  painter,  carver  in  wood,  architect  and  poet,  Raphael  (Saiti, 
1483-1520)  of  Urbino,  and  Titian  (1477-1576)  of  Pieve  di  Cadore  near  Belluno, 
prepared  similar  plates,  so  that  by  the  mutual  support  given  to  each  other  by  science 
and  art  both  departments  were  materially  advanced.  So  far  was  this  the  case  tl  at 
progress  in  the  one  cannot  be  mentioned  without  reference  to  the  other  also,  one  of 
the  most  striking  proofs  that  medicine  can  be  peifectly  understood  only  in  connexion 
with  the  other  sciences  and  arts,  just  as  the  latter  can  be  thoroughly  comprehended 
onlj'  by  a  knowledge  of  the  historj-  of  medicine. 
Alexander  Beneoetti  (died  1525) 
may  be  also  mentioned  here  as  an  anatomist,  as  well  as  a  few  of  the  following 
surgeons,  who  busied  themselves  independently  with  anatomj'. 

d.  Cultivators  of  Surgery. 

Either  as  the  result  of  the  influence  of  the  Crusades,  the  wounds 
resulting  from  which  were  often  first  healed  at  Salerno  ;  or  by  reason  of  the 
revival  of  anatoui}-  —  many  surgeons  of  this  period  were  excellent  anatom- 
ists, since  the  professorship  of  surgery  continued,  as  a  rule,  combined  with 
that  of  anatomy  even  down  into  the  19th  century  —  or  finally,  perhaps,  in 
consequence  of  the  gun-shot  wounds,  now  making  their  appearance  towards 
the  close  of  this  period,  and  which  were  everywhere  considered  then,  and 
even  into  modern  times,  to  be  poisoned  —  probably  rather  as  the  combined 
result  of  all  these  influences  under  the  lead  of  the  latter,  surgery  towards 


1.  These  first  German  anatomical   plates  were  published  as   "  fliegende  Blatter"  in 

1517  by  Job.  Schott,  the  bookseller  of  Mayence.  (Subsequent!}-  his  house  became 
famous  for  its  musical  publications,  and  the  family  did  not  die  out  in  the  male 
line  until  about  ten  years  ago).  They  were  designed  not  only  for  physicians,  but 
also  for  the  great  public,  an  historical  fact  which  shows  into  what  wide  circles  the 
interest  in  the  lively  advances  in  human  anatomy  of  that  time  made  its  way. 
The  localities  of  the  male  and  female  pelvis  seem  to  have  enjoyed  especial 
attention.  Even  earlier  than  these  plates  of  Schott  another  set  of  anatomical 
plates  was  arranged  in  1493  by  Ricardus  Hela,  a  physician  in  Paris,  and  published 
in  pamphlet  form.     (Wieger.) 

2.  He  wrote  with  the  left  hand,  and,  like  the  Hebrews,  from  behind  forward,  so  that 

his  works  could  onty  be  deciphered  by  the  assistance  of  a  mirror.  Probably  his 
right  hand  was  paralyzed. 


—  290  — 

the  close  of  the  Scholastic  period  essayed  a  rather  vigorous  flight.  This 
happened  in  spite  of  the  fact  that  it  still  remained  partly  in  the  hands 
of  the  clerg}'  (who,  since  the  interdiction  of  surgical  practice  was  still  in 
force  against  them,  were  compelled  to  obtain  a  special  dispensation  for 
each  operation)  and  of  the  uneducated,  lower  surgeons,  who  were  originally 
(at  least  some  of  them)  the  assistants  of  the  clerg}"  and  under  the  control 
of  the  physicians,  and  notwithstanding  it  was  still  bound  in  the  fetters 
of  Scholasticism.  The  knife  began  to  be  employed  once  more  in  accordance 
with  the  principles  of  art,  a  practice  which  had  almost  entirely  disappeared 
from  the  later  Byzantine  period  up  to  the  present  time.  Of  course  they 
disputed  whether,  in  the  after  treatment,  wounds  and  abscesses  should  be 
dressed  in  accordance  with  the  "  Relaxation  is  good  "x  of  Hippocrates,  or 
Galen's  "  Dryness  is  allied  to  health  "-  —  the  former  principle  defended  by 
the  school  of  Salerno,  the  latter  at  Bologna  —  with  poultices  or  with  spiritu- 
ous desiccative  dressings  and  powders,  or  —  a  third  method  —  exclusively  by 
ointments.  The  actual  cautery  of  the  Arabians  was  also  freely  employed. 
Operative  midwifery  too  was  united  completely  with  surgery,  so  far  as  it 
could  not  be  managed  by  midwives.  Italians  led  the  array  of  surgeons, 
while  the  Germans,  for  a  long  time,  were  unable  to  follow  their  example. 

a..     Italians. 

It  is  a  peculiarity  of  Italian  surgery  that,  even  from  the  first  portion 
of  the  second  half  of  the  Middle  Ages,  it  always  stood  on  a  level  with  inter- 
nal medicine,  and  was  accordingly  practised  by  persons,  who  were  likewise 
physicians.  It  was  always  what  that  period  called  a  scientific  branch,  and 
it  enjoyed  very  early  the  benefits  of  anatomy.  The  Italian  surgeons  of  the 
earliest  times  varied  very  little  from  the  Arabians  and  Galen.  On  the 
other  hand  the  later  surgeons  struck  out  their  own  path,  and,  indeed,  opened 
the  way  for  plastic  surgery  by  the  construction  of  artificial  noses  and  ears, 
to  which  members  the  justice  of  that  period  was  especially  dangerous. 
Accordingly 

Roger  (Ruggiero)  of  Palermo3  (about  1210), 
who  studied,  and  was  for  a  lon<i  lime  a  professor,  in  Salerno,  borrowed  his  "Surgery" 
from  Albucasis  or  Paul  of  ^Egina.  He  w;i s  acquainted  with  trepanning  of  the 
sternum,  stitching  the  intestine  over  a  hollow  cylinder  etc.  He  makes  the  diagnosis 
of  fissure  of  the  skull  by  observing  whether  the  breath,  when  held,  comes  out  of  the 
wound  or  not.  He  is  the  first  to  describe  a  case  of  hernia  pulmonis,  to  use  the  term 
setaceum  (seton),  and  to  employ  the  sponge  in  the  treatment  of  scrofulous  lesions  etc. 

1.  "  Laxa  bona,  cruda  vero  mala'. 

2.  "  Siccum  vero  sano  est  propinquius,  humidum  vero  non  sano." 

3.  Better  known  as  Roger  of  Parma.      His  original  "  Praclica  chirurgias"  exists  only 

in  MS.,  but  a  substantial  co  y  of  the  work  was  made  b}-  Rolando  Capelluti 
(about  1*250),  and  subsequently  printed.  Roger's  surgery  formed  the  real  basis 
of  the  mediaeval  surgery  of  Italy,  and  was  often  honored  with  commentaries  by 
later  writers.  The  "  Practica  medicinaj",  which  bears  his  name,  is  the  work  cf 
another  person  — Roger  ile  Barone,  or  de  Varone.     (H.) 


—  300  — 

He  belongs  to  the  "Partisans  of  moist  dressings",  and  was  the  earliest  special  writer 
on  surgery  in  Italy. 

Hugo   Borgognoni  of  Lucca  (born  in  the  last  third  of  the  12th  cen- 
tury, died  1252  or  1268,  nearly  100  years  old) 

was  chosen  in  1214  city  physician  of  Bologna,  where,  for  a  stated  salary,  he  was  to 
treat  the  poor,  and  in  ordinary  cases  others  also,  free  of  expense.  In  difficult  cases, 
however,  the  well-to-do  were  to  be  treated  for  a  wagon-load  of  wood,  the  rich  for  a  load 
of  hay,  or  20  solidi.1  He  was  the  author  of  the  "  Dry  method  of  treatment". 
A  son2  or  pupil  of  Hugo,  and  chiefly  a  follower  of  his  teachings,  was 

Theodoric  Borgognoni  of  Cervia  (1205-1298), 

at  different  periods  a  Dominican  monk,  house  physician  of  Innocent  IV.,  finally 
bishop  of  Cervia,  but  a  resident  for  the  greater  part  of  his  life  in  Bologna.  Among 
his  peculiar  teachings  were  :  soft  bandages  in  place  of  wooden  splints;  symptoms  of  the 
western  leprosy,  and  division  of  this  disease  into  species;  salivation  from  mercury; 
narcotism  of  the  patient  to  be  operated  upon  (like  Nicholas  Propositus)  by  opium 
and  hyosc3"amus,  and  re-awakening  him  by  vinegar  and  fennel.  He  was  an  advocate 
of  the  moist  treatment. 

Roland  of  Parma  (about  1250), 
professor  at  Bologna,  followed  his  master  Roger  of  Parma  in  all  respects,  though  he 
excised  chancres,  scrofulous  glands  and  goitre. 

Both  of  these  writers,  however,  were  commented  upon  by  the  "Four  Masters",3  who 
lived  about  1270  in  Salerno,  though  according  to  other  authorities  in  Rome.  They 
were  probablj"  surgeons  living  together  in  the  style  of  the  monks,  and  their  commen- 
tary is  regarded  as  the  ablest  of  the  mediaeval  works  on  surgery.  Guy  de  Chauliac 
also  mentions  in  no  very  honorable  way  a  surgeon 

Jamerius  ( Jamerus),  of  this  period,  but  of  his  life  nothing  further  is  known. 
Bruno  of  Longoburgo  in  Calabria  (about  1252), 
professor  at  Padua,  whose  "  Chirurgia  magna"  and  "Chirurgia  parva",  compiled 
from  the  Greeks  and  Arabians,  were  very  celebrated,  followed  again  the  dry  treatment. 
He  mentions  operations  upon  the  teeth  and  the  antrum  of  Highmore,  and  introduced 
a  powerful  method  of  extension.  He  also  notices  amputation  in  gangrene  of  the 
limbs,  in  which  he  follows  Abulcasem  and  Paul  of  yEgina;  is  acquainted  with  a  hook 
for  the  ligation  of  bleeding  vessels,  and  knows  that  the  haemorrhage  from  pulsating 
vessels  (arteries)  is  difficult  to  stop,  while  that  from  non-pulsating  (veins)  is  easy. 
(Albert. ) 

A  man  of  ointments,  though  he  did  not  shrink  from  lithotomy  even,  and  treated 
goitre  etc.  by  operation,  was  the  acute  observer 

William  of  Salicet  (1201-1277,  or  1280)  of  Piacenza  (hence  called 
William  of  Placentia,  Guilelmus  Placentinus), 

professor  at  Bologna  and  Verona,  where  he  was  municipal  physician.  Besides  his 
"Chirurgia"  he  also  wrote  on  subjects  pertaining  to  internal  medicine,  and  even  a 
short  anatomy.     He  found  the  causes  of  difficult  healing  to  be  e.  g.  full  habit,  dryness, 

1.  The   mediaeval  custom  of  payment   in   kind  (at  least  one-half)  prevailed  also  at 

this  time. 

2.  The  clergy  at  this  time  might  be   legitimately  married,  as  celibacy  was  not  jet 

thoroughly  enforced. 

3.  "Glossula?  Quatuor  Magistrorum  super  Chirurgiam  Rogerii  et  Rolandi",  edited  by 

Daremberg,  and  published  in  1854.     It  forms  a  most  valuable  mirror  of  mediaeval 
surgery,  and  is  well  worth  the  attention  of  students  of  medical  history.     (H.) 


—  301   — 

unhealthy  suppuration,  too  violent  treatment,  presence  of  a  foreign  bod}-  etc.  He 
recognized  ulcers  from  cohabitation  with  a  devotee  of  venal  love,  and  is  said  to  have 
been  the  first  to  expressly  designate  the  latter  as  the  cause  of  ulcers  of  the  genitals 
and  to  ascribe  to  it  even  gangrene  of  the  penis,  but  he  considered  it  improper  for  a 
cleric  to  write  on  the  diseases  of  females.  He  recognized  arterial  bleeding  by  the 
spirting  stream  of  blood  (Albert).  With  clerical  cunning  and  an  accurate  knowledge 
of  mankind  he  advises  not  to  deport  oneself  too  intimately  with  the  laity,  and  under 
all  circumstances  to  claim  good  pa}';  for  this  occasions  respect  for  the  treatment 
(instead  of  for  the  art)  —  a  piece  of  advice  given  as  early  as  the  time  of  Isaac  Juda?us, 
but  not  fully  carried  out  even  to-day. 

Petrus  ab  Argelata, 

a  pupil  of  Gu}'  de  Chauliac  and  professor  at  Bologna,  was  also  a  surgeon  of  import- 
ance. He  left  much  to  nature,  which  alone  accomplished  even  the  most  difficult 
cures.  He  embraced  the  "  dry  method ",  recommended  compressing  bandages  in 
chronic  ulcers,  did  not  sew  up  wounds  of  nerves,  cauterized  varicose  veins,  accom- 
plished the  removal  of  teeth  rather  by  medicine  than  by  pulling  them  out,  occupied 
himself  with  the  smoothening  of  frizzled  hair  and  the  adornment  of  the  nails,  but  also 
practised  bold]}'  the  excision  of  indurated  testicles,  operated  on  fistula  in  ano,  and 
mentions  the  fatality  of  the  entrance  of  air  into  the  jugular  vein.  He  was  the  first 
man  who  once  again,  after  the  manner  of  the  Ancients,  practised  midwifery^  perfo- 
rating the  skull,  and  then  with  the  finger  in  the  wound  extracting  the  head  etc.  In 
wounds  of  the  head  he  employed  a  wound-powder  and  the  Pater-noster. 
A  pupil  of  the  physician  just  mentioned  was 

Marcellus  Cumanus  (14th  and  15th  centuries)  of  Venice, 
who  treated  gun-shot  wounds  (which  he  did  not  regard  as  poisoned)  with  warm  oiled 
bandages. 

Antonio  Guaineri 
must  be  again  noticed  here,  in  consequence  of  his  mention  of  urethral  bougies,  and 

Nicolo  Bertrucci, 
for  his  recommendation  of  the  artificial  rupture  of  the  foetal  membranes. 
So  also  we  must  notice  here  again 

Bartholom.eus  Montagnana, 
who,   like  Petrus  ab  Argelata,   was  acquainted   with  syphilitic  affections.      He  was 
acquainted  with  the  strangulation  of  hernia  and  the  chief  symptoms  of  this  condition. 
He  preferred  to  employ  medication,  rather  than  more  active  measures,  though  he 
operated  on  lachrymal  fistulas  and  extracted  unsound  teeth. 

Leonardo  Bertapaglia  (died  1460), 
professor  at  Padua,  towered  above  the  surgeons  of  his  time,   since  he  had  himself 
dissected  two  corpses  and  practised  operations  for  cancer,  transfixion  and  ligation  of 
vessels  and  resections,  but,  on  the  other  hand,  in  wounds  of  the  head  he  employed 
ointments  only. 

Johannes  Arculanus  (Giovanni  d'Areoli,  Herculanus) 
is  a  follower  of  the  Arabians  in  surgery,  and  consequently  a  man  of  the  hot  iron.  He 
practised  the  taxis  in  strangulated  hernia,  after  premising  enemata,  a  poultice  and  a 
bath;  filled  teeth  with  gold,  and  endeavored  to  remove  splinters  of  iron  from  the  eye 
by  means  of  the  attraction  of  amber  electrified  by  friction.  He  also  gave  a  descrip- 
tion of  30  pairs  of  spinal  nerves  and  of  the  structure  of  the  brain. 

Antonio  Benivieni  (died  1502) 
was  an  important,  independent  and  observing  Hippocratic  physician  of  Florence,  who 


—  302  — 

recommended  paracentesis  at  the  navel,  following  an  observation  of  the  spontaneous 
cure  of  such  a  case;  removed  stone  by  dilatation  of  the  female  urethra,  and  under- 
took bronchotomy  and  the  extraction  of  cataract.  On  the  whole,  however,  he 
embraced  the  established  views.  He  is  also  worthy  of  mention  as  an  obstetrician 
(he  revives  notice  of  podalic  version),  pathological  anatomist  (on  the  hidden  causes 
of  disease),  and  pathological  reporter  (gall-stones  etc.)- 

Of  equal  importance  was 
Alexander  Benedetti  of  Legnago 
(already  once  mentioned),  who  in  1490  practised  in  Crete  and  the  Morea,  then  in  1493 
•was  a  professor  at  Padua,  and  again  in  1495  an  army  physician,  dying  in  1525.     His 
rich  experience  and  his  anatomical  knowledge  rendered  him  an  independent  surgeon, 
who  operated  on  hernia  after  a  special  method,  and,  among  other  matters,  first  men- 
tions artificial  restoration  of  the  nose —  an  operation  abandoned    after  the  time  of 
Celsus,  but  again  invented  independently  in  the  middle  of  the  15th  century  by  lay 
members  of  the  familj'  of 
Branca  of  Catanea. 

The  members  of  this  family  at  first  made  use  of  the  skinof  the  forehead  or  cheek, 
subsequently  of  that  of  the  arm.  They  also  restored  lips  and  ears.  From  them  the 
method  passed  into  the  family  of 

Vianeo  (Bojani  :  Vincenzo,  his  nephew  Bernardino,  and  his  sons  Paolo 
and  Pietro)  of  Tropaea  in  Calabria,  whence 

Caspar  Tagliacozzi1  (1546-1599)  of  Bologna 
learned  the  procedure  and  described  it.     Syphilis  and  a  nose-destro3'ing  pope,   who 
fixed  upon  amputation  of  the  nose  as  a  punishment  for  larceny,  afforded  the  most 
frequent  occasion  for  these  rhinoplastic  operations.     In  the  15th  century  occurs  also 
the  first  appearance  of  the 

Preciani  and  Norsini, 
(guild-surgeons  educated  in  the  surgical  school  which  probably  descended  from  the 
medical  school  of  Crotona)  of  Norcia  in  Calabria.  They  took  their  name  (as  G-yergyai 
insists)  from  their  place  of  birth,  but  had  different  family  names  and  belonged  to 
-different  families.  These  families  were  eminent  as  herniotomists,  for  lithotomy, 
operations  for  cataract,  trepanning  and  operations  for  hernia  were  still  abandoned  to 
itinerant  surgeons,  who,  however,  introduced  no  considerable  improvements  in  the 
operation.     The  same  persons  also  performed  castration.    (Gyergyai.) 

/9.     French. 

Surgery  in  France,  in  contrast  with  Italy,  was  entirely  separated  from 
medicine  in  the  second  half  of  the  Middle  Ages.  As  inferior  to  medicine 
it  was  placed  entirely  in  the  hands  of  the  laity,  in  accordance  with  the 
maxim  "  The  Church  shrinks  from  blood "  —  a  maxim  which,  as  is  well 
known,  was  not  based  in  the  most  remote  degree  upon  the  truth,  and  never, 
indeed,  became  true.     Among  tbe  various  medical   departments,   surgery 

1.    Tagliacozzi's  work  entitled  "  De  chirurgia  curtorum  per  insitionem"  etc.  appeared 
in  1597.     Butler  in  his  "  Hudibras",  published  in  1663,  refers  to  him  as  follows: 
"  So  learned  Taliacotius  from 
The  brawny  part  of  a  porter's  bum 
Cut  supplemental  noses,  which 
Would  last  as  long  as  parent  breech."  (H.) 


—  303  — 

must  be  regarded  as  the  national  branch  of  the  French.  This  is  manifest 
too  from  the  fact  that  the  surgeons  of  France  appear  at  an  early  period  as 
a  graded  and  distinct  class,  possessing  a  special  college  of  their  own.  They 
were  divided  into  guilds  of  inferior  and  superior  surgeons,  the  former  of 
whom  were  subordinate  to  the  latter,  while  both  were  under  the  control 
of  the  physicians  of  internal  medicine,  i.  e.  the  Faculties.  Hence  arose  in- 
terminable disputes  between  the  various  orders,  which  continued  down 
almost  to  the  present  century. 

Such  an  association  of  surgeons,  most  influential  and  important  in  the 
development  of  modern  surgery,  was  the  "  College  de  Saint  Couie",  which 
arose  under  St.  Louis  (reigned  1226-1270),  a  monarch  so  pious  that  he 
forbade  the  employment  of  Jewish  plrysicians.  Its  organizer  and  president 
was  the  royal  surgeon  Jean  Pitard  (1228-1315),  who  has  thus  become  a 
character  of  importance  in  the  development  of  surgery  and  medical  culture. 
The  members  of  this  "  confrt'rie "  had  already  separated  themselves  from 
the  barbers,  and  in  1 254  claimed  a  board  of  examiners  in  order  to  rival  the 
Faculty  and  defend  themselves  against  the  former.  (Daremberg.)  They 
formed  a  guild  of  superior  surgeons,  and,  like  the  laity,  were  permitted  to 
many.  They  must  understand  Latin,  must  have  pursued  the  study  of 
medicine  and  philosophy  at  the  university  for  two  }'ears,  and  the  study  of 
surgeiy  for  two  years  longer,  before  they  were  permitted  to  be  received  into 
the  guild  and  authorized  to  wear  a  long  robe,  like  the  Magistri  in  Plrysica. 
Hence  the}'  were  called  "  Surgeons  of  the  long  robe  "  in  contradistinction 
to  the  lower  class  of  minor  surgeons,  the  "  Surgeons  of  the  short  robe  ", 
—  a  distinction  which  gave  rise  to  offensive  disputes  about  rank  between 
the  two  classes.1 

Although  a  comparatively  high  grade  of  guild-surgery  was  thus 
attained,  it  was  still  held  in  little  esteem  scientifically.     The  latter  element 

1.  Saints  Cosmas  and  Daruianus  were  twin  Christian  phj-sicians,-  who  suffered 
martyrdom  in  the  persecution  of  Diocletian  A.  D.  803.  Many  miraculous  cures 
were  said  to  have  been  accomplished  upon  pilgrims  to  their  tomb,  and  the 
martyrs  themselves  were  eventually  elevated  to  the  position  of  patron  saints  of  the 
surgical  art  The  disputes  between  the  French  physicians,  surgeons  and  barbers 
are  only  equalled  in  persistency  and  gall  by  the  later  disputes  of  medical  histo- 
rians with  reference  to  the  facts  and  dates  of  the  various  events  in  the  historj' 
of  the  famous  *'  College  de  St.  Come".  Even  the  epoch  of  Jean  Pitard  is  a  subject 
of  grave  differences  of  opinion,  and  the  dates  assigned  to  the  foundation  of  the 
College  vary  from  1033  to  1268.  It  is  as  well,  probably,  to  accept  the  statements 
given  in  the  text. 

In  England  the  "Barber-surgeons"  were  incorporated  by  a  charter  bearing 
date  February  24,  1461,  under  the  title  of  the  "Masters  or  Governors  of  the 
Mystery  or  Commonalty  of  Barbers  of  London".  They  had  existed,  however, 
as  an  unincorporated  guild  since  the  early  part  of  the  14th  century.  In  Hamburg 
a  similar  guild  of  "  Meister  Bartscheerer  "  was  formed  in  1452. 

The  "College  de  St.  Come"  maintained  its  existence  as  late  as  1713,  when  it 
was  merged  into  the  "Academie  de  Chirurgie".     (H. ) 


—  304  — 

was  furnished  it  by  a  fortunate  accident.  In  consequence  of  the  wars  of 
the  Guelphs  and  Ghibellines,  Lanfranchi  of  Milan,  a  pupil  of  William  of 
Salicet,  a  man  (after  the  manner  of  the  Italian  surgeons)  well  versed  in  the 
writings  of  the  Ancients,  practical  and  capable,  was  forced  to  tty  from  his 
home.  He  turned  his  steps,  therefore,  first  to  Lyons,  but  went  subsequently 
in  1295  to  Paris,  at  the  university  of  which  city  he  would  have  held  lec- 
tures in  accordance  with  the  wishes  of  Passavant.  the  then  chancellor,  but 
dared  not  do  so  in  consequence  of  his  married  condition — all  professors 
were  required  to  be  clerics,  and  therefore  celibates.  He  then  accepted 
membership  in  Pitards  ■'College  de  St.  Come",  and  delivered  lectures 
which  were  numerously  attended.  Moreover  he  took  his  pupils  to  the  sick 
and  to  operations,  and  thus  held  clinical  lectures.  Lanfranc  died  after 
1315. 

In  his  "Major"  and  'Minor"  surfer}'  Lanfranc  sliows  himself  a  great  partisan 
of  the  actual  cautery  and  very  timid  with  the  knife.  He  avoids  trepanning,  operations 
for  cataract,  lithotomy  etc.,  and  admits  even  paracentesis  in  young  and  strong  persons 
only,  while  he  also  considers  the  extraction  of  teeth  dangerous.  In  these  as  well  as 
other  respects  he  is  evidently  influenced  by  the  belief  of  his  time.  In  fractures  of  the 
skull  he  authorizes  invocation  of  the  Holy  Ghost,  probably  because  he  was  not  willing 
to  do  anything  else,  and  according  to  Albert,  he  is  the  first  to  describe  concussion 
of  the  brain  and  percussion  of  the  bones  for  the  recognition  of  fissures.  On  the  other 
hand,  he  operates  in  empyema,  deep  abscesses  and  wounds  of  the  intestines,  is 
acquainted  with  venous  and  arterial  haemorrhage  (the  former  steady,  the  latter  by 
spirts),  against  the  first  of  which  he  employs  styptics,  compression  with  the  finger  for 
hours,  and  finally  ligation.  He  distinguishes  32  forms  of  ulcers  according  to  the 
cardinal  humors  and  elementary  qualities  —  among  these  such  as  arise  from  impure 
intercourse — •  cups  and  cauterizes  poisoned  wounds,  treats  diseases  of  the  eyes,  ears, 
and  nose,  hernia,  fractures  and  dislocations,  diseases  of  the  skin,  cauterizes  and 
sutures  hernia,  etc.  He  also  gives  excellent  advice  to  the  surgeon  how  to  thrive  and 
how  to  deport  himself,  and  among  other  things  lays  down  the  following  precept  well 
worth  recognition  —  he  should  aid  the  poor  to  the  extent  of  his  ability,  but  get  all  he 
cau  out  of  the  rich. 

After  Pitard,  who  wrote  nothing,  the  next  famous  French  surgeon  and 
author  of  distinction  was  the  already  mentioned  Henricus  ab  Hermondavilla. 
properly 

Henri  de  Mondeville  (died  about  1315), 
teacher  first  at  Montpellier  and  then  pl^-sician  of  Philip  the  Fair  (reigned  1285-1314) 
and  professor  at  Paris,  which  latter  school,  in  spite  of  Lanfranchi,  was  unable  at  first 
to  attain  any  considerable  importance.  According  to  Hyrtl,  he  was  the  inventor  of 
anatomical  plates,  but  they  were  employed  as  earlj-  as  the  days  of  Aristotle  and 
Galen. 

As  soon  as  the  way  to  further  progress  was  revealed  to  the  French, 
with  the  gift  of  quick  conception  and  the  practical  address  so  peculiar  to 
their  race,  the}-  at  once  seized  upon  their  national  branch.  Thus,  though 
not  the  original  founders  —  these  were  the  Italians,  —  they  were  yet  the 
earliest  heralds  and  propagators  of  the  restoration  of  scientific  surgery,  and 
in  this  department  they  have  held  the  lead,  though  in  recent  times  they 
are  compelled  to  yield  something  to  the  Germans  and  the  English. 


—  305  — 

The  earliest  herald  of  the  modern  surgery  was 

Guy  de  Chauliac  (Guido  de  Cauliaco),  born  in  a  hamlet  of  this  name 
on  the  borders  of  Auvergne  about  A.  D.  1300.  He  was  chaplain  and  ordin- 
ary physician  of  pope  Urban  V.  at  Avignon,  after  having  studied  at  Bologna, 
Paris  and  Montpellier,  probably  also  at  Prague,  and  practised  a  long  time 
at  Lyons.  In  his  position  as  chaplain  he  wrote  in  1363  his  pioneer  work 
"  Chirurgia?  tractatus  septem,  cum  antidotario",1  a  treatise  which  retained 
exclusive  sway  in  France  for  many  decennia.  Another  work  by  the  same 
author  "On  gray  cataract',  written  for  the  blind  king  John  of  Bohemia, 
father  of  the  emperor  Charles  IV.,  has  been  lost. 

His  surgical  treatise,  which  also  contains  some  remarks  on  the  subject  of  mid- 
wifery (sternutatories,  the  employment  of  a  screw-like  instrument  for  the  purpose 
of  enlarging  the  os  uteri  sufficiently  to  permit  the  extraction  of  a  dead  child,  Caesarean 
section  through  the  left  side  and  after  the  death  of  the  mother,  cephalic  version  etc.), 
so  far  as  this  art  did  not  then  devolve  upon  midwives,  is  marked  by  historical  com- 
prehensiveness and  critical  judgment  in  its  department,  by  freedom  from  subtilties, 
sober  judgment  of  the  acquisitions  of  an  earlier  day,  truthfulness  in  respect  to  the 
author's  own  observations,  a  very  good  statement  of  the  indications,  a  high  estimation 
and  knowledge  of  anatomy  (proportioned  of  course  to  the  period),  curious  etymolo- 
gies and  definitions  and  some  superstition.  He  performs  venesection  according  to 
the  seat  and  grade  of  the  disease,  without  regard  to  one  or  the  other  side,  opens  boldly 
deep-seated  abscesses,  slits  up  fistula:,  and  employs  compressive  bandages  in  ulcers, 
[n  caries,  anthrax  and  all  suitable  lesions  he  uses,  however,  the  actual  cautery,  espe- 
cially in  open  cancer,  which  he  declares  allied  to  lepros}7.  Non-ulcerating  cancer,  on 
the  other  hand,  he  cuts  out  from  the  roots.  Dislocations  and  fractures  are  discussed, 
and  diseases  of  the  eyes,  i.  e.  operations  upon  them,  are  treated  particularly  well. 
Guy  recommends  spectacles  (berilli,  because  ground  from  the  beryl)  when  eye-waters 
do  not  relieve  weakness  of  si^ht.  He  does  not  avoid  trepanning,  and  lays  down 
precise  indications  for  its  employment  (he  had  removed  a  part  of  a  man's  brain,  yet 
he  recovered),  performs  lithotomj-  and  removes  pharyngeal  polypi;  in  abscesses  of 
the  tonsils  he  curiouslj"  enough  (probably  he  had  had  some  experience  in  haemorrhage 
when  they  were  opened  with  the  knife)  has  the  patient  swallow  a  piece  of  raw  meat 
to  which  a  stout  thread  is  attached,  and  then  draws  it  out  again  with  a  sudden  jerk, 
h  iving  previously  administered  an  anaesthetic  inhalation.  In  case  of  supernumerary 
sound  limbs  he  resorts  to  removal  with  the  knife,  but  in  gangrene  adopts  a  bloodless 
operation  byr  means  of  strips  of  plaster  drawn  tightly  around  the  border  of  the  adjacent 
sound  parts  until  the  gangrenous  part  separates.  He  unites  wounds  with  the  d€sign 
of  securing  healing  b}-  first  intention,  removes  foreign  bodies,  and  spares  the  exuded 
plastic  material  with  the  same  object.  Haemorrhages  he  divides  into  arterial  and 
venous,  and  stays  the  former  by  styptics,  stitching  together  the  edges  of  the  wound, 
division  of  half  severed  vessels,  the  actual  cautery  and  ligation.  According  to  Guy's 
statement,  there  were  in  his  day  five  sects  of  surgeons.  The  first  employed  poultices 
in  all  wounds  and  abscesses.  To  this  sect  belonged  Roger,  Roland  and  the  "Four 
Masters".  The  second  in  the  same  cases  employed  simple  wine  (Bruno,  Theodoric). 
The  third  used  soothing  ointments  and  plasters  (William  of  Salicet,  Lanfranc).  The 
fourth  (the  Germans  and  those  who  accompanied  the  armies)  employed  oil,  wool,  drinks 
and  charms.    The  fifth  (women  and  the  illiterate)  had  recourse  to  the  saints  (Freind). 

1.    Better  known  as  the  "  Chirurgia  magna".     A  Formulary  by  the  same  author  is 
usually  called  his  "  Chirurgia  parva  ".     (  H. ) 
20 


—  306  — 

In  the  fifteenth  century  also  appears  the  first  mention  of  the  family 
of  lithotomists  named  Colot,  one  of  whom,  known  as  Germain,  with  the 
permission  of  Louis  XI.,  is  said  to  have  performed  supra-pubic  lithotomy 
upon  a  condemned  criminal  in  1474.     Among  the 

y.     Ditch, 

Jehan  Yperman  of  Ypern  (1297-1329  according  to  Burggrseve)  had 
introduced  surgery  from  France  as  early  as  the  beginning  of  the  14th 
century.     He  was  of  the  school  of  Lanfranc. 

'5.     The  English. 

John  Ardern,  a  contemporary  of  the  poets  John  Gower  (1323-1408) 
and  Geoffrey  Chaucer  (1340-1400),  should  be  noticed  here  as  an  English 
surgeon.  His  work  contains  numerous  plates  of  instruments.  [Ardern  was 
probably  an  alumnus  of  Montpellier  who  practised  in  Newark  from  1349 
to  1370,  in  which  latter  }ear  he  removed  to  London.  He  wrote  a  '•  Practica ", 
which  exists  only  in  MS.,  but  the  chapter  ••  On  the  fistula  in  ano  "  was  trans- 
lated and  published  in  English  by  John  Lead  in  1588.  According  to 
Daremberg,  who  consulted  and  copied  the  cop}-  of  Ardern's  u  Practica" 
preserved  in  St.  John's  College,  Oxford,  this  work  is  deficient  in  method 
and  order,  but  abounds  in  personal  observations.  He  styles  it  a  collection 
of  short  monographs  on  different  subjects  of  surgery,  with  a  mass  of  plates 
of  curious  instruments  and  operations.  In  the  treatment  of  fistula  Ardern 
professes  to  have  been  particularly  successful. 

We  may  notice  here  also  Thomas  Morestide  and  William  Brede- 
"wardyn,  who,  on  the  occasion  of  Henry  the  Fifth's  second  expedition  to 
recover  Normandy  in  1417,  were  authorized  by  royal  warrant  to  press  into 
service  as  many  surgeons  and  instrument-makers  as  they  could  find  in  the 
city  of  London  or  elsewhere.  Both  were  probably  barber-surgeons,  though 
Morestide  was  ordinary  surgeon  to  three  English  kings,  Hennr  IV.,  Henry  Y., 
and  Henry  YI.  He  was  likewise  the  chief  surgeon  of  the  expedition 
mentioned  above,  and  was  required  to  equip  fifteen  men,  three  archers  and 
twelve  surgeons.  His  salary  was  £40  a  year,  or  twelve  pence  a  day  ;  while 
his  archers  and  assistant  surgeons  received  £20  a  year,  or  six-pence  a  da}-. 
Morestide  was  also  allowed  a  share  of  the  prisoners  and  booty.  He  died 
in  1450.  A  certain  Nicholas  Colnet  (probabh'  a  Frenchman)  acted  as  field- 
surgeon  likewise  on  this  expedition.     (H.)] 

e.     Spaniards, 
who  wrote  in  the  15th  century  upon  surgical  subjects,  were  : 

Diego  del  Cobo  (surgery  in  verse),  John  of  Avignon  and  Juan 
Gutierrez,  a  physician  at  Anteguerra  in  the  province  of  Malaga  (On 
Lithotomy). 


—  307  — 

T.     Germans. 

From  his  name  we  might  mention  here  Rusticus  Elpidius,  ordinary 
surgeon  of  king  Theodoric.  But  we  shall  notice  neither  the  honorable 
"  Leibparpier  "  Peter  Munch  (1458),  the  ordinary  surgeon  Oswald  Tremlinger 
(about  1458),  Meister  Hannsen  von  Beyreut  (1460),  nor  the  oculist  Meister 
Hermann  (about  1490),  as  the  first  German  surgeons,  because  the}-  are 
known  only  by  name  and  none  of  their  writings  are  extant.  But  a  different 
treatment  is  due  to  the  German  surgeon 

Heinrich  von  Pfolspeundt  (or  Pfolsprundt), 
author  of  the  ':  Bundt-Arzney  "  (1460).  He  is  the  earliest  writer  to  mention 
gun-shot  wounds,  and  manufactured  noses  in  Germany  in  the  style  of 
Branca  —  he  had  been  in  Itaby — and  likewise  operated  upon  harelip. 
Second  in  point  of  time,  but  from  his  extensive  importance  the  first  German 
surgical  writer  is 

Hieronymus  Brdnschwigk  of  Strassburg, 
of  the  Saulern  stock  (1424  ?  about  1450-1533),  who  has  left  us  a  surgery : 
"  Dis  ist  das  buch   der  Cirurgia.     Hantwirchung  der  wundartzney.     1497 
strassburgk,  von  Hieronj-mo  brunschwig  ". 

The  contents  of  this  work  are  by  no  means  so  imperfect  as  we  should  expect  in 
such  an  early  age,  and,  accordingly,  it  is  fair  to  infer  that  at  this  period  and  still 
earlier  there  may  have  been  in  Germany,  as  well  as  in  other  lands,  other  persons 
capable  of  writing  on  surgery.  Even  if  the  circumstance  that  Hieronymus  had 
studied  in  Bologna,  Padua  and  Paris  leads  us  to  a  different  conclusion,  still  he  him- 
self mentions  another  capable  German  surgeon, 

Hans  von  Dockenburg, 
who,  in  accordance  with  the  proclamation  for  a  surgeon  of  Matthias  Corvinus  (died 
1490;  founder  of  the  Bibliotheca   Corvina),   king  of  Hungary   and  a  discriminating 
patron  of  the   sciences,  removed  from  that  monarch  an  arrow-head  which  he  had  long 
been  compelled  to  carry  about. 

From  the  treatise  of  Hieronymus  we  gather  that  the  surgeons  of  his  day  were 
laudably  zealous  in  maintaining  their  surgical  honor.  One  should  not  "  when  one 
surgeon  is  not  present  reprove  or  slander  the  others,  but  if  two,  or  more  than  one 
attend,  they  should  manifest  before  the  patient  no  difference  of  opinion",  which  is 
more  than  we  sometimes  experience  to-day.  He  also  admonishes,  in  those  diseases 
where  surgery  and  medicine  jostle  each  other,  e.  g.  in  the  bites  of  rabid  dogs  —  he 
describes  very  satisfactorily  too  the  diagnostic  signs  of  "  tobigkeit  des  Hnndz  "  —  that 
a  physician  (medicus)  should  be  called  in.  Friendliness  among  colleagues  he  regards 
as  a  beautiful  quality  —  a  very  antiquated  idea  according  to  our  present  customs  ! 
The  book  comprehends  merely  subjects  of  surgery  and  military -surgery- ;  wounds  in 
general,  gun-shot  wounds  particularly,  which  he  regards  as  "poisoned";  injuries  from 
blows  and  stabs,  fractures,  dislocations,  recipes  and  the  physical  and  mental  require- 
ments of  the  surgeon.  It  is  clearly  and  calmly  thought  out,  and  passably  well 
written,  so  that  German  surgery  may  be  proud  of  this,  its  first  fruits,  from  the  then 
outpost  of  German  civilization,  Strassburg,  a  city  which  would  fain  be  ashamed  to-day 
of  its  German  origin. 


—  308  — 

e.    Cultivators  of  Pharmacology  (Pharmacy). 

The  number  of  pharmacological  or  pharmaceutical  writings  in  the  last 
half  of  the  Middle  Ages  is  disproportionate!}-  great.  This  might  surprise 
us  did  we  not  know  that,  in  consequence  of  the  scarcity  of  physicians  in 
those  days,  these  books  were  sought  after  as  treatises  on  domestic  medicine 
(about  like  "  unser  Bock  der  Gartenlaube  ",  in  spite  of  the  superfluity  of 
physicians  to-day)  ;  and  that  in  those  times  the  physician  saw  in  the 
knowledge  of  open  and  secret  remedies  the  chief  part  of  his  qualifications  ; 
for  doctors,  as  well  as  patients,  were  the  firmest  of  believers  in  the  influence 
of  drugs,  even  more  credulous  than  at  the  present  day,  when  very  little 
seems  lacking  in  this  respect.  A  number  of  the  following  authors  discussed 
pathological  subjects  also,  and  only  their  best  known  works,  or  those  espe- 
cially esteemed  in  their  day,  belong  in  our  present  section.  It  must  be 
added  too  that,  through  the  influence  of  the  Byzantines,  or  better  the 
Arabians,  through  that  of  alchemy  i.  e.  chemistry,  and  finally  through  the 
origin  of  pharmacies  in  the  West  during  the  last  centuries  of  the  Middle 
Ages,  the  stud}'  of  pharmacology  and  pharmacy  took  a  stride  greater  than 
it  had  done  since  the  Alexandrian  period. 

We  might  mention  again  in  this  place  many  of  the  physicians  already 
noticed,  such  as  Albertus  Magnus,  Arnold  of  Villanova,  Raimond  Lull  and 
others.     We  begin,  however,  with 

John  of  St.  Amand  (about  1200)  of  Hennegau,  Canon  of  Tournav. 
who  must  not  be  confounded  with  the  ordinary  physician  of  the  licentious  monster, 
pope  John  XXII.  (1316-1334),  who  bore  the  same  name.  He  wrote  an  "  Expositio 
supra  antidotarium  Nicolai",  in  which  are  given  especially  the  indications  for  the 
different  remedies  and  their  action,  as  well  as  the  curative  methods  (evacuative, 
symptomatic  etc.).     On  the  other  hand 

PlETRO  DE  TUSSIGNANA1   (about  1250), 
professor  at  Bologna,  limited  himself  to  "  Medical  formulae",  "On  the  baths  of  Bormio", 
but  also  wrote  a  treatise  entitled  "  De  regimine  sanitatis". 

Giacomo  de  Dondis2  (born  1298), 
professor  at  Padua,  in  his  "Aggregator "   and   "Herbarius"  (with  plates)  wrote   on 
simple  medicines. 

1.  Ha-ser  says  there  were  no  less  than  three  physicians  of  this   name:     1.  A   teacher 

of  William  of  Salicet  (about  1270),  who  was  the  author  of  the  "  Regimen  sanitatis"; 
2.  The  author  of  the  "  De  balneis  Burmi  apud  Volturenos  liber",  who  visited  these 
baths  in  1336;  3.  A  later  professor  in  Bologna,  Pavia  and  Ferrara,  who  flourished 
about  the  end  of  the  14th  century.     (H.) 

2.  There  is  considerable  confusion  among  medical  historians  as  to  the  relationship 

of  the  physicians  Dondis  and  their  writings.  According  to  Hagser,  Giacomo 
(Jacobus,  James)  was  the  father  and  author  of  the  "Aggregator  de  medicinis 
simplicibus"  (Aggregator  Paduanus,  Promptuarium)  and  treatises  "  De  causis 
caliditatis  aquarum  Aponensium"  and  "  De  fontibus  medicatis  agri  Patavini ". 
He  died  in  1359.  Giovanni  (Johannes,  John),  a  famous  physician,  orator,  mathe- 
matician and  physicist  (born  1318),  was  a  professor  in  Padua  and  Pavia  and 
author  of  a  treatise  "  De  fontibus  calidis  agri  Patavini".  He  manufactured  a 
famous  astronomical  clock  ("  astrarium")  and  presented  it  to  his  patron  Giovanni 


—  309  — 

To  the  first  part  of  the  13th  century  also  belongs  the  German  dispensatory  of 

Meister  Bartholomaus, 
which   introduces  numerous  drugs,   among  these   some   Arabian   preparations,   e.  g. 
rose-water  etc. 

"  Rose-water  is  good  for  the  face,  it  makes  the  skin  soft  and  beautiful,  and  also 
makes  troubled  eyes  clearer,  while  ailments  on  the  face  it  cures  completely."  — 
"Chamomile-water  is  good  for  him  who  cannot  sleep  from  sickness,  and  it  makes  the 
principal  vein  vigorous,  and  brings  also  the  raedulbe  to  their  normal  vigor". 

GlTILELMO  VARIGNANA, 
who  in  1302  was  professor  at  Bologna  and  died   in  1330,  followed  the  Arabians  and 
the  Cyranid.     He  was  son   of  the   Bartolomeo  Varignana  who  wrote  on  "  The  doses 
of  medicines",  had  also  already  dissected  two  bodies,  and  was  the  father  of  Pietro 
and  Matteo  Varignana,  both  in  like  manner  teachers  at  Bologna. 

Simon  de  Cordo1  (died  1330)  of  Genoa, 
in  order  to  acquire  a  knowledge  of  medical  plants  in  their  native  places,  and  to  learn 
to  name  them  correctly,  made  a  journey  through  Greece  and  the  Orient,  but,  instead 
of  his  own  experience,  used  as  a  guide  the  Galenic  ideas  with  respect  to  the  elemen- 
tary qualities  etc.  of  the  different  plants. 

Giovanni  de  Dondis  (about  1380), 
son   of  Giacomo  and  a  friend  of  Petrarch  (who  lamented  in  him  the  single  fault  that 
he  was  a  physician),  wrote  two  treatises  on  bathing;  "  On  the  source  of  the  warmth  of 
the  springs  of  Abano"  and  "On  the  medicinal  springs  of  the  province  of  Padua  '. 
The  toxicological  work  "  Ue  venenis"  of  the  physician 

Sante  Arduino  (1430)  of  Venice, 
and  the  dispensatory  (Compendium  aromatoriorum2  )  of 

Saladin  of  Asculo  in  Naples, 
about  1447,  do  not  belong  to  the  pharmacological  department. 

To  the  pharmaceutical  writings  of  this  time  belongs  also  the  "  Dispensatory  "  of 
a   certain    French    physician    called    sometimes    Ortolff  Meytenberger,     sometimes 

0.  Meydenberger,  and  again  O.  von  Bayerland,  a  work3  which  already  contains  a 
plate  of  the  human  skeleton.  To  this  we  may  add  the  illustrated  herbal  (herbarius), 
published  in  the  Latin,  German,  Dutch,  French  and  Spanish  languages,  and  in  various 
dialects,  entitled  "A  Garden  of  Health"  and  ascribed  to 

Johann  Wonnecke  (Dronnecke,  also  Job.  v.  Cube  or  Cuba,  about  1484) 
of  Caub,  city-physician  at  Frankfort-on-the-Main,  1483,  who  accompanied  the  great 
Breydenbach  expedition  to  the  Orient.4 

Visconti  of  Pavia.  From  this  circumstance  he  received  the  title  "  dagli  orologi " 
(ab  horologio).  The  "  Herbarius"  is  not  mentioned  by  Ha?ser,  and,  according  to 
Mej'er,  is  probably  the  work  of  a  German  writer. 

1.  Perhaps   better  known   as  Simon   of  Genoa  (Simon   Januensis.    Geniates).     His 

treatise  was  entitled  "  Synonyma  medicinal",  but  is  better  known  as  the  "  Clavis 
sanationis".     (H.) 

2.  Hawser,  for  some  reason  unknown  to  me,  calls  the  work  "Lumen  apothecariorum", 

and  says  Saladin  lived  about  1320.  The  statement  in  the  text  is  that  most  com- 
monly accepted.     (H.) 

3.  It   is   partially   copied   from   the   "  Buch  der  Natur "    of   Kunrat   von    Megenberg 

(1307-1374).     (H.) 

4.  Well-known  participants  in  this  expedition  were:  Sir  Bernhard  von  Breydenbach 

(died  1490),  John  count  of  Salms,  Sir  Philip  von  Bicken,  Baron  von  Meernawe, 
the  Knight  von  Bulach,  Sir  George  Marx,  the  Knight  von  Kurt,  the  painter  Erhart. 


—  310  — 

Dietrich  Ulsen1  (about  14!Hl) 
composed  a  pharmaceutical  poem. 

HlERONYMUS  BrUNSCHWTGK 

was  the  author  of  a  "  Liber  de  arte  distillandi  de  simplicibus"  (1500),  in  which,  among 
other  things,  human  blood  and  human  dung-water  were  adduced  as  great  remedies: 
likewise  cow-dung  water  of  the  month  of  May,  and  even  the  dung  of  a  lustful  bull  in 
t he  treatment  of  ulcers  of  the  bones,  and  internally  for  belly-ache  (Pruckmajer). 
The  author  here  quoted  thinks  the  materia  medica  of  the  Middle  Ages  forms  to-day 
still  the  basis  of  therapeutics! 

Here  must  also  be  mentioned  the  receipt-book2  of  Johann  Tollat  von  Vochenberg, 
a  physician  and  professor  at  Vienna;  the  "  Ricettario  Florentino"  (about  l4'.)0),  and 
finally  special  writings  of  the  alchemists  Basil  Valentine8  (the  discoverer  of  antimony ) 
and  Isaac  and  Joh.  Isaac  Hollandus.4  The  latter  prated  about  the  philosophers' 
stone,  of  which  if  one  took  every  ninth  day  in  wine  a  piece  the  size  of  a  grain  of 
wheat,  he  would,  indeed,  sweat,  but  would  become  more  lusty  and  stout,  so  as  to 
believe  himself  in  paradise  —  a  result  accomplished  satisfactorily  at  the  present  day 
by  wine  without  the  philosophers'  stone! 

f.    Veterinary  Medicine. 

The  condition  of  veterinary  medicine  in  the  first  half  of  the  Middle 
Ages  was  substantially  the  same  as  with  the  Ancients.  Besides  the 
writings  of  the  latter  collected  during  this  period,  we  find  veterinary  medi- 
cine and  veterinary  physicians  mentioned  only  in  the  decrees  of  Charlemagne. 
This  department  of  medicine  also  first  took  a  more  independent  start  in  the 
Scholastic  period,  when  even  ordinary  physicians,  philosophers  and  emperors 
were  not  ashamed  to  cultivate  veterinary  subjects  —  especially  hippology 
and  the  sport  of  falconry,  so  fashionable  at  this  time.  Thus  an  Albertus 
Magnus,  a  Vincent  de  Beauvais,  a  Theodorich  of  Cervia,  and  even  a  Fred- 
erick II.  must  be  named,  among  others,  as  skilled  in  the  veterinary  art. 
Theodorich  wrote  on  diseases  of  horses  and  of  falcons,  while  the  great 
Hohenstaufen,  the  most  liberal  minded  and  least  prejudiced  man  of  the 
Middle  Ages,  composed  a  work  "  De  arte  venandi  cum  avibus  ",  which  con- 
tained a  complete  anatomy  of  the  falcon.  King  Manfred  of  Sicily,  son  of 
Frederick,  also  made  some  commentaries  upon  this  work. 

Frederick  II.  spoke  and  wrote  Italian,  French,  German,  Latin,  Greek  and  Arabic, 


1.  Phillippe  calls  him  Theodor  Ulsenius  and  gives  the  title  of  his  poem  "  De  pharm- 

acandi  com  probata  ratione".     (H.) 

2.  Entitled  "  Margarita  medicine".     (H.) 

3.  A   Benedictine  monk   in    Erfurt  (middle  of  the  15th  century),  who  formed  a  very 

pretty  conception  of  the  resurrection  as  the  termination  of  a  chemical  process. 
"  Men  for  their  sins  were  by  death  salted  down  in  the  earth  until  putrefied  and 
rotten  through  time,  when  they  were  again  awakened  by  the  celestial  fire,  clarified 
and  raised  to  the  heavenly  sublimation  and  exaltation,  since  all  dregs,  sins  and 
impurities  were  separated  forever".  In  opposition  to  Galen  and  the  Arabians 
he  insisted  upon  the  use  of  chemical  remedies,  even  including  poisons. 

4.  Phillippe  says  they  were  father  and  son,  and  assigns  both  to  the  beginning  of  the 

15th  century.     (H.) 


—  311  — 

and  even  ventured  to  gainsay  Aristotle  and  the  pope  (the  two  most  considerable 
authorities  of  that  age),  in  a  period  when  the  former  was  undisputed  emperor  in  the 
kingdom  of  thought,  as  the  latter  in  the  domain  of  faith.  In  his  book  he  remarks 
that  most  of  the  bones  of  birds  are  hollow,  and  he  also  states  untruly  that  birds  can 
move  the  tipper  mandible,  and  describes  the  arrangement  of  the  claws  etc.,  entering 
into  the  minutest  particulars. 
We  must  mention  further 

BONIFACIUS, 
who  lived  under  Charles  of  Anjou  (1266-1285)  and  wrote  on  the   diseases   of   the 
horse ;    also 

Petrus  de  Crescentiis  of  Bologna  (about  1250), 
who,  in  the  style  of  the  Ancients,  in  his  work  on  husbandry  discussed  also  veterinary 
medicine;    and 

Laurenth's  Rusius  (about  1.300), 
veterinary   surgeon  at  Rome,  who  has   left  us  a  "  Liber  marescalciie"  —  veterinary 
medicine  was  called   marescalcia  at   this  time  as   it   was   termed    mulomedicina  in 
Antiquity. 

Writing*  on   veterinary  medicine  of  this  period  by  Albert  of  Cortenova,  Dinus, 
Bartholomew  Spadafora  and  others,  are  also  extant. 

That  veterinary  medicine,  however,  in  this  period,  lay  only  exception- 
ally in  scientific  hands,  may  be  easily  believed,  and  the  just  mentioned 
works  remained,  on  the  whole,  without  influence  on  practical  veterinary 
art.  This  continued  in  the  hands  of  even  the  rudest  empirics,  as  it  does 
for  the  most  part  even  to-day.  The  latter  employed  the  selfsame  methods 
of  cure  as  did  one  of  their  colleagues  of  to-da}T,  who  cut  off  the  dropped 
kid  of  a  goat,  but  when  he  saw  that  the  beast  by  this  method  died,  he 
afterwards  concluded  to  cast  a  ligature  about  the  cord,  when  to  his  astonish- 
ment the  second  kid  died  also. 

5.  EPIDEMICS  AND  NEW  DISEASES  WHICH  AROSE  DURING  THE  LAST  HALF 
OF  THE  MIDDLE  AGES 

If  we  were  justified  in  calling  the  early  portion  of  the  Middle  Ages  the 
epoch  of  plagues,  the  second  half  of  the  same  period  appears  the  special 
germinative  season  of  epidemic  diseases.  The  latter,  after  a  brief  stage  of 
ripening,  produced  a  most  terrible  harvest,  which  promoted,  indeed,  the 
physical,  as  well  as  spiritual,  renovation  of  the  human  race,  but  a  harvest 
which,  after  grievous  conflicts  beyond  the  Middle  Ages,  now  first  began  to 
bear  fruit. 

The  causes  of  this  phenomenon  were  in  part  prolonged  in  theiikeffect 
from  the  last  ages  of  Antiquity.  Tn  this  connection  we  must  mention,  first 
of  all,  the  wandering  and  restless  migration  of  peoples  (including  the 
Crusades)  and  of  individuals.  From  this  arose  gradual^^complete 
insecurity  of  property,  with  its  lack  of  employment,  idleness,  and  their 
result,  imperfect  cultivation  of  the  land.  The  latter  brought  about  a 
failure  of  crops,  which  again,  united  witli  the  utter  want  of  good  roads  and 
commercial  facilities  —  the  first  post-road  e.  g.  in  Europe  was  opened  in 


—  312  — 

1407  —  and  the  lack  of  a  corn  trade,  created  dearth  and  famine,1  continual 
poverty  and  generally  insufficient,  bad  and  coarse  means  of  subsistence. 
The  Middle  Ages  were  socially  and  hygicnically  a  most  degraded  period  ! 
Causatively  united  with  these  phenomena  were  the  inferior  clothing  (almost 
exclusively  leathern  or  woolen  —  regular  hunting-suits)  and'  personal 
uncleanliness,  always  proportional  to  the  general  lack  of  civilization.2 
Bathing- houses  (Badstuben)  existed,  indeed,  in  almost  every  hamlet,  but 
how  great  this  uncleanliness  was  may  be  judged  from  the  facts  (otherwise, 
of  course,  insignificant)  that  pocket-handkerchiefs  were  necessities  unknown 
to  even  emperors  and  high-born  ladies  —  the}'  blew  their  noses  aside  with 
the  finger  !  ;  that  the  fingers  were  the  only  knives  and  forks  at  the  table, 
and  especially  that  they  could  find  in  gross  hoggishness  —  kissing  leprous 
ulcers  for  example  —  such  meritorious  Christian  exercises,  that  they  are 
said  in  some  instances  to  have  resulted  in  securing  a  choice  position  among 
the  saints  of  heaven  !  The  numerous  bathing-houses  too,  from  institutions 
for  cleanliness,  became  places  of  unclean  lust  and  lasciviousness,  as  were 
also  many  of  the  convents,  though  designed  solel}*  for  the  purification  of 
the  soul.  At  a  later  period  too  were  added  dense  crowding  in  for  the  most 
part  small,  irregular  walled-towns,  together  with  public,  added  to  private, 
uncleanliness.  From  some  of  the  evils  mentioned  and  the  abuses  of  the 
religious  orders  there  resulted  now  the  grossest  and  (in  accordance  with 
the  barbarous  period)  the  most  barbarous  immorality.  So  gross  and 
artless  was  this,  that  in  main-  houses  a  school  was  accommodated  below, 
and  above,  a  brothel,  while  in  Paris  e.  g.,  in  consequence  of  the  number  of 
the  importunate  and  "  merry  "  worshippers  of  Venus,  it  was  as  difficult  to 
pass  through  the  streets  by  night,  as  it  was  by  day  in  consequence  of  the 
animals  running  and  driven  about,  and  whose  dung  adorned  the  unpaved 
thoroughfares.3  The  constant  wars  also,  the  defective  structure  of  the 
houses,  the  stinking  gutters  and  bad  methods  of  interment  within  church- 
yards  in  the  midst  of  cities  (prohibited  even  by  the  laws  of  the  Twelve 
Tables)  and  villages,4  must  not  be  forgotten.  All  the  foregoing  evils 
favored  the  contagiousness,  and  thus  the  origin,  of  epidemic  diseases 
among  the  masses.  The  general  overtension  of  the  mind  excited  by  the 
faith  also  caused  an  outbreak  of  psychical  epidemics,  like  the  epidemic 
pilgrimages  which  we  witness  in  France  at  the  present  day. 

The  oldest  and  most  widely  extended  disease  among  those  which  visited  the  Middle 
Ages,   and  which  we  meet  also  in  the  earliest  antiquity   (though   only  in  its  lighter 

1.  Famines  were  among  the  most  frequent  occurrences  of  the  Middle  Ages.     Indeed, 

from  the  1 1th  to  the  15th  century  a  famine  recurred  about  every  fourteen  years, 
and  during  this  period  32  great  plagues  raged. 

2.  As  we  observe  even  to-day,   for  we  judge  the  civilization  of  a  people  by  its  use 

of  soap! 

3.  While  ancient   Rome  had  sidewalks  and  paved   streets,  none  were  laid  in  Paris 

before  the  12th  century. 

4.  These   in    all   quarters    had   open   and    foul   wells   in    ordinary   use,   which   must 

frequently,  therefore,  have  been  looked  upon  as  designedly  poisoned. 


—  313  — 

forms),  was  the  leprosy.  Under  this  term  very  different  contagious  and  non-conta- 
gious skin-diseases,  together  with  the  leprosy  proper,  seem  to  liave  been  compre- 
hended, so  that  the  confusion  can  be  no  longer  unravelled,  particularly  as  the  genuine 
leprosy  lias  long  since  disappeared  from  the  West.  It  must  be  added,  that  this 
disease  in  its  period  of  bloom  was  tortured  into  the  theory  of  the  cardinal  humors  and 
elementary  qualities,  in  accordance  with  which  its  forms,  and  even  its  symptoms, 
were  modeled. 

Cutaneous  discoloration!8,  specks,  scabs  etc.  served  as  premonitory  symptoms.  To 
these  substantially  two  forms  might  follow,  the  common  leprosy,  and  the  knobby  or 
knotty  leprosy  (elephantiasis),  either  of  which  again  might  take  on  an  acute  or  a 
chronic  course,  by  which  the  greater  or  lesser,  the  more  speedy  or  lingering,  mortality 
was  determined. 

The  prodromata  of  the  disease  were  commonly  lassitude,  irritability,  a  peculiar 
staring  look,  disturbances  of  digestion,  fever,  general  redness  and  swelling  of  the  skin, 
and  violent  pains,  especially  in  the  limbs.  Then,  when  recovery  did  not  take  place 
(and  recoverj-  was  a  very  rare  occurrence)  or  a  stationary  condition  or  death  ensue, 
sup?rficial  knobs  were  developed  under  the  skin,  especially  of  the  back  of  the  hands 
and  feet,  of  the  bod}'  or  the  face,  through  which  a  peculiar  coppery  redness  disfigured 
the  latter.  The  misshapen  nose,  the  distorted  ears,  the  diseased  and  everted  mucous 
membrane  of  the  eyes  —  for  both  the  external  and  internal  mucous  membranes  were 
attacked  —  the  baldness,  alternating  here  and  there  with  thin,  wool}'  hair,  all  produced 
a  peculiarly  frightful  appearance.  Besides  these  were  teeth,  filthy,  if  they  had  not 
fallen  out,  foul  breath  and  salivation,  a  dragging,  sluggish  gait,  melancholy,  irascibility 
and  a  sexual  desire  not  much  increased.  This  condition  might  be  prolonged  from  six 
months  to  two  years.  Then  most  of  the  knots,  after  they  had  softened  singly  or  together, 
broke  open,  giving  rise  to  round,  foul-smelling,  leprous  ulcers,  with  yellowish-red 
bottoms.  The  nose  sunk  in,  and  with  the  fixed  stare  gave  to  the  face  a  leonine 
appearance.  The  condyles  became  corroded,  as  well  as  the  privates  of  men  and 
women,  and  in  the  latter  a  foul  discharge  was  produced.  The  internal  organs  also 
ulcerated.  No  wonder  that  all  the  world  shunned  these  unfortunate  beings  and  separ- 
ated them  from  other  society,  especially  as  the  disease  was  contagious,  though  not  very 
markedly  so.     But  dread  of  the  hideous  disease  exaggerated  the  danger  to  the  health}  ! 

If  a  sick  person  was  known  to  be  leprous  (for  the  decision  of  which  question 
certain  individuals,  often  themselves  leprous,  were  appointed),  he  was  secluded  —  often 
with  preceding  religious  burial  rites — in  great  hospitals,  leper-houses,  infirmaries, 
lazaretti,1  outside  of  the  cities  and  villages,  or  in  separate  cottages  in  the  open  fields. 
The  mania  of  the  period  to  form  regular  associations,  as  well  of  those  united  by 
similar  diseases  as  of  those  bound  by  similarity  of  feelings,  may  have  also  influenced 
the  lepers  to  an  isolated  life.  Thus,  in  accordance  with  the  feelings  of  the  age,  a 
meritorious  work  might  be  accomplished,  by  which  one  might  guide  himself  toward 
heaven,  so  that  leprosy,  bad  as  it  was  for  the  present  world,  might  seem  even  profitable 
for  that  which  was  to  come.  Members  of  the  religious  orders  took  care  of  the  sick. 
The  latter  were  permitted  to  go  abroad  in  a  peculiar  dress  only,  a  black  gown  with  two 
white  hands  sewed  upon  the  breast,  and  a  large  hat  with  a  white  band  upon  the  head. 
Whatever  a  leper  wished  to  buy  he  could  only  point  out  with  a  long  stick,  drawing  it 
to  himself  therewith.  Even  his  approach  must  be  indicated  by  a  rattle.  As  far  as 
•concerned  civil  affairs  the  poor  wretch  was  dead,  buried  to  his  friends,  to  his  wife  and 
children,  to  the  community,  to  the  state. 

1.  Leper-houses  are  mentioned  by  Gregory  of  Tours  (about  560),  and  under  king 
Pepin  (757)  leprosy  was  made  a  legal  ground  for  divorce.  In  France  under 
Louis  VIII.  (1223-26)  there  were  no  less  than  2000  leper-houses,  19  in  the  single 
diocese  of  Troyes.     (H.) 


—  314  — 

About  the  year  1000  the  number  of  lepers  had  begun  to  increase  enormously, 
until  in  the  13th  century  it  attained  its  greatest  height.  From  this  time  onward  a 
gradual  decrease  set  in,  until  in  the  16th  century  the  leprosy  —  and  with  it  the  num- 
ber of  leper-houses  —  dwindled  into  insignificance.  According  to  accounts  the  disease 
first  appeared  in  Germany  in  the  7th  century.  It  disappeared  earliest  in  Italy,  then 
in  France,  and  iast  in  Holland  and  North  Germanj\  At  least  it  shows  itself  very 
rarely  still  it  Italy,  though  more  frequently  in  Scandinavia  and  Spain. 

Among  the  early  epidemics  of  the  Middle  Ages  —  from  the  9th  to  the  second  half 
of  the  14th  centur}"-  —  belongs  also  the  so-called  Holy-fire  (St.  Antony's  fire,  Fire- 
plague,  with  many  other  similar  designations),  which  we  understand  as  ergotism.  ' 
Its  consequences  were,  if  possible,  still  more  terrible  and  horrible  than  those  of  the 
leprosy;  for  it  maimed  horribly  those  who  did  not  die,  deprived  them  of  a  hand  or  a 
foot,  or  both  together,  and  though  it  did  not  increase  the  suffering,  yet  it  did,  indeed, 
aggravate  the  disconsolate  and  mournful  appearance  of  the  victim,  when  it  removed 
arms  and  legs  together,  so  that  often,  when  it  destroyed  other  conspicuous  parts, 
literally  only  the  body  with  the  head  remained.  The  most  miserable  victim  then 
cried  fruitlessly  for  a  death  which  could  not  be  granted  him.  The  disease  begun  with 
an  icy  coldness  of  the  skin,  most  frequently  on  the  limbs,  followed  gradually  by  a 
burning  fire  within  which  consumed  the  flesh  from  the  bones,  accompanied  with 
frightful  pains  and  lamentations  on  the  part  of  the  sufferer.  Sometimes  discolored 
blisters  first  rose  upon  the  skin.  Then,  generally,  however,  without  the  previous 
occurrence  of  the  blisters,  appeared  a  discoloration  of  a  limb,  which  either  shrivelled 
awny  to  a  black,  dry  mass,  or,  diffusing  an  unendurable  odor,  became  a  stinking, 
moist,  gangrenous  mass,  in  both  cases  finally  falling  off  from  the  body.  In  this  terri- 
ble condition  many  recovered.  In  other  cases  the  internal  parts  were  first  seized  and 
the  gangrene  ransacked  the  viscera,  torturing  the  poor  wretches  irremediably.  How- 
ever, those  in  whom  the  viscera  were  fortunately  attacked  first,  died  speedily.  Epi- 
demics of  this  kind,  which  never  ravaged  very  extensive  tracts,  prevailed  occasionally 
in  England  ■and  Spain,  but  especially  in  France,  Alsace  and  Lorraine. 

In  the  fermenting  period  of  the  Crusades  there  was  also  separated  from  the 
general  domain  of  disease  a  new,  acute  and  peculiar  form  of  disease,  the  Scurvy, 
which  from  that  time  remained  naturalized,  until  in  more  recent  times  it  has  yielded 
to  the  higher  development  of  external  life  and  its  means  of  assistance.  The  first 
undoubted  descriptions  of  this  disease  spring  from  the  Crusade  of  St.  Louis  (1250). 
But  in  the  15th  century,  with  the  more  frequent  and  longer  sea  voyages,  it  became  first 
distinctly  marked  and  diffused.  Especially  was  this  the  case  on  occasion  of  the  voyage 
of  the  immortal  Vasco  di  Gama  in  the  year  1498,  when  55  sailors  died  of  the  disease. 

Next  followed  the  observation  for  the  first  time  of  the  Plica  Polonica,  a  disease 
which  had  existed  in  Poland  from  the  year  1287,  after  an  invasion  of  the  Mongols,, 
and  was  a  product  of  mediaeval  filthiness  among  an   especially   barbarous  people. 

The  existence  of  epidemic  Influenza  in  the  earlier  ages  (whence  comes  our 
'  God  help  us",  uttered  after  sneezing,  because  those  attacked  died  too  quickly  to 
expect  aid  from  human  means),  as  well  as  in  the  last  half  of  the  Middle  Ages,  is  in- 
deed highly  probable,  but  not  certain,  since  the  descriptions  of  the  disease  are  too 
ambiguous  to  decide  the  question.  The  same  is  true  of  Hooping  Cough,  Scrofula. 
The  Purples  and  Rheumatism.     On   the  other  hand  the  Gout  was  already  known  to 

1.  The  earliest  epidemic  recorded  in  France  occurred  in  590.  The  identity  of  the 
mediasval  ignis  sacer,  ignis  St.  Antonii,  with  our  modern  ergotism  was  first 
established  by  Read,  a  physician  of  Metz,  in  1771.  The  Order  of  St.  Antony, 
designed  especially  for  the  care  of  sufferers  from  the  ignis  sacer,  was  established 
in  1093.     (H.) 


—  315  — 

the  Byzantine  physicians,  and  was  described  as  an  every  day  affair  in  the  compen- 
diums  of  the  Nth  and  loth  centuries. 

Less  frightful  and  terrible  in  the  appearance  of  individual  cases,  but  incompar- 
ably more  terrible  in  the  rapidity  and  universality  of  its  diffusion  over  the  whole 
earth,  as  well  as  in  the  inevitableness  of  its  attack  and  the  unavoidableness  of  the 
death  of  the  sufferers,  was  "  The  Great  Death",  "  The  Black  Death  ",  which  raged 
from  the  year  1348  onward.  It  is  also  distinguished  by  the  enormous  resulting  mor- 
tality, which  attained  figures  never  heard  of  before  or  since  that  period.  In  Europe 
alone  25  millions  of  human  beings  perished,  in  the  East  23  millions,  and  in  China  13 
millions.  No  less  mournfully  characteristic  of  the  animal  nature  of  the  human  race, 
which,  in  ordinary  periods  repressed  for  the  most  part  by  powerful  laws  and  customs, 
yet  breaks  out  in  a  bestial  manner  in  extraordinary  times,  was  this  fatal  plague. 

Before  and  with  it  are  said  to  have  appeared  the  phenomena  noticed  in  all  great 
epidemics,  and  reported  from  that  day  to  this  of  all  momentous  events.  Some 
of  these  were  accurately  recorded  only  because  of  the  search  after  a  cause  for  the 
visitation,  and  were  willingly  referred  by  childish  persons  and  impostors  to  the  puni- 
tive will  and  avenging  power  of  a  deity  :  or  they  were  forced  into  a  connexion  with 
present  or  past  misfortunes  and  often  exaggerated  strongly  bj-  over-excited  fancy,  or 
were  simply  delusions  of  that  fanc3-.  Such  phenomena  wete  the  sinking  of  mountains, 
earthquakes,  great  storms,  inundations  preceded  or  followed  by  drought,  wide-spread 
dearth  and  want,  failure  of  crops,  new  phenomena  in  the  skies,  comets,  poisonous 
fogs,  swarms  of  grasshoppers  etc.  —  phenomena  which  are  in  part  the  natural  conse- 
quences of  public  and  great  misfortune.  Honiger  ("Der  schwarze  Tod  in  Deutschland  ", 
by  Dr.  Rob.  Honiger,  Berlin,  1882)  regards  most  of  them  as  later  creations  of  the  fancy. 

Under  the  form  of  the  Black  Death  such  an  epidemic  as  had  never  before  been 
experienced  overran  Europe,  after  devastating  the  whole  of  Asia,  from  China  to  the 
Caucasus,  as  well  as  Africa.  In  the  single  city  of  Ghaza  there  died  in  one  month 
22000  persons;  in  the  whole  East  23  millions.  The  Arabian  physicians  who  give  an 
account  of  the  Black  Death  estimate  the  number  of  its  victims  at  two-thirds  of  the 
number  of  persons  living  at  that  time.  From  the  Crimea  the  plague  spread  after 
13-17  to  Constantinople,  Greece  and  Italy,  where  it  arrived  in  1348,  speedily  extending 
over  France,  Spain,  England,1  Norway,  Denmark  and  Holstein.  It  even  reached 
Greenland  as  well  as  Iceland  in  the  same  year,  both  of  which  countries  of  the  extreme 
north,  heretofore  very  populous,  were  then  almost  depopulated.  By  another  route 
the  Great  Death  ( which  had  already  in  1348  once  visited  Germany,  coming  from 
France  through  Alsace)  again  spread  from  Carinthia  and  Vienna  in  1349,  destroying 
on  the  whole  a  million  and  a  quarter  of  human  beings.  Poland  too  was  not  exempt 
(according  to  Honiger,  however,  it  with  Silesia,  Bohemia  and  eastern  France,  re- 
mained exempt  for  at  least  the  first  three  years),  and  even  Russia,  in  spite  of  its 
northern  situation  and  colder  climate,  was  subjected  to  its  ravages.  Hence  it  no- 
longer  appears  remarkable  that  even  the  lofty  valleys  of  Switzerland,  especially  of 
Valais,  were  thoroughly  scourged,  so  that  Lucerne  lost  3,000,  Basel  fully  14,000  men. 
Strassburg,  however,  lost  16,000,  Dantzig  13,000,  Vienna  40,000,  Schleswig  four-fifths 
of  its  inhabitants,  Paris  50,000,  London  quite  100,000  souls,  a  mortality  equalled  by 
that  of  the  then  so  populous  Venice.     The  death  rate  was  also  enormous! 

In  the  earliest  epoch  almost  all  those  attacked  died,  a  number  amounting  to  two- 
thirds  of  the  total  population  ;  in  1361,  however,  while  about  half  of  the  population 

1.  The  "Black  Death"  made  its  appearance  in  England  in  August  1348,  leached 
London  about  the  first  of  November  of  the  same  year,  and  continued  to  rage  for 
about  a  year  During  its  prevalence  even  the  sessions  of  Parliament  and  of  the 
courts  of  justice  were  suspended.     (  H. ) 


—  31(5  — 

was  attacked,  a  great  number  still  died ;  at  last  only  about  one-twentieth  of  the 
population  was  attacked  (1382),  and,  as  is  usually  the  case  in  all  epidemics,  only  a 
few  succumbed.  On  the  whole,  however,  the  fourth  part  of  mankind  then  existing 
was  swept  off  by  the  disease!  Its  course  was  often  fatal  in  a  few  hours;  more 
frequently  between  the  first  and  third  day.  Death  might,  however,  ensue  after  weeks, 
though,  when  suppuration  of  the  glands  set  in,  recoverjr  most  frequently  followed. 
Epistaxis  at  the  beginning  was  of  evil  omen  in  ea.^tern  countries;  in  the  West  how- 
ever, sudden  paleness  preceding  the  outbreak  and  vomiting  of  blood  soon  after  bore 
ihe  same  import.  Insensibility  was  also  dangerous,  and  from  it  very  few  awakened, 
and  these  too  often  only  to  die  immediately.  Gangrenous  bulla?  and  numerous 
petechia'  were  of  bad  omen.  .Most  frequently  the  direct  cause  of  death,  besides  the 
immediate  active  and  powerful  'infection  of  the  blood",  appears  to  have  been 
.gangrene  of  the  lungs.  From  this  also  proceeded  the  foul  breath,  in  addition  to 
which  loss  of  sensation  and  of  voice  speedily  showed  themselves.  Next  followed 
paralysis  and  insensibility.  Before  and  during  all  this  period  high  fever,  thirst,  pain 
and  sleeplessness  consumed  the  strength  of  the  patient,  and  (when  time  for  their 
development  remained)  bubos  in  the  axilla  and  groin  were  associated  therewith.  The 
latter,  however,  often  appeared  in  the  beginning,  followed  by  a  dry  and  brown  tongue 
and  black  spots  upon  the  skin.  The  urine  also  was  often  black.  The  phenomena 
varied,  however,  in  accordance  with  the  period  of  the  epidemic  and  its  location,  so 
that  the  symptoms  mentioned  are  likewise  variously  recorded. 

Still  more  terrible,  however,  was  the  condition  of  public  and  private  morals 
following  and  growing  out  of  the  enormous  mortality.  In  considering  this  we  must 
take  into  account  the  superstition  and  universal  barbarity  of  the  time,  and  the  general 
desperation.  Beside  the  innumerable  examples  of  the  vanity  of  all  things  earthly, 
placed  daily  and  hourly  before  all  ej'es,  was  exhibited  the  lowest  avarice;  and  beside 
this  again  as  a  contrast,  was  displayed  a  corresponding  squandering  of  earthly  posses- 
sions in  mortmain  gifts.  For  in  this  wa}'  it  was  believed  that  one  miuht  escape 
judgment,  and  hence  it  resulted  that,  in  a  period  when  all  others  were  losers,  the 
Church  alone  gathered  in  fabulous  wealth.  Moreover  the  bonds  of  blood  and  of 
friendship  were  severed,  since  where  help  failed  all,  each  one  cared  for  himself  only. 
At  last  the  dead  were  laid  in  rows  and  ranks  in  common  gravis,  "careless  of  a  spot 
for  the  memory  of  the  departed".  Some  in  pleasure  led  merry  banquets  and  dances; 
others  in  sorrow  prayed  and  fasted,  while  others  still,  in  gloomy  indifference,  dared 
every  danger.  Licentiousness,  however,  celebrated  its  open  and  secret  orgies,  and 
put  to  flight  corruption,  and  suffering,  and  despair,  and  fear,  in  the  absolute  certainty 
of  ruin.  Pilgrimages  met  carnival  processions,  and  from  the  latter  the  crazy  peni- 
tential dances  were  often  difficult  to  distinguish  No  commands  were  longer  obeyed; 
public  safety  was  wanting  for  both  person  and  property,  and  the  mighty  mob,  even 
while  the  majority  were  sinking  into  death,  practised  robbery,  murder  and  rapine.  The 
Jews,  however,  accused  of  poisoning  the  springs  of  water,1  were  in  many  places 
systematically  murdered,  or  induced  to  sacrifice  themselves  (in  Mayence  alone  12,000 
of  these  persecuted  creatures  threw  themselves  into  the  flames!),  since  their  avarice2 

1.  This  mediaeval  idea  too  has  not  disappeared  everywhere,  even  at  the  present  daj', 

though  we  do  not  accuse  the  Jews  alone  They  are  persecuted  out  of  a  vague 
hatred,  as  e.  g.  in  Russia,  Hungary  and  North  Germany  in  1880-81.  In  Spain 
and  Sicily,  however,  in  1885  even  the  physicians  and  nurses  were  accused  of 
poisoning,  and  maltreated  accordingly. 

2.  They  took  interest  (often  usurious),  which   was  forbidden   to   Christians,   and  had 

in  their  hands  banking  in  general  —  the  only  business,  except  their  ancient 
occupations,  which  they  were  permitted  to  pursue. 


—  317  — 

brought  upon  them  the  suspicion  that  they  were  responsible  for  the  plague  —  a  sus- 
picion in  which  religious  hate  and  the  prejudice  of  race  naturally  played  their  part. 
Yet  happily  there  were  also  heroic  deeds  of  self-sacrifice,  both  on  the  part  of  numerous 
members  of  the  yet  undegenerate  religious  orders,  especially  t lie  Franciscans  and 
certain  associations  of  women,  and  likewise  on.  the  part  of  physicians,  of  whom  a 
large  number,  led  by  the  most  capable,  with  cheerful  self  sacrifice  sought  to  render 
aid  and  —  succumbed  to  the  plague.  For  no  means  were  of  an}*  avail  if  nature 
would  not  assist.  Besides  foolish  medication  and  superstitious  remedies,  an  earnest 
application  of  hygienic  measures,  such  as  isolation  of  the  locality  etc.,  was  also  em- 
ployed. 

After  the  cessation  of  the  plague,  however,  the  already  mentioned  internal  evils 
came  more  openly  to  light,  and  to  these  were  added  the  external  ills  of  want  and 
distress  among  individuals;  for  no  one  had  tilled  the  fields,  nor  would  they  sow  them 
now  for  even  high  wages;1  so  that  this  resulted  in  universal  poverty.  Yet  the  priest- 
hood had,  on  the  whole,  gained  in  power  and  influence! 

After  the  extinction  of  the  plague,  however,  a  greater  fruitfulness  among  women 
was  observed,  so  that  a  surprising  number  of  twin  births  occurred  (Haeser). 

As  evidence  how  a  greatly  overstrained,  one-sided  devotion  (possible  only  to 
those  deprived  of  the  exercise  of  the  powers  of  reason)  led  minds  into  false  feelings, 
madness  and  insane  practices,  as  well  as  how  this  one-sidedness  exaggerated  at  first 
the  lower  impulses,  until,  no  longer  controlled  by  habit  and  law,  they  finally  changed 
into  open  and  shameless  debauchery  and  sensuality,  we  may  adduce  not  only  the 
unexampled  and  universal  immorality,  which  in  these  highly  devout  times  ruled  both 
the  laity  and  clergy,  but  we  are  also  in  a  position  to  show  in  particular  from  these 
psychologically  remarkable  ages,  the  concomitant  and  succeeding  results  of  devout 
frenzy  and  immoralit}*.  First  with  reference  to  the  Geisslern  or  Flagellantes.  These 
we  may  define  as  those  penitents,  who,  for  the  first  time  in  1260,  attacked  by  religious 
frenzy,  for  their  own  justification  and  purification  before  God  and  to  awaken  repent- 
ance and  contrition  in  others,  set  out  in  multitudes  to  scourge  themselves  from  time 
to  time,  or  to  suffer  themselves  to  be  whipped  by  a  president  or  other  associate,  until 
their  bodies  were  full  of  blood}*  stripes,  so  that  their  bare  appearance  excited  com- 
passion. These  lunatics  sang  continually  hymns  of  penitence,  and  their  expeditions 
are  said  to  have  lasted  thirty-three  and  a  half  days.  Their  sanctifying  procedures 
took  place  at  first  in  the  churches,  later,  however,  before  the  walls  of  the  city  and  in 
the  open  fields,  and  finally  at  night,  something  like  the  extravagances  of  our  "Salva- 
tion Army".  These  epidemics  were  repeated  several  times,  until  in  the  year  1S49, 
shortly  before  and  during  the  plague  (and  onlj*  aided  by  the  outbreak  of  the  same), 
they  manifested  themselves  in  the  greatest  number,  so  that  hundreds  and  even 
thousands  of  such  lunatics,  at  first  divided  into  sexes,  gradually  in  mixed  trains,  roved 
about,  especially  along  the  Rhine.  The}-  wore  only  a  shirt,  a  hat  with  a  red  cross, 
and  a  mask.     "These  crazy  Flagellants  roamed  about  half  naked,  scourged  them- 

1.  According  to  Green  the  close  of  the  epidemic  of  the  "Black  Death"  marks  the 
beginning  in  England  of  the  chronic  strife  between  capital  and  labor.  The 
"Statute  of  Laborers",  which  provided  that  "Every  man  or  woman,  of  whatso- 
ever condition,  free  or  bond,  able  in  body  and  within  the  age  of  threescore 
years  .  .  .  and  not  having  of  his  own  whereof  he  may  live,  nor  land  of  his 
own  about  the  tillage  of  which  he  may  occupy  himself,  and  not  serving  any 
other,  shall  be  bound  to  serve  the  employer  who  shall  require  him  to  do  so,  and 
shall  take  only  the  wages  which  were  accustomed  to  be  taken  in  the  neighborhood 
where  he  is  bound  to  serve  "  two  years  before  the  plague  began  —  was  passed 
toward  the  close  of  134!).     (H. ) 


—  318  — 

selves  by  day,  and  by  night  held  lewd  assemblies."  Thus  gross  immorality  developed 
out  of  religious  insanity,  with  manifest  results  as  regards  the  female  participants.  At 
last  the  Church  (though  otherwise  very  indulgent  at  this  time  towards  such  excesses 
of  religious  principle)  saw  herself  compelled  to  oppose  this  public  scandal. 

A  similar  development,  based  on  the  same  ground,  manifested  itself  in  the 
"Dancing  Mania",  which  raged  like  a  sort  of  epidemic  dervish-frenzj-,  in  1021, 
1278  and  1H75.1  Thousands,  at  this  period,  danced  frantically  until  the  foam  gushed 
from  their  mouths,  convulsions  made  their  appearance  and  the  belly  swelled  up 
immensely,  which  latter  symptom  was  relieved  by  bandaging  the  abdomen  and 
belaboring  it  with  kicks.  At  last  the  dances  took  place  among  ranks  of  both  sexes, 
and  for  some  time  the  maidens  had  to  bear  the  frequent,  results  of  this  mania  also. 
Later,  in  the  15th  century,  a  few  such  maniacs  still  showed  themselves.  As  St.  Vitus 
was  their  patron,  the  title  of  "St.  Vitus's  dancers"  was  given  to  these  maniacs,  whence 
our  "St.  Vitus's  dance"  of  to-day  has  received  its  antiquated  name. 

Religious  mania,  however,  worked  its  most  mournful  results  in  the  phenomena 
distinguished  as  "  Childrens'  Pilgrimages"  (Kinderfahrten).  Boys  and  maidens,  all 
of  them  under  age,  infatuated  or  deluded,  set  out  in  hosts  to  the  number  of  HO, 000  for 
the  purpose  of  taking  possession  of  the  Holy  Sepulchre.  In  1212,  carried  away  by  a 
power  so  resistless  that  those  detained  against  their  will  often  sickened  and  died, 
these  mixed  bands  for  the  first  time  in  thousands  broke  away  to  the  sea.  led  by  one 
of  equally  immature  years.  None  attained  the  object  of  the  expedition;  few  only 
returned  to  their  homes.  Many,  after  the  loss  of  discipline  which  had  been  at  all 
times  very  loose,  strayed  about  aimlessly  in  the  greatest  misery.  Many  of  the  girls 
especially,  scarcely  beyond  the  years  of  childhood,  whose  pregnane}'  had  been 
acquired  in  these  expeditions  resulting  from  insane  religious  over-excitement, 
awakened,  instead  of  pity,  only  scoffing. 

Such  epidemics  of  religious  frenzy  (among  which  must  be  included  the  burning 
of  Jews,  "  Judenbrande  ",  especially  in  the  years  lo4S-'50)  thus  worked  at  once  in 
the  body  and  soul  of  their  victims  results  equal  to  those  of  the  plague  —  death  and 
moral  corruption. 

With  the  mania  last  mentioned  we  may  close  the  list  of  public  and  epidemic 
corruptions  of  the  faith  during  the  last  half  of  the  Middle  Ages.  "Thenceforth,  the 
'  Black  Death',  flagellation  and  the  murder  of  Jews  at  an  end,  the  world  began  to  live 
and  to  be  happy."      But  the  physical  corruption  was  not  yet  terminated. 

Next  is  to  be  mentioned  the  "  English  Sweating  Sickness",  so  called  because  it 
always  made  its  first  appearance  in  England  (for  the  first  time  in  the  year  I486).8 
It  began  with  a  feeling  of  great  lassitude,  often  ending  in  trembling  and  a  single  chill. 
Soon  appeared  unutterable  anguish,  burning  sensations,  pain  in  the  region  of  the 
stomach  and  loins  and  unquenchable  thirst. 

From  the  outset,  however,  a  severe  sweating  which  consumed  the  strength 
manifested  itself,  accompanied,  or  more  frequently  followed,  by  a  miliary  eruption. 
These  were  followed  by  unendurable  headache,  and  extremely  troublesome  pal- 
pitation of  the  heart,  frequently  by  delirium  and  sopor,  to  which  the  sick  succumbed 
unless  they  could  be  awakened  therefrom.  The  disease  caused  death  most  frequently 
within  the  first  24  hours.     If,  however,  death  did  not  ensue,  a  change  for  the  better 

1.  A   similar  outbreak   of  epidemic   chorea  following   intense  religious  excitement 

appeared   in  Keutucky  and  Tennessee  in  1803,  and  was  described  by  Dr.  Felix 
Robertson  in  1805.     (H.) 

2.  The  "Sweating  Sickness"  prevailed  epidemically  in  England  in  1486,  1507,  1518, 

1529  and  1551.     The  last  epidemic  was  excellently  described  by  Dr.  John  Kaye 
(Caius)  in  1552.     (H.) 


—  319  — 

set  in  speedily,  though  before  complete  recovery  8  to  14  days  always  elapsed.  —  The 
first  epidemic  extended  over  England  only,  as  did  the  second  likewise  (1508);  the 
third,  however,  extended  also  over  northern  France  (1518) ;  the  fourth  (1529)  over 
Germany,  the  Netherlands,  Sweden,  Russia,  France  and  Switzerland;  while  the  last 
( 1551)  affected  again  only  England  proper,  excluding  Ireland  and  Scotland.  The 
mortality  occasioned  by  these  epidemics  was  enormous,  since  in  the  beginning  not 
one  in  a  hundred  escaped  de&th.  In  Hamburg,  at  a  later  period,  when  the  plague  had 
already  become  milder,  in  22  days  over  1000  persons  Hied;  in  Augsburg  of  15,000  sick 
500  died  in  the  first  five  days  after  the  appearance  of  the  epidemic,  while  later  of  3000 
attacked  600  died.  In  Germany  the  sudorific  treatment  originally  practised  was 
responsible  for  a  large  share  of  the  high  mortality,'  which  diminished  as  better  phy- 
sicians, after  the  English  method,  maintained  the  sweating  gently  and  for  a  brief 
period.  "  Why  should  the  sick  man  sweat  24  hours  without  intermission,  as  if  he 
were  a  horse  or  an  ox?"  said  one  of  our  true-hearted  and  honest  forefathers  ! 

While  the  English  sweating  sickness,  and  most  of  the  mentioned  epidemics  which 
the  Middle  Ages  matured  have  again  forsaken  us,  the  case  is  far  different  in  respect 
to  syphilis,  which  speedily  became  the  most  active  opponent  of  Galen  and  the 
Arabians,  since  they  no  longer  sufficed  to  meet  the  new  disease.  That  this  disease 
is  as  old  as  the  Bible  is  in  the  highest  degree  probable,  since  something  very  similar 
to  it  is  mentioned  in  that  book.  We  also  find  it  delineated  with  tolerable  distinctness 
by  the  physicians  of  the  Greeks  and  Romans.  Pliny  with  a  sigh  even  exhibited  to 
his  wife  his  ulcerated  member,  and  did  not  believe  that  it  could  be  healed  —  a  beauti- 
ful picture  of  marital  consideration!  However  a  knowledge  of  the  causation  (first 
recognized  by  a  few  physicians  of  the  last  period  of  the  Middle  Ages  to  depend  upon 
impure  intercourse)  was  wanting  to  all,  as  we  have  already  seen.  We  have  very 
early-  accounts  of  diseased  royal,  and  more  especially  clerical,  members.  Palladius 
(367-431),  a  priest  of  Helenopolis,  already  relates  a  story  of  a  monk  Heron  who  was 
infected  by  a  dancing  girl  with  whom  he  had  gone  astray',  and  Sir  Astleyr  Cooper 
called  attention  to  cases  even  out  of  the  Acta  Sanctorum  (1010).  So  too  bishop  John 
of  Speyer,  after  he  had  been  long  sick,  died  in  1104  of  an  ulcer  of  the  penis  ''from 
which  a  by  no  means  good  odor  proceeded",  and  even  in  the  16th  century-  the  clergy- 
carried  about  syphilis  and  gonorrhoea  from  one  woman  to  another.  As  early  as  the 
years  1354  and  1361  the  city  physician  of  Frankfort-on-the-Main  received  a  salary  for 
examining  impure  woman  (Kriegk).  Yet  syphilis  is  said  to  have  made  its  appearance 
here  for  the  first  time  in  1496,  in  spite  of  the  fact  that  during  the  Middle  Ages  hosts 
of  wenches  profited  by  the  mass  and  coronation  ceremonies  to  ply  here  their  libidin- 
ous trade.  In  1394  there  were  no  less  than  880  of  these  women  in  the  city,  and  a 
gentleman  of  the  old  school  wished  his  friend  more  luck  than  there  were  prostitutes 
in  Frankfort — nice  times  these  were!  It  was  declared  in  verse  of  king  Wenzel  that 
he  was  presented  with  a  disease  by  his  beloved  Agnes  : 

1.  We  find  even  today  among  the  common  people  on  the  Rhine  the  greatest  fear  of 
"  der  Schweissfriesel ",  so  that  it  is  not  prudent  to  mention  the  name  at  the  bed- 
side. Since  the  miliary-  fever  of  the  present  day  is  usually  quite  harmless,  we  must 
conclude  that  among  the  masses  (as  is  so  often  the  case)  a  knowledge  of  the 
great  danger  of  the  earlier  epidemics  has  been  preserved  in  the  form  of  this 
dread.  Other  views  of  the  common  people  also  admit  of  an  "historical"  ex- 
planation only;  almost  all,  however,  depend  upon  the  unconscious  tradition,  so 
to  speak,  of  earlier,  and  especially  of  mediaeval  occurrences  and  medical 
doctrines.  Thus  the  statement,  often  heard  among  the  laity,  that  the  human 
stomach  is  precisely  similar  to  that  of  the  hog,  undoubtedly-  springs  from  the 
time  of  animal  anatomy. 


—  320  — 

"  Daz  er  davon  muest  sterben 

Wenn  er  faulen  pegann 

An  der  stat,  da  sich  dy  Man 

Vor  Scham  ungern  sehen  Ian."  1 
In  1472  the  disease,  in  witness  of  its  origin,  already  bore  the  name  "die  Franzo- 
sen  ",  a  title  which  it  has  retained  among  us  up  to  the  present  time.  In  charming 
and  golden  .Mayence  a  chorister  (again  a  cleric)  was,  even  at  that  time,  excused  from 
service  since  he  had  the  "mala  Franzosa".  Somewhat  later  (1488)  a  Spanish 
physician  named  Peter  Martyr  commiserated  very  heartil}"  a  professor  of  the  Greek 
language  "because  he  has  caught  the  peculiar  disease  of  our  (that)  period,  which 
in  Spain  they  call  Buba,  in  Italy  the  French  disease,  and  which  some  physicians  call 
elephantiasis,  others,  however,  differently  ".  After  the  disease  first  appeared  in  an 
apparently  epidemic  and  manifestly  contagious  and  virulent  form  in  the  last 
decennium  of  the  loth  century,  an  effort  was  made  to  fix  a  definite  period  for 
its  origin.  Hence  one  nation  shifted  the  paternity  of  it  to  another.  One  threw  it 
upon  the  Indians,  another  upon  the  Maranen,2  another  upon  the  Africans  etc.,  and  at 
one  time  the  year  1490,  at  another  the  year  1492,  then  1498,  1  194,  1495  and  1-1%  was 
pointed  out  as  the  year  of  its  origin.  Between  1494  and  1496  the  "  French  disease" 
or  "St.  Job's  Evil"  was  described  in  Italy  as  a  new  disease,  which  was  onl}-  rarely 
fatal,  and  on  post  mortem  examination  displayed  internal  ulcers  (visceral  syphilis). 
Men  acquired  it  from  impure  women  (Dr.  C.  Quist,  Virchow's  Archiv,  vol.  64).  The 
most  frequent  view,  however,  is  that  the  disease  first  assumed  an  epidemic  form  before 
Naples,  in  the  year  1495.  Thence  it  extended  over  the  south-west  of  Europe,  con- 
tinuing to  diminish  in  its  progress  until  about  1516,  when  another  period  of  increase 
and  decrease  began,  in  which  exostoses  and  warts  were  observed.  Again  a  third 
period  of  exacerbation  and  remission  continued  from  about  1526  until  about  1540,  in 
which  buboes  and  alopecia  were  noticed.  A  fourth  period  extended  from  the  latter 
year  until  1550,  in  which  syphilitic  gonorrhoea  —  male  and  female  genital  discharges 
were  already  known  —  made  its  appearance,  while  gummata  disappeared.  From  that 
time  on  the  disease  acquired  b}r  degrees  its  present  form.  The  first  writer  on 
syphilis  —  1494  or  1495  —  was  Conrad  Schellig,  a  professor  at  Heidelberg.  He  was 
followed  by  Sebastian  Brant  (died  1520),  the  author  of  the  "  Narrenschiff"3  The 
symptoms  with  which  the  disease  manifested  itself  were  as  follows:  general  malaise, 
with  weight  and  pain  in  the  head  and  a  strong  eruptive  fever,  first  noticed  anew  in  the 
present  century.  These  were  followed  by  sweating,  or  more  frequently  a  pustular  or 
vesicular  eruption  on  the  male  or  female  privates,  passing  quickly  into  ulceration. 
The  two  latter  events  might  also  occur  in  other  portions  of  the  bodjr  at  which  an  in- 
fectious contact  occurred,  and  were  not  excited  simplj-  by  sexual  intercourse,  for  the 
contagium  was  very  active.  After  the  continuance  of  these  more  local  symptoms 
from  a  few  days  to  weeks,  a  general  eruption  was  developed,  at  first  mostl}-  upon  the 
face  and   head,   then   over  the  whole  body.     This  at  all  points  quickly  passed  into 


1.  That  he  thereof  must  die, 
When  he  began  to  mortify 

In  the  place  where  everjr  man 

Is  loth  to  show  himself  for  shame.      (H.) 

2.  Clandestine  Jews  (always  the  Jews  !),  who  were  banished  from  Spain  in  1492.     See 

Haeser,  vol.  Ill,  p.  236.     (H.) 

3.  Ha?ser  says  the  earliest  work   on   syphilis  was  the  "  Yaticinium  in  epidemicam 

scabiem  "  of  Theodore  Ulsen,  dated  August  1,  1496.  This  was  followed  in  the 
same  }rear  by  the  works  of  Brant  and  Joseph  Griinpeck,  after  which  came  the 
"  Salubre  consilium  in  pustulas  malas  etc."  of  Schellig.     (H.) 


—  321   — 

terrible  ulcerations,  penetrating  the  muscles  and  even  the  bones.  Before,  during,  or 
after  the  eruption  and  the  ulcers  of  the  skin,  appeared  also  severe  pains  in  the  bones, 
especially  at  night,  followed  later  b}-  gummata,  nodi  or  tubera,  terminating  in  caries 
or  necrosis.  Besides  the  skin  and  bones  the  mucous  membrane  of  the  mouth  and 
throat  were  very  quickly  and  often  terribly  corroded,  so  that  death  not  infrequently 
resulted  therefrom.  Next  appeared  affections  of  the  eyes  to  close  the  disease.  The 
plague  was  often  quickly  fatal;  usually,  however,  it  occasioned  death  after  months 
and  years  of  horrible  suffering. 

The  disease  was  at  that  period  so  universally  diffused  throughout  Italy,  that  even 
the  "most  respectable"  persons  were  affected.  At  the  head  of  these  was  Charles 
VIII.,  king  of  France,  and  of  course  pope  Alexander  VI- — his  ordinary  physician  in 
venereal  matters  was  Caspar  Torella,  a  bishop!  The  pope,  at  all  events,  was  not 
infected  at  a  distance  by  a  venereal  miracle  ad  hoc,  nor  his  whole  posterity,  the 
notorious  Borgia  family.  The  disease  was  diffused  throughout  the  greater  part  of 
Europe  by  the  numerous  soldiers  returning  to  their  homes.  Thus  it  was  earl}-  natu- 
ralized in  Germany,  where  it  was  called  Bos-Blattern,  Lembt  der  Glieder.  As  early 
as  1494  it  prevailed  in  Poland  and  Silesia,  especially  again  among  the  clergy,  whose 
secret  sins  it  thus  brought  to  light.  Alsace  was  in  like  manner  at  once  attacked,  then 
Swabia  also,  and  as  early  as  1495  the  edict  of  the  emperor  Maximilian,  already  men- 
tioned, calls  the  new  "French  disease"  a  punishment  from  God.  It  reached  England 
and  the  Netherlands  in  1496,  Friesland  in  1498  and  at  a  later  period  Russia  also. 

After  its  appearance,  the  people,  influenced  by  astrological  superstition,  assigned 
as  the  cause  of  the  epidemic  and  contagious  venereal  disease  sometimes  the  conjunc- 
tion of  Saturn  and  Jupiter,  sometimes  that  of  Saturn  and  Mars;  then  two  eclipses  of 
the  moon,  one  of  which  took  place  in  the  sign  of  the  Bull,  the  other  in  that  of  the 
Scorpion.  The  bull  indicates  the  throat  and  the  Scorpion  the  sexual  organs,  and 
thus  were  designated  by  the  heavens  the  principal  places  in  which  the  disease  made 
its  appearance.  Among  the  conjunctions  the  most  probable  cause  seems  to  have 
been  that  of  fthe  disciples  of  i  Mars  with  (the  very  numerous  priestesses  of)  Venus.  1 
A  second  theory  ascribed  the  disease  to  local  causes  merely;  another  considered  it  a 
transformation  of  the  leprosy;  again  another  referred  it  to  an  importation  from 
Africa  and  America;  lastly  it  was  considered  a  disease  known  to  Antiquity  and  long 
existing,  but  raised  to  an  epidemic  under  especially  unfavorable  conditions,  and  then 
naturalized.  The  latter  opinion  is  most  probable,  for  in  the  last  deeennium  of  the 
15th  century,  and  especially  before  and  during  the  campaign  of  Charles  VII!.  I  1  195  , 
unusual  heat  prevailed,  alternating  with  inundations,  failure  of  crops  and  famine, 
and,  over  and  above  these,  was  collected  together  a  soldiery  of  the  very  worst  kind,  a 
mixture  of  all  people  and  of  many  races,  which,  in  conformity  with  the  horribly 
barbarous  customs  of  the  "  Landsknechte  ",  after  severe  hardships  and  the  worst 
privations,  in  a  period  of  temporary  abundance  rioted  and  rolled  in  the  deepest  mire 
of  beastly  lust.  It  may  be  remarked  also  that  the  then  "modern"  syphilis  at  first 
involved  nothing  injurious  to  one's  reputation,  but  was  regarded,  like  any  other 
disease,  as  a  misfortune.  This  idea  was  held  even  as  late  as  the  Kith  century  :  in 
fact,  as  Proksch,  following  Erasmus  of  Rotterdam,  relates,  a  man  who  had  not  had 
the  disease  at  least  once  was  regarded  as  boorish  and  no  gentleman!  Nothing 
certain  was  yet  known  of  its  specific  cause  and  occasion,  but  syphilis  wps  looked  upon 
as  a  new  (as  we  would  say  miasmatic-contagious)  disease,  whose  origin  was  referred 
to  its  descent  from  the  liver  into  the  genitals  etc. — in  accordance  with  the  contem- 
porary theories.     Perhaps  the  general  and  extreme  tolerance  of  the  Middle  Ages  in 

1.    The  linen  shirts,  which  at  that  period  began  to  supplant  woolen  garments,  were 
also  considered  to  promote  the  extension  of  the  disease. 
21 


322   

sexual  matters  particularly  may  have  had  something  to  do  with  this  charitable  con- 
clusion; lor  purity  of  morals,  especially  among  the  higher  classes,  was  during  this 
period  a  rare  phenomenon. 

6,    THE  MEDICAL  PROFESSION  DURING  THE  MIDDLE  AGES,  ESPECIALLY  IN  THEIR 

LATTER  HALF.    PHARMACIES  AND  OTHER  INSTITUTIONS 

FOR  THE  SERVICE  OF  THE  SICK. 

The  relations  of  the  medical  profession,  especially  in  the  last  half  of 
the  Middle  Ages,  its  culture  and  position  with  respect  to  private  individuals 
and  to  society,  differed  in  very  many  respects  from  those  existing  both 
earlier  and  later,  and  therefore  offer  especial  interest. 

Above  all  there  developed,  in  accordance  with  the  greater  number  of 
nations  now  entering  upon  cultivation  and  with  the  grades  of  general 
culture,  prosperity  etc.  to  which  they  had  attained,  more  distinct  character- 
istics, and  thus  a  greater  multiplicity  of  conditions,  than  had  appeared 
among  the  Ancients.  Then  the  clerical  element  at  this  period  was,  it  is 
true,  still  predominant  in  medicine  just  as  in  all  other  sciences  and  arts. 
e.  g.  architecture,  painting  etc.;  still  the  secular  element  again  manifested 
itself  in  a  higher  degree  than  was  the  case  during  the  first  half  of  the 
Middle  Ages.  Physicians  for  the  so-called  common-people  continued, 
indeed,  to  be  "for  the  most  part  monks,  who  troubled  themselves  little 
about  the  advance  of  medical  science  ;  physicians  out  of  self-interest,  who 
stained  the  god-like  art  with  superstition  "  — yet  not  they  alone,  for  lay 
practice  too  was  prone  to  the  latter.  The  Church  had  taken  possession  of 
medicine,  ostensibly  to  exercise  and  develop  it  only  for  the  glory  of  God 
and  celestial  profit,  but  in  fact  chiefly  for  earthly  lucre.  It  thereby 
occasioned  not  only  the  total  separation  of  surgery  and  medicine,  but  like- 
wise gave  rise  to  a  totally  distinct  medical  and  surgical  faculty,  with 
numerous  subdivisions  of  the  latter.  Moreover  the  separation  of  pharmacy 
from  the  duties  of  the  physician,  which  developed  rapidly  towards  the  end 
of  the  Middle  Ages  through  the  agency  of  the  apothecary-shops,  new  to 
the  West,  introduced  a  different  type  of  practice  from  that  which  prevailed 
when  physicians  also  regularly  devoted  themselves  to  the  preparation  of 
medicines.  It  was.  however,  the  guild-system  (borrowed  from  the  Romans) 
which  characterized  most  forcibly  the  practice  of  the  last  half  of  the 
Middle  Ages  —  a  system  which  manifested  its  peculiar  influence  as  well  in 
the  privileges  of  the  universities,  their  grades  and  honors  and  their  guild- 
like curriculum,  as  in  the  concession  of  the  exercise  of  higher  i.  e.  internal 
practice  awakened  thereby.  This  influence  was  displayed  too  in  the 
genuine  guilds  of  the  surgical  faculty,  so  lightly  esteemed  by  the  physicians 
and  scorned  in  civil  and  political  life  as  followers  of  a  dishonorable  "trade" 
and  therefore  themselves  "  dishonorable  ".  Besides  the  latter,  all  sorts  of 
empirics  and  empiric  families  carried  on  business  as  "Irregulars",  and 
thus  a  luxuriant  and  grotesque  charlatanry  grew  up,  which  disgraced 
practice  from  this  time  forward  down  to  the  last  century  —  and  in  some 
lands  to  the  present  day. 


—  323  — 

Medical  instruction,  as  we  have  seen,  was  imparted  in  the  early  por- 
tion of  the  Middle  Ages  by  individual  physicians,  as  in  Antiquity,  and 
especiall}'  by  clerical  physicians,  as  among  the  Benedictines.  At  a  later 
period  instruction  was  given  in  the  monastic  schools,  where  medicine  was 
taught  under  the  title  "physica  ",  a  designation  which  proved  permanent. 
Besides  this,  private  study  of  the  writings  of  actual  and  (for  the  time) 
capable  physicians  contributed  to  the  knowledge  then  required.1 

After  the  year  1000,  however,  secular  or  semisecular  faculties  —  there 
were  also  married  clerics  —  stepped  freely  into  the  foreground,  as  at 
Salerno  and  Montpellier.  These  faculties  imparted  theoretic  instruction 
exclusively,  in  accordance  with  a  regular  curriculum,  while  practice  was 
learned  from  a  practising  physician.  Besides  physicians  proper  (after  the 
idea  of  that  day,  a  conception  preserved  down  to  the  present  century), 
these  institutions  of  learning  formed  also  surgeons  of  the  higher  and  lower 
classes. 

Although  these  colleges  were  not  originally  recognized  as  state  insti- 
tutions of  learning,  yet  a  complete  course  of  study  there  gave  to  the  physician 
increased  reputation  from  the  guarantee  thereb}"  afforded  of  the  attainment 
of  medical  capacity  and  maturity.  This  was  accomplished  in  a  still  greater 
degree  when  Salerno  was  raised  by  Roger  and  Frederick  II.  to  the  position 
of  a  legal  place  of  examination,  as  well  as  an  educational  institution  author- 
ized by  the  state. 

The  universities  proper,  which,  however,  devoted  themselves  to  teach- 
ing simply,  not  to  independent  investigation,  and  whose  rigid  curriculum 
did  not  differ  greatly  from  that  of  Salerno,  soon  stepped  into  the  place  of 
these  schools.  Down  to  the  close  of  the  Middle  Ages,  or  more  accurately 
down  to  the  Reformation  (which  introduced  Protestant  universities),  their 
privileges  were  granted  almost  exclusively  by  the  pope.  Subsequently 
these  were  granted  chiefly  by  the  sovereign  or  the  state.  The  universities 
gave  to  the  cities  in  which  they  were  located  much  of  their  importance. 
Not  infrequently,  in  consequence  of  dissensions  with  the  city  or  state 
authorities,  they  migrated  in  toto,  professors,  students  and  paraphernalia, 
to  some  other  place,  even  to  distant  cities,  an  exodus  of  which  our  modern 

1.  Daremberg  gives  us  an  inventory  of  the  books  left  by  a  canon  of  Paris  in  the 
beginning  of  the  15th  century  before  the  invention  of  printing.  Thej-  are  not  so 
very  few:  I  have  seen  far  smaller  libraries  among  physicians  of  the  present  da}r: 
indeed,  with  a  country  practitioner  I  once  found  upon  a  small  wooden  table, 
besides  some  knick-knacks,  five  medical  works.  The  canon's  library  contained  a 
part  of  Avicenna,  Isaac,  the  Lilium  medicinae,  Rosa  Anglica,  Passionarius, 
Hippocrates'  Aphorisms,  John  of  St.  Amand.  Rhazes  ad  Almansorem,  Gariopon- 
tus,  Mesne,  Averrhoes,  one  book  of  Galen,  Serapion,  Lanfranc,  William  of  Salicet, 
the  Tacuin  and  a  few  others.  The  library  of  an  apothecary  of  the  year  1402 
was  not  much  smaller.  In  the  15th  century  one  of  the  largest  public  libraries  in 
Spain  contained  only  120  works.  Of  course  the  "pagan"  writers  — as  through- 
out the  whole  Middle  Ages  —  if  not  under  the  ban,  were  at  least  stigmatized  as 
heretical. 


—  324  — 

" Studentenausziige "  form  only  a  caricature.1  Occasionally  new  univer- 
sities or  perhaps  branches  of  an  old  one  were  thus  established.  In  this  way 
the  university  of  Leipsic  is  due  to  an  emigration  of  the  students  of  Prague, 
and  Padua  owes  its  university  to  an  exodus  of  the  students  of  Bologna, 
while  branches  of  the  latter  university  were  also  established  in  Siena  and 
Florence.  Sometimes,  in  consequence  of  war  or  disease,  an  entire  university 
removed  temporarily  to  another  place,  subsequently  returning  to  its  original 
seat.  Thus  the  universitjT  of  Heidelberg  in  1491  removed  to  Speyer  in 
consequence  of  the  plague;  in  1563  it  removed  again  to  Oppenheim,  in 
1564  to  Eppingen  and  in  1694  to  Frankfort  and  Weinheim.  The  univers- 
ities were  originally  free  and  voluntary  associations  of  teachers  and 
students.  The  earliest  German  universities  were  the  same,  and  most  of 
them  were  organized  after  the  model  of  the  university  of  Paris.  Such  was 
e.  g.  the  university  of  Prague,  to  which,  indeed,  the  first  eight  teachers 
(among  them  one  medical  teacher)  were  called  from  the  school  of  Paris. 
In  this  way  Paris  attained  for  the  first  time  through  its  university  great 
influence  upon  Germany.  Besides  the  university  of  Prague,  the  following 
institutions  were  also  modeled  after  Paris  :  The  universities  of  Vienna, 
Heidelberg,  Cologne  (indirectly  from  Prague),  Leipsic,  Rostock,  Greifs- 
walde,  Erfurt  (largely),  Louvain  (through  Cologne),  Treves,  Freiburg 
(from  Vienna).  Ingolstadt.  "Some  of  their  Statutes  begin  with  a  eulogy 
of  their  alma  matter  of  Paris.  From  Paris  too  the  whole  system  of 
Scholasticism,  the  quarrels  between  Nominalism  and  Realism  and  the 
predominance  of  the  theological  faculty  were  adopted.  Bologna,  the 
second  pattern  university,  was  taken  as  a  model  b}*  Basle  and  Tubingen 
alone."  (Ranke.)  —  At  the  outset  the  teachers  were  not  divided  into 
faculties,  but  the  same  professors  lectured  on  medicine,  jurisprudence  and 
theology.  It  was  only  at  a  later  period  that  these  professors  were  divided 
into  faculties,  and,  as  a  rule,  the  medical  faculty  followed  long  after  the 
establishment  of  the  faculties  of  theology,  law  and  philosophy.  Paris 
received  her  medical  faculty  in  1215,  and  Upsala  not  until  1595.  All  of 
these  organized  themselves  into  guilds,  held  guild-banquets  and  maintained 
guild-quarrels.  There  were  always  two  (one  of  the  theoretical,  and  one  of 
the  practical  branches),  more  rarely  three  or  four,  of  these  teachers,  of  whom 
the  professors  of  medicine  lectured  also  on  botany  etc.  So  also  the  teacher 
of  anatomy  (included  in  the  curriculum  from  the  time  of  Mondino,  and 
practically  demonstrated  by  dissections,  especially  in  Italy  and  France) 
often  made  sport  of  the  teacher  of  botany,  the  teacher  of  botany  of  the 
professor  of  physics  etc.,  just  as  the  medical  professors  do  to-day  in  very 
many  universities,  though  we  profess  to  have  long  outstripped  the  Middle 
Ages.  One  of  the  chief  means  of  instruction  were  the  disputations  between 
the  students,  in  which  they  were  expected  to  prove  their  knowledge  and  dex- 

1..  Such  an  exodus  from  Oxford  occurred  in  1209.  Three  thousand  professors  and 
students  withdrew  to  Cambridge,  Maidstone  and  Reading  and  continued  absent 
for  five  ypars.     In  modem  parlance  Oxford  was  "boycotted".     (H.) 


—  325  — 

ferity  in  repartee.  Besides  these  ordinary  scholastic  and  Arabian  polemics 
there  was  arranged  each  year  a  general  "  grand  debate  "  (disputationes  de 
quolibet).  This,  however,  finally  degenerated,  so  that  at  last  provision  was 
made  for  the  jests  of  the  listeners  and  the  participants  by  a  "  dispntatio  de 
qurestionibus  miris  principalibus  ",  marked  by  wit  and  obscenity.  This  cus- 
tom was  prohibited  at  Heidelberg  for  the  first  time  in  1518.  The  students 
united  themselves,  for  the  most  part  in  accordance  with  their  nationality, 
into  so-called  "Nations",1  which,  however,  did  not  contain  exclusively 
representatives  of  the  nation  from  which  the}-  derived  their  names,  though 
these,  of  course,  formed  the  chief  contingent.  These  "  Nations  "  had  their 
special  assembly-rooms,  their  own  property,  and  when  necessary  supported 
their  own  members  etc.  There  were  many  establishments,  so-called 
"bursa?",'2  where  students  received  board  and  lodging,  or  the  former  only, 
if  necessary  free  of  expense.  The  preliminary  education  was  also  obtained 
at  the  universities  (as  in  English  universities  of  the  present  day),  and 
within  the  philosophical  faculty.  Of  course  holidays  and  vulgarity  were 
not  lacking.  In  Italy  the  carnival  was  an  especial  occasion  of  festivit}-, 
and  notorious  for  its  rudeness.  The  number  of  students  was  relatively  very 
large.  While  the  most  popular  German  universities,  Vienna  and  Berlin, 
had,  the  former  (in  1883-8-4)  5,221  students,  and  the  latter  (in  the  summer 
of  1884)  4,15-4,  Oxford  in  1340  is  said  to  have  had  no  less  than  14,000, 
Paris,  about  the  close  of  the  13th  century,  12,000,  and  Bologna,  though 
attended  chief! 3'  by  students  of  law  only,  is  said  to  have  had  10,000.  Of 
course  there  ma\-  have  been  among  these  students  numerous  learned 
vagabonds,  of  whom  there  was  at  a  later  period  such  a  host  under  the 
title  of  "  travelling  scholars "  (fahrende  Sehiiler).  but  yet  these  numbers 
are  astonishing,  even  if  we  admit  that  some  exaggeration  and  incorrect 
figuring  (university-statistics,  which  here  and  there  also  to-day  smack 
somewhat  of  watering-place  statistics!)  ma}-  have  crept  in.  Complete 
libert}-  of  removal  from  one  university  to  another  (Freiziigigkeit)  was  per- 
mitted to  the  students,  and  the  grades  of  domestic  and  foreign  universities 
were  everywhere  regarded  as  equivalent. 

The  teachers  for  a  long  period  received  no  salary  —  except  at  Salerno, 
where  they  were  paid  from  the  outset.  They  depended  upon  the  receipts 
from  benefices,  their  lectures,  their  examination  and  graduating  fees  and 

1.  In  the  University  of  Paris  there  were  four  "  Nations":   that  of  France,  which  in- 

cluded the  bishoprics  or  metropolitan  provinces  of  Paris,  Sens,  Rheims  and 
Bourses,  with  all  southern  Europe  (Spain,  Italy  etc.):  that  of  England,  including 
the  British  Isles  and  all  northern  and  eastern  Europe;  the  Normandy  nation, 
confined  to  the  province  of  the  same  name;  and  the  Picardy  nation,  representing 
the  dioceses  of  Beauvais,  Noyon,  Amiens.  Laon  and  Terouanne  or  des  Morins. 

2.  From  these  arose  the  modern  term  '' Butschen  ".     The  "  landsmannscliaftlichen 

Corps"  of  the  present  day,  e.  g.  "die  Rhenanen",  "die  Westphalen"  etc.  are 
descendants  or  relics  of  these  "  Nations".  The  "  Colleges"  and  "  Halls"  of  the 
English  universities  are  the  sole  remains  of  the  mediaeval  "  bursae  "  and  pre- 
paratory schools. 


—  326  — 

their  practice  alone.  Many  of  them,  in  consequence  of  the  small  profit  of 
their  teaching,1  if  the}'  were  not  already  bishops  or  arch-bishops  also,  occu- 
pied the  office  of  ordinary  physicians  to  one  of  the  greater  or  lesser  poten- 
tates (at  that  time  as  numerous  as  vermin,  particularly  in  Italy ),  or  they  filled 
the  position  of  city  physician.  In  somewhat  later  times  the  professorial 
salaries,  however,  were  sometimes  tolerabl}'  high,  as  at  Pavia  in  1399,  171 
lire2  per  month,  though  others,  on  the  contrary,  received  only  22,  or  even 
4  lire.  One  of  the  professors  of  medicine  at  Tubingen  in  1491  received  an 
annual  salary  of  only  171  marks  (about  $43),  and  the  other  only  about  140 
marks  |  $35).  The  highest  salary  was  paid  to  the  professor  of  jurisprudence, 
who  received  21).")  marks  (about  #51).  These  professors  too,  in  a  memorial 
to  the  Reichstag  at  Rottenburg,  called  themselves  "  poor  fellows".  In  Mont- 
pellier  until  the  1 5th  century  the  professors  were  dependent  upon  their  honor- 
aria. Of  the  two  professors  of  the  medical  faculty,  one  was  its  dean.  Assis- 
tants to  the  chair  of  the  professor  were  found  in  the  baccalaurei,  licentiati 
and  doctores.  Bologna  in  1451  had  no  less  than  170  professors.  Papal  bulls 
determined  the  text-books.  Thus  e.  g.  such  a  bull  in  the  13th  century  desig- 
nated the  "Aphorisms"  of  Hippocrates,  his  "I)e  ratione  victus  in  acutis", 
the  treatise  of  Theophilus  "  De  corporis  humani  fabrica  ",  Honain  and 
iEgidius  of  Corbeil.  These  designations  continued  in  force  far  into  the 
following  a«;es.3 


1.  Complete  freedom  in  the  choice  of  teachers  prevailed,  so  that  the  students  were 

not  confined  to  any  one  university  and  thus  had  their  teachers  materially  in  their 
power,  particularly  as  the  latter  were  formally  chosen  or  accepted  by  the 
students. 

2.  A  lira  at  present  is  worth  about  10  cents.     (H.) 

3.  What  were  at  least  the  popular  medical  authorities  in  England  during  the  14th 

century  may  be  jrathered  from  Chaucer's  "  Doctour  of  Phisik  ': 
"Wei  knew  he  the  olde  Esculapius 
And  Deyscorides,  and  eek  Risus  (perhaps  Ruffus) 
Olde  Ypocras,  Haly  and  Galyen, 
Serapion,  Razis  and  Avycen, 
Averrois,  Damascien  and  Constantyn, 
Bernard  and  Gatesden  and  Gilbertyn." 
Eseser  furnishes  us  with  the  following  programme  of  the  curriculum  at  the  univer- 
sity of  Leipsic  about  the  same  period  : 


Hour. 

Fikst  Year. 

Second  Year. 

Third  Year. 

6-7  A.M. 

First  canon  of  Avicenna 
with    the   explanations  of 
Jacob  of  Forli. 

The  "Ars  parva  "  of  Ga- 
len, with  the  exposition  of 
Torrigiano. 

The  "  Aphorisms  "  of 
Hippocrates,  with  the  com- 
mentaries of  Galen  and 
Jacobus. 

1  P.  M. 

Book    IX   of    Rhazfs  ad 

Almansorem,  with  the  ex- 
position of  Arculanus. 

First  fen.  fourth  book  of 
the  canon  of  Avicenna. 

Fourth  fen,  1st  book  of 
the  canon  of  Avicenna, 
with  the  commentary  of 
Dinus  de  Garbo  or  Hugo. 

3  P.  M. 

Thi'  "  Doctores"  read  some  work  aloud,  in  this  "  semester"  the  "  Prognostieon " 
of  Hippocrates. 

The  programme  adds:      "Anatomia  sen  corporis  insectio  singulis  annis,  corpore 


—  327  — 

The  legal  age  for  entering  upon  the  office  of  teacher  —  as  well  as  into 
actual  practice  —  was  the  21st  year,  and,  besides  other  qualifications,  in 
those  prejudiced  times  legitimacy  of  birth  was  also  required.  This  was  a 
question  (often  rather  critical  in  those  days),  the  answer  of  which  belonged 
properly  rather  to  the  father  or  mother  of  the  party  concerned  than  to  the 
•student  himself.  Permission  to  teach  was  at  first  free  to  all;  then  it 
was  granted  or  sold  by  the  chief  magistrates,  the  Faculty  or  University. 
It  was  not  until  later,  when  great  abuses  became  practised  in  connection 
with  this  power,  that  the  privilege  was  associated  with  a  definite  examina- 
tion or  a  fixed  term  of  study!  Thus  any  person  after  three  years1  study  at 
Paris  could  impart  instruction  in  the  elementary  branches,  though  he  could 
not  practice,  and  then  bore  the  title  of  Baccalaureus  (Bachalarius).  After 
three  years  more  he  became  a  "Magister",  particularly  a  "  Magister  in 
I'hysica",  when  he  could  lecture  in  all  departments  of  medicine  and  for 
the  first  time  could  practice.  The  number  of  these  teaching  •■  Magistri  " 
was  often  very  great,  so  that  e.  g.  at  [ngolstadl  alone  in  14!»2  thirty  such 
persons  lectured  on  Aristotle.  These  ".Magistri"  and  "Baccalaurei  "  took 
the  place  of  our  "  Privatdocenten  ".  The  university  professors,  in  contra- 
distinction to  the  surgeons  and  the  teachers  of  Salerno,  during  the  Middle 
Ages  were  clerics,  and  were  also  condemned  to  celibacy — hence  the  long 
robe  —  unless  a  special  dispensation  to  the  contrary  was  obtained.  In 
France  they  did  not  receive  permission  to  marry  until  in  1452.  After  this 
time  they  no  longer  scorned  surgery  so  much  as  before.  They  were  classed 
among  the  teachers  of  the  liberal  arts,  and  were  accordingly  distinguished 
as  "Artistse  ",  a  title  which  still  lingers  among  the  teachers  of  fencing, 
dancing  and  equestrianism  in  our  universities.  There  were  also  female 
teachers  of  medicine  originally  at  Salerno,  who,  by  the  way,  occupied  them- 
selves with  a  curious  treatment  of  ulcers,  tor  which,  in  consequence  of  the 
softness  of  their  hands,  they  were  in  especial  demand.  "Academic  freedom  " 
dates  from  the  year  1057  or  1055,  when  Frederick  I.  Barbarossa  took  the 
professors  under  his  protection,  permitted  them  to  sojourn  at  any  univer- 
sity and  liberated  the  students  from  the  jurisdiction  of  everyone  save  their 
own  professors  and  the  bishop. 

Besides  the  already  named  grades  of  physicians  proper — -the  Baccal- 
aureus and  the  Magister  in  Physica,  which  latter  corresponded  pretty  nearly 
to  our  modern  ••Doctor"  —  there  was  also  at  that  period  the  grade  of 
Doctor,  which  made  its  appearance  in  the  12th  century,  but  came  into 
vogue  in  its  present  sense  at  a  much  later  period.  In  earlier  times,  on  the 
contrary,   it  belonged,  and  was   assigned   only  to  teachers    proper.     The 

exanimi  oblato,  habebitur,  sine  qua  nulla  perfecta  niorborum  et  humana-  consti- 
tutiouis  co^nitio. —  Disputationis  exercitium  uon  deerit." 

It  will  be  seen  that  the  lectures  began  early  i(i  A.  M.  in  summer  and  7  A.  M.  in 
winter),  and  that  there  were  only  two,  or  at  most  three,  a  day.  Jn  early  times 
the  students  themselves  selected  the  authors  for  study  and  explanation,  but  at  a 
later  period  this  question  was  determined  for  them  by  the  authorities.     (H.) 


—  328  — 

graduation  fees  almost  everywhere  were  high,  and  were  paid  partly  in  money, 
partly  in  articles  of  industry  etc.,  and  this  latter  system  has  been  preserved 
down  to  the  present  da}-  under  the  form  of  obligatory  presents  to  the 
examining  professors.  These  "  presents  "  consisted  of  gloves,  sundry  yards 
of  cloth,  hats,  caps  etc.,  and  to  these  must  be  added  the  expenses  of  the 
doctors'  banquet.  Graduation  at  Salerno  cost  in  money  about  $60  ;  in 
Paris  it  is  said  to  have  cost  as  much  as  $1000,  a  colossal  sum  when  we 
consider  the  relative  value  of  money  in  those  days.  Originally  the  pope 
gave  to  the  faculties  the  permission  to  administer  degrees.  The  Paris 
faculty  graduated  a  doctor  of  theology  for  the  first  time  in  1231.  After 
the  14th  century,  however,  the  emperor  also  authorized  the  faculties  to 
graduate  students.  The  Doctorate  was  bestowed  upon  "  learned  ",  i.  e.  inter- 
nal physicians  alone,  and  these  were  required  to  take  an  oath  to  maintain 
the  doctrines  and  methods  of  treatment  etc.  which  had  been  delivered  to 
them  (just  as  in  Egypt).  Even  surgeons  were  educated  in  the  schools  of 
the  earlier  periods,  e.  g.  at  Salerno,  and  the  custom  of  the  latter  school  was 
transmitted  to  all  the  Italian  universities.  In  Vienna  too,  as  early  as  the 
15th  century,  separate  lectures  upon  surgery  were  delivered,  long  before 
this  was  done  in  any  other  German  university.  The  curriculum  appointed 
for  surgeons  included  fewer  branches  and  a  shorter  term  of  stud}'  than  that 
of  physicians  proper,  and  was  also  characterized  by  the  fact  that,  according 
as  one  wished  to  become  a  higher  or  an  inferior  surgeon,  the  course  of  study 
was  differently  framed,  even  in  respect  to  the  language  employed  in  instruc- 
tion and  examination.  This  for  higher  surgeons  alone  was  the  Latin,  while 
for  the  lower  it  was  their  native  tongue.  The  superior  surgeon  only  could 
be  a  ;:  Magister  in  Chirurgia  ".  In  the  universities  outside  of  Italy  the 
surgeons  were  not  considered  members  of  the  faculty  (in  Paris  not  of  the 
Sorbonne).  but  as  subordinate  to  that  body,  and  such  was  the  case,  indeed, 
from  the  beginning  onward.  Accordingly,  as  early  as  the  13th  century, 
there  developed  at  Paris  a  rival  institution,  the  fraternity  of  superior 
surgeons,1  which  claimed  the  right  of  teaching  and  examination  in  surgery, 
was  nominally,  indeed,  subordinate  to  the  University,  but  was  in  fact  very 
little  under  the  control  of  the  latter.  This  independence  was  openly  mani- 
fested in  imparting  the  grade  of  "  Magister  in  Chirurgia",  which  corres- 
ponded to  that  of  "  Magister  in  Physica  "  and  entitled  the  recipient  to  a 
similar  dress  with  the  latter  ("  Chirurgiens  de  la  longue  robe  ").  Subordin- 
ate again  to  these  were  the  inferior  surgeons,  who  at  the  outset  were 
always  instructed  by  the  superior  (and  often  too  at  a  later  period  amid 
man}'  struggles),  until,  in  consequence  of  quarrels  relative  to  rank,  the 
Faculty,  from  envy  and  jealousy  against  the  higher  surgeons,  took  the 
lower  under  their  instruction  and  protection,  although  the  business  of  the 
latter  was  regarded  as  disreputable.  As  "  Chirurgiens  de  la  courte  robe'' 
they  were  also  permitted  to  wear  a  short  black  gown  trimmed  with  velvet. 
In  England  at  an  early  period  there  were  schools  and  universities  in 

1.   Or  Confrerie  de  Saint-Cnme.     i  H.  i 


—  320  — 

which  medical  instruction  was  imparted.  In  spite  of  the  existence  of  the 
latter,  however,  English  physicians  went,  as  a  rule,  to  Montpellier  and 
Paris  :  for  in  the  English  universities  of  that  period  (as  at  the  present  day) 
only  a  few  lectures  were  delivered  on  the  subject  of  medicine,  while  Mont- 
pellier and  Paris  enjojed  so  great  a  reputation,  that  the  number  of  students 
of  the  university  of  the  latter  city  e.  g.  in  the  13th  century  exceeded  even 
that  of  the  ordinary  inhabitants  of  the  city. 

Germany,  besides  a  few  physicians-in-ordinary,  had  for  a  long  period 
no  other  medical  faculty  than  the  bath-keepers  and  barbers.  Instruction 
in  their  respective  arts  was  imparted  by  the  skilled  brothers  of  the  trade, 
especially  after  these  were  organized  into  guilds.  The  regulation  prevailed 
that  no  bath-keeper  should  take  more  than  three  apprentices.  Sons  of 
Masters  of  their  art  were  compelled  to  undergo  instruction  for  two  years, 
children  of  other  persons  for  four  years.  Their  examination  was  often  made 
by  physicians,  or  at  least  in  the  presence  of  physicians  ;  frequently,  how- 
ever, by  tlie  guild  alone.  A  sample  of  work  ("  Meisterstiick  ",  masterpiece), 
consisting  originally  in  sharpening  a  knife,  later  in  preparing  certain  salves 
or  plasters,  was  required. 

Only  the  higher  German  Wundarzte  were  educated  abroad,  and  espe- 
cially in  Italian  and  French  schools.  So  great  were  the  sacrifices  necessary 
to  procure  an  education  in  these  schools,  that  such  surgeons  are  not  found 
in  Germany  until  towards  the  close  of  the  Middle  Ages,  in  the  frontier 
cities  Strassburg  and  Basel,  and  also  in  Vienna.  Even  then,  however,  they 
were  very  scarce,  though,  as  Pfolspeundt  tells  us,  some  surgeons  immigrated 
into  Germany  from  Italy  at  an  early  date.  Apothecaries  received  their  in- 
struction originally  partly  from  physicians,  partly  from  Masters  in  their 
department.  Thus  the  French  apothecaries  e.  g.  in  the  13th  century  took 
an  oath  : 

"  To  honor,  esteem  and  serve  not  only  the  doctors  of  medicine  who  instructed 
them  in  the  knowledge  of  the  prescriptions  of  pharmacy,  but  also  the  teachers  and 
master-apothecaries:  to  speak  no  evil  of  either,  and  to  do  everything  which  may  con- 
tribute to  the  honor,  reputation,  embellishment  and  majesty  of  medicine.  Also  in  no 
way  to  touch  the  forbidden  parts  of  women,  except  "in  the  extremest  necessity." 

This  latter  clause  seems  to  hint  at  some  very  curious  customs  on  the  part 
of  the  apothecaries  of  those  times,  which  are  explained  and  authenticated 
still  more  clearhT  by  the  advice  of  Saladin  of  Asculo  that  apothecaries 
should  marry  early,  "  because  in  this  way  their  youthful  vigor  would  be 
curbed  and  they  would  become  quiet,  gentle  and  decorous".  Apothecaries 
at  this  time  (and  long  after)  were  allowed  to  treat  internal  diseases.  In 
fact  there  were  apothecary-surgeons  etc..  as  in  England  at  the  present  day. 
In  France  after  133G  their  term  of  study  lasted  four  years.  At  the  termin- 
ation of  this  period  they  were  required  to  make  a  '•  masterpiece  ".  Their 
knowledge  was  expected  to  extend  to  the  reading  of  prescriptions,  the 
comprehension  of  the  Antidotarium  of  Nicholas,  and  the  skilful  manufac- 
ture of  confections. 


—  330   - 

Veterinary  instruction  was  probably  imparted  simply  b\*  the  "  Practi- 
tioners "  of  that  branch  ;  possibly  also  by  a  few  higher  physicians.  So  too 
the  midwives  instructed  each  other  in  their  art  or  want  of  art,  and  at  leasl 
in  the  eloquence  necessary  for  teaching  the  aforesaid  art  they  could  cer- 
tainly not  have  been  lacking. 

The  body  of  practitioners  —  both  practice  and  migration  were  every- 
where free  —  was,  as  we  have  already  partly  seen,  divided  in  manifold  ways. 
First  of  all  were  the  higher  and  lower  practitioners,1  the  latter  beginning 
with  the  surgeons,  while  the  former  included  only  the  physicians.  By  the 
latter  were  at  first  understood  only  the  numerous  clerical  physicians,  who 
of  course  treated  the  sick  with  charms,  exorcisms  etc.  These,  as  already 
mentioned,  practised  medical  treatment  in  this  period,  but  in  general, 
though  the}'  professed  "  to  interest  themselves  in  the  sick  through  compas- 
sion only,  they  yet  acquired  wealth  by  avarice  and  deceit ",  rather  than 
treated  the  sick  with  care,  so  that  even  the  Council  of  Vienna  (1312) 
ordered  :  "  In  future  the  laity  only  shall  superintend  hospitals,  in  order  that 
the  sick  may  be  better  cared  for."  Accordingly,  even  at  this  time,  there 
must  have  been  'hospital  physicians." 

The  higher  physicians,  who  at  the  beginning  of  the  15th  century  began 
to  belong  chiefly  to  the  laity,  were  authorized  to  practice  all  branches  of 
medicine  in  all  places,  and  were  called  Physici  ("  Puchasrzte  ",  in  contrast 
to  the  clerical  physicians  or  "  Seelenrerzte  "),  Magistri  in  Physica,  and  later 
Doctores  Medicinse.  Until  the  14th  century  most  of  them  were  educated 
in  Italian  or  French  universities,  whither  the  Germans  were  compelled  to  go 
from  the  lack  of  such  institutions  at  home,  and  the}'  always  practised 
medicine  alone.  Indeed  this  fact  became  so  much  a  distinction,  that  it 
alone  seemed  adapted  to  give  the  higher  medical  rank.  From  the  fellows 
of  the  Faculty  of  Paris  an  oath  was  required  that  they  would  not  join  the 
surgeons  —  a  regulation  in  which  malevolence  and  envy  undoubtedly  played 
their  part !  This  separation  was  marked  in  the  strongest  manner  in  France. 
and  was  followed  also  in  German}*,  where  the  occupation  of  surgery  made 
one  "  disreputable  ".  This  was  never  the  case  in  Italy,  since  there  many 
physicians,  and  even  teachers,  did  not  occupy  themselves  exclusively  with 
medicine,  but  also  practised  surgery,  in  which  case  they  had  the  required 
operations  performed  b}-  assistants.2  Clerical  physicians  belonged  to  the 
lower  as  well  as  the  higher  clergy  ;  but  those  who  sprung  from  the  lower 

1.  A  Silesian  document  of  1353  distinguishes  :   "  Kunstarezt,  wundarczt,  vrowen,  <ly 

do  wassir  beseen  und  aptheker."  Sebastian  Brant  makes  a  distinction  as  follows: 
a  physician  gives  sour  and  bitter  drinks,  that  the  patient  may  get  well;  a  barber 
dresses  and  cuts  wounds. 

2.  The  same  was  the  case  with  the  other  arts  (including  painting)  in  Italy.     While  in 

Germany  these  were  reckoned  among  the  guild-trades,  and  accordingly  among 
the  lower  occupations  in  which  indentures  were  required  and  employed,  in  Italy 
eminent  painters  were  highly  esteemed  and  entirely  out  of  the  control  of  the 
guilds.  Yet  D'rirer  said  that  at  home  he  was  merely  tolerated  by  the  higher 
classes,  while  in  Italy  the  artists  wen-  highly  respected  and  prosperous. 


—  331  — 

class  were  so  ignorant  that  even  the  Church  itself  was  forced  to  declare  the 
successes  of  certain  individuals  veritable  miracles,  and  to  canonize  the 
parties  concerned.  In  case  of  the  death  of  one  of  these  clerical  physicians 
—  indeed  with  other  physicians  too  —  some  writing  of  Galen,  Hippocrates 
etc.  was  usually  laid  in  the  coffin.  The  practice  of  medicine  was  frequently 
forbidden  to  the  monks  and  clergy  in  general  (e.g.  in  1131,  1162,  1212), 
but  without  doing  much  good.  The  decrees  of  the  councils  were  simply 
ignored,  even  as  regards  surgical  operations,  which  were  most  strongly  in- 
terdicted. (Ecclesia  abhorret  a  sanguine).  In  the  ranks  of  the  higher 
clergy,  however,  were  often  found  well  educated  physicians,  as  well  as  some 
clerical  adventurers.  In  the  former  class  we  may  mention  John  of  St.  Amand, 
Peter  of  Spain  (died  1277  ;  Thesaurus  pauperum),  Simon  de  Cordo  etc. 
Among  the  adventurers  from  the  ranks  of  the  higher  clergy  were  not  a  few 
physicians-in-ordinary,  e.  g.  William  of  Beaufet,  Canon  of  Paris  under  Philip 
IV.,  who  in  1304  exchanged  his  practice  for  the  episcopal  chair;  Magister 
Wilbelm  (1233),  the  first  physician  in  Moravia,  priest  and  physicus  in 
Znaim  etc.  To  this  office  were  chosen  the  more  capable,  or  more  frequently 
the  more  fortunate  physicians,  who  had  already  acquired  distinction.  As 
an  example  of  an  adventurer  we  may  mention  Peter  of  Aichspalt,  bishop 
of  Basel,  who  was  deputed  to  solicit  in  Rome  an  archbishopric  for  another 
person,  but  cured  pope  Clement  V.  of  an  accidental  sickness  and  received 
for  himself  in  return  the  Electorate  of  Mayence  —  the  most  brilliant  hono- 
rarium ever  given  to  a  physician.  Clerical  physicians  at  that  period  often 
enjoyed  church  benefices,  in  return  for  which  they  were  expected  to  instruct 
pupils  gratuitous!}-  and  to  treat  the  sick  without  expense  —  a  thing,  how- 
ever, which  seems  never  to  have  been  done.  Hence  the  emperor  Sigismund 
in  1406  enforced  these  regulations,  and  in  reference  to  these  benefices  says  : 
"  The  high  Magistri  in  Physica  treat  no  one  gratuitously,  and  hence  the}*  are 
going  to  hell."  Clerical  physicians,  moreover,  in  man}-  cities  imparted 
gratuitous  advice  on  appointed  days,  chiefly  in  the  vestibules  of  the 
churches,  whither  the  sick  were  brought,  or  whither,  if  able,  they  were 
compelled  to  come  —  a  custom,  as  it  seems,  recognizing  the  claims  of 
priestly  charity,  though  in  other  respects  the  priests  did  not  perform  their 
duties   very    zealously,   as   the   decree  of  the   Council  of  Vienna   proves. 

We  saw  something  similar  during  the  papal  rule  in  Rome,  where  all  the 
cripples  and  sick,  with  the  beggars  etc.  collected  at  the  church  doors, 
although  no  longer  to  obtain  medical  advice  ;  and  we  also  observe  at  the 
present  da}-  something  analogous  in  our  advertised  hours  of  consultation 
for  the  poor,  which,  however,  seem  designed  to  attract  principally  the  purses 
of  the  rich. 

The  secular  physicians,  who  for  a  long  period  were  scarce,  were  for 
the  most  part  physicians-in-ordinary  or  communal  physicians,  more  rarely 
private  physicians.  As  city  physicians  —  this  class  already  existed  in 
North  Germany  in  the  13th  century,  and  from  this  time  began  to  be  more 
numerous  in  Germany  generally  —  they  served  only  for  a  definite  period  at 


—  332  — 

one  place  and  then  exchanged  for  another  ;  or  they  were  chosen  for  life  for 
a  single  place.  The  origin  of  a  class  of  free  citizens  elevated  also  the 
medical  profession  and  increased  the  number  of  its  members.  Thus  Liibeck 
in  1316  had  a  ciruticus  (chirurgus)  with  an  annual  salary  of  16  marks, 
and  in  1477  both  a  physicus  and  a  surgeon  who  were  members  of  the 
council.  There  were  also  others  who  were  not  members  of  the  council. 
In  Vienna  too,  at  that  time  a  small  city,  there  were  as  early  as  1480  eleven 
physicians.  They  enjoyed  salaries,  which  were  made  up  usually  partly  of 
money  and  partly  of  natural  productions  —  in  the  early  Middle  Ages  the  latter 
alone  were  commonly  employed,  and  this  custom  is  still  preserved  with  regard 
to  certain  classes  of  officers  —  in  return  for  which  they  were  required  to  treat 
the  poor  gratis,  others  at  a  fixed  rate.  In  Munich,  each  of  the  two  city 
physicians  in  1325  received  a  salary  of  four  pounds,  about  $145,  a  sum  to 
be  esiimated  at  from  ten  to  fifty  times  its  present  value.1  Physicians-in- 
ordinary  to  the  lower  courts  were  often  better  situated,  on  the  whole,  than 
are  their  colleagues  of  the  present  day  at  the  greater.  A  Mecklenburg  phy- 
sician e.  g.  at  the  end  of  the  15th  century  received,  besides  quarterly  pay 
for  both  for  himself  and  two  assistants  (one  of  whom  performed  the  duties 
of  an  apothecary),  an  office  rent-free,  and  was  required  in  return  to  treat 
gratuitously  only  the  court  officials.  He  was  permitted  to  receive  other 
patients  also,  and  these  were  expected  to  pa}-  both  the  medical  fee  and  for 
any  medicine  furnished  by  the  doctor.  In  surgical  cases  the}'  were  also 
required  to  provide  a  barber  to  apply  the  necessary  dressings.  The  Jewish 
physicians  also,  who.  however,  thanks  to  the  hatred  of  the  Christians, 
decreased  in  numbers  more  and  more  towards  the  end  of  the  Middle  Ages, 
belonged  (e.  g.  in  Frankfort-on-the-Main)  to  this  class,  and  were  in  early 
times  appointed  physicians  to  the  emperors  or,  indeed,  to  the  popes.  At  a 
later  period,  however,  they  were  permitted,  as  a  rule,  to  treat  only  the 
members  of  their  own  creed,  for  this  was  the  decision  of  the  Council  of 
Vienna  in  1267,  and  it  was  even  forbidden  to  the  sick  to  emplo}-  Jewish 
physicians  under  penalty  of  the  ban.  It  was  the  duty  of  physicians  (in 
Italy  down  to  very  recent  times),  as  soon  as  the  patient  became  severely 
ill,  to  summon  him  to  partake  of  the  sacraments,  a  practice  which  the  Jews 
did  not  follow.  There  were,  however,  even  at  that  time  too,  baptized  Jews, 
e.  g.  a  certain  Hans  von  Costnitz  (15th  century)  in  Munich.  The  prohibi- 
tion of  the  employment  of  Jewish  physicians  does  not  seem,  however,  to 
have  been  very  strictly  observed,  for  it  was  relieved  at  the  Synod  of 
Bamberg  in  1491,  and  again  at  Passau  in  1497.  On  the  latter  occasion, 
old  women  etc.  were  also  forbidden  to  practise  medicine.  Man}-  "  famous" 
physicians  were  summoned  only  for  the  duration  of  a  particular  case,  and 

1  When  we  compare  this  salary  with  e.  g.  that  of  the  assistant  physician  of  the 
"  Biirgerhospital "  at  Worms  in  1S78  ($125  and  hoard,  but  no  private  practice), 
it  can  be  regarded  as  nothing  less  than  evidence  of  the  high  estimation  of  phy- 
sicians in  mediaeval  times.  In  Hesse,  until  a  short  time  ago,  the  salary  of  the 
physici  amounted  to  about  $250. 


—  333  _ 

their  pay  was  colossal  e.  g.  that  of  Thaddaeus  of  Florence,  who  received 
from  pope  Honorius  IV.  100  gold  pieces  daily,  and,  in  addition  thereto, 
10,000  pieces  after  the  completion  of  the  cure.  The  chief  part  of  the 
practice  of  this  period  was.  however,  generally  of  the  worst  kind.  Uroscopy, 
mysterious  feeling  of  the  pulse,  mystery  in  general,  alchemy,  sympathy 
cures,  superstition  and  astrology  (taught  even  in  the  universities)  were 
every  da}-  matters.  Disgusting  and  curious  remedies  and  compounds  were 
also  customary.  Such  were  snakes,  toads  etc.,  dung  and  per  contra 
precious  stones,  the  Mithridaticum,  theriaca.  universal  remedies,  incanta- 
tions, Arabian  syrups,  juices,  pills  etc.  Hanging  the  patient  up  by  the 
feet,  or  gouging  out  one  of  his  eyes,  so  that  the  poison  might  run  out,  was 
regarded  as  a  cure  for  poisoning.  Such  treatment  is  even  said  to  have 
been  the  reason  why  the  emperor  Albrecht  was  one-eyed.1  To  lie  down 
before  the  coffin  of  a  saint,  still  more  to  creep  under  it,  passed  for  an 
excellent  remedy.  Even  so  eminent  a  naturalist  as  Conrad  von  Megenberg 
in  the  year  1342  went  from  Vienna  to  Regensburg,  to  the  grave  of  St. 
Erhard.  for  the  sole  purpose  of  "  creeping  under  his  grave,  while  a  hymn  of 
his  own  composition  was  sung" — and  was  thus  cured  too  of  his  hemi- 
plegia. Even  the  constant  current,  which  to-day  plays  the  same  role  in 
medical  faith  as  the  grave  of  St.  Erhard.  could  do  no  more  !  Medicines 
were  compounded  in  accordance  with  idle  speculations,  or  after  mathe- 
matical formulae,  as  we  have  seen  in  Alcuindus.  The  time  for  taking  these 
mixtures  was  determined  by  the  position  of  the  sun,  moon  and  stars  ; 
indeed  the  very  dalliance  of  the  marriage  bed  was  medically  prescribed  (as 
among  the  ancient  Egyptians  and  Arabians)  with  a  view  to  secure  success. 
Very  commonly,  prudential  considerations  with  respect  to  the  purse,  i.  e. 
the  lesser  or  greater  wealth  of  the  patient,  guided  the  practitioner  in  his 
prescriptions.  Even  open  swindling  seems  to  have  been  permitted,  as  we 
have  seen  in  Gaddesden  and  others.  Moreover  old  wives,  like  those  of  the 
present  day.  shepherds,  jugglers,  flayers  and  especially  executioners,  with 
all  similar  gentry,  dabbled  in  medical  practice.  Of  course  there  were  also 
honest  and  judicious  physicians  (measured  by  the  standard  of  the  age),  who 
may  somewhat  illumine  the  picture  of  the  practice  of  that  day.  The  murder- 
ous and  frequent  epidemics  of  the  Middle  Ages,  however,  permit  the  real]}- 
great  fidelity  to  duty  of  the  physicians  of  the  period,  both  generally  and  in 
special  cases,  to  appear  in  the  brightest  light.  Very  many  died  in  the 
practice  of  their  calling.  Thus  e.  g.  at  Montpeliier,  Venice,  Florence  etc.,  at 
the  time  of  the  great  plague,  almost  all,  or  at  least  the  majority  of  those  who 
sought  to  protect  themselves  by  wearing  masks  filled  with  odorous  materi- 

1.  Putting  out  the  eyes  was  disgracefully  common  in  the  Middle  Ages,  especiall}r  as  a 
method  of  punishment.  The  Byzantine  (excellentissimus,  God  save  the  mark!) 
emperor  Basil  II.  on  one  occasion  put  out  the  eyes  of  15,000  Bulgarians,  leaving 
one  eye  to  one  of  every  thousand,  in  order  that  he  might  lead  his  more  un- 
fortunate fellow-sufferers  back  to  their  czar,  who,  though  certaiuly  not  a  soft- 
hearted prince,  at  sight  of  such  an  outrage,  swooned  away  and  died  in  two  days. 


—  334  — 

als  (and  no  one  will  venture  to  blame  them  for  it)  —  almost  all,  I   say 
died  ! 

The  mode  of  visiting  and  of  payment  customary  among  the  better 
physicians  of  the  period,  as  well  as  the  fees,  ma}-  be  best  seen  in  the  decrees 
of  Frederick  II.  quoted  above.  In  Vienna,  in  the  15th  century,  a  single 
visit  cost  one  gold  gulden  (about  $2.50)  ;  to-day,  on  the  average,  48  cents, 
although  the  value  of  money  at  that  time  was  much  greater  than  at  present. 
This  appears  almost  incredible  !  That,  however,  individual  city-physicians 
received  large  sums  in  gross,  and  especially  honoraria  in  kind  (e.  g.  a  wagon- 
load  of  hay  and  the  like),  we  have  already  seen.  Likewise  that  the  honor- 
arium by  previous  arrangement  might  often  be  fixed  very  high,  especially 
when  famous  physicians,  in  a  special  case,  travelled  to  a  remote  place  and 
were  compelled  to  tarry  there  for  some  time.  Vroscopy,  which  has  been 
held  in  great  esteem  b}*  the  common  people  down  to  the  present  time  (and 
is  accordingly  still  practised  by  '-speculative"  doctors),  cost  at  Frankfort 
in  1421,  12  pfennige  (at  the  present  valuation  of  money  a  little  more  than 
24  cents),  an  average  price  which  it  maintained  long  after  the  Middle  Ages. 

Many  physicians  proper  also  devoted  their  attention  both  theoretically 
and  practically  to  surgeiy,  especially  in  Italy,  as  we  have  already  mentioned. 
In  Italy,  the  higher  surgeons  proper  (Magistri  in  Chirurgia,  Chirurgi  Physici) 
stood  next  to  the  physicians  in  education  and  rank,  as  is  manifest  from  the 
curriculum  of  Salerno.  To  practice  medicine  was  strictl}-  forbidden  them, 
though  this  prohibition,  as  may  be  easily  understood,  was  often  disregarded. 
The}'  were  the  special  operators  in  difficult  cases,  and  were  not  rarely  also 
very  capable  theorists  and  authors.  Besides  the  magistri  in  chirurgia  there 
were  also  chirurgi  phlebotomatores.  In  France,  which,  at  the  earliest,  pos- 
sessed a  class  or  guild  of  higher  surgeons  from  the  middle  of  the  13th 
century,  these  higher  surgeons  came  from  the  college  of  St.  Come  (founded 
about  12G0  by  Pitard).  They  belonged  to  the  laity,  for  the  Church  had 
forbidden  surgery  since  about  the  12th  century,  and  with  especial  strictness 
in  the  13th,  and  from  this  period  we  may  date  the  origin  of  lay  surgeons  in 
that  country.  At  least  after  this  time  the}'  came  more  and  more  into  the 
foreground.  They  seem  to  have  been  a  class  copied  from  the  Italian 
physicians,  and  were  either  permanently  settled  (at  least  the  more  celebrated 
of  them  certainly),  or  travelled  about.  In  Germany  this  class  appeared 
only  very  sparingly  and  late.  To  it  belonged  the  Wiirzburg  practitioner 
(1312-1321)  Magister  Sifridus.  cyrurgicus.  surnamed  "  Pfaffenarzt ";  the 
surgeon  Meister  Heinrich,  a  citizen  of  Eegensburg  ;  at  a  later  period 
Pfolspeundt  and  Brunschwig.  Better  surgeons  appear  to  have  developed 
here  only  gradually,  after  the  complete  establishment  of  a  class  of  higher 
surgeons  in  France,  and  probably  also  in  Italy.  They  came  from  the  class 
of  barbers  and  bath-keepers,  and  were  not  distinguished  from  the  latter  by 
the  place  and  manner  of  their  education  (that  is  they  had  received  no  higher 
education),  but  rather  by  the  extent  of  their  technical  knowledge,  acquired 
by  travelling  and  private  study.     The  "  herniotomists  "  and  "  lithotomists  " 


—  66d  — 

were  "  specialists  ''  among  this  class.  The}'  travelled  about  freely,  and  were 
particularly  dangerous  people  to  the  testicles,  as,  even  in  cases  of  reducible 
hernia,  they  laid  hands  not  only  on  the  radix  of  the  hernia,  but  on  the  radix 
of  humanity  itself,  a  method  which  was  almost  the  rule  too  until  the  18th 
century.  Surgeons-in-ordinary  also  existed.  We  have  already  seen  that 
there  were,  especially  in  Itaby,  single  families  of  surgeons,  in  which  certain 
operative  procedures,  like  herniotomy,  rhinoplasty,  and  such  secret  "  special- 
ties ".  were  handed  down  from  one  member  to  another. 

The  treatment  of  wounds,  venesection,  in  short  everything  not  peculiarly 
operative,  together  with  minor  surgery,  fell  to  the  common  surgeons 
(Chirurgi  vulgares,  Barbiers-chirurgiens,  Chirurgiens  de  la  courte  robe),  who 
of  course,  as  already  noticed,  made  as  many  encroachments  upon  the  domain 
of  their  superiors  as  do  our  barbers  of  to-day,  and  were,  it  seems,  also  just 
as  ignorant.  The  first  statement  at  least  is  supported  by  the  fact  of  their 
long  continued  quarrels  with  the  higher  surgeons  in  Paris,  in  which  quarrels 
the  Faculty  of  Physicians,  while  superior  to  both  branches  of  surgeons,  did 
not  always  play  the  most  honorable  role. 

In  England,  where,  as  already  mentioned,  there  were  schools  at  a  very 
early  period,  we  of  course  find,  clerical  pli3'sicians  existing  equally  early. 
In  like  manner  there  were  surgeons,  who,  however,  were  called  "  Bone- 
setters  ".  Later  the  profession  was  so  divided,  that,  besides  the  medical 
practitioners,  there  called  •'  Physicians ",  there  were  also  "  Surgeons " 
(Chirurgeons)  and  barbers  or  plaster-spreaders,  the  former  educated  in 
institutions,  the  latter  by  masters.  Since  1461  the  ':  Surgeons  "  have  pos- 
sessed corporate  rights  procured  for  them  by  the  military-surgeon  Thomas 
Morestide,  and  the  physicians  Jacques  Fries  and  William  Hobbes.  and  have 
been  subject  to  the  city  magistrates.  At  the  instance  of  the  latter,  in  the 
year  1308.  a  member  of  the  guild  of  barber  surgeons  was  appointed  to  the 
superintendence  of  the  barbers,  and  likewise  in  the  year  1334  a  commission 
of  three  members  was  named,  of  whom  one  was  president,  to  deliver  a 
decision  with  respect  to  the  treatment  of  a  serious  wound,  which  one  John 
le  Spicer  of  Cornhill  had  undertaken.  In  like  manner  in  1369  three  sworn 
master  barbers  were  appointed  as  overseers  of  the  barbers.  Finally  in  1376 
a  board  of  examiners  for  students  of  minor  surgery,  and  consisting  of  two 
master-barbers,  was  appointed,  in  order  by  the  skilled  examination  of  these 
persons  to  protect  patients  from  wrong  treatment,  particularly  such  as  came 
from  the  country,  and  to  thus  keep  away  from  them  the  old  wives  who 
hitherto  had  practised  minor  surgery  undisturbed.1 

1.  According  to  Toner,  the  title  of  "surgeon"  or  "chirurgeon"  was  first  recognized 
by -law  in  England  in  1 21)9,  though  that  of  "barber-surgeon"  was  much  older. 
The  "chirurgeon"  was  educated  in  some  institution  of  learning,  and  was  therefore 
permitted  to  wear  the  long  robe  and  a  peculiar  style  of  hat,  both  of  which  were 
denied  to  the  simple  "barber-surgeon",  who  had  received  such  education  as  he 
could  boast  from  the  hands  of  a  "Master".  Both  barbers  and  surgeons  employed 
a  striped  pole  (blue  and  white)  as  the  sign  of  their  calling,  but  while  the  barbers 


—  336  — 

Even  veterinary  surgeons  existed  there  very  early.  ;i  When  a  horse  01 
other  animal  is  shot,  take  a  seed  of  doek  and  some  Scotch  wax  ;  let  a  priest 
read  over  them  12  masses,  add  holy  water  thereto,  and  put  this  upon  the 
horse."'  It  seems,  therefore,  that  these  veterinary  surgeons  were  likewise 
clerics,  or  at  least  stood  in  good  business  relations  with  the  latter.  At  all 
events  they  were  certainly  good  Church-people.1 

In  Germany  the  lower  class  of  surgeons  was  represented  by  the  bath- 
keepers  and  barbers,  who  first  made  their  appearance  in  the  12th  century 
and  subsequently  formed  themselves  into  guilds.  Until  the  13th  century 
they  seem  to  have   been  not  only  the  sole  surgeons  in  Germany,  but  in 


were  limited  to  the  simple  pole,  the  surgeons  were  permitted  to  have  in  addition 
a  gallipot  and  a  red  tlag  to  distinguish  their  vocation.  The  first  meeting  of  barber- 
surgeons  in  England  took  place  quite  early  in  the  14th  century,  ami  consisted 
of  Roger  Strippe,  W.  Hobbs,  T.  Goddard  and  Richard  Kent.  The  records  of  the 
company  from  1309  to  1377  and  its  by-laws  in  1387  are  still  preserved  in  the 
Guildhall,  together  with  an  act  of  Parliament  of  1420  relating  to  the  company. 
The  charter  of  the  company,  as  stated  in  the  text,  dates  from  1461.  This  charter, 
however,  did  not  prohibit  other  persons  ( not  belonging  to  the  company)  from 
practising  surgery  in  London.  Hence  in  1512  a  new  charter  was  procured  from 
Henry  VI lb,  which  forbade  the  practice  of  surgery  by  others  than  members 
of  the  company  of  barber-surgeons  within  the  city  of  London  and  seven  miles 
of  the  same.  Holbein  (1494-1543)  painted  a  picture  of  Henry  VIII.  delivering 
this  charter  to  the  company,  and  this  painting  is  still  preserved  in  their  hall  in 
Monkwell  St.  The  names  of  the  surgeons  present  at  this  ceremony  are  painted 
upon  their  persons,  and  are  as  follows:  Thomas  Vicary  (master),  John  Chambre, 
William  butts  and  J.  Alsop  (past-masters),  J.  Aylef,  N.  Symson.  E.  Hat  man. 
J.  Monforde,  J.  Pen,  N.  Alcocke,  B.  Fereis,  W.  Tylby  and  X.  Sam  on,  Vicary  is 
said  to  have  been  the  author  of  the  first  work  on  anatomy  written  in  the  English 
language.  In  1515  the  barber-surgeons  of  London  numbered  19,  and  were 
exempted  by  act  of  Parliament  from  "serving  in  ward  or  parish  offices,  but 
likewise  from  all  military  service."  By  1540  a  disposition  to  separate  the  duties 
of  barbers  and  surgeons  began  to  appear,  and  in  that  year  an  act  was  passed 
providing  "  that  no  person  using  any  shaving  or  barbery  in  London  shall  occupy 
any  surgery,  letting  of  blood  or  other  matter,  except  only  drawing  of  teeth.' 
Surgeons  were  also  prohibited  in  this  act  from  practising  shaving.  Four  years 
later  the  separation  of  the  two  classes  was  still  further  effected  by  an  act  which 
seems  to  have  allowed  the  surgeons  a  distinct  organization  of  their  own,  though 
apparently  still  connected  in  some  waj-  with  that  of  the  barbers.  The  company 
of  surgeons  built  themselves  a  new  hall  in  the  Old  Bailej',  where  they  had  a  large 
theater  and  a  dissecting  room  for  instruction  in  anatomy.  No  further  legal 
differentiation  of  surgeons  and  barbers  occurred  until  1745,  when  "An  act  for 
making  the  surgeons  and  barbers  of  London  two  distinct  and  separate  corpora- 
tions" put  an  end  entirely  to  their  mediaeval  relations.  A  new  charter  was  also 
granted  to  the  College  of  Surgeons  in  1800.  (For  most  of  the  facts  contained  in 
this  note  I  am  indebted  to  Toner's  "  Contribution  to  the  Annals  of  Medical  Pro- 
gress and  Medical  Education  in  the  United  States".  (H.) 
1.  In  1510  (Dec.  4. )  Thomas  Fabyan  was  appointed  veterinary  surgeon  to  the  king's 
(Henry  VIII.)  horses,  during  good  conduct,  with  a  salary  of  twelve  pence  a 
day.    "(H.) 


—  337   — 

general  the  only  medical  faculty.  On  the  other  hand,  about  the  same  time 
there  were  numerous  physicians  in  Italy  :  during  the  12th  century  31  are 
named  in  Bologna  alone,  and  in  the  13th,  no  less  than  47  (Daremberg). 
These  bath-keepers  and  barbers  enjoyed  a  civil  position  like  that  of  the 
flayers,  fifers,  butchers  and  such  people,  that  is  they  practised  a  disreputa- 
ble calling  and  passed  before  the  law  and  in  civil  society  as  "  disreputable  ". 
Probably  it  was  one  of  these  fellows  who  hewed  off  without  ceremony  the 
foot  of  duke  Leopold  of  Austria  in  1104.  when  at  a  tournament  he  had 
received  a  complicated  fracture  of  the  leg  by  a  fall  from  his  horse  ;  though 
according  to  another  lection  he  was  forced  to  hack  off  the  limb  himself, 
because  there  was  not. a  single  such  surgeon  present.  Even  they,  about 
the  century  mentioned  were  still  so  scarce  that  Walter  von  der  Vogelweide. 
when  he  desired  to  have  his  split  lip  operated  on,  could  find  in  Worms  on 
the  Rhine  no  competent  "  Meister  '.  Accordingl}'  he  was  so  treated,  or 
rather  maltreated,  by  such  a  surgeon  in  Thuringia,  that  he  was  worse  after 
than  before  the  operation,  and  looked  more  disfigured.  The  emperor 
Wenceslaus  in  1406  (out  of  regard  for  a  bath-keepers  daughter,1  of  whom 
he  was  enamored)  first  declared  the  bath-keepers  reputable,  but  without 
effect,  as  lie  himself  about  that  time  was  declared  deposed  for  six  years. 

The  bath-keepers3  were  either  owners  of  their  own  bath-houses,  or  they 
were  appointed  to  licensed  houses,  or  to  such  as  belonged  to  the  municipal- 
ity, in  which  case  they  were  required  to  pay  a  tax  or  lease.  Their  number 
and  their  privileges  in  their  respective  residences  were  always  determined 
by  the  magistrates,  or  by  the  guild.'1  One  of  their  chief  branches  of 
business  was  cupping  and  bleeding  the  bathers.  Guild-ordinances  for  their 
regulation  first  appear  quite  late  in  the  14th  century — in  Wiirzburg 
not  until  1515.  On  Sunday  barbers'-basins  were  beaten  through  the  streets 
by   the  apprentices  to  give  notice  to  the  people  of  the  beginning  of  the 


1.  Such  girls  were  at  that  period  frequently  employed  as  bath-attendants  etc.,  for  the 

bathing-houses  were  generally  used  as  places  of  rendezvous,  and  also  served  as 
places  for  public  gossip  and  the  retailing  of  city  news,  in  the  absence  of  hotels. 
In  consequence  of  the  use  of  woolen,  fur  and  leather  clothing,  all  of  which  was 
rarely  renewed,  bathing  was  much  more  common  in  the  Middle  Ages  than  at  the 
present  day.  A  bath  of  special  festivity  was  that  to  be  taken  by  bride  and  groom 
before  the  bridal  night,  on  which  occasion  male  and  female  friends  supplied  the 
necessary  services.  This  was  a  sort  of  fashion  of  the  sexual  toilette.  The  city 
of  01m  is  said  in  1489  to  have  had  no  less  than  1(58  bath-houses.  Free  baths 
were  furnished  to  the  poor. 

2.  "  Badeknechte  ",  male  attendants  of  the  bath,  from  whom  the  bath-keepers  usually 

came,  existed  at  Aix-la-Chapelle  as  early  as  the  days  of  Charlemagne.  They 
were  boudmen,  and  attended  upon  the  bathers,  like  the  Bademagde  or  female 
attendants,  who  rubbed  down  the  bathers,  particularly  the  men.  Among  the 
latter,  Agnes  Bernauer,  who  was  drowned  in  14:55  in  consequence  of  her  relations 
with  duke  Albrecht's  son,  is  the  most  famous. 

3.  In   oriental  bath-houses   massage   of  the  limbs   was  customary  even  at,  this  time: 

"  On  the  Wednesday  after  St.  Thomas's  day,  1450,  we  went  before  breakfast  to  a 

bath  in  Jerusalem  and  drank  some  good  new  wine In  the  bath  they 

cudgeled  and  throttled  us.     They  break  one's  arms  across  his  back  and  behind  his 
head,   and  lay  him  upon  his  belly  and  jump  upon  his  back.   It  is  almost  murder  " 
22 


—  338  — 

great  hath.  They  hung  out  for  signs  at  their  places  of  business  a  white 
cloth,  and  at  a  later  period  1-3  barbers'  basins.  Their  coat-of-arms  —  a 
knotted  bandage  on  a  golden  field,  with  a  green  parrot  (an  appropriate 
heraldic  emblem  of  their  loquacity)  —  bestowed  upon  them  by  Wenceslaus. 
like  his  simultaneous  declaration  of  their  respectability,  was  held  in  little 
respect.  The  golden  age  of  the  bath-keepers  fell  between  the  12th  and  15th 
centuries.  From  the  16th  they  gradually  disappeared,  together  with  the 
bathing-houses,  which  at  this  period,  in  consequence  of  the  disappearance 
of  the  leprosy,  of  the  immorality  prevailing  in  them,  and  the  infectious 
diseases  to  which  they  gave  rise,  also  began  to  decline.  The  bath-keepers 
too  were  a  despised  and  "disreputable"  people  during  the  Middle  Ages,  and 
at  an  early  day  were  united  with  the  barbers.  Besides  cupping  and  bleed- 
ing, they  had  the  right  to  treat  wounds  which  had  broken  out  afresh,  to 
shave  and  to  cut  hair,  all  of  which  duties  were  to  be  performed  within  their 
residences,  while  outside  they  might  also  treat  fractures  and  dislocations. 
The  executioners  also,  to  whom  from  their  occupation  extraordinary 
knowledge  was  ascribed  until  late  into  modern  times  —  one  of  them  was 
Prussian  court-physician  as  late  as  the  18th  century!  —  belonged  among 
the  most  popular  and  most  valued  members  of  the  medical  fraternity.  The 
bath-keepers  often  fell  into  disputes  about  their  privileges  with  the  guild 
of  the  barbers,  who  enjoyed  the  same  rights,  and  could  in  addition  take 
care  of  fresh  wounds  and  hang  out  as  many  basins  as  they  pleased. 
Strict  regulations,  however,  existed  relative  to  what  the  barbers  could,  and 
what  they  could  not  do.  without  the  presence  of  a  physician.  Thus  they 
could  e.  g.  treat  ordinaiy  bites,  but  not  the  bites  of  poisonous  animals  or 
mad  dogs,  at  least  without  the  advice  of  a  physician.  After  the  conclusion 
of  their  travels,  which  were  often  remarkably  extensive,  and  after  passing 
their  examination  in  knife-sharpening,  plaster- spreading  etc..  most  of  them 
settled  down  as  regular  business-members  of  their  guild,  and  they  were  not 
infrequently  appointed  inspectors  of  the  leprous:  or  in  times  of  the 
plague1  the}-  were,  as  ''  Pestparpierer  ".  charged  with  the  duty  of  opening 
and  treating  the  plague-boils.  At  a  later  period  they  officiated  as  physicians 
to  the  syphilitic.  They  were  also  frequently  "  Leibparpierer"  ( body-barbers) 
to  the  greater  and  lesser  lords,  with  whom,  by  their  cunning,  their  pander- 
ing, their  knowledge  of  the  world  and  of  human  nature  (acquired  by  their 
travels)  and  other  good  service  they  often  made  their  fortunes.  Such  was. 
for  example,  the  notorious  Oliver  le  Daim.  barber  and  accomplice  of  that 
disgrace  of  France,  king  Louis  XIV..  after  whose  death  he  met  with  the 
rope  which  he  so  richly  deserved.  The  ordinary  physician  of  Louis  was 
Jacques  Coytier.  died  1506.  Another  of  these  notorious  barbers  was  the 
uncle  of  Dneveke  Slaghoek,  mistress  of  Christian  IT.  of  Denmark,  at  whose 
court  this  worthy  associate  of  Oliver  displayed  his  talents.  Some  of  these 
fellows  had  large  incomes.     Thus  in  England  the  body-barber  received  from 


1.   The  burial-grounds  for  those  dead  of  the  plague  were  often  located  in  the  midsl  of 

the  city,  :is  e.  g.  at  Worms! 


—  339  — 

each  new-fledged  lord  the  sum  of  $10  ;  from  a  count,  $25,  and  from  a  duke 
$50.  Yet  the  somewhat  unjustly  despised  barbers  were  the  fathers  of 
surgerv  and  the  higher  surgical  profession,  which  did  not,  however,  begin 
to  develop  among  us  until  the  17th  century.  Many  barbers  were  salaried 
by  the  cities,  and  some  of  them  were  famous  writers,  as  e.  g.  the  learned 
Hans  Foltz  of  Worms,  barber  in  Nuremberg  and  a  meistersinger  (last  quarter 
of  the  15th  century),  who  wrote  the  earliest  German  treatise  on  balneology, 
and  as  a  printer  contributed  to  the  extension  of  the  new  art.  In  the  im- 
perial cities,  however,  after  1-124  '•  Meister-Aerzte  "  were  provided,  who 
attended  to  the  treatment  of  the  poor  (though  the  Physici  were  similar  in 
their  functions)  and  were  sworn  to  perform  their  duties  honestly,  receiving 
a  salary,  which  ordinarily  amounted  to  100  gulden.  The  latter  sum  was 
fixed  by  the  council  of  Basel,  and  from  the  increased  value  of  money  in 
that  day  was  higher  than  the  salary  of  our  present  district-physicians. 

Besides  the  higher  and  lower  surgeons,  bath-keepers  and  barbers, 
settled  in  permanent  residences,  there  were  others  who.  according  to  the 
custom  of  the  age,  travelled  about;  for  at  that  time  many  persons  (e.  g. 
priests,  harlots,  artisans,  artists,  etc.)  who  at  the  present  day  are  stationary, 
travelled  about  the  country  extensively.  Such  :-  fahrende  Wundaerzte  " 
who  (as  in  later  times  too)  called  themselves  physicians,  mostly  without 
any  regard  to  the  guilds  or  the  faculties,  were  often  accompanied  by 
buffoons  and  numerous  assistants,  had  booths  at  fairs  with  monkeys  and 
the  like,  permitted  their  ineffable  fame  to  be  trumpeted  about,  and  wore 
striking  and  grotesque  apparel  in  order  to  attract  the  sick  public,  whom 
they  provided  with  miraculous  remedies  against  all  possible  and  impossible 
infirmities.  One  of  their  chief  branches  of  business  was  tooth-pulling  or 
tooth-breaking,  which  physicians  and  regularly  educated  surgeons  in  the 
Middle  A-ges  avoided  on  theoretical  grounds,  or  held  beneath  their  dignity. 
These  itinerant  surgeons  in  open  market  also  operated  upon  cataract 
(oculists),  and  performed  other  similar  responsible  operations.  In  1351 
even  a  famous  •'  female  oculist  "  died,  antl  again  in  Frankfort  we  read  of  one 
in  1428  named  Zerline.1  These  oculists  operated  more  quickly  than  ••one 
can  describe  the  operations  ;  many  patients,  however,  became  blind  ".  Beu- 
edetti,  who  makes  the  preceding  statement,  greatly  laments  that  this  branch 
of  surgerv  was  practised  by  farriers,  peasants  and  hired  laborers  instead 
of  physicians.  Their  knowledge,  especially  in  anatomy,  we  may  imagine. 
Yet  such  fellows  treated  in  this  way  not  only  the  common  people,  but  also 
those  in  high  position,  until  late  in  the  18th  century  (in  Tnrkey  even  at  the 
present  day),  since  nothing  better  was  to  be  had.  It  may  be  remarked,  by 
the  way,  that  certain  diseases  of  the  eye  were  treated  in  a  dark  chamber  in 


I.  Zerline  ivus  a  Jewess,  who  believed  that  her  reputation  would  warrant  her  residing 
outside  of  t lie  Judeiurasse  and  claiming  exemption  from  taxes  The  municipal 
council,  however,  rejected  her  application,  and  in  1489  it  ordered  that  Jewish 
female  physicians  should  either  leave  the  city  or  pay  taxes  like  other  Jews.  In 
1494,  however,  a  Jewish  "doctress"  was  exempted  from  the  "sleeping  tax",  a 
tax  imposed  on  foreign  Jews  for  every  day  that  they  remained  in  Frankfort.  (HJ 


—  340  — 

Iceland,  even  at  this  early  period.  At  last  a  stop  was  compelled  to  be  put 
to  their  mischief  by  law.  Indeed  such  protective  regulations  existed  in 
many  places,  e.  g.  in  the  charter  of  the  university  of  Tubingen  from  the 
3-ear  1477.  though  without  effecting  much  improvement.  That  medical 
affairs  in  Germany  during  the  whole  of  the  Middle  Ages  must  have  occupied 
a  very  low  grade,  is  evident  from  the  existence  of  such  preventive  regula- 
tions, particularly  as  the  good  of  mankind  in  other  respects  during  this 
period  was  not  looked  after  any  too  anxiously.  Thus  an  itinerant  surgeon 
once,  in  order  to  relieve  a  corpulent  nobleman  —  Dedo  II.  (died  llfMh,  called 
the  Good,  count  of  Rochlitz  and  Croitz — of  his  paunch  (Bantingism),  ripped 
up  his  bell}"  so  that  he  died  on  the  spot.  The  count  obtained  more  than  he 
wanted  ;  for  he  has  become  immortal  even  to  the  present  day  as  a  genuine 
example  of  knightly  stupidity;  while  the  physician,  like  a  true  artist,  simply 
did  "enough"'  for  this  "noble"  of  his  time,  and  then  vanished  from  the  re- 
membrance of  mankind.  Such  cures  in  those  energetic  and  sensitive  times 
forced  artists  of  this  sort  to  fly  at  once  from  the  vengeance  of  the  relatives. 

Monks  and  nuns  officiated  as  nurses  in  the  hospitals,  and  in  special 
cases  bath-keepers  and  barbers  also,  though  the  latter  was  rare.  In  private 
houses  both  kinds  of  nurses  were  common. 

When  we  see  surgery  (the  practice  of  which  was  fruitlessly  forbidden  to 
the  barbers  in  France  by  act  of  parliament  as  early  as  1425.  and  in  England1 
in  1401  )  almost  entirely  in  such  hands,  we  cannot  wonder  that  all  midwifery 
also  lav  in  the  hands  of  the  midvvives  ("rohe  Weiber  "').*  At  the  same 
time  we  can  form  an  idea  of  the  original  condition  of  obstetrical  knowledge. 

The  midwives  received  instruction  in  their  art,  even  at  this  time,  from 
the  clergy.  Albertus  Magnus  e.  g.  had  published  a  course  of  instruction 
for  them,  and  indeed  Councils  devoted  their  attention  to  this  subject.  The 
council  of  Cologne  e.  g.  decreed  in  1280,  that  in  case  of  the  sudden  death 
of  a  woman  in  labor,  the  midwife  must  keep  her  mouth  open  with  gags 
until  the  child  was  delivered  by  Cesarean  section,  so  that  the  latter  should 
not  suffocate.  Even  the  oversight  of  the  midwives  was  in  some  places  tin- 
business  of  the  clergy.     Singularly  enough  Jews  employed  Christian  mid- 

1.  It  was  not  until  1540  that  an  act  was  passed  providing  "that  no  person  using  any 

shaving  or  barbery  in  London  shall  occupy  any  surgery,  letting  of  blood  or  other 
matter,  except  only  drawing  of  teeth".  The  same  act  also  prohibited  surgeons 
from  practising  shaving.  The  separation  of  the  two  crafts  was  further  effected 
by  Parliament  in  1  "> 4 4 ,  but,  as  already  mentioned,  the  complete  separation  of 
the  barbers  and  surgeons  of  London  into  two  entirely  distinct  corporations  did 
not  take  place  until  1745.     (H.  i 

2.  There  were  five  of  these  in  Wurzburg  during  the  14th  century.     They  were  com- 

pelled to  attend  poor  and  rich  bjr  day  or  night,  and  could  not  depart  before  the 
termination  of  the  labor.  If  they  wished  to  go  into  the  country,  they  were 
obliged  to  give  notice  thereof  to  the  burgomaster.  In  case  one  alone  at  an}'  time 
could  not  terminate  the  labor,  she  might  call  in  others,  on  which  occasion,  how- 
ever, they  were  not  allowed  to  scold,  stop  or  swear  at  (!)  each  other.  The 
assistance  of  the  nurses  was  recompensed  with  four  schillings  (12  cents)  for  each 
birth,  though  they  were  allowed  to  take  more  if  it  was  voluntarily  offered  them. 


—  341  — 

wives,  though  this  was  forbidden  by  the  Talmud.  Such  cases  are  mentioned 
in  Frankfort-on-the  Main,  and  in  Speier  in  108-1  permission  was  given  to 
the  Jews  to  employ  Christian  nurses  (wet-nurses  ?).  The  itinerant  surgeons 
usually  performed  the  special  operations  (or  massacres)  of  midwifery,  if  the 
midwives  by  their  own  exertions  could  not  accomplish  them.  In  either 
event  it  was  merelv  a  question  of  a  more  speedy  end  to  the  mother  and 
child.  On  the  other  hand  they  were  very  careful  about  the  life  of  children, 
as  in  the  following  case,  which  also  furnishes  us  the  first  German  Caesarean 
section  upon  a  living  mother.  A  pregnant  woman  had  stolen  some  conse- 
crated bread  in  order  to  sell  it  to  the  Jews.  She  was  condemned  to  be 
burned,  but  before  executing  the  sentence  the  child  was  removed  by  an 
incision.  This  occurred  at  Medingen  in  Suabia  in  the  year  1350,  all  for  the 
sake  of  a  few  wafers  (Lammert).  That  there  were  also  in  the  Middle  Ages 
female  physicians  proper,  is  proved  by  the  females  of  Salerno.  In  Mayenee 
too  a  female  physician  lived  as  early  as  1288,  and  another  in  Frankfort-on- 
the-Main  in  1391.  The  doctresses  of  Salerno  busied  themselves  very  suitably 
with  e.  g.  the  dressing  of  ulcerated  male  members,  and  pressing  out  abscesses 
not  yet  opened  in  these  localities.  There  were  even  Jewish  doctresses,  for 
in  1419  one  of  them  received  a  patent  from  the  bishop  of  Wiirzburg. 

Although  veterinary  medicine  during  the  Middle  Ages  enjoyed  the 
labors  of  educated  physicians  and  non-professional  men,  still  veterinary 
practice  remained  generally  in  the  hands  of  veterinary  surgeons  little,  or 
not  at  all  instructed  in  their  own  department,  who  were  called  maresealci 
marscalci,  or  manescalci.  In  other  cases  it  was  abandoned  (as  we  have 
seen  with  a  part  of  human  medicine)  to  the  hands  of  executioners  and 
flayers,  of  manifold  medical  activity.  Diseased  cattle,  like  diseased  sheep 
(and  even  cases  of  difficult  labor  in  women  requiring  operation),  were 
treated  for  the  most  part  by  shepherds,  while  sick  horses  were  cared  for  by 
the  farriers,  to  whom  the  title  of  marescalcus  was  earliest  applied.  In 
certain  cities  salaried  "Pferdeiirzte"  made  their  appearance  toward  the  close 
of  the  14th  century.  One  is  mentioned  e.  g.  in  Ulm  in  1388.  In  Frankfort- 
on-the-Main.  however,  none  appears  until  1491. 

Even  in  the  second  half  of  the  Middle  Ages  there  was  no  specially 
commissioned  class  of  state-physicians,1  though  some  of  the  duties  of  our 
similar  officials  of  to-day  fell  to  the  physicians  of  that  period.  Thus  Hugo 
of  Lucca  as  early  as  1249  received  from  the  burgomaster  a  commission 
(after  being  sworn)  to  draw  up  a  legal  opinion;  indeed.  Innocent  III.,  as 
early  as  1209.  recommended  the  appointment  of  such  physicians  (in  canon 
law).  Ordinarily  the  city-physicians  or  physicians-in-ordinary,  indeed  even 
surgeons,   were    employed    as  state-physicians.       Physicians  appointed    in 

1.  A  paper  of  the  13th  century  (Wormser  Urkundenbucb,  1886)  relates  a  case  in 
which  a  woman  had  declared  that  her  husband  was  incompetent  to  perform  marital 
duty,  and  the  case  was  investigated  by  seven  respectable  and  trusty  matrons. 
When  the  latter  had  brought  in  a  sworn  verdict  as  to  her  complete  virginity,  a 
decree  of  divorce  was  granted  the  wife,  and  sl.e  was  permitted  to  marry  another 
man.     (In  ancient  Rome  five  midwives  were  required  in  such  cases.) 


—  342  — 

cities  wcif  oalled  physici  publici  and  were  sworn  officials,  since  as  early  as 
the  14th  century  the  physicians  in  cities  were  generally  required  to  take  an 
oath  to  conform  to  certain  instructions,  the  transgression  of  which  involved 
a  penalty.  Thus  e.  g.  in  Nuremberg:  "It  is  also  recommended  that  all 
physicians,  of  whatever  name,  who  desire  to  practice  medicine,  shall  swear 
that  they  will  protect  the  sick  so  far  as  lies  in  their  power,  that  they  will 
take  moderate  fees  and  put  up  no  prescriptions  (the  dispensing  of  drugs 
was  prohibited  to  them  here  even  thus  early),  but  take  all  their  prescrip- 
tions from  the  apothecaries."'  ( Lochner.  "Anzeiger  fur  die  Kunde  der 
deutschen  Vorzeit,"  1ST").  Strassburg  had  a  city-physician  as  early  as 
1328.  Several  legal  regulations  required  an  inspection  by  physicians  in 
cases  of  bodily  wounds  and  the  rape  of  virgins  (in  which  the  jus  prima? 
noctis,  then  in  vogue,  was  not  included).  Autopsies,  however,  were  as  yet 
not  permitted,  but  merely  external  inspection  of  the  dead,  or  of  the 
wounded  living  body.  Besides  the  old  Bavarian,  Burgundian.  Frieslandic. 
Thuringian  and  Norman  codes  on  this  subject,  even  the  canon  law  itself 
(a  digest  of  papal  law  during  the  period  1250-1582)  required  such  action. 
These  inspections  had  for  their  chief  object  the  graduation  of  the  fine 
according  to  the  gravity  of  the  wound,  since  the  Germans  very  sensibly 
regarded  the  skin  as  a  part  of  their  movable  personal  property,  and  per- 
mitted injuries  thereto  to  be  atoned  for  in  mone\\  Cases  of  poisoning, 
as  well  as  adulterations  of  the  means  of  subsistence,  e.  g.  wine  etc.. 
were  subject  to  medical  arbitrament,  and  severe  penalties  existed  for 
such  cases.  The  sick,  too,  were  investigated,  in  case  they  claimed  or 
needed  assistance.  Since  the  time  of  Frederick  the  inspection  of  phar- 
macies has  been  added  as  a  regular  public  function  of  physicians.  It  was 
practised  in  Ulm  in  142G.  in  Frankfort-on-the-Main  in  1461,  in  Berlin  in 
1499,  in  the  former  cities  by  the  city-physician,  in  the  latter  by  the  ordin- 
ary physician  of  the  elector  Joachim  1.  Sworn  surgeons,  employed  by 
cities  and  courts  (e.  g.  the  Chatelet  in  Paris)  as  medical  experts,  existed  in 
the  13th  century  in  France  and  in  the  kingdom  of  Jerusalem.  In  the 
latter  kingdom  physicians  and  surgeons  were  likewise  employed  as  public 
witnesses,  each  in  his  own  department,  in  certain  cases. 

To  the  emperor  Sigismund  ( 1410-1437)  is  usually  ascribed  the  founda- 
tion of  the  Physicate  proper. 

.Military  physicians,  as  is  easily  understood,  belonged  for  the  most 
part  to  the  class  of  surgeons.  They  also  (even  down  into  the  18th  century  ) 
shaved  the  faces  of  the  soldiers.  Their  German  name  "Feldscheerer"  springs 
from  the  last  half  of  the  Middle  Ages,  particularly  from  the  time  of  the 
armies  of  "  Landsknechte  "  (15th  century  forward),  and  they  were  enlisted 
for  the  war  only,  as  standing  armies  did  not  exist.  The  emperor  Conrad  11. 
had.  as  early  as  1038,  a  field-physician  Wipo,  and  higher  physicians  followed 
even  the  Crusaders.  They  led  a  life  of  adventure  like  all  the  soldiers  of 
that  period.  The  higher  physicians  for  the  most  part  went  only  as  physi- 
cians-in-ordinary to  princes  and  leaders.     Many — Italians  especially- — seem 


—  313  — 

to  have  been  at  an  early  date  regular  field-physicians  with  their  armies,  and 
these  when  serving  on  ships  of  war  arc  to  be  regarded  as  marine  physicians 
The  same  is  true  also  of  the  Germans.  Subsequently  many  of  these,  hav- 
ing acquired  sufficient  experience,  settled  down  in  permanent  homes.  Such 
was  the  case  with  Hugo  of  Lucca,  1218-1221,  who  accompanied  an  expedi- 
tion to  Palestine.  He  took  no  arms,  but  merely  his  instruments  and 
medicines,  which  were  furnished  by  the  city  of  Bologna.  Even  with  the 
troops  of  condottieri  there  was  no  lack  of  surgeons,  at  least  there  were 
such  with  the  soldiers  of  Braccio  I  1368-1424).  (Platen).  English  armies 
as  early  as  the  13th  century  had  military  physicians  with  formal  gradations 
of  rank,  as  ••  Royal  physician."  (with  pay  2  shillings  per  diem),  his  servant 
(1  shilling  per  diem).  "  Royal  surgeon  "'  and  servants,  common  surgeon  etc. 
Tn  contrast  with  our  officials  of  to-day  the  military  physicians  who  bore  the 
titles  of  "  Royal  physician"  and  "  Royal  surgeons'  enjoyed  the  pay  of  an 
admiral,  their  assistants,  that  of  a  ship-captain.  At  the  beginning  of  the 
15th  century  'surgeons",  field-surgeons,  accompanied  English  armies,  and 
(as  was  the  case  also  in  Germany  at  a  later  period)  were  so  enlisted  that 
their  assistants  were  included  in  their  own  appointments.  The  surgeon 
received  as  pay  10£  per  annum,  each  of  his  assistants  2<l£  :  the  former  12 
pence  per  day  additional  for  subsistence,  the  latter  six  pence — high  pay 
when  we  consider  that  at  the  close  of  the  15th  century  an  English  laborer 
received  only  about  84.2.")  annually,  with  $1.00  for  clothing.'  in  addition 
they  were  entitled  to  a  share  of  the  booty.  Of  the  proceeds  of  the  booty 
the  surgeons  were  expected  to  give  up  one-third  to  the  King,  together  with 
all  precious  stones,  gold  and  silver,  in  case  the  sum  total  of  these  exceeded 
lit:  a  lesser  sum  or  the  residue,  however,  belonged  to  themselves.  In 
addition  the  armies  had.  even  at  this  period,  field-pharmacies.  At  a  little 
later  period  Spain  had  a  regular  system  of  military  hygiene,  including 
field-hospitals.  (Frohlich).  German  cities,  which,  when  war  broke  out. 
were  summoned  to  furnish  troops  for  the  field,  about  the  same  time  appointed 
for  their  contingents  Feldscheerer,  pharmacies  and  hospital  wagons.  Little. 
however,  can  be  learned  of  their  general  arrangement.  Since  their  were  no 
standing  armies,  there  could  be  no  permanent  military  physicians,  but  such 
medical  help  was  taken  as  could  he  found  in  the  vicinity  (including  even 

1.  This  was  thf  pay  of  Thos.  Mores  tide  and  Nicholas  Colnet,  surgeons  to  the  French 
expedition  of  Henry  V.  in  1417.  Morestide  seems  to  have  been  the  surgeon-in- 
chief  of  the  expedition,  though  Colnet  must  also  have  held  high  rank.  This 
probably  accounts  to  some  extent  for  their  high  pay,  which  must  not  be  taken  as 
the  regular  pay  of  an  ordinary  surgeon  in  those  days.  But  even  the  pay  of  their 
assistants.  20£  per  year,  must  have  been  far  above  the  average  pay  of  surgeons; 
for  in  1514  the  pay  of  an  ordinary  surgeon  in  the  Held,  according  to  Richards, 
was  only  Sd.  per  diem,  or  about  12£  per  annum,  the  same  as  that  of  an  archer. 
The  ordinary  pay  of  a  laborer  in  1350  was  only  a  penny  a  day,  and  this  sum  did 
not  reach  2d.  until  nearly  a  century  later.  Yet  the  pay  of  an  archer  at  the 
earlier  period  was  (id.  per  diem.  Perhaps  ordinary  surgeons  may  have  felt 
extraordinary  aversion  to  military  service  at  tins  period,  for  we  find  them 
impressed  into  service  as  late  as  16H6.      (H.) 


—  344  — 

experienced  women),  and  it  was  not  badly  paid.  Thus  in  1450  a  -Meister" 
received  for  the  cure  of  four  soldiers  the  sum  of  200  old  groschen  (about 
$6.25),  a  considerable  fee  for  that  day  (Fiohlich). 

After  the  12th  century  there  also  developed  graduallj'  in  Europe  (on 
the  Arabian  model1)  a  class  of  men  and  institutions,  which  henceforth  have 
stood  in  the  most  intimate  relations  with  practical  medicine  —  I  refer  to 
pharmacists  and  pharmacies,  in  our  modern  sense  of  the  terms. 

This  was  the  case  perhaps  earliest  in  Spain  ;  for  pharmacies  were  very 
early  established  by  the  Arabians1  in  Cordova  and  Toledo.  In  Italy,  how- 
ever, such  shops  must  have  existed  before  1140.  since  in  that  year  Roger 
published  decrees  relative  to  them,  which  Frederic  II.  in  1224  enlarged 
into  a  formal  ordinance  for  apothecaries.  In  this  ordinance  a  distinction  is 
made  between  confectionarii  (druggists)  and  stationarii  (apothecaries)  - 
Apotheke  =  statio,  in  France  =  Boutique,  in  Germany  at  that  period  =Bude, 
and  later  Medicin-  or  Doctorapotheke.  In  the  13th  century  there  also 
existed  in  France  an  ••Instruction"  for  apothecaries.  The  latter  formed 
here  a  guild,  the  fifth  in  rank.  In  the  beginning  of  the  14th  century  they 
were  raised  to  the  second  rank,  and  their  "Masters"  accordingly  had  the 
right  to  wear  long  black  gowns  with  wide  sleeves  and  velvet  facings,  like 
the  judges.  They,  with  the  merchants,  preserved  the  standard  weights  of 
Paris.  The  physicians  were  their  overseers.  Many  compound  remedies 
were  prepared  by  them  in  the  presence  of  medical  commissioners  or  magis- 
trates—  the  latter  in  German  cities  also.  Among  these  compounds  was 
theriaca,  which  was  prepared  in  some  cases  even  in  the  last  century  in 
accordance  with  this  method,  so  as  to  escape  adulteration. 

In  (rermany  the  apothecaries  were  originally  rather  druggists  and  con- 
fectioners, and  procured  their  wares  chiefly  from  Italy.  Wetzlar  in  1233 
had  one  of  the  earliest  pharmacies.  Another  existed  in  Worms  as  early 
as  1248  (Urkundenbuch,  1886),  and  several  pharmacies  are  mentioned  in 
the  year  1207.  The  apothecary  Thomasius  had  one  in  1254  in  Wiirzburg 
(Lammert);  a  certain  Willekin  opened  another  in  Minister  in  1207  ;  another 
has  existed  in  Augsburg  since  1285.  They  were  then  established  also  in 
Strassburg  1207,  in  Esslingen  1300,  in  Ulm  1364,  Nuremburg  1378,2  Leipsic 
1400,  and  in  Stuttgart  1480.  The  cost  of  a  pharmacy  in  that  day  was 
about  the  same  as  now.  In  1412  the  establishment  of  a  pharmacy  at 
Schweinfurth  cost  5000  French  gulden  (according  to  the  present  value  of 
money  $12,500).  The  business,  however,  was  privileged  ;  at  least  the 
Bcrliuer-Deutsch  privilege,  granted  in  14SS  to  the  Barenapotheke  in  Berlin. 

1.  Harun  al  Raschid  erected  the  Hist  institution  of  this  kind  in  Bagdad.      See  p.  235. 

2.  The  tariff  of  a  Silesian  pharmacy  in  t  lie  14th  century  jiives  the  following  juices: 

Syrup  of  Roses  )  ,  ,        ,  ,  ,,     , 

,.      K    „  V  ....     l  pound        1-.  Mark. 

simple  Syrup     i 

Aurea  Alexandrina  )  ,  ■>  \t     \ 

_.,.  -        -         -         -  1  ounce       1  Marks. 

J  henaca  -  ) 

01.  Rosati     ------      1  pound       2  Marks. 

Aromatic  Pills  -  No.  In        1  Groschen. 

01.  Benedicti         -        -        -        -        -     1  pound       10  Marks. 


—  345  — 

guaranteed  protection  against  grocers,  a  gown  and  a  free  residence  —  on  the 
whole  a  good  arrangement.  Its  late  owner,  Dr.  Carl  Edward  Simon,  is 
honorably  known  in  a  wide  medical  circle  by  his  "Arzneiverordnungslehre  '*, 
published  in  connexion  with  Posner.  ■ 

We  an  1  o;ir  successors  will  not  permit  any  iirocer,  whether  resident  or  itinerants 
to  keep  for  sale  any  confection  or  colored  wax,  nor  anything  which  serves  tor.  or 
belongs  to.  an  apothecary-shop.  Moreover  we  and  our  successors  shall  and  will  give 
to  him  and  to  his  successors,  while  they  posse.-.-  such  an  apothecary -shop,  every  year 

a  irown  and  a  free  residence 

The  association  at  that  time  of  the  business  of  the  apothecary  and  the  confec- 
tioner is  proven  by  the  following  obligation,  imposed  upon  the  apothecary-shop 
erected  at  Halle  in  1499  by  Simon  Puster:  "Therefore  he  shall  and  will  give  to  us 
and  to  our  successors  each  year,  being  ten  of  us,  as  a  council,  two  collations  on  fast 
days  at  our  council  house — eight  pounds  of  well  confectioned  sugar,  honest  and 
suitable  for  such  collations." 

In  London  an  apothecary-shop  existed  as  early  as  the  year  1345.'  In 
France  a  law  for  the  inspection  of  pharmacies  was  promulgated  as  early 
as  133ti.  What  benefits,  however,  the  pharmacies  have  conferred  and  must 
confer  upon  practice,  and  consequently  upon  suffering  humanity,  ma}'  be 
seen  from  a  consideration  of  the  great  evils  which  prevailed  even  in  the 
capital  of  France  in  1352,  and  to  which  it  was  sought  to  put  an  end  by  the 
following  prohibition  : 

"The  Dean  and  Masters  of  the  Faculty  of  Medicine  of  the  University  of  Paris 
have  represented  to  u.-  that  persons  of  both  sexes,  some  women  of  advanced  age, 
converts,  country-people  and  a  few  herb-doctors,  practise  in  Paris,  though  the  science 


1.  Edward  III.  in  1345  conferred  a  pen-inn  of  lid.  a  day  upon  Cowrsus  de  Gangeland, 
a  London  apothecary  who  hail  attended  him  during  his  illness  in  Scotland. 
Freind  also  mentions  Pierre  de  Montpellier  and  J.  Falcand  de  I.uca  as  apothe- 
caries in  England  about  the  middle  of  the  14th  century.  A  few  years  later 
Chaucer  says  of  his  "  Doctour": 

"Ful  redy  hadde  he  hise  apothecaries 
To  sende  him  drogges  and  his  letuaries, 
For  ech  of  hem  made  oother  for  to  wynne." 
In  1540  four  physicians  were  appointed  to  inspect  all  ''wares,  drugs  and  stuffs" 
sold  by  the  apothecaries  of  London.  In  early  times  the  apothecaries  and  grocers 
of  London  were  associated  in  one  guild,  but  they  do  not  seem  to  have  been 
regularly  incorporated  until  1606.  This  corporate  union,  however,  was  very 
short-lived,  for  in  1617  they  were  separated  by  a  new  act.  (Toner.)  This 
separation  seems  to  have  occasioned  no  little  dissatisfaction  among  the  grocers, 
but  king  James  was  firm  in  his  determination,  and  in  reply  to  an  address  seeking 
a  restoration  of  the  union  declared  "he  intends  to  maintain  the  Apothecaries' 
Company  separate  from  the  grocers,  who  have  no  skill  in  their  wares ".  This 
was  as  late  as  1624.  In  1618  a  proclamation  commanded  "all  Apothecaries  to 
compound  their  medicines  after  the  directions  of  the  Pharmacopoeia  Londonien- 
sis,  lately  compiled  by  the  College  of  Physicians  of  London  ".  and  in  lf>24  a  new 
act  of  incorporation  of  the  apothecaries  of  London  was  passed  "for  avoiding  of 
deceipts  and  abuses  in  making  and  compounding  of  phisicall  receipts  and 
medicines,  and  for  the  suppressing  of  empiricks  and  unskilful  practizers  and 
professeurs  of  the  art  or  mysterie  of  Apothecaries  in  and  about  die  city  of 
London"   (J.  M.  Richards).  iH.i 


346  — 

of  medicine,  the  bodily  constitution  of  men,  the  right  moment  and  t li « •  right  method 
and  way  of  employing  drugs,  as  well  as  their  properties,  are  unknown  to  them, 
especially  cathartics,  which  may  bring  life  into  danger;  thai  these  people  alter 
remedies  against  all  reason  and  all  the  rules  <>f  art,  and  supply  and  administer  very 
strong  purgative,  and  badly  acting  clysters,  concerning  the  use  of  which  they  are  not 
sufficiently  informed  :  that  this  abuse  of  drugs  aggravates  diseases,  has  human  death 
for  its  result,  as  well  as  secret  and  untimely  birth  and  sometimes  even  open  abortion 
.  so  we  prohibit  any  altering  medicine,  syrup,  elixir,  or  any  clyster  from 
being  compounded  or  administered." 

The  administration  of  enemata  was,  originally  a  very  profitable  and 
privileged  business  of  the  apothecary — it  was  for  a  long  time  quite  fashion- 
able among  the  tine  lords  and  ladies,  in  whose  boudoir  a  neat  syringe  was 
never  lacking  —  and  was  either  practised  upon  patients  by  the  apothecaries 
themselves,  or  by  their  assistants,  until  this  duty  was  taken  from  them  by 
the  barbers.  Purchases  of  drugs  were  often  made  at  the  Frankfort  fair. 
How  much  money  was  expended  for  this  purpose  by  an  apothecary  is 
shown  by  the  case  of  Peter  Schmitt,  apothecary  in  Ritzingen,  who  im- 
ported for  his  pharmacy  ■all  roots,  flowers,  juices,  oils,  syrups  in  summa, 
which  belong  to  the  pharmacy,  and  likewise  coniposita.  such  as  pills. 
trochisci  and  other  tilings  in  general  use  '  (Lammert),  for  sale  in  the  place 
mentioned,  having  secured  from  the  magistrates  for  this  purpose  in  1474  a 
grant  of  60  gulden.  The  hitter  was  a  huge  sum  in  that  century,  when  an 
annual  income  of  $62  to  $125.  even  in  cities  like  Augsburg,  stamped  upon 
the  possessor  the  seal  of  great  prosperity,  and  an  income  of  S^T.")  made  a 
man  a  perfect  Crcesus  (Scherrj. 

In  Stuttgart  an  ordinance  regulating  apothecaries  and  their  prices  has 
existed  since  1486.  An  earlier  one,  however,  appeared  in  Strassburg  in 
1400.  In  the  former  ordinance  it  is  directed  that  the  drugs  must  always 
be  well  selected  and  not  decayed  :  that  nothing  except  what  is  prescribed 
shall  be  put  into  a  medicine,  especially  nothing  dangerous  by  way  of  sub 
stitution  ;  That  the  apothecary  shall  be  responsible  for  his  "Apothekers- 
knechte'*  (clerks),  and  shall  not  give  any  pernicious  drug  or  any  abortive  ; 
that  the  price  list  of  the  apothecary  shall  be  correct ;  that  in  doubtful 
cases  he  shall  apply  to  the  physician  etc.  Prices  were  arranged  as  follows: 
Species  1  Loth1  .">  Schillinge,  4  Heller;  Confection  with  musk,  amber  or 
precious  stones,  1  Loth  8  Pfennige;  Sugar  1  Once  6  Pfennig  :  Theriaca  and  all 
ordinal*}' opiates  1  Loth  8  Pfennige;  Mithridaticum  1  Loth  2  Schillinge:  Syrup 
1  Loth  =  8  Pfennige:  1  clyster  8  Schillinge;  Palma  Christi  1  Loth  1  Schilling 
I  Pfennige;  poor  diachylum  1  Loth  8  Pfennige;  common  salve  from  common  oil 
1  Loth        8  Pfennige. 

That  there  existed  in  the  monasteries  a  sort  of  medico-botanic  gardens 
we  have  already  mentioned.  A  public  medical  garden  was  laid  out  in 
Venice,  however,  in  1333. 

Lunatic  asylums  (as  we  call  them  to-day)  must  also  be  mentioned 
here,  as  most  beneficent  beginnings  of  a  regular  treatment  of  the   insane. 

1.    The  Loth  was  a  weight  of  about  half  an  ounce.      Species  are  what  we   now  call 
pulveres  eompositi.     iH.i 


—  347  — 

The  latter  in  the  Middle  Ages  were  regarded  as  persons  ''possessed"  by  the 
devil  and  his  male  and  female  assistants.  :ind,  when  not  abandoned  to  their 
fate  or  shut  up  in  prisons  (indeed  private  prisons,  where  a  certain  sum 
paid  for  their  lodging  and  care),  they  were  maltreated  by  the  clergj7  with 
conjurations,  exorcisms,  etc.  Such  institutions  existed  as  departments  of 
hospitals,  which  were  so  numerous  during  the  Middle  Ages,  and  which, 
under  the  charge  of  the  clerical  orders,  were  little  hut  houses  of  death  for 
the  pooi',  so  wretched  were  their  arrangements.  But  there  were  also 
special  houses  for  the  insane,  the  first  of  which  was  established  at  Feltre  in 
Ttal)\  The  next  was  that  of  Seville,  established  in  140!);  then  one  in 
Padua  141(1,  Saragossa  142."),  Toledo  1483  and  Fez  14M2.  In  these  institu- 
tions the  raving  and  turbulent  were  chained  up  and  occasionally  soundly 
beaten.  That  such  asylums  for  the  care  or  detention  of  the  insane  (though 
so  totally  unlike  our  asylums  of  the  present  day)  arose  at  so  late  a  period. 
though  the  Middle  Ages  were  very  fruitful  in  charitable  institutions  for 
other  sick  persons,  is  explicable  only  on  the  ground  of  the  aforesaid 
ecclesiastical  superstition,  which,  indeed,  prevailed  down  into  so-called 
modern  times.  The  fact  loo  that  in  the  .Middle  Ages  (and  sometimes  also 
to-day)  many  forms  and  expressions  of  religious  insanity  were  regarded  as 
godly  piety,  and  open  religious  lunatics  passed  for  saints,  will  assist  in 
explaining  the  comparatively  late  origin  of  institutions  for  the  insane. 
We  must,  however,  picture  these  to  ourselves  rather  as  houses  of  correction 
or  penitentiaries  in  Liibeck  these  houses  of  detention  were  called 
"Tollkisten",  and  were  under  charge  of  the  jailer  —  than  as  institutions  for 
the  care  and  treatment  of  the  inmates.  Debtors'  prisons,  leased  by  private 
individuals  or  to  creditors,  were  likewise  regarded  occasionally  as  institu- 
tions for  the  safe-keeping  of  the  insane.  Such  was  the  case  in  Frankfort- 
on-the-Main  in  1460,  where  there  were  nine  such  prisons,  each  nine  feet 
long,  broad  and  high,  one  of  which  contained  a  crazy  woman,  another  a 
priest,  a  third  a  crazy  apothecary.  Of  medical  treatment  there  was  not  the 
least  thought.  The  insane  wallowed  about  in  chains  and  without  clothing 
in  such  horrible  dens,  covered  with  tilth  and  their  own  excrement,  as  long  as 
they  were  able  to  endure  it  without  dying.  Towards  the  close  of  the  Middle 
Ages  the  treatment  of  the  insane  became  a  little  better,  especially  in  the 
free  cities,  where  compassionate  and  charitable  citizens  assumed  their  care 
instead  of  the  police  goalers.  This  was  done  e.  g.  in  Liibeck  from  the  year 
1478  (Pauli).  Proper  houses  for  the  guardianship  of  the  insane  were  also 
called  into  existence  gradually  by  the  example,  donations  etc..  of  others.' 
From  the  last  period  of  the  .Middle  Ages,  which,  as  we  have  seen,  has 
transmitted   to  modern    times   (though    mainly  in  an  unfinished  state)   so 


1.  In  antiquity  too  the  treatment  of  the  insane  was  no  better.  Solon  e.  g.  ordained 
that  bad  maniacs  should  be  confined,  while  the  jiood-natured  should  remain 
under  private  care.     The  same  was  the  arrangement  among  the  Romans. 

In  Iceland  they  were  entrusted  to  relatives  who  had  enough  servants  to  take 
care  of  them,  and  where,  at  all  event.-,  they  were  not  abused  as  in  other  lands. 
(Weinhold.) 


—  348  — 

many  fruitful  ideas,  beneficent  discoveries,  fortunate  suggestions  and  new 
institutions,  spring  certain  regulations  which  are  to-day  again  the  sub- 
ject of  lively  discussion.  I  refer  to  measures  for  the  isolation  of  the  sick 
and  quarantine  establishments  against  infectious  diseases.  These  owe 
their  existence  to  the  observation  that  the  plague  spread  by  contagion  and 
was  carried  about  by  ships.  In  this  latter  way  the  disease  came  from  the 
Crimea  to  Venice,  and  from  England  to  Norway.  Accordingly  there  was 
established  —  the  first  arrangements  of  this  nature  reach  back  to  the  10th 
century  —  in  Venice  in  1348  a  '-'Board  of  Supervision",  a  sort  of  council  of 
hygiene,  which  in  the  end  served  as  a  model  for  all  Italy.1  At  Majorca  as 
early  as  1374  a  committee  of  officials,  under  the  presidency  of  a  ph}'sician, 
Lucien  Colomines,  was  appointed  with  extensive  powers,  to  whom  the  local 
magistrates  at  the  outbreak  of  the  plague  were  directed  to  report.  This 
committee  was  also  allowed  a  hospital,  and  it  was  directed  that  no  ship 
should  discharge  passengers  nor  unload  freight  without  their  knowledge, 
nor  should  any  port-sales  be  held  without  preceding  notice  to  the  sanitary 
council.  Suspected  ships  were  required  to  keep  quarantine  for  40  days 
(hence  the  name  quarantine).2  Another  effort  to  prevent  the  plague  by 
isolation  was  made  in  Milan,  and  the  city  remained  exempt  by  this  means 
until  1350.  This  was  again  attempted  at  Eeggio  in  1374  by  an  ordinance 
of  the  viscount  Barnabo,  and  subsequently  in  numerous  other  places.  In 
Paris  a  similar  sanitary  commission  was  appointed  in  1350,  and  a  sanitary 
council  in  Venice  in  1485.  Strict  regulations  regarding  the  adulteration 
of  food  and  the  sale  of  bad  food  also  existed.  Thus  the  Berlin  butchers 
were  compelled  to  take  an  oath  about  1400:  "I  will  sell  no  suckling  sow, 
no  consumptive  or  one-eyed  cattle,  and  no  cattle  purchased  from  poor 
people  out  of  the  hospitals  or  out  of  the  Hospital  of  the  Holy  Ghost"  etc. 
The  so-called  "Libenziichter''  as  early  as  the  14th  century  exei'cised  super- 
vision in  Strassburg  over  the  moral  and  sanitary  relations  of  the  populace. 
From  the  great  mortality  manifested  by  epidemics  during  this  portion 
of  the  Middle  Ages  it  seems  to  follow  that  these  regulations  occasioned,  on 
the  whole,  as  little  benefit  as  the  similar  regulations  of  the  present  day 
accomplish  against  the  epidemics  of  modern  times.  This  failure  was  much 
more  readily  explicable  in  the  Middle  Ages,  since  the  cemeteries  lay,  as  we 
have  already  remarked,  in  the  midst  of  the  cities.  But  the  sublime  police 
of  the  universe  cares  not  the  snap  of  its  fingers  for  the  petty  police  of  man- 
kind, and  upon  this  fatal  rock  a  great  portion  of  the  practical  work  of  the 
physician  in  epidemics  is  brought  to  wreck,  though  in  single  cases  here  and 
there  a  good  result  is  accomplished,  or  apparently  accomplished.  The  next 
epidemic,  however,  reverses  the  teaching. 


1.  And  in  fact  for  Germany  also.  At  least  Augsburg  and  Nuremberg  in  the  16th 
century  took  for  their  model  the  arrangements  of  Venice,  a  city  with  which  thej" 
enjoyed  an  active  commerce. 

H.  The  term  of  40  days  was  chosen  either  on  medical  grounds — the  40th  day  was  looked 
upon  as  the  most  critical  in  inflammatory  diseases —  or  on  religious  or  astrolog- 
ical  grounds,  since  Moses  was  40  days  upon  Mt.  Sinai,  Lent  lasted  40  days  etc. 


THIRD  PERIOD. 


THE  MODERN  ERA. 


MEDICINE   FROM  THE   DISCOVERY   OF  AMERICA   TO    THE   CLOSE 

()F  THE  FIRST  FRENCH    REVOLUTION. 

A.   D.    I492-180O. 


HISTORY  OF   MODERN    MEDICINE. 


THE  MODERN   ERA. 


Each  period  in  the  history  of  the  civilization  of  a  particular  people,  as 
of  mankind  in  general,  is  obviously  the  sum  of  a  great  number  of  ante- 
cedent factors,  mental,  moral  and  physical.  Each  age>  too  is  the  result  of 
the  past,  as  well  as  an  active  and  determining  part  of  the  future. 

Thus  the  so-called  Modern  Era  appears  as  the  uninterrupted,  but 
more  vigorous,  continuation  of  the  course  of  mediaeval  civilization,  which 
had  been  so  unmistakably  progressive  in  its  character.  More  especially  it 
seems  an  expansion  of  the  individual  culture  of  the  past  into  a  future 
cultivation  of  the  masses  —  of  the  people  now  purified  by  the  physical 
agitation  of  the  Middle  Ages. 

Accordingly  the  limitation  of  historical  periods  by  certain  definite 
years  is  more  or  less  arbitrary,  and  at  bottom  merely  an  expression  of  the 
impossibility  of  dealing  in  a  literary  way  with  history  without  the  aid  of 
such  artificial  and  rude  landmarks.  For  history  in  fact  displays  an  un- 
broken, but  constantly  ebbing  and  flowing  development,  and  these  artificial 
divisions  are  mainly  the  work  of  scholastic  convenience. 

Thus  the  so-called  Modern  Era  may  be  merely  externally  separated 
from  the  Middle  Ages  by  some  event  of  special  prominence,  e.  g.  the  Dis- 
covery of  America.  Yet  this  customary  limit  is  by  no  means  a  matter  of 
historical  necessity.  It  does  not  separate  in  the  history  of  civilization  a 
period  wanting  in  development  from  another  period  new  and  progressive 
in  its  character.  For  while,  on  the  one  hand,  the  latter  half  of  the  Middle 
Ages  displayed,  as  we  have  seen,  a  lively  progress  in  culture,  on  the  other, 
the  mediaeval  period  continually  projects  a  thousand  dark  shadows  into  our 
so-called  Modern  Era  —  shadows  which,  as  may  be  easily  shown,  yet  hover 
daily  and  hourly  above  us  and  cross  our  path  with  gloom.  Great  gaps,  it 
is  true,  are  broken  in  the  frail  boundaries  of  both  periods,  but  the  walls 
are  not  yet  entirely  thrown  down,  nor,  to  all  appearances,  will  they  be  com- 
pletely destroyed  for  a  long  time. 

Yet  the  discovery  of  America  forms  a  landmark  better  adapted  cer- 
tainly to  the  history  of  medical  culture  than  to  that  of  other  branches  of 
civilization  (with  the  movements  and  tendencies  of  which  it  ever  keeps 
pace),  since  from  that  epoch  new  and  vigorous  representatives  enter  the 
field  and  begin  the  struggle  for  that  supremacy  which  they   to-day  possess 

— we  mean  the  Germanic  races. 

(351) 


—  352  — 

If  we  have  heretofore  claimed  for  the  Middle  Ages  (in  many  respects  so  unjustly 
despised)  such  importance  in  the  advancement  of  civilization,  this  claim,  if  based 
upon  correct  ideas,  must  he  established  particularly  by  the  phenomena  of  their  close. 
And  such  is  the  fact !  We  need  mention  again  merely  the  introduction  of  the  compass, 
which  alone  rendered  possible  the  discovery  of  a  new  world  ;  the  invention  of  firearms, 
which  rendered  harmless  feudalism  and  its  outgrowths,  the  "  Raubritter"  and  their 
castles;  above  all  the  immeasurabh'  important  invention  of  printing,1  from  which 
epoch  forward  the  masses,  and  no  longer  the  learned  alone,  took  part  in  the 
intellectual  life  of  mankind.  We  ma}'  notice  further  the  invention  of  clocks  (steeple- 
clocks  in  the  14th  century)  and  the  rapid  development  of  the  arts,  especially  archi- 
tecture and  sculpture,  then  painting  anil  music.  In  the  sphere  of  religion  we  may 
recall  the  resistance  of  the  Waldenses  ( originating  in  1170)  and  of  John  Wickliffe 
(1324-1384);  the  death  of  the  hero  Huss  (born  1373,  binned  at  Constance  in  1415. 
declared  the  doctrine  of  papal  infallibility  to  be  the  creation  of  a  fourth  member  of 
the  Godhead)  and  the  fiery  Girolamo  Savonarola  (born  1452.  first  strangled  and  then 
burned  in  1498),  from  whose  funeral  pyres  avenging  sparks  penetrated  into  the  rotten 
Papal  System.  To  these  we  may  add  the  revival  of  the  study  of  tin1  Ancients  — 
Humanism'-  —  and  the  struggle  under  the  standard  of  Italian  Platonism  against  the 
fetters  of  that  scholasticism  which  dominated  from  the  9th  to  the  loth  century. 

On  the  other  hand,  modern  times  have  undoubtedly  preserved,  even  to  the 
present  day,  ver}r  much  —  more  almost  than  we  are  willing  to  admit- — of  medieval- 
ism.—  At  the  outset  of  this  period  a  perfectly  enormous  mass  of  superstition  and 
delusion  prevailed  among  even  the  greatest  minds.  Luther  himself —  the  hero  of  the 
greatest  political  and  religious  achievement3  of  all  modern  centuries  —  believe.] 
absolutely  in  an  incarnate  Devil,  who  not  only  tormented  him  out  of  Wartburg 
(1521),  but  also  plagued  him  after  his  marriage.  Melancthon  (1497-1560)  too  was 
devoted  body  and  soul  to  astrology.  Many  physicians  likewise,  and  the  most  emin- 
ent of  them  too,  like  Pare,  Fernel,  Peucer,  De  Ha'en  etc.,  were,  and  continued  to  be 
down  into  the  18th  century,  convinced  of  the   influence  of  demons   and   the  devil! 

1.  How  small  was  the  number  of  medical  works  appearing  annually  in  that  day  may 

be  judged  from  the  fact  that  a  catalogue  of  1564  mentions  only  24  on  medical 
subjects. 

2.  By  the  term  "  Humanismus"  the  Germans  designate  a  system  of  education  based 

upon  the  study  of  the  classics.  The  revival  of  classical  learning  in  England  began 
with  the  lectures  of  William  Grocyn  (1442-1519,  a  pupil  of  Chalcondyles)  at 
Oxford  in  1491,  and  was  ably  promoted  by  Linacer  (1460-1524),  John  Colet 
(1466-1519),  dean  of  St.  Paul's  and  founder  of  St.  Paul's  School  in  1510: 
William  Lilye  (1466-1523),  the  first  master  of  St.  Paul's  School,  and  the  first 
teacher  of  Greek  in  London;  Richard  Fox  (died  1528),  bishop  of  Winchester, 
founder  of  Corpus  Christi  College  in  1516,  the  first  college  in  Oxford  to  make 
provision  for  the  study  of  Latin  and  Greek;  John  Fisher  (1459-1535),  bishop  of 
Rochester;  Sir  Thomas  More  (1478-15351;  Cuthbert  Tunstall  (1475-1559), 
bishop  of  Durham;  Hugh  Latimer  (1490-1555);  Roger  Ascham  i  1515-1568),  the 
teacher  of  queen  Elizabeth,  who  was  herself  quite  a  fluent  reader  of  the  classics  : 
and  others.     ( H.) 

3.  An   achievement,    however,    for    which    he    had   been    fitted    by   the  men   of  the 

preceding  century.  In  the  aetiology  of  diseases  Luther  regarded  the  influence 
of  Satan  as  paramount.  His  son  Paul  (1533-1593)  was  physician  and  alchemist 
to  Joachim  II.  of  Brandenburg  and  to  the  Elector  Augustus  of  Saxony.  He  was 
the  first  clergyman's  son  to  become  a  physician,  though  subsequently  he  found 
man}'  imitators. 


—  353  — 

And  the  poor  people,  to  whom  the  grossest  superstition  was  served  up  annually  in 
their  almanacs  I1  And  the  belief  in  witches,  which  the  Church  utilized  for  its  own 
ends,  and  to  which  secular  justice  also  lent  its  aid  by  employing  the  rack  to  procure 
evidence  and  then  executing  the  poor  victims,  while  the  Church  with  hypocritical 
innocence  could  often  lament  the  rigor  of  its  ally!  Yet  that  superstition  ought  not  to 
seem  to  us  so  very  monstrous!  Indeed,  we  have  to-day  many  a  one  which  surpasses 
very  considerably  the  belief  and  superstition  of  the  Middle  Ages  !  Did  the  Middle 
Ages  venture  to  proclaim  as  a  dogma  to  the  astonished  world,  first  an  immaculate 
conception,2  and  next  the  infallibility  of  a  man? — Moreover  we  still  retain  a  good 
part  of  mediaeval  political  life.  Does  representative  government,  to  say  nothing  of 
popular  self-government,  everywhere  exist?  Have  we  not  still  the  greater  part  of 
mediaeval  class-distinctions,  instead  of  the  equality  of  all  persons  intellectually 
qualified  therefor?  So  long  as  we  have  an  hereditary  nobility,3  disposed  at  all  times 
to  unite  with  the  parsons  under  the  priests,  when  such  a  course  furthers,  or  seems  to 
further,  their  own  advantage  in  opposition  to  that  of  the  masses;  so  long  too  as  the 
priests  exercise  on  weak  minds  their  mediaeval  influence,  rooted,  as  it  is,  in  super- 
stition, so  long  we  still  retain  a  good  share  of  the  worst  inheritance  which  the  Middle 
Ages  have  left  us.  In  the  Middle  Ages  too  originated  the  war  between  classes, 
which  began  in  the  foundation  of  the  citizen  class  and  crowned  itself  with  noble 
results  in  the  bloodiest  revolutions;  hence  the  dismal,  but  historical  struggle  of  the 
fourth  estate,  which  began  with  the  poor  people  of  the  Middle  Ages,  relieved  itself 
first  in  blood  during  the  peasant  wars,  and  is  continued  to-day  in  our  modern 
socialism.  Externally,  indeed,  a  so-called  new  era  has  been  marked  out,  but  inter- 
nally no  new  era  has  been  in  truth  as  yet  attained.  The  shadows  of  the  Middle  Ages 
have  not  to  the  present  hour  yet  reached  their  end  in  too  many  ways  and  in  un- 
numbered minds.  A  new  era  may  justly  be  assumed  to  exist  only  when  the  tasks 
which  the  so-called  Middle  Ages  in  their  closing  centuries  delivered  to  us  are  com- 
pleted, and  when  their  problems  are  solved. 

1.  What  frightful  things  these  ( Aderlass-)  calendars  contained  the  following  prophecy 

for  the  years  1528-29  will  testify:  "  In  this  j-ear  the  aspect  of  the  three  superior 
planets  will  be  frightful.  This  will  be  followed  by  terrible  casualties  to  human 
life  and  by  many  sorts  of  disease,  madness,  apoplexy,  sore  throat,  abscess  of  the 
breast,  coughs,  consumption,  the  bloody  flux,  premature  births,  sterility,  uterine 
disease,  gout  in  the  feet,  fever  on  every  second  or  third  day  .  .  .  frenzy,  dropsj-, 
jaundice,  colic,  the  French  disease."  Erhard  Etzlaub, 

Amateur  in  the  Free  Art  and  in  Medicine. 
The  least  to  be  anticipated  from  all  this  was  the  end  of  the  world,  a  catastrophe 
which  was  expected  with  perfect  certaintj'  dining  the  16th  century  by  everyone, 
with  Luther  as  we  know,  at  the  head  ! 

2.  That   conception    was    possible    without    male    co-operation  —  the    popes    during 

the  Middle  Ages  declared  the  latter  to  be  a  defilement,  though  without  in 
any  way  shunning  such  defilement  themselves  —  was  a  common  idea.  This  pre- 
posterous, but  very  ancient  opinion  the  Egyptians  long  before  had  called  to  their 
aid  in  the  well-known  case  "of  the  daughter  of  one  of  their  kings,  who,  without 
waiting  for  a  religious  or  civil  ceremony,  had  fallen  into  an  "immaculate" 
condition  ! 

3.  Among  the  ridiculous  qualifications  in  accordance  with  which  mankind  classifies 

its  members,  nobility  of  birth  is  one  of  the  most  pregnant  in  an  historical 
view ! 

23 


—  354  — 

From  the  schools  —  and  so  thought  the  reformers  of  education  in  that  day 
— from  the  schools  only  could  the  genuine  new  era  arise  ! 

Doubtless  a  mighty  impulse  was  at  once  given  in  the  discovery  of 
America  (Oct.  12.  1492)  by  the  noble  Columbus1  (1436-1506),  an  impulse 
second  to  that  of  printing  only  ;  for  b}-  it,  at  one  stroke,  half  of  the  actual 
world  and  an  entire  new  world  of  mind  were  revealed,  and  unexpected  food 
supplied  to  the  observation  and  thought  of  mankind.  This  discovery  had 
in  a  material  point  of  view  a  similar  effect  to  Christianity  in  a  religious  :  as 
with  the  latter  began  the  universal  phase  of  religion,  so  in  the  discovery  of 
America  began  the  universal  phase  of  material  progress.  The  two  phenom- 
ena resemble  each  other  also  in  the  the  fact  that  they  both  worked  for  the 
benefit  of  the  "  lower  "  classes.  By  the  discovery  of  America  the  circle  of 
vision  of  the  masses  was  infinitely  enlarged,  and  above  all  an  indescribable 
influence  was  exercised  upon  their  minds.  The}'  were  aroused  and  health- 
fully shaken  out  of  their  plodding  existence,  in  material  and  intellectual 
oppression,  b}'  the  knowledge  of  the  astonishing  discovery  of  a  New  World, 
with  other  inhabitants,  with  treasures  and  magic  productions  exaggerated 
in  fable,  indeed,  with  genuine  antipodes,2  whose  existence,  among  the  popu- 
lar subjects  of  dispute  in  the  Middle  Ages,  had  most  persistently  struck 
the  fane}'  (Fi^-tag). 

To  this  was  added  the  doctrine  of  Nicholas  Copernicus3  (1543)  that  the 
earth,  now  explored  for  the  first  time  with  regard  to  its  size  and  form,  was 
no  longer  the  fixed  center  of  the  universe,  about  which  the  latter  revolved, 
but  that  (in  opposition  to  the  teachings  of  the  Church)  it  revolved  about 
the  sun,  itself  a  small  planet,  like  the  other  planets  of  the  vault  of 
heaven.  A  mighty  breach  was  thus  made  in  the  doctrine  of  the  Church, 
and  a  broad  pathway  was  broken  towards  the  light,  in  spite  of  the  fact 
that  the  Church  at  once  rejected  this  truth  as  a  heresj'  and  prohibited  its 
teaching.4 

Equally  powerful  as  a  leaven  of  life  for  the  masses  was  the  doctrine 
of  Luther ;  for  by  it  they  were  touched  in  their  inmost  feelings  and 
awakened  from  their  circumscribed  views.     The  people  saw  in  this  doctrine 

1.  Even  before  Columbus,  the  Northmen,  about  a.  d.  1000,  and  500  years  earlier  the 

Buddhist  priest  Hwui  Shan,  had,  as  we  know,  visited  America.  The  latter  came 
from  Asia  to  Alaska,  and  then  went  as  far  south  as  Mexico. 

2.  During  the  years  1519  to  1522  Fernando  de  Magelhaens,  by  his  circumnavigation 

of  the  earth,  had  furnished  the  proof  of  its  spherical  form. 

3.  Copernicus  (Coppernics,  Kopernigk,   1473-1543),  the  son  of  a  merchant  of  Thorn, 

studied  medicine  first  (1491-'94)  in  Cracow  and  then  in  Bologna.  Graduating  at 
Padua  in  1503,  he  was  appointed  canon  in  his  native  city,  and. devoted  his  atten- 
tion also  to  astronomy.  His  work  "  De  Orbium  Celestium  Revolutionibus  '  was, 
as  we  know,  never  shown  to  him  in  print  until  he  lay  upon  his  death-bed.  He 
always  practised  medicine,  and  has  ieft  a  collection  of  his  recipes  which  are  in 
no  respect  superior  to  those  of  his  day. 

4.  As  a  matter  of  fact  this  prohibition  was  not  removed  until  1811. 


—  355  — 

their  liberation  from  an  unprecedented  3-oke  and  from  priestly  oppression,1 
beneath  which  they  had  groaned  in  religious  and  political  slavery  for 
centuries.  Hence  it  acquired  from  the  outset,  besides  its  religious  effect,  a 
decided  political  and  social,  in  fact  a  revolutionary,  influence. 

By  the  restoration  of  marriage  the  priests,  as  sons  of  the  people, 
stepped  back  again  into  their  midst,  upon  the  ground  which  was  to  be  the 
field  of  their  spiritual  labor. 

'"Above  all  the  removal  of  celibacy  was  a  social  advance It.  is  true  the 

marriage  of  the  clergy  had  not  been  discontinued  (de  facto  1  during  the  whole  Middle 

Ages In    Germany    the    housekeepers    of  the    clergy    (who   were    to   be  of 

"  canonical"  age  —  as  they  are  to-day  —  that  is  to  say  at  least  40  years  old,  so  that 
menstruation  and  child-bearing  might  have  ceased  —  the  latter  too  a  moral  institu- 
tion!) were  a  numerous  and  not  unassuming  class.  But  the  country  clergy  were 
compelled   to  purchase  toleration   of  this  relation   from   their  bishop  and  from    the 

Curia and  however  complaisant  the  higher  clergy  might  be  ...  .  the  masses 

looked  with  hate  and  scorn  upon  these  irregular  marriages.  And,  most  important 
of  all,  the  children  of  such  unions  remained  under  the  curse  of  their  birth  as  long  as 
they  lived.  Scarcely  a  single  civil  occupation  was  open  to  them,  and  even  the  guilds 
of  the  artisans  declined  to  receive   them.     They  were  lost  among  the  laborers  and 

vagrants.     And  yet  the  permanent  sexual  relations   of  the  Catholic  clergy 

were  indeed  a  piece  of  good  fortune  to   the  congregations From  a  hundred 

pamphlets  it  may  be  seen  how  heinously  the  fickle  sensuality  of  the  priests  in  hamlet 
and  city  corrupted  the  domestic  life  of  the  members  of  their  congregation.  Among 
the  Protestant*,  on  the  other  hand,  the  profession  of  the  clerg}-  was  a  convenient 
bridge,  over  which  the  blood  of  the  peasant  ascended  to  a  higher  activity  !"  (Freytag. ) 
Equally  influential  with  the  fact  just  mentioned,  if  not  even  more 
active,  was  the  circumstance  that  the  national  languages-  now  finally  came 

1.  "A  presentiment  of  their  own  power  and  ability  for  the  first  time  penetrated  the 

souls  of  the  common  people Christ  had  by  his  death  redeemed  even  the 

peasants.'  Rut  they  had  been  the  victims  of  the  youthful  noblemen  and  of  the 
Church.  *'  Dishonest,  cunning  and  luxurious,  like  the  Italians,  was  the  dean 
who  rode  through  the  village  with  his  falcon,  his  wenches  and  his  troopers;  their 
priest,  whom  they  had  the  right  neither  to  choose  nor  to  dismiss,  who  seduced 
their  wives,  or  lived  in  scandalous  domestic  life  with  his  mistress  and  children  ; 
the  mendicant  friar,  who  insinuated  himself  into  their  kitchens  and  demanded 
for  his  cloister  the  meat  in  the  chimney,  the  eggs  in  the  basket.  A  smothered 
agitation  spread  throughout  the  congregations  of  South  Germany."  Expulsion 
of  the  mistresses  of  the  clergy  (whom  Luther  called  " Platte nhengste"  i.e. 
stallions  with  a  tonsure)  became  the  order  of  the  day :  "for  the  common  people, 
moved  ami  vexed  by  their  injuries  suffered  in  property,  body  and  soul,  and 
oppressed  treacherously  and  immeasurably  by  the  priests,  would  suffer  no  longer, 
and  had  everycau.se  to  strike  right  and  left  with  club  and  flail."  (Gustav  Freytag 
"Aus  dem  Jahrhundert  der  Reformation."  I 

2.  How  far  at  this  time   a   similar  current  of  culture  reached,  and  how  widely  the 

development  of  human  civilization  at  this  epoch  had  a  reformative  tendency, 
may  be  inferred  from  the  fact  that  the  oldest  Asiatic  peoples,  like  the  Chinese 
and  Indians,  embraced  the  same  idea.  With  both  of  these  nations  the  national 
tongue  took  in  religious  writings  the  place  of  the  sacred  language,  and  the 
reformers    who    then     appeared  —  Kabir    (1450),    his    teachers    Rainanand    and 


—  356  — 

into  common  use,  and  even  took  precedence  in  writings,  sermons,  popular 
poetry  (once  more  revived)  etc.  In  this  way  the  masses  for  the  first  time 
took  part  in  the  intellectual  life  of  the  age,  a  part  which  the  dead  language 
of  the  Church  (in  itself  an  indication  of  foreign  domination)  had  hereto- 
fore wrested  from  them.  This  was  particularly  conspicuous  in  Germany, 
and  by  means  of  this  lever  e.  g.  Luther  (1483-154G)  and  Hutten  (1488- 
1523),  through  inflammatory,  and  as  yet  almost  uncensured.  pamphlets,  laid 
the  foundation  of  our  modern  press,  and  exercised  a  prodigious  influence, 
utterly  inconceivable  to  us.  For  their  words,  scattered  everywhere  by  the 
art  of  printing  and  the  indefatigable  printers  and  publishers  of  this  century, 
were  now  intelligible  to  all.  Upon  this  powerful  agent  the  Reformers 
(including  Paracelsus  also)  based  their  calculations  and  built  up  their  super- 
structure. Hutten  declared  that  he  wrote  German  at  this  time  in  order  to 
be  intelligible  to  his  native  land,  which  he  was  not  before  when  he  wrote  in 
Latin.  And  these  fearless  and  free  words  by  no  means  spared  the  high, 
mighty  and  powerful,  whether  noble,  or  king,  or  priest,  or  bishop,  or  pope 
—  all  were  scourged  with  a  recklessness  of  language  heretofore  entirely 
unheard  of.  The  16th  century  was  the  epoch  which  gave  birth  to  that 
part  of  modern  society  which  we  call  the  "  people  ",  and,  on  the  other  hand, 
the  priests  and  feudal  lords  of  earlier  times  step  henceforth  into  the 
background.  It  inaugurated  the  modern  democracy.  A  democratic  tend- 
ency spread  at  this  time  throughout  all  lands,  a  tendency  which  the 
absolutism  of  the  following  century  could  only  now  and  then  suppress, 
onhT  however  to  burst  forth  again  more  powerfully  at  the  close  of  the 
18th  century. 

But  the  most  powerful  agents  in  the  introduction  of  a  better  era  were 
the  new  philosophical  and  skeptical  currents  of  thought  which  began  to 
make  their  appearance,  and  subjected  all  medievalism  to  the  tests  of  proof 
and  doubt.  To  these  must  be  added  the  powerful  upgrowth  of  popular  i.  e. 
universal  schooling  and  mental  culture,  which  began  towards  the  close  of 
the  Middle  Ages  and  in  the  commencement  of  the  Modern  Era.  This  fell 
henceforward  more  and  more  into  the  hands  of  the  state  and  the  communi- 
ties, like  the  care  of  the  poor  and  the  sick :  for  the  means  squandered  b}' 
the  Church  during  the  Middle  Ages  now  remained  in  their  hands,  and 
furnished  them  with  the  facilities  for  such  work.  The  Church  had  always 
recognized  the  fact  that  the  possession  of  the  money  and  the  schools  was 
its  greatest  lever,  and  now  the  communities  too  had  caught  the  idea  and 
utilized  it  for  their  own  benefit.     To  perfect  this  scholastic  and  mental 

Nanak  —  extended  their  influence  by  means  of  the  popular  language  down  into 
the  strata  of  the  uneducated  masses.  (Prof.  Trumpp,  "Die  Religion  der  Sikhs".) 
The  Indian  emperor  Akbar  the  Great  (1542-1605)  even  compared  the  religion  of 
the  Jesuits  (from  whom  he  received  instruction)  with  the  Indian  creed,  but 
finally  remained  true  to  his  original  faith,  because  he  could  not  conceive  that  God 
could  have  upon  earth  a  standing  representative  (pope).  (Duke  of  Schleswig- 
Holstein,  pseudonym  Count  Nuhn). 


: 


—  357  — 

education  is,  therefore,  even  to-day  our  most  pressing  duty.  Among  the 
numerous  external  influences  which  effected  an  improvement  in  the  condition 
of  mankind  we  ma}'  only  mention  further,  as  the  most  powerful  and  most 
prominent,  commerce,  to  which  the  new  ocean-routes  and  new  productions 
afforded  a  support  heretofore  wanting.  Through  it  men  of  different  lan- 
guages and  customs  first  came  into  more  frequent  and  intimate  contact 
with  each  other,  and  thus  the  Cosmopolitanism  of  modern  times  (like  the 
the  earlier  Humanism  resulting  from  the  study  of  the  Ancients,  particularly 
the  Greek  authors  now  introduced  into  the  schools)  was  awakened  and 
vivified — in  the  main  a  blessing,  though  in  many  respects  also  productive 
of  evil.  The  greatest  promotion  of  ocean  navigation  (which  as  earl}'  as  the 
15th  century  had  received  its  fundamental  principles  from  German  mathe- 
maticians, by  whose  means  the  Portuguese  and  Spaniards  accomplished 
their  voyages  of  discovery)  in  the  16th  century  again  proceeded  from  a 
German,  Gerhard  Kremer  (Mercator,  1512-1594),  the  discoverer  of  the  mag- 
netic pole.  He  also  furnished  the  first  useful  ocean  charts  and  geographical 
maps  in  general,  and  called  the  complete  collection  of  them  an  "atlas". 
In  both  centuries  too  the  Germans  furnished  the  scientific  principles  upon 
which  other  nations  based  their  voyages,  their  commerce  and  their  wealth, 
while  they  themselves  were  not  able  to  appropriate  the  ocean  trade,  although 
at  an  earlier  period  they  had  carried  on  the  most  extensive  commerce 
(Hanseatic  League).  In  the  new  era  they  lost  their  position  as  the  first 
commercial  power  to  England1  and  the  Netherlands. 

That  the  influences  already  mentioned  had  a  powerful  direct,  and 
especially  an  indirect,  effect  upon  medicine,  is  easily  understood  and  as 
easily  proven. 

Besides  these,  other  special  influences,  partly  continued  from  the  past, 
partly  of  new  origin,  made  themselves  felt  in  either  advancing  or  hindering 
medicine  as  a  special  branch  of  general  culture.  • 

First  of  all  the  Humanistic  physicians,  or  rather  the  medical  philolo- 
gists, quietly  but  actively  undermined  the  preceding  Galenico-Arabian 
structure.  They  erected  the  arsenal  from  which  the  warriors  on  the  battle- 
field of  medicine  took  their  armor.  Yet  they  undermined  not  only  the 
Galenico-Arabian  medical  system,  but  with  it,  though  partly  involuntarily, 
the  ancient  medicine  in  general. 

Medicine  in  the  beginning  of  the  Modern  Era  received  its  mightiest 
impulse  by  far  from  the  same  strongly  Protestant  and  progressive  spirit, 
which  in  the  department  of  religion  broke  the  authority  of  the  ancient 
Church;  save  that  in  medicine  this  spirit  led  the  struggle  against  the 
medical  pope  of  the  Middle  Ages,  Galen,  and  against  his  servile  and  subtle 

1.  It  may  be  remarked  here  that  even  at  this  time  a  tariff  war  prevailed  between 
England  and  Germany.  The  struggle  between  the  "Monopolists ".  as  the 
English  company  of  "  Merchant  Adventures"  was  called,  and  the  comparative 
'"Free-traders",  who  belonged  to  the  Hanseatic  league,  was  also  lighted  up. 
(Moser,  "Patriotische  Phantasien."). 


—  358  — 

expounders,  the  Arabians,  and  finally  against  the  superstition  of  the  priests 
and  monks.  Thus  was  called  into  existence  what  we  must  call  a  national 
medicine,  which,  through  the  living  spirit  of  the  nations  and  through  their 
language,  won  fresh  momentum  and  better  comprehension  by  all,  than  the 
must}'  dead-letter  of  mediaeval  medicine.  In  this  way  only  can  we  com- 
prehend e.  g.  the  immense  influence  of  a  Paracelsus  ! 

In  medicine  the  German  element  now  supplied  the  productive  part  of 
the  ideas  and  the  lasting  intellectual  deeds.  A  characteristic  peculiarity 
both  of  the  new  culture  in  general,  and  of  medical  culture  in  particular, 
was  their  extension  to  an  ever  increasing  number  of  people,  while  in  pre- 
ceding ages,  especially  during  Antiquity,  a  single  nation  was  almost  always 
their  sole  support.  Thus  began  what  may  be  designated  as  the  Universal 
Medicine,  in  the  acquisitions  and  services  of  which  all  civilized  people  will 
one  day  take  an  equal  part,  and  for  the  completion  of  which  a  broad  foun- 
dation was  then  laid. 

New  forms  of  disease,  which  the  last  years  of  the  Middle  Ages  had 
generated,  and  whose  number  the  modern  period  still  increased,  brought  a 
more  reliable  differentiation  of  the  species  of  disease,  new  material  for 
reflection  and  new  demands  upon  medical  treatment,  since  the}-  could  not 
be  fitted  to  the  old  system. 

The  subsidiary  sciences  of  chemistry  (which  proceeded  from  the 
Arabians)  and  botany,  to  which  the  New  World  constantly  supplied  new 
material,  also  advanced  in  numerous  and  positive  ways  further  into  the 
foreground  of  medicine,  and  the  same  is  true  of  natural  philosophy.  These 
sciences  above  all  afforded  aid  to  medical  investigation,  and  have  thus 
given  to  the  latter  a  powerful  impulse  even  up  to  the  present  time.  Anat- 
omy, newly  created  at  the  close  of  the  Middle  Ages,  and  the  physiology 
founded  thereon,  now  first  exercised  an  influence,  more  especially  upon  the 
learned,  theoretic  side  of  medicine.  This  influence,  though  not  glaring  and 
speedy,  was  therefore  only  more  enduring  and  profound.  To  this  was 
united  pathological  anatomy. 

Through  definite  observation,  which  now  supplied  material  in  every 
way  better  and  immense  in  amount,  the  field  of  medicine  was  so  extended, 
that  by  degrees  there  appeared  a  division  of  labor,  which  seems  to  have 
not  quite  reached  its  climax  even  to-day.  At  first  this  division  took  place 
under  the  idea  of  the  unit}'  of  medical  science,  but  in  the  end  it  seems  to 
have  terminated  in  the  exactly  opposite  theory. 

As  the  result  of  the  prominence  of  the  method  based  upon  actual 
facts,  and  in  place  of  the  preceding  speculation  and  faith,  observation 
stepped  in,  and  thus  the  revolution  to  the  new  medicine  was  completed. 
While  Antiquity  sought  to  penetrate  into  the  inmost  recesses  of  human 
life,  especially  in  the  paths  of  speculation  and  without  occupying  itself 
sufficiently  with  its  phenomena  ;  while  the  Middle  Ages  in  faith  extended 
their  grasp  over  the  temporal  world  and  the  terrestrial  lever  of  existence 
and  its  phenomena  ;  so  the  Modern  Era,  and  still  more  its  medicine,  seeks 


—  359  _ 

chiefly  by  a  careful  observation  of  phenomena  to  penetrate  into  the  inmost 
laws  of  health}',  as  well  as  morbid  life.  Thoughtful  observation1  then  im- 
presses its  stamp  upon  the  whole  of  modern  medicine,  while  philosophy 
and  philology  only  rarely  gain  the  preponderance.  Yet  religious  belief 
and  superstition  still  continue  to  whisper  in  secret  in  this  department. 

Through  the  struggles  which  we  have  indicated  the  medicine  of  the 
Modern  Era  attained  by  degrees  the  grade  of  development  of  scientific 
medicine  so-called,  the  highest  grade  attainable,  according  to  the  judgment 
of  the  present  day.  Yet  the  universal  and  humane  medicine,  founded  upon 
ethics,  will  one  day  acquire  the  pre-eminence  even  over  this. 


II.  MEDICINE  UNDER  THE  INFLUENCE  OF  PROTESTANT  VIEWS. 
(THE  MEDICINE  OF  THOUGHTFUL  OBSERVATION). 

The  Sixteenth  Century 

is  one  of  the  grandest  and.  for  humanity,  the  most  important  of  all  history  ! 
It  laid  down  new  laws  and  new  forms  for  almost  eveiy  department  of 
human  thought  and  human  knowledge.  And  not  onl}'  the  lofty,  in  a  social 
and  intellectual  sense,  often  hazarded  their  all  for  the  attainment  of  higher 
intellectual  and  moral  objects,  but  the  common  people  likewise  took  part 
with  enthusiasm  in  the  reformation.  The  learned  particularly  satisfied 
their  burning  thirst  for  investigation,  knowledge  and  truth,  often  at  the 
expense  and  sacrifice  of  all  the  pleasures  and  conveniences  of  life,  both  at 
home  and  on  the  journeys  which  they  undertook  under  the  compulsion  of 
this  mighty  thirst  for  knowledge.  The  fundamental  chord  of  the  whole 
century  was  thoroughly  idealistic,  and  its  result  was  an  astonishing  creative 
activity  towards  even-  point  of  the  intellectual  compass  —  in  religion,  the 
arts,  the  sciences,  technics  and  social  life.  So  that  Hutten,  the  harbinger 
of  a  new  era,  burst  forth  into  a  song  of  triumph  :  "0  century  !  Studies 
bloom,  spirits  awaken,  it  is  joy  to  live  !"  We  of  later  birth,  however,  raay 
justly  cry  out :  0  century  !  Ours  thou  wert,  the  century  of  German 
mind  !  It  was  without  question  the  time  in  which  the  German  mind  as- 
sumed a  position  of  predominance  over  all  people  of  culture,  and  addressed 
itself  to  all  nations.  Luther  had  given  to  it  the  watchword  :  "  The  time 
of  silence  is  past  and  the  time  to  speak  has  come  !"  —  and  the  German  art 
of  printing  spoke  with  a  thousand  tongues  and  in  accordance  with  all  the 
tendencies  of  the  new  era  !  For  medicine  especially,  the  sixteenth  century 
is  of  an  importance  similar  to  the  age  of  Hippocrates  ;  for  during  this  era 
was  first  enlarged  the  edifice  whose  foundation  he  had  already  laid.  Dur- 
ing this  period  too  medicine  stepped  forth  from  the  fetters  of  authority 
and  the   halls  of  the  universities  within  the  jurisdiction  of  authority,  into 

1.   From  the  16th  century  onward,  therefore,  we  frequentlj'  meet  complete  collections 
of  "  Observationes". 


—  360  — 

a  new  and  vigorous  life.  It  became  once  more,  so  to  speak,  exoteric,  after 
a  long  period  of  esoteric  confinement  in  the  barriers  of  the  Church  and 
unhealthy  thought.  The  16th  century  ripened  free  investigation,  and  was 
in  medicine  too  peculiarl}-  the  century  of  reformation,  of  struggle  and  of 
protest  against  all  medicine  which  had  abandoned  the  principles  of  Hippo- 
crates, principles  which  placed  the  observation  of  nature,  not  the  letter  of 
tradition,  in  the  fore-front  of  knowledge.  The  levers  by  which  this  reform- 
ation was  accomplished  were  Humanism,  the  new  anatoury,  new  diseases 
and  the  doctrines  of  Theophrastus  von  Hohenheim  and  Pare  (odd  as  the 
association  may  sound).  The  struggle  was  intimately  allied  with  Protest- 
antism in  religion1,  only  medicine  went  further  than  religion,  and  in  its 
own  department  began  to  dig  up  and  remove  gradually  the  roots  of  all 
faith  and  the  grounds  of  all  authority  founded  therein,  in  order  to  afford 
room  for  reason  and  sight  alone. 

That  the  16th  century  was  a  century  of  struggle,  in  which  the  old  was 
demolished  and  the  new  built  up,  is  very  manifest  when  we  consider  the 
services  which  it  rendered  to  science  and  the  names  to  which  these  ser- 
vices are  forever  united. 

Above  all  Galen  and  the  Arabians  were  thrown  down  (though  not  in 
the  lecture  rooms)  from  their  seats  of  authority,  heretofore  uncontested, 
and,  on  the  one  hand,  the  banner  of  Hippocrates,  on  the  other,  that  of  a 
new  and  independent  medicine  was  firmly  planted.  So  fierce  was  the 
struggle  thus  begun,  that  it  stirred  to  its  very  bottom  the  whole  medical 
world  of  the  period.  Opinions  clashed  so  strongly  against  each  other,  that 
even  the  temporal  power  was  at  one  time  called  upon  to  aid  in  opposing 
the  innovations.  Upon  this  battle-field  gleamed  the  name  of  Paracelsus, 
and  here  that  of  Brissot  became  prominent. 

The  sixteenth  century  is  likewise  the  golden  age  of  the  great  anato- 
mists, of  Vesalius,  Falloppio,  Eustachi,  and  all  the  others,  who.  partly  by 
the  genuine  excellence  of  their  work,  partly  too  by  the  newness  and  conse- 
quent fertility  of  their  field  of  labor,  became  immortal  in  the  department 
of  anatomy. 

Surgery  and  midwifery  also  received  a  new  impulse.  This  is  evidenced 
by  the  single  name  of  Ainbroise  Pare,  and  by  the  single  fact  that  in  this 
period  occurred  the  reintroduction  of  that  most  beneficent  operation, 
podalic  version,  and  the  performance  of  the  first  Caesarean  section  upon 
the  living  woman.  Ophthalmology  was  likewise  newly  founded,  and  the 
subsidiary  sciences  of  botan}-  and  chemistry  were  made  subservient  to 
medicine.  Yet  chemistry  still  wore  the  deceptive  cloak  of  alchemy,  which, 
together  with  other  forms  of  foil}*,  Cabalism,  magic,  astrology,  chiromancy 
and  necromancy,  still  held  even  the  best  minds  in  its  toils. 

1.  It  is  manifest  that  the  partisans  of  the  Protestant  movement  in  medicine  were  not 
necessarily  all  of  them  actual  followers  of  Protestantism  in  religion  also.  Their 
work,  however,  brought  them  into  intellectual  relations  with  the  latter. 


—  361  — 

The  revival  of  the  study  of  the  genuine  writings  of  the  Ancients1 
brought  once  more  improved  artistic,  historical  and  philosophical  views 
(which  had  been  so  long  wanting),  and  with  them  a  pagan  soberness  of 
thought  and  clear  and  more  beautiful  forms  and  language. 

In  addition  to  the  earlier  universities,  those  founded  more  recently  in 
Germany  —  Wittenberg2  (1502),  Frankfort-on-the-Oder  (1506  or  1499,  re- 
moved to  Breslau),  Marburg  (1527),  Kijnigsberg  (154-4),  Strassburg  (1566), 
Jena  (1557),  Helmstadt  (1575),  Altdorf  near  Nuremberg  (1571),  Herborn 
(1584),  Gratz  (1565),  Paderborn  (1592)  and  others  in  other  lands3  —  with 
scientific  efforts  limited  b}'  statutes  and  entirely  consonant  to  the  spirit 
of  the  age,  contributed  their  share  to  the  cultivation  of  these  innovations. 
They  promoted  medicine  in  this  century  more  than  in  the  preceding,  although 
these  institutions  were  still  designed  purely  for  teaching  (as  they  are  to-day) 
and  not  for  investigation.  The  so-called  "Academies  "  of  savants,  associa- 
tions which  took  their  name  from  the  example  of  Plato  (now  revived),  were 
institutions  designed  exclusively  for  investigation. 

1.    INFLUENCE  OF  PHILOSOPHY  (ASTROLOGY  AND  THE  ALLIED  BRANCHES),  THE 

NATURAL  SCIENCES,   MATHEMATICS,  THE  ARTS  AND  PHILOLOGY 

UPON  THE  MEDICINE  OF  THE  SIXTEENTH  CENTURY. 

For  the  comprehension  of  the  often  contradictory  phenomena  and 
struggles  of  the  sixteenth  century  in  the  field  of  medicine,  a  consideration 
of  the  general  tendency  of  thought  (which  made  itself  felt  of  course  in 
medicine,  as  in  all  other  sciences)  is  more  necessary  than  for  any  other 
period. 

Beside  an  earnest  effort  to  advance,  a  retrograde  impulse  of  equal 
strength  manifested  itself;  beside  the  clearest  discernment  appeared  the 
darkest  superstition  ;  beside  poor  dupes  stood  the  grandest  impostors  ; 
beside  philanthropic  efforts  were  deeds  of*  the  most  terrible  delusion  ;  in 
short  we  observe  a  collection  of  revelations  and  riddles  of  the  human  mind 
and  of  national  psychology,  such  as  no  other  period  can  offer. 

In  the  field  of  philosophy,  especially  in  Ital}-,  there  had  occurred  as 
early  as  the  preceding  century  a  revival  of  the  (ideal)  Platonic  philosophy, 
as  a  reaction  against  formal,  realistic  (Aristotelian)  Scholasticism.  This, 
however  (and  the  point  is  of  interest  in  the  history  of  culture),  under  the 
influence  of  mediaevalism,  soon  terminated  in  Neo-Platonism,  and  allied 
itself  with  Cabalism,  with  which  it  stood  in  close  relations  at  an  earlier 
period.     In  Germany  even  the  learned,  though  superstitious,  Reuchlin   (a 

1.  Hence  this  whole    period   received,    as  we  know,   the   title   of  the   "Era  of  the 

Renaissance". 

2.  Raised  to  world-wide  historical  fame  by  the  labors  of  Luther,  and  the  first  univer- 

sity established    by   the   state,    as   well    as   the   first   Protestant    university,    in 
Germany. 

3.  Toledo  (1518),  Seville  (1531),   Granada  (1531),   Leyden  (1575),  Edinburgh  (1582), 

Venice  (1592),  Dublin  (1593),  Parma  (1599).     (H.) 


—  362  — 

benefactor  of  Germany  by  his  diffusion  of  a  knowledge  of  Greek  and 
Hebrew),  as  we  have  already  mentioned,  embraced  Cabalism,  and  in  1517 
published  a  pregnant  work  "  De  arte  cabbalistica  ",  in  which,  in  the  failure 
of  other  evidence,  he  brought  forward  the  Cabala  as  the  best  support  to  the 
doctrines  of  the  Trinity,  the  Godhead  of  Christ  etc.  Of  the  same  opinion 
were  his  contemporaries  Francesco  Giorgio  (Dardi,  1460-1540),  a  Minorite, 
and  his  pupil,  the  farmer's  son  Joh.  Heidenberg,  named  Trithemius  (1462- 
1516),  of  Tritheim  near  Treves.  The  latter  became  abbot  of  Sponheim 
near  Kreuznach.  and  was  one  of  the  chief  disseminators  of  Cabalism  in 
Germany.1 

Another  famous  Cabalist  was  the  notorious  and  quixotic  theosophist? 
Heinrich  Cornelius  AoRirPA  von  Netteshelm  (1486-1535), 
a  man  interesting  from  the  course  of  his  destiny  and  the  originalit}-  of  his 
mind,  incomprehensible  from  the  contradictions  of  his  doctrines  and  his 
life,  and  probably  rather  a  deceiver  than  a  dupe. 

Born  in  Cologne  on  the  Rhine,  as  early  as  his  24th  year  he  taught  Cabalism  in 
Dole,  in  accordance  with  Reuchlin's  book  "  De  Verbo  mirifico".  In  1510,  banished 
through  the  influence  of  the  monk  Catelinet,  he  went  thence  to  London,  and  from 
this  city  to  Pavia,  where  in  1515  —  an  evidence  of  the  odd  tendency  of  the  universities 
of  that  day  —  he  expounded  the  spurious  "  Hermetic  Books". 

But  the  fickle  Proteus  did  not  remain  here.  Entering  the  military  service,  he 
roved  through  the  half  of  Europe,  became  a  lawyer  in  Metz,  but  expressing  some 
views  opposed  to  the  belief  in  saints  and  witches,2  sensible  in  themselves,  but  danger- 
ous at  that  time  (as  they  would  be  in  certain  places  to-day),  he  was  forced  to  fly. 
Next  he  was  a  physician  at  Freiburg  in  Switzerland,  then  at  Lyons,  and  finally  in  the 
train  of  the  queen  of  France.  Declining,  however,  to  predict  the  future  for  his  royal 
mistress  he  was  dismissed  from  her  service,  and  again  compelled  to  become  a  wanderer, 
until  at  last  he  found  in  15155  his  first  and  last  permanent  home  in  the  grave  at 
Grenoble,  after  having  published  a  work  "  De  vanitate  scientiarum  ",  in  which  he 
repudiated  everything  which  he  had  taught  during  his  life,  Cabalism,  alchemy,  astrol- 
ogy,3 and  all.  In  his  "  Occulta  philosophia"  he  teaches  the  existence  of  three  worlds : 
a  celestial,  an  elementary  and  an  intellectual.  These  furnish  the  subjects  of  mathe- 
matics, physics  and  theologj".  From  out  of  bodies  and  beings  flow  into  space  in- 
divisible idols,  unaffected  by  distance,  so  that  by  their  means  e.  g.  communication 
may  be  had  with  another  person  across  the  greatest  spaces,  indeed  over  into  eternity, 
as  in  the  modern  Spiritualism.  The  human  mind  is  similar  to  the  anima  mundi, 
which  dwells  in  all  bodies,  and  is  attracted  from  one  to  another.  Hence  it  is  possible 
for  the  initiated  to  produce  entirely  new  matter,  and  even  gold.  Sympathy  towards 
similar  tilings  and  antipathy  towards  dissimilar  things  rule  all  worlds  —  a  Xeo-Platonic 


1.  Trithemius,  though  not  an  entirely  legendary  character  like  the  Dr.  Juh.  Faust, 

whose  "  history "  during  the  16th  century  gave  occasion  for  Goethe's  immortal 
dramatic  poem,  was  regarded  as  a  miracle  worker  and  magician.  An  actual 
Dr.  George  Faust  is  said  to  have  been  the  source  of  the  Faust  legend. 

2.  Wier  was  one  of  his  pupils. 

3.  Astrology  at  this  period   and  still  later  was  considered   an   authorized,  "exact" 

science,  which  included  mathematics,  astronomy  and  medicine,  and  was  therefore 
taught  in  the  universities,  so  far  as  it  was  independent  of  magic,  that  is  the  effort 
to  accomplish  the  supernatural  by  the  aid  of  angels  and  devils.  It  requires 
mention  here  from  its  connection  with  the  medicine  of  that  period. 


—  363  — 

idea  —  and  these  influences  bring  the  things  of  one  world  into  union  with  those 
of  another.  Thus  each  part  of  the  body  is  associated  with  a  constellation  or  an  in- 
telligence, i.  e.  a  demon.  Of  these  demons  everj-  man  possesses  three:  a  celestial  one 
from  God,  another  from  his  birth,  and  a  third  from  his  constellation  and  the  heavenly 
intelligence.  These  demons  are  lords  of  the  four  elements  and  of  the  constellations. 
But  since  the  planets  influence  the  destiny  of  man,  so  the  spirits  also  have  indirectly 
an  influence  upon  man's  fate.  By  fumigation  with  "corresponding "  materials,  as 
well  as  by  the  use  of  certain  words,  they  may  be  made  obedient,  and  in  this  way  they 
may  be  expelled  in  diseases,  of  which  thej"  are  the  authors  and  the  cause.  The  most 
powerful  words  are  those  of  the  sacred  Hebrew  tongue.  Numbers  too  contain  super- 
natural powers.  Thus  e.  g.  verbenaca,1  cut  at  the  third  joint,  cures  tertian  fever;  but 
if  separated  at  the  fourth,  it  cures  quartan  !  Finally,  by  the  aid  of  curious  scales 
of  trinity,  duality  etc.,  the  three  worlds  above  mentioned  were  so  divided  that  an 
infinity  of  worlds  and  a  world  full  of  nonsense  originated. 
Similar  to  the  above  were 

Francesco  Greoorio  Zorzi  <-  Venetus  ".  the  Venetian,  from  his  native 
city,  died  153G)  and 

Hieronymus  Cardanus  (1501-1576)  of  Pavia, 
"the  wisest  fool  and  most  foolish  wise  man''  of  his  time.  Descended  from  a  lovely 
pair  —  his  mother  lived  apart  from  her  husband  and  endeavored  in  vain  to  destroy 
the  offspring  of  her  union  (the  future  Cardanus),  while  the  father  continually  mal- 
treated his  son  —  he  passed  through  a  youth  of  constant  ill  health,  having  survived  an 
attack  of  the  plague  shortly  after  his  birth.  Living  under  the  rod  of  paternal  super- 
stition and  unfeeling  vulgarity  (his  father  believed  himself  the  possessor  of  a  special 
"  demon"  and  employed  his  son  as  —  a  servant!,  it  was  not  until  his  l'Jth  year  that 
he  began  to  receive  ordinary  instruction  in  the  gymnasium.  By  this,  however,  he 
profited  so  fully,  and  after  his  father's  death  he  labored  so  incessantly,  that  at  the  age 
of  twenty-one  he  had  become  so  much  a  master  of  medicine,  mathematics  and  philos- 
ophy as  to  be  able  to  dispute  publicly  upon  these  subjects.  In  his  2:!d  year  he  went 
to  Padua  anil  obtained  a  livelihood,  though  a  scanty  one,  by  playing  chess,  an  accom- 
plishment in  which  he  speedily  acquired  great  skill.  Graduating  at  the  age  of  24-,  he 
practised  in  small  towns  in  continual  poverty,  until  in  1534  he  was  called  as  professor 
to  Milan.  Two  years  later,  however,  he  removed  from  this  city  to  Piacenza.  From 
154o  onward  he  lived  alternately  in  Milan  and  Pavia,  but  in  1550  went  to  Scotland  in 
pursuance  of  a  call  to  assume  the  treatment  of  a  certain  archbishop.  Returning  to 
Italy,  he  again  lived  alternately  in  the  two  cities  mentioned  until  he  received  a  call  to 
Bologna,  but  falling  into  the  prison  for  debtors,  where  he  spent  a  year,  he  died  finally 
in  Rome,  just  as  he  had  attained  a  better  financial  position  through  an  annual  salary 
granted  to  him  by  the  pope. 

That  under  such  circumstances  a  great  mind,  rather  than  a  good  character,  may 
be  developed,  is  shown  by  the  infirmities  of  Cardanus  and  the  later  example  of  Brown. 
Cardanus  taxes  himself  with  the  following  infirmities,  though  some  of  them  may 
figure  rather  as  the  inventions  of  self-torment,  than  as  actually  existing  faults:  deceit, 
envy,  libidinousness,  calumniation,  scorn  for  religion  etc.  His  chronic  impotence  he 
laid  to  the  charge  of  the  constellations,  claimed  for  himself  a  special  demon,  taught 
the  sympathy  of  the  parts  of  the  body  with  the  stars,  believed  that  beings  of  a  lower 
order  originate  in  putrefaction,  declared  that  he  was  one  of  the  seven  great  physicians 
who,  up  to  his  time,  had  blessed  or  afflicted  the  world,  maintained  the  impossibility 
of  life  without  suffering,  drew  the  horoscope  of  the  whole  world  (like  a  second  Christ), 
and  was  guilty  of  many  other  similar  absurdities.     Astrology  too  he   called  to  his  aid 

1.    Verbena  officinalis.     (H.) 


—  364  — 

in  the  explanation  of  symptoms  and  the  administration  of  laxatives  —  the  latter  a 
grotesque  and  conspicuous  piece  of  quacketT  which  long  maintained  existence,  though 
since  the  17th  century  it  has  assumed  different  forms  and  is  more  concealed.1  On  the 
other  hand  he  declares  himself  in  another  place  entirely  free  from  prejudice  against 
astrology,  chiromancy,  magic,  poisoning  and  alchemy,  and  towards  superstition  and 
faith  in  miracles. 

The  contradictions  of  which  Cavdanus,  as  well  as  Agrippa,  was  guilt}-, 
must  be  taken  parti}-  as  signs  of  a  weak  character,  and  partly  as  founded 
in  the  spirit  of  an  age  rich  in  similar  combinations  of  folly  and  the  clearest 
insight.  This  ma}-  be  seen  more  plainly  from  the  fact  that  in  the  university 
of  Salamanca  a  special  chair  for  the  invocation  of  the  dead,  necromancy, 
existed,  and  that  text-books  on  the  art  of  chiromancy  were  published  e.  g. 
by  Bartholonueus  della  Rocca  (called.  Codes),  Johannes  ab  Indagine  and 
Andreas  Corvin.  This  ought  not  to  occasion  much  surprise,  for  in  our  own 
day  even  professors  publish  absurdities  of  the  same  kind. 

According  to  the  principles  of  chiromancy,  the  thumb  is  under  the  control  of  Mats, 
and  from  its  form  in  any  individual  ma}-  be  determined  his  strength,  sensuality  and 
courage;  the  forefinger  is  under  the  control  of  Jupiter,  and  it  indicates  positions 
of  honor;  the  little  finger  belongs  to  Venus,  and  indicates  children  and  beautiful 
wives;  while  the  external  border  of  the  hand  signifies,  under  certain  circumstances, 
discoveries,  catarrhs  —  shipwrecks  and  similar  disagreeable  accidents! 

The  people  were  educated  to  a  belief  in  astrology2  by  almanacs,  and, 
indeed,  chiefly  by  physicians,  who  at  that  period  frequently  got  up  these 
calendars,  and  who  must,  therefore,  be  regarded  as  involved  in  the  same 
superstition,  nnless  we  are  willing  to  condemn  them  undeservedly,  and  to 
regard  them  as  mere  advertising  charlatans.  Even  the  noble  Melanchthon 
was  one  of  the  most  zealous  champions  of  astrology,  and  his  son-in-law,  the 
physician  Caspar  Peucer  (1525-1602),  professor  of  medicine  at  Wittenberg, 
was  a  believer  in  demons.  A  special  figure,  inscribed  with  suitable  direc- 
tions, pointed  out  the  proper  places  for  bleeding  under  each  constellation, 
and  was  called  the  "  Aderlassman'  .  That  these  calendars  were  also  inter- 
larded with  prophecies  concerning  the  end  of  the  world  etc.,  should  again 
occasion  no  surprise,  for  the  same  things  are  to  be  seen  at  the  present  day. 
But  medicine  itself  was  constantly  allied  with  astrology,  as  e.  g.  by  Peucer's 
predecessor.  Prof.  Jacob  Milieh  of  Wittenberg,  by  Corvin,  by  Michael  Nos- 
tradamus3 (1503-1566),  a  physician  and  alumnus  of  Montpellier,  by  Jacob 
Pons,  who  considered  astrology  one  of  the  preparatory  branches  of  medicine, 
by  Thomas  Giannozzi,  and  very  many  others. 

1.  It  began  to  fade  away  very  gradually  before  the  discovery  of  Copernicus. 

2.  The  stars  during  the  Middle  Ages  (and  in  Antiquity )  were  regarded  as  living  beings, 

who  exercised  an  influence  over  men  from  their  birth  and  were  skilled  in  giving 
to  men  public  and  private  revelations  as  to  the  future. 

3.  Nostradamus's   predictions  were   expressed   in   quatrain   verse   and   published   in 

"  Centuries".     The  first  seven  "  Centuries"  appeared  at  Lyons  in  1555  and  gave 
occasion  to  the  following  jeu  d'  esprit: 

"Nostra  damus,  cum  falsa  damns,  nam  fallere  nostrum  est, 

Et  cum  falsa  damus,  nil  nisi  nostra  damus."  (H.) 


—  365  — 

The  belief  in  witches  too,  atid  the  trial  of  witches  (still  frequent  in  the 
century  of  the  Reformation  and  not  opposed  by  the  reformers  themselves), 
so  disgraceful  to  both  human  reason  and  to  civilization,  must  not  pass 
unnoticed,  if  for  no  other  reason,  because  they  gave  occasion  to  a  member 
of  the  medical  profession,  Johannes  Weyer  (Wierus,  1515-1588),  an  honest 
and  learned  man,  but  without  genius,  though  immortal  for  his  sound  under- 
standing), to  stand  up  first  against  this  superstition,  and  thus  to  benefit 
medicine  yet  entangled  in  the  bands  of  astrology. 

According  to  the  popular  belief  alliance  with  the  devil  was  of  three  kinds.  The 
man  renounced  God  and  went  over  to  the  worship  of  the  devil,  offering  him  an  oath 
of  allegiance,  homagium.  This  was  the  method  of  witches  and  their  assistants.  Or 
the  devil  took  possession  of  the  man  during  life,  converting  him  into  one  possessed. 
This  belief  the  Germans  borrowed  from  Holy  Writ.  Finally  the  man  might  make  a 
compact  of  mutual  obligation,  assigning  his  soul  to  the  devil  etc.  Even  before  the 
introduction  of  Christianity  there  existed,  beside  the  worship  of  the  ancestral  gods,  a 
service  of  demons,  among  whom  were  the  devil  (Diabolus,  Tiuf'al,  Gott  Fol,  Voland) 
and  his  grandmother.  The  priestesses,  by  means  of  incantation  of  the  goddess  of 
death,  could  bring  stormy  weather  upon  the  crops,  and  destroy  the  herds.  It  was 
they  too,  probably,  who  rendered  the  body  and  weapons  of  the  warriors  invulnerable. 
Thejr  celebrated  their  sacred  ceremonies  by  night,  and  offered  dark-colored  victims  to 
the  gods.  It  was  these  priestesses  especially  who,  as  Hazunser  or  Hegisten,  witches, 
preserved  their  own  traditions  of  the  old  faith  far  into  the  Middle  Ages.  "From  the 
year  1481,  after  the  unfortunate  bull  of  pope  Innocent  VIII.  (1484-141)2)  entitled 
"  Summis  desiderantes  ",  a  wholesale  burning  of  witches  began  in  Germany  and  con- 
tinued with  some  interruptions  far  into  the  18th  century."  (Gustav  Freytag).  Under 
the  mantle  of  the  religion  of  Christ,  so  outrageously  abused,  the  trial  of  witches  was 
carried  on  against  poor  crack-brained  creatures  (demonomaniacs)  and  utterly  innocent 
victims.  By  means  of  instruments  of  torture,  whose  verj7  description  makes  one 
shudder,  the  desired  evidence  was  extorted  —  all  to  the  greater  honor  of  God!  In- 
quisitors were,  indeed,  created  by  pope  Gregory  IX.  as  early  as  1233,  but  the  fatal 
beginning  was  first  made  in  Germany  by  Heinrich  Institor  and  Jacob  Sprenger 
(author  of  the  witches  codex  "  Malleus  maleficarum  ",  1489)  under  the  authority  of  the 
bull  mentioned.  This  bull,  as  a  matter  of  fact,  applied  to  heretics  only,  in  order  to 
reach  whom  the  better  the  priests  with  devilish  cunning  had  exhausted  their  ingenuity, 
though  they  failed  to  attain  their  object.  The  prejudiced  civil  authorities  lent  their 
arm  to  the  execution  of  their  disgraceful  decrees,  and,  indeed,  in  the  law-books 
witchcraft  was  enumerated  among  the  crimes!  In  this  way  children  between  the  ages 
of  one  and  twelve  years  were  murdered  as  witches.  In  Geneva  more  than  500  men 
were  burned,  and  in  the  Electorate  of  Treves  full  6,500  were  in  a  short  time  executed. 
A  single  executioner  —  his  name  was  Balthasar  Voss  —  had  in  nineteen  years  burned 
700  human  beings  (among  them  a  woman  who  had  given  birth  to  an  infant  under  the 
torture  of  the  rack,  and  whose  infant  was  burned  with  her!),  and  aspired  to  bring  his 
number  up  to  a  full  1000!  The  witch-finding  inquisitor  of  course  received  12-15 
marks  for  each  witch  —  hence  his  zeal  and  their  tears!  That  the  Reformers  were 
also  involved  in  the  belief  in  demons  is  proven  by  Luther  himself,  who  advised  that 
a  possessed  maiden  should  be  cast  into  the  river  Mulde,  and  was  greatly  provoked 
when  he  heard  that  his  advice  had  not  been  followed !  The  twelve  years  old  child 
was  simply  troubled  with  a  voracious  appetite!  The  epidemic  of  witch-burning  con- 
tinued until  late  into  the  18th  century,  and  the  belief  in  witches  still  prevails  among 
the  masses!  Weyer' s  footsteps  were  followed  by  the  theologians  Joh.  Wagstaff,  Balth. 
Becker,   Hieronymus  Tartarotti,   Ferd.   Sterzinger,   Spee,  J.  Gal.  Semmler,   and   the 


—  366  — 

lawyers  T.  G.  Godelmann,  Thoinasius.  prince  Wilhelm  von  Clove,  the  elector  of 
Mayence,  Joh.  Phil,  von  Schonborn,  and  others,  so  that  the  trial  of  witches  was  not 
abolished  until  close  upon  the  threshold  of  the  present  century.1 

1.  The  frenz\'  reached  England  somewhat  later,  hut  raped  none  the  less  fiercely. 
The  practice  of  witchcraft  was  made  a  capital  offence  by  a  statute  of  Elizabeth 
in  1562,  and  a  similar  statute  was  enacted  in  Scotland  in  the  following  year.  In 
1590  king  James  VI.  of  Scotland  himself  took  part  in  the  torture  and  examina- 
tion of  a  number  of  persons  accused  of  practising  the  black  art  against  his  own 
person,  and  thirty  of  them  were  executed  for  the  crime  on  the  Castle-hill  in 
Edinburgh.  The  same  versatile  monarch  in  1597  published  a  professed  treatise 
on  "Demonology  ".  Immediately  upon  his  accession  to  the  throne  of  England  a 
new  statute  carefully  defining  the  crime  of  witchcraft  was  passed,  and  henceforth 
conviction  and  punishment  for  this  offence  became  more  common.  The  chief 
witch-finder  of  England  was  one  Matthew  Hopkins,  who,  with  his  assistants,  from 
the  year  1(U4  onward  made  regular  visits  to  the  chief  towns,  agreeing  for  the  very 
moderate  sum  of  20s.  to  detect  all  the  witches  in  their  neighborhood.  In  Scotland 
no  official  witch-finder  seems  to  have  been  appointed,  but  the  work  was  zealously 
performed  by  the  clergy,  who  vied  with  each  other  in  the  detection  of  these 
malignant  offenders.  It  was  during  the  session  of  the  Long  Parliament,  howe\er 
(1640-1044),  that  the  persecution  of  so-called  witches  reached  its  height  in 
England,  and  no  less  than  3,000  legal  executions  on  the  charge  of  witchcraft  are 
said  to  have  occurred  during  this  period.  As  late  as  1664  two  women,  Amy  Punnj- 
and  Rose  Callender,  were  condemned  and  executed  at  Bury  St.  Edmunds,  under 
the  judicial  decision  of  that  well-known  and  upright  judge  Sir  Matthew  Hale,  and 
it  is  said  that  their  conviction  was  largely  due  to  the  opinions  and  arguments 
of  the  famous  Sir  Thomas  Browne,  a  Poctor  of  Medicine  of  Leyden,  and  author 
of  the  work  "Enquiries  into  Vulgar  and  Common  Errors."  The  first  persons 
of  eminence  in  England  to  expose  the  absurdity  of  the  trials  for  witchcraft  were 
Chief  Justices  North  and  Holt  in  1694,  but  a  Mrs.  Hicks  and  her  daughter,  aged 
9  years,  were  condemned  and  hanged  at  Huntingdon  for  selling  their  souls  to  the 
devil  in  1716,  and  the  statute  relative  to  the  practice  of  witchcraft  was  not 
repealed  until  1736. 

In  America,  as  the  frenzy  arrived  late,  so  also  it  was  happily  of  short  duration. 
A  turbulent  Swedish  woman  of  Pennsylvania  was  accused  of  witchcraft  in  1684, 
and  brought  to  trial  before  Penn  and  a  jury,  the  majority  of  whom  were  Quakers. 
The  verdict  "  The  prisoner  is  guilty  of  the  common  fame  of  being  a  witch,  but 
not  guilty  as  she  stands  indicted",  put  an  end  forever  to  similar  prosecutions  in 
that  province.  But  in  New  England  the  superstition  was  more  serious  in  its 
results.  Here,  too,  the  clergy,  under  the  lead  of  the  famous  Cotton  Mather  and 
Samuel  Parris,  were  the  most  prominent  inquisitors  and  persecutors.  Mather 
declared  from  the  pulpit  "Witchcraft  is  the  most  nefandous  high  treason  against 
the  Majesty  on  high"  ;  "a  capital  crime ".  "A  witch  is  not  to  be  endured  in 
heaven  or  on  earth".  In  1688  a  poor  Irish  woman,  supposed  by  some  to  be 
"crazed  in  her  intellectuals",  was  condemned  and  executed.  In  1692  the  village 
of  Salem  (now  Danvers),  under  the  spiritual  direction  of  the  minister  Samuel 
Parris,  became  the  scene  of  the  most  outrageous  cruelties  practised  under  the 
cloak  of  the  trial  of  witches.  Twenty  persons  were  put  to  death,  and  fifty-five 
tortured  or  frightened  into  confessions.  The  jails  were  filled  with  the  accused 
and  suspected.  But  the  awakened  common-sense  of  the  people  soon  asserted 
itself  once  more,  and  in  1693  all  the  prisoners  were  dismissed  or  acquitted  and 
the  delusion  came  to  an  end. 


—  367  — 

The  absurd  story  of  the  golden  tooth,  which  a  boy  of  Schweidnitz  was 
said  to  have  possessed  from  birth,  is  connected  with  the  history  of  medicine 
only  from  the  fact  that  it  was  a  physician  of  that  town,  Jacob  Horst 
(1537-1600),  who,  in  accordance  with  the  superstition  of  his  time,  in  1595 
prophesied  from  this  miracle  the  approach  of  the  Golden  Age  (which 
physicians  at  least,  as  we  all  know,  in  spite  of  Horst,  do  not  yet  enjoy). 
Other  forms  of  the  dark  spirit  of  this  age,  the  search  for  the  philosophers' 
stone  and  the  art  of  making  gold,  are  interesting,  however,  from  the  fact 
that  it  was  chiefly  physicians  who  busied  themselves  with  such  investiga- 
tions, and  again  that  chemistry,  which  has  proved  so  useful  in  medicine, 
originated  therefrom.  Indeed  there  is  no  folly  so  gross  that  it  may  not 
bring  with  it  something  good. 

A  revival  of  the  philosophy  of  Aristotle  speedily  appeared  in  oppo- 
sition to  the  Platonism  and  Neo-Platonism,  with  which  the  phenomena  just 
mentioned,  the  offspring  of  perverted  spiritual  life,  stood  in  genetic  con- 
nection. Among  the  adherents  of  this  philosopy  in  Germany  were  Luther 
and  Melanchthon,  that  immortal,  but  modest  teacher  of  German}",  to  whom 
the  Germans  owe  more  than  to  all  the  universities  of  that  day  combined. 
Yet  Melanchthon  too  was  not  exempt  from  Neo-Platonic  vagaries.  The 
new  Peripatetics  based  their  views,  for  the  most  part,  on  the  genuine  works 
of  Aristotle,  though  some  of  them  adopted  his  views  as  corrupted  by  the 
Arabians.     The  earliest  among  them  was 

Pietro  Pomponazzi  (Pomponatius,  1462-1525), 

who,  in  his  skepticism  founded  in  profound  reflection,  declared  himself  opposed  to 
cabalistic,  astrological  and  all  other  absurdities,  including  miracles  and  even  the 
immortality  of  the  soul,  which  latter  seemed  to  him  an  assumption  incapable  of  proof 
on  the  grounds  of  reason.      Allied  to  him  in  thought  was  the  physician 

Andrea  C.esalpino  (1519-1603), 
whose  conclusions  led  him  to  outspoken  pantheism.  —  Among  the  followers  of  Pom- 
ponazzi were 

Sepulyeda  (died  1572),  a  Spaniard  ; 

Giovanni  Batt.  Porta  (1535-1615), 
Uiventor  of  the  camera  obscura  in  1588,  an  opponent  of  the  belief  in  witches  and  a 
predecessor  of  Lavater  in  the  science  of  physiognomy  ; 

Agosttno  Nifo  (1473-1546)  of  Calabria, 
a  famous  physician  and  glorifier  of  female  charms.     Next  the  latter  stood 

Marc  Antonio  Zimara  (died  1532). 
a  professor  in  Padua,  and  later 

Lucilio  Vanini  (1585-1619), 
who  was  burned  at  the  stake  as  a  rejector  of  God  and  therefore  a  most  mischievous 
heretic,  and  others.  —  On  the  other  hand 

Pierre  de  la  Ramee  (Petrus  Ramus,  1515-1572), 
who  was  slain  in  the  massacre  of  St.  Bartholomew's  night,  was  a  hearty  scorner  of 
Aristotle.     He  was  followed  by  the  numerous  schools  of  Ramists,  who  fell  into  dis- 
sensions with  the  partisans  of  Aristotle  similar  to  those  which  took  place  between 
the  Realists  and  Nominalists  of  the  Middle  Ages. 


—  368  — 

Bernardino  Telesio  (1508-1588)  of  Cosenza, 
the  founder  of  a  special  academy  of  natural  philosophy  (Telesian  or  Cosentine)  and 
a  partisan  of  the  Eleatic  philosophy,  was  likewise  an  opponent  of  Aristotle. 

Franciscus  Patritius  (Patrizzi,  1529-1597) 
also  appeared  as  an  opponent  of  Aristotle  with  a  Neo-Platonic,  Christian,  mystic  and 
pantheistic  natural  philosophy,  as  did  also 

Giordano  Bruno  of  Nola  (1548-1600), 
who,  after  abandoning  the  Dominican  order  and  wandering  about  through  France, 
England,  Germany  and  Switzerland  for  eleven  years,  imprudently  returned  to  Rome, 
and  was  there  burned  as  a  heretic.  He  was  the  first  to  teach  that  the  fixed  stars  were 
like  our  sun,  and  to  inculcate  the  eternity  of  the  universe.  In  1879  his  statue  was 
set  up  before  the  very  eyes  of  the  pope  —  such  has  been  the  change  in  the  spirit 
of  the  times  ! 

Besides  these  philosophic  sects,  which  chiefly  led  and  indicated  the  active  mental 
struggles  of  the  16th  centurj',  there  also  appeared,  though  less  aggressively,  certain 
partisans  of  the  Stoa  like 

Justus  Lipsius  (1547-1606). 
and  skeptics  like  that  scorner  of  medicine 

Michel  de  Montaigne  (1533-1592), 
the  first  important  skeptic  of  the  modern  period,  and  as  such  of  great  influence  upon 
the   skeptical   tendencies  of  the   French  and  English  during  the  two  succeeding  cen- 
turies.    Montaigne  was  bold  enough  to  call  the  belief  in  witches  a  palpable  absurdity. 

In  the  16th  century  the  natural  sciences  (entering  also  upon  their 
reformation)  began  silently  to  exercise  upon  the  course  of  medicine  that 
influence  which  is  to-day  so  excessive.  This  was  effected  chiefly  by  the 
botanical  and  pharmacological  results  of  the  travels  of  savants,  incited  b}' 
the  active  impulse  toward  discover}',  investigation  and  travel,  so  character- 
istic of  that  age.     The  Portuguese  physicians 

Garcia  del  Huerto  and 

Christobal  da  Costa, 
both  finally  residents  of  Goa,  were  the  first  to  take  advantage  of  the  opportunities 
offered  by  the  colonies  of  their  fellow-countrymen  on  the  coasts   of  Africa  and  in 
India.     They  were  followed  by  the  Spaniards 

Gonzalvo  Hernandez  Oviedo  y  Valdez  (1478  until  after  1547), 

the  famous  viceroy  of  Mexico,  and 

Nicholas  Monardes  of  Seville  (about  1580), 
both  of  whom  described  the  medicinal  plants  of  the  New  World.     The  latter  was  in 
1569  the  first  person  to  mention  coca.     The  Frenchman 

Pierre  Belon  (Belonius,  1518-1564), 
in  his  travels  through  Greece,  Egypt  and  Asia  Minor  from    1546  to  1549,  thoroughly 
investigated  the  ancient  Orient  for  information  respecting  old  drugs  and  in   search 
of  new  ones.     The  same  was  done  by 

Leonhard  Rauwolf  of  Augsburg  (died  1596), 
who  in  1573-76  travelled  throughout  the  entire  Orient.     Finally 

Prosper  Alpino  (1553-1617), 
secretary  of  an  embassy  to  Egypt,  the  most  famous  of  all  the  Venetians  and  "  the 
last  of  the  Methodists"  (he  endeavored  to  revive  the  doctrines  of  that  sect),  traveled 
throughout  the  whole  of  Egj-pt  from   15S0  to   1583.     On   his  road  home  he  visited 


—  369  — 

Crete  and  Greece,  and  entered  the  service  of  Andrea  Doria  (1468-1560),  for  whom 
he  went  to  Geneva.  Responding,  however,  to  an  honorable  recall  to  his  home,  he 
returned  to  his  native  city,  which  conferred  upon  him  the  professorship  of  botany  at 
Padua.  Among  his  more  important  works  were  his  "  De  plantis  iEgypti  liber", 
"  Historia  JEgypti  naturalis",  "  De  medicina  yEgyptorum"  etc. 

Otto  Brunfels  (died  a  physician  in  Berne  in  1534), 
born  in  the  castle  of  Brunfels  near  Mayence,  distinguished  himself  by  his  labors  in 
botany.     Declining  to  copy  the  Ancients,  he   observed   for  himself,  and  was  the  first 
physician  to  furnish  good  plates  of  plants.     He  was  followed  by 

Valerius  Cordus1  (Cordi,  1515-1544,  died  in  Rome), 
the  discoverer  of  sulphuric  ether.     "  His  early  death  was  regarded  as  a  general  mis. 
fortune"    (Rankel. 

Hieronymus  Tragus  (1498-1560)  of  Heiderbach,  near  Bretten, 
a  physician  of  Zweibriicken,  superintendent  of  the  gardens  of  the  prince,  and  subse- 
quently a  resident  of  Hernbach,  was  a   man   of  reputation  and  political  influence. 
His  real  name  was  Bock,  but  the  pedantry  of  the  age  converted  good  German  names 
into  Greek  or  Latin  equivalents.     Bock  was  also  an  evangelical  minister. 

Leonhard  Fuchs  (1501-1566) 
and  Tragus's  pupil 

Jac.  Theod.  TaberNjEmontanus  (died  1590)  of  Bergzabern, 

physician  to  the  Elector  of  Speyer  and  subsequently  in  Zweibriicken,  and  in  his  quality 
of  honorary  citizen  of  Worms  a  predecessor  of  Bismarck  and  Moltke.  He  had 
eighteen  children,  of  whom  two  sons  were  likewise  physicians.  Tabernaemontanus 
also  rendered  valuable  service  in  the  study  of  medicinal  springs. 

Melchior  Wieland  (Gruilandini,  died  1589), 
superintendent  of  the  botanical  garden  at  Padua  and  subsequently  a  professor  of 
botany  and  medicine  in  the  same  city,  carried  on  a  continual  literary  quarrel  with 
Mathiolus.     Among  the  Italians  the  following  acquired  reputation  as  botanists: 

Pietro  Andrea  Mattioli  (Mathiolus,  Matthiole,  1501-1577,  died  in 
Florence) : 

Bartholom^eus  Maranta  (about  1559); 

Luigi  Anguillara  (about  1561); 

Andrea  (Lesalpino  (1524-1603), 
who  has  been  already  mentioned,  and  who,  like  Linnreus,  classified  plants  artificially 
in  accordance  with  their  organs  of  reproduction.     Among  the  Netherlander, 

1.  Cordus  was  the  author  of  the  first  official  Dispensatory,  whose  printing  and  intro- 
duction into  the  pharmacies  of  Nuremberg  was  authorized  by  the  Senate  of  that 
city  in  1535.  He  was  likewise  the  son  of  that  Euricius  Cordus  (1486-1535). 
professor  of  medicine  in  Marburg,  whose  epigram  is  (or  should  be)  known  to 
every  doctor : 

"  Tres  medicus  facies  habet;  unam  quando  rogatur 
Angelicam  ;   mox  est,  cum  juvat  ipse,  Deus  : 
Post,  ubi  curato  poscit  sua  praemia  morbo, 
Horridus  apparet,  terribilisque  Sathan." 
"  God  and  the  doctor  we  alike  adore 
When  on  the  brink  of  danger,  not  before. 
The  danger  past  both  are  alike  requited, 

God  is  forgotten,  and  the  doctor  slighted."  (H.) 

24 


—  370  — 

Rembertus  DoDONiEUS  (Podoens,  1517-1586), 
Carl  Clusius  (Charles  de  1'  Ecluse,  1526-1609)  and 
MATTHiEUS  Lobelius  (1538-1616), 
ordinary  physician  of  James  I.,  distinguished   themselves  in   botany.     On   the   other 
hand  in  physics  the  famous  ordinary  physician  of  queen  Elizabeth, 

William  Gilbert  (1540-1603), 

was  the  discoverer  of  electricity  in  the  resins,  glass  and  certain  precious  stones;  of 
static  electricit}' ;  the  repulsion  of  similar,  and  the  attraction  of  dissimilar,  poles  of  the 
magnet;  the  diversion  of  the  magnetic  needle  by  electricity;  the  strengthening 
of  magnets  by  an  armature;  the  fact  that  iron  bars  become  magnetic  along  t he 
magnetic  meridian;  that  the  earth  itself  is  an  enormous  magnet  etc. 

Mineralogy  also  found  its  cultivators.     In  Germany  were: 

Georg  Agricola  (Ackermann,  1494-1555)  of  Glauchau, 
the  discoverer  of  bismuth,  who  studied   mineralogy   systematical!}-  after  the  Ancients 
and   his  own  observations,  laid   the  foundation  of  geology,   and   collected  a  cabinet 
of  natural  curiosities; 

K  A  SPAR  SCHWENCKFELD  (1490-1561), 
both  of  the  latter  physicians,   the  former  in  Chemnitz,  Schwenckfeld  in   Hirschberg 
and  Gorlitz;  the  Dresden  physician 

Joiiann  Kentmann  (1518-1568)  and 

Christoph  Enzel  (Encelius), 
the  minister.     In  France  we  may  mention 

Palissy  (died  1590). 
and  in  Italy 

Aranzi. 

The  chief  promoter  of  Zoology  was 

Ulysses  Aldrovandi  (1522-1605)  of  Bologna, 
where  in  1567  he  established  a  botanical  garden.1  He  left  to  his  native  city,  where 
his  decendants  are  still  living,  a  collection  of  natural  curiosities  which  is  still  in  ex- 
istence. His  writings  are  devoted  to  all  classes  of  animals,  both  the  higher  and 
lower.  Another  eminent  zoologist,  who  surpassed,  however,  all  those  mentioned  as  a 
universal  investigator  of  nature,  and  manifested  a  love  for  science  under  adverse 
circumstances  exhibited  by  few  only,  was 

Conrad  Gesner  (1516-1565)  of  Zurich,  the  "German  Pliny  ". 
He  practised  in  Zurich,  Strassburg,  Paris,  Venice,  Augsburg  and  other  places,  until 
poor,  sick,  and  almost  blind,  he  was  finally  (1555)  appointed  professor  of  natural 
history  in  his  native  city.  Thirty-nine  works  were  the  fruit  of  his  untiring  and 
inextinguishable  zeal.  Gesner  was  the  first  writer  to  essay  a  classification  in  natural 
philosophy.  "  He  rose  to  the  idea  of  adding  descriptions  to  names,  and  of  collecting 
in  a  comprehensive  work  on  the  animal  world  all  that  was  known  in  reference  to  it. 
The  talent  for  compilation  is  not  so  common  as  is  generally  believed.  Compilation, 
to  be  of  service  to  science,  must  not  only  proceed  from  extensive  and  varied  reading, 
but  it  must  be  founded  upon  genuine  interest  and  personal  knowledge,  and  must  be 
controlled  by  definite  ideas.  A  talent  of  this  kind  was  one  of  the  greatest  qualifica- 
tions of  Conrad  Gesner  "  (Ranke). 

The  advances  of  mathematics  and  astronom}T  under  the  influence  of  the 
Copernican  system  laid  the  foundation  for  the  final  disbelief  in  astrology. 

1.    A  public  botanical  garden  existed  in  Venice  as  early  as  1333  (Marx).  • 


—  371   — 

The  popularizing  of  these  advances  (by  Adam  Riese,  whose  arithmetic  is 
still  proverbial)  and  the  rectification  of  the  calendar  (by  Ignacio  Danti  and 
Aloysio  Lilio  with  the  German  Clavius)  under  Gregory  XIII.  (in  1582  ten 
days  were  dropped  out1)  gave  to  the  common  people  new  conceptions  and 
notions.  Mathematics  laid  the  foundation  of  the  exact  treatment  of  medi- 
cal subjects  in  the  following  century.  The  arts,  especially  painting  and 
sculpture,  stood  in  relations  of  mutual  interest  with  medicine,  especially 
with  anatomy. 

Wood-cuts  and  copper-plates  served  as  means  for  the  diffusion  of  artistic  works  in 
this  science.  The  great  painters  ennobled  the  works  of  the  great  anatomists,  and  the 
latter  gave  to  the  former,  so  to  speak,  the  scientific  principles  of  their  art.  We  need 
mention  here  only  a  few  names,  in  order  to  indicate  the  greatness  of  their  productions. 
At  the  head  we  must  place  the  Italians  Raphael,  Titian,  da  Vinci,  Michael  Angelo, 
Correguio  (14D4-15H4 ),  Fra  Bartolomeo  (1469-1517),  Paolo  Veronese  (died  1588), 
Guido  Reni  (1575-1642)  and  others.  Among  the  Germans  were  Albrecht  Durer 
(1471-1528),  Lucas  Cranach  (1472-1553),  Hans  Baldung  Grier  (1476-1552),  Hans 
Holbein  the  Younger  ( 1497-155,)),  Hans  Schaeuffelin  (1492-1540)  etc.  The  tendency 
of  the  arts,  in  unison  with  the  other  branches  of  culture,  was  directed  towards  the 
ideal  and  the  religious.  Even  music  shows  this,  as  whose  Catholic  representative  we 
may  mention  Palestrina  ( 1524-1594),  while  Luther,  who,  as  we  know,  valued  music 
very  highly,  may  be  called  the  creator  of  Protestant  Church-music.  A  notable  im- 
pulse to  the  generalization  of  this  art  was  given  by  the  invention  of  movable  note- 
types  by  Ottavio  Petrucci  of  Tossembrone  in  the  States  of  the  Church  in  1502. 

The  activity  of  numerous  physicians  of  the  16th  century  in  philolog}', 
and  in  translating  and  commenting  upon  the  works  of  the  Ancients,  was 
of  greater  immediate  influence  upon  the  medicine  of  that  time  than  the 
studies  just  noticed.  The  latter  did  not  manifest  their  full  effect  until 
the  succeeding  age.  Philolog}T  was  the  mother  of  modern  medicine,  and 
with  the  help  of  the  Ancients  reared  medicine  and  the  natural  sciences. 
By  the  labors  of  these  physicians  a  finishing  stroke  was  prepared  for  the 
Arabists  or  scholastic  physicians  ;  observation  was  opposed  to  the  proofs 
and  subtilties  of  authority  ;  the  writings,  methods  and  practice  of  Hippoc- 
rates were  brought  into  the  foreground,  and  an  improved  linguistic  treatment 
of  medical  subjects  was  also  introduced.  In  fact  there  arose  a  genuine 
apotheosis  of  Hippocrates  and  the  Greeks  in  general,  which  has  been  desig- 
nated disparagingly  a  "  Grecomania  ".  —  Most  of  the  physicians  belonging 
here  merit  honorable  mention  also  in  the  history  of  philology.  Among 
these  German}'  is  best  represented,  both  as  regards  number  and  importance- 
The  line  of  German  cultivators  of  the  Ancients  is  opened  by  the  famous 

Winther  von  Andernach  (1487-1574), 
a  teacher  in    Goslar  and   professor  successively  in    Louvain,  Strassburg  and  Paris, 
finally  ordinary  physician  of  Francis  I.  and  baron  of  the  empire.     He  translated  the 
works  of  Oribasiaus,  Paul  of  ^Egina,  Alexander  of  Tralles,  Ca?lius  Aurelianus  and  Galen. 
According  to  Puschmann  he  likewise  foisted  upon  the  public  a  text  of  Philumenos 

1.  The  new  calendar  was  speedily  adopted  by  all  Roman  Catholic  countries,  but  the 
Protestant  states  of  Germany  and  Denmark  adhered  to  the  Julian  calendar  until 
1700,  and  England  did  not  adopt  the  improvement  until  1752.     (H.) 


—  372  — 

and  Philagrius,  which  he  had  himself  prepared,  and  thus  became  a  literary  forger. 
But  as  the  same  thing  was  done  with  respect  to  other  ancient  writers,  particularly  at 
that  time,  by  various  philological  coryphaei  quasi  exercitii  causa,  Winther's  trans- 
gression must  be  judged  more  charitably  than  it  would  be  at  the  present  day. 
Winther  finally  became  a  Protestant  and  is  buried  at  St.  Gall. 
Hieronymus  GrEMrjs^EUS  (Geschmaus,  died  1543) 
devoted  his  time  to  translations  of  Theophrastus,  Galen  and  Paul  of  JSgina.  Both 
these  physicians  were  surpassed  in  extent  of  study  by 

Janus  Cornarus  (properly  Johann  Hagenbut,  1500-1558)  of  Zwickau, 
professor  in  Rostock  and  Mecklenburg  physician-in-ordinary,  who  translated  the 
works  of  Hippocrates  and  wrote  commentaries  on  Galen,  Dioscorides  and  Aetius. 

Leonard  Fuchs  (1501-1565), 

originally  a  schoolteacher  of  Wendingen  in  Suabia,  subsequent]}-  professor  in 
Tubingen  and  a  bitter  rival  of  Cornarus,  was  a  most  violent  opponent  of  the 
Arabians,  declaring  that  the  longer  continuance  of  their  science  would  promote  the 
overthrow  of  Christianity.     He  wrote  commentaries  on  Galen  and  Hippocrates. 

Johann  Lange  (1485-1565)  of  Lowenberg  in  Silesia, 
a  friend  of  Melanchthon  and  Peucer.  was  likewise  an  opponent  of  the  Arabians,  and 
in    his    "Epistolas    medicinales"   combated    their   uroscopy   and    advocated    Greek 
semeiology. 

Tiieodor  Z winger  (1533-1588)  of  Basel 
also  contributed  to  a  knowledge  of  Hippocrates,  and  the  two 

Scaligers  (Julius  Caesar,  1484-1558  and  Jos.  Justus,  1540-1609) 
wrote  commentaries  upon  certain  of  the  ancient  authors.  Many  German  trans- 
lations of  the  ancient  physicians  appeared  in  the  16th  centurj',  e.  g.  Pliny's  "  Historia 
Naturalis"  by  H.  Eppendorf  in  1543;  Celsus  by  Khiiffner,  1532 ;  Vegetius  Renatus, 
1532;  Dioscorides  by  Danz  of  Ast.  Joh.  Sambucus  (1531-1584)  published  an 
historical  and  biographical  work  concerning  physicians  and  philosophers  ,  particul- 
arly those  of  the  16th  century.     This  work  was  adorned  with  copper  plates. 

Among  the  French 

Jacob  Hollerius  (Houillier,  1498-1562), 

Francois  Rabelais  (1500-1553), 
long  a  professor  of  medicine  in  Montpellier,  but  far  better  known  as  the  witty  author 
of  the  history  of  Gargantua  and  Pantagruel ; 

Johannes  Gorr^eus  (de  Gorris,  1515-1577) 

Ludovicus   Duretus  (Duret,  1527-1586) 
and  most  important  of  all  the  students  of  the  great  physician  of  Cos, 

Anutius  FoEsius  (Foes,  1528-1595)  of  Metz, 
rendered  eminent  service  in    the   introduction   of  Greek   medicine,    especially  that 
of  Hippocrates,  and  in  the  struggle  against  the  Arabians.     The   Englishman 

Johannes  Caius1  (John  Kaye  or  Key,  1510-1573)  of  Norwich, 
professor  in   Cambridge,    bestowed   his  labors  upon   Galen,   Celsus  and   Scribonius 
Largus.  while  the  Portuguese 

1.  John  Caye  (Kaye),  as  one  of  the  eminent  benefactors  of  medicine  in  England, 
deserves  perhaps  a  more  extended  notice.  Born  in  Norwich,  Oct.  6,  1510,  he 
was  educated  at  Gonville  Hall,  Cambridge,  and  subsequently  visited  Italy,  where 
he  studied  medicine  under    Montanus   and  Vesalius  at  Padua.     Graduating  at 


—  373  — 

Ludovicus  Lemosius  (about  1580), 
and  the  Italians 

Giov.  Battista  Monte  (Montanus,  1497-1557)  in  Verona, 

Hieronymus  Mercurialis  (1530-1606)  of  Forli, 
professor  at  Padua,  Bologna  and  Pisa,  and  the  first  of  the  Moderns  to  recommend 
medical  gymnastics,  as  well  as  the  author  of  the  first  special  treatise  on  diseases 
of  the  skin  (De  morbis  cutaneis  libri  II  etc.,  Venice,  1570),  and 

Marsilius  Cagnatus  (Cagnati,  died  1610), 
devoted  their  attention  to  the  determination  of  the  genuineness  of  the  ancient  authors, 
particularly  Hippocrates  and  Galen,  and  to  the  improvement  of  their  text. 

The  so-called  "  Conciliatores  "  rendered  excellent  service  to  medicine 
by  comparing  the  Arabians  with  the  Greeks  and  reconciling  their  differ- 
ences.    The  most  eminent  of  these  were  : 

Symphorianus  Campegitjs  (Campier,  1472-1539). 
a  medical  star  of  the  first  rank  in  those  days,  who  resided  in  Lyons; 

Franciscus  Vallesius  (died  1572)  of  Covarrubias  near  Burgos, 
ordinary  physician   of  the  fanatical  Philip  II.,  who  fell  a  victim  to  phthiriasis  and 
once  gave  to  his  physician  6,000  crowns  for  curing  him  of  a  fever: 

Jul.  Alexandrinus  von  Neustain  (1506-1590)  of  Trent ; 

Nicolaus  Rorarius  (Rorario,  about  1572)  of  Udine  ; 

Joh.  Baptist.  Sylvaticus  (1550-1621), 
professor  in  Pavia,  and  the  great  Spaniard 

Michael  Seryet  (according  to  others  Miguel  Servede-y-Reves,  1509- 
1553)  of  Villanova  in  Aragon,  though  born  at  Tudela  in  Navarre, 
the  unfortunate,  but  enlightened  victim  of  the  overbearing  and  fanatical  Picard,  John 
Calvin  (Jean  Cauvin,  1509-1564),  at  whose  instigation  he  was  very  slowly  ( !  )  burned 
at  the  stake  as  an  heretical  opponent  of  this  heretical  pope —  to  his  own  eternal  honor 
and  to  the  everlasting  disgrace  of  his  malignant  enemy.  In  his  treatise  entitled 
"Syruporum  universa  ratio  etc.",  on  account  of  which  he  was  impeached  before 
Parliament  by  the  Faculty  of  Paris,  he  showed  himself  as  free  from  bigotry  in  the 
sphere  of  medicine  as  in  religion.     The  enlightened  Parliament,  however,  acquitted 

Bologna,  in  1543  he  traveled  throughout  Italy,  engaged  in  the  collation  of  the 
MSS.  of  Galen  and  Celsus  for  the  purpose  of  improving  the  text  of  these  writers. 
On  his  return  to  England  he  took  the  degree  of  M.  D.  at  Cambridge  and  settled 
in  Shrewsbury,  but  was  soon  summoned  to  London  by  Henrj'  VIII.  to  deliver 
lectures  on  anatomy  to  the  surgeons  of  that  city.  He  became  a  Fellow  of  the 
College  of  Phj-sicians  in  1547,  and  was  the  president  of  that  College  for  seven 
years.  He  also  compiled  its  Annals  from  the  date  of  its  origin  down  to  his  own 
times.  At  his  instigation  an  establishment  was  founded  for  the  annual  perform- 
ance of  two  public  dissections  of  human  bodies  —  the  first  of  the  kind  in  England. 
During  the  reign  of  queen  Mary,  Caye  obtained  a  license  to  convert  Gonville 
Hall  into  a  college,  under  the  title  of  Gonville  and  Caius  College.  This  institu- 
tion he  liberally  endowed,  and  was  also  its  first  master.  The  best  known  of 
Caye's  literary  labors  is  his  "  Boke  or  Counseill  against  the  Disease  commonly 
called  the  Sweate  or  Sweatyng  Sickness",  which  appeared  at  London  in  1552.  A 
Latin  version  of  this  work,  considerably  enlarged,  was  published  in  1556.  Caye 
died  at  Cambridge,  July  29,  1573,  and  his  grave  was  marked  by  the  simple  epitaph 

"Fui  Cains".  (H.) 


—  374  — 

him.  Servet  is  immortalized,  however,  by  the  fact  that  he  was  the  first  among  the 
Moderns  to  revive  the  idea  of  the  pulmonary  circulation  (1553),  including  the  imper- 
meability of  the  septum  ventriculorum,  an  idea  which  he  brought  forward  in  his 
religious  treatise  "  De  Trinitatis  Erroribus",1  and  failed  to  explain  entirely  satisfac- 
torily only  because  of  his  conjoined  use  of  the  vital  spirits  and  the  blood.  His 
statements  were  thus  obscured  by  ideas  consonant  with  the  spirit  of  his  age.  He 
gives  the  lesser  circulation  "not  as  ordinarily  described",  but  correctly,  and  is 
acquainted  with  the  change  effected  in  the  color  of  the  blood  in  the  lungs.  On  the 
other  hand  he  still  thinks  that  spirits,  not  plain  blood,  flow  from  the  lungs  into  the 
left  auricle. 

2.  REFORM  OF  THE  PRACTICAL  BRANCHES. 

a.  Medicine. 

The  revolution  in  medicine,  prepared  during  the  latter  portion  of  the 
Middle  Ages  and  consummated  in  the  16th  century,  first  showed  in  the 
practical  departments  its  palpable  effect  upon  the  life  of  the  age,  while  the 
other  branches,  especially  anatomy,  were  only  secondarily  and  silently  con- 
cerned therein. 

The  reform  proceeded  from  no  single  individual  (as  we  now  and  then 
read  perhaps  of  Paracelsus),  nor  from  several  ;  indeed  from  no  one  nation 
alone.  Individual  men  formed  merely  the  heralds  of  the  reformative  ideas 
of  this  period,  and  these  reformers  then,  as  almost  always  and  everywhere, 
sprung  up  by  the  grace  and  the  necessities  of  the  time  ;  were  rather  driven 
and  borne  along  by  its  ideas,  than  the  sole  and  independent  creators  of  them. 
They  had  innumerable  co-workers,  who.  by  quiet  contributions,  interested 
themselves  in  the  good  work,  or  rather  furnished  the  ground  work  of  that 
picture  on  which  the  glowing  figures  of  the  reformers  stood  forth  so 
prominent. 

The  struggle  was  directed  against  the  Arabians  and  Galen,  and  termin- 
ated with  the  demolition  (though  incomplete)  of  those  intellectual  bulwarks 
of  mediaeval  medicine. 

A  purifying  combustible  was  first  cast  into  the  stagnant  air  of  blind 
faith  in  authority  and  of  scholastic  practice  in  the  form  of  a  struggle  con- 
cerning the  proper  place  for  venesection  in  pleurisy  (pleuritis  and  pneumo- 
nia). Over  this  subject  of  dispute,  so  insignificant  in  appearance  to  us  of 
the  present  day.  was  awakened  at  that  time  a  most  wide-spread  and  signifi- 
cant excitement  of  the  medical  world,  which  divided  the  latter  formally 
into  two  camps.     The  place  for  bleeding  was  the  shibboleth  by  which  the 

1.  This  must  be  a  lapsus  calami.  Servetus's  description  of  the  circulation  is  con- 
tained in  his  "  Christianismi  Restitutio",  which  wa<  printed  in  1553.  The  entire 
edition  was  condemned  to  the  flames,  and  but  two  copies  of  the  original  work  are 
known  to  be  now  in  existence,  one  in  the  National  Library  at  Paris,  the  other  in 
the  Imperial  Royal  Library  at  Vienna.  From  the  latter  copy  a  small  edition  in 
fac  simile  was  reprinted  at  Nuremberg  in  1790.  The  passage  on  the  pulmonary 
circulation  was  quoted  for  the  first  time  in  an  English  book  by  Wotton,  "Reflec- 
tions on  Ancient  and  Modern  Learning",  London.  l(i'.»7.     (Dalton   I 


—  375  — 

conservatives  aud  the  men  of  advanced  ideas  were  recognized.  Here  too, 
as  is  usually  the  case  in  times  of  revolution,  the  partisans  of  the  views 
heretofore  prevalent  were  stronger  in  numbers  than  those  who  were  disposed 
to  favor  the  new  ideas. 

The  later  Greeks,  and  with  them  the  Arabians,  their  pupils,  had  taught  that  at 
the  outset  of  inflammation  blood  should  be  taken  at  a  distance,  and  on  the  opposite 
side,  from  the  seat  of  disease,  in  small  quantity,  slowly  and  drop  by  drop ;  since  abstrac- 
tion of  blood  in  the  vicinity  of  the  diseased  part,  especially  if  considerable,  only 
attracted  still  more  blood  into  it  and  thus  weakened  the  part.  That  procedure  by 
which  the  fluids  were  diverted  from  the  diseased  to  the  causative  part  or  organ,  for  the 
purpose  of  removing  the  disease  (e.  g.  to  the  uterus  in  inflammations  occasioned  bj' 
suppression  of  the  menses),  was  called  "derivation",  in  contrast  to  the  Hippocratic 
"  revulsion",  which  provided  for  free  venesection  in  the  vicinity  of  the  diseased  organ 
and  upon  the  same  side.  The  Hippocratic  method  of  venesection,  which  in  these 
times  seemed  an  extremely  dangerous  innovation,  to  be  combated  by  every  possible 
means,  was  first  taught  by 

Pierre  Brissot  of  Fontenay-le-Comte  in  Poitou  (1478-1522),  who 
practised  in  Paris.  Through  the  results  of  this  doctrine,  which  scattered 
many  fruitful  seeds  of  knowledge  and  at  the  close  of  the  century  was 
fortunately  victorious,  Brissot  became  a  reformer  of  practice  almost  as  great 
as  Theophrastus  von  Hohenheim. 

Thoroughly  versed  in  the  teachings  of  the  Greek  authors,  Brissot  had  long  been 
quietly  a  follower  of  the  Hippocratic  method  of  bleeding,  until  he  ventured  in  1515 
to  step  forth  openly  in  its  defence,  having  once  more  experienced  its  manifest  advan- 
tages on  the  occasion  of  an  epidemic  of  pleurisy.  He  maintained  also  that  both 
derivation  and  revulsion  might  be  undertaken  on  the  same  bloodvessel.  He  won 
over  to  his  views  Villemore  and  Helin,  members  of  the  Faculty  of  Paris,  "a  rare 
triumph",  but  gained  also  many  more  opponents,  who  even  succeeded  in  procuring 
a  parliamentary  interdiction  of  his  method.  Influenced  by  this  and  by  his  love  for 
the  natural  sciences,  Brissot  then  went  to  Portugal,  where  in  1518  he  —  a  matter  of 
very  little  difficulty  —  aroused  the  envy  of  Dionj-sius,  the  physician-in-ordinaiy, 
against  whom  he  wrote  a  treatise  "Apologetica  disceptatio,  qua  docetur,  per  qua?  loca 
sanguis  mitti  debeat  in  viscerum  inflammationibus,  pra;sertim  in  pleuritide"  (first 
published  in  1525  by  Brissot's  friend  Luceus  of  Evora).  Strange  to  say,  too,  the 
Faculty  of  Salamanca,  to  whom  the  court-physician  had  appealed,  decided  in  favor 
of  Brissot.  Charles  V.  was  also  solicited  to  extirpate  the  new  heresy,  which  was 
equally  objectionable  with  Lutheranism.  Fortunately,  however,  one  of  the  emperor's 
relatives  had  recently  died  of  pleurisy  in  spite  of  the  Arabian  method  of  bleeding, 
and  this  fact  alone  probably  averted  the  burning  of  numerous  medical  heretics  also, 
for  burning  was  not  at  that  period  an  exclusively  Spanish  fashion. 

The  steadfast  defender  of  his  own  doctrine  and  that  of  the  Ancients 
obtained  many  followeis,  as  well  as  numerous  opponents,  and  the  number 
of  both  furnishes  sufficient  evidence  of  the  profound  importance  and 
effectiveness  of  his  action,  the  significance  of  which  in  that  day  is  no  longer 
fully  comprehensible  to  us.  It  was,  at  all  events,  of  such  importance  that 
it  divided  the  physicians  of  a  whole  century  into  two  parties.  The  fact  too 
that  the  weightiest  names  were  represented  in  these  parties  argues  in  favor 
of  the  extent  of  the  struggle,  which  excited  especialfy  the  Roman  physi- 


—  376  — 

cians,  who,   as  we  know,  are   not  even  to-day   thoroughly  decided   on  the 
employment  of  venesection. 

The  opponents  of  Brissot  took  their  stand  partly  upon  "  The  authorities",  partly 
on  speculative  considerations,  partly  on  anatomical  facts  either  misunderstood  or  im- 
perfectly known,  and  partly  too  on  the  pure  spirit  of  contradiction.  Among  them  we 
find  such  names  as:  Diomedes  Cornarus  (1467-1566),  physician-in-ordinary;  the 
famous  Winther  von  Andernach;  Benedictus  Victorius  (Vettori,  born  1481),  professor 
in  Bologna;  Victor  Trincavella  (1496-1568),  a  physician  of  Venice,  professor  in 
Padua;  Anton.  Donatus  of  Altomare  (Antonio  Donato  d' Altomare,  1508-1566),  a 
physician  of  Naples,  and  one  of  his  most  zealous  opponents;  Giov.  Argentieri 
(1513-1572),  in  other  respects  a  friend  of  the  advanced  ideas;  Andreas  Thurinus 
(about  1525),  ordinary  physician  of  Clement  VII.  (1523-1534)  and  Paul  III.  (1534- 
1549),  and  author,  among  other  things,  of  a  treatise  on  the  benefits  of  spring-waters  ; 
Thomas  Erastus  (1523-1583),  the  enemy  of  Theophrastus  von  Hohenheim,  a  professor 
in  Basel  and  Heidelberg,  and  a  very  learned  Humanistic  physician;  Tbomas  Augenius 
(1527-1603),  professor  in  Turin  ;  Csesar  Optatus  (about  1536),  a  physician  of  Venice; 
Ludovico  Panizza  (about  1544),  a  physician  of  Mantua  ;  Mariano  Santo  di  Barletta 
(died  1539);  Nicolaus  Monardes  (about  1563)  of  Seville;  Conrad  Gesner;  Job.  Bapt. 
Sylvaticus  and  others. 

On  the  side  of  Brissot  stood  physicians  of  no  less  weight :  Joh.  Manardus  (Giov. 
Manardo) ;  Matth.  Curtius  (1474-1544)  at  Bologna;  J.  B.  Montanus;  Hieronymus 
Cardanus ;  Christophorus  a  Vega  (1510-1580),  professor  at  Alcala;  Mercurialis; 
S3~mphorien  Champier ;  Thaddaeus  Dunns  (about  1540)  of  Locarno,  physician  in 
Zurich;  Franc.  Cassani  of  Turin  (about  1550);  Jeremias  Drivere  ( Thriverius  Braehelius, 
died  1554),  professor  at  Louvain,  who,  however,  took  only  a  half-way  position  in  the 
struggle,  and,  like  others  of  those  whose  names  precede  and  follow,  raised  his  voice 
in  the  contest  half  against  a  rival  and  half  for  the  subject  itself;  iEmilius  Campolon- 
gus  (about  1580),  professor  at  Padua;  Vallesius  and  others.  Followers  of  Brissot  on 
anatomical  grounds  were  the  great  Vesalius,  J.  B.  Cannani  (1540),  the  discoverer  of 
the  valves  of  the  veins,  Vidus  Yidius  and  others,  while  in  surgical  injuries  Ambroise 
Pare  also  adopted  his  views. 

That  extravagance  might  follow  upon  the  heels  of  the  reform  in 
bleeding,  an  elder  Bouillaud,  Leonardo  Botallo,  born  at  Asti  in  Piedmont 
in  1530,  a  pupil  of  Falloppio,  but  not  the  discoverer  of  the  ductus  arteriosus 
(this  was  known  even  to  Galen)  which  bears  his  name,  taught  that  blood 
ought  to  be  drawn  in  all  diseases,  even  in  those  of  a  chronic  character,  and 
that  it  should  be  taken  frequently  and  abundantly.  This  sanguinary 
doctrine  gained  many  adherents,  especially  in  Italy  and  Spain  ;  indeed, 
even  to-day  it  is  not  entirely  vanquished,  as  the  sad  case  of  Cavour 
testifies. 

If  the  reform  of  Brissot,  however  wide  a  circle  it  might  embrace,  was 
still  at  base  only  an  outward  one,  that  accomplished  at  almost  the  same 
time  b}*  the  great  German-Swiss  Theophrastus  von  Hohenheim  stirred  up 
and  revolutionized  the  whole  substance  of  medicine.  In  contrast  too  with 
the  reform  of  Brissot  it  affected  the  German  people  especially.  But,  while 
the  French  reformer  finally  received  recognition  everywhere,  the  importance 
and  the  reputation  of  the  German  have  been  for  a  long  time,  and  are  even 
to-day  often  belittled.     Whatever  was  necessary  for  this  purpose  has  been 


—  377   — 

contributed  from  the  very  beginning  (in  accordance  with  a  well  known 
German  custom)  by  his  own  countrymen,  with  his  colleagues  and  his  pupils 
at  the  head.  On  the  other  hand,  however,  he  has  been  also  extolled  too 
highly,  especially  in  the  present  century. 

(Philippus)  Theophrastus  (Aureolus  Paracelsus)  Bombast  von  Hohenheim  was 
born  in  1493  (1490,  1491?)  in  the  vicinity  of  Maria-Einsiedeln,  a  famous  Swiss  locality, 
where  even  to-day  a  black  imase  of  the  Virgin  Mary  is  still  fervently  worshipped. 
His  father,  Wilhelm  Bombast  von  Hohenheim  (born  1463),  was  a  physician  who 
studied  in  Tubingen,  had  then  practised  in  the  vicinity  of  Einsiedeln,  and  had 
married  one  of  the  matrons  of  the  hospital  connected  with  the  convent.  In  1502, 
however,  he  settled  as  physician  at  Villach  in  Carinthia,  where  he  died  in  1534.  To 
his  only  son  (who  seems  in  his  youth  to  have  been  rachitic,  and  whom,  in  the  third  or 
fourth  year  of  his  life,  a  hog,  or  according  to  others,  his  own  father,  is  said  to  have 
castrated1  —  a  most  improbable  story)  he  imparted  his  first  instruction,  which 
included  alchemj-,  astrology  and  medicine.  At  a  later  period  Theophrastus  received 
instruction  also  from  Eberhard  Paumgartner,  a  bishop  and  monk  of  Carinthia,  and 
from  Matthaus  Scheyt  of  Seckau.  At  the  age  of  16  he  went  to  the  university  of  Basel, 
where  he  enjoj^ed  the  instruction  of  Johannes  Trithemius,  abbot  of  Sponheim,  and 
made  use  of  the  laboratory  of  Sigmund  von  Fugger  at  Schwatz  in  Tyrol.  Then  he 
travelled  around,  after  the  manner  of  the  itinerant  students  and  as  a  surgeon  in  the 
wars:  "In  the  Netherlands,  the  Romagna,  Naples,  in  the  Venetian,  Danish  and 
Netherland  wars,  1  have  cured  a  goodly  number  of  fever  patients,  and,  as  regards  the 
forty  diseases  of  the  body,  I  have  restored  to  health  those  whom  I  found  suffering 
from  them."  He  seems  to  have  also  visited  the  universities,  which  he  in  general 
designates  as  training  institutions:  ''I  was  brought  up  in  the  garden  where  the  trees 
are  mutilated."  To  increase  his  metallurgical  knowledge,  as  well  as  in  great  part  to 
earn  his  daily  bread,  like  many  physicians  of  that  day  ;  finally  out  of  a  pure  passion 
for  wandering,  he  travelled  over  half  the  world,  was  in  Spain,  Portugal,  Prussia i 
Denmark  (where  he  was  probably  a  military  physician),  the  Orient,  Egypt  and  even 
Tartary,  as  he  himself  relates.  Everywhere  he  listened  without  distinction  to  the 
opinions  of  physicians,  barbers,  bath-keepers,  executioners,  old  women  and  gipsies, 
"in  order  to  understand  the  wonders  of  nature."  He  busied  himself,  however,  very 
little  with  books,  and  in  ten  years  published  no  work,  a  fact  which,  from  his  steady 
devotion  to  nature  and  experience  (the  true  text-books  of  the  physician)  and  from  his 
constant  travels,  is  easily  intelligible.  In  fact  he  left  at  his  decease  the  Bible,  the 
New  Testament,  the  Biblical  concordance,  St.  Jerome's  "  Commentaries  upon  the 
Evangelists",  and  some  few  medical  treatises,  simple  works,  which,  as  we  see,  had 
very  little  relation  to  medicine.  "  Reading  never  made  a  doctor,  but  practice  is  what 
forms  the  physician.  For  all  reading  is  a  foot-stool  to  practice,  and  a  mere  feather- 
broom."  He  places  a  high  value  upon  free  thought:  "  He  who  meditates,  discovers 
something."  In  his  thirty-second  year  he  returned  to  Germany  and  speedily  rendered 
himself  famous  through  his  cures.  As  the  result  of  these,  and  at  the  special  instance 
of  Hausschein  ((Ecolampadius),  he  became  in  1527  a  professor  at  Basel,  as  well  as 
city  physician  with  a  good  salary.  Paracelsus  had  very  many  hearers,  since  he 
delivered  even  his  academic  lectures  in  the  German  language  —  a  thing  utterly 
unheard  of  in  the  universities  of  that  da}',  when  German  literati,  as  already'  remarked, 
were  ashamed  of  their  plain  German  names,  and  in  order  to  appear  truty  "  learned  " 
translated  them  into  Latin  or  Greek  !  He  had  no  hesitation  in  declaring,  in  his  zeal 
as  a  reformer  and  in  the  boastful  strain  of  the  age,  that  he  was  the  greatest  medical 


1.    Hence  probably  arose  his  repugnance  for  women. 


—  378  — 

genius  of  German}',  as  Hippocrates  (whom  lie  greatly  esteemed,  and  upon  whose 
works  he  had  even  written  commentaries)  had  been  the  first  of  Greece.  As  an  out- 
ward, and  in  those  days  popular  sign  that  he  had  made  them  substantially  a  tabula 
rasa,  he  burned  the  works  of  Galen  and  Avicenna  in  his  lecture  room,  and  said 
plainly  "  that  all  the  universities  had  less  experience  than  his  beard,  and  that  the 
down  on  his  neck  was  more  learned  than  all  the  authors."  He  was  reproached  with 
not  having  been  regularly  graduated,  a  charge  which  was  adapted  to  call  forth,  and 
reall}-  did  call  forth,  his  earnest  and  humorous  defence.  Moreover,  although  he  seems 
to  have  been  weakly,  he  was  a  thorough  drunkard,  in  accordance  with  the  custom 
of  the  times,  in  which  even  princes,  true  knights  of  the  bottle  —  whoever  could  swill 
the  most  was  king!  —  considered  genuine  drinking  tournaments  as  quite  appropriate 
to  their  rank,  went  at  it  as  recklessly  as  Luther,  and  led  an  extremely  irregular 
life.1     In    1528    Theophrastus    (who  was   possibly   a   clerical   physician    under    vows 

1.  The  condition  of  morals  in  the  good  old  times  may  be  judged  from  the  following 
passage  of  Freytag's  "Aus  dem  Jahrhundert  der  Reformation  ".  "  Prince  Maurice 
of  Saxony  made  the  acquaintance  of  the  Bavarian  woman,  and  had  also  his  sport 
in  his  lodging,  the  house  of  a  Doctor  Medicina\  The  latter  had  a  grown 
daughter,  a  lovely  piece,  called  Miss  Jacobina,  with  whom  he  took  his  baths  etc. 
Other  princes  and  nobles,  both  clerical  and  lay,  also  played  a  pretty  part.  Thus 
I  was  once  a  spectator  when  Margrave  Albrecht  and  other  young  princes,  with 
young  bishops  (sic!)  who  were  not  born  princes,  went  into  a  drinking  bout. 
.  .  .  "  Young  princes  laid  themselves  down  upon  the  ground  beside  the 
ladies  of  princes  and  counts,  especially  those  of  high  and  noble  rank,  for  they  do 
not  sit  upon  benches  or  chairs,  but  costly  carpets  are  spread  in  the  center  of  the 
room,  upon  which  they  sit  comfortably,  and  can  stretch  themselves  out,  hug.  kiss, 
and  fondle  each  other.''  This  was  when  the  emperor  Charles  V.  held  the  Imperial 
Diet  in  Augsburg.  The  illumination  of  the  table  was  so  simple  that  a  servant 
i  held  here  and  there  two  tallow  candles.  He  had  at  that  time  Vesalius  for  his 
physician.  Charles  said  "  Ubi  est  noster  Carlovitius  "  :  "  Most  Gracious  Emperor, 
he  is  somewhat  unwell!"  Then  said  the  emperor  in  Dutch:  "  Vesalius,  go  to 
the  Carlowitz,  he  is  a  little  unwell,  and  see  that  you  cure  him.''  "  When  the 
emperor  wished  to  drink  —  which  he  did  only  thrice  during  his  meals  —  he  made 
a  sign  to  his  Doctores  Medicinal  who  stood  by  the  table.  They  went  to  the 
buffet,  where  stood  two  silver  flagons  and  a  giass  goblet,  the  latter  of  which  held 
full  a  pint  and  a  half  (!),  and  filled  the  goblet  from  the  two  flagons.  This  he 
drank  completely,  leaving  not  a  drop,  though  he  was  forced  to  draw  his  breath 
once  or  twice  before  he  took  the  glass  from  his  mouth."  Thus  did  the  emperor, 
who,  as  we  know,  was  very  temperate!  yet  Theophrastus  von  Hohenheim  has 
been  always  condemned  for  his  passion  for  drink,  though  at  that  time  every  one 
"swilled  it",  as  Luther  expresses  it,  and  it  had  been  already  said  of  the  ancient 
Germans  : 

"  Blue-eyed  men  and  blond  of  hair,'' 

"  Such  the  ancient  Germans  were." 

"  Lions  in  danger  always,  but  " 

"  Lambs  in  dealing  with  the  cup." 
To  drinking  was  not  rarely  added  also  the  old  German  passion  for  gambling  and 
prodigality  among  all  classes.  The  latter  is  shown  by  the  example  of  those 
widows  of  the  commonalty  who  were  married  for  the  second  time,  and  "on  their 
bridal  day  walked  to  the  church  upon  a  piece  of  English  cloth,  which  they 
had  spread  from  their  house  to  the  church:  they  also  made  use  of  the  purest, 
softest  Riga  flax  in  their  water-closets,   to   wipe   their   unmentionables."     Suck 


—  379  — 

—  Oetter),  unmarried  and  a  Catholic  in  spite  of  his  regard  for  Luther,  fled  from 
Basel,  an  action  which  was  prompted  especially  by  the  fact  that  he  had  disturbed  his 
sordid  colleagues  and  the  apothecaries1  in  their  collusive  and  disgraceful  transactions, 
and  had  naturally  thus  made  them  his  bitter  enemies.  In  a  suit  for  his  fee  too 
against  a  niggardly  prebendary'  (who  after  his  cure  wished  to  pay  only  six  florins  in- 
stead of  the  hundred  florins  previously  stipulated),  unable  to  obtain  his  rights  because 
the  Churchman  based  his  defence  upon  the  legal  tariff,  he  abused  the  court,  a  course 
which  at  that  time  in  the  little  republic  was  taken  in  very  bad  part.  After  his  flight 
he  went  to  Esslingen,  where  he  had  a  house  (in  which  some  chemical  apparatus  was 
found  as  late  as  the  present  century)  and  where  he  remained  a  long  time;  then  he 
removed  to  Alsace,-  Nuremberg,  St.  Gall,  Augsburg,  Pfaffers,  Moravia,  Vienna, 
Villach,  always  treating  the  sick  and  imparting  advice  by  mouth  and  by  letter,  alway-s 
followed  by  pupils,  concerning  whom,  however,  like  Hegel,  he  said  very  little  in  praise, 
since  they  only  wished  to  learn  his  reputed  secret  methods.  Finally  Paracelsus  died 
of  disease  Sept.  24,  1541,  at  the  "White  Horse"  in  Salzburg;  or,  according  to  some, 
of  a  wound  inflicted  upon  him  at  the  instigation  of  his  colleagues,  though  the  fissure 
in  the  petrous  portion  of  his  temporal  bone,  at  all  events,  did  not  occur  until  his  grave 
was  uncovered.  "  Glory  to  the  physician  who  has  completed  his  days  with  the  arcana, 
and  has  lived  in  God  and  Nature  as  a  mighty  master  of  the  earthly  light!  " 

Tbeophrastus  von  Hohenheim  was  a  man  of  extraordinary  power  and 
independence  of  mind  :  hence  his  maxim  '•  Qui  suus  esse  potest,  non  sit 
alterius ".  Although  not  properly  educated  in  his  department,  he  was 
possessed  of  ingenious  medical  instincts,  and  through  his  extensive  travels 
and  his  exemption  from  the  narrowing  and  rigid  education  of  the  schools 
of  his  time  was  better  fitted  for  the  work  of  a  reformer  than  were  the 
literati  of  the  profession,  who  trod  almost  universally  the  paths  of  Galen 
and  the  Arabians.  To  the  latter  it  was  not  agreeable,  in  fact  not  even 
intelligible,  when  Tbeophrastus  said  "  The  physician  should  be  a  traveller. 

Does  not  travelling  supply  more  information  than  sitting  by  the 

fireside?  He  who  wishes  to  investigate  nature  thoroughly  must  tread  her 
books  with  his  feet.  The  first  schoolmaster  of  medicine  is  the  corpus  and 
the  material  of  nature.  What  is  it  to  enter  medicine  b}*  the  right  door  ? 
Is  it  through  Avicenna,  Galen,  Mesue,  Ehazes  etc.,  or  through  the  light 
of  nature  ?  "This  is  the  right  door,  the  light  of  nature  !  "  Again  :  "As 
Christ  said  perscrutamini  Scripturas,  why  should  I  not  say  perscrutamini 
naturas  rerum  ?  "  If  by  such  hints  at  an  open  observation  of  nature 
Tbeophrastus  had  merely  cast  the  leaven  of  improvement  into  medicine, 

were  the  good  old  times  in  which  Paracelsus  lived.  The  mediaeval  Church  had 
not  improved  the  ancient  morals,  but  had  rather  increased  sensuality.  In  France 
and  England  too  drinking  was  openly  indulged  in,  even  by  respectable  ladies. 
Manners  were  still  so  primitive,  that  in  these  countries  they  ate  with  the  fingers 
down  to  the  year  1608.  In  German}-,  however,  forks  were  used  a  century  earlier; 
indeed  they  seem  to  have  been  invented  here. 

1.  "The  apothecaries  too  are  my  enemies.     .     .     .     write  short,  small  and  rare  pre- 

scriptions. .  .  .  the  third  part  of  what  they  give  me  is  not  good.  .  .  .  this 
is  the  business,  and  for  this  they  cry  out  against  me." 

2.  Schlettstadt  at  that  time  had  a  famous  school,  which  at  one  time  contained  nine 

hundred  scholars. 


—  380  — 

he  would  be  sure  of  an  important  position  in  the  history  of  the  latter 
science.  But  he  added  thereto  apt  ideas  of  great  and  wide  application 5 
though  they  were  enveloped  in  the  fantastic,  boasting  and  superstitious 
rodomontade  of  the  age.  If  it  is  true  that  from  the  downfall  of  all  forms 
of  culture,  and  from  the  by-gone  labors  of  eminent  men,  only  a  few  fruitful 
ideas1  are  ever  preserved  to  the  following  ages  and  maintain  an  active 
influence  upon  the  future,  it  must  be  admitted  that  Theophrastus  von  Hohen- 
hehn  possessed  such  ideas,  and  that,  as  will  be  seen,  these  still  maintain 
their  influence,  even  at  this  late  day.  He,  however,  like  all  those  who  minister 
to  the  true  benefit  of  mankind,  and  who  must  consequently  face  the  coteries 
and  petty  vanity  of  the  putative  lease-holders  of  the  wisdom  and  learning  of 
their  age,  the  envy,  the  secret  and  open  dishonesty  and  the  prejudices  of  their 
time  -—  even  the  unprofessional  dress  of  Paracelsus  was  made  a  reproach 
to  him  —  he,  I  say,  became  a  martyr  in  his  struggle.  Povert}'  was  his 
portion,  so  that  he  was  forced  to  sa}'  sorrowfull}',  "  They  who  labor  in  the 
arts,  if  there  were  no  trees,  would  have  no  shade."  To  this  were  added 
calumny  and  the  ingratitude  of  common  minds,  at  the  head  of  which  latter 
class  stood  his  "  trusty  "  pupil  Joh.  Herbst  (Oporinus).  Undoubtedly  he 
frequently  laid  himself  open  to  his  enemies,  and  his  own  undeniable  failings 
and  weaknesses  were  therefore  naturally  made  the  most  of  by  the  latter. 
Yet  his  faults  —  and  the  history  of  culture  must  confess  it  —  were  for  the 
most  part  rooted  in  the  rudeness,  or  if  you  will,  in  the  natural  exuberance 
and  simplicity  of  the  manners  of  that  age,  whose  undisguised  son  'I  heophras- 
tus  was  in  both  the  good  and  bad  senses  of  the  expression.  This  rudeness 
was  so  great  that  e.  g.,  as  before  mentioned,  it  was  considered  a  becoming 
amusement  of  a  high  nobilit}-  for  lords  and  ladies,  reclining  on  carpets,  to 
feel  of  the  clothed  portions  of  each  others  body  in  simple  sport.  Rough- 
ness, coarseness,  rude  manners  are  indicated  b}'  Theophrastus  himself  too 
as  the  fashion  of  his  time  and  his  country,  just  as  rudeness  is  the  fashion 
of  the  Swiss  to-day.  Compare  also  the  charming  titles  exchanged  b}' 
Luther  and  his  adversaries,  and  the  "  Polsterdoctoren,  Kalberarzte,  Sudel- 
koche  "  and  the  like  of  Theophrastus  may  perhaps  appear  rather  joking 
expressions,  than  characteristics  of  his  exceptional  rudeness  ;  or  they  may 
be  credited  in  part  to  a  rough  doctor's  humor,  like  his  dubbing  of  medicinal 
mixtures  "  Besohissgruben ",  a  term  certainly  quite  characteristic  of  the 
age,  although  it  may  have  contained  also  a  germ  of  truth.  At  all  events 
Theophrastus  possessed  humor  in  a  high  degree.  He  abandoned  the 
Ancients  :  hence  those  physicians  who  depended  upon  the  Ancients  called 
him  a  heretic  and  a  barbarian,  although  in  those  days  obscenity  of  expres- 
sion was  common  even  in  polite  societ}1,  and  boxes  on  the  ear  were  admin- 
istered by  the  hands  of  queens  themselves. 

How  the  character  and  practical  services  of  Theophrastus  were  judged 
in  unprejudiced  circles  of  his  own  day,  may  be  inferred  unequivocally  from 

1.    Even  Goethe  in  his  "Italian  Travels"  cries  out  "How  little  trace  survives  of  any 
existence!" 


—  381  — 

his  epitaph,  even  if  we  rnake  some  little  allowance  for  the  De  mortuis  nil 
nisi  bene  principle.  This  runs  as  follows  :  "  Here  lies  Philippus  Paracelsus, 
the  famous  Doctor  Medicinte,  who,  by  his  wonderful  art,  cured  bad  wounds, 
lepra,  gout,  drops}-  and  other  incurable  diseases,  and  to  his  own  honor 
divided  his  possessions  among  the  poor  ".  What  this  epitaph  extols  con- 
ceals his  more  enduring  services  —  the  simplification  and  improvement 
of  the  treatment  of  the  sick,  a  subject  in  which  he  could  follow  to  the  best 
advantage  his  empirical  genius.  His  humanity  and  charity,  virtues  of  the 
genuine  physician,  were  famous.  He  himself,  however,  said  that  the 
physician  must  seek  the  kingdom  of  God  among  the  Samaritans.  He  was 
an  eminent  observer,  extremely  prompt  in  comprehending  what  he  saw,  a 
deep  thinker,  for  whom  has  been  accomplished  in  our  century  that  which 
he,  in  his  prescience,  held  up  to  his  enemies  of  that  day  :  "  Truly  I  shall 
accomplish  more  against  you  after  my  death,  than  before  !  "  We  are  com- 
pelled to  do  justice  even  to  the  correctness  of  his  modes  of  expression  and 
of  writing,  and  in  the  history  of  literature  to  count  him  as  the  earliest 
architect  of  our  language,  which  he  handled  in  so  masterly  a  manner. 

By  the  very  fact,  however,  that  he  wrote  in  German,  Theophrastus  von 
Hohenheim  resigned,  from  the  outset,  a  great  part  of  the  assurance  of  im- 
mediate results  and  of  the  halo  of  the  learned.  For  the  German  tongue 
seemed,  even  to  the  German  emperor,  one  suitable  only  to  address  horses, 
and  the  learned  paid  very  little  attention  to  its  cultivation,  a  condition 
which  continued  down  into  the  18th  centuiy,  and,  so  far  as  regards  its 
higher  cultivation,  down  even  to  our  own  time.  Thus  the  influence  of 
Theophrastus  was  limited  mostly  to  Germans,  and  again  more  to  the  un- 
learned than  the  learned.  Moreover  it  cannot  be  denied  that  many  of  his 
ideas  are  unintelligible  or  obscure,  in  consequence  of  his  alchemistic, 
astrological  and  unfamiliar  statement  of  them,  and  of  their  disagreeable 
embellishment.  In  the  quiet  times  of  the  present  day,  the  prominent  self- 
assertion  of  Theophrastus  (founded  in  a  sense  of  his  destiny  and  duty  as  a 
reformer)  and  his  fancy,  which  often  overshot  the  mark,  excite  little  sympa- 
thy. Their  boastful  manifestation  may  have  often  been  aroused  by  his 
antagonists  as  well  as  his  admirers. 

"  Follow  me,  not  I  you,  follow  ye  me,  follow  me  Avicenna,  Galen,  Rhazes,  Mont- 
agnana,  Mesue,  and  ye  others !  Follow  me,  not  I  you !  ye  of  Paris,  Montpellier,  ye 
of  Suabia,  ye  of  Meissen,  ye  of  Cologne,  ye  of  Vienna  and  the  banks  of  the  Danube 
and  the  Rhine,  ye  islands  of  the  sea,  Italy,  Dalmatia,  Sarmatia,  Athens,  ye  Greeks, 
ye  Arabs,  ye  Israelites,  not  one  of  you  shall  remain  in  the  remotest  corner  upon 
whom  the  dogs  shall  not  void  their  urine!  I  shall  be  the  monarch,  and  mine  the 
monarchy!  How  does  this  please  you,  Cacophrastus  ?  This  dung  must  ye  eat!  And 
ye  Calefactores,  ye  shall  become  chimney-sweeps !  What  will  you  think  when  the 
sect  of  Theophrastus  triumphs?"  (S.  Griinder). 

Theophrastus  was  (at  that  time  a  rare  circumstance)  both  a  plysician 
and  a  surgeon  :  still  more  he  reformed  both  branches.  When  we  consider 
the  fashion  of  this  branch  of  education  in  his  day,  the  views  of  Paracelsus 
in  the  department  of  surgery  (which  he  wished  to  have  considered  a  branch 


—  382  — 

of  general  medicine,  without  a  knowledge  of  which  a  profitable  pursuit  of  the 
former  was  not  to  be  thought  of)  are  very  clear,  and,  for  the  time,  even 
phenomenal.  He  ascribes  high  value  to  "local"  anatomy  in  surgery, 
though  he  denies  its  importance  in  medicine.  The  operative  side  of  surgery, 
however,  was  not  in  his  line.  Lithotomy  alone  he  permitted,  but  otherwise 
prohibited  entirely  all  cutting,  burning  and  stitching  by  the  "  Folterhansen  " 
(torturing  idiots),  as  he  called  them.  On  the  other  hand  his  principles  for 
the  treatment  of  wounds,  derived  at,  all  events  from  a  rich  experience  in 
military  surgery,  are  those  of  a  master.  How  strongly  reformatory  his 
teachings  were  considered,  may  be  inferred  from  the  fact  that,  as  Wiirtz 
(the  great  pupil  of  Theophrastus,  whose  doctrines,  doings  and  thoughts  con- 
stitute a  constant  panegyric  upon  his  master;  relates,  in  many  localities  the 
surgeons  were  compelled  to  take  an  oath  not  to  follow  the  teachings  of 
Theophrastus.  And  Hytell  too  exclaims  :  "  They  deprecate  the  use  of  the 
Holy  Bible  among  Christians  :  why  should  the  devils  not  poison  Theophras- 
tus also  ?  But  this  proceeds  from  the  haughty  devil,  that  the  truth  may 
not  come  forth.  The  " Chirurgia  Magna"  of  Theophrastus  is  collected 
from  nature."  These  incorporated  sciolists  (Podexgelehrten)  have  always 
persecuted  talent  which  towered  above  them  ! 

The  vis  mi  Cicatrix  naturae  he  installed  in  its  undiminished  rights,  and 
held  that  it  accomplished  the  union  of  divided  parts  by  means  of  a  "  natural 
balsam  or  animal  mummy  ",  separated  from  the  body  within  wounds.  To 
protect  the  latter  is  the  task  of  the  physician  :  "  Every  surgeon  should 
understand  that  it  is  not  he  who  heals,  but  the  balsam  within  the  bod}1  is 
that  which  heals,  and  that  wherein  thou  art  a  good  surgeon,  is  that  thou 
offerest  to  nature  defence  and  protection  in  the  wounded  part."  For  the 
production  of  this  balsam  the  body  supplies  the  material,  but,  on  the  other 
hand,  it  can  be  fostered  or  increased  by  drugs  applied  externally.  The 
latter  object  is  served  by  bandages  impregnated  with  balsam  etc.  Theo- 
phrastus held  very  strongly  to  the  cleanliness  of  wounds,  almost  too  strongly 
it  would  seem,  in  direct  opposition  to  the  custom  of  that  day  :  "  1  have 
often  seen  the  ignorance  of  you  surgeons,  while  the  wounds  fairly  stunk 
and  poured  forth  a  foul  pus,  like  a  stinking  old  hole  in  elephantiasis 
(stinckend  altes  Loch  am  olschenkel  ?i,  which  suited  you!"  He  recom- 
mended further  spare  diet  and  regulation  of  the  drink,  and  was  sufficientlv 
acquainted  too  with  the  accidental  complications  of  wounds,  such  as 
diphtheritis  of  wounds  with  simultaneous  diphtheritis  of  the  throat,  surgi- 
cal fever,  traumatic  tetanus,  erysipelas  etc.1  In  fractures  he  opposed  the 
barbarous  efforts  and  methods  for  the  reduction  of  the  broken  bone,  am 
laid  stress  upon  the  fact  that  nature  could  accomplish  repair  in  these  in- 
juries also,  without  an}r  aid.  In  other  places,  however,  he  recommended 
bandaging  the  fractures  twice  a  day. 

1.    The  enigmatical  "  Gliedwasser"  of  the  German  surgeons  (mentioned  as  early  as 
the  time  of  Pfolspeundt)  he  refers  to  bad  ointments  employed  in  the  dressings. 


—  383  — 

His  views  on  the  origin  and  nature  of  ulcers  are  less  clear.  Their 
treatment  consisted  mostly  in  the  use  of  mineral  remedies,  though  he 
also  recommended  the  compressing  bandage.  For  fractures  of  the  leg  he 
brought  forward  a  special  apparatus.  In  syphilis,  the  division  of  the  dis- 
sease  into  local  and  general,  primary  and  secondary,  as  well  as  information 
relative  to  its  inheritance,  its  manifold  forms,  and  its  influence  upon  the 
course  of  other  diseases  (Proksch),  form  the  most  important  service  of 
Theophrastus  von  Hohenheiin.  Tie  administers  mercury  internally  ("  This 
poison,  as  }'ou  call  it,  has  a  far  different  and  a  better  effect  than  the  wagon- 
grease  with  which  in  the  treatment  of  the  French  disease  you  are  so  fond 
of  smearing  your  patients,  worse  than  a  cobbler  greases  his  leather"),  and 
lie  rejects  all  other  measures,  particularly  inunction  with  mercurial  ointment. 
fumigation,  baths  and  decoctions  of  various  woods,  and  sweating,  for  he 
says  ■•  If  sweating  will  expel  the  French  disease,  a  warm  oven  or  a  warm 
skin  and  the  dog-days  would  be  good  for  it."'  Fie  employed  internall}-  a 
great  number  of  mercurial  preparations,  prepared  after  alchemistic  form u he. 
and  discarded  the  popular  abuse  of  regimen  during  the  treatment.  He 
also  erroneously  regarded  gonorrhoea  as  an  initial  stage  of  s}-philis,  but  was 
correct  in  ascribing  its  causation  to  coitus  (Proksch).  He  is  no  stranger 
even  to  hospital  hygiene. 

The  medical  doctrines  of  Theophrastus  are  intimately  united  with  his 
theosophy.  cosmogony,  physiology  and  philosophy,  which  latter  science  was 
most  nearly  allied  to  Neo-Platonism.  Thus  he  considers  all  existence  as 
an  emanation  from  God,  which  transformed  itself  first  into  the  primitive 
force,  the  ';  Yliaster  ",  whence  again  the  "  Mysterium  magnum  ",  the  "  Limbus 
major"  or  "  Yliades"  is  descended. 

From  the  latter  proceeds  the  "Limbus  minor",  or  the  L.  major  flows 
into  this.  This  is  the  last  creature,  the  "  original  man  "  ("  Urmensch  "), 
from  whom  all  spirits  emanate.  From  the  knowledge  of  God,  of  whom 
Theophrastus  has  a  pantheistic  conception,  and  from  communion  with  God 
(without  which  the  physician  can  be  nothing)  spring  all  enlightenment,  all 
wisdom  (scientia),  in  which  latter  term  are  included  also  the  Cabala  and 
magic. 

Besides  this  the  physician  must  also  possess  experience  (experientia). 
which  consists  in  the  knowledge  of  the  great  world  (excluding  mankind), 
the  rnacrocosmus,  and  of  the  lesser  world  (mankind),  the  microcosmus, 
which  two  stand  always  in  intimate  interchanging  relations  and  influences, 
are  one  and  the  same,  but  not  dependent  upon  each  other,  although  each  is 
inconceivable  without  the  other.  Hence  Theophrastus  also  designates  the 
rnacrocosmus  as  "outward  man''  (iiusseren  Menschen). 

In  the  Mysterium  magnum  were  contained  the  alchemistic  elementary 
bodies,  salt,  sulphur  and  mercury,  which  Theophrastus  and  Basil  Valentine, 
on  the  one  hand,  regard  as  components  of  all  metals,  and  Theophrastus 
himself  considers  components  of  eveiything  organic  also.  He  was  the  dis- 
coverer of  the  metal  zinc. 


—  :JS4  — 

Out  of  that  Mysterium  flowed,  and  from  various  combinations  of  the 
three  bodies  above  mentioned  originated,  the  four  common  elements  :  air, 
water,  earth,  as  representatives  of  the  earth}',  fire,  as  the  celestial  element. 
Each  of  these  has  an  archaeus  or  active  principle,  which,  in  contrast  to 
dead  matter,  possesses  a  creative,  formative  power  of  its  own.  From  the 
union  of  the  elements  originating  within  that  triad,  and  arising  organically 
all  material  objects  and  all  beings  take  their  origin. 

The  predominating  element  in  each  of  these  is  its  quintessence  —  a 
term  derived  from  Aristotle. 

Theophrastus,  in  his  usual  metaphorical  style,  calls  the  elements  the 
'•'  mother''  of  things,  and  declares  that  the  latter  originate  by  way  of  devel- 
opment. All  organisms  arise  from  the  active  elements  and  the  original 
mud  (Urschleim,  limus  terrae),  i.  e.  from  its  decomposition  (putrefaction), 
and  from  water  with  the  aid  of  heat. 

That  this  attempt  to  explain  the  origin  and  existence  of  objects  is  also 
obscure,  ma}"  depend  upon  the  inscrutableness  of  the  subject,  which  has 
occasioned  the  wreck  of  so  man}'  philosophical  systems  (and  will  cause  the 
wreck  of  so  many  others)  from  the  earliest  Gnosticism  down  to  Darwinism, 
of  late  so  highly  esteemed.  Indeed  Theophrastus  himself  was  close  upon 
the  track  of  the  latter  system. 

With  his  introduction  of  "salt,  sulphur  and  mercury"'  Theophrastus 
came  into  rude  conflict  with  the  elementary  matters  and  qualities  of  Galen. 
The  former  too,  in  his  view,  do  not  actually  exist,  but  are  merely  immate- 
rial agencies,  or  symbolical  designations  for  these  agencies  —  a  symbolism 
of  which  Theophrastus,  like  the  alchemists,  furnishes  many  instances  in 
other  places  also.  Sulphur  represents  the  combustible,  salt  the  soluble, 
mercury  the  volatile  element  in  things.  During  life  they  are  one  and  in- 
separable, and  it  is  not  until  death  that  their  previous  combination,  under 
the  influence  of  the  vital  force,  ceases. 

Magic  and  Cabalism  are  likewise  component  parts  of  his  philosophy. 
All  magic  proceeds  from  the  will,  which,  according  to  circumstances,  pro- 
duces good  or  evil.  In  this  matter  he  goes  hand  in  hand  with  the  alchem- 
ists, though,  on  the  other  hand,  he  does  not  admit  that  "  the  things  which 
the  common  people  believe  to  be  magical,  witchlike  and  devilish,  are  really 
so,  since  they  are  natural  and  contrived  on  natural  principles  ".  Concerning 
these  he  says  further  :  "  Ere  the  world  perishes,  many  arts  now  ascribed  to 
the  work  of  the  devil  will  become  public,  and  we  shall  then  see  that  the 
most  of  these  effects  depend  upon  natural  forces"  —  an  inconsistency  often 
observed  in  Theophrastus,  and  indeed,  in  Galen  likewise,  though  the  latter, 
as  a  Greek,  was  and  is  pardoned  more  readily  than  Theophrastus. 

Theophrastus  held  what  he  designated  philosophy  to  be  an  indispensa- 
ble requisite  for  the  physician,  for  "  if  a  physician  comes  not  into  medicine 
well  instructed  in  philosophy,  he  must  struggle  up  to  daylight  in  it."  In 
this  respect  he  greatly  resembles  Hippocrates,  who  said  :  "A  philosophic 
physician  is  a  godlike  man."' 


—  :-585  — 

Besides  the  doctrines  contained  in  his  philosophy  and  in  his  so-called 
astronomy  (according  to  Theophrastus  the  comparison  and  consideration 
of  the  macrocosmus  and  inicrocosmus),  alchemy  and  virtus  form  the  basis 
of  medicine,  the  former  understood  as  the  knowledge  of  the  chemical 
preparation  of  drugs,  and  the  latter  as  professional  capacity  and  probity. 
In  the  sincere  love  of  Theophrastus  for  his  profession,  the  latter  must 
necessarily  appear  to  him  as  one  of  the  four  chief  requisites  of  the  art 
of  medicine.  '-The  physician  must  be  no  masker  (Larvenmann),  no  old 
woman,  no  hangman,  no  liar,  no  trifler,  but  a  genuine  man.'"  In  this  he 
was  undoubtedly  right :  for  without  morality  in  its  fullest  sense  a  good 
physician  is  inconceivable  ! 

The  principle  of  activity  in  inanimate  and  animate  objects  was  for 
Theophrastus  something  personal  and  spiritual  (archaeus,  astrum,  spiritus), 
an  emanation  from  the  Deity,  and  each  element  had,  as  we  have  seen,  its 
own  active  and  living  agent.  Thus  in  the  air  he  found  the  Lemures  (spirits 
of  air,  sylvans);  in  the  earth,  gnomes  and  pigmies  ;  in  the  water,  nymphs 
or  water-sprites,  and  in  the  fire,  the  salamander. 

The  physiolog}'  of  Theophrastus  recognizes  as  the  proper  active  and 
life-giving  agent  in  man  also  his  "  archaeus  ",  whose  home  is  in  the  stomach 
who  separates  the  material  useful  for  nutrition,  the  "  essence  "',  from  the 
useless,  the  "poison"',  and  becomes  thus  the  "alchemist  of  the  body." 
Moreover  he  is  the  spirit  of  life,  the  -  astral  body.'"  The  "  poison  "  is  ex- 
creted by  two  routes  —  all  excrements  are  therefore  "  poisons ''  —  the 
•' essence"  remains  in  the  bod}'.  It  nourishes  and  maintains  the  latter, 
while  each  part  and  each  member  (since  all  possess  their  own  special  archaeus, 
alchemist  or  stomach)  attracts,  extracts  and  assimilates  what  is  appropriate 
for  it.  Digestion  is  a  kind  of  putrefaction,  by  which,  on  the  one  hand, 
the  assimilation  of  the  nutritive  slime,  on  the  other,  the  formation  of  the 
excrement,  is  rendered  possible.  Health  is  recognized  by  the  regular  action 
of  this  archaeus.  It  presides  also  over  generation.  The  semen  is  a  secre- 
tion from  the  liquor  vitae,  from  the  general  fluids  of  the  body,  which  secre- 
tion is  effected  by  the  exciting  influence  of  the  woman  upon  the  fancy 
of  the  man,  and  takes  place  only  momentarily  during  coitus.  It  is  the 
quintessence  of  the  fluids,  which,  being  derived  from  each  member,  is  there- 
fore in  condition  to  reproduce  each  member.  Monsters  originate  in  a  defect, 
or  multiple  presence,  of  the  semen  out  of  a  certain  part  of  the  body.  The 
woman  supplies  no  semen,  but  she.  and  especially  her  uterus,  is  mereby  the 
soil  into  which  the  male  semen  flows  and  is  deposited,  in  order  to  be 
nourished  and  ripened.  The  nutrition  of  the  embryo  takes  place  by  means 
of  the  breast-milk,  which  in  some  unknown  way  reaches  the  uterus.  The 
latter  organ  attracts  the  semen  as  the  magnet  attracts  iron.  Tf  this  attrac- 
tion takes  place  more  than  once,  multiple  pregnancies  arise.  In  these  cases 
the  woman's  fancy  also  takes  part.  By  it  that  of  the  man  is  supplemented. 
Man  and  woman,  however,  supply  in  generation  only  the  body  and  soul, 
while  the  spirit  is  furnished  during  the  process  by  God  alone.  "  That  which 
25 


—  386  — 

forms  man  is  the  spirit  of  the  Lord  in  its  place."  Hence  men  are  godlike 
and  immortal.  He  distinguishes  two  kinds  of  semen,  the  true,  generated 
b}T  fancy  in  the  astral  body  —  the  yliastric  semen  —  and  that  secreted  from 
the  ordinary  body  —  the  cagastric  —  (probabl}'  the  aura  seminalis  and  the 
semen  without  this).  The  cagastric  is  a  mere  excrement  ;  the  yliastric  alone 
serves  for  reproduction,  and  is  the  effective  agent  in  coition  and  generation. 

A  striking  similarity  with  the  doctrines  of  Darwin  is  found  in  the 
view  of  Theophrastus,  that  the  origin  of  everything  is  simply  the  transfor- 
mation of  germs  always  existing  (and  therefore  is  a  metamorphosis),  as  well 
as  in  the  fact  that  he  maintained  that  every  object  and  being  originated  at 
the  expense  of,  and  through  the  destruction  of,  another  —  a  doctrine  in 
which  we  see  already  developed  the  war  of  individual  against  individual, 
and  the  struggle  for  existence,  so  much  talked  about  now-a-days. 

Upon  anatomy  in  our  sense  of  the  term  —  he  calls  it  local  anatomy 
—  Theophrastus,  as  we  have  said,  laid  no  weight,  so  far  as  concerns  internal 
diseases.  He  opposes  to  it  a  universal  anatom}",  which  the  physician  must 
know  in  order  to  cure  and  to  understand  diseases.  Under  this  universal 
anatomy  he  understands  the  separation  into  that  triad  of  fundamental 
bodies  —  salt,  sulphur,  mercury,  of  which  the  body  consists  —  as  well  as 
the  knowledge  of  the  nature  and  power  of  an  object  and  of  its  celestial 
model.  The  parts  of  the  body  stand  in  reciprocal  relation  with  the  stars, 
and  in  fact  the  seven  great  organs,  the  brain,  heart,  lungs,  gall,  kidneys  and 
spleen,  correspond  to  the  moon,  the  sun.  Mercury.  Mars,  Jupiter,  A^enus 
and  Saturn. 

The  aetiology  of  Theophrastus  distinguishes  five  causes  of  disease  : 
1.  The  Ens  astrale  (a  certain  power  of  the  stars),  i.  e.  the  influence  of  the 
stars  by  means  of  foul  air  etc.  :  2.  The  Ens  veneni  (power  of  poison),  the 
troubles  which  spring  from  assimilation  or  digestion  ;  3.  Ens  naturale 
(power  of  nature  or  of  the  body),  the  maladies  which  originate  from  the 
body  itself  (diatheses);  4.  Ens  spirituale  (power  of  the  spirit),  the  infirmi- 
ties which  come  from  the  spiritual  sphere,  e.  g.  perverted  ideas  ;  5.  Ens  Dei 
(power  of  God;,  the  injuries  or  causes  of  disease  predetermined  by  God. 
"  We  say  also  that  our  body  is  subjected  to  five  Entibus,  and  each  Ens  lias 
under  it  all  diseases,  and  with  them  power  over  our  body.  Thus  there  are 
five  kinds  of  dropsy,  five  kinds  of  jaundice,  five  kinds  of  fever,  five  kinds 
of  cancer,  and  the  same  of  other  diseases."  In  this  Theophrastus  again 
squarely  controverts  the  Arabians  and  Galenists.  "But  ye  also  hold,  and 
erroneously  lay  down  in  opposition  to  us.  the  law  that  all  pestilence  springs 
from  the  humors,  or  out  of  that  which  is  in  the  body."  Moreover  he  affirms 
the  existence  of  a  "Seed  of  disease",  in  fact  two  forms  of  it.  an  hereditary 
(•■yliastric").  and  one  originating  from  corruption  ("cagastric"). 

In  a  similar  way  he  sets  himself  in  opposition  to  Galen  in  regard  to 
the  general  pathological  conceptions  of  health  and  disease.  The  former. 
according  to  Theophrastus.  consists  in  the  due  proportion  of  "sulphur,  salt 
and  mercury  "  in  the  body,  together  with  the  correct  action  of  the  archseus: 


—  387  — 

disease  is  the  opposite  of  this.  "  Therefore  the  physician  should  know  that 
all  diseases  lie  in  these  three  substances,  and  not  in  the  four  elements." 
The  so-called  fundamental  humors  are,  therefore,  only  results  and  expres- 
sions of  disease.  The  latter  itself,  in  accordance  with  the  laws  the  of  body, 
is  a  phenomenon  conditioned  by  nature,  the  introduction  to  its  destruction, 
or  to  death.  Diseases  also,  in  their  qualit}'  as  integral  parts  of  the  micro- 
cosm, like  microcosm  in  microcosm,  have  their  models  in  the  macrocosm. 
Thus  epilepsy  resembles  the  earthquake,  apoplexy  the  lightning,  flatulence 
the  wind-storm  ;  drops}',  inundations  ;  the  chilliness  of  fever,  the  quaking 
at  the  origin  of  new  worlds.  Fever  in  itself,  according  to  his  views,  is  an 
effort  of  the  healing  power  of  nature  to  equalize  the  disturbances  of  the 
body,  i.  e.  to  cure.  Theophrastus  divided  diseases  into  material  and  spirit- 
ual, acute  and  chronic. 

In  special  pathology  Theophrastus  differs  entirely  from  the  established 
doctrines,  inasmuch  as  he  does  not  separate  and  name  the  special  forms 
of  disease,  but  brings  them  under  certain  classes,  named  after  his  funda- 
mental elements  and  the  products  of  their  chemical  transformation,  as  well 
ns  after  their  remedies,  a  plan  equally  adapted  to  overthrow  the  ancient  medi- 
cine, which  named  them  after  the  humors.  External  diseases  are,  in  his  view, 
diseases  of  the  elements  salt  and  mercury  :  most  fevers  and  internal  dis- 
eases are  diseases  of  the  sulphur.  He  bases  his  classification  upon  their 
remedies,  a  system  in  which  Rademacher  was  his  descendant.  "A  natural, 
genuine  physician  says  this  is  a  morbus  helleborinus  or  turpentinus,  not 
that  it  is  phlegma,  chorryza  or  catarrhus." 

Thus  he  formed  also  the  great  class  of  "  Tartaric  Diseases  "  (so  named 
because  they  burn  like  hell,  and  form  deposits  of  matter,  as  wine  deposits 
tartar),  which  embrace  those  diseases  that  deposit  solid  products  of  morbid 
character,  or  which  render  the  tissues  rigid.  The  mildest  form  of  the 
"  Tartarus  "  is  the  so-called  dental  tartar.  In  other  cases  it  has  a  special 
predilection  for  the  joints  (gout-stones),  and  forms  also  (by  a  disappearance 
of  its  mucous  portion  and  the  deposit  of  earthy  matter)  calculi  of.  the 
bladder,  kidneys,  gall-bladder,  lungs  and  intestines  etc.  It  is  transmissible 
in  procreation,  so  long  as  it  has  not  been  manifestly  deposited  by  the  indi- 
vidual concerned.  In  other  cases  it  is  no  longer  hereditaiy.  The  diseases 
of  the  Tartarus  are  e.  g.  ischias.  lumbago,  sciatica,  gout  (of  the  intestines 
and  stomach,  podagra,  chiragra  etc.)  and  diseases  of  the  liver.  The  "  Tar- 
tarus "  arises  from  errors  of  assimilation,  when  the  "poison"  of  the  food  is 
not  excreted  but  remains  in  the  body  :  it  is  also  retained  excrement.  The 
paroxysms  of  the  disease  in  question  are  nothing  but  occasional  efforts 
of  the  bod}'  to  remove  the  poison.  On  hydrophobia  also  Theophrastus 
expresses  peculiar  views.  The  diseases  of  women  he  considers  actually 
different  from  those  of  men  (e.  g.  hysteria  and  hypochondria),  since,  like 
Goethe,  he  always  ascribes  the  chief  role  within  women,  and  in  the  origin 
of  their  diseases,  to  one  point,  the  uterus  (the  microcosmus  in  the  micro- 
cosma)  and  its  appendages.  ' 


—  338  — 

In  regard  to  Semeiology,  Theophrastus  insists  that  it  must  be  based 
not  upon  the  symptoms  of  diseases,  but  upon  a  knowledge  of  their  various 
connexion  with  the  microcosmus  —  lie  regards  disease,  as  we  know,  as  a 
microcosmus  in  a  microcosmus,  a  human  being  within  a  human  being. 
Their  physiognomy,  like  that  of  a  man,  should  be  looked  upon  as  a  dis- 
tinctive mark.  Each  organ,  as  we  have  seen  before  in  his  universal  anat- 
omy, is  dependent  upon  the  stars.  His  conception  of  the  pulse  is  similar 
thereto.  It  reveals  to  him  those  relations  and  the  temperature  of  the  body. 
He  makes  seven  kinds  of  pulse,  as  there  are  seven  planets.  The  pulse  of 
the  sun  lies  beneath  the  heart;  two  pulses  in  the  neck  belong  to  Venus 
and  Mars  ;  two  in  the  feet  to  Jupiter  and  Saturn  ;  those  of  the  temples  to 
the  moon  and  to  Mercury.  The  physician  must  know  the  planets  of  the 
microcosmus,  the  meridian  line  etc.,  before  he  can  determine  the  vital 
actions  of  the  body  and  can  cure  diseases.  Intermission  of  the  pulse  cor- 
responds Lo  the  eclipse,  and  a  host  of  similar  foolish,  absurd  and  unintel- 
ligible fancies,  consonant  however  to  the  age,  and  held  to  be  perfectly 
comprehensible  !  Theophrastus.  ingenious  as  he  is,  though  prone  to  the 
faults  of  his  day.  discards  the  uroscopy  customary  in  his  time  —  he  calls  it 
bluntly  "Seichbesehen" — but  replaces  it  by  speculations  equally  untenable. 
Thus  lie  refers  the  form  of  sediment  which  lie  names  "  Alcola "  to  the 
stomach,  the  "Hypostasis",  to  the  liver  etc.,  and,  in  accordance  with  his 
views  of  the  "Tartarus",  sees  the  latter  in  urinary  deposits,  "lie  who 
cannot  distinguish  the  Tartarus,  looks  into  the  piss  like  a  calf  out  of  a  gate  !  " 
In  the  foregoing  statements,  which  to-day  are  as  unsatisfactory  as  many  a 
demonstration  in  the  ••exact"  style  of  the  present  day  will  be  to  subsequent 
generations,  Theophrastus  remains  the  true  son  of  his  time  !  He  made  no 
account  of  the  signs  observed  in  the  blood  drawn  from  the  veins,  which 
often  had  a  healthy  appearance  even  in  the  plague,  and,  on  the  other  hand, 
lays  stress  upon  the  chemical  examination  of  the  urine,  in  order  to  acquire 
a  knowledge  of  the  Tartarus. 

Theophrastus  admits  that  he  was  led  to  his  reformatory  ideas  by  the  bad 
results  of  the  ancient  practice.  ••  Since  I  saw  that  the  doctrine  accomplished 
nothing  but  the  making  of  corpses,  deaths,  murder,  deformity,  cripples,  and 
decay,  and  had  no  foundation,  I  was  compelled  to  pursue  the  truth  in 
another  way.  to  seek  another  basis,  which  I  have  attained  after  hard  labor." 
The  aim  of  Theophrastus,  therefore,  was  so  strongly  directed  to  prac- 
tice;  in  other  words  his  recognition  of  the  first  and  last  duty  of  medicine- 
—  that  of  healing — was  in  him  so  overpowering  and  controlling,  that  he 
even  said  :  •■  If  (rod  will  not  help,  so  help  me  the  devil  !"  —  a  remark  in 
which  undoubtedly  the  existence  of  a  so-called  purely  '-rational"  system 
of  therapeutics  (which,  however,  in  spite  of  all  pretensions,  has  never 
existed)  was  from  the  outset  denied.  And  thus  Theophrastus  in  his 
therapeutics  also  produced  a  successful  and  lasting  reformation.  In  this 
he  greatly  resembled  Hippocrates,  with  whom  also  he  shared  a  high  regard 
for  the  "internal  physician",  the  healing  power  of  nature,  a  power  which 


—  38!)   — 

led  the  struggle  of  the  sound  parts  against  disease.  The  latter,  Theo- 
phrastus, indeed,  ever  regarded  as  a  hostile  being,  to  be  fought  witli  all  his 
power.  '•  If  a  disease  is  in  the  body  all  the  sound  organs  must  fight 
against  it  :  not  one,  but  all.  Nature  notes  this  fact."  "  Nature  is  the 
physician,  not  you  !"  If  she  refuses,  then  first  begins  the  office  of  the 
physician,  the  "external  physician",  who  has  the  "archseus"  to  support, 
that  this  "internal"  physician  may  gain  the  victory.  Then  begins  the  art 
of  healing,  upon  which  Theophrastus  lays  equal  weight,  since  he  assumes 
that  a  remedy  exists  for  every  disease.  He  considers  no  disease  incurable. 
"  If  thou  lovest  th}-  neighbor  thou  must  not  say  there  is  nothing  which  can 
help  thee  :  but  thou  must  say  I  cannot  help  thee,  and  I  do  not  know  any- 
thing to  help  thee  !"  One  should  be  willing  to  cure  not  only  with  opposing 
remedies,  like  the  Ancients,  but  also  with  similar  remedies,  not  only 
■contraria  contrafiis,  but  also  similia  similibus,  a  maxim  upon  which  Hahne- 
mann subsequently  seized,  as  did  Rademacher  upon  his  system  of  nomen- 
clature of  diseases.  Among  the  various  remedies  too  the  physician  must 
know  above  all  their  relations  to  celestial  things,  and  then  to  the  organs, 
since  the  stars  impress  their  "signature"  upon  all  drugs.  This  is  recog- 
nized by  the  form,  color  etc.,  as  a  woman  is  by  her  breasts.  Therefore  the 
testiculate  orchis-root  indicates  its  use  in  diseases  of  the  testicle:  the  black 
spot  on  the  flower  of  the  euphrasia  points  to  the  pupil  of  the  eye  ;  the 
color  of  the  lizard,  to  unhealthy  ulcers  :  gold,  which,  according  to  the 
cabalistic  assumption,  harmonizes  with  the  heart,  indicates  its  employment 
in  diseases  of  the  heart  etc.  Therefore  these  remedies  cure  diseases  of  the 
organs  indicated.  The  best  remedies  for  any  special  disease  are  always 
found  in  the  place  where  that  disease  prevails  :  hence  indigenous  remedies 
are  in  general  the  best  :  '-For  where  there  is  a  new  disease,  there  is  also 
its  remedy."  l  The  special  duty  of  the  physician  consists,  according  to 
Theophrastus,  in  finding  for  each  disease  its  special  remedy,  the  specificum 
and  arcanum.  Under  the  last  title  he  understands  the  active,  immaterial 
principle  of  the  specifics,  the  quintessence  of  the  remedy.  "  All  arcana  are 
so  conditioned  that  they  accomplish  their  work  without  matter  and  bodies." 
From  this  grew  two  further  peculiarities  of  his  therapeutics:  the  essences, 
tinctures  and  extracts,  in  which  he  exhibited  simple  drugs,  with  the  idea  of 
thus  coming  nearer  to  the  arcanum;  and  the  so-called  elixir  of  life,  or 
universal  remedy,  which  Theophrastus  professed  to  have  discovered  in  his 
Laudanum  (perhaps  our  tincture  of  opium).  Hence  too  proceeded  the 
stress  which  he  laid  upon  simple  recipes,  in  contrast  with  the  half  a  hundred 
drugs  of  the  (lalenistic  potions  —  simple,  indeed,  in  the  ideas  of  that  day. 
though  the  very  simplicia  of  Theophrastus  would  appear  to  us  now  extremely 
complex  prescriptions.     In   combating  the   method  of  treatment  directed 


1.  This  was  a  teleologieal  view.  Or  perhaps  it  may  be  considered  (as  with  Hutten) 
the  expression  of  considerations  of  political  economy,  and  designed  to  prevent 
the  outflow  of  German  money  for  foreign  products  —  a  subject  at  that  period 
much  discussed. 


—  3y0  — 

against  the  four  cardinal  humors  —  the  so-called  canonical  treatment  —  and 
compound  remedies,  Theophrastus  gives  free  rein  to  his  humor  and  satire. 
"In  making  recipes  a  single  prescription  often  contains  40-50  simplicia. 
It  cannot  well  be  denied  too  that  your  disciples  will,  without  hesitation,  put 
300  or  1000  simplicia  in  one  recipe  ....  Now,  if  the  addition  and 
then  the  much  vaunted  multiplication  upon  the  humors  had  been  employed 
in  the  body  of  man,  then  the  whole  world  should  have  erected  a  cotter,  in 
order  to  build  a  church  and  ordain  and  place  therein  monks  to  sing  the 
requiem  of  multiplication  in  prescription  writing,  and  a  Te  Deum  laudamus 
to  multiplication  of  the  humors.  Then  I  too  would  become  a  monk  therein, 
and  expiate  my  sins  also  in  the  multiplication  of  the  humors.  And  I  wish 
to  God  it  might  be  done  to-da}'."  "Which  trowsers  are  the  best?  the  whole 
or  the  patched  ?  What  man  is  so  silly  as  to  think  that  nature  has  divided 
up  her  virtue,  so  much  in  the  cabbage,  so  much  in  something  else,  and  then 
orders  you  doctors  to  compound  them  !  Bah  !  This  miserable  compound- 
ing business  !  Yet  the  woman  requires  only  one  man  to  father  her  child  : 
man}-  seeds  only  corrupt  it.  Mix  many  kinds  of  seed  and  bray  them  like 
an  apothecary  and  bury  them  in  the  earth:    no  fruit  will  come  from  them." 

Theophrastus  did  not  ascribe  much  importance  to  dietetic  measures, 
especially  in  chronic  diseases.  "  He  who  treats  disease  by  diet  is  weak  in 
the  art  of  medicine,  and  forgets  that  diet  ends  in  dung." 

As  regards  particular  remedies  the  fact  should  be  emphasized  that 
Theophrastus  first  introduced  into  therapeutics  many  mineral  remedies  and 
chemical  preparations  as  such  (including  mineral  baths,  iron,  sulphur, 
antimony,  gold,  tin,  lead  etc.),  and  thus  claimed  for  the  strongest  poisons 
always  the  capacity  to  be  used  as  remedies.  In  this  too,  as  in  his  so-called 
specifica,  he  gave  the  greatest  aid  to  an  abuse  which  crept  in  in  succeeding 
times.  He  thought  —  far  in  advance  of  his  time  —  that  chemistry  was 
designed  not  for  making  gold,  but  for  the  preparation  of  medicines.  Still 
he  also  made  use  of  vegetable  remedies,  such  as  arnica,  opium,  hellebore 
etc.,  though  he  fulminated  his  hatred  against  guaiac,  which  he  compares  to 
oak  wood.  In  opposition  to  the  Arabians  and  Galen  he  chooses,  however, 
chemical  and  mineral  substances  as  purgatives.  He  is  cautious  in  the  use 
of  venesection,  though  the  operation  was  then  held  in  great  esteem,  but 
recommends  it  chiefly  at  the  time  when  a  "sign  "  not  related  to  the  disease 
prevails,  though  he  discards  the  astrological  calendar.  That  Theophrastus.  in 
contradiction  to  his  numerous  and  better  reformatory  ideas,  employed  also 
the  precious  stones,  preparations  of  mummies  and  other  corpses,  cabalistic 
words,  the  magnet  (he  was  acquainted  with  its  polarity),  talismans  etc., 
should  not,  in  consideration  of  the  dense  superstition  which  controlled  even 
the  better  minds  of  the  age,  be  made  an  absolute  reproach  against  him, 
since  in  good  as  well  as  evil  he  was  certainly  a  genuine  son  of  his  century 
and  of  his  nation.  For  this  reason  he  has  become  an  historical  and  repre- 
sentative personage.  His  later  critics  called  him  an  ass  (like  Zimmermann), 
or  the  greatest  of  Swiss  physicians  (like  Hans  Locher),  according  to  their 


—  391  — 

special  consideration  of  his  good  or  bad  peculiarities.  Where  there  is  much 
light,  there  too  are  heavy  shadows !  Yet  posterity  soon  forgets  inconsider- 
able men,  which  has  not  been  the  case  with  Theophrastus  von  Hohenheim. 
The  writings  of  Theophrastus,  as  he  himself  complains,  were  often  corrupted  by 
his  copyists,  and  the  writings  of  others  even  were  foisted  upon  him.  A  complete 
edition  of  them,  including  also  some  of  the  spurious,  appeared  in  Basle  in  1589 
(10  parts  folio),  and  in  Strassburg  1616-18  (published  in  three  folio  volumes  by  Joh. 
Huser).  Among  the  84  treatises  contained  in  these  the  following,  among  others,  are 
regarded  as  "genuine":  "  Die  grosse  und  kleine  Chirurgie  ";  "  Paramirum  ";  "  Para- 
granum  ";  "  De  morbis  ex  tartaro  oriundis  '';  "  Von  des  Bads  Pfeffers  etc.";  "  Buchlein 
von  der  Pestillentz";  "  Drei  Bvicher  von  den  Franzosen";  "  Von  den  lmposturen  der 
Aerzte  "    (Marx). 

That  so  quarrelsome  and  provoking  a  man  as  Theophrastus  should  find 
and  arouse  both  followers  and  opponents  is  readily  understood,  as  well  as 
the  fact  that  both  parties  should  fall  into  exaggerations  and  go  to  extremes. 
It  is  also  not  an  uncommon  experience  that  his  pupils  chiefly  elaborated 
only  the  superstitious,  m\Tstic,  incomprehensible  side  of  his  doctrines,  in 
fact  pursued  them  into  absurdity  and  deception.  Still  less  is  it  surprising 
that  his  opponents  made  use  of  this  side  for  their  point  of  attack,  although 
they  themselves  adhered  to  superstition  of  a  different,  but  quite  as  bad  a 
type.  It  is  remarkable  rather  that  his  theoretical  views,  in  so  many  and 
such  weighty  respects  opposed  to  those  which  had  hitherto  prevailed,  should 
have  aroused  so  little,  comparatively,  the  more  important  spirits  —  the  sub- 
ordinates interested  themselves  quite  enough  —  of  his  time. 

Ill-fortune,  or  rather  the  often  unfortunate  tenor  of  the  doctrines  of 
Theophrastus,  led  pure  laymen  to  educate  themselves  up  to  '•  physicians'' 
a  la  Paracelsus,  and  the  same  fate  befell  his  silly  descendant  Hahnemann, 
though  with  more  justice  to  the  latter  than  to  that  profound  and  ingenious 
reformer,  whom  Shakespeare,  in  his  "All's  well  that  ends  well  ",  calls  the 
greatest  physician  after  Galen,  and  of  whom  Ranke  says  :  "  In  him  there 
lived  a  spirit  ingenious,  profound  and  endowed  with  rare  knowledge,  which 
from  the  single  point  which  he  grasped  intended  to  vanquish  the  world  : 
reaching  out  far  too  widely,  self-sufficient,  arrogant  and  fantastic  ;  such  a 
spirit  as  often  presents  itself  still  in  the  German  nation."  It  is,  however, 
characteristic  that  the  central  point  of  his  reform,  his  transformation  of 
practice,  was  precisely  that  which  procured  him  followers  (and  right  zealous 
ones  too)  even  among  the  learned  of  his  own.  and  the  following  age.  That 
the  partisans  pro  and  contra  belonged  —  at  least  two-thirds  of  them  —  to 
the  German  nation  is  explained  by  the  fact  that  the  German  was  at  that 
time  a  language  unintelligible  to,  and  therefore  despised  by,  all  foreigners, 
as  lias  been  the  case  down  even  to  the  present  day.  His  really  great  ideas 
too  la}r  buried  in  fustian,  "bombast",  and  alchemistic  and  astrological 
nonsense  and  frippery,  so  that  bringing  them  to  light  at  a  later  period  was 
in  man)-  respects  like  working  a  difficult  mine,  a  work  which  only  a  savant 
like  Marx  could  accomplish  satisfactorily  and  finalby.  But  the  germ  of  his 
doctrine,   thus  extracted   from    the   works  of  Theophrastus,    speaks   more 


—  392  — 

loudly  for  his  greatness  —  he  was  even  free  from  the  belief  in  demoniacal 
possession  —  than  could  any  palliation  of  his  weaknesses  and  any  enthusi- 
astic laudation  !  Theophrastus  must  be  understood  and  criticised  in  and 
from  his  own  time,  and  not  measured  by  the  rule  of  the  present  day.  He 
must  be  judged  in  accordance  with  his  influence  upon  his  own  day  and  upon 
succeeding  ages. 

The  followers  of  Theophrastus.  who  clung  chiefly  to  his  alchemistie, 
cabalistic,  theosophic  and  similar  doctrines,  by  which  only  he  was  criticised 
far  into  the  future,  were  also  called  Spagyrists  (Rosicrucians);  those,  how- 
ever, who  followed  him  in  his  better  views,  and  were  not  unconditional 
••  I'aracelsists''.  but  partly  Galenists.  were  named  ••  Syncretists  ",  "  Concilia- 
tors ",  terms  also  employed  at  another  period  to  designate  the  middle  party. 

Among  the  followers  of  Paracelsus  many  were  bold  adventurers  and 
impostors,  others  fools  and  ignoramuses,  and  some  were  both.  In  the  latter 
class  must  be  reckoned,  before  all  others. 

Leonhard  Thurneysser  of  Thurn  (1530-1595), 
son  of  a  goldsmith  of  Basle,  who  followed  his  father's  business  (and  collected  herbs 
for  Dr.  Huber,  a  physician  of  that  day,  at  whose  instance  he  also  read  the  writing.-. 
of  Theophrastus)  until  he  coated  tin  with  gold  and  sold  it  for  pure  gold,  a  piece  of 
fraud  which  in  1548  necessitated  the  flight  of  this  precocious  scamp  to  England. 
Thence,  however,  he  soon  went  into  the  military  service  of  Brandenburg,  then  became 
a  smelter,  then  again  a  goldsmith  in  Strassburg  (1555),  from  which  place  he  came  to 
Tyrol  as  inspector  of  mines.  In  addition  lie  mined  upon  his  own  account  with  such 
success,  and  consequently  with  such  credit,  that  he  was  sent  out  as  travelling  inspec- 
tor with  a  salary  from  the  archduke.  In  this  way  he  went  in  1560  to  Scotland,  a  year 
later  to  Spain,  then  to  Africa,  Asia  Minor  and  Arabia,  where  on  Mount  Sinai  he 
joined  the  order  of  St.  Catharine.  In  1568  he  returned  to  Austro-Hungary  and 
practised  medicine  witli  such  success,  that  (as  often  happens  to-day  i  he  regarded  him- 
self as  a  great  physician,  and  was  also  as  such  very  "famous".  In  order  to  bring 
out  his  books  on  medicine  in  the  best  style  he  went  to  Frankfort-onthe-Oder,  a  famous 
publishing  place  at  that  time,  and  at  the  same  time  made  himself  so  useful  to'the 
elector  Johann  Georg  in  his  sickness,  that  he  was  appointed  his  ordinary  physician 
with  a  considerable  salary.  Next  he  came  to  Berlin,  where  he  sold  rouge  and  tincture 
of  gold  to  the  court  dames  who  needed  them,  Magisterium  Solis  to  fools,  constructed 
horoscopes,  went  into  the  business  of  a  usurer  and  pawnbroker,  published  astrological 
almanacs  etc.,  by  which  devices  he  acquired  wealth,  built  himself  a  private  laboratory, 
a  private  printing-office  and  type-foundry  (in  both  of  which  he  introduced  improve- 
ments), and  employed  in  his  works  more  than  200  men.  He  also  established  in 
Berlin  its  first  botanical  and  zoological  garden,  as  well  as  the  first  cabinet  of  natural 
curiosities.     AH  at  once 

Caspar  Bofmann,  professor  at  Frankfort-on-the-Oder, 
published  a  book  entitled  "  Oe  barbaric  imminente  '.  which  deprived  Thurneysser  of 
much  of  his  reputation.  A  lawsuit  now  cost  him  most  of  his  ill-acquired  wealth,  and 
lie  therefore  went  to  Italy.  Finally  he  became  very  poor,  and  died  in  a  cloister  at 
Cologne — in  his  life,  career  and  fate  a  model  of  the  alchemist  and  miracle-working 
doctor  of  his  day!  The  titles  of  the  works  (some  illustrated  with  wood-cuts)  of  this 
clever  swindler,  who  had  read  a  few  scraps  of  Greek  and  stolen  a  little  Latin,  are 
characteristic  of  their  contents  :  "  Quinta  essentia,  das  ist  die  hochste  Subtilitet,  Krafift 
and   Wirckung  beider  der   flirtreffiichsten   K'unsten   der   Medicina  und  Alchemia  "; 


—  393  — 

"  Pison  ;  "  Bsftaiwaic  aYiuvttr/xou,  i-  e.  confirmation  of  uroscopy."  Of  similar 
worth  was 

Adam  von  Bodenstein  (died  1576), 
a  son  of  the  famous  theologian   Karlstadt   (the  Lassalle  of  the  socialistic  and  com- 
munistic peasant-revolution  of  that  time),   but  a  practising  physician  in  Basle.     He 
wrote  an   "  Onomastikon"  to  the  writings  of  Theophrastus  von  Hohenheim,  a  work 
subsequently  republished  bjT 

Michael  Toxites  and 

Valentin  Antaprassus  Siloranus. 

Martin  Ruland  (1532-1602)  of  Lauingen  in  Swabia, 
following  the  crudest  observation,  compiled  a  catalogue  of  remedies  and  diseases  in 
which  they  were  of  service.  He  was  the  father  of  a  physician  of  the  same  name  who 
disputed  with  Job.  Ingolstetter,  a  physician  of  Nuremberg,  concerning  the  theory  of 
the  "golden  tooth".  He  was  also  the  inventor  of  the  "aqua  benedicta"  (vinum 
stibiatum  |. 

GrEORG  PHADRO  VON  RODACH  (1562  i. 
physician  to  the  archbishop  of  Salzburg. 

Bartholomjeus  Carrichter  (about  1570)  of  Reckingen. 
ordinary    physician   of  the   emperor   Maximilian    IT.    (1527-1576,    his    post   mortem 
revealed  three  "heart-stones"),  recommended  e.g.  as  an  arcanum   against  luxations 
bandaging  the  joint  with  the  lendo  Achillis  of  an  elk. 

Gerhard  Dorn  (about  1580)  of  Frankfort-on-the-Main. 
like  Paracelsus,  was  a  partisan  of  the  Cabala,  alchemy  etc. 

Michael  Bapst  (died  1603)  of  Rochlitz. 
a  minister  and    proprietor  of  a  boarding-school   for    boys,    wrote    a   "  Giftjagend.es 
Kunst-  und  Hausbuch  "  (1592)  and  other  similar  works,  while 

Georg  Amwald, 

the  itinerant  lawyer  and  drug-peddler  (he  left  Augsburg  in  1583,  and  died  at  the 
beginning  of  the  seventeenth  century),  at  the  same  period  sold  a  panacea  which  con- 
sisted  of  egg-shells,  saffron  and  cinnabar,  and  introduced  in  his  writings  bulky 
testimonials  of  persons  who  had  been  saved  thereby  —  a  genuine  Barry  du  Barry 
of  the  16th  century  ! 

Among  the  theosophistieal,  mystical  and  cabalistic  followers  of  Para- 
celsus belong  the  Rosier uoians,  a  secret  society,  which,  curiously  enough, 
owes  its  formal  existence  to  the  satirical  and  humorous  writings  (among 
these  the  "  Chymische  Hochzeit  Christian's  Rosenkreuz  ")  of  the  minister 
Valentin  Andrea1  (1586-1654)  of  Calw  in  Wurtemberg.  composed  for  the 
express  purpose  of  combating  the  nonsense  of  the  alchemists.  An  informal 
secret  association,  however,  had  existed  hefore  this,  whose  members  were 
to  pursue  openly  no  other  occupation  than  the  gratuitous,  but  only  mystic. 
treatment  of  the  sick,  in  return  for  which,  however,  they  were  to  receive 
the  philosopher's  stone.1 

1.  According  to  Sprengel  the  earliest  historical  trace  of  the  Bosicrucians  appears  in 
1610,  when  a  notary  Haselmayer  is  said  to  have  read  in  MS.  the  "  Fama  fraterni- 
tatis"  or  constitution  of  their  order.  In  1614  appeared  at  Regensburg  a  work 
entitled  "Allgemeine  und  General  Reformation  der  ganzen  Welt,  benebst  der 
Fama  fraternitatis  der  Bosenkreuzer ".  In  the  "Fama"  it  is  related  that,  a 
German.  Christian  Rosenkreuz,  had  founded  the  society  in  the  Nth  century,  after 


—  394   — 

For  the  sake  of  preserving  the  connection  they  are  enumerated  here, 
though  the  most  important  of  them  iFludd)  belonged  to  the  following 
century,  during  which  they  displayed  their  greatest  activity  and  monopolized 
most  of  the  treatment  of  the  sick.     We  mention  the  rediscoverer  of  ether. 

Oswald  Croll,  a  Hessian  (1560-1609  . 
whose  "  Basilica  chymiua"  survived  twenty  editions,  and  who,  like 

Julius  Sperber. 
was  ordinary  physician  of  Anhalt.     Croll  was  also  the  Hist   ;o  furnish  a  formula  for 
the  preparation  of  calomel. 

HeXNIMt  Scheunemann, 
a  physician  in  Bamberg  and  Aschersleben ; 

Heinrich  Kunrath  (1560—1605),  a  physician  of  Hamburg  ; 

Johann  G-ramann    about  1593  .  a  minister; 

Valentin  Weigel     L533  until  after  1504'.  a  minister  near  Chemnitz  : 

^Egidios  Guttmann  (about  1575),  a  minister  in  Swabia,  and  finally 

Levinus  Battus  i  died  1591  in  Rostock  . 
who  declared  the  herb  fleabane.  washed  in  the  river  and  hung  upon  the  seat  of  di~ 

_.  the  nipples,  the  ears,  penis  etc.  — compare  the  Talmudists^  and  then  buried,  to 
be  a  sovereign  remedy  against  all  evil  spirits  and  diseases.  Gramann  administers 
the  oil  of  nutmeg  in  injuries  of  the  brain,  weak  memory  etc.  (because  it  has  tie 
-  .nature"  of  the  brain  I,  as  well  as  in  hiccups,  vapors,  female  leucorrhoea,  foul 
breath  and  stone  in  the  bladder.  Finally,  according  to  the  same  authority,  the  same 
remedy  rubbed  in  about  the  navel  will  help  the  frigid  husband  into  the  saddle,  and 
warm  up  the  swollen,  cold  uterus  to  become  fruitful,  if  rubbed  in  in  that  neighborhood  ! 

Caspar  Peucer  (1525-16<  I 
likewise  counted  among  the  Paracelsists. 
In  England  the  Pseudo-Paracelsists  included: 

John  Michell1  (about  1585),  the  surgeon  John  Hoster,9  and  the 
most  famous  of  the  Eosicrucians, 

having  learned  in  Egypt  and  Fez  the  sublime  wisdom  of  the  Orient.  Rosenkrenz 
imparted  his  mysteries  to  three  disciples,  who  established  the  following  la 
the  society  :  1.  The  members  of  the  society  should  openly  practice  no  other  than 
the  medical  profession,  and  treat  all  the  sick  gratuitously.  2.  They  should  wtar 
the  dress  of  the  country  in  which  they  resided.  3.  They  should  assemble  each 
year,  on  the  anniversary  of  the  birthday  of  their  founder,  at  the  chapel  of  the 
Holy  Spirit,  a  secret  rendezvous.  4.  They  should  initiate  suitable  laymen  to 
inherit  their  mysteries.  5.  They  should  choose  the  word  "Rosenkreuz"  for  a 
watchword,  6.  They  should  conceal  the  existence  of  the  society  for  a  hundred 
years.  All  members  of  the  society  were  assured  of  complete  celestial  know" 
unspeakable  riches,  exemption  from  all  diseases,  eternal  youth,  and  the  philo>o- 
'phers'  stone  to  boot.  Andrea-  is  said  to  have  written  the  "  chymische  Hochzeit" 
as  early  as  1603.       H. 

1.  Sprengel  calls  him  Johann  Michelius,  and  says  he  came  from  Antwerp  to  Lor. 

where  he  deceived  everyone  with  his  philosophers'  stone  and  universal  medicii  e. 
He  also  wrote  an  "Apologia",  in  which  he  shamefully  abused  the  ancient  physi- 
cians and  lauded  Paracelsus  to  the  skies. 

2,  Haller  calls  him   Hester,  and  ascribes  to  him  a  "Compendium  secretorum  raii'>n- 

alium  "  and  a  treatise  on  practice  entitled  "  Pearle  of  practice,  or  pearle  for 
physik  and  chirurgerie".  London.  1592.       II 


—  395  — 

Robert  Fludd1  (1574-1637), 
who  declared  :  "  He  who  will  be  sound  must  have  pleasure  in  the  law  of  the  Lord, 
and  speak  of  it  day  and  night."  He  likewise  peopled  the  whole  world  with  demons 
and  spirits.  One  knows  at  once  where  he  stands,  and  is  filled  with  delight  when  he 
reads  :  "  Therefore  the  faithful  physician  must  lay  hold  of  the  armor  of  God,  that  he 
may  be  able  to  withstand  ;  for  he  has  not  to  struggle  with  flesh  and  blood." 
In  Denmark 

Peter  Severin  (1540-1602)  of  Ribe  in  Jutland, 
ordinary  physician  of  the   king,   was  an   especially  zealous  partisan  of  Paracelsus, 
whom  he  follows  in  everything. 

Olaus  Rorrichius  (Ole  Rorch,  died  1690)  belonged  to  the  same  school. 

In  France  the  partisans  of  Paracelsus  adhered  particular]}*  to  his  materia  medica 
and  surgery,  and  the  treatise  of  Paracelsus  upon  the  latter  subject  was  translated 
into  French  by 

Claude  Dariot  (1533-1594)  of  Pomar  near  Reaume. 

Claude  Aubery  of  Trecourt, 
who  in  earlier  life  had  been  a  wealth}-  alchemist,  became  subsequently  very  poor  and 
died  wretchedly  in  a  hospital  at  the  age  of  98. 

Rernard  Georges  Penot,  Jacques  Gohory  (Leo  Suavius,  died  1576) 
and 

ROCH  LE  RAILLIP  DE  LA  RlVIERE, 
ordinary  physician  of  Henry  IV.  (1533-1610),  are  not  so  well  known  as 

1.  Called  also  De  Fluctibus.  He  was  born  in  Milgate.  Kent,  graduated  at  Oxford  in 
1605  and,  after  travelling  for  six  years,  finally  settled  in  London,  where  he  became 
a  member  of  the  College  of  Physicians.  He  was  also  a  prominent  member  of 
the  society  of  Rosicrucians  and  wrote  a  "Tractatus  apologeticus  "  in  its  defence. 
His  voluminous  writings  are  full  of  unintelligible  Rabbinical  and  alchemistic 
absurdities,  which  possibly  accounts  for  his  great  reputation  in  his  own  day — onme 
ignotum  pro  magnifico.  Perhaps  his  best  known  medical  treatise  is  the  "  Medicina 
Catholica,  seu  Mysticum  Artis  medicandi  Sacrarium  ".  Another  of  these  Pseudn- 
Paracelsists  was  Francis  Anthony  (1550-1623),  an  alumnus  of  Cambridge,  who 
devoted  himself  zealously  to  the  study  of  chemistry  and  published  in  1598  a 
treatise  "  Panacea  aurea,  seu  de  auro  potabili",  in  which  he  proclaims  his  dis- 
covery of  an  arcanum  capable  of  curing  all  diseases.  The  College  of  Physicians, 
of  which  he  was  a  member,  compelled  him  to  undergo  an  examination,  which  he 
stood  so  badly  that  he  was  interdicted  from  practice.  But,  far  from  daunted  by 
this  opposition,  he  continued  to  practice  in  spite  of  fines  ami  imprisonment,  until 
he  fairly  wore  out  the  opposition  of  the  College  and  finally  regained  his  doctor's 
title.  In  1610  he  again  published  a  treatise  "  Mediciine  chymicae  et  veri  auri 
potabilis  assertio",  and  six  years  later  appeared  an  "Apology  in  defence  of  his 
medicine  stiled  aurum  potabile",  in  reply  to  an  attack  by  Matthew  Gwiune. 
Anthony  had  two  sons,  both  of  whom  where  physicians,  and  while  one  of  them 
continued  to  make  the  most  of  his  father's  aurum  potabile,  the  other  became  an 
eminent  practitioner  in  Bedford. 

William  Butler  (1534-1617),  of  the  county  Clare  in  Ireland,  was  also  a  famous 
alchemist,  who  was  held  in  high  esteem  by  king  James  I.  and  by  Van  Helmont 
himself.  He  was  reputed  to  have  discovered  a  stone  by  means  of  which  he  cured 
the  most  dangerous  diseases,  and  an  investigation  of  the  subject  by  Sir  Kern  1m 
Digby  convinced  the  investigator,  at  least,  of  the  truth  of  the  report.      (H.) 


—  396  — 
Jos.  du  Ciiksne  (Quercetanus,  1521-1609), 

a  nobleman  of  Gascony  and  also  ordinary  physician  of  Henry  IV.  The  latter 
physician  was  the  first  in  France  to  recommend  the  antimonial  remedies  of  Paracel- 
sus. These,  however,  wore  proscribed  by  Parliament  in  1566,  at  the  instance  of  that 
indefatigable  champion  of  Antiquity  and  personification  of  contradiction, 

Joh.  Riolan  (1538-1606), 

whose  example  furnishes  proof  that  even  eternal  opposition  brings  about  a  kind  of 
immortality.  This  quarrel  about  antimony,  i.  e.  the  struggle  between  the  ancient 
Galenic,  and  the  new  chemical,  therapeutics  nave  occasion  to  the  famous  Faculty  of 
Paris  in  1603  to  place  formally  under  the  ban  Theodore  Turquet  de  Mayerne  tl57;>- 
1655)  and  Pierre  de  la  Poterie.  "All  physicians  too,  who  practice  medicine  anywhere, 
are  admonished  to  banish  from  themselves  anil  their  thresholds  the  said  Turquet.  and 
all  similar  monsters  of  mankind  and  monstrosities  of  opinion,  and  to  remain  true  to 
Galen".  The  same  fate  befell  in  l(iO!>  a  physician  Besnier.  who  was  not  received 
again  into  the  Faculty  until  he  had  sworn  to  renounce  the  use  of  antimony.  This 
interdiction  was  not  removed  until  1666.      In  Italy 

Giov.  Battista  Zapata.  Isabella  Cortese,  the  impostor 

Leonardo  Fiorayanti  (about  1564)  of  Bologna, 
who  sought  to  establish  the  theory  that  syphilis  originated  from  feeding  animals  upon 
the  flesh  of  their  own  species,  and 

Tomasso  Bono  (Thomas  Bovius,  about  1592), 
who  called  himself  Zefiriel  after  his  guardian  angel,  whose  name,  singularly  en<  ugh, 
he  knew —  were  all  zealous  propagators  of  the  arcana. 

More  conducive  to  the  honor  of  Paracelsus  were  his  semi-partisans,  at 
the  head  of  whom  was 

Winther  (Giinther)  von  Audernach, 
who  in  his  later  days  at  least  employed  the  remedies  of  Paracelsus,  ah  hough  he  also 
recommended  those  of  the  ancient  physicians.  This  learned  physician,  in  accordance 
with  the  views  of  bis  age,  also  considered  ordinary  anatorm  quite  unessential  in 
medicine.  —  The  following  ph}-sicians,  though  opponents  of  the  theoretical  side  of  the 
teachings  of  Paracelsus,  were  yet  followers  of  his  pharmacology  : 

Andreas  Ellinger  (died  1582),  professor  in  Jena  ;  Beneclictus  Aretius 
(about  1572)  ;  Theodor  and  Jacob  Zwinger  (1569-1610);  Michael  Boring 
(died  1644),  one  of  the  most  famous  of  the  old  professors  of  Giessen  : 
Heinrich  Petriius,  and  Guillaume  Arragos  (1513-1610)  of  Toulouse,  ordin- 
ary physician  at  Paris  and  subsequently  at  Vienna,  who  died  in  the  house 
of  his  friend  Jacob  Zwinger  at  Basle. 

The  weightiest  opponent  of  Theophrastus  (and  quite  naturally  his 
earl i or  colleague  in  the  universit}-  of  Basel)  was 

Thomas  Erastus  (in  German  Lieber,  1527-1583). 
who  was  joined  by  his  colleague  in  Heidelberg, 

Heinrich  Smet  (Smetius.  1537-1614). 
a  native  of  Flanders.     Paracelsus  was  also  opposed  by 

Bernhard  Dessenhs  (1510-1574)  of  Amsterdam,  a  physician  in 
Groningen  and  subsequently  in  Cologne;  Andreas  Libavius  (1540-1  Gl 6)  of 
Halle,  a  physician  in  Coburg  and  an  eminent  chemist  :  the  Altdorf  professor 
Caspar  Hofmann  (1572-1648)  and  Angelus  Sala,  the  successor  of  Libavius, 
who  died  in   1637.     Sala  was  originally  from   Vicenza.  but   in   1625  was 


—  307   — 

appointed  ordinary  physician  in  Mecklenburg.  He  recommended  the  inter- 
nal employment  of  nitrate  of  silver. 

In  a  more  quiet  way  than  that  of  the  Paracelsists  the  dispute  among 
the  learned  against  Galen  served  also  to  introduce  a  new  medicine.  Besides 
Cardanus,  who  has  been  already  mentioned,  this  dispute  was  carried  on 
most  zealously  by 

Giovanni  Argenterio  (1513-1572)  of  Castelnuovo  in  Piedmont.  He 
practised  without  success,  and  consequently  without  acquiring  confidence 
(after  finishing  his  studies  in  Turin),  first  at  Lyons,  then  in  Antwerp,  and 
was  subsequently  appointed  a  professor  in  Pisa.  Naples,  Rome  and  finally 
in  Turin. 

In  opposition  to  Galen,  who  sought  disease  in  an  unnatural  condition  in  which 
the  "euexia"  is  wanting,  disease,  according  to  Argenterio,  is  an  "air.etria"  in  the 
composition  of  the  parts.  He  did  not  find  its  causes  in  the  elementarj-  qualities,  nor 
did  he  allow  that  the  so-called  secondary  qualities  were  dependent  upon  these.  In 
this  he  flew  directly  in  the  face  of  the  Galenic  system.  Still  bolder  almost  —  at  least 
at  that  period — was  his  refusal  to  accept  the  manifold  varieties  of  pneuma.  M<  re- 
over  Argenterio  denied  the  "special  forces"  etc.  Medicine  he  held  very  properly  as 
an  experimental  science,  intermediate  between  art  and  science. 

These  doctrines  awakened  the  violent  opposition  of  the  Galenist 
Alexander  von  Neustain  (1506-1500).  his  opponent  Rainer  Solenamler 
(1521-1596),  ordinary  physician  of  Cleves,  George  Bertini,  and  the  Aristo- 
telian Remigius  Megliorati, 

who  wished  to  uphold  the  possibility  of  "  putridity  "  in  living  bodies,  and  the  theory 
that  this  was  the  cause  of  the  so-called  putrid  fever — a  doctrine,  as  we  know. 
borrowed  from  the  Pneumatists.  The  denial  of  this  was  the  chief  merit  of  Ar°en- 
terio's  pupil,  and  after  him  the  most  important  of  the  Antigalenists. 

Laurent  Joubert  (1529-1583)  of  Valence  in  Dauphine'e.  He  was  ;i 
professor,  and  afterwards  the  influential  chancellor  of  the  school  of  Mont- 
pellier,  and  his  work  entitled  "  Erreurs  populaires  au  fait  de  la  medecine  et 
regime  de  sante  "  awakened  such  attention  and  found  such  approval,  that 
6000  copies  of  it  were  disposed  of  in  six  months,  an  astonishing  success  at 
a  time  when  newspaper  advertising  was  still  in  its  infancy  ! 

This,  at  that  time  very  revolutionary,  doctrine  excited  great  attention,  and 
awakened  the  opposition  of  Bruno  Seidel,  professor  at  Erfurt,  and  of  Erastus.  fu 
opposition  to  the  former  of  these  Joubert  maintained  that  a  foul  odor,  even  of  the 
excrements,  was  no  certain  evidence  of  putridity,  as  many  things  had  a  foul  odor 
without  being  either  excrements  or  putrid.  Moreover  Joubert  asserted  that  menstiual 
blood  was  not  poisonous,  rejected  Galen's  doctrine  of  forces  etc.  Simon  Simonius, 
physician  of  the  elector  of  Saxony,  gave  his  aid  to  the  side  of  the  author  of  "Erreurs 
populaires"  etc.  and  "  Paradoxa  medica". 

Guillaume  Rondelet  (1507-1566),  his  pupil  Hieronimo  Capivaccio 
(died  1589).  professor  in  Padua,  and  the  truly  Catholic  and  conscientious 
Andreas  Dudith  von  Horekovicz  (1533-1589), 

privy-councillor  of  Ferdinand  I.  (1503-1564,  who,  though  the  son  of  the  Spanish 
Philip,  did  not  persecute  Protestants),  bishop  of  Tina  in  Dalmatia,  deputy  at  the 
Council  of  Trent,  ambassador  to  Poland  etc.,  and  a  partisan  of  the  Eeformation,  for 
which  reason  he  also  married. 


—  398  — 

Other  subjects  of  reform  were  found  in  semeiology,  which  was  first 
specially  cultivated  in  the  sixteenth  century.  Among  these  subjects  were 
oroscopy  or  uromancy,  the  doctrine  of  the  pulse  and  that  of  critical  da}S. 

The  following  physicians  wrote  on  the  subject  of  semeiology,  which  was  revived 
upon  Greek  principles  and  bloomed  anew  in  the  16th  century.  Uldaricus  Binder 
(,1506,  Epiphania  medicorum ) ;  Jacobus  Sylvius  (1539,  De  signis  omnibus  medicis) ; 
Joh.  Jac.  Huggel  (1560,  De  semiotice  medicinse  etc.)  ;  Jodocus  Lommius  (Observ. 
medicte,  1560);  Franc.  Valerius  (1565,  De  urinis,  pulsibus  ac  febribus) ;  Andreas 
Planer  (1579,  Theses  de  signis);  Ludov.  Lemmosius  (1588,  De  optime  praedicandi 
ratione) ;  Jac.  Hollerius  1576;  Ludov.  Duretus  (Interpretationes  in  Hippocratis 
prasnoriones,  1585);  Giov.  Argenterio,  Thomas  Mouffet  ;x  Joh.  Bapt.  Donatus  ;  Peter 
Foreest;  Thorn.  Fyens  ;  Emilio  Campolongo  (Semiotice,  published  bj'  Joh.  Jessen 
a  Jessen,  who  was  beheaded  in  1621)  ;  Prosper  Alpino  (De  prassagienda  vita  et  morte 
segrotantium)  and  others. 

Uroscopy  and  uromancy,  which  even  to-day  are  pursued  secretly  by  a  few  in  a 
purely  "  business "  point  of  view,  were  in  the  16th  century  still  an  open,  recognized 
and  honorable  occupation  of  the  physician,  and  an  ordinary  demand  of  practice. 
They  were  elaborated  particularly  by  the  Arabians,  then  imported  into  the  West  and 
based  upon  the  Galenic  doctrine  that  the  condition  of  the  natural  forces  can  be  deter- 
mined from  the  condition  of  the  urine,  as  that  of  the  spiritual  forces  from  the  pulse; 
and  that  in  the  same  way  the  health  or  disease  of  each  important  organ  may  be 
determined.  In  support  of  such  nonsense,  which  was  especially  current  in  Germany, 
such  men  even  as  Joubert,  Capivaccio,  Thoinas  Fyens  (1567-1631)  at  Louvain,  and 
Hercules  Sassonia  (1550-1607)  declared  themselves.  More  numerous  and  weighty, 
however,  were  its  opponents  :  Joh.  Lange,  Diomedes  Cornarus,  Horekovicz,  Clementius 
Clementinus  (about  1512)  at  Rome;  Christopher  Clauser  (about  1531)  of  Zurich; 
Fundus  Cordus  (1486-1534)  of  Simmershausen  in  Hesse  (lived  about  1520  in  Erfurt, 
then  in  Marburg,  died  1534  in  Bremen  and  introduced  the  term  "  Scharbock " )  : 
Franz  Emerich  (about  1552)  of  Vienna;  Bruno  Seidel  (about  1562),  professor  in 
Erfurt;  Wilhelm  Adolf  Scribonius  (about  1585)  in  Marburg;  Siegmund  Koelreuter 
(about  1574)  in  Nuremberg,  and  Peter  van  Foreest  (1522-1597)  of  Alkmaer  in  north- 
ern Holland.  Such  were  the  most  famous  of  the  opponents  of  this  doctrine,  who 
contended  that  the  causes  of  disease  and  diseases  themselves  etc.  could  not  be  deter- 
mined from  the  urine,  since  temperament,  season,  mode  of  life  and  age  had  a  great 
influence  upon  its  excretion.2 

1.  Mouffet  was  a  physician  and  naturalist,  and  a  member  of  the  College  of  Physicians 

of  London.  He  died  about  the  close  of  the  16th  century.  His  treatise  on 
semeiology  was  entitled  "  Nosomantica  Hippocratica,  seu  Hippocratis  prognostica 
cuneta",  Frankfort,  1588.  Among  other  works  by  the  same  author  is  a  treatise 
upon  dietetics:  "  Health's  improvement,  or  rules  concerning  the  nature,  method 
and  manner  of  preparing  all  sorts  of  food  ".     ( II. ) 

2.  "  Carry  his  water  to  the  wise  woman  " 

says  Fabian  in  "Twelfth  Night",  and  to  the  question  of  the  doughty  Sir  John 
Falstaffin  "Kins:  Henry  IV.", 

"  Sirrah,  you  giant,  what  says  the  doctor  to  my  water?' 
his  page  replies  : 

"  Be  said,  sir,  the  water  itself  was  a  good  healthy  water:   but  for  the  party  that 
owned  it,  he  might  have  more  diseases  than  he  knew  for." 

On  which  the  learned  Steevens  makes  the  following  comment:   "  The  method 
of  investigating  diseases  by  the  inspection  of  urine  only  was  once  so  much  the 


—  399  — 

The  axe  was  also  laid  at  the  root  of  the  extremely  subtile  Galenic  doctrine  of  the 
pulse,  though  very  coyly  at  first,  and  only  superficially.  Thus  the  Polish  ordinary 
physician  Joseph  Struthius  (Strus,  1510-1568)  studied  the  subject  anew,  but  accepted 
five  chief  classes  of  the  pulse,  with  15  simple,  and  17  compound  varieties.  Leo 
Rogani  (about  1556)  and  Capivaccio  varied  from  him  very  little.  Horekovicz,  Fyens, 
Sassonia  and  especially  Prosper  Alpino  also  taught  that  Galen  was  not  entirely 
infallible  in  regard  to  the  interpretation  of  the  pulse.  The  work  of  Alpino  already 
mentioned  laid  the  foundation  of  semeiology  as  a  special  branch  of  instruction.  In 
spite  of  the  invention  of  the  minute-watch  b.y  Peter  Hele  (also  Henlein,  died  1542),  a 
locksmith  of  Nuremberg,  counting  the  pulse  still  did  not  take  the  place  of  estimating, 
its  frequency. 

The  doctrine  of  critical  days,  as  it  related  to  practice,  was  still  less  properly 
reformed,  though  it  was  at  least  considered  anew  by  Girolamo  Fracastori  ( 1483— 
155.'!).  who  referred  such  days  to  the  prominence  of  a  materies  morbi  (mucus  con- 
ditioned a  quotidian,  yellow  bile  a  tertian,  black  bile  a  quartan  type),  while  mathe- 
matics and  astrology  (especially  the  influence  of  the  moon)  were  taken  into  consider- 
ation by  Amatus  Lusitanus  (died  1562),  by  the  famous  Nipho  of  Sessa  in  Calabria 
and  many  others,  something  in  this  style:  "The  bodj*  consists  of  four  elements  and 
th."  soul  of  three  forces,  hence  the  seventh  day  is  the  critical  day;  7  plus  7,  however, 
is  14.  hence  the  14th  day  is  also  critical"  etc. 

Yet  we  have,  even  to-day,  substantially  no  more  certain  explanation  of  this 
subject  ! 

b.  Surgery. 

The  reform  of  surgical  practice  grew  out  of  the  change  in  the  methods 
of  carrying  on  war ;  for  war,  alas,  has  ever  possessed  the  greatest  influence, 
as  well  in  promoting,  as  in  retarding,  the  course  of  civilization.  The 
daughter  of  war,  surgery,  was  compelled,  so  to  speak,  to  conform  herself  to 
the  development  of  the  former,  although  the  ancient  weapons  continued  to 
be  frequently  employed  still  in  the  16th  century.  The  transformation  of 
surger}-,  however,  may  with  more  justice  and  accuracy  be  referred  to  a 
single  man.  than  can  be  done  with  the  practice  of  medicine,  although  he 

fashion,  that  Linacre,  the  founder  of  the  College  of  Physicians,  formed  a  statute 
to  restrain  apothecaries  from  carrying  the  water  of  their  patients  to  a  doctor,  and 
afterwards  giving  medicines  in  consequence  of  the  opinions  they  received  con- 
cerning it.  This  statute  was  soon  after  followed  by  another,  which  forbade  the 
doctors  themselves  to  pronounce  on  any  disorder  from  such  an  uncertain  diag- 
nostic. 

It  will  scarcely  be  believed  hereafter,  that  in  the  years  1775  and  1776  a 
German,  who  had  been  a  servant  in  a  public  riding  school  (from  which  he  was 
discharged  for  insufficiency),  revived  this  exploded  practice  of  water-casting. 
After  he  had  amply  increased  the  bills  of  mortality  and  been  public!}-  hung  up 
to  the  ridicule  of  those  who  had  too  much  sense  to  consult  him.  as  a  monument 
of  the  folly  of  his  patients,  he  retired  with  a  princely  fortune,  and  perhaps  is  now 
indulging  a  hearty  laugh  at  the  expense  of  English  credulity.' 

Why  should  it  not  be  believed?  Do  not  "  eminent"  doctors  now  profess  to 
diagnosticate  not  only  diseases,  but  even  conjugal  compatibility,  by  a  micros- 
copic examination  of  the  blood?  And  this  not  in  1775  but  the  year  of  our  Lord 
1886!     (H.) 


—  400   — 

too  could  not  have  appeared  without  much  that  had  gone  before  and  much 
that  was  contemporaneous  with  him.  The  merit  of  this  individual  was 
based  not  so  much  upon  any  preconceived  plan  of  action,  as  upon  the 
systematic  utilization  of  an  accidentally  fortunate  experience  in  a  position, 
and  at  a  time,  favorable  to  its  development.  Tt  consisted  simply  in  the 
experience  that  a  piece  of  unexampled  barbarity,  the  cauterization  of  gun- 
shot wounds  (up  to  this  time  generally  regarded  as  poisoned),  was  by  no 
means  necessary  for  their  cure,  ami  that  they  in  fact  healed  even  better 
and  with  less  pain  under  simple  treatment  with  cold  dressings  and  charpie, 
than  after  cauterization  witli  boiling  oil.  To  this  was  added  the  recom- 
mendation and  practice  of  the  ligation  of  arteries  at  the  divided  extremity,1 
with  the  inclusion  of  a  small  portion  of  muscular  tissue.  This,  however, 
was  known  already  to  the  Ancients,  through  them  to  the  Arabians,  and 
through  both  these  to  the  mediaeval  surgeons,  though  it  was  discovered 
again  by  Pare  independently.  He — and  this  was  new  and  important — intro- 
duced it  into  the  practice  of  amputation,  which  latter  operation  too  he  per- 
formed through  the  sound  tissues,  and  not,  as  had  always  been  done  here- 
tofore, through  the  gangrenous  parts  only.  He  introduced  it  also  in  place 
of  the  cauterization  heretofore  employed,  though  the  latter  barbarity  was 
not  entirely  supplanted  by  ligation  until  the  18th  century.  So  long  the 
prejudice  against  the  new  precedure  endured  !  Every  great  and  lasting 
improvement  wins  its  way  slowly,  for  it  is  repugnant  to  small  minds.  The 
unimportant  and  transitory  alone  arouses  immediate  enthusiasm.  Dieffen- 
bach  compares  the  value  of  ligation  in  surgery  to  that  of  printing  in  gen-" 
eral  culture  and  of  the  railroad  in  commerce.  With  these  two  experimental 
facts  (especialby  the  first),  which  supplied  to  the  future  rather  principles 
than  simple  matters  of  fact,  begins  a  new  era  in  the  treatment  of  wounds. 
Thus 

Ambroise  Pare'1  (1509  or  1510-1590),  originally  a  barber  and  the  son 
of  a  barber  of  Bourg-Hersent  near  Laval  in  Maine,  the  father  of  modern 
surgery,  furnished  new  proof  that  not  the  most  learned,  but  almost  exclu- 
sively the  most  gifted,  have  accomplished  revolutions  in  the  department  of 
medicine  also.  He  adopted  the  pious  motto,  which  ought  to-day,  particu- 
larly,  to  be  recalled  to  remembrance  :  "Je  le  pansay.  Dieu  le  guarit  ".  More- 
over in  practical  life  he  followed  the  precept  :  "An  approved  remedy  is 
much  more  valuable  than  one  newly  discovered  '" ;  and  that  other  maxim 
which  bears  witness  to  his  eminent  character  and  his  scientific  spirit  :  ••  He 
who  becomes  a  surgeon  for  the  sake  of  money,  and  not  for  the  sake  of 
knowledge,  will  accomplish  nothing".     This  character  he  preserved  as  well 


1.  Pare,  like  other  earlier  surgeons,  passed  a  curved  needle  around  the  artery, 
seized  the  latter  with  forceps  (pince  a  corbin  and  pi  nee  a  patin),  and  then  tied 
it  with  a  thread  upon  a  thin  pledget  of  linen.  He  included  the  nerves  also  in 
the  ligature  (as  was  done  designedly  too  at  a  later  period,  to  prevent  the  escape 
of  the  spirits),  since  the  dangers  involved  in  the  ligation  of  nerves  were  not  known 
until  the  18th  century. 


—  401  — 

in  the  hard  school  of  life  as  on  the  slipper}-  field  of  the  royal  court,  a  model 
of  the  upright,  courageous  and  frank  Frenchman  of  the  olden  time.  Like 
man}'  great  surgeons  down  even  to  the  nineteenth  century,  Pare  stepped 
from  the  barber-shop  to  his  studies,  and  acquired  the  elements  of  his  spe- 
cial knowledge  in  the  Hutel-Dieu.  But  he  was  also  a  great  surgeon  in  war, 
the  best  school  of  surgery,  in  which  he  passed  a  great  part  of  his  life.  He 
is  said  to  have  decided  to  pursue  surgery  from  witnessing  a  case  of  litho- 
tomy. As  early  as  his  19th  year,  after  becoming  a  barber-surgeon,  he 
enlisted  as  such  in  the  army  of  marshal  Monte-Jan,  during  whose  campaign 
the  accidental  want  of  hot  oil  suggested  to  him  his  first  and  most  important 
surgical  reform.  In  1545  he  published  this  in  his  treatise  "La  methode  de 
traicter  les  playes  faictes  par  hacquebutes  et  aultres  bastons  a  feu  etc.", 
written  like  a  true  surgeon  in  the  French  language.  Shortly  afterwards 
Pare"  was  appointed  a  prosector  and  wrote  a  work  entitled  "  Briefve 
Collection  de  Tadministration  anatomique  etc."  (1550),  which,  however, 
discussed  also  surgical  and  obstetrical  subjects.  In  the  campaign  of 
the  year  15521  he  employed  the  ligature  in  amputations.  Soon  after  his 
return  he  was  appointed  one  of  the  twelve  royal  surgeons.  In  1554  he  was 
made,  without  any  compensation  —  a  very  rare  thing  with  the  learned  cor- 
porations of  all  times — a  fellow  of  the  College  de  St.  Come,  though  of  course 
against  the  opposition  of  the  professors  of  the  University,  who  objected  to 
him  that  he  did  not  understand  Latin.  Ultimately  Pare  was  advanced  to 
the  position  of  surgeon  to  king  Henry  II.  (died  1559  of  a  wound  inflicted 
at  a  tournament),  at  whose  death  he  succeeded  to  the  same  office  under 
Francis  II.  (1544-1560)  and  later  also  under  Charles  IX.  (1550-1574).  The 
latter  is  said  to  have  protected  him  on  the  night  of  St.  Bartholomew  by 
concealing  him  under  his  own  bed,  though  as  Pare  was  a  Catholic  the  story 
is  doubtful.  In  1573  appeared  his  -Deux  livres  de  chirurgie  ",  and  in  1582 
his  "  Discours  de  la  mumie,  des  venins.  de  la  licorne  etde  la  peste".  In  the 
latter  work  he  declared  the  remedies  derived  from  mummies  and  from  the 
unicorn2  to  be  inactive,  a  statement  which  of  course  excited  the  violent 
opposition  of  almost  the  whole  Paris  Faculty,  against  whom  the  author  was 
forced  to  publish  a  defence.  Pare  died  full  of  years  and  highly  honored  by 
his  nation,  in  spite  of  the  fact  that  he  was  decried  by  the  literati  of  his  day 
as  an  ignorant  upstart  and  plagiarist.  In  his  native  place,  however,  during 
the  present  century,  a  well-merited  monument  to  his  honor  has  been  erected. 

1.  Pare,  like  Larrej'  (whom  the  soldiers,  in  spite  of  their  own  dangers,  bore  off  across 

the  bridge  of  the  Beresina  upon  their  heads),  was  so  beloved,  that  when  he  had 
slipped  by  night  into  Metz,  the  troops  carried  him  through  the  city  in  triumph! 

2.  The  horn  of  the  unicorn  was  regarded  as  the  greatest  of  miraculous  remedies,  and 

was  only  rarelj*  employed.  It  was  represented  by  the  tooth  of  the  narwhal,  an 
animal  of  extreme  rarity.  A  specimen  in  Dresden  was  valued  at  that  time  at 
ST."). 000,  and  the  Venetians  vainly  offered  30,000  zechins  for  another  specimen. 
When  a  piece  of  the  specimen  at  Bayreuth  was  sawed  off,  two  delegates  of 
princely  rank  were  required  to  be  present. 
26 


—  402  — 

Besides  the  eminent  services  already  mentioned,  Pare  merits  further  credit  for 
the  following  improvements  in  surgery.  He  discarded  the  frequent  dressing  of  ulcers, 
and  castration  in  the  so-called  "  radical "  operation  for  hernia.  He  performed  her- 
niotomy in  strangulated  hernias  (most  probably  only  at  the  suggestion  of  Franco), 
though  this  operation  was  often  performed  too  in  his  day  by  itinerant  herniotomists. 
He  was  the  first  surgeon  to  habitually  employ  trusses,  though  this  instrument  was 
already  known  to  Antiquity.  Pare  also  taught  how  to  recognize  induration  of  the 
prostate  and  fracture  of  the  neck  of  the  femur.  He  introduced  the  operation  of 
staphyloplasty  and  an  improved  method  of  trepanning  with  the  crown  trepan,  and 
invented  numerous  instruments,  including  feeding  bottles  for  artificial  nourishment. 
He  performed  bronchotomy,  and  employed  the  ligature  in  the  treatment  of  fistula  in 
ano;  healed  wounds  of  the  nerves;  circumscribed  the  emploj'ment  of  the  actual 
cautery,  particularly  in  operations  for  cancer  of  the  breast;  revived  the  operation  for 
hare-lip  with  the  figure  of  S  suture,  in  which  he  was  the  first  to  follow  the  Arabians 
and  Pfolspeundt ;  was  the  first  to  perform  direct  excision  of  the  so-called  "loose  car- 
tilages" in  the  joints,  and  was  also  acquainted  with  abscesses  of  the  liver  resulting 
from  injuries  of  the  head.  Pare  likewise  improved  the  medico-legal  doctrine  of 
mortal  wounds;  practised  amputation  of  the  leg1  at  the  point  of  election ;  taught 
version  by  the  feet  etc. 

Part'  permanently   advanced   surgeiy   also   b}-    instructing   numerous 
gifted  and  able  pupils,  both  male  and  female,  including  his  son-in-law 

Jacques  Gillemeau  (1550-1613), 
physician  of  Charles  IX.   after  the  death  of  Pare,   who  also  enriched  both  surgery 
(indicating,  among  other  things,  the  Hunterian  operation  for  aneurism)  and  obstetrics. 

Severin  Pineau  (died  (1619); 

Pierre  Pigray  (1533-1613), 
a  pupil   of  Pare  and   royal  surgeon,   who  performed   herniotomj'  after   a  peculiar 
method  (Gyergyai); 

Nicholas  Habicot  (died  1624), 
a  surgeon  and  anatomist  of  Paris  and  a  famous  teacher,  who  regarded  a  skeleton  25 
feet  long  as  the  remains  of  the  aboriginal  king  Teutobocchus,  while  Prolan  recognized 
it  as  the  skeleton  of  a  whale  ; 

Adrien  and  Jacques  Amboise  ; 

Jacques  be  Marque  (1569-1622); 

Barthelemy  Cabrol ; 

Louise  Bourgeois  etc. 

Pierre  Franco  (about  1550),  of  Turners  in  Provence, 
a  surgeon  at  Freiburg,  Lausanne,  Berne  and  Orange,  was  distinguished,  like  all  great 
surgeons,  by  his  clear  and  simple  literary  style.  He  reformed  lithotomy  by  the 
invention  of  the  "  haut  appareil"  (supra-pubic  lithotomy),  succeeding  in  a  bold 
venture,2  to  which  (after  trying  perineal  section)  he  was  forced  by  a  very  large  stone 
in  a  child  of  two  years.     He  also  brought  into  credit  the  operation  of  herniotomy  in 

1.  Wounds  of  the  head  (at  an  earlier  period  the  most  frequent  and  most  important), 

in  consequence  of  the  decline  of  the  exclusive  use  of  weapons  for  inflicting 
blows  and  cuts,  receded  both  practically  and  scientifically  before  gunshot  wounds 
of  the   limbs. 

2.  Since  the  days   of  Hippocrates  wounds  of  the  upper  segment  of  the  bladder  had 

been  regarded  as  mortal,  because  the  flesh  would  fail  to  heal.  Such  was  the  idea 
even  as  late  as  the  time  of  Brunschwigk. 


—  403  — 

strangulated  hernia,  and  was  the  first  to  describe  clearly  the  method  by  which,  in  the 
majority  of  cases,  he  preserved  the  testicles,  when  the  patient  did  not  desire  the 
radical  operation  (Albert). 

Finally  the  perfection  of  plastic  surgery  (already  mentioned)  by 
Taglkicozzi  must  be  recalled  here,  as  well  as  the  artificial  replacement  of 
lost  parts  (artificial  eyes,  limbs,  noses  etc.),  which  Pare\  who  was  likewise  a 
good  cosmetic  surgeon,  was  particularly  active  in  promoting. 

c.    Midwifery  and  Gynaecology. 

With  the  name  and  age  of  Pare  is  also  associated  the  reform  of  mid- 
wifery. This  was  due  to  the  fact  that  operative  midwifery,  through  the 
revival  of  podalic  version  (already  clearly  taught,  e.  g.  in  breech  presenta- 
tions, by  Eucharius  llosslin1  in  1513),  made  a  great  stride  forward.  The 
practice  of  Caesarean  section  too  on  the  living  mother  was  promoted,  and 
fell  at  least  partially  into  the  hands  of  men.  and  from  this  time  forward 
midwifery  was  liberated  from  its  dependence  upon  surgery  and  made  an 
independent  department.  Yet  the  reform  of  Rosslin  and  Pare,  in  spite  of 
the  influential  position  of  the  latter,  had  no  decisive  influence  upon  this 
branch.  Obstetrical  butchery,  on  the  whole,  still  maintained  the  upper  hand 
during  the  10th  century.  —  With  the  advances  already  mentioned  should 
also  be  classed  the  separate  cultivation  of  the  diseases  of  women. 

Podalic  version,  even  in  head  presentations,  when  the  labor  conld  not  be  other- 
wise completed,  after  falling  into  oblivion  since  the  days  of  the  Indians  and  tioranus, 
was  subsequently  permanently  introduced  on  the  recommendation  of  the  French 
(1550).  The  German  practitioner  and  thoroughly  German  writer  of  Worms,  up  to 
this  period,  was  never  seriously  mentioned.  Nicholas  Lambert  and  Thierry  de  Heiy," 
shortly  before  the  time  of  Pare,  bad  performed  the  operation.  Its  technique  and 
indications  were  specially  determined  by  Pierre  Fianco,  Guillemeau  (1594),  and  the 
midwife  of  Marie  de  Medicis,  Louise  Bourgeois  (born  1564).  The  latter  was  also  the 
first  to  direct  attention  independently  to  the  innocuousness  of  footling  births.  (The 
Ancients,  as  we  know,  considered  them  very  dangerous  and  even  fatal  for  both 
mother  and  child).  Pare  was  the  first  to  induce  labor  artificially  at  full  term  in  cases 
of  haemorrhage  (Corradi). 

The  first,  Caesarean  section  on  the  living  and  parturient  woman  was  practised  by 
the  sow-gelder,  Jacob  Nufer,  of  Siegershausen  in  Thurgau,  upon  his  own  wife,  about 
the  year  1500.  After  13  midwives  and  several  lithotomists  had  endeavored  in  vain  to 
relieve  her,  her  husband,  having  invoked  the  assistance  of  God  and  obtained  the 
special  permission  of  the  governor  of  Frauenfeld,  operated  "just  as  on  a  sow"  with 
such  good  fortune  that  the  mother  survived  to  the  age  of  77,  and  was  able  subsequently 
to  bear  several  children  —  and  even  twins  —  in  the  usual  way.     Undoubtedly,  there- 

1.  "  Item  ob  das  kind  sich  mitt  dem  hindern  erzeugte,  so  soil  der  hebamm  mit  ynge- 

lassner  had  das  kind  ober  sich  heben  und  mit  den  fuessen  uszfahren."  (Edition 
of  1513  in  possession  of  the  author).  Pare  may  perhaps  have  learned  this  oper- 
ation from  the  French  translation  of  Rosslin's  work,  and  extended  its  application. 

2.  This  curious  fellow  was  "  Deputy  of  the  king's  first  barber",  and  so  famous,  even 

at  this  period,  as  a  "  specialist  in  syphilis"  that  he  became  a  rich  man.  Accord- 
ingly he  often  made  pilgrimages  to  the  grave  of  Charles  VIII.  at  St.  Denys,  since 
this  peculiar  saint  had  introduced  syphilis  into  the  world. 


—  404  — 

fore,  the  operation  was  unnecessary,  and  the  same  was  true  of  many  of  the  operations 
which  soon  followed  ;  for  Caesarean  section  became  the  fashion  for  a  short  time.  A 
sow-gelder  is  said  to  have  removed  the  ovaries  of  his  daughter,  in  consequence  of  her 
lasciviousness,  during  the  TtJth  century  (Wej'er  tells  t lie  story),  so  that  such  fellows 
and  operative  gynaecologists  are  to  be  considered  the  predecessors  of  Hegar,  and  to- 
be  praised  accordingly. 

As  the  result  of  this  enrichment  of  the  technique  of  operative  midwifery  by  a 
simple  sow-gelder,  the  Ca?sarean  section  seems  in  the  course  of  the  lfith  century  to 
have  been  practised  repeatedly,  e.  g.  in  Italy  in  1540  bjr  Christof.  Bain,  1581,  in 
Neusse,  1549,  by  Paul  Dirlewang,  on  Marie  Volcser,  in  Vienna  etc.  Ncw,'however,  it 
was  performed  in  a  somewhat  more  becoming  fashion,  and  chiefly  by  barbers, 
though  some  will  admit  as  the  first  actual  Caasarean  section  only  the  one  performed 
by  surgeon  Trautmann  in  Wittenberg  in  1610. 

The  first  writer  on  the  Caesarean  section  was 

Francois  Rousset,  (about  1581), 

who  studied  at  Montpellier  and  became  ordinary  physician  of  the  duke  of  Savoy. 
His  treatise,  or  rather  its  German  translation,  dedicated  to  a  countess  Palatine,  bears 
a  title  like  that  of  a  penny-ballad :  "  Hysterotomotokia,  seu  De  partu  casareo,  das  ist : 
Von  der  im  Fall  tiusserster  not,  wunderbarlicher  und  vor  nie  erhorter  noch  bewusster 
kunstlicher  losung,  cedirun<_r,  und  scheydung  eynes  Kindes  auss  und  von  Mutterleib."1 
It  enumerates  15  successful  cases.  Rousset  also  undertook  extirpation  of  the 
kidneys  (Albert),  and  was  in  general  a  good  surgeon  and  operator.  He  performed 
herniotomy  in  strangulated  hernia,  and  was  acquainted  with  the  musculature  of  the 
bladder.  Still  the  opponents  of  the  Caesarean  section  were  numerous,  and  included 
even  Pare;  for  many  of  those  operated  upon  died,  and  most  of  the  "saved"  after- 
wards bore  children  perfectly  well  in  the  natural  way. 

The  16th  century  also  furnished  indications  of  the  subsequent  employ- 
ment of  the  forceps,  the  accouchement  force,  and  the  artificial  removal  of 
the  placenta.  Pierre  Franco  made  the  first  effort  to  extract  the  head  by 
means  of  an  instrument  like  a  vaginal  speculum,  and  removed  the  placenta 
artificially.  Guillemeau  uttered  a  warning  against  the  latter  procedure, 
while  he  recommended  the  accouchement  force"  in  ante  partum  haemorrhage. 
Finally  Jacob  Sylvius  mentions  the  operation  of  symphyseotomy  (theoretic- 
ally). 

G}*na?cology  was  made  a  separate  branch  by  Conrad  Gesner,  and  then 
discussed  by  his  pupil,  Caspar  Wolf  (1532-1601  of  Zurich,  in  some  com- 
pendia, which  the  printer  Waldkirch  and  Caspar  Bauhin  (1550-1624) 
followed  with  a  similar  book.  The  compilation  of  the  last  two  was  repub- 
lished in  1597  by  Israel  Spach,  professor  in  Strassburg. 

Rodericus  a  Castro  (died  1627),  a  Portuguese  Jew2  who  had  settled 
in^Hamburg,  published  in  1603  the  next  great  g}-naecologieal  work. 

1.  The  original  French  title  was  little  less  extensive:   "  Traite  nouveau  de  1'  Hystero- 

tomotokie,  ou  enfantement  eesarien,  qui  est  extraction  de  1' enfant  par  incision 
laterale  du  ventre  et  matrice  de  la  femme  grosse,  ne  pouvant  autrement  accoucher; 
et  ce,  sans  prejudicier  a  la  vie  de  1'  un  ni  de  1'  autre,  ni  empecher  la  feeondite  mater- 
nelle  par  apres  :  par  Francois  Rousset,  medecin."  Paris,  1581 .  The  German  trans- 
lation was  by  Melchior  Sebiz,  and  was  dedicated  to  Elizabeth  of  Hesse.     (H.) 

2.  The  Portuguese  Jews  at  this  time  were  especially  distinguished  for  their  erudition, 

and  formed  an  intellectual  aristocracy  among  their  fellow-believers.     Hence  the 


—  405  — 

The  reform  of  this  "branch"  was,  as  we  have  said,  chiefly  literary,  and 
consisted  simply  in  the  separate  study  of  the  subject.  This  was  also 
true  of 

d.  Ophthalmology, 

which  for  the  first  time  was  based,  at  least  in  some  degree,  upon  observation 
and  treated  independently  in  his  "Augendienst  "  in  1583  by  Georg  Bartisch 
(1535  to  about  1606)  of  Konigsbruck  near  Dresden,  subsequently  court- 
oculist  of  the  Elector  of  Saxony  and  a  pupil  of  "  Meister  Abraham  Mey- 
scheider  ".  Bartisch  again  was  not  a  learned,  but  rather  a  gifted  man.  He 
was  also  an  '-ordinary"  surgeon,  but  treated  his  subject  in  a  very  different 
way  from  Benvenutus  Grapheus  (1340),  who  simply  followed  the  eminent 
acquisitions  of  Antiquity.  Even  in  those  days  the  Germans  proved  their 
special  talent  for  ophthalmology,  which  they  have  demonstrated  anew  in 
such  an  unexpected  and  brilliant  degree  in  our  own  century.  Everywhere 
else,  in  Italy,  France  and  England,  this  continued  for  a  long  time  to  be 
simply  a  subordinate  department  of  surgery  and  was  cultivated  only  in 
accordance  with  the  precepts  of  the  Ancients. 

Bartisch  was  an  independent  spirit  and  a  man  of  character  and  heart,  inspired 
by  a  love  of  his  profession  and  of  mankind,  whom  he  saw  outrageously  maltreated  in 
his  own  department.  This  aroused  his  righteous  anger.  This  wrath  and  hatred 
(imbibed,  as  Gothe  would  say,  from  the  plentitude  of  his  love),  his  zeal  for  humanity, 
right  and  truth,  stamped  upon  him  the  seal  of  a  reformer  and  of  a  talented  spirit. 
That,  however,  this  truly  assiduous,  upright  and  conscientious  man  should  be  free 
from  the  superstition  and  medical  credulity  of  his  time  is  not  to  be  expected.  Accord- 
ingly we  find  in  his  work  a  great  number  of  astrological  prescriptions  for  all  diseases 
and  for  the  cure  of  everything,  with  warnings  against  incantations  etc  ,  especiallj' 
against  women  (who  were  therefore  to  be  entirely  and  especialhy  excluded  in  all  oper- 
ations), and  a  mass  of  internal  and  external  remedies. 

The  preparations  necessary  before  operations,  on  the  part  of  both  the  patient  and 
the  physician,  are  specified  very  carefully  and  circumspectly:  the  patient  should 
continue  fasting  the  whole  day;  the  operating  room  should  be  light,  and  the  bed  well 
prepared  etc.  :  the  physician  too  should  have  drunk  nothing  for  a  few  days  previous 
to  the  operation,  and  should  not  have  set  up  long  by  candle  light ;  curiously  enough 
too  he  was  "  to  abstain  entirely  from  conjugal  duty  with  his  wife  for  two  days  and 
nights  before  the  operation",  so  that  the  possession  of  an  ordinary  practice  in  oper- 
ating for  cataract  must  have  furnished  by  itself  very  good  legal  ground  for  divorce. 
Great  weight  was  also  justly  laid  upon  instruments.     The  sole  operation  for  ordinary 

Portuguese-Hebrew  idiom,  compared  with  the  so-called  Polish,  is  still  regarded  as 
the  more  polished.  Persecuted  for  their  faith,  they  wandered  away  to  the  Nether- 
lands etc.  —  By  the  way,  it  maj-  be  remarked  here  that  in  Portugal  too  Germans 
were  the  first  printers,  and  thus  exercised  a  great  influence  upon  its  culture. 
Again  during  the  Kith  century'German  culture  exercised  generally,  through  the 
art  of  printing  and  the  Reformation,  the  greatest  influence  upon  the  culture  of  all 
the  people  of  that  time.     (B.) 

A  Portuguese  Jew,  Roger  Lopez,  captured  in  the  defeat  of  the  Spanish  Armada 
(1588),  became  ordinary  physician  of  queen  Elizabeth,  but  was  convicted  of  con- 
spiring against  the  life  of  the  queen,  and  hanged  at  Tyburn,  June  7,  15!)4.     (H.) 


—  406  — 

cataract  —  he  distinguishes  the  white,  pray,  blue,  green  and  yellow —  is  depression 
through  the  sclerotic.  Besides  this,  operations  for  pannus,  trichiasis,  ectropium, 
fistula  laehryinalis,  symblepharon,  and  ankyloblepharon,  tumors  of  the  lids,  exstir- 
patio  bulbi,  ptosis,  the  black  cataract  etc.,  were  performed  by  Bartisch,  and  the 
diseases  of  the  conjunctiva  etc.  were  very  carefully  treated,  indeed  so  carefully  that 
even  the  devil  and  enchantments  were  exorcised  and  rendered  harmless  by  amulets. 
This  was  rather  the  fault  of  his  time  than  of  himself.  Bartisch  laid  great  weight  upon 
the  after-treatment  of  operations,  a  subject  upon  which  the  "  eye-destroyers"  of  that 
day  had  nothing  at  all  to  say.  On  the  contrary  lie  justly  prides  himself  upon  it,  and 
upon  the  fact  that  he  attends  to  it  himself.  He  utters  a  word  of  warning  against 
'"Prillen"1  (spectacles),  which  were  the  fashion  even  in  his  da}-. 

How  highly  Bartisch,  in  contrast  with  the  "  couchers  and  eye-destroy- 
ers "  of  his  day,  estimated  the  responsibility  and  the  calling  of  the  operative 
oculist  may  be  inferred  from  the  fact  that  he  insisted  on  the  utmost  possible 
technical  dexterity,  and  an  equal  use  of  both  hands.  He  therefore  declared 
even  drawing  and  travelling  useful  for  the  physician,  since  "  man  becomes 
more  ingenious  and  meditative  through  painting  and  travel,  qualities  which 
are  of  great  advantage  in  the  healing  art.''  All  this  he  had  himself  expe- 
rienced, and  in  it  everyone  to-day  must  agree  with  him  ! 

Popular  books  on  the  treatment  of  the  eyes  also  made  their  appearance  early  in 
the  16th  century,  e.  g.  "  Em  neues  hochnutzliches  Buchlein  von  erkenntniss  der 
krankheiten  der  nugen"  etc.,  by  Vogtherr  of  Strassburg  in  15r'8. 

[A  similar  popular  treatise,  entitled  "A  brief  treatise  of  the  preservation  of  the 
eye-sight",  was  composed  by  Walter  Bailey,  Queen's  Prof,  of  Physic  in  Oxford  and 
ordinary  physician  of  queen  Elizabeth.  Bailey  was  born  at  Portsham  in  Dorset  in 
1529  and  died  in  1592.  The  precise  date  of  the  first  edition  of  his  work  is  unknown, 
but  the  second  edition  appeared  in  1616.  Another  work  by  the  same  author,  entitled 
"A  discourse  of  three  kinds  of  pepper  in  common  use",  was  published  in  1588,  and 
the  first  edition  of  his  treatise  upon  diseases  of  the  eyes  probably  appeared  about  tin- 
same  time.  The  latter  was  a  small  12mo  volume,  and  is  important  only  as  the  earliest 
contribution  of  England  to  the  science  of  ophthalmology.     (H.)] 

3.    CULTIVATION  OF  THE  PRACTICAL  BRANCHES. 

The  liberation  of  medicine  from  the  sway  of  Galen  and  the  Arabians, 
as  well  as  the  spirit  of  medical  observation  and  investigation,  newly  excited 
by  the  study  of  the  Ancients  (especially  Hippocrates)  and  the  new  theoret- 
ical views,  manifested  their  influence  of  course  also  upon  the  writings  and 
text-books  of  the  16th  century.  This  was  seen  chiefly  in  those  works  on 
the  subject  of 

a,  Medicine, 

although,  quite  naturally,  in  accordance  with  the  stand-point  of  the  authors 
concerned,  more  or  less  of  medievalism  was  preserved.  Among  these  are 
found  even  some  who  were  hostile,  indeed,  to  all  innovation,  yet  obeyed 
unwittingly  the  new  spirit.     We  notice  the  following  : 

1.  The  earliest  attempt  to  explain  the  optical  working  of  concave  and  convex  lenses 
was  made  by  the  Italian,  Franc.  Maurolycus  (1494-1595).  He  also  thought  that 
the  effect  of  the  crystalline  lens  of  the  eye  was  that  of  a  convex  lens  (Magnus). 


—  407  — 

a.  Italians. 

As  representatives  of  the  new  tendencies,  although  their  activity  still 
belonged  in  part  to  the  fifteenth  century,  we  mention  :  Baverius  de  Baveriis 
(about  1480),  Benivieni,  Benedetti  and  Manardo.  To  these  we  may  join 
Montanus,  who  has  also  been  already  named.     Further  : 

Aloysio  MuNDELLa  (died  1553)  of  Brescia, 
a  vigorous  opponent  of  astrology  and  the  efficacy  of  precious  stones  and  amulets,  as 
well  as  a  good  observer  and  a  simplifier  of  treatment. 

Vettore  Trincavella  (1496-1568) 
also  belongs  here  through  his  "  Consilia",  which  contain  numerous  medical  histories. 
He  observed,  among  other  things,  that  hereditary  diseases  may  skip  one  generation. 

Taddeo  Duno  (1523-1613), 
who  acquired  eminence  in  the  dispute  relative  to  venesection,  and  wrote  on  semi- 
tertian  fever. 

Girolamo  Fracastori  (1483-1553)  of  Verona, 
for  a  long  time  ordinary  physician  of  Paul  III.   during  the  Council  of  Trent,  wrote  a 
treatise  "  De  morbis  contagiosis  ",  and  a  famous  poem  on  the  most  unpoetical  subject 
of  syphilis.1    In  the  latter  he,  like  Hutten,  praises  the  guaiac,  and  declares  coitus  the 
chief  cause  of  infection. 

Alessandro  Massaria  (1510-1598) 
composed,  among  other  works,  a  pathological  text-book  and  some  writings  on  the 
plague,  small-pox  etc.  He  was,  however,  such  a  partisan  of  Galen  that  he  originated 
the  notorious  maxim  (recalling  that  of  Archigenes)  that  it  was  better  to  err  with 
Galen  than  to  maintain  the  right  with  the  Moderns.  This  esteem  for  Galen  was  also 
shared  by 

Franc.  Valleriola  (1504-1583), 

a  practitioner  in  Valence   and  finally  professor  in  Turin,  and   a  fertile  author  and 
good  observer. 

Nicolo  Mass  a  (1499-1569)  of  Venice, 
a  famous  practitioner,  wrote  on  contagious  diseases,  including  the  plague,  petechial 
fever,  measles,  small-pox  and  buboes,  and  especially  syphilis,  in  which  he  frequently 
recommends  preparations  of  mercury,  as  well  as  a  decoction  of  sarsaparilla,  thus 
anticipating  Zittman.  He  is  also  the  first  writer  to  point  out  syphilis  as  the  cause 
of  mental  diseases  (Proksch),  and  regards  it  as  contagious  and  the  cause  of  articular 
pains  (Purjesz).  Massa  also  made  some  good  individual  observations.  A  good 
therapeutist  was 

Ludoyico  Settala  (1552-1632,  Septalius)  of  Milan, 
who  studied  in  Pavia,  was  extraordinary7  professor  in  that  university  for  two  years, 
and  subsequently  a  professor  and  the  first  state-physician  in  Milan. 

1.  Many  subjects  were  at  this  time  discussed  in  verse  after  the  manner  of  the 
Ancients.  Fracastori  too  was  a  contemporary  of  Ariosto  and  Tasso,  and  be- 
longed to  the  second  bloom  of  poesy  in  Italy.  He  was  the  author  of  the  term 
"syphilis",  or  the  fable  of  the  herdsman  "Syphilos",  who  is  said  to  have  first 
had  the  disease.  In  this  way  he  assisted  in  putting  an  end  to  the  dispute  over 
the  paternity  of  the  disease,  a  dispute  which  was  raging  between  the  various 
nations  of  his  day  (Proksch).  The  name  syphilis  has  also  been  derived  from 
GUfiqiiAeiv,  or  <ruq  (genitalia  muliebria)  <f>u£tv. 


—  408  — 
Antonio  Mtjsa  Bbassavola  (1500-1555)  of  Ferrara 

accepted  234  different  varieties  of  syphilis,  and  performed  the  first  tracheotomy  of  the 
Modern  Era,  making  a  transverse  incision  between  the  cartilages. 

Ercole  Sassonia  (1550-1607  . 
in  addition  to  works  on  syphilis  (syphilis  larvata),   the   urine   and   the   pulse,  wrote 
also  on  the  plague,  Plica  Polonica.  and  a  comprehensive  text-book. 

Oddo  DEGLI  Oddi 
wrote  on  the  plague.      His   son 

Marco  dei;li  Oddi.  with 

Albertixo  Bottom  (died  1596  . 
was  one  of  the  first  to  give  actual  clinical  instruction  (in  Padua  I.     He  also  wrote  on 
the  diseases  of  women.     The  eminent  observer. 

Petrus  S alius  Pi  versus  (Salio  Diverso.  about  1580)  of  Faenza, 
discussed  the   plague  and  its   treatment,  and  mentions  inflammation  of  the  cerebral 
cortex  and  of  the  diaphragm,  phthisis  sicca  etc. 

Marcello  Donato  (died  about  1600), 
a  physician  of  Mantua,  private  secretary  and  counsellor  of  Vincenzo  Gonzaga.  dis- 
tinguished himself  b}-  his  freedom  from  prejudice  and  his  zeal  in  the  collection  of 
observations.  Among  the  latter  we  may  notice  a  case  of  lactation  in  a  man,  apparent 
pregnancy  due  to  hydrometra,  paralysis  resulting  from  division  of  the  nerves  of 
motion. 

Fortunati rs  Fidelis  (died  1630), 
a  physician  of  Palermo,  is  eminent  for  the  independence  of  his  ideas  and  his 
thoughtful  observation.  He  disputed  all  authority,  particular!}-  in  therapeutics,  and 
not  excepting  that  of  Hippocrates,  and  with  a  clear  intellect  considered  no  medicine 
in  many  cases  the  best  treatment!  He  was  also  the  first  physician  to  develop  the 
subject  of  state-medicine,1  pointing  out,  among  other  things,  the  injuriousness  of  lead 
pipes  in  the  conduction  of  drinking-water. 

Amatus  Lusitanus  (his  Christian  name  was  Juan  Roderigo  da  Castel- 
lo  Bianco,  born  about  1510), 

who  has  been  already-  once  mentioned,  and  who  was  a  nominal  convert  from  Judaism, 
born  at  Beira  in  Portugal,  but  a  teacher  in  Ferrara,  finally  declared  publicly  his  con- 
tinuance in  Judaism,  after  becoming  a  professor  in  Thessaloniea.  He  was,  indeed,  a 
great  partisan  of  Galen,  but  also  distinguished  himself  as  a  good  observer  in  his 
"  Curationum  medicinalium  centuria  VII."     Also  the  Portuguese 

Bodrigi'ez  da  Fonseca  (died  1622)  of  Lisbon 
taught  in  Pisa  and  Padua,  and  belonged  rather  more  to  Italy  than  to  his  native  land. 

,5.     Spaniards. 

Spain,   in   her   palmy   days,    also    took    considerable    interest    in    the 
struggles  of  medicine.     Thus 

Christobal  de  Vega  ( 1510-1580 

who  has  been  ahead}-  mentioned,  published  a  work  entitled  "  De  arte  medendi  liber'', 
in  which  he  advanced  a  mixture  of  Galenism,  Scholasticism  and  Arabism,  but  also 
furnished  a  few  good  ;etiological  hints.      He   mentions  that  in   his  time  brandy  was  a 


1.  His  "  De  relationibus  medicorum  libri  IV,  in  quibus  ea  omnia,  qua'  in  forensibus 
ac  publicis  causis  a  medicis  referri  solent,  plenissime  traduntur'  was  published  at 
Palermo  in  lf»02.     (II 


—  409  — 

common  drink,  gives  even  culinary  receipts,  and  in  cases  of  weakness  of  memory 
puts  aromatic  drugs  in  the  nose.  Much  more  important,  however,  is  the  "  Methodus 
medendi"  of  Francesco  Valles  (Vallesius,  about  1589).  Francesco  Lopez  de  Yillalo- 
bos  (1473-1560),  ordinary  physician  of  Charles  V.  and  Philip  II.,  in  his  "El  sumario 
de  la  medecina  con  un  tratado  sobre  los  pestiferas  bubas"  (Salamanca,  1498),  gives 
us  one  of  the  earliest  descriptions  of  syphilis.  Luis  Lobera  d'  Avila,  likewise  ordinary 
physician  of  Charles  V.,  as  well  as  a  syphilographer,  wrote,  among  other  works,  a 
"  Banquetos  de  nobles  Caballeros",  furnished  with  woodcuts  by  Hans  Burgkmair. 
These  cuts  represented  the  author  in  his  study,  as  well  as  certain  medico-chirurgical 
operations.  Juan  Huarte  wrote  a  work  entitled  "  Examen  de  ingenios  para  las 
sciencias"  (Baeza,  1575),  subsequently  translated  into  French  by  several  different 
authors. 

Luis  Mercado  (Mercatus,  1520-1606), 
like  Vallesius,  ordinary  physician  of  Philip  II.,  in  spite  of  his  scholasticism,  wrote 
well  on  the  subjects  of  the  plague,  typhoid  fever,  Garotillo,  and  other  epidemic 
diseases.  Equally  eminent  for  their  epidemiological  writings  were:  Francesco  Bravo 
(about  1571),  a  physician  of  Mexico,  who  described  the  Tabardete  or  Tabardillo; 
Luis  de  Toro  (about  1574)  of  Piacenza,  who  wrote  on  the  same  disease;  Onofre 
Bruguera  (about  15G3),  professor  in  Barcelona,  who  described  the  catarrhal  fever 
(influenza)  of  the  3'ear  1562  ;  Nicolas  Bocangelino  (Bocangel,  about  1600)  of  Madrid, 
a  champion  of  contagion  in  epidemic  diseases,  and  author  of  a  treatise  on  the  plague 
and  malignant  affections  ;  Juan  Tomas  Porcell  (1565),  professor  in  Saragossa  and 
author  of  a  treatise  on  the  plague  dedicated  to  Philip  II.  Francesco  Diaz  (about  1575), 
ordinary  surgeon  of  Philip  II.  and  a  professor  in  Alcala,  wrote  a  "  Compendio  de 
cirujia  "  with  treatises  on  diseases  of  the  bladder  and  kidneys,  on  the  plague  etc. 
Finally  the  noble  monk 

Pedro  Ponce  de  Leon1  (died  1584) 
should  be  mentioned  here  with  honor  as  the  founder  of  a  system  of  instruction  for 
the  deaf  and  dumb. 

;-.     French. 

Jean  Fernel  (born  near  Amiens  about  1497,  died  1558), 
wrote  a  complete  text-book  of  pathology  (anatomy,  physiology  and  therapeutics), 
entitled  "  Medicina  universa",  in  which  he  advanced  views  of  pathological  solidism, 
and  indicated  his  sympath}'  with  psychical  theories.  He  classified  diseases  into  those 
of  the  tissues  (similares),  those  of  the  organs  (organici)  and  those  depending  upon 
loss  of  cohesion  (communes),  in  which  subordinate  divisions  were  also  laid  down. 
Though  a  partisan  of  Aristotle,  he  was  still  very  devoted  to  Galen,  and  of  course  an 
anti-mercurialist,  while  his  famous  friend 

Guillafme    Baillou    (Ballonius,    1536-1614;    according   to   others 
1538-1616)  of  Paris 

depicted  in  excellent  language  the  forms  of  disease  which  he  had  faithfully  observed 
in  the  true  Hippocratic  method.  He  is  also  regarded  as  the  first  who  demonstrated 
post  mortem  the  existence  of  laryngeal  croup.     Among  the 

1.  Isensee  calls  him  Pedro  de  Ponce.  According  to  the  accounts  of  his  contempora- 
ries the  method  of  this  physician  must  have  been  very  successful.  He  first 
taught  his  pupils  to  write,  then  pointed  out  to  them  the  various  objects  represented 
by  the  different  words,  and  finally  conveyed  to  them  the  sounds  corresponding  to 
the  characters  by  observation  of  the  motions  of  his  lips  etc.     (H.) 


—  410  — 

S.  Germans, 

who.  as  we  know,  occupied  a  high  grade  in  all  other  sciences  as  well  as  in 
art  and  technics,  a  brisk  activity  prevailed  also  in  the  department  of 
medicine,  as  compared  with  the  preceding  century.  Thus  the  earlier 
theologian,  a  pupil  of  Luther  and  Melanchthon, 

Johaxx  Crato  vox  Krafftheim  (1519-1586), 
ordinary  physician  of  three  em?  erors.  after  studying  medicine  in  Verona  and  Padua 
became  finally  a  good  observer  and  a  sober  physician.  Born  in  Breslau,  he  practised 
there  and  in  Augsburg  until  appointed  ordinary  physician  of  Ferdinand  I.  1 1503- 
1561),  a  position  which  he  retained  under  Maximilian  II.  1 1527-1576)  and  Rudolf  II. 
i  1552-1612). — Less  eminent,  though  also  educated  in  Italy,  was 

Rainerus  (Reinert)  Solexaxber  (1521-1596), 

ordinary  physician  of  the  duke  of  Cleves,  like  Diomedes  Cornarus  'died  1598),  ordin- 
ary physician  of  Maximilian  II.     We  should  also  mention 

Thomas  Jordax  (1539-1 585  . 
city-physician  of  Briinn    in    Moravia,   famous  for  his  description   of  the  "  Lues  Pan- 
nonica"  and  for  an  account  of  more  than  200  cases  of  syphilis  contracted  in  Briinn 
from  the  employment  of  infected  cupping-glasses  in   the  hands  of  a   certaiu   bath- 
keeper. 

Joh.   Schexk    vox    Grafexberg    (1531-1598).    of  Freiburg   in   the 
Breisgau. 

was  distinguished  for  his  observations,  both  original  and  collected  from  other  writers. 
They  included  descriptions  of  monsters  developed  only  in  the  fancy  of  the  writer,  but 
which  excited  great  interest  in  their  day. 

Felix  Platter  (Platerus.  Plater.  1536-1614), 
a  zealous  and  careful  observer,  son  of  the  Swiss.  Thomas  Platter,  of  the  valley  of 
Zermatt  (a  man  sprung  from  the  deepest  poverty,  and  the  product  of  a  most  wretched 
student-life  —  he  had  been  a  "  fahrender  Schuler),  is  to  be  equally  esteemed  as  a  man 
and  a  physician.  Educated  in  Montpellier,  a  professor  in  Basel  and  ordinary 
physician  of  the  margrave  of  Baden,  he  was  the  earliest  systematic  nosologic. 
dividing  diseases  into  three  classes:  1.  Disturbances  of  function  'diseases  of  the 
mind,  the  senses  and  of  motion) ;  2.  Pains  (febrile  diseases)  and  diseases  of  the 
fluids;  3.  Defects  i  of  formation  and  secretion".  Both  the  Platters  left  auto- 
biographies. 

e.     Dutch. 

Joh.  Wyer  (Weyer.  Wierus,  1515-1588)  of  Grave  in  Brabant, 
who  merits  immortal  fame  for  his  opposition  to  the  belief  in  witches,  deserves  mention 
also  as  a  writer  on  epidemic  diseases,  particularly  the  English  '"sweating  sickness 
and  scurvy.  He  was  likewise  acquainted  with  amenorrhcea  due  to  an  imperforate 
hymen,  and  treated  it  by  incision  of  the  membrane.  He  enjoyed  rich  opportunities 
to  make  observations  upon  all  these  subjects  during  his  travels  in  Africa,  Greece  and 
Holland.  Wyer  finally  became  ordinary  physician  of  the  enlightened  duke  William 
of  Cleves,  while  his  countryman 

Rembert  Dodoens  (Dodonaeus.  1517-1585), 
who   distinguished  himself  as  a  pathological  anatomist,  epidemiologist  and   careful 
observer,  was  ordinary  physician  to  Maximilian  II.  and  Rudolf  II. 


—  411   — 

Peter  van  Foreest  (Petrus  Forestus,  1522-1597) 
was  prominent  among  his  contemporaries  for  his  numerous  observations,  including 
some  which  are  not  to  be  classed  as  mere  curiosities.  His  varying  residence  —  he 
studied  in  Louvain,  Bologna,  Rome  and  Paris,  and  practised  at  Pluviers  in  France, 
Delfft,  Leyden  and  Alkmaer,  his  native  town  —  must  have  furnished  him  rich  oppor- 
tunities for  observation. 

Thomas  Fyens,  already  mentioned,  professor  in  Louvain,  and  his 
father,  Johann  Fyens, 

a  physician  in  Antwerp,  also  distinguished  themselves  as  observers.  The  latter  also 
wrote  an  excellent  monograph  "  De  flatibus",  while  both  father  and  son,  like  many 
of  the  physicians  here  named,  were  not  exempt  from  the  superstition  of  their  day. 

Jodocus  Lommius  (his  real  name  was  Joost  van  Lorn,  about  1560)  of 
Buren  in  Gelderland. 

city-physician  of  Tournay  and  Brussels,  wrote  in  the  style  of  Hippocrates  a  "  De 
curandis  febribus  continuis  liber"  and  "  Medicinalium  observationum  libri  tres",  both 
of  which  survived  numerous  editions.  In  these  works  he  studied  semeiology  synthet- 
ically.    A  good  observer  and  fertile  author  was 

Jan  van  Heurne  (Johannes  Heurnius,  1543-1601)  of  Utrecht, 
who  studied  in  Italy,  and  then  became  physician  of  several  of  the  higher  piinces, 
including  the  unfortunate  count  Egmont  (1532-1568).  He  was  finally  appointed  a 
professor  in  Leyden,  and  became  famous  through  some  successful  cases  —  the  treat- 
ment of  the  count  of  Xoortcarmes,  who  had  been  poisoned,  and  the  Princess  Emilie, 
sister  of  Maurice  of  Nassau,  who  endeavored  to  starve  herself  in  return  for  unrequited 
love. 

'■:.     The  English. 

At  the  beginning  of  the  16th  century  the  study  of  the  classics  was  so 
popular  in  England  that  numerous  translations  of  the  ancient  authors 
appeared,  and  a  knowledge  of  the  literature  and  language  of  the  Ancients 
—  a  sign  of  improved  education  —  was  familiar  even  to  the  "  ladies  ".  Dur- 
ing this  century  the  English  national  literature  (Marlowe,  Sidney,  Fletcher, 
Beaumont.  Shakespeare)  matured,  and  at  its  close  England  had  attained  the 
meridian  of  her  political  and  literary  greatness.  Yet,  in  spite  of  all  this, 
English  medicine  during  the  16th  century  remained  surprisingly  far  behind 
that  of  the  other  civilized  nations.  Li  nacre  and  John  Ka}e  are  its  sole 
prominent  representatives,  and  these,  in  their  day,  were  so  highly  esteemed 
that  they  shared  the  honor  of  that  greatest  recognition  of  intellectual  great- 
ness in  England  —  a  tomb  in  Westminister  Abbe}". 

These  two  ph\-sicians  emancipated  English  medicine  from  the  control 
of  the  clergy,  and  at  the  same  time  laid  the  foundation  of  the  self-govern- 
ment of  English  physicians.  Heretofore  licenses  to  practice  had  been 
granted  by  the  bishops.  Linacre  founded  the  College  of  Physicians  in 
London  ;  Kaye  established  Caius  College  in  Cambridge  (where  a  century 
later  a  Harvey  received  his  education),  and  likewise  described  the  English 
"  Sweating-sickness  ".  In  Scotland  the  university  of  Edinburg  was  founded 
in  1584. 


—  412  — 

[The  comparative  dearth  of  English  medical  literature  during  the  16th  century 
will  seem  less  surprising  when  we  reflect  that  the  development  of  English  literature  in 
general  was  exceedingly  slow  until  the  latter  half  of  the  reign  of  Elizabeth  ( 1558-1603), 
when,  almost  at  once,  it  burst  forth  into  the  full  bloom  of  maturity.  The  poems  of 
Wyatt  and  Surrey,  which  heralded  the  coming  change,  did  not  appear  until  1557; 
Sackville's  first  tragedy  appeared  in  1561;  Lyly's  "Euphues"  in  1579:  Sidney's 
"Arcadia"  in  1580;  Marlowe  began  to  write  in  1586;  Spenser's  "  Faerie  Queen " 
appeared  in  1590;  Shakespeare's  "  Venus  and  Adonis",  which  he  calls  "the  first  heir 
of  ni}'  invention",  was  published  in  1593 ;  Ben.  Jonson's  first  comedy  appeared  in 
159G;  Bacon's  "  Essays"  in  1597,  while  the  works  of  Beaumont  and  Fletcher  did  not 
appear  until  the  early  part  of  the  17th  century.  "  The  renascence  had  done  little  for 
English  letters.  The  overpowering  influence  of  the  new  models  both  of  thought  and 
style  which  it  gave  to  the  world  in  the  writers  of  Greece  and  Rome  was  at  first  felt 
onl}r  as  a  fresh  check  to  the  revival  of  English  poetry  or  prose.  Though  England 
shared  more  than  any  European  country  in  the  political  and  ecclesiastical  results 
of  the  new  learning,  its  literary  results  were  far  less  than  in  the  rest  of  Europe,  in 
Italy,  or  Germany,  or  France.  More  alone  ranks  among  the  great  classical  scholars 
of  the  sixteenth  century.  Classical  learning,  indeed,  all  but  perished  at  the  universi- 
ties in  the  storm  of  the  Reformation,  nor  did  it  revive  there  till  the  close  of  Elizabeth's 
reign  "    (Green  |. 

The  comparative  barbarity  of  England  during  the  first  half  of  the  16th  century 
is,  perhaps,  not  generally  appreciated  None  of  the  streets  of  London  were  paved 
until  1534,  and  the  first  carriages  appeared  in  1564;  knives  were  not  made  in  England 
until  1563,  and  forks  were  still  uncommon  in  1608.  The  substitution  of  the  gentle- 
man's rapier  for  the  two-handed  sword  of  the  warrior,  which  marks  the  change  of 
feudal  into  court  life,  did  not  occur  until  1 578.  Harrison,  writing  in  1580,  calls 
attention  to  the  recent  change  of  wooden  into  brick  or  stone  houses,  to  the  common 
use  of  glass  for  windows,  to  the  recent  frequency  of  chimneys,  "  whereas  in  their 
young  daies  there  were  not  above  two  or  three,  if  so  manie,  in  most  uplandishe  townes 
of  the  realme";  to  the  great  improvement  in  beds  and  bedding,  "although  not 
generall,  for  our  fathers  (yea  and  we  ourselves  also)  have  lien  full  oft  upon  straw 
pallets,  on  rough  mats  covered  onelie  with  a  sheet,  under  coverlets  made  of  dagswain 
or  hopdiarlots,  and  a  good  round  log  under  their  heads,  instead  of  a  bolster  or  pillow. 
If  it  were  so  that  the  good  man  of  the  house  had  within  seven  yeares  after  his  marriage 
purchased  a  mat.teres  or  flocke-bed  and  thereto  a  sacke  of  chaffe  to  rest  his  head  upon, 
he  thought  himselfe  to  be  as  well  lodged  as  the  lord  of  the  towne.     .    .    .    Pillowes 

(said  they)   were  thought  meet  onelie   for  women  in   childbed The  third 

thing  is  the  exchange  of  vessell,  as  of  treene  platters  into  pewter,  and  wodden  spoones 
into  silver  or  tin  ;  for  so  common  was  all  sorts  of  treene  stuff  in  old  time,  that  a  man 
should  hardlie  find  four  peeces  of  pewter  (of  which  one  was  peradventure  a  salt)  in  a 
good  farmer's  house."     (See  Taine's  "  History  of  English  Literature". ) 

The  political  independence  of  England  too  was  not  fully  assured  until  the  defeat 
of  the  "Armada"  in  1588.  Henry  VIII.,  in  the  beginning  of  his  reign,  possessed 
one  single  ship  of  war;   Elizabeth  sent  out  150  to  encounter  the  Armada. 

Besides  the  English  medical  authors  already  mentioned,  and  who  must 
be  regarded  as  the  best  representatives  of  English  medicine  in  the  16th 
century,  we  may  also  mention  : 

Andrew  Borde  (Boorde,  Perforatus;  died  in  prison  1549),  an  alumnus  of  Mont- 
pellier  and  professor  at  Oxford,  who  is  said  to  have  also  been  ordinary  physician  of 
Henry  VIII.  He  wrote  "A  Breviarie  of  Health  ",  printed  in  black  letter  in  1547,  in 
which  he  advises  for  toothache  depending  upon  worms  "  a  candell  of  waxe  with  hen- 
bane seeds,  which  must  be  lighted  so  that  the  perfume  of  the  candell  do  enter  into  the 


—  413  — 

tooth."  We  have  also  from  his  pen  a  "  Compendyous  regiment,  or  dietary  of  health, 
made  in  Mount  Pyllor",  published  posthumously,  at  Oxford,  in  1562.  He  is  said 
to  have  been  a  man  of  much  wit,  and  to  have  been  in  the  habit  of  frequenting  fairs 
and  markets,  where  his  humorous  speeches  made  him  quite  popular  with  the  masses. 
Hence  arose  our  term  "merry  Andrew",  to  designate  the  class  of  itinerant  quacks 
who  adopted  his  style. 

William  Bolletn  (died  1576),  who  ranked  high  as  a  botanist  and  physician 
during  the  reigns  of  Edward  VI.,  Mary  and  Elizabeth.  Educated  at  Cambridge,  he 
travelled  extensively  in  Germany  and  Scotland,  and  practised  in  Norwich,  Bla.xhall, 
Durham  and  London.  His  works  were  entitled:  "The  Government  of  Health" 
(London,  1548);  "  Book  of  Simples"  ;  "A  Dialogue  between  Soarenes  and  Chirurgi", 
and  "A  Comfortable  Regiment  and  Very  Wholesome  order  against  the  most  perilous 
Pleurisie".  Bulleyn  was  a  firm  believer  in  witchcraft  and  the  medical  virtues  of 
precious  stones,  but  his  works  furnish  very  valuable  information  of  the  medical 
customs  of  his  day. 

William  Turner  (died  1568),  an  eminent  physician,  naturalist  and  theologian, 
the  friend  and  follower  of  bishop  Ridley.  He  was  educated  in  Italy,  receiving  his 
doctor's  degree  at  the  university  of  Ferrara.  In  consequence  of  his  reformative 
religious  views  he  was  banished  from  England  under  Henry  VIII.,  and  spent  a  con- 
siderable time  in  Cologne  and  Weissenburg.  On  the  accession  of  Edward  VI.  Turner 
returned  to  England,  and  was  appointed  Dean  of  Wells,  but  was  again  driven  into 
exile  under  the  succeeding  reign.  During  his  travels  on  the  continent  Turner  em- 
ployed his  leisure  in  collecting  specimens  of  plants,  and  on  his  final  return  to  England 
after  the  accession  of  Elizabeth  he  wrote  and  published  his  chief  work,  entitled  : 
"A  new  herball  etc.",  the  first  part  of  which  appeared  in  1551.  Parts  II.  and  HI. 
followed  in  1562  and  1568.  He  also  wrote  works  on  the  bathing-resorts  of  England 
and  the  continent,  on  ornithology,  the  nature  of  the  wines  used  in  England  etc. 
Turner  was  a  contemporary  and  a  warm  friend  of  Gesner. 

We  should  also  mention  Sir  Thomas  Elyot,  wliose  "  Castel  of  Health  "  appeared 
in  1534;  Thomas  Phayer,  author  of  "The  Regiment  of  life,  whereunto  is  added  a 
treatise  of  the  pestilence  with  the  Book  of  Children"  (1544);  Nicholas  Gyer,  who 
published  in  1592  "The  English  Phlebotomy  ;  or  a  Method  and  Way  of  Healing  by 
Letting  of  Bloud",  in  which  he  combats  the  popular  idea  of  the  necessity  of  regular 
and  periodic  bleedings  to  preserve  health;  George  Etheridge  (born  1518),  Regius 
professor  of  Greek  at  Oxford  and  practising  in  that  vicinity,  an  eminent  mathema- 
tician, linguist,  musician  and  poet,  who  wrote  "  Hypomnemata  quasdam  in  aliquot 
libros  Pauli  iEginetse  etc.",  London,  1588;  Timothy  Bright  (died  1616),  a  physician 
and  theologian,  author  of  a  "  Treatise  on  melancoly  ",  London,  1586;  "  Hygieine, 
sea  de  sanitate  tuenda"  (1588),  with  other  works;  Thomas  Gibson  (died  1562)  of 
London  wrote  a  work  on  the  prophylaxis  and  treatment  of  the  plague  (1536). 
D.  Marten,  "Glass  of  health"  (1540);  Thomas  Hollybush,  "Excellent  physic  book 
for  alle  the  griefs  and  diseases  of  the  body  etc."  (1561);  Philip  More,  "Hope  of 
health  etc."  (1565);  Thomas  Morgan,  "Haven  of  health  "  (1589);  Francis  Record, 
"  Urinal  of  physik  "  (1582) ;  Thomas  Brasbridge,  "The  poor  man's  Jewel  etc."  (1578); 
Simon  Kelling,  "  Defensative  against  the  plague"  (1593);  William  Tooker,  "Charisma, 
seu  donum  sanitatis  etc."  (1597);  George  Baker,  "The  practise  of  the  new  and  old 
phisicke  etc."  (1599),  and  many  similar  writers.  Other  eminent  physicians,  who, 
however,  left  no  writings  to  preserve  their  fame  to  posterity  were  :  John  Clement 
(died  1572),  Thomas  Francis,  ordinary  physician  of  queen  Elizabeth  ;  Doctor  Butts, 
ordinary  physician  of  Henry  VIII., whose  name  has  been  immortalized  by  Shakespeare; 
William  Kunyngham,  Thomas  Paynell,  the  translator  of  the  Schola  Saleruitana,  etc. 
(H.)] 


—  414  — 

b.  Surgery, 

(a  branch,  which  fortunately  has  never  had  to  occupy  itself  with  theories, 
since  its  subjects  submit  themselves  with  more  definiteness  to  our  knowl- 
edge and  recognition)  under  the  hands  of  surgeons  educated,  for  the  most 
part,  in  guilds  alone,  but  yet  ingenious  in  their  department,  was  enriched 
with  much  that  was  new  and  capable  of  immediate  and  profitable  employ- 
ment in  actual  life.  For,  as  Wiirtz  thought  :  "  In  surgery  much  more 
depends  upon  dexterity  and  experience  than  on  lengthy  twaddle.''  From 
this  century  onward  it  manifested  a  steady  advance,  and,  as  everyone  must 
admit,  a  much  more  satisfactory  development  than  medicine.  Prior  to, 
and  along  with,  the  reform  of  surgery,  which  emanated  chief!}'  from  the 
French,  the  cultivation  of  this  branch  was  a  subject  of  special  interest  to 

a.  The  Italians, 

in  continuation  of  their  great  activity  in  this  department  during  the  Middle 
Ages.  Through  the  invention  of  powder  and  firearms,  and  the  consequent 
introduction  of  gun-shot  wounds  into  surgery,  this  branch  now  received  a 
special  impulse.  The  improvement  of  the  study  of  anatomy  was  also  of 
great  benefit  to  it,  since  most  of  the  famous  Italian  anatomists  of  that 
period  were  surgeons  too,  and  furnished  to  surgery,  which  they  also  taught, 
a  scientific  foundation.  Rome  and  Bologna,  particularly,  enjoyed  and 
educated  a  long  line  of  eminent  surgeons. 

The  father  of  the  so-called  Roman  School  was 

Giovanni  de  Vigo  (Ludovico,  1460-about  1519)  of  Rapallo  near  Genoa. 

suli^equentl.y  physician  of  the  art-loving  pope  Julius  II.  (1503-1513).  Without  any 
considerable  erudition.  Vigo  practised,  on  the  whole,  a  mere  "  salve-surgery  ",  and 
the  emplastrum  de  Vigo  — ■  mercurial  plaster  ■ —  bears  his  name  to  this  day.  He 
regarded  gunshot  wounds  as  poisoned,  and  accordingly  cauterized  them  with  the  hot 
iron  (this  he  used  frequently),  or  with  boiling  oil,  thus  laying  the  foundation  of  this 
vicious  treatment  of  such  injuries.  He  still  considered  great  operations  quite 
unworthy  of  a  physician,  and  believed  that  these  should  be  abandoned  to  the  itinerant 
inferior  surgeons.  Yet  he  introduced  the  crown  trepan,  and  practised  the  ligation  of 
the  Ancients  (transfixing  the  artery  itself  with  needles  and  tying  it  above  these).  He 
also  discussed  syphilis  fully  in  his  larger  and  smaller  surgical  compendiums.  His 
father, 

Battista  di  Rapallo, 
is  said  to  have  been  the  inventor  of  the  method  known  as  the  "  apparatus  major  "  in 
lithotomy,  and  by  him  it  was  made  known  first  to  Giovanni  de  Romani  of  Cremona, 
and  ultimately  to  Mariano  Santo  di  Barletta  (14S9-15o!)  or  1550),  who  published  a 
description  of  it  in  1531.  From  the  latter  the  method  was  learned  by  Ottaviano  da 
Villa,  an  itinerant  surgeon  devoted  to  the  practice  of  lithotomy,  who  communicated 
it  to  Colot,  and  thus  the  method  reached  France.     A  pupil  of  Ottaviano  was 

Michel  Angelo  Biondo  (Blondus,  1497-1565)  of  Venice, 
who  rendered  an  important  service  to  surgery  by  his  use  of  warm  and  cold  water  in 
the  treatment  of  wounds,  though  in  other  respects  he  was  a  devoted  follower  of  the 
Ancients. 


—  415  — 

Alfonso  Ferri  (born  about  1500)  of  Faenza, 
after  1534  ordinary  physican  of  Paul  III.  (1534-1549),  deserves  no  credit  for  his 
treatment  of  gunshot  wounds,  which  he  still  regarded  as  poisoned  and  even  treated 
with  internal  remedies,  but  he  rendered  excellent  service  to  surgery  by  his  treatment 
of  syphilitic  strictures  of  the  urethra.  He  observed  that  balls  might  remain  in  the 
bodv  more  than  twenty  years  without  bad  consequences,  and  he  also  practised 
ligation  in  haemorrhage. 

To  the  so-called  School  of  Bologna  belonged,  among  others  : 

Angiolo  Bolognini. 
professor  at  Bologna  from  1508  to  151".     The  most  important  army-surgeon  of  that 
day,  rivalling  even  Pare,  whose  teacher  he  had  probably  been,  was 

Bartolomeo  Maggi  (1516-1552)  of  Bologna, 
who  established  by  his  own  investigations  that  gunshot  wounds  could  be  neither 
burned  or  poisoned  wounds,  for  which  reason,  after  removal  of  the  ball,  he  employed 
simply  soft  oiled  dressings,  and  did  not  cleanse  the  wound  too  often.  In  gangrene  he 
amputated  through  the  sound  parts,  leaving  sufficient  skin  to  cover  the  stump. 
Another  surgeon  of  great  eminence  was 

Giacomo  Berengario  (Bc'renger.  Berengarius,  died  1550)  of  Carpi, 
who  treated  gunshot  wounds  quite  as  simply  as  Maggi,  but  managed  wounds  of  the 
skull  with  much  less  reliance  upon  the  powers  of  nature,  for  in  these  he  employed  the 
trepan.  He  extirpated  the  prolapsed  uterus,1  and  treated  syphilis  by  mercurial 
inunction  with  such  success,  that  (as  Cellini  relates)  he  could  not  show  himself  but 
once  in  anj-  one  place  without  running  the  risk  of  his  life.  Matthiolus  had  already 
administered  mercury  internally.  In  strangulated  hernia  Berengario  knew  no  treat- 
ment save  manual  taxis,  after  softening  the  faeces  per  intra  et  extra.     His  pupil 

Giulio  Casserio  (1561-1616) 
handed  down  the  method  of  bronchotomy  practised  by  Fabricius  ab  Aquapendente, 
while  a  pupil  of  Falloppio  (who,  like  most   anatomists,  was  himself  a  surgeon,  and 
wrote  on  tumors  and  ulcers1. 

Giambattista  Carcano  Leone  (1536-1606)  of  Milan 
discussed  wounds  of  the  head.     The  same  subject  occupied  the  attention  of  Pietro 
Martire  Trono    (about  1580),    and    numerous   others  of   this   period.      Besides    the 
anatomists  already  mentioned,  the  following  physicians  interested  themselves  in  the 
promotion  of  surgery : 

Botallo  (amputation  by  means  of  a  sort  of  guillotine) ;  Falloppio  (author  of  the 
well-known  maxim,  that  the  road  to  surgery  leads  through  anatomy) ;  Ingrassias 
(1510-1580);  Guido  Guidi  (died  1569),  and  particularly  Hieronymus  Fabricius  ab 
Aquapendente  (1537—1619),  who,  however,  was  also  eminent  as  a  surgeon,  mentioning 
goitre,  and,  according  to  Ferd.  Fuhr,  the  first  to  differentiate  it  anatomical!}-  from 
other  tumors  of  the  neck  (its  extirpation  (?)  is  first  mentioned  by  Fabricius  Hildanus  . 
practising  trepanning,  hanging  up  the  patient  by  the  feet  in  strangulated  hernia  etc. 
To  this  period  belong  also  Giovanni  Andrea  della  Croce,  a  physician  and  teacher  of 
Venice  (about  1560),  who  improved  the  trepan,  and  seems  to  have  been  in  general  a 
bold  surgeon;  and  Durante  Scacchi  of  Calabria,  a  decendant  of  the  old  medical 
colony  of  the  Preciani  or  Norsini.  How  bold  the  surgeons  of  that  day  were,  may  be 
inferred  from  the  example  of  Zaccarelli,  a  surgeon  of  Palermo,  who,  in  1519,  under- 
took the  extirpation  of  a  spleen  weighing  about  two  pounds.  The  patient  recovered 
in  21  days. 

1.  It  may  also  be  remarked  en  passant  that  Berengario  considers  the  direction  of  the 
face  towards  the  anus  during  parturition  a  designed  and  punitive  reference  to 
original  sin ! 


—  416  — 

,;.  French. 

Before  the  time  of  Pare"  flourished  the  famous  French  surgeon 

Jean  Tagault  (died  1545). 
a  native  of  Vimeu  in  Pieardy,  and  professor  at  Paris  and  Padua.     We  must  also  notice 

Etienne  Gourmelen  (died  1593), 
professor  of  surgery  at  Paris,  and  an  opponent  of  Pare.     In  seeking  to  describe  the 
character  of  the  latter,  Gourmelen  betrayed  his  own,  when  he  said:   "An  ignorant 
and  fool-hardy  man  has  recently  ventured,  in  his  ignorance,  to  discard  the  cauteriza- 
tion of  the  vessels  with  the  hot  iron,  and  to  substitute  for  it  a  new  procedure,  viz.  :  the 
use  of  the   ligature — a  proceeding   contrary   to   all   the   precepts  of  the   ancient 
physicians,   and   opposed  to  all   the   principles   of  sound   reason    etc."    (Wernher). 
Andre   Dulaureus  (died   1609\   ordinary  physician   of  Henry  IV.,    a  physician   who 
performed  paracentesis  through  the  navel;  Jean  Girault  of  Lyons;   Antoine  Chaum- 
ette  (about   1560);    the   more   eminent  Jacques  Dalechamps  of  Lyons  ( 1513-1588 
Philippe  de  Flesselle  (died  1562) ;  Laurent  Joubert  (1529-1588),  whose  "  Traite  du  ris" 
suggests  by  its  title  a  French  Democritus,  and  finally  Francois  Ranchin  i  1565-1641) 
who  commented  upon  the  works  of  Guy  de  Chauilac.     The 

;-.  Spaniards 

attained  in  the  16th  century  their  greatest  power  and  chief  importance  in 
the  history  of  civilization,  as  well  as  the  meridian  of  their  medical  achieve- 
ments. What  Spanish  surgery  (and  medicine)  accomplished  in  the  age  of 
Charles  V.  and  Philip  II..  or  rather  the  fame  which  it  then  enjoyed,  was 
never  surpassed,  indeed,  was  never  equalled,  in  after  times  ;  just  as  Spanish 
historical  composition,  poetry  (Cervantes.  Lope  de  Vega  etc.).  sculpture 
and  painting,  never  again  were  able  to  attain  their  grade  of  that  day. 
Upon  this  lofty  ascent  followed,  even  hefore  the  close  of  the  century,  a 
more  abrupt  fall  than  ever  occurred  to  any  other  people.  The  precious 
metals  of  America,  by  facilitating  luxury  and  indolence  (henceforth 
national  and  pregnant  characteristics  of  the  Spanish  race),  corrupted  the 
physical  and  mental  power  required  to  maintain  their  ascendancy.  The 
most  famous  Spanish  surgeon  was 

Francesco  de  Arce  (Arcseus,  Arceo,  1493-1573)  of  Fregeual, 
surgeon  in  Llerena  and  Valverde  in  Estremadura,  who  was  justly  so  highly  esteemed, 
especially  as   an   operator,    that  patients   visited   him   from   foreign  countries.     His 
name  is  preserved  to  us  to-day  in  the  balsamum  Arcsei  (unguentum  elemi ). 

Andreas  Alcazar    (about  1575)  of  Guadalaxara. 
professor  at  Salamanca,  like  Arcseus,  was  a  friend  of  the  trepan. 

Bartolom.eus  Hidalgo  de  Aguerro  (1531-1597) 
was  also  a  surgeon  very  highly  esteemed   in   Spain.     He  was  even  called  the  Spanish 
Pare,  and  defended  first  intention,  or  rather  the  immediate  union  of  wounds. 

Juan  Fragoso  (about  1570), 
ordinary  surgeon  of  Philip  II.  ;  the  famous  army-surgeon  Dionisio  Daza  Chacon 
(1503?  1510-1596?),  who  held  the  same  office  under  Charles  V.  and  again  under 
Philip:  Michael  Juan  Pascal,  a  surgeon  of  Valencia  (about  1548),  and  even  Abraham 
Zacuto  i  Zacutus  Lusitanus,  1575-1642 1,  a  Jew,  born  in  Lisbon,  and  a  partisan  of 
Galen  and  the  Arabians,  are  also  worthy  of  mention. 


—  417  — 

The  Portuguese  Amatus  Lusitanus  (born  1511,  not  to  be  confounded  with  the 
preceding  physician),  together  with  Ferri,  diffused  the  knowledge  of  the  urethral 
bougies  invented  by  professor  Aldarete  of  Salamanca,  and  employed  by  the  itinerant 
surgeon  Philip.  These  instruments,  in  consequence  of  the  increasing  frequency  of 
syphilitic  strictures,  came  more  and  more  into  use.     Among  the 

(J.  Engltsh, 

who  still  possessed  few  higher  surgeons,  there  lived,  among  others,  at  the 
close  of  the  16th  century:  Greenfield,1  a  lithotomist.  who  immigrated  from 
Holland  :  Thomas  Gale"  (1565);  John  Banister3  (1575);  John  Read  (1588) 
and  John  Hoster,4  a  Paracelsist.  A  surgeon  John  Woodall,5  who  even 
performed  primary  amputation,  also  enjoyed  much  reputation. 

[Other  English  surgeons  of  this  period  were  : 

George  Bvker,  ordinary  surgeon  of  queen  Elizabeth,  and  president  of  the 
College  of  Surgeons  of  London  in  1597.  He  was  t he  author  of  numerous  surgical 
and  medical  works. 

Peter  Lowe,  a  Scotchman,  who  studied  in  Paris  and  practised  for  many  years 
in  Spain,  France  and  Flanders,  but  in  his  old  age  returned  to  Glasgow  and  published 
'The  whole  course  of  chirurgerie,  wherein  is  briefly  set  down  the  causes,  signs''  etc., 
London,  1596;  and  "An  easie,  certain  and  perfect  method  to  cure  and  prevent  the 

1.  John  Greenfield  is  the  English  synonym  of  Jan  Groeneveldt,  a  native  of  Deventer 

(Overyssel),  and  a  pupil  of  the  famous  Dutch  lithotomist,  Lambert  Velthuysen 
(born  1622)  of  Utrecht.  Accordingly  he  belongs  to  the  17th,  not  the  16th 
century.  Groeneveldt,  who,  like  his  master,  was  an  eminent  lithotomist,  settled 
in  London,  and  met  with  such  success  that  he  finally  adopted  his  new  home,  and 
Anglicised  his  name  into  John  Greenfield.  His  works  were  written  in  Latin  and 
English,  and  relate  chiefly  to  his  own  specialty.  Among  them  we  may  mention  : 
" Atihihiyia.  A  treatise  of  the  stone  and  gravel  etc."  (London,  1677);  "A  com- 
plete treatise  on  the  stone  and  gravel  etc."  (London,  1710);  "Dissertatio  litholog- 
ica  variis  observationibus  et  figuris  illustrata  "  (London,  1684).     (H. ) 

2.  Thomas  Gale  (1507-1586),  sometimes  called  the  "English  Pare",  was  an  eminent 

army-surgeon  under  Henry  VIII.  and  Elizabeth.  He  final!}-  settled  in  London, 
where  he  published  in  1.363  "An  excellent  treatise  of  wounds  made  with  gun-shot" 
etc,  and  "An  enchiridion  of  chirurgerie"  etc.,  with  other  surgical  treatises.  He 
opposed  the  opinion  that  gun-shot  wounds  were  "poisoned",  and  advocated 
simple  treatment.     (H.) 

3.  John  Banister  was  an  eminent  surgeon  of  Nottingham.     He   wrote  "A   needful, 

new  and  necessary  treatise  of  chirnrgery"  etc..  London,  1575;  "The  history  of 
man  sukked  from  the  sappe  of  the  most  approved  anatomists  in  this  present  age" 
etc.,  London,  1578;  and  other  surgical  works.      (  H. ) 

•1  Haller  calls  him  Hester,  and  ascribes  to  him  a  treatise,  entitled  "  Compendium 
secretorum  rationalium",  London,  1582,  and  "  The  pearle  of  practice,  or  pearle 
for  physik  and  chirurgerie",  London,  1592.     (H.) 

5.  Woodall  was  in  1589  surgeon  of  the  troops  sent  by  Elizabeth  to  the  aid  of  Henry  IV. 
of  France.  After  extensive  travels  upon  the  continent,  he  finally  settled  in 
London,  and  was  appointed  Surgeon  General  of  the  East  India  Company  in  1613, 
and  surgeon  to  St.  Bartholomew's  Hospital  in  1615.  In  1626  he  published  a 
handbook,  entitled  "The  Surgeon's  Mate",  and  two  years  later  the  "Viaticum, 
being  the  pathway  to  the  surgeon's  chest."  His  collected  writings,  entitled 
"  Various  treatises"  etc.,  appeared  in  1639.  (H.) 
97 


—  418  — 

Spanish  sickness  ',   London,  1596.      Lowe  was  for  many  years  t ho  chiel  surgeon  <>f 

western  Scotland,  and  in  1599  received  from  king  James  VI.  a  charter  for  the  founda- 
tion of  the  Faculty  of  Physicians  and  Surgeons  of  Glasgow.      He  died  in  1  <3 1  li . 

William  Clowes,  an  eminent  surgeon  of  London,  consulting  surgeon  to  St.  Bar- 
tholomew's Hospital  and  ordinary  physician  of  queen  Elizabeth  in  1596.  He  wrote 
a  treatise  on  the  cure  of  syphilis  by  inunction  (1575),  which  survived  many  editions, 
and  also  a  treatise  on  gunshot  wounds,   in  its  day  very  popular. 

Richard  Caldwell  (1513-1584),  president  of  the  College  of  Physicians  ot 
London  (1570),  in  which  he  founded  a  chair  for  instruction  in  surgery.  John  Veyrery 
and  Marcellus  de  la  More  were  surgeons  to  king  Henry  VIII.,  and  William  Goodoums 
"Serjeant  Surgeon"  to  queen  Elizabeth.     II.] 

The  surgery  of  the 

s.  Germans 
during  the  16th  century  had  its  headquarters  in  Strassburg  and  Basel,  cities 
which  were  united  by  contiguity  with  Italy  and  Prance,  and  were  accord- 
ingly able  to  get  from  these  countries  at  an  early  period  such  information 
as  they  possessed  :  for  in  Germany  proper,  surgery  was  still  in  a  very 
languishing  condition.  These  two  universities  formed  the  distributing 
reservoirs,  from  which  the  improved  surgery  (as  at  a  later  period  the 
reformed  midwifery)  spread  itself  throughout  Germany.  The  city  first 
mentioned  could  show  in 

Hans  von  Gersdorff  (about  1517),  called  Schylhans,  of  Silesia, 
a  surgeon  of  advanced  views,  whose  "  Feldtbuch  der  Wundt  Artzney  sampt  des  Men- 
chen  Anatomy,  vnnd  chirurgischen  Instrumenten,  wahrhafftig  abconterfej"t  vnd  be- 
schrieben",  Strassburg,1  1517  (with  25  woodcuts  by  Hans  Waechtlin,  surnamed  Pilgrim  i 
describes  and  depicts  even  major  operations.  In  amputations  ("to  cut  off  an  arm  or 
a  bone  requires  a  certain  amount  of  skill"!  Gersdorff  had  cut  off  100-200,  and 
ought  to  be  a  judge)  the  incision  was  made,  for  the  sake  of  safety,  between  two 
bandages  bound  around  the  limb,  "for  this  cut  is  very  sure,  and  conies  out  even." 
After  sawing  through  the  bone  a  (propulsive)  bandage  forces  the  soft  parts  over  the 
bone,  so  that  this  is  covered.  The  day  preceding  the  operation  the  patient  should 
receive  the  Holy  Sacrament,  and  the  surgeon  himself  should  hear  mass.  He  rejects 
narcosis  with  opium  etc.,  because  the  patients  become  irrational.  The  bandage  is 
applied  without  sutures,  and  the  bleeding  is  checked  by  a  caustic  plaster  or  by  the 
hot.  iron.  Fractures,  dislocations,  cancer,  fistuhe  etc.  and  gunshot  wounds  are 
noticed,  and  the  latter  are  still  burned  with  hot  oil,  in  order  that  the  powder  and  the 
gangrenous  tissue  may  be  removed  in  the  best  and  neatest  way.  He  describes  a  t ri- 
val vular  speculum  to  open  the  genitalia  muliebria  and  the  anus. 

Gregorius  Fluguss  (also  Fleugaus,  about  1518),  also  of  Strassburg,  is  of  little 
importance. 

Felix  Wuertz  (1518-1575)  of  Basle, 
distinguished  for  his  honesty  and  originality,  his  faculty  ot  observation,  his  freedom 
from  prejudice,  his  lack  of  faith  in  authority  (all  qualities  manifestly  forged  of  the 
metal,  and  upon  the  anvil  of  Paracelsus)  and  his  great  experience,  is  one  of  the 
best  German  surgeons.  His  "  Practica  der  Wundartzney",  a  little  handbook,  as  he 
calls  it,  for  times  of  war  and  peace,  written  in  a  lively  style,  treats  of  the  abuse  of 
stitches,  styptics,  bandages,  tents  and  plasters,    of  wounds  and  fractures,   of  salves 

1.    Strassburg  at  this  time  was  likewise  the  headquarters  of  the  art  of  wood-cutting 
and  of  book-publishing. 


—  41  y  — 

etc.,  to  which  is  "appended"  a  useful  little  book  on  children  (by  his  son  Rudolph), 
directed  against  the  abuses  of  mid.wives  and  children's  nurses  —  so  that  the  whole,  in 
its  very  title,  implies  in  not  too  mild  a  way  the  abandonment  of  the  old  paths.  All 
surgeons,  he  says,  must  give  place  to  Theophrastus  von  Hohenheim,  and  it  has  quite 
the  tone  of  Paracelsus  when  he  speaks  of  the  "old  song  and  dance",  which  must  be 
abandoned,  and  asserts  that'  nothing,  however,  is  older  than  nature".  With  Theo- 
phrastus von  Hohenheim  too,  Wuertz  is  earnest  in  his  opposition  to  stitching,  pro- 
bing, bleeding  to  check  haemorrhage,  poultices  in  fresh  wounds,  burning  for  hemor- 
rhage, charms  and  "  Characteres "  or  spells,  as  well  as  against  cramming  wounds 
with  rags  and  clouts  las  "  Quellmeissel  '),  the  so  railed  tents:  "Medicine  is  what 
belongs  in  the  wounds,  and  tint  such  clouts''.  "They  make  use  of  clouts  and  rays 
and  other  things  in  their  balsam,  oil  or  salve,  and  forcibly  stuff  such  things  down 
between  the  sutures  of  the  wounds.  Thus  they  wipe  out  the  wounds  just  as  a  gunner 
cleanses  his  barrel  after  making  a  shot."  Upon  the  diet  of  the  wounded  also,  Wuertz, 
with  Theophrastus  von  Hohenheim,  laid  great  sties-.:  "Hold  him  as  a  woman  in 
childbed!  In  gunshot  wounds  he  no  longer  follows  the  method  of  Gersdoff,  and 
censures  the  maltreatment  ol  such  wounds  with  instruments  and  fillets  drawn  through 
them,  while  he  also  speaks  against  the  checking  of  bleeding  by  caustics  and  the  hot 
iron.  Penetrating  wounds  of  the  chest  he  carefully  closes  by  a  suture,  and  discards 
trepanning,  a  course  in  which  he  shows  himself  the  forerunner  of  a  long  line  ol' 
eminent  surgeons  of  the  18th  and  19th  centuries,  Desault,  Dieffenbach,  Stromeyer  etc. 
Like  these  he  prefers  to  leave  depressions  of  the  skull  to  the  healing  powers  of  nature. 
Foul-smelling  pus  he  regards  everj  where  of  evil  omen  as  regards  the  course  of  w  ounds. 
Fractures  he  treats  with  splints,  and  not  with  the  earlier  and  cu.-tomaiw  barbarous 
exteuding  machines,  while  he  distinguishes  "concealed  fractures"  (fissures  etc.)  from 
those  of  the  ordinary  kind.  He  is  acquainted  with  traumatic  fever,  pyaemia  and  the 
diphtheria  of  wounds,  is  the  first  to  perform  amputation  of  the  thigh,  and  one  of  the 
earliest  surgeons  to  insist  niton  healing  by  first  intention,  which  he  declares  possible 
only  before  t lie  entrance  of  air.  Finally  Wuertz  insists  upon  a  knowledge  of  anatomy 
as  thoroughly  necessary  for  the  surgeon !  "A  surgeon  should  know  the  structure  of 
the  skeleton,  the  muscles  and  the  chieJ  in  rv<  s  ai  d  vessels,  so  thai  v\]  i  n  1  e  ]<  ol  s  at  a 
wound  he  may  at  once  recognize  what  organs  are  wounded,  and  not  need  first  to  rake 
ami  poke  with  the  probe  Ignorance  of  anatomy  is  to  blame  for  so  many  crooked 
fractures.1 

The  German-Belgian  Vesalius  and  Ryff  must  also  be   mentioned   as  surgeons  of 
importance.     The  former  wrote  a  "  Chirurgia  Magna." 

c.  Midwifery  and  Gynsesology. 

The  labors  in  this  department  wore  intended  for  surgeons  and  mid- 
wives,  and  were,  on  the  whole,  mere  reproductions  of  old  material.  Mid- 
wifery, including  its  operative  branch,  lay  entirely  in  the  hands  of  the 
midwives,  and.  as  a  rule,  the  empirics  or  ordinary  surgeons,  as  well  as  the 
better  surgeons,  where  such  existed,  operated  simply  in  the  worst  cases 
(where  they  could  not  become  expert),  or  rather  massacred  with  them,  or 
better  after  their  style.  This  was  the  case  in  Rheinhesse  too  even  as  late 
as  1848. 


1.  Among  the  Swiss  surgeons  of  that  day  a  brisk  scientific  activity  must  have  pre- 
vailed. Jacob  Buwmann,  a  surgeon  at  Zurich,  published  an  anatomy  written 
in  German  and  adorned  with  38  plates,  after  sketches  by  Albrecht  Diirer,  1575. 


—  420  _ 

"  Der  swangeren  Frawen  und  Hebammen  Rosengarten" '  of  Eucharius 
Roesslin8  (called  also  Rhodion,  died  1526)  the  Elder,  a  physician  of  Wornis- 
on-the-Rbine  and  Frankfort-on-the-Main,  was  written  in  the  style  of  the 
Greek  und  Arabian  physicians  and  Albertus  Magnus. 

This  work  is  more  important  as  the  first  separate  treatise  on  midwifery  in  the 
German  language  (written  principally  too  for  midwives  and  women),  than  for  its 
contents,  which  relate  chiefly  to  medical  midwifery.3  Still  it  also  discusses  some  of 
the  manipulations  of  the  art,  together  with  instruments,  the  treatment  of  childbed, 
the  diseases  of  children  etc.,  and  the  foetal  positions  (  face  presentations  are  mentioned  !), 
some  of  which  are  constructed  entirely  from  fancy.  Among  the  operative  procedures 
even  podalic  version  in  breech  presentations,  definitely  and  precisely  marked,  finds 
place,  so  that  Rosslin  here  anticipated  Pare,  though  he  in  general  still  gives  preference 
to  version  by  the  head.  When  the  child  is  dead,  he  recommends  the  induction  of 
premature  delivery.  This  charming  "Rosengarten"  contains  little,  indeed,  yet  quite 
enough,  of  the  truly  horrible  doctrines  of  operative  midwifery  in  that  day,  and  which 
continued  in  vogue  for  a  long  time  thereafter.  In  spite  of  Christianity  the  parturient 
woman  had  not.  yet  attained  sufficient,  importance  to  claim  the  notice  and  aid  of  the 
highly  educated  physicians!  In  this  "Garden  of  Roses"  too  there  is  occasionally  a 
stronger  odor  of  blood,  fumigations  with  doves'-dung,  hawks'-dung  etc.  than  of  roses! 
Perhaps  the  title  may  have  sprung  from  the  "  Rosengarten  "  near  Worms,  well-known 
from  the  Nibelungen,  and  which  still  bears  the  same  name  to  day.  The  book,  in  spite 
of  its  semi-popular  design  and  plan  and  its  lack  of  independence  in  many  things, 
was  a  pioneer  work  in  its  day,  and  was  translated  into  all  the  languages  of  the  time.4  It 
should,  however,  be  mentioned  that  it  recommends  mothers  to  nurse  their  own  children, 
and  gives  a  good  description  of  puerperal  diseases,  the  eye-diseases  of  children  etc. 
A  similar  but  much  less  valuable  work,  "  De  uteris,  de  pariente  et  partu  liber  ",  was 
published  by 

J.  VAN  de  Meersche*  (Jason  a  I'ratis.  1487  -1558). 
Another  "  Frawen-Rosengarten  "  was  written  by 

Waltiier  Hermann  Ryfp  (Reiff,  about  1545), 
a  physician  and  surgeon  of  Strassburg,  and  a  writer  of  text-books  on  the  subjects  of 
distilling,  anatomy  and  surgery,  which  display  some  originality.      In  his  "  Die  deutsche 
Chirurgie",  1559,  he  mentions  the  ligation  of  arteries  with  a  silk  thread,   in  the  arm 
above,  in  the  neck  below,  the  wound. 

"  Ein  schon  lustig  Trostblichle  von  den  empfangkniissen  und  gebUrten  der  Men- 
schen"  etc.,  designed  for  midwives,  had  for  its  author  the  surgeon  and  astronomical, 
political,  historical  and  dramatic  writer  of  Zurich, 

Jacob  Riteff  (died  1558). 
In  this  work  smooth  and  toothed  forceps  for  the  extraction  of  dead  foetuses  are  given. 
The  author  recommends  cephalic,  in  addition  to  podalic  version,  and,  like  Pare,  gives 
an  account  of  terrific  monsters. 

1.    Argentine  edition,   Martinus  Flach,  junior.     Dnica   letare  anno   1513,    correctore 

Adelpho  physico. 
'_'.    Doctor,  as  he  expressly  calls  himself,  and  as  he  is  designated  in  the  "  Privilegium  " 

of  the  emperor  Maximilian,  bearing  date  Sept.  1512. 

3.  It  is  dedicated  to  the  dutchess  Catherine  of  Saxony,  Brunswick  and  Liineberg,  and 

is  adorned  with  good  woodcuts. 

4.  In    England    it   was   translated,  under    the   title  of  "The   Byrthe  of  Mankynde" 

(London,  1565),  by  a  Dr.  Raynalde.     (H.) 


—  421  — 

The  belief  in  the  influence  of  the  devil  upon  pregnant  and  lying-in  women  was 
still  so  great,  that  it  was  a  common  opinion  that  he  often  substituted  "changelings" 
for  the  natural  children,  and  Luther,  with  all  his  intellectual  power,  declared  that 
these  changelings  could  be  distinguished  by  their  loud  cries,  faecal  evacuations 
(Scheissen  ! )  etc.  Monsters  originated  from  the  sins  of  their  parents  etc.  In  cephalic 
version  the  author  gives  the  following  directions:  "Die  kindend  frouw  (soil)  durch 
die  Hebamm  zu  dem  Bett  verordnet  und  gelegt  werde  mit  dem  houpt  nider  und  dem 
Arss  holier.  Die  Hebamm  aber  sol  vor  der  frouwen  sitzen,  sie  warten,  wysen,  leiten, 
schyben  und  bucken,  das  kind  mit  beeden  schenckeln  sampt  dem  arssle  hinder  oder 
ob  sich  gegen  der  frouwen  rugken  schyben,  damit  es,  mit  dem  houptlein  umbkeert  mit 
rechter  hurt  werden  konne."  (Schroder.) 

Ludovicus  Bonaciolus  (Buonaccioli,  about  15-10), 
a  professor  in  Ferrara,  discusses  natural  pregnancy  and  parturition,  and  believes  that 
a  woman  could  bring  forth  as  many  as  150  children  — too  small  a  number,  at  least  if 
we  count  all    the    ova    which    perish    without    bearing    fruit.     Other    handbooks    for 
midwives,  some  of  which  were  purely  gynaecological  in  their  contents,  were  written  by: 

Nicol.  Rocheus  (about  1542),  a  physician  of  Paris; 

Matte.  Cornax  (about  1550),  a  professor  in  Vienna  ; 

Ant.  Maria  Venusti  (about  1562)  ;  the  versatile 

Fabrichs  ab  A'qu  a  pendente,  who  fixed   the  duration  of  involution 
at  fifteen  days  : 

Realdo  Colu.mbo  : 

Thadd.eus  Dunus,  author  of  •■  Muliebrium  morborum  oinnis  genesis, 
remedia  etc.",  Strassburg.  1565: 

Scipio  Mercurio  (Geron.  Mercurii,  died  1602)  of  Rome,  a  surgeon  and 
Dominican  monk  (La  commare  o  raceoglitrice); 

Adam  Loniceris  (1528-1586).  city-physician  of  Frankfort  : 

A.mbrosifs  Papen  (about  1580)  : 

Jon.  Wittich  (1537-1596)  of  Weimar,  ordinary  physician  in  Arnstadt ; 

David  Herlicius  (1557-1636)  ; 

Bald.  Bonsseis  (about  1597)  ; 

Martin  Akakia,  professor  at  Paris  (1539-1588)  : 

(tERVais  de  la  Touche  i  about  1587),  and 

Loeise  Bourgeois  (Boursier,  born  1564).  who  was  educated  in  Pares 
school  for  midwives  in  the  Hotel-Dieu. 

The  Diseases  of  Children  were  separately  treated,  as  we  have  seen,  as  early  as  the 
close  of  the  Middle  Ages.  During  the  course  of  the  16th  century  this  subject  was  also 
discussed  by  Lobera  d'  Avila  (1551  i ;  Hieron.  Mercurialis  (1583)  ;  P.  Seb.  Michelburg 
(Seb.  Austrius,  1540),  even  in  a  popular  style,  as  in  "  Ein  Regiment  der  Gesundheit 
fiirdiejungen  Kinder''  etc.,  Frankfort,  1540;  Quirinus  Apollinaris,  a  new  Albertus 
Magnus  ("von  Weibern  "  etc.,  1540);  ^Emil.  Vezosius  of  Arezzo  discussed  fecunda- 
tion, pregnancy  and  parturition  in  hexameter  verse  (1598).  [To  these  we  may  add 
Leonello  Vettori  (  Victorias,  Leonellus  Faventinus,  died  1520),  a  professor  in  Bologna, 
and  author  of  "  De  aegritudinibus  infantum  tractatus"  ( Ingolstadt,  1544);  Thomas 
Phayer,  whose  "  Regiment  of  life,  whereunto  is  added  a  treatise  on  pestilence  and  a 
book  of  children  "  t  London,  1544 ),  has  been  already  mentioned  ;  and  Michele  Colombo, 
a  pupil,  and  commentator  upon  the  writings,  of  Mercuriali,  (De  morbis  puerorum. 
Venice,  1600).     II.] 


422  

4.    THE  REFORM  OF  NORMAL,  AND  SIMULTANEOUS  FOUNDATION  OF  PATHOLOG- 
ICAL ANATOMY.    THE  FOUNDING  OF  PHYSIOLOGY. 

Mondino  had  already  made  a  beginning  in  the  erection  of  the  science 
of  anatomy  on  the  basis  of  the  examination  of  the  human  cadaver,  but  the 
structure,  as  we  have  seen,  was  pushed  forward  only  very  slowly  after  his 
day.  It  was  not  until  the  16th  century  that  it  advanced  rapidly  and  became 
independent,  through  the  refutation  of,  and  its  emancipation  from,  the 
doctrines  of  Galen.  In  this  work  Vesalius  took  the  lead  of  all  others. 
Through  his  exertions  was  effected  that  which  we  may  properly  call  the 
reform  of  anatomy,  and  thus  too  the  preparatory  excavations  were  made 
for  the  foundations  of  pathological  anatomy  and  physiology. 

At  first  serious  errors,  handed  down  from  Antiquity,  proved  genuine  hindrances  to 
a  far  grander  advancement.  Such  was  the  Galenic  doctrine  that  the  arteries,  since 
they  were  empty  in  the  cadaver,  contained  only  the  vital  spirits,  and  that  the  veins 
alone  contained  blood  ;  that  the  blood  flowed  forwards  in  the  veins  during  inspiration, 
and  backwards  in  expiration,  without  returning  to  the  heart,  and  was  entirely  con- 
sumed in  the  processes  of  nutrition.  United  to  this  was  the  further  error  that  the 
blood  and  the  calidum  innatam  oozed  through  the  septum  ventriculorum  from  the 
right  to  the  left  half  of  the  heart.  Moreover  large  pore-shaped  anastomoses  between 
the  veins  (as  well  as  between  the  arteries)  were  everywhere  son-lit.  ami.  in  spite  of  the 
discovery  of  the  valves  of  the  veins  and  the  detection  of  the  impermeability  of  the 
septum,  in  spite  too  of  the  removal  of  the  erroneous  opinion  that  the  veins  took  their 
Origin  from  the  liver,  anatomists  were  unable  to  free  themselves  from  the  old  ideas. 
Thus  only  the  1 1  > E A  of  the  lesser  circulation  was  discovered.  The  vital  spirits  were 
still  supposed  to  flow  through  the  arteries  into  the  body,  that  is  into  the  veins  and  the 
brain,  where  the  animal  spirits  were  separated.  (Compare  Galen  and  Ancient 
Medicine  in  General. 

a.    Anatomy, 

inasmuch  as  it  was  for  the  most  part  entirely  uncultivated,  as  well  as  largely 
falsified  by  inferences  drawn  from  the  anatomy  of  the  lower  animals,  furnished 
a  fruitful,  as  well  as  suitable,  field  for  fhe  acquisition  of  medical  facts,  the 
creation  of  medical  principles,  and  for  numerous  discoveries.  These  were 
heaped  together  in  a  proportion  utterly  impossible  at  a  later  period.  Hu- 
man anatomy  owed  the  active  culture  which  it  received  in  Italy  during  the 
16th  century,  as  in  the  Alexandrian  period,  to  the  fancy  of  contemporary 
princes,  including  the  popes.  Without  their  patronage  fhe  human  bodies 
necessary  for  its  prosecution  would  not  have  been  accessible.  Wherever 
these  were  wanting,  as  in  Germany  etc..  anatomy  remained  in  a  languish- 
ing condition,  even  as  late  as- the  threshold  of  the  present  century.  From 
the  necessary  comparison  of  Galenic1  (or  animal)  anatomy  with  the  new 
human  anatomy,  in  order  to  refute  the  former  and  to  separate  it  from  the 
latter,  a  beginning  of  the  later  science  of  comparative  anatomy  was  like- 
wise made. 

1.    Versalius  was  the  first  to  declare  that  Galen's  anatomy  was  based  upon  the  dissec- 
tion of  the  lower  animals. 


—  423  — 

The  eminent  pioneer  of  anatomy-  and  the  positive  tendency  in  general 
of  all  the  new  medical  science  was  the  ingenious,  indefatigable,  dauntless, 
inspired   and  self-sacrificing  German-Belgian  investigator, 

Andreas  Vesalius  (born  Dec.  31, 1514.  died  Oct.  2,  1564)  of  Brussels. 

He  it  was  who  first,  and  for  a  long  period  alone,  boldly  and  persistently 
combated  by  tacts,  and  not  dike  Theophrastus  von  Hohenheim)  by  specu- 
lations, the  popular  reverence  for  the  authority  of  Galen's  animal  anatomy, 
eradicated  it.  if  not  among  all  his  contemporaries,  at  least  for  the  future. 
and  thereby  placed  observation  in  possession  of  its  rights.  In  this  task  he 
was  the  first  to  employ  wood-cuts  drawn  after  nature  in  illustration  of  his 
anatomical  works.-1  and  thus  to  furnish  a  good  substitute  for  direct  per- 
sonal inspection  to  those  who  could  not  themselves  make  dissections,  a 
class  whose  number,  for  reasons  easily  conceivable,  was  at  that  period  very 
large.  Fortunately  Job.  Stephan  von  Calcar  (Kalker),  a  pupil  of  Titian 
and  an  excellent  artist,  was  at  his  command,  and  the  name  of  this  artist 
has  been  particularly  immortalized  by  the  plates  of  Vesalius. 

Almost  everywhere  Vesalius  placed  himself  in  express  opposition  to 
Galen.  Thus  he  denied  the  existence  of  the  os  intermaxillare  in  adults, 
and  the  composition  of  the  inferior  maxilla  of  two  bones.  In  like  manner 
he  reduced  Galen's  seven  bones  of  the  sternum  to  three,  and  gave  to  the 
sacrum  (and  coccyx)  five  or  six  pieces,  instead  of  the  three  of  Galen.  Tn 
opposition  to  the  latter  Vesalius  also  established  the  existence  of  marrow 
in  the  bones  of  the  hand,"  and  refuted  his  assumption  of  an  imputrescible 
bone  of  the  heart,  as  well  as  his  assertion  of  the  strong  curvature  of  the 
bones  of  the  upper  arm  and  the  thigh.  He  maintained  that  nerves  and 
muscles  stood  in  no  relation  of  proportionate  strength  to  each  other,  for 
that  stout  nerves  were  distributed  to  small  muscles,  and  conversely : 
that  the  tendons  were  similar  in  constitution  to  the  ligaments  and  not  to 
the  muscles,  that  the  latter  were  in  some  respects  independent.  Vesalius 
denied  the  existence  of  a  general  muscle  of  the  skin,  proved  that  the  inter- 
costal muscles  merely  separate  the  ribs  from  each  other,  without  either  ex- 
panding or  contracting  the  thorax  ;  discarded  the  origin  of  the  vena  cava 
inferior  from  the  liver,  the  assumption  of  cotyledons  in  the  human  female, 
the  separation  of  the  bones  of  the  symphisis  during  parturition  etc.  — all 
in  opposition  to  Galen.  He  first  described  the  course  of  the  vena  azygos 
and  the  subclavian  vein,  the  ductus  venosus.  the  absence  of  the  rete  mira- 
bile  in  the  brain,  the  five  cerebral  ventricles  and  the  non-glandular  charac- 

1.  These  were:    "  De   corporis   humani    fabrica    libri    septem'',      Basil,    1543;     and 

"  Suorum  de  fabrica  corporis  humani  librorum  epitome  ",  Basil,  1543.  In  defence 
of  these  works  he  also  wrote:  "  Gabr.  Cunei  Mediolanensis  apologias  Franc.  Putei 
pro  Galeni  anatome  examen".  Yenet.,  1564,  and  "Anatomiearuin  Gabrielis 
Falloppii  observationuni  examen",  Venet.  1564.     (H.) 

2.  Sylvius  meets  this  fact  by  styling  its  discoverer  "  Yesanus"  (one  of  the  amenities 

of  controversial  literature  in  that  day),  and  assuming  that  the  bones  of  the  hand 
were  differently  constructed  in  the  days  of  Galen  !     (H.) 


—  424  — 

ter  of  the  caruncles  ;  gave  a  description  of  the  vestibule  of  the  ear  and 
the  long  process  of  the  malleus,  the  tensor  tympani  muscle,  the  labyrinth, 
the  sphenoid  bone,  the  mediastinum,  the  peritoneum  and  omentum,  the 
cardia  and  pylorus,  the  fornix  and  septum  pellucidum.  the  movements  of 
the  brain  etc.  etc.  —  proof  enough  that  he  overturned  the  old  anatomy  in 
all  points,  replaced  it  with  a  new  science,  and  added  even  to  the  latter  new 
discoveries  !  Of  course  Vesalius  was  no  more  exempt  than  any  other  man 
from  individual  errors,  and  those  of  his  own,  and  the  past,  age  !  Thus  in 
his  view  the  veins  alone  were  bloodvessels,  while  the  arteries  were  still  car- 
riers of  the  vital  spirits  and  simply  appendages  of  the  veins.  In  like 
manner  he  still  assumed  originally  the  existence  of  pores  in  the  septum 
ventriculorum.  and  it  was  not  until  1543  or  1555  that,  under  the  lead  of 
other  anatomists,  he  gave  up  this  idea.  These  art.-  all  mere  shadows, 
necessary  to  the  brilliancy  of  the   picture  ! 

Vesalius  had  the  extremely  rare  fortune  to  find  favorable  conditions 
for  the  perfection  and  realization  of  his  great  endowments  as  an  anatomist 
and  physician  in  his  family  and  in  his  age.  He  was  also  fortunate  enough 
to  strike  upon  a  subject  almost  entirely  unworked  and  readily  accessible  to 
the  senses.  Scion  of  a  family  of  physicians  —  his  great  great-grandfather. 
Peter  of  Wesel  on  the  Rhine,  had  been  a  physician,  his  great  grandfather. 
Johann  von  Wessele  (who  subsequently  immigrated  as  a  professor  to  Lou- 
vain,  for  which  reason  the  family  came  to  Belgium  and  changed  its  name), 
was  physician  to  the  emperor  Maximilian,  his  grandfather  (Eberhard) 
again  was  a  physician  —  he  himself  was  also  the  son  of  the  apothecary  of 
a  relative  of  Charles  A'.,  whose  attention  was  thus  directed  to  him.  In 
addition  to  all  these  fortunate  circumstances,  he  was  able  to  attend  the  best 
schools,  at  a  time  when  anatomy  was,  so  to  speak,  in  the  very  air  !  He  was 
never  lacking  in  assiduity,  zeal  and  strength  of  character,  qualities  which, 
in  contrast  to  the  certainly  rare  favors  of  fortune  already  mentioned, 
redounded  to  his  credit!  His  primary  education  he  received  in  Louvain. 
Subsequently  he  was  able  to  go  to  Montpellier  and  Paris,  where  the  anato- 
mist Guido  Guidi  (Yidus  Vidius,  died  1569)  of  Florence,  the  friend  of 
Benvenuto  Cellini,  with  whom  he  lived  for  a  long  time  in  Paris,  and  the 
restjess  Winther.  (Giinther)  ol  Andernach  on  the  Rhine,  both  at  this  period 
residing  in  Paris,  were  his  teachers.  Jacob.  Sylvius  (Dubois,  died  1555), 
the  famous  practical  anatomist  (discoverer  of  the  fissure  and  acqueduct  of 
Sylvius,  the  muscles  of  the  calf  of  the  leg,  the  panniculus  etc.).  who  gave 
names  to  the  vessels  and  muscles  and  suggested  the  injection  of  the  ves- 
sels, was  also  one  of  Ids  teachers.  The  most  famous  of  his  fellow  students 
under  Sylvius  was  Servetus.  Sylvius,  however,  as  is  often  the  case  with 
teachers  and  pupils,  in  his  efforts  to  uphold  the  ancient  Galen,  became 
afterwards  the  chief  of  Vesalius's  opponents.  With  the  object  of  defending 
Galen  he  asserted  that  the  perfectly  straight  thigh  bones,  which,  as  even- 
one  saw,  were  not  curved  in  accordance  with  the  teachings  of  Galen,  were 
the  result  of  the  narrow  trowsers  of  his  contemporaries,  and  that  they  must 


—  425  — 

have  been  curved  in  their  natural  condition,  when  uninterfered  with  by  art  ! 
In  Paris,  at  this  time  animal  dissections  exclusively  were  practised,  and  it 
was  only  after  his  return  home  —  in  his  20th  year — to  Louvain  that 
Vesalius  was  able,  at  considerable  risk  to  himself,  to  steal  a  human  skele- 
ton from  the  gallows.  Soon  after  he  entered  the  military  service  as  sur- 
geon, a  position  which,  by  the  investigation  of  dead  bodies,  he  made  fruit- 
ful in  the  attainment  of  the  object  of  his  life.  At  the  age  of  23  years  he 
became  professor  of  anatomy  at  Padua,  where  at  first  he  lectured  in 
accordanee  with  the  doctrines  of  Galen,  but  subsequently  independently  of 
these.  Vesalius  also  taught  in  Pisa  and  Bologna  at  this  period  when  he 
wrote  his  chief  work.  In  the  year  1543  lie  was  called  to  Belgium  as  phy- 
sician of  the  emperor  Charles  V..  and  in  this  position  he  came  also  to 
Germany. 

As  soon  as  his  book  made  its  appearance  it  awakened  opposition 
everywhere.  In  the  front  rank  of  his  opponents  was  the  professor  of 
anatomy  at  Rome. 

Bartolommeo  Eustacchi  (died  1574), 
the  discoverer  of  the  Eustachian  tube  (1562;  he  regarded  it  as  adapted  to  conduct 
pus  etc.  out  of  the  ear,  and  to  receive  medicines),  the  stapes,  the  modiolus  of  the 
cochlea,  the  membranous  cochlea,  the  tensor  tympani  muscle,  the  origin  of  the  optic 
nerves,  the  sixth  cerebral  nerves,  and  the  supra-renal  capsules.  He  described  the 
muscles  of  the  throat  and  neck,  the  thoracic  duct,  the  four  pulmonary  veins,  the 
uterus  etc.,  and  prepared  some  anatomical  plates,  famous  for  their  artistic  perfection, 
which  were  first  found  and  published  by  Lancisi  in  the  18th  century.  With  him  were 
united  in  their  opposition  to  Vesalius  : 

Franciscus  Puteus  (about  1562)  of  Vercelli,  and 

Joh.  Dryander  (Eichmann,  died  1560)  of  the  Wetteraw, 
professor   in    Marburg,   but   a   man   of  little   importance    (Anatomia?  pars  prior  etc.. 
Marburg,  1537) ; 

Matteo  Realdo  Colombo  (born  1400  ?.  died  1559)  of  Cremona, 
a  pupil  and  prosector  of  Vesalius.  He  described  the  duplicatures  of  the  peritoneum, 
the  ventricles  of  the  larynx,  the  terminations  of  the  nerves  in  the  muscles,  the 
musculus  omohyoideus,  the  tigroid  gland  and  its  increased  size  in  women,  which 
produced  a  fullness  of  their  necks  (Fuhr)  etc.  Subsequently  he  was  the  successor  of 
Vesalius  at  Padua,  but  most  ungrateful  to  his  master.  Colombo  was  an  especially 
good  osteologist,  and  likewise  an  excellent  practical  obstetrician,  the  first  who  com- 
bated the  doctrine  of  the  culbiite.  He  likewise  was  the  first  who  demonstrated 
experimentally  that  the  blood  passed  from  the  lungs  into  the  pulmonary  veins.  That 
it  pushed  on  further  into  the  left  ventricle,  thus  establishing  the  lesser  circulation  from 
one  side  of  the  heart  to  the  other,  this  he  did  not  expressly  teach,  but  it  was  reserved 
for  Harvey.  Servet  as  well  as  Colombo  could  not  get  rid  of  the  idea  of  the  "  spiritus", 
and  thus  both  had  only  approximations  to  the  correct  idea  of  the  lesser  circulation. 
Harvey  was  the  first  who  recognized  this  as  a  pure  circulation  of  blood.  Colombo 
bears  the  responsibility  of  having  been  the  first  person  to  perform  vivisection  upon 
dogs  instead  of  hogs,  for  the  reason  that  the  latter  were  annoying  by  their  squealing. 
On  the  other  hand,  however,  there  appeared  as  partisans  of  Vesalius, 

Giov.  Filippo  Ingrassias  (1510-1580)  of  Becalbuto  in  Sicily, 
professor  at  Naples,   the   most  accurate  osteologist  of  his  age,   and   one  of  the  best 
myologists ; 


—  426  — 

Giambattista  Canano  (1515-1579), 

a  professor  at  Ferrara,  and  ordinary  physician  of  the  duke  of  that  city,  who  described 
first  in  1546  the  valves  of  the  veins  (though,  according  to  Landois,  the}*  were  already 
known  to  Theodoret,  bishop  of  Syria),  and  also  gave  a  very  accurate  description  o1" 
the  muscles  of  the  upper  extremities.  The  hitter  physician,  however,  did  not  enter 
very  energetically  into  the  contest. 

As  the  fame  of  Vesalius  increased,  so  also  did  the  opposition  to  his 
work,  and  accordingly  Charles  V.  requested  the  Faculty  of  Salamanca  to 
examine  into  the  orthodoxy  of  the  book.  Here  again  that  enlightened 
body  rendered  their  decision  in  the  interests  of  persecuted  science  (1556). 
Vesalius,  however,  weary  with  the  opposition  encountered  in  Italy,  returned 
to  his  home,  and  thence  went  to  Basel  (he  left  here  a  skeleton  which  is  still 
preserved).  The  latter  change  was  made  partly  in  the  interests  of  a  new 
edition  of  his  hook,  partly  to  deliver  lectures  in  that  city.  Finally  Philip  II. 
called  the  wandering  investigator  to  .Madrid  as  his  physician.  But  here 
again  he  suffered  renewed  persecutions,  especially  from  the  priests,  who  saw 
clearly  that  a  portion  of  the  light  with  which  Vesalius  was  illumining  the 
body  must  also  fall  upon  the  belief  in  immortality  and  the  resurrection,  and 
that  the  latter  would  thus  finally  be  broken  into  fragments.  It  is 
also  said  that  during  the  dissection  of  a  Spanish  woman  signs  of  life 
were  still  observed,  or  according  to  another  version  of  the  story,  as  Vesalius 
was  dissecting  the  mistress  of  a  priest  he  discovered  some  disagreeable 
results  of  priestly  potency  ;  perhaps  the  latter  circumstance  may  have 
given  origin  to  the  former  calumnious  story.  However  this  may  be,  this 
much-persecuted,  irritable  and  impetuous,  rather  than  good  and  discreet, 
reformer  and  champion  of  the  truth,  in  a  fit  of  ill-humor,  undertook  a 
pilgrimage  to  Jerusalem.  He  came  near  losing  his  life  by  shipwreck,  and 
died  on  his  return,  upon  the  island  of  Zante,  of  a  disease  contracted 
through  the  accident,  to  which  he  had  been  exposed,  and  just  at  the  time 
when  he  was  honorably  recalled  to  Padua  as  a  professor. 

We  may  consider  as  a  predecessor  of  Vesalius    the  already  mentioned 

G-iacomo  Berengario  of  Carpi, 

who  was  a  professor  at  Bologna  from  1502  to  1527,  in  which  latter  year  he  withdrew 
to  Ferrara  banished,  as  it  would  seem,  by  the  justifiable  hatred  of  the  Bolognese. 
lie  first  dissected  swine,  and  then  numerous  human  bodies,  and  also  defended  (and 
his  enemies  said  practised)  vivisections  and  pederasty1  upon  comiets.  He  was  the 
first  to  describe  the  os  basilare  and  the  sinus  sphenoidei,  the  latter  of  which  he  con- 
sidered the  source  of  catarrh  :  the  rnembrana  tympani,  concerning  the  origin  of  which 
whether  from  the  auditory  nerves,  or  from  the  meninges,  he  however  remained  in 
doubt.  He  also  described  inexactly  the  muscles  of  the  eye,  the  cerebral  ventricles, 
the  choroid  plexus,  the  pineal  gland,  the  connexion  of  the  ventricles  with  the  canal 
of  the  spinal  cord,  the  absence  of  nerve-roots  in  the  cerebellum,  the  spinal  cord  and 
cervical  nerves,  the  puncta  lachrymalia,  caecum,  vermiform  appendix  etc.  He  also 
taught  that   there  were  no  pores  in  the  septum  ventrioulorum.   that   the  veins  and 

1.  This  crime,  in  consequence  of  the  unexampled  immoralty  which  prevailed  in 
Italy  at  this  time  and  still  later,  was  by  no  means  uncommon.  There  were  even 
books  upon  all  sorts  of  possible  and  improper  varieties  of  sexual  intercourse. 


—  427  — 

arteries  possessed  valves  at  the  heart,  and  that  valves  also  existed  between  the  auricles 
and  ventricles  of  that  organ.  By  the  injection  into  the  veins  of  fluids  which  made 
their  appearance  upon  the  papilla;,  he  settled  the  question  whether  the  kidneys  were 
simple  organs  of  urination,  and  cleared  up  the  course  of  the  abdominal  veins. 

Among  his  contemporaries  the  following  were  anatomists  of  importance  : 
Nicolaus  Massa  (1499-1569), 

a  physician  of  Venice,  who,  in  his  "Liber  introductorius  anatomise "  etc.,  15I56,  des- 
cribed many  things,  including  the  muscles  of  the  face  and  submental  region,  the 
position  of  the  stomach,  the  lymphatics  of  the  kidneys,  the  accessaries  of  the  female 
sexual  organs,  and  the  choroid  plexuses,  in  which  latter  he  sought  for  the  soul.  He 
also  discovered  much  that  was  new,  and  corrected  some  of  the  old  ideas  e  g.  the 
relations  of  the  bladder,  the  abdominal  muscles,  the  scrotum,  the  lung-tissues,  the 
first  pair  of  nerves  etc.  i  Si'_rm.  Purjesz,  sen.).  He  likewise  described  Cesarean 
section. 

Andreas  Laguna  (died  1560)  of  Segovia. 

The  following  physicians  continued  mainly  followers  of  Galen:  Loys 
Vasse'  (Latinized  Vassaeus  ;  the  French  form  Levasseur  is  incorrect,  as  well 
as  the  conversion  of  Loys  into  Ludovicus.  It  should  lie  properly  Lodoicus) 
of  Chalons-sur  Marne,  (Compendium  of  anatomy,2  1553,  with  anatomical 
plates  |  : 

Charles  Estienne  (Stephanus,  1503-1564)  of  Paris, 
a  pupil  of  Sylvius,  and  a  man  of  liberal  ideas  (he  was  arrested  for  heresy  and  died 
in  prison),  who,  in  an  illustrated  work,  gave  his  own  views  on  desmology.  chondrology 
and  osteology,  and  described  the  differences  between  the  white  and  gray  matter  of  the 
brain,  between  venous  and  arterial  blood,  and  the  phrenic  nerve;   and 

G-TJILLAUME  RoNDELET,  vvho  has  been  already  mentioned. 

The  most  important  anatomist  after  Vesalius  (whose  pupil  he  had  been  i, 
equally  distinguished  as  a  man  and  as  a  savant  by  his  sense  of  justice,  his 
modesty  and  his  gentleness,  was 

GrABRlELE  FALLOPPIO  i  Fallopia.  Falloppia,  Fallopio,  Fallopius,  1523- 
1562)  of  Modena. 

He  had  studied  in  Padua,  and  visited  Greece  and  France.  At  the  age  of  twenty -four 
he  was  appointed  professor  at  Ferrara,  and  subsequently  filled  the  same  position  at 
Paris,  and  finally  in  Padua.  The  fact  that  even  Falloppio  did  not  shrink  from 
accepting  the  gift  of  some  convicts,  and  then  poisoning  them  —  indeed,  when  the 
first  experiment  proved  a  failure,  be  tried  it  again  with  better  success  —  is  character- 
istic of  the  zeal,  of  the  age  in  the  investigation  of  the  human  body,  and  of  the 
barbarous  idea  that  might  makes  right  towards  those  guilty  before  the  law  ! 

Of  his  numerous  discoveries  and  descriptions  we  mention  those  of  the  aquaeductus 
vestibuli,  the  foramen  ovale,  the  lamina  spiralis  of  the  cochlea,  the  chorda  tympani, 
his    naming  of  the    membrana  tympani ;    of  the   petrosal    and    sphenoidal   sinuses  (he 

1.    Eloy  gives  the  full  title  of  this  work  "  Ludovici  Vassasi  Catalaunensis  in  A  natomen 
corporis  humani  Tabulae  quatuor'  ,  Lutetise,  1540.     The  question  of  its  authorship 

is  disputed.  Some  authorities  ascribe  it  to  Loys  Vasse,  a  native  of  Catalonia, 
and  pupil  of  Sylvius :  others  to  dean  Vasses  (Vassaeus)  of  Meaux  in  Brie,  dean 
of  the  Faculty  of  Paris  in  1582  and  an  eminent  Hippocratist.  Eloy  says  if  the 
author  was  born  in  Catalonia  he  should  be  called  "Catalanus",  instead  ot 
"  Catalaunensis",  which   means  a  native  of  Ch&lons-sur-Marne.      (H.) 


—  428  — 

demonstrated  the  absence  of  the  latter  in  the  foetus,  as  well  as  the  fact  that  the  foetal 
sternum  consists  of  seven  bones,  and  the  foetal  lower  jaw  of  two  bones);  of  the 
muscles  of  the  forehead,  occiput  and  tongue  ;  the  three  scaleni ;  the  obliqui  abdominis  ; 
the  so-called  Poupart's  ligament;  the  so-called  valvula  Bauhini;  the  seminal  vesicles, 
hymen,  clitoris,  ovaries,  ovarian  tubes  in  the  human  female1  (Rufus  of  Ephesus  had 
seen  them  in  sheep),  round  ligaments;  the  lymphatic  vessels;  trigeminus,  acoustic 
and  glosso-pharyngeal-nerves,  nervous  ganglia  etc.  He  showed  that  the  membranes 
of  the  brain  have  no  part  in  the  origin  of  nerves  etc.  Falloppio  was  a  man  of  great 
versatility,  and  a  practical  surgeon  and  author.  He  wrote  even  on  medicinal  springs, 
syphilis  (lie  recommended  condoms  of  linen,  and  was  an  anti-mercurialist)  and  other 
subjects. 

A  pupil  of  Falloppio  was  the  Dutchman 

Yolcher  Koyter  (1534-1600)  of  (Troningen, 
who,  after  serving  as  a  military  surgeon,   settled   in   Nuremberg.     He  described  the 
facial  canal,  the  labyrinth,  muscles  of  the  e}re-brows,  and  was  the  first  to  describe  two 
anterior  and  two  posterior  spinal  nerve-roots  etc.      Other  renowned  anatomists  of  that 
day  were : 

Hieronymus  Fabricius  All  Aqi  AI'ENDENTE  (1537-1619), 
the  very  eminent  teacher  of  Harve^y  (who  owed  much  to  his  suggestions  —  the  greatest 
praise  probably  which  could  be  given  him),  a  pupil  and  successor  of  Falloppio,  who 
won  deserved  credit  by  his  teachings  regarding  the  valves  of  the  veins,  and  his  studies 
in  .the  history  of  development  and  in  comparative  anatomy.  How  carefully  he 
observed  maj7  be  judged  from  the  fact  that  he  knew  the  cavity  of  the  tympanum  in 
the  new-born  was  filled  with  mucus,  a  fact  rediscovered  in  our  day. 

Costanzo  Varolio  (1543-1575), 
professor  at   Bologna,    ordinary    physician    of   the   pope,    who    described    the    pons, 
commissure,  cms  cerebri,  and  the  nervous  system  in  general: 

G-iul.  Cesare  Aranzio  (1530-1589), 
professor  at  Bologna  and  a  pupil  of  Maggi,  who  also  studied  the  nervous  system 
and  described  the  pes  hippocampi.  He  likewise  discovered  the  levator  palpebral 
superioris  and  coraco-brachialis  muscles,  the  foramen  ovale,  ductus  arteriosus,  corpora 
Arantii  etc.,  and  was  acquainted  with  the  contracted  pelvis  as  the  chief  cause  of 
difficult  labor,  and  the  muscular  nature  of  the  uterus,  before  Fabricius,  to  whom  a 
knowledge  of  these  facts  is  usually  ascribed. 

CiESALPINO, 
whom  the  Italians  desired2  to  stamp  as  the  discoverer  of  the  complete  circulation 
(he  is  said  to  have  been  the  first  to  employ  the  term  circulatio).  although  he  still 
assumed  that  only  a  portion  of  the  blood  passed  through  the  lungs,  another  part 
passing  through  the  pores  in  the  left  ventricle.  However  we  must  grant  that,  of  all 
the  predecessors  of  Harvey,  he  came  nearest  to  the  doctrine  of  the  complete  circula- 
tion, and  especially  that  he  supplied  the  data  of  the  greater  circulation.  Yet  he  was 
far  from  closing  the  double  circle  formed  by  the   complete  circulation. 

1.  Falloppio  demonstrated  that  they  opened  into  the  abdominal  cavity  and  were  not 
connected  with  the  so-called  female  testicles.  The  latter  too  he  did  not  con- 
sider organs  lor  the  elaboration  of  semen,  which,  according  to  his  view,  was 
prepared  by  the  blood. 

'_',  The  professors  Mazziorani  and  Guido  Baccelli  of  Rome  attempted  the  same  thing 
in  1876,  and  even  erected  a  monument  to  his  memory  as  the  discoverer  of  the 
circulation  of  the  blood. 


—  429  — 

Giul.  Casserio  (1561-1616), 

professor  at  Padua,  a  teacher  of  Harvey,  and  discoverer  of  the  muscles  of  the  ossicles 
of  the  ear; 

Eustachio  Eudio  (died  1611), 
mentioned  also  in  the  doctrine  of  the  circulation  ; 

Archanuelo  Piccoluomini  of   Ferrara   (died   1605.     Described    the 
linea  alba)  : 

Carcano  Leone  (1536-1606)  ; 

Andr.  du  Laurens  (1558-1609)  of  Aries, 
chancellor  of  Montpellier  and  subsequently  of  Paris,  physician-in-ordinary  of  Henry 
IV.,  who  wrote  a  famous  "Historia  anatomica  humani  corporis",  which  takes  Galen 
under  its  protection  and  contains  little  that  is  original.  He  is  devoted  to  mysticism 
and  unworthy  of  belief.  He  declares,  however,  that  the  king  had  cured  1500  scrofu- 
ous  persons  by  laying  his  hands  upon  them. 

Abraham  Thorer  (1489-1550)  of  Basel  ; 

Walther  Ryff,  who  wrote  in  1541  the  first  anatomy  in  the  German 
language  ; 

Salomon  Alberti  (1540-1600),  professor  at  Wittenberg; 

Felix  Platter  ((1536-1614),  discovered  the  ampulla?  and  expressed 
his  opinion  as  to  the  stronger  curvature  of  the  posterior  surface  of  the  lens  ; 

Caspar  Balhin  (1550-1624),    professor  at  Basel  ; 

Pieter  Pa  an  (1564-1617)  of  Amsterdam  ; 
the  famous  ordinary  physician  of  the  Palatinate,  selfsufficient  gossip  and  insignificant 
anatomist 

Joh.  Posthils  (1437-1597),  of  Germersheim  in  the  Palatinate  ; 
described  the  milk-ducts  in  1590; 

Leonhard  Fuchs, 
who  deserves  special  credit  for  diffusing  the  doctrines  of  Yesalius  ; 

J.  Bockl  (about  1585); 

Thomas  Vicary,1 
the   first  surgeon  of  St.  Bartholomew's  Hospital,  who  wrote  in   1548  the  first  English 
work  on  anatomy,  in  which  he  follows  the  Ancients,  especially  Galen; 

Thomas  Gemini,2 
who  published  in   London  in  1559  a  "  Treatyse  of  Anatomie  "  with  .39  copper-plates, 
the  first  anatomical  work  so  illustrated  in  England; 

1.  Thomas  Vicary  has  been  mentioned  before  p.  336,  in  connection  with  the  charter- 

ing of  the  guild  of  barber-surgeons  in  1512.  His  book  was  entitled  "The  English- 
man's treasure,  or  the  true  Anatomy  of  man's  body",  London,  1548,  1577,  in  8vo., 
1587,  1633  in  4to.  According  to  Mangetus,  Douglas  and  other  authorities,  an 
anatomy  of  the  human  body  in  two  books  was  written  by  William  Horman  oi 
Salisbury,  an  Englishman  who  died  in  1535.  The  title  of  this  work,  when  and 
where  it  was  published,  in  what  language  it  was  written  and  whether  Horman 
himself  was  a  physician  are  all  unknown  to  the  translator.      (H.) 

2.  According  to  Elo}',   Thomas  Gemini  was  a  foreign  artisan  and  skilful  engraver 

who  settled  in  London  in  the  early  part  of  the  16th  century.  He  was  the  first 
who  engraved  the  plates  of  Vesalius  on  copper,  and,  with  the  aid  of  some  literary 
friends  (he  himself  understood  neither  English,  Latin  nor  anatomy),  supplied 
them  with  the  descriptions  of  their  author  and  published  them  as  of  his  own 


—  430  — 

J  tan  Valverde  de  II  am  i  sen  (about  1  Til  in  i  of  Castilla  hi  Viega  in  Spain. 
author  of  "  Historia  de  la  composicion  del  cuerpo  hutnano",  Roma,  1556,  with  42 
copper-plates. 

b.    Pathologicil  Anatomy 

in  the  16th  century  won  at  least  a   beginning.     This,  however,  was  rather 

the  result  of  the  search  for  curiosities,  so  prevalent  at  that  lime,  than  the 
natural  consequence  of  the  active  anatomical  zeal  of  the  age,  or  of  any  inves- 
tigations having  directly  in  view  the  development  of  pathological  knowledge 
and  the  advancement  of  practice.  It  too  was  chiefly  employed  in  thejefuta. 
tion  of  the  views  of  the  ancient  physicians,  and  thus,  like  almost  everything 
else  in  the  16th  century,  acquired  a  reformative  signiticanc  ■. 

The  human  body  was  investigated  particularly  for  stones  and  concre- 
tions. Stones  of  the  kidney,  bladder,  lungs,  gall-bladder,  tongue,  brain,  etc. 
were  found,  and  this  fact  worked  against  Galen,  who  admitted  the  existence 
of  the  first  two  varieties  only.  Here  too  it  was  a  question  of  the  observa- 
tion of  reformative  facts  in  medicine,  and  Benivieni.  Kenntmann,  Dodoens 
and  Donatus  were  particularly  active  in  the  work.  'I  he  possibility  of  the 
continuance  of  life  with  absi  of  the  heart,  which  had  been  denied  by 

G-alen,  was  also  demonstrated.  Ulcers  of  the  stomach,  degeneration  of  the 
kidneys  and  hypertrophy  of  the  bladder  with  simultaneous  ulceration  of 
the  urethra  resulting  from  gonorrhoea,  hydrometra  and  other  pathological 
lesions  were  observed  by  Dodoens,  who  has  been  already  mentioned.  More 
extensive  advances  in  pathological  anatomy  were  made  by  Schenck  von 
GTrafenberg  (who  published  the  firsl  case  of  cystic  mole")  and  Felix  Platter, 
■•who  in  51  years  dissected  300  bodies,  was  the  teacher  of  all  Europe  and 
yet  lefl  to  posterity  not  one  single  truth"  (Rohlfsj,  a  fate  which  he  shared 
with  many  others,  for  it  is  not  every  one  who  can  find  truths.  Of  spe- 
cial distinction  in  this  department  were  (inillaume  Baillou  (TSallonius  . 
Foreest.  Fernel  and  others.  Koyter's  observations  on  the  changes  observed 
in  the  brain  and  spinal  cord  after  delirium,  convulsions  and  paralysis,  are 
surprising  for  their  delicacy. 

igning.  The  first  edition  was  published  under  the  Latin  title  "  Compendiosa 
totius  Anatomia}  delineatio  are  exarata",  London  1545,  in  folio.  English 
editions  also  appeared  in  1553  and  1559. 

John  Half  an  English  surgeon,  also  published  in  1565  a  quarto  volume  con- 
taining a  translation  of  Lanfranc's  "Chirurgia  parva",  a  handbook  of  anatomy, 
entitled  'Very  frutefull  and  necessary  briefe  worke  of  anatomie",  and  tin  "  Histor- 
ical expostulation  against  the  beastlye  abaters  both  of  chyrurgerie  and  physicke 
in  oure  tyme".  The  book  was  dedicated  to  the  Company  of  Surgeons,  and  the 
author  states  that  the  "Chirurgia  parva"  had  been  already  translated  from  the 
French  into  An^lo-Saxon  some  200  years  before,  and  that  his  own  translation 
was  merely  the  conversion  of  this  An^lo-Saxon  work  into  modern  English. 

The  English  surireon  John  Banister,  who  has  been  already  mentioned,  should 
also  be  noticed  here  for  his  "The  history  of  man  sucked  from  the  sappe  of  the 
most  approved  anatomists  of  this  present  age  etc.",  London,  1578.     (H.) 


—  431   — 

c.    Physiology 

too  acquired  incidentally  from  the  labors  of  the  anatomists  much  additional 
knowledge  regarding  the  action  of  the  muscles.  Thus  Falloppio  proved 
that  the  transverse  fibres  do  not  always  preside  over  expulsion  and  the 
oblique  fibres  over  retention,  as  Galen  declared,  but  that  both  functions 
might  be  performed  by  fibres  of  a  different  direction,  while  Yesalius  demon- 
strated that  longitudinal  division  of  a  muscle  did  not  deprive  it  of  con- 
tractility. With  regard  to  the  internal  and  external  intercostal  muscles, 
Vesalius  held  that  both  sets  merely  approximated  the  ribs,  while  Galen 
believed  that  the  external  intercostals  contracted  the  thoracic  cavity,  and 
were  therefore  expiratory  muscles,  while  the  internal  intercostals,  by  enlarg- 
ing the  cavity  of  the  thorax,  were  active  in  effecting  inspiration.  At  the 
present  day  we  hold  conversely  the  external  intercostals  to  be  muscles  of 
inspiration,  the  internal,  muscles  of  expiration.  Most  of  the  muscles  too 
were  tested  as  to  their  action,  and,  wherever  necessary,  the  views  of  the 
Ancients  on  this  subject  were  rectified.  In  the  prosecution  of  this  work. 
besides  the  physicians  who  names  have  been  already  mentioned,  all  those 
who  held  to  modern  views,  and  a  part  too  of  the  partisans  of  Antiquity, 
took  a  share. 

The  investigations  concerning  the  use  of  the  valves  found  in  the  heart 
and  the  veins,  and  the  impervious  septum  ventriculorum,  led  to  a  very 
active  discussion  of  the  circulation  of  the  blood.  Serveto,  a  pupil  of 
Dubois  in  anatomy,  was  the  first  to  teach  the  imperviousness  of  the  septum, 
and  concluded  that  the  blood  (inasmuch  as  more  of  it  went  to  the  lungs, 
through  the  large  pulmonary  arteries,  than  was  required  for  their  nutrition), 
after  thorough  intermixture  with  the  pneuma  in  the  lungs — an  intermixture 
which  could  not  take  place  in  either  of  the  ventricles  in  consequence  of 
their  diminutive  size  — returned  again  to  the  heart  by  way  of  the  pulmon- 
ary veins.  That  the  blood  mixed  with  the  pneuma  returned  to  the  heart, 
formed,  therefore,  the  only  obscure  point  in  Serveto's  idea  of  the  lesser 
circulation.  This,  six  years  later,  was  removed  by  Colombo,  who  demon- 
strated experimentally  that  the  pulmonary  veins  contained  blood  alone. 
Oaesalpino,  a  pupil  of  Colombo,  came  still  nearer  the  truth,  since  he 
explained  the  lesser  circulation  perfectly  correctly,  even  spoke  of  anasto- 
moses between  the  arteries  and  veins  in  the  lungs,  and  did  not  teach  that 
the  blood  became  intermixed  with  the  pneuma  in  the  latter  organs,  but 
merehy  that  it  was  cooled  by  the  inspired  air  contained  in  the  branches  of 
the  bronchi  adjacent  to  the  vessels.  Yet  he  again  admitted  the  existence 
of  pores  in  the  septum  ventriculorum.  He  also  sketched  correctly  the 
greater  circulation,  but  is  obscure  in  regard  to  the  ''  spirits  ".  "  In  animals 
we  see  the  nutriment  borne  b}'  the  veins  to  the  heart,  as  to  the  laboratory 
of  the  indwelling  heat,  and,  having  acquired  here  its  final  perfection,  dis- 
tributed by  way  of  the  arteries  to  the  whole  body  by  the  working  of  the 
spirit,  which  is  prepared  from  that  aliment  in  the  heart."     He  recognized 


—  432  — 

the  distention  of  veins  behind  a  compressing  bandage,  though  he  was 
ignorant  of  the  existence  of  valves  in  these  vessels.  —  After  the  discover}-  of 
the  foramen  ovale  in  the  septum  of  the  auricles  and  of  the  ductus  arteriosus 
and  ductus  venosus,  the  foetal  circulation  was  also  frequently  described 
correctly.1 

Even  experimental  studies  were  made  upon  the  mechanism  of  the 
secretion  of  urine,  and  the  physiology  of  generation  and  of  development — 
a  subject  naturally  very  popular  since  the  days  of  antiquity  down  —  was 
cleared  up.  The  explanation  of  the  latter  subjects  was  based  upon  investi- 
gation of  the  genitalia,  and  the  observation  of  incubated  eggs  and  of 
human  embryos.  Even  the  physiology  of  the  brain  and  spinal  cord  was 
somewhat  advanced. 

Jean  Fernel  (1485-1558),  who.  after  having  thoroughly  studied  philo- 
sophy and  physiology  in  Paris,  in  the  interest  of  his  own  health  turned  his 
attention  to  medicine,  is  regarded  as  the  most  memorable  physiologist  of 
this  period.  Fernel  was  a  professor  at  Paris  and,  towards  the  close  of  his 
life,  physician-in-ordinary  to  Henry  II. 

The  seat  of  the  soul,  which  Fernel  considered  a  simple  substance,  regarding  its 
individual  faculties  as  simple  functions,  was  located  in  the  brain.  The  nerves  of 
sensation  he  held  to  originate  from  the  brain  itself,  those  of  motion  from  its  mem- 
branes. Fernel  considers  the  elements  actual  bodies,  and  assigns  to  them  heat  (the 
substratum  of  which  is  spiritus)  as  the  animating  principle.  He  thinks  the  blood 
originates  in  the  liver,  assigns  semen  and  testicles  to  women  as  well  as  men,  and  holds 
correctly  that  the  testicles  of  men  do  not  escape  through  openings  in  the  peritoneum, 
but  follow  tliis  membrane  as  a  prolongation  —in  the  two  former  ideas  following  Galen, 
in  the  latter  opposing  him. 

5.    STATE  MEDICINE  AND  PSYCHIATRY, 

A  few  ordinances  within  the  sphere  of  state  medicine  existed,  as  we 
have  seen,  even  in  the  Middle  Ages  ;  indeed  autopsies  were  made  in  cases 
of  poisoning.  This  was  the  case  particularly  in  the  numerous  free  cities, 
which  had  been  powerful  aids  in  the  promotion  of  general  culture  towards 
the  close  of  the  Middle  Ages,  and  especially  in  German}'.  The  criminal 
ordinance2  of  Charles  V.,  of  the  year  1530  or  1533  (an  extension  of  the 
Bamberg  ordinance  of  1507),  was,  however,  the  ffrst  effort  to  determine 
definitely   and  connectedly  the  cases  in  which  the  judge  should  summon 


For  a  more  complete  account  of  the  gradual  development  of  the  true  theory  of 
the  circulation,  the  reader  is  advised  to  consult  Dr.  J.  C.  Dalton's  "  Doctrines  of 
the  Circulation".  (Phila.  1884),  a  work  admirable  both  for  its  thoroughness  and 
for  the  clear  and  interesting  style  in  which  the  somewhat  obscure  subject  is 
handled.     (H.) 

Very  mild  for  its  day,  but  extremely  barbarous  in  appearance  to  us  of  the  19th 

century,  though,  alas,  it  continued  in  force  down  to  the  present  century.     (Baas.) 

The  ordinance  referred  to  in  the  text  is  the  "  Constitutio  criminalis  Carolina", 

an  amplification  of  a  similar  ordinance  published  by  George,  bishop  of  Bamberg, 

in  1507.     (H.) 


—  433  — 

physicians  or  midwives  as  experts.  Such  cases  were  infanticide,  mortal 
wounds,  apoplexy,  poisoning,  concealed  pregnancy  and  childbirth,  abortion, 
the  practice  of  medicine  by  incompetent  persons  etc.  From  this  time  for- 
ward the  reciprocal  action  upon  each  other  of  medicine  and  jurisprudence 
became  permanent,  a  fact  which  increased  the  estimation  of  medicine  and 
physicians.  In  this  ordinance  of  Charles  V.,  however,  judicial  autopsies 
were  still  not  directed.  They  were  opposed  b}^  that  superstition  which  was 
still  so  omnipotent,  and  the  anatomical  capacity  required  for  dealing  with 
such  cases  could  not  have  been  generally  presupposed.  Yet  Pare"  made  a 
judicial  autopsy  in  1562,  and  after  this  time  post  mortems  for  judicial  pur- 
poses took  place  frequently.  Haeusser  criticises  these  most  too  severely  : 
"Nothing  can  be  more  ridiculous  than  the  medical  opinions  of  that  period, 
essaying  to  exhibit  the  facts  and  symptoms  of  a  disease."  Ordinances  of 
medical  police  were  issued  in  a  few  cities,  e.  g.  one  in  Nuremberg  in  1518, 
relating  to  the  sale  of  food,  popular  amusements  and  adulteration  of  wine, 
a  thing  often  clone  even  in  Antiquity. 

Strict  imperial  ordinances  against  the  "  improvement "  of  wine  by 
sugar  of  lead  etc.  were  promulgated  by  the  imperial  diet  in  1475,  by  the 
emperor  Frederick  III.  in  1487  and  by  Maximilian  in  1497.  The  penal  or- 
dinance of  the  criminal  court  directed  its  attention  to  the  falsification  of 
goods  in  a  special  section  on  "  Falscher  mit  Mass,  Wag  und  Kaufmann- 
schaft ",  and  their  example  has  been  followed  in  the  modern  German 
Empire.  Beer  too  was  kept  under  supervision,  though  this  and  other  in- 
dustrial productions  were  chiefly  controlled  by  the  guilds.  In  Frankfort- 
on-the-Main  there  existed  a  long  list  of  most  judicious  hygienic  ordinances. 
The  medical  ordinance  of  1577  directed  :  1.  "In  order  to  improve  the  air 
the  streets  shall  be  cleaned  Wednesda}^  and  Saturday  of  each  week  after 
the  closing  of  the  market ;  2.  The  passing  of  urine  on  the  streets  is  pro- 
hibited ;  3.  Privies  shall  be  erected  in  all  houses  " — very  many  persons  at 
that  time  must  have  sought  some  other  convenient  place  ;  4.  "  The  knacker 
(Schinder)  shall  transact  business  only  during  cold  weather  (and  in  sum- 
mer?)"; 5.  "The  shops  of  butchers,  tanners,  fishermen  and  furriers  shall 
be  removed  etc.  Hog-pens,  goose-pens  and  wells  shall  be  cleaned.  During 
foggy  weather  no  one  should  go  out  at  night,  and  the  mouth  should  be  kept 
closed  etc."  (Strieker).  Even  the  soul's  welfare  was  a  subject  of  anxiety, 
for  piety  is  the  fons  omnis  salutis.  "  Pest-ordinances  ''  in  great  numbers 
were  promulgated  in  Germany,  Italy,  Switzerland,  France,  England  etc. 
In  Italy,  however,  both  these  branches,  towards  the  close  of  the  16th 
century,  seem  to  have  assumed  an  important  position,  for  at  this  period 
lived  Fortunatus  Fidelis  (Fedeli,  1550-1630),  who  wrote  a  special  book 
entitled  "  De  relationibus  medicorum"  etc.,  in  which  everything  commonly 
reported  upon  by  physicians  in  medico-legal  cases  is  treated  of  at  length. 
He  regarded  post  mortem  inspection  as  very  important,  but  not  always 
decisive.  Joachim  Striippe,  a  physician  of  Gelnhausen,  was  the  first  in 
Germany  to  write  on  the  subject  of  medical  police  in  his  work  entitled 
28 


—  -134  — 

"Niitzlichen  Reformation  zu  guter  (iesnndheit  unci  christlicher  Ordnung", 
which  appeared  in  17)73. 

Psychiatry  was  yet  in  a  very  bad  condition,  for  Jac.  Sylvius  remarks  : 
•■  In  some  eases  (of  insanity)  scolding  is  required,  in  others  blows  and 
shackles."  In  opposition  to  him  F.  Platter  insists  upon  psychical  treatment 
instead  of  incarceration.  The  maltreatment  of  the  insane  at  this  period, 
and  which,  indeed,  in  many  places  continued  down  to  the  present  centmy, 
may  be  frankly  compared  with  the  trial  of  witches  (for  both  agree  in  arising 
from  religious  superstition  in  demoniacal  possession),  only  that  with  the 
witches  shorter  work  was  made  while  the  insane  were  imprisoned,  some- 
times as  much  as  forty  years. 

They  were  chained  up.  left  to  wallow  in  their  own  filth,  often  naked, 
starving  and  tormented  and  beaten  by  inhuman  jailors  and  keepers.  Some 
died  of  cold  in  their  very  prisons.  Platter  divided  mental  disorders  into  four 
classes  :  mentis  imbecillitas.  defatigatio,  consternatio  and  alienatio.  Foreest 
also  made  some  observations  on  mania  and  recognized  lycanthropia. 

How  far,  however,  genius  often  outstrips  its  time  is  shown  by -the  brilliant  example 
of  Shakespeare  in  his  fictitious  treatment  of  the  insane  king  Lear.  Shakespeare's 
son-in-law  was  a  Dr.  Hall,1  but  the  dramatist  could  not  have  obtained  his  information 
from  him,  for  in  England  too  at  this  period  the  maltreatment  of  the  insane  was 
shameful,  and  so  it  continued  for  a  long  time.  The  harmless  lunatics  in  London  at 
that  time  wore  a  ring  upon  the  left  arm.  had  a  large  ox-horn  suspended  from  their 
neck,  and  were  compelled  to  support  life  by  begging.  [In  Dr.  Andrew  Borde's 
"A  Breviarie  of  Health",  published  in  1547,  is  a  chapter  entitled  "An  order  and  a 
dyett  for  them  the  whiche  be  madde  and  out  of  their  wytte"  in  which  he  gives  the 
following  advice :  "I  do  advertyse  every  man  which  is  madde  or  lunatycke,  or  fran- 
tycke  or  demonyacke.  to  be  kept  in  safegarde  in  some  close  house  or  chamber  where 
there  is  lytell  light:  and  that  he  have  a  keeper  the  whiche  the  madde  man  do  feare," 
Yet  Tuke  says  that  many  of  Dr.  Borde's  suggestions  as  to  the  treatment  of  the  insane 
were  not  unkind,  however  peculiar  they  may  have  been.  The  Hospital  of  St.  Mary 
of  Bethlehem   for  the   insane,   popularly   known    as    'Bedlam",    was   founded   as   a 

1.  This  Dr.  John  Hall  was  a  man  of  considerable  celebrity  in  Stratford-on-Avon  and 
its  vicinity.  He  wrote  a  work,  entitled  "  Select  Observations  on  English  bodies; 
or  cures  both  empericall  and  historicall,  performed  on  very  eminent  persons  in 
desperate  diseases",  which  was  published  by  Dr.  James  Cooke  in  1657.  The 
work  contains  the  histories  of  nearly  200  cases  of  disease,  and  the  editor  in  his 
preface  says:  "It  seems  the  author  had  the  happiness  (if  I  may  so  stile  it)  to 
lead  the  way  to  that  practice,  almost  generally  used  by  the  most  knowing,  of 
mixing  scorbutics  in  most  remedies."  Indeed  scurvy -grass  figures  in  many  of 
his  prescriptions  (Phila.  Med.  News,  Aug.  1,  1885). 

The  following  epitaph  is  said  by  the  N.  Y.  Med.  Record  to  appear  upon  a  stone 
in  the  cemetery  at  Fredericksburg,  Ya.  :  "  Here  lies  the  body  of  Edward  Heldon, 
Practitioner  in  Physics  and  Chirurgery.  Born  in  Bedfordshire,  England,  in  the 
year  of  our  Lord  1542.  Was  contemporary  with,  and  one  of  the  pall-bearers  of, 
William  Shakespeare,  of  the  Avon.  After  a  brief  illness  his  spirit  ascended  in 
the  year  of  our  Lord  161^  —  aged  7G."  As  Shakespeare  did  not  die  until  April 
1616,  the  margin  of  probability  in  the  reported  epitaph  is  small,  though  of  course 
its  truth  is  possible.     (H.) 


—  435  — 

monastery  by  Simon  Fitz  Mar}-  in  1246,  and  converted  into  an  insane  asylum  in  1547. 
Toward  the  close  of  the  16th  century  it  was  described  as  "  so  loathsome  as  to  be  unfit 
for  any  man  to  enter".     (H.) 

6,    VETERINARY  MEDICINE.    PHARMACOLOGY. 

Veterinary  medicine  in  the  16th  century  enjoyed  special  advantages 
in  the  translation  into  the  national  tongues  of  the  works  of  the  ancient  wri- 
ters on  this  subject,  and  in  the  increased  accessibility  of  these  works  re- 
sulting from  the  invention  of  printing.  The  anatoim'  of  the  horse  was 
most  advanced  by  independent  observation.  The  veterinarian  Francesco 
de  la  Reyna  (1564),  a  Spaniard,  and  Claudio  Corte(1562j  made  their  ap- 
pearance as  veterinary  writers.  The  physician  Jean  Ruelle  (1474-1537), 
at  the  instance  of  Francis  I.,  translated  into  Latin  in  1530  the  "  Hippiater" 
of  Constantine  Porphyrogenitus,  from  which  it  was  then  translated  into 
French  b}r  Jean  Masse  in  1563,  and  subsequently  into  German.  A  work 
of  more  importance,  however,  was  the  "  Dell '  anatomia  e  dell '  infirmita 
del  cavallo"  (1598),  published  by  Carlo  Ruini  (died  1590  ?),  a  senator  of 
Bologna,  a  book  which  acquired  great  popularit}'  in  the  following  age. 
Ruini  was,  indeed,  the  creator  of  zootomy. 

Pharmacology  in  this  centur}*  was  chiefly  enlarged  by  a  great  number 
of  metallic  remedies,  though  some  permanent  enrichment  of  the  science 
also  occurred.  The  impulse  to  this  advance  was  due  chiefly  to  Theophras- 
tus  von  Hohenheim  and  the  advancing  science  of  chemistry.  Yet,  in  addi- 
tion to  the  newly  introduced  mineral  remedies,  which  continued  to  be  of  a 
very  complex  character,  and  to  whose  introduction  great  objections  were 
also  opposed,  many  old  vegetable  remedies  were  retained,  so  that  e.  g.  in 
the  Augsburg  pharmacopceia  nearly  700  of  these  old  herbs  were  specified  ! 
The  discovery  of  America  speedih-  displayed  its  influence  upon  pharma- 
cology. Among  the  newby  introduced  vegetable  remedies  must  be  men- 
tioned the  guaiac  wood  (1508,  celebrated  in  verse  by  Ulrich  von  Hutten 
in  1517);  China  root  (1525);  sarsaparilla  (1530).  Pharmacognosy  too  con- 
tained many  novelties.  Thus  e.  g.  a  book  of  1534  (according  to  Proksch) 
says  of  guaiac  that  it  grows  upon  the  Antilles,  has  a  brown  or  black  pith, 
its  fruit  and  its  nuts,  which  are  good  to  eat  but  laxative  etc. — Pharmacog- 
nosy, pharrnaco-dynamics  and  pharmaceutics,  and  pharmac}'  also,  to  some 
extent,  were  contained  in  the  "Krauterbuchern"'  (herbals)  of  that  day, 
e.  g.  in  that  of  Eucharius  Roesslin,  junior  (died  1553  or  1554)  etc.  The 
preparations  of  drugs  were  endlessly  increased  by  essences,  quintessences, 
specifics,  tinctures,  arcana,  extracts  etc.,  and  reall}'  enriched  by  the  use  of 
mineral  waters,  though,  in  comparison  with  earlier  times,  pharmaceutical 
science  was  somewhat  simplified.  Yet  under  the  head  of  "  simple"  reme- 
dies (a  name  used  at  this  period  in  contradistinction  to  the  endless  com- 
posite remedies)  some  very  complex  mixtures  were  still  included.  Thus 
the  above  mentioned  pharmacopoeia  of  the  }ear  1564  introduces  among  its 
simple  remedies  the  following  list : 


—  436  — 

Simplicia  from  the  vegetable  kingdom:  leaves,  flowers,  fruits,  juices,  woods 
and  barks.  Simplicia  from  the  animal  kingdom :  fat,  marrow,  bones  and  hair. 
Simplicia  from  the  mineral  kingdom:  metals,  stones,  precious  stones  and  earths. 
Simplicia  from  the  kingdom  of  the  sea  and  the  waters:  coral,  salt,  pearls,  shell-fish 
etc.  To  be  more  specific,  the  following  remedies,  with  numberless  others,  were  men- 
tioned in  the  different  classes: 

Emollient  herbs althaea,  malva,  acanthus; 

Seeds,  warm  in  the  highest  degree  .     .     .   anise,  fennel : 
Seeds,  warm  in  a  lower  degree  ....     daucus,  amomum  : 
Seeds,  cold  in  a  higher  degree     ....   cucumbers,  melons; 
Seeds,  cold  in  a  lower  degree    ....     endives,  lettuce. 
Fats  —  goose,  dogs',  eunuch's,  goats',  horses',  stags',  man's.     Bones  —  human  skull, 
asses'  hoofs.     Metals  —  white  arsenic,  copper-filings,  calamine,  iron,  alum,  tin,  lead, 
sulphur.     From  the  sea  and  the  waters  —  petroleum,  spermaceti,  shell-fish.      The  fol- 
lowing may  serve  as  examples  of  the  specifica,  with  their  formula?  of  preparation  : 
"  Specific-urn   for   epilepsy — vitriol,  calcined  until  it  becomes  3-ellow,  saturate  with 
alcohol,   add   misletoe,  hearts  of  peonies,  elks'  hoofs  and  the  pulverized  skull  of  an 
executed  malefactor  (!) :  distil   all  these  dry,   rectif}-  the  distillate  over  eastoreuin, 
species  diamoschi   dulcis,    elephants'  lice:  then  digest  in   a  water-bath  for  a  whole 
month,  after  mixing  with  salt  of  peony,  alcohol,   liquor  salis  perlarum  et  corallorum, 
ol.  anisi  et  succini.     Tincture  of  mummy  —  select   the  cadaver  of  a  red,   uninjured, 
fresh,  unspotted,  malefactor.  24  years  old,  and  killed  by  hanging,  broken  on  the  wheel 
or  impaled,   upon  which  the   moon   and  the  sun   have   shone  once :  cut  it  in  pieces, 
sprinkle  with  myrrh  and  aloes:   then  macerate  for  a  few  days,  pour  on  spirits  etc. 

Examples  of  composita,  with  their  names:  pills — hiera  picra  Rhasis,  pil.  ale- 
phanginas  Mesua?,  pil.  pestilentiales  Ruffi.  Species  —  diambar,  diamargariton  calidum. 
Xarcotica — theriaca,  aurea  Alexandrina,  Philonium,  Mithridaticum,  thryphera  etc., etc. 
A  comparatively  large  number  of  popular  'Krauterbuchern"  (Herbals),1  which 
maintained  their  popularity  long  afterwards,  made  their  appearance  in  this  century: 
e.  g.  that  of  the  far  famed  Meister  Barthol.  Vogter,  an  oculist  of  Dillingen  ;  that  of 
J.  Schoener  of  Carlstadt  (1528)  etc.  Numerous  scientific  pharmacopoeias  also 
appeared,  among  the  forerunners  of  which  we  may  mention  the  works  of  a  certain 
Quiricus  de  Augustis,2  a  physician  of  A'ercelli;  of  J.  J.  Manlius  de  Bosco  !  Luminare 
majus,  medicis  et  aromatariis  necessarium  —  Lumen  apothecariorum  —  Thesaurus 
aromatariorum,  1528)  and  Paulus  Suardus  from  the  end  of  the  15th  century.  Among 
the  pharmacopoeias  were  the  first  German  pharmacopoeia  of  Nuremberg,  published 

1.  These  "  Herbals"  at  that  time  filled  the  place  of  "popular  medical  treatises"  in 

general,  and  must  have  been  very  much  sought  after.  Physicians  also  occupied 
themselves  with  the  composition  of  "  Guidebooks"  a  la  Baedecker.  which  con- 
tained some  directions  upon  medical  subjects  for  all  sorts  of  accidents  occurring 
upon  the  journey.  Guilhelmo  Grattaroli  (Grattarolo,  1515-1568)  of  Bergamo,  a 
professor  in  Marburg,  published  such  a  guide-book.  ["A  new  herball"  etc.  by 
William  Turner  of  Northumberland,  England,  first  appeared  at  London  in  1551. 
The  second  part  was  published  in  1562,  and  the  third  in  15fi8.  John  Gerarde 
1545-1607),  head-gardener  of  Lord  Burghley  and  a  practitioner  of  surgery  in 
London,  also  published  a  very  quaint  and  curious  "Herbal"  in  1597.      (  H.  l] 

2.  Phillippe   calls  him    Quiricus  de  Augustis  de  Tortona  of  Milan.     His  work   was 

entitled  "  Lumen  apothecariorum  ",  and  was  published  at  Venice  in  1495.  Paulus 
Suardus  was  an  apothecary  of  Bergamo,  who  copied  his  "  Thesaurus  aromatario- 
rum "  almost  entirely'  from  the  work  of  Quiricus.  It  appeared  at  Milan  in  1512, 
and  was  often  published  with  the  "  Luminare  majus"  of  Manlius  de  Bosco.     (H.) 


—  437  — 

by  Valerius  Cordus  in  1535  (or  1546)  ;  the  pharmacopoeia  of  Cologne,  1565;  that  of 
Bonn,  1574;  the  pharmacopoeia  of  Bergamo  1580,  etc.  The  elements  of  military 
pharmacy  also  developed  in  this  century  of  genuine  progress,  a  title  to  which  the 
16th  century,  finally,  may  lay  claim  in  that  herbaria  with  plates  made  their  way  into 
Russia  as  early  as  1534,  and  that  in  it  the  visiting1  of  bathing  resorts,  in  accordance 
with  the  prescription  of  physicians  (a  proceeding  customary  as  early  as  the  15th 
century)-,  began  to  become  more  and  more  frequent. 

7.    EPIDEMIC  DISEASES. 

In  the  department  of*  epidemic  diseases  too  the  16th  century  proved 
its  reformative  mission,  if  we  may  be  allowed  such  an  expression.  On  the 
one  hand  it  witnessed  the  end  of  a  few  diseases  of  the  Middle  Ages,  and, 
on  the  other,  it  introduced  several  new  diseases  into  the  life  of  the  people. 

Leaving  out  of  consideration  the  epidemic  forms  of  religious  frenzy, 
which  henceforth  withdrew  more  and  more  from  the  public  eye  into  the 
privacy  of  family  life,  the  leprosy  and  the  English  sweating  sickness  belong 
especially  in  the  class  of  diseases,  which,  from  this  time  forward,  faded 
gradually  out  of  existence.  On  the  other  hand,  the  plague  henceforth 
simply  retreated  further  and  further  into  the  regions  of  the  East. 

Leprosy  disappeared  earliest  from  Italy,  so  that  while  at  the  beginning  of  the 
ltltli  century  a  few  cases  were  still  observed,  at  the  close  of  this  century  it  no  longer 
appeared  in  this  locality,  save  in  a  few  places  about  Genoa  and  Ferrara,  where  it 
continues  to  prevail  even  to-day.  In  France  likewise  it  lost  its  epidemic  character, 
but  did  not  entirely  disappear  until   the  following  century.      The  same  was  true  of 

1.  On  these  journeys  to  the  bathing-resorts  considerable  luxury  was  often  displayed. 

Thus  the  count-palatine  Philip,  prince  and  lord  on  the  Rhine,  travelled  to 
Gastein  in  1534  with  70  horses.  The  count-palatine  Otto  Heinrich,  who  built  the 
famous  "  Otto-Heinrichs-Bau  "  of  the  castle  of  Heidelberg,  travelled  with  20 
wagons,  50  horses  and  18  mules.  A  servant  of  the  poor  carpenter's  son  Christ, 
however,  surpassed  both;  for  archbishop  Wolf  Dietrich,  count  of  Rahman,  took 
with  him,  in  the  year  1591,  139  horses  and  240  persons,  a  goodly  part  of  whom 
were  females.  The  elector  Augustus  of  Saxony  in  the  year  1584,  having  sent 
forward  scouts,  travelled  with  225  horses  to  Eltville,  in  order  to  enjoy  the  baths  of 
Schwalbach.  In  these  bathing-resorts  everything  was  of  the  most  primitive  style. 
In  the  baths  themselves  —  both  sexes  often  mingled  together  —  they  had  a  right 
merry  time.  Before  starting  on  the  journey  to  the  baths  a  venesection  was 
performed  and  a  purgative  taken,  according  to  the  constitution  and  complexion. 
The  same  thing  is  done  to-day  among  the  people,  only  the  bleeding  etc.  are 
practised  at  the  bathing-resorts. 

2.  "  The  polished  Italian  Poggio  writes  with  great  gusto  from  the  Council  of  Constance, 

how  at  Baden  in  Aargau  — ■  the  elegant  and  notorious  bathing  resort  of  the  15th 
century  —  he  had  seen  the  German  men  and  women  bathing  without  clothing  in 
the  same  room,  and  how  charming  it  was  to  see  their  innocent  familiarities.  (He 
called  the  German  men  coarsely  enough  "wine-skins'',  born  to  gormandize  and 
guzzle.)  A  hundred  years  later  Hutten  praises  the  same  German  custom  of 
bathing,  and  contrasts  it  with  Italian  manners,  in  which  anything  like  the  same 
freedom  would  be  impossible  without  the  grossest  excesses."  Freytag  1.  c.  The 
term  of  residence  at  these  bathing-resorts  was  ordinarily  nine  da}-s,  and  the 
bathers  remained  many  hours  in  the  water,  as  at  Leuk  in  the  present  day. 


—  438  — 

Switzerland  and  Spain.  Denmark  and  England  in  the  course  of  the  10th  century  rid 
themselves  completely  of  the  lepros}-,  while  Scotland,  the  Netherlands  and  Germany 
were  forced  to  suffer  from  its  ravages  in  the  seventeenth  centur}-,  and  in  Sweden  and 
Norway  it  still  appeared  epidemically  even  in  the  eighteenth.  As  leprosy  disappeared 
the  leper-houses  also  fell  into  disuse,  so  that  Louis  XIV.  (1638-1715)  was  finally  able 
to  distribute  their  possessions  among  the  poor.  The  greater  cleanliness  of  this  period, 
including  the  common  use  of  shirts  (which  became  customary  during  the  16th  century), 
is  regarded  as  the  cause  of  the  decline  of  this  foul  disease. 

We  have  already  stated  that  in  the  middle  of  the  16th  century  the  English 
sweating  sickness  disappeared  from  the  list  of  epidemic  diseases. —  On  the  other  hand, 
the  plague,  during  the  whole  16th  century,  prevailed  more  generally,  and  in  places 
more  fatally,  than  ever  before,  as  if  desirous,  before  beginning  in  the  succeeding  cen- 
tury its  return  to  the  East,  to  make  the  West  feel  once  more  its  reign  of  terror.  Tins 
was  true  too  in  spite  of  a  great  number  of  "  Plague-ordinances",  issued  in  the  form  of 
books,  reports  and  pamphlets  by  the  authorities,  as  measures  of  public  sanitation. 
Still  the  plague  ravaged  all  places.  Thus  in  1500-1507  it  raged  in  Germany.  Italy 
and  Holland,  in  1528  in  Upper  Italy*,  1534  in  Southern  France,  1562-1568  pretty 
generally  throughout  Europe.  In  1564  it  was  particularly  severe  at  Freiburg  in  the 
Breisgau,  1568  in  Paris,  1574-1577  a  general  epidemic  prevailed,  during  which  in 
Lou  vain  e.  g.  500  persons  perished  in  a  single  da}-,  and  in  Vicenza,  340  in  one  month. 
The  disease  prevailed  again  in  1591. — It  is  characteristic  of  the  improvement  in  the 
art  of  observation  of  this  century  that  the  plague  was  declared  contagious  and  port- 
able, and  accordingly  measures  of  isolation  and  disinfection  were  put  in  force  against 
it,  though  without  proving  in  any  degree  effectual.  With  a  view  to  disinfection  horn, 
gunpowder,  arsenic  with  sulphur  or  straw  moistened  with  wine  etc.  were  burned  in 
the  streets,  so  that  the  statement  "  They  are  burning  horn"  signified  at  that  time 
"  The  plague  is  there,  and  we  can  do  nothing  against  it  "  —  a  condition  which  we  now 
express  euphemistically  by  the  odor  of  carbolic  acid!  The  administration  of  pre- 
ventive doses  of  disinfectants  was  also  customary  at  that  period.  The  "  Pestmedici  " 
anointed  the  uncovered  portions  of  their  bodies  with  oil  etc.,  or  wore  special  "plague- 
dresses"  and  "plague-masks",  "plague-gloves"  etc.  The  plague-dresses  were  red  or 
black;  the  masks  were  made  of  leather,  had  openings  filled  with  glass  for  the  eyes 
and  a  beak-like  prolongation  for  the  reception  of  disinfecting  substances.  Similar 
clothing  was  considered  a  means  of  protection  down  into  even  the  present  century. 

Among  those  who  wrote  accounts  of  the  plague,  the  following  were  the  most 
prominent:  Victor  de  Bonagentibus,  Mercurialis,  Salius  Diversus  (died  1591),  Paie, 
Crato,  Massa,  Gesner  etc. 

With  regard  to  the  diseases  which  extended  from  mediaeval  into  modern  times,  it 
should  be  remarked  that  syphilis,  as  our  experience  shows,  laid  aside  its  malignant, 
epidemic  character  with  the  development  of  gonorrhoea  in  1520,  but  only  to  extend 
more  widely  its  milder  sway;  so  that,  in  spite  of  the  introduction  in  the  16th  centur}- 
of  the  external  and  internal  employment  of  mercury  and  the  administration  of 
guaiac,  sarsaparilla,  sassafras  and  China  smilax.  it  still  exists  to-day,  equally  among 
civilized  and  uncivilized  people.  A  whole  host  of  "Anti-mereurialists  "  existed  even 
in  that  day,  some  of  whom  based  their  objections  upon  the  doctrines  of  Galen. 
Among  them  we  may  mention :  Leonicenus,  Torella,  Montagnana,  Montesaurus, 
Monardus,  Alex.  Benedetti,  Schellig,  Raut,  Vochs,  Poll,  Schmaus,  Villalobos.  Among 
the  "  Mercurialists  "  were:  Sebastian  A  qui  tan  us,  Brocardus,  Ant.  Benivieni,  Peter 
Pinctor  (Pinto,  a  Spaniard),  Cataneus,  Vella,  Fracastoro,  Widmann,  Joh.  Benedictus, 
Wendelin  Hock  (whom  Procksch,  the  author  of  this  catalogue,  calls  the  most  stupid  of 
compilers),  Joh.  Almenar  etc.  Scurvy,  in  the  course  of  this  century,  appeared 
epidemically  at  sea  and  often  also  on  land,  especially  on  the  coasts  of  the  North  Sea 


—  439  — 

(Sweden,  Norway,  Finland,  Denmark,  Friesland,  Prussia,  the  Netherlands,  Lower 
Saxony),  but  also  in  the  interior.  It  found  its  principal  describers  in  Euricius  Cordus, 
1534;  George  Agricola  (died  at  Ingolstadt  in  1570)  in  1539;  Joh.  Echth  (1515-1544), 
a  Dutchman,  who  died  in  Cologne;  Olaus  Magnus,  in  the  year  1555;  Ronss;  Weyer; 
Dodoens,  who  gives  an  account  of  two  epidemics,  in  the  years  1556  and  15G2  ;  Foreest; 
Eugalenus  (158S) ;  Heinrich  Brucreus,  professor  at  Rostock,  in  the  year  1589;  Alberti, 
in  the  year  1594;  Balth.  Brunner  (ordinary  physician  of  Anhalt,  died  1604)  etc.  At 
this  period,  however,  other  diseases  also  were  included  in  the  term  "Scorbutus',  as 
e.  jr.  a  condition  in  which  worms,  accompanied  with  great  pain,  are  said  to  have 
developed  in  ulcers.  This  disease,  however,  was  described  under  the  title  "de  lopende 
Varen"  by  Heinrich  von  Bra  (died  1601),  a  physician  of  Dockum  in  West  Friesland, 
who  prescribed  for  it  maybugs,  while  Petraus  recommended  angleworms  ! 

Ergotism  also  continued  its  epidemic  visitations,  though  in  much  milder  form, 
down  into  the  Modern  Era.  Instead,  however,  of  the  gangrenous  form  of  the  Middle 
Ages  (which  yet  appeared  in  Spain  in  1565  and  1590),  the  nervous  form  of  the  disease, 
characterized  by  itching,  formication,  pains,  rigidity,  cramps,  loss  of  consciousness  etc. 
manifested  itself,  especially  in  German}-  (1581,  1587,  1592,  generally  extended  in 
1595  and  1596,  in  Griinberg  in  upper  Hesse  in  1600)  and  in  Holland. 

Small-pox  ( first  observed  or  described  in  Germany  in  1493)  and  measles,  whose 
specific  nature  was  still  unknown  to  the  physicians  of  the  West,  likewise  appeared  in 
the  16th  century  i  e.  g.  small-pox  in  Sweden  in  1578). 

The  Grippe  (influenza),  for  the  first  time  recognizable  with  certainty  as  such, 
showed  itself  in  the  j-ear  1510,  and  spread  over  all  Europe.  A  second  epidemic. 
beginning  in  1557,  was  less  widely  extended.  On  the  other  hand,  in  1580  and  1593  it 
became  again  pandemic,  while  in  1591  Germany  alone  was  visited. 

The  following  new  epidemic  diseases  appeared  in  the  16th  century:  under  the 
name  "  Garotillo  ",  diphtheritic  diseases  appeared  at  six  different  times  in  Spain 
between  the  years  1583  and  1600,  and  were  mentioned  by  Gutierrez  as  early  as  the 
15th  century.  The  chronicler  Frank  von  Word  also  speaks  of  the  disease  in  1517 
as  an  epidemic  in  which  the  fauces  and  tongue  were  covered  with  something  like 
mould.  Under  the  designation  of  "  Colica  Pictonum "  an  endemic  lead-poisoning, 
resulting  from  bad  management  of  cider  or  wine,  broke  out  in  the  year  1572  in 
southern  France.  Under  the  title  of  "The  Hungarian  disease"  appeared  (1566)  a 
form  of  disease  intermediate  between  the  plague  and  typhus  fever.  Whether  this 
latter  disease  existed  in  earlier  aires  is  not  entirely  free  from  doubt,  but  this  much  is 
certain,  that  in  the  beginning  of  the  16th  century  ( 1501 1  it  ravaged  almost  all  Europe, 
from  Cyprus  across  Italy,  in  the  form  of  an  epidemic  disease  new  to  the  physicians 
of  that  period.  At  this  time,  as  was  subsequently  observed  too  in  individual  epidemics 
of  the  disease  in  England,  young  people  of  the  higher  classes  were  especially  attacked. 
This  peculiarity  was  manifested  particularly  by  the  epidemic  of  1505  in  upper  Italy. 
a  country  which  seemed  to  be  a  favorite  home  of  the  petechial  fever,  by  which  it  was 
ravaged  in  1527,  1528,  1535,  1537,  and  15S7.  France,  however,  was  severely  visited 
by  it  in  1557.  The  wars  of  the  16th  century  contributed  greatly  to  its  origin  and 
extension,  so  that  the  spotted  typhus  i  called  also  at  that  period  Hauptkrankheit, 
Faulfieber  etc. ),  in  the  middle  of  this  century,  had  already  acquired  in  Europe,  in 
place  of  the  plague,  the  preeminence  among  pestilential  diseases,  a  position  which. 
as  the  prevailing  form  of  typhus,  it  maintained  up  to  the  beginning  of  the  present 
century.  Typhoid  pleuro-pneumonia,  closely  related  to  the  foregoing  disease,  appeared 
epidemically  in  the  16th  century,  especially  in  Italy  in  1521,  1535,  1537,  1557,  1568, 
1586;  in  France  1571  and  1598;  Switzerland  1550,  1564;  the  Netherlands  1557  and 
1563,  and  finally  in  Germany  1564,  1567,  1583  and  1585.  In  the  investigation  of  the 
diseases  last  mentioned  the  prominent  epidemiologists  of  the  16th  century  rendered 


—  440  — 

valuable  service.  These  were  Fracastori  (a  decided  advocate  of  contagion),  Victor 
de  Bonagentibus,  Massa,  Dodoens,  Ballonius,  Weyer,  Codronchi,  Dunus,  Montanus, 
Mundella  etc.  The  undoubted  transmission  of  disease  in  many  cases,  and,  indeed,  in 
entire  epidemics,  by  contagion  —  a  method  of  conveyance,  as  Marx  has  shown,  known 
even  to  the  Ancients  —  was  securely  established,  and  its  possibility  by  contact,  by 
fornites  and  by  the  air  was  carefully  examined.  Finally  the  whooping-cough,  now 
newly  described,  appeared  in  the  16th  century  in  the  list  of  epidemic  diseases. 
Ballonius,  who  was  the  first  (1578)  to  furnish  us  with  a  description  of  the  disease, 
speaks  of  it,  however,  as  of  one  already  well  known. 

8.    CONDITION  OF  THE  MEDICAL  PROFESSION, 

If  the  foregoing  observations  have  shown  us  how  greatly  medical 
science,  its  cultivation  and  nurture,  were  reformed  and  advanced  in  the  16th 
centuiy,  particularly  by  the  knowledge  of  the  Greek  language  and  writers, 
as  well  as  by  anatomy  and  the  revival  of  independent  observation  ;  on  the 
other  hand  the  condition  of  actual  medical  practice,  in  a  peculiar  and  ever 
recurring  way.  depending  upon  the  superstition  and  idleness  of  the  masses 
and  the  timidity  and  indolence  of  the  plrysicians,  occupied  a  grade  almost 
entirely  mediaeval.  At  that  time  ordinary  practice  was,  in  many  respects, 
more  than  a  century  behind  the  age,  a  condition  which  we  may  likewise 
observe  again  to-day. 

In  the  16th  century  the  higher  ph}Tsicians,  the  vast  majorit}'  of  whom 
belonged  to  the  laity,  generally  received  their  education  exclusively  in 
the  universities. 

Among  the  latter  the  Italian  (for  reasons  explicable  from  the  history  of  the 
development  of  these  institutions)  enjoj'ed  the  greatest  reputation  as  schools  of 
medical  education.  Next  in  rank  were  the  French,  and  last  of  all  the  German,  though 
the  latter  too  were  well  attended.  The  Italian  universities  were  therefore  naturally 
the  aim  of  all  those  who  desired  a  thorough  education,  especially  as  attendance  upon 
these  schools  recommended  the  physicians  of  that  da}'  in  the  same  wa}T  as  did,  until 
a  short  time  ago,  attendance  at  the  university  of  Paris  or  Vienna  the  physicians  of 
the  present  day,  although  in  neither  was  anything  new  learned.  Most  famous  of  all 
1  a  condition  at  that  time,  as  well  as  to-day,  and  even  more  than  to-day,  associated 
with  the  greatest  concourse  of  students)  were  the  medical  faculties  of  Bologna,- Pisa 
and  Padua,  next  to  which  ranked  Paris  and  Montpellier,  then  Basel. 

The  constitution  of  the  universities  of  Upper  Italy — and  in  this  respect 
the  other  universities  of  Italy  did  not  differ  materially  therefrom — was 
from  the  outset  quite  democratic,  inasmuch  as  the  students  formed  the  con- 
trolling body  of  the  community,  and  the  professors  were  dependent  upon 
them.  This  arrangement  was  in  strong  contrast  with  the  institutions  of 
to-day  in  our  own  and  foreign  lands,  which  are,  as  a  rule,  monarchical  in 
their  organization  and  dyed  in  nepotism. 

The  students  chose  the  rector1  and  officers  of  the  universities  and  even 

1.  In  the  Scotch  universities  the  rector  is  chosen  by  the  students  at  the  present  day. 
The  university  of  St.  Andrews  was  founded  in  1411,  Glasgow  1450,  Aberdeen 
1494  and  Edinburgh  1582.  Xo  complete  medical  faculty,  however,  existed  in  the 
university  of  Edinburgh  until  1(58.5.     (II.  i 


—  441   — 

the  teachers,  and  assisted  in  determining  the  curriculum  of  stud}' —  a  plan 
which,  in  man}'  cases  at  least,  would  be  judicious  to-day.  They  also  watched 
over  the  execution  of  the  curriculum.  Besides  this,  divided  in  the  differ- 
ent faculties,  generally  after  their  nationalities  or  so-called  "  Nations  'n  (the 
modern  •'  Corps"),  the)'  had  their  "  Rectors"  and  "  Vice-rectors  ",  chosen 
from  each  one  of  these  nations.  These  officials,  either  singly,  or  in  a  body 
as  a  kind  of  "  College  of  Rectors  ",  negotiated  with  the  officials  of  the 
state,  a  power  which  the}'  did  not  lose  until  the  close  of  the  16th  century. 
The  German  nation  e.  g.  was,  during  this  century,  especially  influential  at 
Padua,  and  therefore,  as  Fabricius  ab  Aquapendente  once,  while  exhibiting 
and  demonstrating  the  muscles  of  the  tongue,  indulged  in  some  would-be 
witty  remarks  concerning  the  way  in  which  Germans  spoke  Italian,  they 
almost  completely  broke  up  his  audience.  (These  "witty"  remarks  had  a 
thoroughly  "  learned  "  basis  ;  for  they  sprung  from  the  fact  that  the  pro- 
fessorial vanity  of  the  teacher  had  been  wounded  by  the  Germans,  who  one 
year  before  had  elected  another  person  for  their  instructor  instead  of  him.) 
Presidents  or  "  Rectors  "  of  any  nation  were  originally  required  to  be^  stu- 
dents, and  were  then  frequently  dukes  or  princes  by  birth.  The  nations 
possessed  their  own  means  and  property. 

The  students,  at  least  those  of  the  poorer  class,  often  as  "  Travelling 
Scholars"  acquired  in  German}"  the  preliminary  knowledge  necessary  for 
attendance  upon  a  university.  As  such  they  travelled  from  one  of  the 
Latin  schools,2  founded  at  that  period  in  numerous  places,  especially  through 
the  activity  and  influence  of  Melanchthon,  or,  what  amounts  to  the  same 
thing,  from  one  of  the  then  famous  teachers  at  one  of  those  schools,  to 
another  still  more  famous.  This  was  done  by  bands  of  students  united 
together,  and  during  their  travels  the  worst  barbarities  were  an  every  day 
occurrence.  These  travelling  scholars  supported  life  by  singing  before  the 
doors,  by  begging  or  stealing,  and  for  these  objects  the  bands  were  form- 
ally organized. 

The  "  travelling"  began  in  early  youth,  and  for  many  students  never  came  to  an 
end.  "The  younger  scholars,  called  Schiitzen.  like  the  apprentices  of  the  artisans, 
were  obliged  to  perform  the  most  menial  duties  for  their  elder  comrades,  the  Bacchan- 
ten.  They  were  compelled  to  beg  for  their  tyrants,  often  to  steal,  and  they  enjoyed 
in  return  such  protection  as  the  fists  of  their  stronger  comrades  could  afford.  To 
have  numerous  Schiitzen  was  for  the  Bacchanten  a  matter  of  honor  and  of  profit,  for 
they  brought  to  him  the  charitable  contributions  of  the  inhabitants.  But  when  the 
rude  Bacchant  pushed  on  to  the  university  or  the  high-school,  he  was  paid  off  for  all 
the  injustice  inflicted  upon    the    younger  scholars;    for    he  was    now    compelled    to 

1.  Some  of  these  "Nations"  had  special  seals,  and  examples  of  these  from  the  16th 

century  are  still  extant. 

2.  While   the   Latin    schools  were  founded    by  cities,  after  1540  there  arose,  at  the 

instance  of  princes  or  the  state,  "  Gymnasia  ".  which  were  under  state  supervision 
even  in  the  matter  of  their  curriculum.  The  learned  professions  were  also 
limited  to  certain  districts.  ( F.  Paulsen,  "  Geschichte  des  gelehrten  Unterrichts" 
etc.,  Veit  &  Co.,  Leipzig,  1885.) 


—  442  — 

promise  under  oath  to  lay  aside  his  scholar's  clothing;  and  his  rude  manners,  he  was 
received  with  humiliating  ceremonies  into  the  noble  fraternity  of  students,  and  was 
even  obliged,  like  a  slave,  to  endure  wild  jokes  and  insults".  (Freitag  1.  c.)  The 
"Pennal''  (  Anglice  "  Freshman")  was  forced  to  submit  to  the  most  horrible 
indignities.  "Disgusting  drinks,  composed  of  phlegm,  ink,  vile,  stinking  butter  and 
candle-snuffs,  were  given  him  to  drink,  and  he  was  initiated  by  cuffs  and  kicks  into  the 
honorable  position  of  an  academic  citizen"  (A.  Griin).  Some  grounds  exist  for 
referring  this  "travelling",  and  still  more  the  begging,  of  the  students,  to  an  Oriental 
model.  [The  "fagging"  of  English  public  schools  and  the  "hazing"  or  "training" 
of  our  American  colleges  are,  of  course,  variations  of  this  same  system.  Its  antiquity, 
however,  may  be  traced  back  even  to  the  philosophical  schools  of  Athens.      (H.)] 

On  their  marches  the  students  stole  money,  geese,  hens,  goats,  fruits, 
ifcc.  whatever  was  not  nailed  fast,  and  they  prepared  their  food  in  the 
nearest  lodging  or  even  in  the  open  fields.  Frequently  the  sky  was  their 
only  covering  b}T  night.  Yet  many  of  these  travelling  scholars,  after  hard 
fortune,  attained  respectable  positions,  as  e.  g.  Thomas  Platter,  father  of 
Felix  Platter.  Many,  however,  indeed  the  most  of  them,  fell  into  dissolute 
and  vicious  lives. 

Again  students  who  did  not  belong  to  the  so-called  travelling  scholars, 
especially  the  poor,  sang  hymns  before  the  doors  and  received  food  as  pay. 
or  alms  in  vessels  which  they  carried  with  them,  or  they  were  invited 
into  the  house  to  eat,  which  was  considered  an  honor.1  Others  boarded 
around,  or  earned  mone}T  as  choristers  in  the  churches.  The  latter,  how- 
ever, was  done,  for  the  most  part,  b}-  future  divines  alone. 

The  students  of  that  time  drank  wine  and  beer  still  more  than  they  do  now,  for, 
owing  to  the  cheapness  of  liquors,  bousing  was  the  order  of  the  day.  A  mug  or  litre 
of  the  famous  Einbecker  beer  cost  4  pfennige  (about  one  cent).  Other  famous  beers 
were  those  of  Torgau.  Beer  was  also  brewed  in  private  houses,  as  it  is  in  Bavaria 
to-day. 

Those  students  who  were  better  situated  pecuniarily  usualry  entered 
foreign,  and  most  frequently  Italian,  universities. 

In  these  universities  the  number  of  teachers  was  limited  from  the  early  part  of 
this  century.  Thus  in  Bologna  the  number  was  fixed  in  1579  at  166;  in  Rome  from 
1514  at  88,  including  15  teachers  of  medicine.  The  regular  duration  of  lectures  at 
an  early  period  was  two  hours;  subsequently  it  was  reduced  to  one  hour  and  a  half, 
and  then  to  only  three  quarters  of  an  hour,  as  at  present.  Excesses  of  various  kinds 
were  common  in  the  Italian  universities,  especial!}-  during  the  Carnival,  so  that  it 
was  forbidden  to  attend  lectures  in  masquerade  attire.  The  Jews  too  were  compelled 
to  pay  a  certain  sum  of  money  into  the  students'  carnival  treasury,  e.  g.  among  the 
students  of  law  in  1514,  104  lire;  among  the  "Artists",  70  lire.  The  number  of  the 
students  was  in  man}7  of  the  universities  quite  considerable.  Thus  in  the  small  uni- 
versity of  Wittenberg  it  was  in  1502.  208;  in  1513,  151:  in  1514.  213;  in  1515,  218; 
in  1519,  458;  in  1520,  578;  while  Vienna  could  count  at  the  same  period  no  less  than 
7.000.  Still  the  attendance  varied  very  greatly.  Thus  Erfurt  had,  in  1520,  310 
students;  in  1521,  120;  and  in  1522,  only  15  students,  while  Leipzig,  in  the  same  years, 

1.  Luther  was  the  recipient  of  such  an  honor.  The  reformer  too,  like  all  students 
of  that  day,  wore  a  sword,  and  on  one  occasion,  when  he  suffered  a  bad  fall 
wounded  himself  severely  with  it  in  the  thigh. 


—  443  — 

had  417,  340,  285  and  126.  Foundations  and  bequests  in  aid  of  poor  students  were 
frequent,  and  professors,  particularly,  distinguished  themselves  in  this  matter  much 
more  frequently  than  in  the  present  day,  when  medical  professors,  especially,  leave 
estates  of  millions  without  devoting  one  cent  to  science.  In  Bologna  fourteen  such 
foundations  were  established  between  1257  and  1650,  and  in  Padua  no  less  than  27. 

The  students  often  wandered  from  one  university  to  another,  just  as 
they  do  to-daj',  only  they  travelled  either  on  foot  or  horseback.  Even  the 
professors  in  the  16th  century  (an  age  characterized  generally  by  its  migratory 
disposition)  were  very  mercurial  people,1  and,  in  spite  of  their  want  of  any 
other  means  of  locomotion  than  were  afforded  by  their  own  feet,  a  horse  or 
a  purgatorial  cart,2  they  were  sometimes  here,  sometimes  yonder,  and  in 
one  j'ear  frequently  occupied  a  residence  widely  removed  from  that  of  the 
preceding  year.  Thus  e.  g.  Vesalius  taught  now  in  Padua,  now  in  Pisa, 
now  in  Louvain,  again  in  Basel,  sometimes  in  Augsburg,  again  in  Spain. 
So  Winther  von  Anderuach  taught  in  Louvain  and  again  in  Paris,  and  the 
Italian  Franc.  Antonio  Pigavetta,  in  Heidelberg.  "As  regards  medicine, 
many  pl^-sicians  were  eminent  cultivators  of  classical  or  medico-philo- 
logical studies,  for  the  sciences  were  not  yet  elaborated  so  much  in 
detail  and  in  so  exclusive  a  method  that  this  course  was  impracticable. 
The}'  could  still  support  a  universal  and  liberal  desire  for  knowledge.-' 
(Ranke.)  Everywhere  free  emigration3  was  the  rule  for  both  students  and 
teachers.     The  universities,  consequently,  frequently  changed  their  corps  of 


1.  Among  the  savants  this  depended  upon  their  desire  for  learning  and  passion  for 

science;  for  there  was  no  periodical  press  by  the  aid  of  which  they  could  quickly 
obtain  information  of  the  acquisitions  and  discoveries  of  remote  countries,  and 
letters  circulated  only  slowly. 

2.  The  use  of  wagons  was  looked  upon  as  effeminate  from  the  time  of  the  Middle 

Ages.  A  public  post  has,  indeed,  existed  in  Germany  since  1517,  but  at  the  period  to 
which  we  now  refer  it  was  very  imperfect.  Letters  were  taken  charge  of  by  private 
or  public  messengers  ("  geschworne  Boten  ").  The  public  post  was  an  imitation 
of  the  cursus  publici  which  existed  among  the  Romans  from  the  days  of  Augustus, 
who  was  the  first  to  emploj"  wagons  in  its  service.  Postage  bj"  messenger  was 
relatively  high.  Thus  between  Frankfort-on-the-Main  and  Mayence  in  1487  it 
was  four  heller,  or  one  twenty-fifth  the  value  of  a  wether,  and  four-sevenths  that 
of  a  hen.  A  quire  of  paper  cost  9  heller.  The  hire  of  the  wagon  with  three 
horses  for  42  days  with  which  Luther  travelled  to  Worms,  was  at  the  rate  of  4,30 
marks  per  diem  (about  $1,07),  a  sum  to  be  estimated  at  about  five  or  six  times 
that  amount  in  our  money  of  the  present  dajr. 

[A  system  of  postal  communication  was  begun  in  England  in  the  reign  of 
Edward  IV.,  1481,  when  riders  on  post-horses  went  stages  of  twenty  miles  each 
in  order  to  procure  for  the  king  the  earliest  information  relative  to  the  war  with 
Scotland.  .The  system  was  improved  and  extended  in  1543,  and  in  1643  the 
post-office  yielded  an  annual  income  of  £5,000.  Louis  XL  established  posts  in 
France  as  early  as  1470.     (H.)] 

3.  Freiziigigkeit,  i.  e.  liberty  to  come  and  go  whenever  or  wherever  they  pleased, 

without  requiring  any  special  permission  from  the  authorities.  In  the  total 
absence  of  any  restrictions  upon  voluntary  migration  in  this  country  we  have  no 
word  which  precisely  translates  the  German  term.     (H.) 


—  444  — 

professors.  This,  however,  accorded  with  the  fact  that  the  members  of  the 
Faculty  were  in  part  chosen  by  the  students  (especially  in  Italy)  for  only 
one  .year,  or  at  least  after  the  lapse  of  such  a  period  they  must  be  again 
confirmed,  an  arrangement  to  which  an  exception  was  made  in  the  case  of 
greatly  respected  and  beloved  teachers  only.  If  a  teacher  was  defeated  in 
such  an  election  at  one  university,  he  went  to  another.  The  professors 
gave  also  so-called  ••  Gastrollen",1  without  any  view  to  obtaining  positions, 
a  custom  also  common  at  an  earlier  period.  Thus  e.  g.  Peuerbach  and 
Regiomontanus  delivered  lectures  by  invitation  at  Padua.  Famous  teach- 
ers were  received  with  great  ceremony.  Professors  and  students  too  stood 
in  more  friendly  relations  than  at  the  present  day  (when  the  former  keep 
themselves  aloof  from  the  latter),  and  thus  the  attachment  of  the  students 
was  secured  throughout  their  life.  The  rates  of  salary  of  teachers  in  the 
universities  naturally  varied  very  much.2  Still  those  of  the  German 
schools  were  the  poorest.  Melanchthon  e.  g.,  one  of  the  most  important 
and  famous,  received  during  his  first  eight  years  a  salaiy  of  171  marks 
($43).  so  that,  during  this  period,  he  was  unable  to  buy  his  wife  a  new 
dress  ;  after  1526  he  received  242  marks  ($60);  ten  years  later,  520  marks 
($130),  and  from  1541,  680  marks  ($170),  a  sum  at  the  present  da}'  equiv- 
alent to  about  $750.  The  professors  at  Heidelberg  received  an  annual 
salary  of  only  85-105  florins  ;  those  at  Wiirtzburg,  210  marks  with  free 
board  in  the  Julius  Hospital  and  a  female  assistant  (!)  in  distilling,  while 
Vesalius  at  Pisa  received  4000  marks  ($1000).  To  this  salary  are,  of  course, 
to  be  added  the  fees  for  lectures  and  examinations.  But  with  German, 
and  especially  with  teachers  of  little  celebrity,  the  amount  of  the  latter 
also  was  quite  insignificant,  so  that  they  were  compelled  to  make  up  the 
deficiency  by  literary  work  (especially  translations),  although  this  business 
was  then  still  worse  paid  than  now.  Besides  this  the}'  were  forced  to 
resort  to  private  practice,  through  which  they,  from  necessity  (as  many  do 
to-day  without  similar  need),  withdrew  their  best  energy  from  their  profes- 
sorial office  and  calling  in  order  to  make  a  bare  living.  Many  professors, 
therefore,  pursued  other  reputable  occupations,  e.  g.  printing,  or  they  took 
—  frequently  —  students  to  board  etc.  A  few  also  were  ordinary  physi- 
cians of  the  various  princes.  Many  of  these  men  too  fairly  challenge  our 
admiration  by  their  heroic  struggle  with  the  most  adverse  fortune,  in  which 
only  the  love  of  science  strengthened  and  sustained  them.  They  satisfied 
their  thirst  for  science  and  their  efforts  after  truth  and  knowledge,  while  not 
infrequently  hunger  and  its  results  preyed  upon  their  bodies.     Still  it  is 

1.  These  were  extraordinary  lectures,  given  upon  invitation,  bjT  certain  eminent  pro- 

fessors, of  other  universities.  In  theatrical  parlance  these  eminent  professors 
occasionally  "starred  it".     (H.) 

2,  The  income  of  two  of  the  professorships  founded   at  Oxford  and   Cambridge  b}- 

Iiinacre  in  1524  was  £12  each.  The  income  of  the  third  professorship  was  only 
£6.  I  presume  this  gives  a  fair  idea  of  the  salary  of  English  professors  in  the 
lf.th  century.     (H.) 


—  445  — 

not  in  the  16th  century  alone  that  the  vast  majority  of  those  who  have 
promoted  the  sciences  and  arts  have  sprung  from  the  so-called  lower  class, 
and  often  enough  from  actual  proverty.  The  history  of  civilization  teaches 
that  the  advances  of  science,  knowledge  and  ability  have  proceded  not 
from  the  rich,  but  from  the  poor.  rich,  however,  in  spirit  and  energy. 

That  bitter  literary  struggles  and  disputes  between  the  professors  took 
place  also  in  the  16th  century  needs  no  special  mention,  for  this  has  been 
the  case  in  all  ages,  frequently  with  a  total  disregard  of  personal  reputa- 
tion, always  in  disregard  of  the  honor  of  science,  and  not  always  from  the 
purest  of  motives.  But  it  should,  however,  be  noticed  that  such  disputes 
and  quarrels  in  the  16th  century  were  the  occasion  of  the  founding  of  sev- 
eral universities.  "The  physicians  Simon  Pistorius  (died  1523)  and 
Martin  Pollich  (surnarned  lux  mundi,  died  1513),  who  lived  in  Leipzig, 
had  become  so  embittered  against  each  other  from  their  antagonistic  views 
relative  to  syphilis,  whether  it  was  epidemic,  endemic  or  contagious,  that 
they  could  not  bear  the  sight  of  each  other  and  resolved  to  seek  another 
home.  In  order  to  obtain  in  another  place  a  suitable  position  as  professor, 
Pistorius  influenced  the  elector  Johann  to  select  Frankfort-on-the-Oder 
as  the  site  of  a  new  university.  Pollich  was  equally  fortunate  with  the 
elector  Friedrich,  who  selected  Wittenberg  for  his  university  "  (Marx. 
"  Caspar  Hofmann,"  1873). 

The  curriculum  of  instruction,  even  in  the  16th  century,  in  the  main 
embraced  only  discussion  and  explanation  of  certain  works  of  the  Greeks 
and  Arabians.  Even  anatomy  at  the  beginning  of  the  century  was  studied 
almost  exclusively  in  Galen,  more  rarely  in  Mondini,  and  not  at  all  in  the 
works  of  the  recent  investigators.  Man}-  of  the  professors  were  originally 
"  Humanists",  i.  e.  classical  philologists,  and  then  turned  their  attention 
to  medicine.  Such  was  e.  g  the  '-'schoolmaster''  Fuchs.  Others  of  them 
had  been  mathematicians  etc.  Yet  in  the  course  of  the  century  instruction 
won  a  better,  or  if  you  will,  a  "  modern",  form.  ':  Botanical  gardens  "  e.  g. 
were  now  established  at  different  universities. 

In  anatomy  dissections  at  least  were  made  frequently,  though  for  the 
most  part  these  were  confined  to  animals,  as  e.  g.  even  in  Paris. 

In  the  department  of  anatomy,  however,  there  were  great  theoretical 
disputes  also  between  the  doctors.  Naturally  !  for  the  actual  section  of 
human  bodies  (in  which  the  thoracic  and  abdominal  cavities  alone  were 
opened,  while  the  cranial  cavity  was  left  untouched  in  obedience  to  pop- 
ular prejudice)  was  performed,  as  a  rule,  by  the  barbers,  while  the  learned 
professor  of  anatomy  merely  explained  the  exposed,  but  not  dissected 
parts.  The  first  operation  was  considered  unworthy  of  an  educated 
physician,  ungentlemanly,  and  even  disreputable,  and  was  accordingly 
abandoned  to  the  barbers.  For  the  performance  of  such  dissections  in  the 
universities  (they  were  still  prohibited  by  the  Church)  papal  indulgences 
were  necessary,  and  these,  of  course,  cost  money,  for  the  acquisition  of  this 
was  the  chief  stud}-  of  the  pope.     Tubingen  received  such  an  indulgence  as 


—  44(3  — 

earl}-  as  1482,  while  in  Strassburg,  in  spite  of  papal  prohibition,  permission 
to  dissect  an  executed  criminal  was  granted  by  the  magistrates  in  1517. 
Before  and  after  each  special  dissection  (which  was,  however,  a  relatively 
infrequent  occurrence)  religious  ceremonies  in  man}-  places  were  considered 
necessary.  In  order  that  those  who  came  into  contact  with  it  might  not 
become  "disreputable",  the  corpse  was  first  made  "reputable"',  the  professor 
beginning  the  proceedings  by  reading  a  decree  to  that  effect  from  the  lord 
of  the  land  or  the  magistracy  and  then,  by  order  of  the  Senate  or  the 
medical  faculty,  stamping  upon  its  breast  the  seal  of  the  university.  The 
body  was  then  carried  (upon  the  cover  of  the  box  in  which  it  had  been 
brought  in)  by  volunteers  for  this  service  into  the  anatomical  hall,  and  the 
cover,  upon  which  it  rested  during  these  ceremonies,  was  then  taken  back 
to  the  executioner,  who  had  meanwhile  remained  at  some  distance  with  his 
vehicle.  Where  the  corpse  had  been  beheaded,  the  head,  during  the  per- 
formance of  the  necessaiy  ceremonies,  lay  between  its  legs.  Afterwards 
entertainments,  graced  with  music  by  the  guilds  of  city  fifers.  trumpeters, 
trombone  players  etc.,  or  by  "itinerant  actors'",  were  given.  Gradually, 
however,  this  folly  waned,  and  in  the  second  half  of  the  century  public 
anatomical  theaters  were  established.  This  occurred  at  Paris  and  Mont- 
pellier  in  1551. 1  Such  a  theater  was  built  b}T  Fabricius  ab  Aquapendente 
in  Padua  (the  most  popular  and  famous  medical  institution  of  the  16th 
century)  at  his  own  expense  in  1549.  This,  however,  in  consequence  of 
the  excessive  height  of  the  tiers  of  seats,  was  so  dark  that  the  dissections, 
even  by  day,  could  be  made  only  by  torch-light.  Basel  had  an  anatomical 
theater  in  1588.  In  Bologna  the  professor  of  anatomy  only  was  permitted 
to  give  lectures  on  practical  anatomy  whenever  he  wished,  while  to  the 
other  professors  it  was  allowed  only  at  stated  times.  Until  the  16th 
century  all  the  professors  had  the  same  authority  as  the  professor  of 
anatomy.  In  spite  of  the  improvement  in  the  conditions  of  anatomical 
instruction,  it  was  still  considered  a  special  attraction  for  a  university, 
and  still  more  for  a  professor  or  a  physician,  to  possess  an  entire  skeleton. 
The  price  of  a  skeleton  in  that  day  was  very  high.  Thus  Heidelberg  in 
1569  paid  $72.00  for  a  single  skeleton. 

Clinical  instruction,  which,  as  we  have  already  seen,  had  existed 
among  the  Arabians  long  before,  was  imparted  nowhere  in  the  Christian 
West  (with  the  exception  probably  of  Salerno)  before  the  sixteenth  century. 
M  on  tan  us  was  the  first  person  to  hold  clinical  lectures  for  a  short  time. 
He  died  in  1552,  and  it  was  not  until  the  }'ear  1578  that,  at  the  instance  of 
the  German  students  —  the  students,  as  we  learn  above,  took  the  initiative 

1.  The  first  law  relative  to  the  study  of  practical  anatomy  in  England  was  passed 
under  Henry^  VIII.  in  1540,  and  authorized  the  "  Masters  of  the  Mystery  of 
Barbers  and  Surgeons"  to  take  each  year  four  bodies  of  executed  felons  "  for 
anatomies".  This  number  was  increased  to  G  under  Charles  II.,  "provided  they 
be  afterwards  buried".  Under  queen  Elizabeth  in  1565  a  similar  privilege  was 
granted  to  the  College  of  Physicians.     (H.) 


—  447  — 

—  the  experiment  was  continued  at  Padua,  where  "Albertino  Bottoni  (died 
1596  or  1598)  visited  the  sick  men  and  Marco  degli  Oddi,  the  sick  women, 
and  discussed  their  diseases.  (At  a  later  period  this  example  was  followed 
at  Pavia  and  Geneva. )  As  towards  the  end  of  October  of  that  year  the 
weather  became  colder,  female  bodies  were  also  opened,  and  the  professors 
pointed  out  the  diseased  parts."  This  confirmation  of  diagnosis  by  the 
sectio  cadaveris  or  pathological  anatomy  was  at  once  stopped,  however,  by 
an  official  prohibition,  "since  the  rival  of  the  above  mentioned  physicians" 

—  at  that  period  too  the  envious  rivalry  of  the  professors  (often  of  late 
years  so  disgustingly  renewed;  was  a  positive  injury  to  science  —  "Emilio 
Campolongo  had  carried  away  to  his  house  upon  the  same  day  the  uteri  of 
these  women,  over  which  action  the  surviving  old  wives  raised  a  great 
clamor".  Indeed  they  finally  succeeded  in  effecting  the  prohibition  of  such 
examinations,  because,  in  accordance  with  the  superstition  of  that  time, 
they  dreaded  lest,  after  the  resurrection,  the  absence  of  the  uterus,  not  safe 
against  theft  even  after  death,  might  deprive  them  of  fecundity  in  the 
world  of  eternit}'.  The  influence  of  the  Church  too  was  so  great  that  in 
Bavaria  the  professors  of  medicine  were  compelled  to  take  an  oath  to  obej', 
and  to  teach  in  accordance  with,  the  decrees  of  the  Council  of  Trent,  and 
the  same  was  the  case  in  other  countries.  Pathologico-anatomical  dissec- 
tions, however,  together  with  clinical  instruction,  speedily  came  to  an  end. 

The  scientific  and  other  demands  made  upon  the  fut.ure  German 
physicians  may  be  most  clearly  and  best  shown  from  the  statements  which 
follow.  These  may  serve  also  for  a  model  of  the  arrangements  existing  in 
the  Middle  Ages,  from  which  they  do  not  differ  materially. 

Statutes  of  the  Medical  Faculty  at  Frankfort-on-the-Oder 
from  the  year  1588. 

The  Faculty  at  the  close  of  the  16th  century  showed  the  following  7  professors, 
viz:  Jacob  Bergmann  (received  1559,  died  1595),  Johann  Cnobloch  (1562,  d.  1599), 
Sebast.  Moller  (1588,  d.  1609),  Matthaus  Zeisius  (1591  to  1607),  George  Seiler  (1591, 
d.  1606),  Christ.  Stimmelius  (1595,  d.  1615),  Laurent.  Heilandus  (died  1621).  The 
first-named  was  dean  4  times,  the  third  11  times,  the  second  4  times,  the  fourth  once, 
the  fifth  8  times,  Stimmelius  8  times,  Heilandus  8  times. 

1.  "it  is  ordered  that  no  one  exercise  the  authority  or  office  of  a  physician  unless 
he  has  at  least  first  received  the  degree  of  "  Baccalaureus  "  in  this  academy".  (The 
Baccalaureate,  from  the  very  beginning  of  the  universities,  was  the  first  preparatory 
grade  for  the  dignity  of  the  doctor.  Originally  too  evidence  of  the  ordinary  knowl- 
edge required  for  this  first  grade  was  sufficient  for  reception  into  a  faculty,  even  if 
this  knowledge  had  not  been  acquired  strictly  in  the  institution  concerned.  At  a 
later  period  this  knowledge  was  required  to  be  obtained  in  the  universit3r  itself). 
"  If,  however,  he  has  received  such  a  degree  from  another  university,  he  shall  not  be 
admitted  to  the  course  on  practice  until  he  has  paid  the  fees.  These  fees  for  the 
reception  of  a  Baccalaureus  are  established  at  8  goldpieces  (ducats),  to  go  to  the 
treasury  and  to  the  doctors." 

"  2.  The  candidate  for  the  Baccalaureate  in  medicine  must  be  a  Magister  artium 
liberalium,  or  bring  evidence  of  having  been  well  instructed  in  philosophy  (The 
examination  for  the  degree  of  Magister  artium  corresponded  to  our  Maturitatsexamen, 
and  the  candidate  after  passing  was  also  called  "  Baccal.  Philosoph."     The  philo- 


—  448  — 

sophical  faculty  claimed  the  right  to  confer  this  degree  upon  the  students  of  all  facul- 
ties.), "and  he  must  have  heard  carefully  the  following  lectures  :  one  fen  (section)  of 
the  first  Canon  of  Avicenna,  the  Aphorisms  of  Hippocrates,  and  Galen's  Tegni  l. 
Besides,  he  must  have  followed  the  practice  of  a  doctor  for  six  months  or  more"  (this 
corresponded  to  our  clinical  instruction).  —  "If,  however,  the  Baccalaureus  in  his 
lessons"  (which  the  Baccalaureus,  as  an  assistant  to  the  professors,  was  compelled 
to  give  to  the  "Scholars")  "  laj-s  himself  open  to  the  charge  of  carelessness,  he  shall 
pay  6  gulden  in  gold  for  the  Baccalaureate  in  medicine,  as  an  indemnity  for  the 
trouble  occasioned  (by  his  carelessness)  to  the  doctors"  (the  Baccalaureus  was  in 
fact  a  preparatory  assistant)  "and  shall  preserve  his  grade  as  Baccalaureandus  for 
9  gulden  in  gold,  of  which  one  half  goes  to  the  treasury." 

Statutes  for  those  who  have  Graduated  as  Baccalaurei. 

3.  "  For  the  attainment  of  the  Doctorate  in  medicine,  he  who  has  attained  the 
degree  of  Baccalaureus  must  for  at  least  one  year  deliver  lectures  upon  the  following 
subjects:  one  book  of  the  treatises  of  the  first  Canon  of  Avicenna,  or  the  Aphorisms 
of  Hippocrates,  or  the  books  —  De  locis  affectis  —  of  Galen.  Besides  this  he  must 
attend  the  lectures  of  the  doctors,  delivered  for  the  attainment  of  the  Doctorate,  on 
the  subject  of  Galen's  first  book  De  accidenti,  De  morbo,  or-the  Tegni  and  the  9th 
book  of  Almansor."     (The  student  was  not  only  a  learner  but  a  teacher  likewise). 

4.  "  The  Baccalaureus  in  medicine,  during  his  vacation  and  upon  the  requisition 
of  the  Dean  of  the  Medical  Faculty,  shall  discuss  once  in  public  some  subject  taken 
from  his  lessons.  This  disputation  must  be  attended  by  the  Dean  on  penalty  of  a 
fine  of  3  gulden  in  gold." 

.">.  "  Xo  Baccalaureus,  Licentiate  or  Doctor  in  medicine  shall  enter  into  a  dispu- 
tation, unless  the  question  to  be  defended  is  laid  before  the  Dean  and  receives  his 
approval." 

6.  "The  Dean  of  the  Medical  Faculty,  after  having  made  a  requisition  upon  the 
doctors  specially  and  individually,  shall  twice  each  year  summon  the  graduates  and 
scholars  together,  in  spring  to  visit  the  meadows,  mountains  and  valleys,  in  order  to 
acquire  information  of  herbs  and  their  properties.  To  these  gatherings  the  apothe- 
cary or  apothecaries  shall  be  invited.  In  the  autumn  the  object  of  these  excursions 
shall  be  to  gain  a  knowledge  of  the  roots  of  importance  in  medicine.  The  scholars 
shall  provide  the  usual  banquet."  These  botanical  excursions,  which  existed  also 
among  the  Arabians  and  were,  indeed,  adopted  from  them,  terminated  with  substan- 
tial enjoyments. 

7.  "After  a  disputation  has  been  held  "  i  with  other  students  etc.)  "  for  the  Bacca- 
laureate or  the  Licentiate  of  the  Medical  Faculty,  the  candidate  may  demand  the 
opening  of  his  examination  whenever  he  wishes  to  do  so,  and  the  Dean  shall  be  bound 
then  to  summon  the  Doctors  of  Medicine,  in  order  that  his  petition  may  be  answered." 

Statutes  for  the  Candidate  for  the  Licentiate. 

8.  "  If  the  candidate  for  the  licentiate  of  medicine  aspires  to  a  higher  degree, 
but  has  been  careless  in  the  delivery  of  his  appointed  lectures  or  in  attendance  upon 
his  own  instruction,  he  shall  pay  18  gold  gulden  for  .distribution  among  the  Doctors, 
that  they  may  be  correspondingly  compensated  for  their  trouble  thus  occasioned.  He 
shall,  however,  finally  receive  his  degree  for  14  ducats,  of  which  one-half  belongs  to 
the  treasury." 

9.  "  In  the  Doktoratsaula  he  shall  again  give  15  gold  gulden  (120  marks  or  $30), 
of  which  one-half  shall  go  to  the  treasury,  the  remainder  shall  be  divided  among  the 
Doctors,  as  compensation  for  trouble  had  in  the  aula  and  for  the  disputations  etc." 

1.    Tegni  =  riywft  larpurj  =  the   "Ars  parva".     (H.) 


—  449  — 

Statutes  for  the  Reception  of  the  Doctors  into  the  Faculty. 

10.  "  The  newly  graduated  Doctor  shall  pay  6  ducats  for  his  reception  into  the 
Faculty.  If,  however,  one  has  graduated  from  another  university,  but  desires 
to  be  received  into  practice  here"  (at  that  time  the  universities  alone  granted  per- 
mission to  practice)  "  and  to  be  taken  into  the  Faculty,  he  shall  pay  as  much  as  the 
Doctor  of  Medicine,  who  graduated  here,  has  paid  for  his  Licentiate  and  Doctorate, 
that  is  38  golden  gulden."  (The  "  Licentiate  "  authorized  the  exercise  of  practice 
under  certain  conditions,  while  the  Doctorate  permitted  an  unconditional  practice.) 
Luther  paid  for  his  degree  of  Doctor  of  Theology  50  Rhenish  gulden,  about  85  marks 
($21).  In  Bologna  graduation  cost  160  marks  ($40),  and  this  was  considered  very 
dear. 

Oath  of  the  Medical  Faculty. 

11.  "IN....  swear  to  you,  the  Dean  of  the  Medical  Faculty,  and  to  both 
Professors,  as  well  as  to  the  other  Doctors  of  the  Faculty,  obedience  and  reverence 
in  everything  honorable  and  allowable;  that  I  will  keep  all  the  present  and  future 
statutes  of  this  alma,  and  wherever  I  go  I  will  keep  in  view  her  best  interests.  So 
may  God  and  his  Evangels  be  gracious  to  me." 

The  conditions  and  the  closing  ceremonial  of  graduation  we  have  already  given 
in  speaking  of  Salerno.  The  first  dissection  at  Frankfort-on-the-Oder  is  noticed  in 
1600.  The  subject  was  a  criminal  executed  by  hanging.  The  total  cost  of  the 
Doctorate  amounted  to  52  ducats  —  at  that  time  a  considerable  sum  of  money.  To 
this  must  be  added  the  expense  of  presentation-gloves,  of  a  special  mass  and  banquets, 
besides  presents  to  the  professors.  The  ceremonial  of  graduation  took  place  generally 
in  church.  As  early  as  1590  the  privilege  of  practising  was  granted  to  the  students  by 
resolution  of  the  Faculty.  The  degrees  of  all  universities,  even  those  of  foreign 
lands,  were  considered  equivalent  everywhere. 

The  number  of  graduated  physicians  (who  enjoyed  as  yet  absolute 
freedom  of  travel  through  all  lands,  while  the  professors  enjoyed  similar 
liberty  as  to  teaching)  was  in  general  inconsiderable.  Thus  in  Brem.en  the 
first  regularly  graduated  physician  settled  in  1510.  On  the  other  hand,  the 
number  of  persons  who  practised  medicine  was  tolerably  large.  Thus  in 
Basel  in  1557  there  were  not  less  than  17  empirics  and  regular  plrysicians. 
How  practice  was  obtained  there  may  be  judged  from  the  following  passages 
in  the  autobiograph}-  of  Felix  Platter  : 

"  Before  the  New  Year,  and  even  later  in  the  Spring,  I  did  not  have  much  to  do. 
Still  1  did  the  best  I  could  whenever  an  opportunity  offered,  at  meal  times  or  on  other 
occasions,  to  talk  about  diseases  and  how  to  treat  them,  so  that  often  when  at  home 
conversing  with  my  father-in-law,  who  sometimes  took  a  meal  with  us,  and  was  a  good 
and  very  experienced  surgeon  —  he  was  a  butcher — I  was  picked  up  and  taken  in 
hand  by  him.  I  needed  still  more  experience:  "  practice  is  different  with  us" — Platter 
had  studied  in  France.  As  a  young  man  I  listened  unwillingly  to  such  comments 
and  often  disputed  them,  yet  I  could  do  nothing  but  submit,  as  I  had  still  no 
practice.  However  practice  began  to  come  to  me  and  gradually  to  increase.  As 
there  were  IT  doctors  in  the  place,  I  was  forced  to  use  artifice  if  I  wished  to  support 

myself  by  my  practice,  and  God  also  imparted  to  me  his  rich  blessings 

I  began  to  receive  the  patronage  first  of  citizens,  then  of  the  nobles,  who  tested  me 
specially  bjr  sending  me  urine,  from  which  I  was  expected  to  make'a  prognosis.  In 
this  business  I  so  managed  that  several  were  filled  with  astonishment  and  began  to 
emplo}'  me  regularly.  From  day  to  day  I  gained  more  and  more  practice,  both 
amoni;  residents  in  the  city  and  also  among  strangers,  some  of  whom  came  to  me  and 
29 


—  450  — 

remained  for  a  long  time  in  order  to  use  my  remedies,  while  others  again  departed 
carrying  with  them  my  medicines  and  my  counsels.  Foreigners  also  summoned  me 
to  their  houses  and  castles,  to  which  I  hastened  and  remained  but  a  few  moments, 
hurrying  away  at  once  again  to  my  house,  so  as  to  he  able  to  attend  to  many  at  home 
as  well  as  abroad." 

As  regards  the  competition  which  the  regular  physicians  had  to  overcome  he 
remarks  as  follows:  '"The  Ammann,  called  the  Bauer  von  Ulzeudorf,  was  also  very 
famous  at  this  time,  and  many  people  patronized  him.  He  could  prognosticate  fr<  m 
the  water,  and  made  use  of  many  curious  arts,  by  which  he  had  acquired  great  v\ealth. 
After  him  the  Jew  of  Alsweiler  was  for  a  long  time  very  popular.  'I  h<  re  was  also  an 
old  woman  in  Gerbergasslein,  who  had  a  throng  of  patients,  as  did  the  two  execution- 
ers, the  brothers  Kase,  Wolf  and  George,  of  whom  the  elder  was  famous  it:  nudicine 
at  Schaffhnusen,  as  was  his  father  Wolf  also,  executioner  at  Tubingen." 

Felix  Platter  began  his  housekeeping  very  modestly  as  a  city  physician  The 
dowry  of  his  wife  consisted  of  71  marks  (SIS)  cash,  and  in  the  line  of  household 
furniture  —  an  old  pan  and  a  wooden  bowl  in  which  .food  was  carried  to  her  mother 
when  in  childbed,  together  with  a  few  other  poor  at  tides.  Their  residence  for  thtee 
years  consisted  of  a  single  room,  their  table  had  belonged  to  his  father,  and  Platter's 
•consulting  office  was  a  room  without  tire.  (Vid.  Freitag  1  c  )  All  this,  of  course,  was 
very  plain,  but  we  must  not  measure  it  by  the  rule  of  the  present  day.  At  a  time 
when  people  took  off  their  shirts  at  night  in  order  to  save  them,  and  in  c:tiz<  n  chiles 
went  to  bed  stark  naked,  simplicity  was  as  natural,  as  in  our  age  of  external  show 
are  silken    furniture   and   oil-paintings   in    the   consultation  rooms  of  dentists. 

At  Frankfort-on-the-Main  there  was  only  one  Christian  physician  ;  all  the  others 
were  Jews.  Giessen  had  no  physicians  of  the  higher  class  at  all,  and  in  case  of  need 
was  compelled  to  summon  them  from  Frankfort. 

The  physicians  of  the  16th  century  were  often  quite  as  roving  as  the 
students  and  professors.  As  ordinary  physicians  of  the  then  numerous  tem- 
poral and  spiritual  potentates,  or  as  city -physicians,  they  were  frequently 
bound  to  a  fixed  residence  b}-  a  contract  for  a  shorter  or  longer  period,  at 
the  expiration  of  which  the}T  exchanged  for  another  residence,  when  they 
made  a  new  contract.  In  1519  the  cit}-  physician  of  Heilbronn  received  a 
salaiw-  of  85  marks  ($21)  and  his  wood  —  the  same  as  a  councilman.  He 
was  required  to  practise  in  accordance  with  the  regular  tariff,  could  not 
leave  the  city  over  night  without  the  permission  of  the  burgomaster,  and 
twice  a  year,  after  the  Frankfort  fair,  he  was  expected  to  inspect  the 
apothecary's  shop.  He  was  forbidden  to  dispense  drugs,  but.  on  the  other 
hand,  was  protected  from  competition  for  ten  years,  since  no  other  physician 
could  settle  in  the  city  as  long  as  his  contract  lasted  (Betz).  As  a  kind  of 
itinerant  phj-sicians  too,  like  Paracelsus  e.  g.  and  others,  they  practised 
and  held  consultations  in  writing  at  a  distance  in  cases  of  disease  which 
were  described  to  them.  This  was  done  by  Vesalius  e.  g.  as  well  as  Para- 
celsus. But  the  former  went  to  work  very  cautiously  in  a  certain  case  and 
was  ver}"  reserved,  because  he  had  not  seen  the  patient  —  a  cripple  in  one 
foot  — while  Paracelsus  ridiculed  with  the  utmost  boldness  the  former 
physicians  of  his  patients.  The  physicians  in-ordinary  (in  Spain  they  were 
required  to  kneel  down  when  they  felt  the  kings  pulse)  were  not  infre- 
quently also   alchemists    and  astrologers   to  their  lords — e.g.  the    great 


—  451  — 

astronomer  and  physician  Johann  Kepler  —  and  most  of  them  occupied 
a  miserable  position.  In  this  double  office  the}-  frequently  received  consid- 
erable salaries,  as  e.  g.  Tburneysser,  who  enjoyed  an  annual  salary  of  3756 
marks  ($939)  from  the  margrave  of  Brandenburg.  Others,  like  Dr.  Stolle, 
physician  of  the  bishop  of  YViirzburg,  were  compelled  to  be  satisfied  with  a 
salary  of  140  marks  ($35),  a  court  dress  (uniform),  and  a  few  other  per- 
quisites. A  Brandenburg  court-physician  received  annually  171-220  marks 
($43-55).  and  had  his  office,  servants  and  use  of  horses  free.—  City  physi- 
cians of  Frankfort-on-the-Main — there  were  three  of  them  —  received  a 
salary  of1  17-171  marks  ($4.25-$43).  Complete  medical  ordinances  now 
existed  in  many  places  in  Germany,  e.  g.  in  Wiirzburg,  Frankfort-on  the-Main 
Nuremberg  etc.  The  Nuremberg  ordinance  permitted  sworn  physicians  only 
to  practise.  "  Empirics,  like  peddlers  of  theriaca,  tooth-drawers,  alche- 
mists, distillers,  ruined  tradesmen,  Jews,  dealers  in  the  black  art.  as  well  as 
old  women  who  are  accustomed  to  attend  the  sick  and  to  boast  that  they 
possess  the  art  of  the  doctors,  and  all  such  persons,  are  forbidden  to  treat 
the  sick  or  to  administer  drugs  to  them,  either  publickly  or  secretly, 
without  the  permission  of  the  council,  under  penalty  of  banishment  if 
foreigners,  or  of  a  fine  of  20  marks  (if  5).  if  residents  of  the  city.  Those 
who  conceal  or  patronize  them  shall  suffer  an  equal  punishment."  The 
ordinance  was  likewise  directed  against  the  practice  of  uroscopy,  because 
nothing  certain  could  be  concluded  therefrom  —  an  example  of  insight 
quite  exceptional  in  those  days  (E.  Solger). 

The  usual  pay  of  physicians  was  not  generally  so  small  in  reality  as 
it  appears  when  we  take  the  present  value  of  mone}-  as  the  basis  for  com- 
parison. Such  a  basis  would  be  entirely  false,  for  an  equal  sum  at  that 
period  had  at  least  a  fivefold,  and  often  a  tenfold,  value.  In  fact  we  may 
call  the  remuneration  very  good  in  comparison  with  the  fees  of  the  present 
daj'.  The  Germans  in  the  16th  century  were  still  counted  among  the  most 
well-to-do  nations.  According  to  the  Wiirzburg  medical  tariff,  the  physi- 
cian in  chronic  cases,  when  he  visited  the  patient  once  a  day,  received  two 
gulden  per  week.  The  system  of  visiting  and  payment  was.  however, 
different  in  severe  cases  and  in  acute  diseases.  When  the  physician  was 
compelled  ''to  see  the  patients  almost  every  hour"  he  might  demand  1,71 
marks  (41  cents)  every  second  day,  but  he  might  also  accept  higher  pay 
if  offered  to  him  voluntarily.  The  treatment  of  the  poor  was  gratis  hi/ 
law,  a  regulation  which  until  a  short  time  ago  still  prevailed  everywhere 
among  us.  Similar  regulations  existed  at  Frankfort-on-the-Main.  Accord- 
ing to  the  medical  ordinance  of  1577,  uroscopy  cost  in  this  city  1  Batzcn, 

1.  The  salary  of  Benedict  Frutze.  ordinary  physician  of  Henry  VII.  <>f  England  in 
14S."i,  was  £40.  John  Yeyrery.  chief  surgeon  of  Henry  VIII.  in  l.vio,  received  the 
same  sum,  as  did  William  Goodoums,  Serjeant  burgeon  of  queen  Elizabeth  in 
l.r>8'.  Dr.  Venando  probably  a  Spaniard),  physician  to  Uatharire  of  Aragon, 
wife  of  Henry  VIIL,  in  1519  received,  however,  semiannually  a  salary  of  £  v.\  (is  sd. 
The  usual  salary  of  the  English  physician-iu-ordinary  during  the  Kith  century 
would  seem,  however,  to  have  been  £40. 


—  452  — 

about  12  pfennige  (3  cents;.  A  single  visit  to  a  laborer  was  1.65  marks 
(40  cents)  ;  a  night  visit  to  a  well-to-do  patient,  1.71  marks  (41  cents)  ;  to 
one  of  very  moderate  means,  half  this  sum.  In  chronic  diseases  the  fee 
per  week  was  1.71  marks  (41  cents)  ;  a  consultation  by  letter  cost  5 
marks  (SI. 20)  ;  simple  advice  by  letter,  75  pfennige,  to  1.50  marks  (18 
cents  to  36  cents)  ;  consultations,  for  each  physician  10  marks  ($2.40)  ; 
among  foreigners,  a  single  visit  1.50  marks  (36  cents)  ;  the  second  visit  58 
pfennige  (15  cents)  ;  the  oversight  of  quacks  was  very  severe.  (Strieker) 
In  Heilbronn  uroscopy  cost  about  10  pfennige  (2.5  cents)  ;  a  single  visit  to 
persons  worth  1700  marks  was  30  fennige  (Scents)  •  per  week  1.40  marks 
(34  cents)  ;  the  single  prescription,  20  pfennige  (5  cents).  (Betz.)  On 
the  other  hand,  in  Nuremberg  the  first  visit  cost  2.15  marks  (52  cents)  ; 
in  plague  cases,  2.85  marks.  At  Wimpfen,  even  prior  to  1404,  the  council. 
In  cases  of  dispute,  determined  the  "amount  of  the  honorarium  to  be  paid 
to  the  ph}-sicians. 

A  few  physicians,  particularly  "Specialists"  in  syphilis — at  that 
period  as  fruitful  afield  as  the  "  secret "  diseases  are  to-day  —  acquired 
considerable  wealth.  Thus  Fabricius  ab  Aquapendente  —  the  professors 
even  at  that  time  skimmed  Off  the  ci'eam  of  practice  —  in  spite  of  consid- 
erable expense  in  building  as  we  have  seen,  left  200,000  ducats,  Berenga- 
rius  of  Carpi,  besides  valuable  furniture,  had  5000  ducats,  which  he,  like 
Thierry  de  Her}',  whose  possessions  were  quoted  at  150.000  livres,  had 
acquired  chiefly  from  this  then  quite  new  specialty.  With  most  physi- 
cians —  most  German  physicians  at  least  —  the  results  of  practice  were 
like  those- of  Theophrastus,  who  left  nothing.  In  our  father-land,  ever  dis- 
tinguished for  its  poverty  and  its —  faith,1  science  and  practice  at  that  time 
too  were  in  a  very  bad  condition.  This  will  explain  e.  g.  the  fact  that,  after 
several  persons  had  died  suddenly,  one  after  another,  with  similar  symptoms, 
while  two  post  mortems  had  been  made  and  two  months  had  flown  in  con- 
sideration of  the  cases  by  several  physicians,  three  doctors  finally  found 
that  the  drugs  of  an  itinerant  Jewish  physician  had  killed  the  patients.2 

1.  How  far  this  faith  went  may  be  judged  from  the  story  related  by  Thomas  Platter 

that  Dr.  Epiphanius,  a  physician  of  the  duke  of  Bavaria,  was  compelled  to  fly 
from  Munich  because  he  had  eaten  meat  upon  a  fast-day  ;  otherwise  he  would 
have  been  beheaded,  as  were  his  companions  who  did  not  fly. 

2.  The  following  account  also  gives  us  a  pretty  picture  of  the  condition  of  medical 

matters  at  that  time.  Besides  all  sorts  of  so-called  physicians,  many  itinerant 
Jews  carried  on  business:  "The  shameless,  idiotic  Jews  also,  though  banished 
from  the  land,  had  nevertheless  no  hesitation  in  travelling  and  riding  about  in 
W'urzburg  and  the  adjacent  places,  their  urinalia  in  hand  or  carried  upon  the 
pommel  of  the  saddle,  professing  and  boasting,  whenever  anyone  was  sick  they 
would  from  a  simple  examination  of  the  water  diagnosticate  and  make  known 
the  disease  and  its  causes,  whatever  length  of  time  it  might  have  existed.  Thus 
they  cheated  the  poor  people,  and,  indeed,  sometimes  the  nobles  and  great  lords, 
out  of  large  sums  of  money  .  .  .  which  is  pitiable  and  disgraceful,  to  be 
overrun  and  mocked  at  by  such  heathens,  who  would  more  properly  be  persecuted 
by  the  Christians.    After  such  management,  and  after,  if  possible,  invoking  the- 


—  453  — 

The  penalty  for  these  murders  consisted  in  subjecting  the  Jew  to  a  new 
examination,  and  then,  when  he  had  passed  this- — -to  let  him  go  on  quietly 
again  with  his  murdering  !  Superstition,  astrology,  the  making  of  horo- 
scopes, miraculous  cures  and  quackery  never  bloomed  more  freely  than 
among  the  people,  and  in  the  century,  of  the  Reformation.  Uroscop}*  par- 
ticularly— "Brunnenschau"  as  it  was  then  called  (Luther  had  translated 
the  Hebrew  term  for  the  meatus  urinarius  in  women  b}'  "Brunnen") — 
and  urinary  prognostics  were  an  every  day  business,  so  that  in  pictures 
the  doctor  and  the  urinal  always  stood  beside  each  other.  These  urosco- 
pists  found  their  doggerel  immortality  in  the  right  royally  pitiful  rhyme  of 
the  "Theuerdank",1  though  these  same  things  are  done  frequently  enough 
also  to-da}'  in  both  open  and  secret  practice. 

"  Doktor!     I lir  habt  nun  seinen  Brunnen  geschaut : 
Sagt  mir  ob  ihr  eucb  getraut 
Ihm  zu  lielfen  von  der  Krankheit?" 

The  doctor  said  that,  according  to  the  indications  of  uroscopy,  the  disease 
might  be  a  fever,  and  that,  with  God's  help,  he  would  eure  the  patient.     But 

"  Nach  Inbalt  Avicenna  lehr, 

So  muss  man  ihm  schwach  Arznei  sehr 

Eingeben,  denn  die  starke  soil  nit: 

Ein  simpel  Complexion2  wohnt  ihm  mit!" 

Physicians-in-ordinary  were  appointed  especially  to  inspect  every 
morning  the  "water"  of  their  gracious  lord,  so  as  to  anticipate  with 
medicine,  while  there  was  yet  time,  an}-  danger  which  threatened  their 
most  gracious  master  and  might  be  discerned  in  the  urine.  From  this 
exquisite  humor  and  salty  fluid  were  made  not  only  the  diagnosis  of  the 
disease,  but  also  of  its  procatarctic5  causes — something  in  the  style  of  that 
doctor  of  the  present  day  who,  b}-  holding  up  before  his  eye  the  urine  glass, 

aid  of  the  magic  spells  of  both  males  and  females,  then  for  the  first  time  recourse 
was  had  to  the  doctor,  in  order  to  have  him  examine  the  water"  —  a  system, 
which,  with  some  variations  depending  upon  the  times,  is  frequently  followed 
to-day  ! 

1.  The  "Theuerdank"  is  an  allegorical  epic  poem  by  Melchior  Pfinzing,  provost  of 

the  Sebalduskirche  in  Nuremberg  and  private  secretary  of  the  emperor  Maximilian 
I.     It  was  published  in  1517.     (H.) 

2.  A  simple  temperament  or  natural  constitution.     There  were  four  complexions 

with  their  combinations.     (Baas.) 

Perhaps  we  may  venture  to  translate  these  verses  into  right  royal  and  pitiful 
English  doggerel  as  follows  : 

"  Doctor  !    His  water  you  now  have  surveyed  : 
Dare  you  promise  me  truly  that  be  shall  be  made 
Well,  sound  and  free  from  his  present  disease?" 
***** 

"  After  the  teachings  of  old  Avycen, 
Weak  drugs  alone  must  be  given  to  him. 
Strong  drugs,  I  ween,  will  not  answer  so  well, 
For  a  simple  complexion  within  him  doth  dwell  !  "        (H.) 

3.  That  is  exciting  causes.     (H.) 


—  454  — 

diagnosticated  a  fall  down  a  flight  of  twelve  steps.  Moreover  in  this  way 
was  determined  the  existence  or  non-existence  of  pregnane^'  —  "  a  deceit 
of  which  the  physicians  themselves  were  conscious",  which  fact  renders 
the  disgrace  only  the  more  indelible.  Such  an  examination  of  the  urine 
cost  about  12  pfennige  (3  cents),  in  Wiirzburg  in  1502,  10  pfennige.  Here 
and  there  a  urinary  glass  was — the  sign  of  a  physician. 

Many  a  one  may  have  thus  earned  for  himself  a  fur-trimmed  robe,  though  he 
understood  nothing  of  special  chemical  investigation,  upon  which  Paiacelsus  laid 
such  stnss.  On  this  point  savs  Basil  Valentine,  "  Hereon  now  the  doctor  in  the  long 
fur  knows  little  to  say.  ...  0  ye  poor,  miserable  people,  ye  inexperienced 
physicians  and  pretended  doctors,  who  write  great  long  prescriptions  on  a  long  paper 
and  lariie  scraps!",  and,  as  he  warms  up  still  more,  he  cries  in  the  pith}'  parlance  of 
the  times,  "Ah  thou  poor,  pitiable,  stinking  bag  of  worms,  thou  miserable  earth-worm, 
and  wretched  creature,  why  dost  thou  fumble  after  the  husk  and  neglect  the  kernel?" 

It  was  also  still  an  important  part  of  the  business  of  the  physician  to 
determine  from  the  stars  the  proper  time  for  bleeding  and  purgation.  If 
somewhat  qualified  in  literary  matters,  he  prepared  the  "  Aderlasszettel  ", 
that  is  the  "  Aderlass-  or  Lassman  " — a  human  figure  having  the  points 
suitable  for  bleeding  marked  thereon,  with  information  when,  and  under 
what  constellation,  each  should  be  chosen — for  the  almanac.  In  accord- 
ance with  this  chart  barbers  proceeded  to  bleed  without  the  advice  of  a 
physician,  and  the  sick  assumed  their  own  guidance.  It  was  towards  the 
close  of  the  10th  century  that  physicians  first  found  this  humbug  unwor- 
thy of  their  profession,  but  the  figure  and  the  business  of  the  barber  con- 
nected therewith  may  yet  be  seen  in  the  almanacs  of  the  beginning  of  our 
own  century.  The  physicians  were  also  famous  experts  in  astrology,  and 
therefore  in  predicting  the  weather,  fortune  and  misfortune  etc.,  and  as  the 
almanacs  were  filled  with  such  things  (as  they  are  even  at  the  present 
day),  they  formed  the  most  acceptable  calendar-makers.1  (In  China  phy- 
sicians are  still  the  court  astrologers.) 

1.  According  to  Briggs,  similar  almanacs  appeared  in  England  at  a  very  early  date. 
The  Savilian  Library  at  Oxford  contains  a  MS.  calendar  compiled  by  Petrus  de 
Dacia  about  the  year  not).  This  Petrus  is  credited  with  the  invention  of  the 
"Homo  signorum  "  or  "Anatomy",  a  figure  analogous,  1  presume,  to  the  German 
"Aderlassnian  ".  Roger  Bacon  (1292),  Walter  de  Elvendene  1327,  John  Somers 
(1380),  Nicolas  de  Lynne  (1386)  and  numerous  others,  are  also  said  to  have  issued 
almanacs  at  a  very  early  date.  The  earliest  almanac  known  to  have  been  printed 
in  England  was  the  "  Sheapherd's  Kalendar'',  translated  from  the  French  and 
printed  by  Richard  Pynson  in  14'JT.  About  the  same  time  appeared  an  almanac 
in  black  letter  from  the  press  of  Wynkynde  Worde.  Other  almanacs  by  Anthony 
Ask  ham  1  r»5  » ),  Simon  Henringius  and  Lodowyke  Boyard,  "  Doctors  in  Physike" 
(1551  ,  William  Kenningham,  "Phjsician"  (1558)  etc.  are  mentioned  by  the 
antiquarians.  Dr.  Thomas  Twyne  of  Canterbury  is  also  mentioned  as  a  famous 
editor  of  almanacs  in  the  16th  century.  A  more  notorious  astrologist  ami  almanac- 
maker,  however,  was  William  Lilly,  whose  "  Merlinus  Anglicus  Junior  "  appeared 
in  llUl  and  was  continued  after  his  death  in  1<>S1  by  his  pupil  Henry  Uoley.  In 
the  United  States  almanac  literature  developed  early  and  with  astonishing 
rapidity.     The   first  book   issued   from   the   Harvard   printing  press   was   "An 


—  455  — 

Such  almanacs  of  that  period  and  still  later,  taught,  among  other  val- 
uable information  :  "  When  Phlegmatici,  mucous  and  snotty  people,  Melan- 
cholici,  low-spirited  and  melancholic  people,  and  Colerici,  passionate,  lean 
people,"  should  be  bled. 

In  general,  however,  the  physicians  in  the  long  velvet-trimmed,  official 
doctors'-robe,  or  in  their  fur  pelisses,  enjoyed  great  respect,  although  at 
that  time,  as  at  all  times,  they  incurred  the  satire  that  they  professed  to 
be  able  to  cure  diseases,  but  in  fact  could  not  cure  them  ;  that  they  were 
ready  to  emplo}-  at  once  the  newest  therapeutic  fashions,  and  that  they 
thus  filled  the  churchyards.1  Regularly  educated  physicians  (called  at  an 
early  period  "Puchaerzte")  were  for  gentlemen  and  rich  merchants,  coun- 
sellors, burgesses  and  citizens,  rather  than  for  the  masses.  The  latter  still 
lived  in  oppression  and  want,  and  were  not  situated  much  higher  or  better 
than  bondmen,  of  whom  there  was  still  a  large  number.  The  common 
people,  indeed,  even  in  the  16th  century,  were  not  quite  advanced  enough  to 
go  to  a  physician,  like  the  mediaeval  Arabians  —  in  fact  they  are  not  equal 
to  this  everywhere  to-day  ! —  but  they  still  stuck  to  God  and  the  saints  in 
their  diseases,  or  resorted  to  vagabond  charlatans  and  quacks,  Jews,  old 
women,  hangmen,  etc.,  or  to  clergymen,  nurses,  barbers,  itinerant  drug- 
peddlers  and  similar  pseudo-physicians.  The}-  were  still  far  too  poor  to 
paj'  the  expensive  physicians,  a  fact  which  may  be  inferred  from  the  exist- 
ence of  books  such  as  "An  apothecary  for  the  common  man,  who  cannot 
call  the  physicians"  (1564).  So  diy  had  they  been  sucked,  and  into  such  sloth- 
fulness  had  they  been  precipitated,  by  the  church  and  the  feudal  lords  ! — 
although,  even  in  accordance  with  special  medical  ordinances,  the  physi- 
cians were  required,  e.  g.  at  Wiirzburg,  to  grant  credit  until  after  the  next 
harvest  to  those  of  very  moderate  means.  Besides,  the  common  people 
recoiled  from  the  gentlemanly  and  grave  manners  of  the  doctors,  as  they 
do  in  some  cases  to-daj\ 

[The  famous  Dr.  John  Kaye  (IfioO)  discourses  of  the  quacks  of  his  day,  and 
reproves  the  fondness  of  his  countrymen  for  foreign  novelties,  in  the  following  sesqui- 
pedalian sentence,  which  would  delight  the  heart  of  a  German  professor.  "  And  flie 
the  vnlearned  as  a  pestilence  in  a  commune  wealth.  As  simple  women,  carpenters, 
pewterers,  brasiers,  sopeballesellers,  pullers,  hostellers,  painters,  apotecaries  (other- 
wise than  for  their  drojiges)  auau liters  themselves  to  come  from  Pole,  Constantinople, 
Italie,  Almaine,  Spain,  Fraunce,  Greece  and  Turkie,  Inde,  Ejiipt  or  Jury;    from  ye 

Almanack  calculated  for  New  England,  by  Dr.  Pierce,  Mariner."  (1639)  and  this 
pioneer  was  followed  by  a  host  of  similar  productions.  Perhaps  the  most  famous 
of  these  was  the  "Poor  Richard"  of  Benjamin  Franklin,  which  appeared  at 
Philadelphia  in  1733  and  was  continued  until  17t>7.  (II.) 
1.  The  last  indictment  is  at  least  as  old  as  Martial  (A.  D.  80),  who  furnishes  the 
following  epigram  : 

"Nuper  erat  medicus.  nunc  est  vispillo  Diaulus  : 
Quod  vispillo  facit,  fecerat  et  medicus." 

"  Diaulus  was  a  doctor;  an  undertaker  now, 
His  title,  not  his  work,  is  changed,  all  must  a'low."        (H.) 


—  456  — 

seruice  of  Emperoures,  kings  and  quienes,  promising  helpe  of  al  diseases,  yea  vncur- 
able,  with  one  or  twoo  drinckes,  by  waters  sixe  monethes  in  continualle  ditstilliiige,  by 
Aurum  potabile  or  quintessence,  by  drynekes  of  great  and  bygh  prices,  as  though  thei 
were  made  of  the  sunne,  moone  or  sterres,  by  blessynges  &  Blowinges,  Hipocriiiealle 
prayenges  &  foolysh  smokynges  of  shirtes,  Smockes  and  kerchieffes,  wyth  suche 
others  theire  phantasies  &  mockeryes,  meaning  nothitige  els  but  to  abuse  your  light 
belieue,  and  scorne  .you  behind  your  backes  with  their  medicines  (so  filthie  that  1  am 
ashamed  to  name  theim)  for  your  single  wit  and  simple  belief  in  trusting  them  most 
whiche  you  know  not  at  al  and  vnderstand  least:  like  to  them  whiche  thinke  f:\rre 
foules  haue  faire  fethers,  althoughe  thei  be  neuer  so  euil  fauoured  &  foule :  as  tbougbe 
there  coulde  not  be  so  cunning  an  Englishman  as  a  foolish  running  stranger  (of  others 
I  speake  not),  or  so  perfect  helth  by  honest  learning  as  by  deceiptfull  ignorance. 
For  in  the  erroure  of  these  vnlearned  reasteth  the  losse  of  your  honest  estimation, 
diere  bloudde,  precious  spirites  and  swiete  lyfe,  the  thyng  of  most  estimation  and 
price  in  this  worlde,  next  vnto  the  immortal  soule."     (H.)] 

Though,  as  we  have  seen,  the  physicians,  who  were  regarded  simply  as 
such,  during  the  16th  century  were  not  ashamed  to  hold  their  daily  "Brun- 
nenschau",  yet,  on  the  other  hand,  the}'  scorned  all  surgical  or  obstetrical 
practice,  like  the  Arabians,  still  considering  it  unbecoming  their  dignity. 
Thus  it  resulted  that  in  many  places  the  despised  Jews,  who,  in  a  most 
Christian  way,  were  now  shut  out  of  the  universities  and  thus  excluded 
from  the  higher  walks  of  the  medical  profession,  to  which  they  in  the 
Middle  Ages  so  frequently  devoted  themselves — these  Jews,  I  say,  were 
considered  the  only  persons  mean  enough  to  practice  surgical  operations. 
This  was  the  case  in  Silesia  and  in  many  other  places. 

The  students  of  noble  birth,  who  at  this  time  crowded  into  their  places  in  the 
universities,  may  be  looked  upon  as  a  compensation  of  very  doubtful  value,  and  cer- 
tainly of  no  higher  value  than  that  of  the  Jews  whom  they  displaced.  They  were 
distinguished  for  their  rudeness,  their  ignorance,  and  still  more  for  their  unfounded 
pride.  Yet  seats  separate  from  those  of  the  commonalty  were  given  to  them  in  the 
colleges,  and,  in  order  to  satisfy  their  noble  bringing-up  and  habits,  a  fencing-  and 
dancing-master  for  the  university  were  employed.  Most  of  them,  however,  remained 
rude  and  dissolute,  and  they  were,  therefore,  unwelcome  students  in  all  the  universities. 
They  were  students  merely  because  robbery  was  out  of  fashion,  and  practised  duelling 
out  of  pure  fondness  for  fighting  and  as  a  compensation  for  mediaeval  feuds.  Fight- 
ing, especially  towards  the  close  of  the  10th  century  and  in  the  beginning  of  the  17th, 
became  the  fashionable  foil}'  of  the  better  classes,  and  even  Harvey  in  his  youth  fell 
into  the  bad  habit.  Even  at  the  present  day  too  it  is  not  entirelj'  overcome.  The 
fashion  originated  in  Italy  and  spread  thence  over  France  to  the  North. 

That  surgery  remained  in  the  hands  of  the  lower  class  of  practitioners 
was  due,  as  we  know,  to  the  mediaeval  injunctions  of  the  Church,  which  for 
a  long  time  after  (indeed  almost  into  the  present  century)  exercised  its 
influence  in  this  direction.  The  Holy  Father,  unfortunately,  had  not  in  the 
16th  century  yet  issued  his  "  indulgence  "  for  the  practice  of  this  art  in 
Germany  !     (Probably  no  money  had  been  offered  him.     After  the  Tetzel1 

1.  Johann  Tetzel  fdied  1519)  was  a  Dominican  monk  appointed  by  pope  Leo  X  to  sell 
indulgences  in  Germany.  It  was  against  his  practices,  directly,  that  the  famous 
theses  of  Luther,  nailed  to  the  church  door  in  Wittenberg,  were  aimed.        (H.) 


—  457  — 

affair,  however,  the  price-current  of  indulgences  fell  in  Germany,  so  that 
now  no  one  felt  disposed  to  offer  his  Holiness  anything).  Enough — the 
surgical  indulgence  was  given  by  the  Holy  Father  to  the  French  alone  in 
the  year  1579,  and  through  it  the  French  surgeons  gained  greatly  in  the 
eyes  of  their  countrymen. 

In  tlie  good-fortune  of  procuring  for  the  French  surgeons  this  indulgence  the 
famous  Faculty  <>f  Paris  had  the  chief  share.  In  1505  they  succeeded  in  taking  the 
barbers  into  their  bosom,  and  thus  vexing  the  souls  of  the  surgeons  of  the  College  de 
St.  Come.  They  instructed  them  in  t lie  French  tongue  in  anatomy,  and  gave  them 
the  honorary  title  of  "Tonsores  chirurgici '",  "barber-surgeons",  in  return  for  which 
they  were  required  to  promise  to  employ  no  internal  remedies,  and  always  (in  fact  the 
chief  point;  to  consult  with  a  Fellow  of  the  Faculty.  The  College,  on  the  other  hand, 
vexed  the  Faculty  sorely  again  by  managing  in  1515  to  have  its  tribute  to  the  Faculty 
remitted,  and  its  Fellows  by  a  resolution  of  the  University  —  distinct  from  that  of  the 
Medical  Faculty  —  named  "Scholars"  of  the  University. 

Once  more  too  the  Medical  Faculty  was  notably  excited,  when  under  Francis  I., 
by  the  mediation  of  Guillaume  Vavasseur  (1544),  the  College  was  authorized  to  grant 
academic  grades.  Surgeon,  Licentiate  and  even  the  "  Doctor  Chirurgia?  ".  In  1551, 
however,  the  exertions  of  the  Faculty  were  again  triumphantly  successful  in  subject- 
ing the  surgeons  to  their  control.  From  this  yoke  they  were  freed  by  the  above 
mentioned  indulgence,  and  by  the  renewal  under  Henry  III.  (horn  1551,  murdered  bjT 
the  Dominican  Jacques  Clement  in  1589),  Henry  IV.  (born  1553,  murdered  by 
Ravaillac  in  1610)  and  Louis  XIII.  (1601-164H)  of  their  privileges  granted  in  1515 
and  1545.  and  this  vexatious  and  wearisome  quarrel  of  the  doctors  was  thus  about 
ended      The  apple  of  discord,  the  barbers,  now  stepped  into  the  background. 

The  French  surgeons  accordingl}-  stood  in  fair  esteem,  though  they 
still  remained  often  devoid  of  literary  education,  acquired  most  of  their 
technical  knowledge  from  "  Masters"  and  were  compelled  to  work  up 
from  the  bottom.  It  was  not  until  towards  the  end  of  the  16th  century 
that  they  began  generally  to  receive  education  in  the  College  and  the 
Hotel  Dieu.  A  few,  especially  the  powerful  surgeons-in-ordinary,  were 
possessed  of  large  influence.  Of  these  ordinary  surgeons  the  king  had 
twelve.  Their  pay,  however,  amounted  annually  to  only  100  francs,  except 
that  of  the  "  First  Royal  Surgeon,"  who  also  treated  the  venereal  diseases 
•of  their  majesties. 

In  the  numerous  foreign  and  domestic  wars  carried  on  at  this  period  by 
and  within  France,  the  surgeons  had  rich  opportunities  to  enroll  themselves 
as  field  surgeons.  This  enrollment  was  always  made  for  a  single  campaign 
only,  and  03-  the  commander  of  the  enlisted  troops.  On  the  completion  of 
the  campaign  the}7  became  again  private  surgeons.  In  Italy  the  cultiva- 
tion of  surgery  lay  chiefly  in  the  hands  of  the  great  anatomists.  It  was 
also  taught  in  the  universities,  that  is  lectures  were  delivered  upon  the 
subject  of  surgery  by  the  professors  of  anatomy.  The  same  thing  was 
done  in  Vienna  after  1555,  in  imitation  of  the  Italian  example.  The  first 
professor  who  lectured  on  surgery  in  the  latter  city  was  Franz  Emrich, 
who,  like  a  jolly  Viennese,  founded  a  pleasant  banquet  to  his  own 
memory. 


—  45S  — 

[In  the  English  army  the  inferior  surgeons  were  often  impressed  into  the  service, 
and  their  pay  in  1514  was  (id.  to  Sd.  a  day,  the  same  as  an  archer.  According  to  the 
law  of  arms  they  were  "  unharnessed  "  in  the  field.  The  character  of  the  surgical 
talent  obtained  by  the  munificent  pay  mentioned  above  ma}-  be  learned  from  the 
account  of  the  famous  surgeon  Thomas  Gale,  who  writes:  "  1  remember  when  I  was 
in  the  wars  at  Montreuil  (1544),  in  the  time  of  that  most  famous  Prince,  Henry  VIII. , 
there  was  a  great  rabblement  there  that  took  upon  them  to  be  surgeons.  Some  were 
sow-gelders  and  some  horse-gelders,  with  tinkers  and  cobblers.  This  noble  sect  did 
such  great  cures  that  they  got  themselves  a  perpetual  name  ;  for  like  as  Thessalus' 
sect  were  called  Thessalions,  so  was  this  noble  rabblement  for  their  notorious  cures 
called  dog-leaches;  for  in  two  dressings  they  did  commonly  make  their  cures  whole 
and  sound  for  ever,  so  that.  th*'y  neither  felt  heat  nor  cold,  nor  no  manner  of  pain 
after.  But  when  the  Duke  of  Norfolk,  who  was  then  general,  understood  how  the 
people  did  die,  and  that  of  small  wounds,  he  sent  for  me  and  certain  other  surgeons, 
commanding  us  to  make  search  how  these  men  came  to  their  death,  whether  it  were 
by  the  grievousness  of  their  wounds,  or  by  the  lack  of  knowledge  of  the  surgeons; 
and  we.  according  to  our  commandment,  made  search  through  all  the  camp  and 
found  many  of  the  same  good  fellows  which  took  upon  them  the  names  of  surgeons, 
not  only  the  names,  but  the  wages  also.  We  asking  of  them  whether  they  were 
surgeons  or  no,  they  said  they  were",  we  demanded  with  whom  they  were  brought  up, 
and  they  with  shameless  faces  would  answer  either  with  one  cunning  man  or  another 
which  was  dead.  Then  we  demanded  of  them  what  chirurgery  stuff  they  had  to  cure 
men  withal:  and  they  would  show  us  a  pot  or  a  box  which  they  had  in  a  budget, 
wherein  was  such  trumpery  as  they  did  use  to  grea.^e  horses'  heels  withal  and  laid 
upon  scabbed  horses'  backs  with  verval  and  such  like.  And  others  that  were  cobblers 
and  tinkers,  the}"  used  shoemakers'  wax  with  the  rust  of  old  pans,  and  made  there- 
withal a  noble  salve,  as  they  did  term  it.  But  in  the  end  this  worthy  rabblement  was 
committed  to  the  Marshalsea  and  threatened  by  the  Duke's  Grace  to  be  hanged  for 
their  worthy  deeds  except  the}'  would  declare  the  truth,  what  they  were  and  of  what 
occupation,  and  in  the  end  they  did  confess  as  I  have  declared  to  you  before." 

In  the  latter  half  of  the  16th  century  native  English  surgeons  seem  to  have  been 
scarce,  for  the  same  Gale  says:  "I  have  myself  in  the  time  of  king  Henry  VIII. 
holpe  to  furnish  out  of  London,  in  one  year,  which  served  by  sea  and  land,  three-score 
and  twelve  surgeons,  which  were  good  workmen  and  well  able  to  serve,  and  all 
Englishmen.  At  this  present  day"  (when  he  wrote,  say  1586)  "there  are  not  34  of 
all  the  whole  company,  of  Englishmen,  and  yet  the  most  of  them  be  in  noblemen's 
service,  so  that,  if  we  should  have  need,  I  do  not  know  where  to  find  12  sufficient  men. 
What  do  I  say?  sufficient  men?  nay,  I  would  there  were  10  among  all  the  company 
worthy  to  be  called  surgeons."     H.] 

That  there  were  famous  surgeons  too  in  Spain,  which  at  this  period 
was  still  progressive  in  its  tendencies,  and  that  patients  at  this  time,  in 
spite  of  remote  residence  and  poor  means  of  communication,  went  to 
visit  the  il  famous"  surgeons,  is  proven  by  the  example  of  Arcaeus.  How- 
ever, at  that  period  such  conduct  is  easily  explained,  for  the  celebrities 
were  not  then  so  numerous  as  to-day,  when  every  universit}-  or  larger  city 
has  several  coryphaei  for  life. 

The  Germans  in  the  16th  century  had  still  but  few  proper  Wund- 
iirzte  —  also  called  Schneidiirzte  —  i.  e.  surgeons  educated  in  schools  or  by 
able  masters,  improved  by  travel,  especially  in  foreign  lands,  and  thor- 
oughly versed  in  the  science  and  surgical  technics  of  their  time.    The  few  to 


—  459  — 

be  found  were  either  educated  in  Italy  or  France,  or  were  self-taught,  as 
the  result  of  an  extraordinary  genius  for  their  calling.  For  in  surgery  the 
latter  has  ever  been  of  much  greater  weight  than  in  medicine,  which 
demands  rather  a  systematic  mass  of  scientific  information  and  formulae. 
Most  of  these  surgeons  remained  settled  in  large  cities,  e.  g.  in  Strassburg  and 
Basel  (two  cities  which  formed  a  kind  of  surgical  center),  and  in  Worms,. 
Frankfort,  Dresden  etc.  Even  when  they  changed  their  residence,  it  was 
done  rarely,  and  with  the  view  of  a  better  and  more  suitable  sphere  of 
labor,  not  from  love  of,  and  the  necessity  for,  a  change. 

They  devoted  themselves  chiefly  to  the  greater  operations,  but  also 
attended  to  ordinary  surgery,  though  their  department  was  strictly  divided 
from  that  of  the  physicians.  City-,  body-  and  court-surgeons,  as  well  as 
higher  military  (wound-)  surgeons,  sprung  often  from  this  class. 

In  general,  however,  surgery  in  German}'  still  lay  almost  entirely,  or 
at  least  chiefly,  in  the  inferior  hands  of  the  itinerant  herniotomists,  tooth- 
drawers,  couchers  for  cataract  and  bai'bers,  whom  the  obscene  Theophrastus 
von  Hohenheim  calls  "  Arschkratzer."  They  carried  their  dressings  for  wounds 
in  brass  boxes,  which  the  author  has  himself  seen.  The  bath-keepers 
gradually  died  out.  These  itinerant  surgeons,  mostly  ignorant  and  rude 
journeymen,  practised  constantly  in  the  country  and  at  the  annual  fairs, 
perpetrated  the  same  evils,  and  exercised  the  same  deceit,  as  they  did  in 
the  heart  of  the  Middle  Ages.  Many  of  the  better  surgeons  too,  either 
voluntarily  or  perforce,  trod  in  the  same  steps,  and  were  distinguished  from 
their  questionable  colleagues  simply  by  a  more  decent,  and  better,  practice. 
Thus  from  these  despised  circles  proceeded  frequently  a  good  surgeon, 
just  as  many  a  great  actor  has  descended  from  a  travelling  theater.  The 
better  class  of  inferior  surgeons  remained  stationary  and  formed  the  so-called 
"  Meisterarzte."  Persons  of  this  class  filled  the  positions  of  city-  and  body- 
barbers,  and  had  journe3*men  and  pupils.  The  "  Pest-barbers"  were  also  a 
class  of  physicians  still  existing  in  almost  all  cities.  "  Pest  examiners" 
from  this  class  were  also  to  be  found.  These  were  stationed  at  the  gates 
of  the  city  to  examine  strangers  and  learn  whence  they  came.  If  the  latter 
could  not  prove  that  the}'  had  not  been  in  any  plague  neighborhood  for  the 
last  forty  days  they  were  sent  away.  The  itinerant  fellows,  of  whom  we 
shall  speak  hereafter,  were  called  "Marktarzte"'.  The  dividing  line  between 
the  superior  barbers,  the  Wundarzte  proper  and  the  itinerant  lower  surgeons, 
was,  however,  in  Germany  always  uncertain,  so  that  the  different  titles  were 
employed  promiscuously.  The  guild-surgeons  in  Germany  were  not  allowed 
to  practise  unless  they  had  made  their  "  Meisterstuck",  and  the  same  was 
the  case  in  France  and  Italy.  The  guild  examination  consisted  mainly  in 
answering  questions  upon  all  the  traditions  of  the  art.  ''Such  questions 
and  Meisterstiicke  are  found  written  or  printed  in  many  places,  and  many 
persons  learn  them  by  heart,  just  as  the  nuns  do  the  Psalter.  In  this 
way  they  stand  their  examination  very  well  and  are  reeeived  as  "  Meister", 
-.although  they  have  neither  seen  nor  practised  any  surgery"  (Wiirtz). 


—  460  — 

The  pay  of  the  Wund'arzte  was  generally  good,  for  the  surgeons  always 
demanded  more  respectable  pay,  and  guarded  the  honor  of  their  profession 
more  carefully  in  this  respect,  than  did  the  physicians.  A  Brandenburg 
bod}"- surgeon  e.  g.  received  free  board,  a  glass  of  wine  daily,  two  court 
suits  annually,  and  every  five  3-ears  a  festive  dress,  together  with  a  salary 
of  103' marks  ($26).  Besides  this  he  had  at  his  disposal  "  Knechte  " — 
the  sui'geon's  assistants  were  so  called  at  this  time  —  who  were  also 
boarded  free  of  expense  and  even  received  14  marks  (S3. 50)  annually  as 
wages.  Each  "Heften  "  (as  we  should  say  to-day  each  needle)  was  charged 
separately,  in  accordance  with  the  maxim  "  viel  Hiifft  (Niihte),  viel  Geld", 
though  this  kind  of  computation  was  criticised  occasionally,  since  it  gave 
occasion  for  the  insertion  of  a  larger  number  of  stitches  than  was  neces- 
sary. The  care  of  a  broken  bone  in  some  places  was  paid  by  a  fee  of  42 
marks  ($10.50).  In  Nuremberg  from  a  remote  period,  in  cases  of  exorbi- 
tant charge,  the  "  sworn  "  surgeons  formed  the  court  of  last  resort.  In 
this  city  the  barbers,  bath-keepers  and  surgeons  were  annually  sworn  to 
assist  everyone  who  requested  their  aid,  by  da}'  or  night,  with  surgical 
dressings,  bleeding  and  everything  which  pertained  to  their  art,  and.  in 
cases  of  dangerous  wounds,  to  call  in  a  sworn  physician  and  sworn  repre- 
sentatives of  their  own  occupation.  Internal  medication,  especially  the 
administration  of  strong  purgatives  and  clysters  or  other  evacuative  drinks, 
was  forbidden  to  them  under  the  penalty  of  21  marks,  45  pfennige  ($5.15), 
for  each  offence.  They  might  also  receive  from  the  council  corporal  pun- 
ishment. Only  in  venereal  troubles,  wounds  and  other  infirmities,  for  the 
healing  of  injuries,  wounds,  stabs  and  for  the  discussion  of  abscesses  and 
buboes,  were  they  permitted  to  prescribe  vulnerary  and  lenitive  potions. 
In  dangerous  and  malignant  troubles,  however,  especially  in  women,  they 
were  permitted  to  prescribe  only  upon  the  advice  of  a  doctor.  They  were 
protected  against  itinerant  herniotomists  etc.  and  other  vagabond  quacks, 
who  kept  petroleum  and  other  salves  and  oils  for  sale.     (E.  Solger.) 

Surgery  in  German}7  naturally  passed  for  a  ''disreputable"  handicraft, 
In  even  the  eyes  of  the  law,  until  Charles  V.  in  1548  declared  it  "  honora- 
ble"', an  edict  so  little  heeded,  however,  that  Rudolph  II.  (1552-1 G12) 
was  compelled  in  1577  to  renew  it. 

"  He  who  dealt  with  felons,  e.  g.  the  barber  who  shaved  the  offender 
or  prepared  him  for  his  last  journey,  was  regarded  as  disreputable.  So  too 
the  barber  or  surgeon  who  dressed  the  wounds  of  him  who  had  been  tor- 
tured on  the  rack,  or  who  aided  him  in  any  other  way,  was  regarded  as 
"disreputable".     (F.  W.  Hahl,  "  das  deutsche  Handwork  ",  1874.) 

Doubtless  also  the  surgeons,  or  those  who  professed  to  be,  and  who 
passed  for  such,  may  have  fallen  into  the  drunkenness  of  the  age  and  into 
still  worse  vices,  for  in  all  the  surgical  text-books  of  the  period  stress  is 
laid  upon  regularity  of  life  as  a  chief  requisite.  Yet  probably  matters 
were  so  very  bad  in  special  cases  only,  and  the  evil  was  made  so  prominent 
because  it  affected  with  special  unpleasantness  the  better  class  of  surgeons, 


—  461  — 

who  advocated  with  their  whole  influence  a  better  position  for  their  profes- 
sion, and  expected  and  desired  this  from  the  rabble,  who  speculated  at  most 
in  external,  never  in  internal  honor,  and  over  whom  the}'  towered  so  high. 
In  consequence  of  the  numerous  and  great  abuses,  it  was  established  by  an 
imperial  decree  in  1580  that  ';  no  barber  or  surgeon  should  practise  surgery 
unless  his  dexterity  had  been  previously  well  examined  into  by  Medici 
and  experienced  surgeons,  and  the  fact  established  by  witnesses."  (Fro- 
lich.)  This,  however,  like  most  imperial  decrees,  remained  a  dead  letter. 
The  situation  of  operative  opthalmology  and  obstetrics,  however,  if  the 
accounts  handed  down  to  us  are  only  half  proportioned  to  the  truth,  must 
have  been  veiled  in  the  deepest  shadows.  "  Peddlers  of  theriaca,  tooth- 
drawers,  vagabonds  or  other  loose  and  wanton  fellows  ",  in  booths  at  the 
annual  fairs  or  without  ceremony  in  the  squares,  without  the  slightest 
knowledge  of  the  diseases  and  the  anatomy  of  the  eye  and  with  inferior 
instruments  too.  operated  upon  every  one  who  would  permit,  or  who  asked 
for  it,  couching  cataracts —  at  30-60-120  pfennige  (7-15-30  cents) 
apiece  I1  After  the  operation  was  performed,  or  after  the  close  of  the  fair, 
when  nothing  more  could  be  made,  these  "  Couchers  "  (who  better  deserved 
the  name  of  eye-stickers  and  blind-masters),  without  troubling  themselves 
further  about  the  after-treatment  of  their  patients,  drew  off  "  like  a  sow 
from  the  trough  "  and  left  them  to  "  the  Pawer  or  Furpech,  to  the  shoe- 
maker's or  tailor's  apprentice."  Undoubtedly  it  was  not  a  matter  entirely 
devoid  of  danger  to  be  unsuccessful  in  one's  treatment  in  that  day  ;  for 
club  and  Lynch  law,  though  not  legalized,  were  regarded  as  permissible 
against  physicians.  Poor  women  in  difficult  labor,  whom  the  "Hebammen" 
(mid  wives'),  travelling  around  with  their  instruments,  had  not  }"et  assisted 
into  eternity,  were  even  worse  maltreated  b}-  the  surgeons.  Such  "  fellows  " 
terminated  matters  in  the  true  sense  of  the  word  by  dragging  the  dead 
children  piecemeal  from  the  womb  with  iron  and  hooks.  Male  obstetri- 
cians existed  at  this  period — at  least  in  Germany  —  only  for  this  and 
similar  work.  That  there  were  male  obstetricians  in  Ital}'  during  the  16th 
century,  who  belonged  to  the  class  of  regular  physicians  and  were  even 
professors,  may  be  concluded  from  the  following  remark  of  Ptealdo  Colom- 
bo :  '•  I  have,  with  my  own  hands,  drawn  not  only  dead,  but  also  living, 
children  out  of  the  uterus  of  their  mother,  not  once,  but  frequently,  and  as  I 
did  this  I  observed  carefully  the  position  of  the  womb."  A  few  only  of 
the  better  class  of  surgeons  were  acquainted  with  podalic  version,  and  these 
scarcelv  ever  employed  it,  so  that  it  was  not  without  reason  that  the  poor 

1.  This  was  by  no  means  a  small  sum.  In  England,  the  wealthiest  of  countries,  a 
pound  of  pork  at  that  time  cost  but  little  more  than  one  cent,  a  fat  calf  '24  cents,  a 
fat  ox  $6-$t!.75;  the  farm-hand  received  10  cents  pier  diem,  the  journeyman  12 
cents.  A  litre  of  wine  cost  in  Germany  "3-314  cents,  and  the  entertainment  of  the 
Bey  of  Tunis  with  his  suite  of  five  persons  in  1,548  cost  the  German  emperor  only 
$1.35  a  day.  The  annual  stipend  of  a  free  student  in  Canterbury  amounted  to 
$-'0  and  upon  this  he  was  able  to  live.  If  a  "coueher"  too  only  had  something 
to  do,  he  did  not  fare  badly. 


—  462  — 

female  to  be  operated  upon  obstetrically  (as  well  as  in  other  major  opera- 
tions) always  made  her  confession  to  the  priest  before  the  beginning  of  the 
massacre,  in  order,  in  accordance  with  the  faith  of  the  time,  to  save  at  least 
her  soul,  as  the  body  must  always  perish.  Indeed  even  more  deplorable 
fellows  than  the  inferior  surgeons  gave  their  attention  to  operative  mid- 
wifery. This  branch  had  always  been  partially  in  the  same  hands  as  the 
delivery  of  the  lower  animals,  (and  indeed  with  equal  impropriety)  is  at 
the  present  day  ;  for  in  1580  it  was  necessary  to  prohibit  shepherds  and 
herdsmen  from  delivering  women  !  The  physicians  proper  (horrible  as  this 
seems),  at  that  time  and  long  after,  held  the  practice  of  obstetrics  to  be 
unworthy  of  them,  but  prescribed,  on  the  contraiy,  cordials,  oxytocics  etc. 
for  parturient  women,  and  neglected  and  even  scorned  to  learn  merely  how 
to  extract  the  dead  child.  That  sort  of  obstetric  butcher  of  which  we  have 
already  made  mention,  and  to  whom  boldness,  at  least,  was  probabl}-  never 
wanting  —  a  swine-gelder  at  that  time  performed  the  first  Caesarean  section 
upon  his  own  wife! — was  also  called  in  to  help  in  the  extremest  cases  onl}-, 
when  the  art  of  all  the  midwives  of  the  neighborhood  was  at  an  end.  Such 
was  the  case  with  Nufer's  wife,  upon  whom  no  less  than  a  dozen  of  mid- 
wives,  one  after  another,  had  tried  their  skill.  Ordinarily  midwives  outy 
were  admitted  to  the  lying-in-room,1  a  custom  so  strong  1  y  maintained  that  in 
the  year  1521  a  Hamburg  physician  named  Veithes,  who  dressed  himself 
as  a  midwife  and  brought  to  a  happy  conclusion  a  labor  which  the  mid- 
wives  could  not  complete,  is  said  to  have  been  burned  in  punishment  of 
his  "  sorcery  ".  The  midwives  of  that  day  entered  upon  their  office  and 
vocation  without  any  other  knowledge  than  that  which  the}'  acquired  from 
ignorant  mistresses,  thoroughly  superstitious,  rude  and  purely  empirical 
in  their  treatment,  like  themselves.  They  "  worked  "  in  the  vagina  during 
parturition  in  a  way  to  make  one's  hair  stand  on  end,  oiling,  poulticing, 
fumigating  etc..  in  order  to  facilitate  labor;  they  gave  all  sorts  of  cordial 
and  oxytocic  remedies,  and  constantly  emplo}'ed  the  labor-stool.  Never- 
theless they  managed  to  eat  and  drink  a  fair  amount  during  the  intervals 
of  their  "  working  ".  During  the  lying-in  period  too  they  were  in  the 
habit  of  feeding  the  mother  (and  above  all  themselves)  with  viands  of  vari- 
rious  sorts,  and  administering  (to  themselves  also  and  particularly)  a  con- 
siderable quantity  of  drink.2  Their  "  Besteck  "  (case  of  instruments)  was 
carried   in  a  pocket  suspended  from  their  belt.     In  the  lying-in  room,  as 

1.  The  exclusion  of  strange  men  from  the  women,  that  is  the  ostracism  of  male  aid 

in  the.  diseases  and  special  conditions  of  married  women,  particularly  in  those 
conditions  which  relate  to  the  sexual  sphere,  is  found  among  almost  all  races  and 
people  not  enlightened  by  civilization.  It  is  an  evidence  of  the  natural  tendency 
of  feeling  and  action  on  the  subject  of  coition  or  generation,  and  is  by  no  means 
nn  evidence  of  high  moral  conceptions,  still  less  of  high  morality  or  even  modesty. 

2.  Genuine  prototypes  of  the  "  Mrs.  Sarah  Gamp"  of  Dickens,  whose,  antitypes  of  the 

present  day  are.  found  in  the  acquaintance  of  every  practising  physician.  Happily 
our  schools  for  nurses  are  gradually  replacing  these  old-fashioned  "  monthlies  " 
with  better  material.     (II.) 


—  4G3  — 

pictures  of  Diirer  and  in  the  work  of  Roesslin  show,  there  was  great  noise 
and  confusion,  the  result  of  all  sorts  of  female  fussiness  etc.,  and  the  air 
must  have  been  none  of  the  best.  The  wife  of  the  burgomaster  of  a  city  now 
and  then  established  a  kind  of  board  of  examiners  for  them.  The  mid- 
wives  too,  then  as  now,  discouraged  the  calling-in  of  physicians,  even  in  diffi- 
cult cases,  on  the  plea  that  they  knew  nothing  about  midwifery,  in  which 
statement,  at  that  time  at  least,  they  were  in  the  right.  In  the  ltith  cen- 
tun*,  however,  in  order  to  repress  the  evils  just  mentioned,  ordinances  for 
midwives  began  to  be  established,  and  of  these  the  first  was  drawn  up  by 
Lonicerus  for  Frankfort-on-the  Main  in  1573.  The  midwives  were  sworn 
officials.  The}'  were  permitted  (e.  g.  in  Nuremberg)  to  administer  harm- 
less remedies  to  lying-in  women  and  to  infants,  though  in  this  the}"  must  be 
cautious.  "  It  was  forbidden  to  the  old  women  who  dealt  in  roots  and  herbs 
to  sell  hellebore,  laurel,  (Daphne),  caper-spurge  (Treibwurz  ?),  savin  and  other 
purgative  and  oxytocic  etc.  articles,  under  penalty  of  corporal  punishment." 
(E.  Solger. )  It  would  seem  to  follow  from  this  that,  in  those  '-good  old 
times"  too,  artificial  abortion  was  not  very  rare.  In  France  at  this  time 
the  midwives,  at  least  a  few  of  them,  were  certainly  much  more  highly 
educated,  so  that  Bourgeois  e.  g.  was  even  eminent  as  an  authoress.  [In 
England  the  practice  of  midwifery  by  regular  physicians  is  said  to  have 
begun  about  the  time  of  the  founding  of  the  College  of  Physicians  in 
1518.  Perhaps  the  translation  of  Roesslin's  work  under  the  title  of  '•  The 
Byrthe  of  Mankynde,  set  forth  in  Englishe  b}*  Thomas  Raynalde,  Phisition  " 
which  appeared  in  1540,  may  be  taken  as  evidence  of  an  increased  inter- 
est in  this  branch  of  their  profession  by  the  physicians  of  England.  Dr. 
George  Owen  (died  1558),  physician-in  ordinary  to  Hemy  VIII..  Edward  VI 
and  queen  Mary,  and  president  of  the  College  of  Physicians  in  1553,  professed 
to  have  delivered  queen  Jane  Se}mour  of  prince  Edward  by  the  Caesarean 
section  in  1537,  but  the  statement  lacks  all  confirmation  and  probability. 
Nor  is  there  very  much  evidence  that  physicians  regularl}-  attended  ordin- 
ary cases  of  labor  before  the  beginning  of  the  17th  centuiy.  Still  Harvey 
is  known  to  have  practised  obstetrics  as  early  as  lb"03,  and  his  action  does 
not  seem  to  have  excited  surprise  as  anything  unusual.  His  treatise  "  On 
Parturition,"  which,  however,  was  not  published  until  1651,  shows  that  the 
author  was  quite  familiar  with  the  ordinary  management  and  course  of 
labor,  as  well  as  that  he  likewise  practised  gynaecology.  It  is  probable,  there- 
fore, that  the  custom  of  attending  ordinary  cases  of  midwifery  grew  up 
gradually  among  English  pln'sicians  during  the  16th  century,  and  had 
become  quite  common  by  the  beginning  of  the  17th.  No  public  teacher 
of  obstetrics  is  recorded  in  England,  however,  before  Dr.  John  Maubray, 
about  1723.     (H.)  ] 

A  special  class  of  state-physicians  did  not  exist  in  the  16th  century. 
The.  duties  of  such  officials,  which,  in  contrast  with  earlier  times,  at  the  end 
of  the  centuiy  were  increased  occasionally  b}*  that  of  making  judicial 
autopsies,   were    still    performed    by  the  body-physicians    and  city-physi- 


—  464  — 

cians,  or  by  the  city-  and  body-barbers,  who,  as  well  as  the  ordinary  physi- 
cians, were  sworn  for  each  case. 

The  regulations  prescribed  by  the  cities  in  times  of  pestilence  were  very  strict. 
Boards  of  health  were  frequently  convoked  and  strict  health  ordinances  issued,  even 
in  Rome  under  Sixtus  V.  in  1588,  while  Hadrian  VI.  regarded  all  preventive  measures 
as  impious.  *' It  was  forbidden  to  attend  foreign  markets  and  lairs.  Whosoever, 
however,  did  attend  fairs  must  undergo  quarantine,  the  guard  of  the  gates  was 
strengthened,  suspected  persons  were  not  admitted,  strangers  must  bring  evidence 
that  they  had  not  sojourned  in  places  afflicted  bjr  the  pestilence;  "  Blotterhauser  " 
were  built,  the  attendants  were  forcibly  impressed  into  service  as  nurses,  the  sick  were 
shut  up  in  their  houses,  suitable  directions  as  to  mode  of  life,  even  as  to  purification 
of  the  washings  of  the  body  and  bed,  on  interment  etc.,  were  published. —  The  council 
sought  to  suppress  the  use  of  secret  remedies,  sorcen'  and  coscinomancy  :  amulets 
(Passauer  Kunst)  were  interdicted  and  burned.  The  streets  must  he  kept  clean''  etc. 
The  physicians,  at  the  demand  of  the  authorities,  also  decided  cases  of  doubtful  sex. 
Hermaphrodites  ran  considerable  risk.  One  who  was  baptized-  Elizabeth,  but,  on  the 
decision  of  a  doctor,  re-baptized  privately  in  1527,  and  yet  afterwards  performed  the 
functions  of  a  woman,  was  burned.  Physicians  who,  through  ignorance  or  careless- 
ness (but  not  intentionally),  killed  a  person  with  medicine,  according  to  the  criminal 
code  of  Charles  V.  were  punished  in  accordance  with  the  counsel  of  those  skilled  in 
med  icine. 

In  1582  also  there  was  introduced  in  Augsburg  a  "Collegium  medicum",  which 
was  also  an  institution  for  instruction.  ''The  genuine  Augsburg  Medici  of  this  place, 
at  the  especial  instance  of  Dr.  Lucas  Stengling,  an  experienced  and  learned  man,  in 
order  to  distinguish  themselves  better  from  the  quacks  and  other  impostors  who 
boasted  of  their  medical  art,  with  the  approval  of  the  council,  associated  themselves 
into  a  College,  and  made  also  a  special  medical  ordinance  and  statutes"  '1  here 
were  too,  even  in  the  16th  century,  so-called  "  Landschaftsphysici  ",  i.e.  physicians 
employed  by  the  states  of  a  province,  and  often  provided  with  even  very  high 
salaries.  Thus  in  the  year  155.")  Martin  Stopius  of  Vienna  was  appointed  to  the 
district  over  the  Enns  with  a  salary  of  600  marks  ($150),  and  Matth.  Sabiseh  vriih  a 
salary  of  570  marks  ($142)  for  three  jears,  with  the  right  to  six  months'  nonce  before 
the  termination  of  the  engagement.  About  the  same  time  Dr.  Friedricli  Lagus  and 
the  same  Stopius,  bjr  reason  of  their  long  service  there,  were  allowed  171  marks  ($43) 
for  provisions  annually,  while  a  certain  Matth.  Anomaus  "by  reason  ol  hi.>-  previous 
service,"  and  in  the  expectation  that  he  would  interest  himself  in  school  matteis  until 
his  actual  appointment,  received  a  remuneration  of  171  marks  ($43).  The  latter  was 
actually  appointed  to  the  position  in  1583  with  a  salary  of  600  marks  ($150).  These 
physicians  were  required  to  render  aid  to  the  "  Landesmitglieder  "  and  their  subjects, 
and,  when  requested,  to  travel  through  the  country,  for  which  latter  service  the?  were 
authorized  to  demand  one  mark  (24  cts.)  for  each  mile  of  travel,  1.71  marks  (43  cts.) 
for  each  day  spent  with  the  sick,  and  their  subsistence."  In  the  same  year  Ilaitholo- 
mseus  Schoenporn  was  called  to  Linz  as  "  Landschaftphysicus",  and,  in  addition  to 
his  regular  salary  of  600  marks,  received  a  bonus  of  300  marks,  because  he  had  more 
business  in  this  city.  Besides  this  his  travelling  expenses  were  repaid  lo  1  im.  and  he 
received  300  marks  to  purchase  a  horse.  In  15(J.'!,  "in  order  to  prevent  disputes", 
only  513  marks  were  paid  to  each  of  the  Landschaftsphysici.  In  this  year  Doctor 
Lagus  was  pensioned  with  600  marks,  and  Doctor  Springer  appointed  in  his  place 
with  a  salary  of  513  marks.  Another  Landschaftspbysiker,  Johann  Attemstetter, 
even  received  1200  marks  ($300)  annually,  "because  he  had  resigned  his  good  service 
with  Duke  William  in  Bavaria."  In  1569  the  states  had  also  commissioned  a  special 
surgeon  Horstauer.     One  of  the  medical  ordinances  runs  :   "  No  one  shall  be  permitted 


—  4b'5  — 

to  practice  as  a  doctor  who  has  not  been  examined  in  Vienna,  and  who  is  not  provided 
with  testimonials.  In  like  manner  no  one  shall  be  admitted  as  an  apothecary,  surgeon, 
barber,  bath-keeper,  lithotomist,  herniotoniist,  oculist  and  "  Franzosenarzt "  (specialist 
in  venereal  disease),  who  has  not  been  examined  by  the  "  Landschaftsphysiker "  and 
is  not  provided  with  testimonials.  The  examination  must  take  place  in  the  presence 
of  a  Landherr  or  of  a  member  of  the  council  of  the  place  in  question,  together  with 
a  sworn  notary  or  state-secretary.  The  testimonials  shall  be  laid  before  the  state 
commissioners.  The  apothecaries  were  to  be  sworn,  to  be  sober  persons,  and  the 
physicians  were  expected  to  watch  over  this  matter.  No  city  could  have  two  apothe- 
caries, and  no  practising  physician  could  own  an  apothecary -shop.  No  medicines 
were  to  be  delivered  without  a  prescription,  and  the  physicians  must  not  give  to  their 
patients  any  medicines  not  purchased  from  the  apothecaries,  nor  specially  recommend 
any  pharmacy  to  the  sick.  Monasteries  were  allowed  pharmacies  for  their  own  use 
alone.  To  root-peddlers  and  itinerant  dealers  the  sale  of  harmful  articles  was  pro- 
hibited. Confections  unfit  for  eating  were  also  prohibited.  Surgeons,  bath-keepers 
etc.  were  not  allowed  to  treat  the  sick  and  midwives,  female  inspectors  ( Bcseherinnen  ?) 
and  Jews  could  not  prepare  drugs,  unless  the  Jews  were  baptized  and  examined.  The 
price  must  be  marked  upon  the  prescription.  Some  one  must  be  always  present  in 
the  apothecary -shops.  Prescriptions  must  be  kept  secret."  (Ulrich  )  All  these 
directions  point  to  the  modern  style  in  medical  matters  (if  we  except,  the  irregular 
practitioners),  and  are  evidence  how  high  was  the  grade  of  civilization  in  Germany 
prior  to  the  Thirty  Years'  War. 

The  s}-stem  of  military  hygiene  of  the  infantry  (Landsknechte)  of  the 
period  enjoyed  a  relatively  good  organization.  At  its  head  was  placed  in 
each  so-called  :i  Hauffen  "  of  5,000  to  10.000  men  one  u  Obrist-Feldartzet  ". 
who  was  an  educated  physician,  like  the  captain,  quartermaster  and  com- 
missary was  counted  among  the  superior  officials,  and,  as  a  member  of  the 
staff  of  the  commander,  was  expected  always  to  keep  in  the  vicinity  of  the 
latter.  To  him,  as  to  the  more  highly  educated  physician  (more  rarety  to 
a  higher  Wundarzt)  were  subordinated  the  •' Feldscheerer  ",  of  whom  there 
was  one  to  every  200  cavalry  or  infantry.  The  "  Obrist-Feldartzet "  was 
expected  to  give  aid  and  counsel  to  the  "  Feldscheerer  "  in  the  performance 
of  operations,  in  the  transportation  of  the  wounded,  in  cases  of  sickness  etc., 
as  well  as  to  superintend  the  "dragging  out"  of  the  dead  and  wounded 
from  the  line  of  battle.  Each  Feldscheerer  too  had  one  "  Knecht  "  (assist- 
ant) at  his  side.  Feldscheerer  and  Knechte,  especially  the  latter,  went 
when  necessary  into  the  midst  of  the  troops,  i.  e.  the  combatants,  in  order 
to  help  them  quickly.  The}'  also  carried  drugs,  instruments  etc.  with 
them,  and  these  they  were  expected  to  keep  in  good  condition  at  their  own 
expense.  The  "  Oberst-Arztet,  who  must  be  a  doctor,  or  otherwise  a  man 
of  official  authority",  was  required  to  direct  his  special  attention,  in  his 
prescribed  monthly  inspection,  to  the  performance  of  these  duties.  In  the 
cavalry,  to  each  squadron  of  about  2000  men  two  surgeons  were  allotted: 
in  the  artillery  (-arckeley"),  one  surgeon  and  one  Knecht. 

When  the  army  was  settled  in  camp  a  pennant1  marked  the  place  where 

1.  With  this  diminutive  term  was  designated   a  gigantic  signum  belli,   in   which 
the  standard-hearer  could  wrap  himself  up  several  times  if  he  was  in  danger, 
though  only  to  die  in  it. 
30 


—  466  — 

the  Feldscheerer  was  stationed.  By  night  he  was  near  the  "Fendricb." 
(ensign),  but  during  the  battle,  in  the  I;  Hinterhut"  (rear-guard),  when  not 
actually  engaged  in  the  ranks. 

During  the  stay  of  the  army  in  camp  the  sick  and  wounded  were  col- 
lected in  a  special  and  isolated  tent — a  sort  of  Roman  field-hospital  — 
and  nursed  by  the  baggage-women  and  young  men,  who  together  frequentl}' 
almost  equalled  in  numbers  the  actual  fighting  strength  of  the  army,  and 
whom  the  rude  Landsknechte  designated  shortly,  but  probably  quite  justly, 
as  "  whores  "  and  "  boys  ".  For  these  priestesses  of  Venus  of  the  lowest  sort 
there  was  a  special  "  Hurenwaibel  "  (whore-sergeant  !).  On  long  marches 
the  wounded  were  carried  along  in  wagons,  or,  under  charge  of  a  ••  Spittel- 
meister"  (hospital  superintendent),  left  behind  in  villages  or  cities.  The 
expense  of  attendance  upon  those  thus  left  was  defrayed  by  a  deduction 
from  the  regular  pay  of  the  Landsknechte  for  this  purpose. 

In  great  contrast  to  the  times  of  Chauliac,  when  drinks,  charms  etc.  and  hot  oil 
poured  into  wounds  made  up  the  whole  of  military  surgery  (an  art  practised  at  that 
period  chiefly  by  Germans,  but  also  in  the  French  armies),  regular  sanitary  regula- 
tions already  existed.  Yet  the  "weapon-salves"1  of  course  still  enjoyed  greatesteem. 
These,  however,  were  of  assistance  only  when  the  weapon  inflicting  the  wound  had 
been  preserved,  and  when  neither  the  heart,  the  brain  nor  the  liver,  in  a  word  when 
no  vital  organ,  was  injured,  in  which  cases  aid  was  of  course  easy.  The  weapon  was 
then  anointed  daily,  or  every  second  or  third  day,  wrapped  in  clean  linen  and  kept  in 
a  warm  place,  free  from  dust  and  wind  etc.  The  weapon-salve  of  Paracelsus  may 
serve  as  a  specimen  of  one  of  them.  It  consisted  of  the  fat  of  very  old  wild  hogs  and 
bears  heated  half  an  hour  in  red  wine,  then  dropped  into  cold  water,  which  was  next 
skimmed  and  the  fat  rubbed  up  with  roasted,  but  (for  heaven's  sake!)  not  burned 
angle-worms  and  moss  from  the  skull  of  a  person  hung,  scraped  off  during  the 
increase  of  the  moon,  to  which  were  added  bloodstone,  the  dried  brain  of  the  wild  hog, 
red  sandal-wood  and  a  portion  of  a  genuine  mummy!!  This  genuine  mummy-flesh 
was  kept  by  apothecaries  even  as  late  as  our  own  century.  Charms  too  were  still 
often  regarded  as  efficacious  in  the  treatment  of  wounds,  and  were  said  by  old  women 
in  cases  of  disease.  Some  of  these  are  frequently  made  use  of,  word  for  word,  even  at 
the  present  day. 

The  engagement  of  the  medical  staff  for  the  army  was  the  business  of 
the  commander,  who,  indeed,  had  to  enlist  the  entire  contingent.  The  bel- 
ligerent parties  made  contracts  with  him  alone,  and  he,  on  his  part,  made 
the  final  contract  with  his  subordinates. 

The  "  Oberst  Feldartzet"  of  infantry  received  as  pay  about  $17  per 
month  ;  the  surgeon  of  cavalry  the  same  ;  the  surgeon  of  artillery,  $13  for 
himself  and  his  assistant,  together  with  $9  for  the  maintenance  of  two 
horses.  The  Feldscheerer  received  about  7-1-1  marks  (in  Saxony  30  marks), 
but  might  treat  civilians  and  might  demand  special  pay  from  the  Lands- 


Perhaps  the  most  popular  of  these  was  the  "Sympathetic  Powder  "  of  Sir  Kenelm 
Digby  in  the  following  century.  It  is  said  to  have  been  simply  calcined  green 
vitriol.  In  cases  of  wounds  this  powder  was  to  be  applied  to  the  weapon  by 
which  they  were  inflicted  ;  this  was  then  covered  with  ointment  and  dressed  two 
or  three  times  a  day.  The  wound  meanwhile,  was  carefully  bound  up  with  linen 
bandages  and  thoroughly      let  alone  for  seven  days.    (H.  I 


—  467  — 

knechte  for  services  not  strictly  in  the  line  of  his  official  duty.  All  dis- 
putes between  the  two  latter  parties  were  to  be  arranged  by  the  "  Oberst 
Feldartzet."  In'^  fortresses  and  in  cases  of  siege,  the  physicians  resident 
in  these  places  or  their  vicinity  were  employed  as  "  Festungsmedici  ",  i.  e. 
garrison-physicians. 

In  France  Henry  IT.  (1518-59)  and  Henry  IV.  organized  field- 
hospitals  and  field-pharmacies,  over  which  latter  field-pharmacists 
presided. 

The  civilian  colleagues  of  the  latter,  the  ordinary  apothecaries 
("  appentegker").  were  in  the  10th  century  quite  numerous,  in  accordance 
with  the  number  of  the  newly  established  pharmacies,  which  had  already- 
reached  the  lowlands.  Nevertheless  this  period,  in  contrast  to  earlier 
times,  was  relatively  unfavorable  to  the  apothecaries,  at  least  to  the  bad 
fellows  among  them  ;  for,  in  consequence  of  the  unheard-of  increase  in 
cities  and  states,  innumerable  ordinances  for  apothecaries  sprung  into 
existence  everywhere.  These,  as  has  naturally  been  the  case  with  other 
'•ordinances"  up  to  the  present  day,  contained  chiefly  threats  of  punishment 
for  transgressions  of  the  law  and  for  falsification  of  drugs,  with  definitions 
of  the  allowable  substitution  for  rare,  difficult  to  be  obtained  or  expensive 
remedies,  price-lists  etc.  Such  ordinances  for  apothecaries — at  that  time 
mostly  called  "E3Tdt",  or  in  Suabian  Aydt  —  appeared  for  Annaberg  e.  g.  in 
1563,  for  Hesse  in  1564,  for  the  electorate  of  Saxony  in  1573,  for  the  province 
of  Mecklenburg  in  1580,  for  the  earldom  of  Henneberg  in  1596.  Accord- 
ing to  the  latter  of  these  ordinances,  the  apothecary  himself  must  swear 
obedience  to  the  magistracy  and  to  the  medici,  to  follow  the  "ordinance", 
to  exact  nothing  improper  from  his  assistants,  but,  on  the  other  hand,  to 
keep  them  to  their  duty  ;  while  the  apothecaries'  "  Gesellen  "  (appren- 
tices) promised  "  to  be  honest,  pious,  true,  as  well  as  obedient  and  respect- 
ful to  the  physicians  and  to  their  masters,  and  also  to  follow  the  prescrib- 
ed articles.  Finally  the  (apothecaries')  "apprentices",  if  old  enough, 
took  the  following  oath  :  "  I  promise  and  swear  to  strive  after  all  fear 
of  G-od  and  honesty  "  —  the  apothecaries  at  that  time,  early  as  it  was, 
seem  to  have  behaved  like  sinners  — "  to  exercise  myself  in  Latin  and 
in  grammar"  etc.  However  the  pl^-sicians  very  frequenth'  prepared  their 
own  medicines. 

[William  Bulle}!!  (died  1576),  of  whom  we  have  already  made  men- 
tion, gives  the  following  rules  for  the  guidance  of  English  apothecaries  : 

'•  The  Apoticarye 

1.  Must  fyrst  serve  God,  forsee  the  end,  be  clenly,  pity  the  poore. 

2.  Must  not  be  suborned  for  mone}'  to  hurt  mankynde. 

3.  His   place  of  dwelling  and  shop  to   be   clenly  to  please  the  sences 

withal. 

4.  His   garden    must    be    at    hand    with    plenty   of    herbes,    seeds,    and 

rootes. 


—  468  — 

5.  To  sow,  set,  plant,  gather,  preserve  and  kepe  them  in  due  tyme. 

6.  To  read  Dioscorides,  to  know  }re  natures  of  plants  and  heroes. 

7.  To  invent  medicines,  to  chose  by  coloure,  tast,  odour,  figure  &c. 

8.  To  have  his  morters,  stilles,  pottes,  filters,  glasses,  boxes,  cleane   and 

sweete. 

9.  To  have  charcoles  at  hand,  to  make  decoctions,  syrupes  &c. 

10.  To  kepe  his  cleane  ware  closse.  and  cast  away  the  baggage. 

11.  To  have  two  places  in  his  shop — one   most  cleane  for  the  phisik,  and 

a  baser  place  for  the  chirurgie  stuff. 

12.  That   he  neither  increase   nor  diminish  the  phisiciaifs  bill,  and  kepe  it 

for  his  own  discharge. 

13.  That  he  neither  bii}r  nor  sel  rotten  drugges. 

14.  That  he  peruse  often  his  wares,  that  they  corrupt  not. 

15.  That  he  put  not  in  quid  pro  quo  without  advysement. 

16.  That  he  may  open  wel  a  vein  for  to  help  pleuresy. 

17.  That  he  meddle  only  in  his  vocation. 

IS.    That  he  delyte  to  reede  Nicolaus  Myrepsus,  Valerius  Cordus.  Johannes 
Placaton,  the  Lubik  &c. 

19.  That  he  do  remember  his  office  is  only  to  be  ye  phisician's  cooke. 

20.  That  he  use  true  measure  and  waight. 

21.  To  remember  his  end  and  the  judgement  of  God  :  and  thus  I  do  com- 

end  him  to  God,  if  he  be  not  covetous  or  crafty,  seeking  his  own 
lucre  before  other  men's  help,  succour  and  comfort." 

Richard  Bubhani,  the  apothecaiy  of  king  Hemy  VIII..  was  granted  in 
1510  an  annuity  of  £10.  Hugo  Morgan,  the  apothecary  of  queen  Eliza- 
beth, received  for  one  quarter's  bill  the  sum  of  £83  7s.  8d.,  a  large  amount 
in  those  days.  But  among  the  articles  charged  for  in  this  bill  were  such 
expensive  articles  and  delicacies  as  :  "  A  confection  made  like  manus 
Christi,  with  bezoar  stone  and  unicorn's  horn,  lis.;  a  royal  sweetmeat  with 
incised  rhubarb,  16d.;  rosewater  for  the  King  of  Navarre's  ambassador, 
12d.;  a  conserve  of  barberries,  with  preserved  damascene  plums  and  other 
things  for  Mr.  Ralegh,  6s.;  sweet  scent  to  be  used  at  the  christening  of  Sir 
Richard  Knightley's  son,  2s.  6d."  etc.     (H.)] 

The  inspections,  which  occurred  regularly  and  were  made  by  ph}  si- 
cians,  seem  often  to  have  been  very  jolly  affairs,  for  one  held,  i.  e.  celebra- 
brated,  in  the  year  1574  —  it  must  certainly  have  been  thorough  for  it  last- 
ed three  weeks —  cost  the  apothecaries  concerned  ;' for  eating,  wine,  beer 
and  fifers "  495  marks,  40  pfennige,  (about  $124).  which  sum,  compu- 
ted on  our  present  value  of  gold,  may  be  estimated  five  times  as  much. 
Besides,  even  in  that  time,  the  use  of  copper  and  brass  vessels  was  inter- 
dicted to  the  apothecaries  from  considerations  of  public  lngiene. 

According  to  the  price-list  of  that  day  (that  of  the  electorate  of  Bran- 
denburg in  the  year  1574  included  1800  articles),  ordinary  plaster  cost  1 
groschen  6  pfennige  ;  other  plasters,  "with  pay  for  cutting  (Schneiderlohn) 
when  the  apothecary  furnished  the  leather,"  if  used  for 


3  Gr. 

6 

Pf. 

3    " 

6 

« 

O 

3    " 

3    " 

G 
6 

u 

~  469  — 

The  liver         .... 

The  uterus      • 

The  kidne3-s  .... 

The  spleen     .... 
The  administration  of  an  enema 
though  it  was  suggested  to   the  rich  in  the  latter  case  to  go  deeper  into 
their  pockets,  since  this  "is  an  unclean  business".    (Vid.  Phillippe-Ludwig, 
whom  we  often  follow  in  regard  to  the  condition  of  apothecaries.) 

The  apothecaries  of  the  period,  especially  the  French,  allowed  themselves  many 
serious,  as  well  as  ludicrous,  adulterations  and  deceptions!  The  latter,  for  the 
administration  of  strengthening  enemata,  supplied,  among  other  things,  live  hens  and 
cockerels.  These,  however,  they  placed  in  the  poultry-yard  or  roasted  for  their  own 
use,  substituting  in  their  place  something  from  their  witches'  caldron,  in  which  case, 
as  is  readily  understood,  the  inverted  organ  of  taste  was  unable  to  detect  the  deceit. 
Again,  in  the  exhibition  of  strengthening  drops  they  brought  the  ducats  entire — gold 
was  considered  the  remedy  for  impotence  in  the  male  —  and  then  put  them  into  their 
pockets,  instead  of  into  the  essence  as  they  pretended  &c,  &c. 

The  veterinary  profession  was  still  exactl}'  the  same  as  in  the  Middle 
Ages :  farriers,  shepherds,  flayers,  executioners  etc.  The  first  class  in 
particular  were  frequently  formally  appointed  veterinarians  in  cities,  as 
e.  g.  in  Frankfort.  Their  pay  in  1503  consisted  of  corn  and  a  suit  of  cloth- 
ing, in  1553  of  the  same,  together  with  a  salaiy  of  68  marks  ($17)  annu- 
ally.1 

Inspectors  ofj  bread,  wort  and  meat  exercised  a  sanitary  oversight  upon  the 
actions  of  brewers,  bakers  and  butchers,  as  had  been  done  also  in  the  Middle  Ages 
from  the  11th  century  onward.  In  1404  such  inspectors  were  already  established  by 
law  in  Wimpfen.     In  Scotland  there  were  also  inspectors  ot  the  dead  (coroners). 

Bath-houses  still  existed.  In  Wimpfen  the  two  bath-houses  were  to 
be  heated  twice  a  week  for  general  use.  The  weekly  rent  paid  by  the 
bath-keeper  amounted  to  10  Batzen.  "  The  hereditary  disease  ",  however 
could  not  be  treated  in  "  bath-houses  ".  Male  and  female  nurses  were  to 
be  found  in  every  city,  and  man}'  of  these,  indeed,  as  the  natural  result  of 
Protestantism,  were  now  lay  persons.  Hospital  matters  were  in  a  bad  con- 
dition when  compared  with  our  ideas  of  the  present  day.  and  were  left 
almost  without  exception  in  the  hands  of  the  religious  orders.  In  London 
the  first  hospital  for  the  insane  was  founded  in  1580,2  and  from  this,  in 
course  of  time,  the  modern  lunatic  as}dum  was  developed.  The  hospital 
authorities,  however,  had  already  some  very  judicious  regulations.  Thus 
in  Strassburg  in  1500  it  was  ordered:  "  Where  the  doctor  can  cure  by 
means  of  diet  he  shall  give  the  patients  no  drugs". 

A  mournful  side  to  the  condition  of  medicine  in  those  simple  times  is 

1.  In  1510  Thomas  Fabyan  was  appointed  veterinary  surgeon  for  the  horses  of  king 

Henry  Vf.ll.   "during  good  conduct",  with  a  salary  of  12d  a  day  —  nearly  twice 
that  of  a  surgeon  in  the  field.     ( H.  j 

2.  The  hospital  of  St.  Mary  of  Bethlehem  (Bedlam)  was  founded  in  1547,  St.  Barthol- 

omew's in  1546  and  St.  Thomas's  in  1553.     (H.) 


—  470  — 

revealed  in  the  admonition  of  the  authorities  to  the  physicians,  adopted 
in  all  the  rnedical'and  apothecaries'  ordinances,  and  warning  them  to  treat 
each  other  with  respect  and  to  live  in  harmony.  The  same  is  true  of  the 
prohibition  of  collusion  with  the  apothecaries  for  the  sake  of  gain,  the 
recommendation  of  certain  apothecaries  &c.  &c.  The  apothecaries  were 
also  everjwhere  directed  not  to  slander  the  physicians,  nor  to  secretly 
embitter  them  against  each  other,  nor  to  recommend  especially  any  one  in 
preference  to  another  &c.,  &c. 

Such  truly  humiliating  ordinances,  at  least  such  a  constant  repetition 
of  them  in  all  the  laws  relating  to  the  subject,  are  certainly  not  to  be  found 
in  any  other  profession  :  and.  if  we  admit  that  perverted  judgment  and  a 
poor  comprehension  of  the  duties  of  the  medical  profession,  on  the  part  of 
the  law  makers  of  that  time  (as  at  the  present),  had  the  chief  share  therein, 
yet  there  must  always  have  been  occasion  given  in  the  conduct  of  some  of 
its  members,  which  casts  a  mournful  light  upon  the  whole.  The  above 
ordinances  indicate  a  condition  of  the  relations  between  -colleagues" 
adapted  to  injure  the  whole  profession  at  all  times,  and  which  vet.  as  it 
seems,  has  never  been  removed,  at  any  time  or  b}"  any  people,  through  the 
advance  of  culture.  Indeed  culture  appears,  alas,  to  make  the  matter  only 
worse!  It  must  have  been  most  deeply  humiliating,  however,  to  the  better 
physicians  of  the  16th  century  that  the  medical  ordinance  of  Wurzburg 
formally  exhorted  the  physicians  to  humanity  :  -  That  the  sick  may  always 
continue  to  hope  for  recovery  the  ptn-sicians  shall  visit  them  often,  and 
shall  not  relax  such  diligence  in  visiting,  even  when  they  can  see  actually 
no  hope  of  their  improvement !  " 

THE  SEVENTEENTH  CENTUEX. 

The  course  of  development  of  individual  nations,  in  fact  of  humanity 
in  general,  and  with  it  that  of  the  sciences,  is  like  the  pulsation  of  the 
heart,  with  the  single  difference  that  the  individual  phases  of  the  move- 
ments of  mind  in  history  are  not  repeated  with  pulsations  of  regular  dura- 
tion, as  in  the  heart-beats  of  the  body.  To  a  systole  of  the  mind  succeeds 
a  diastole  and  a  pause.  Both  the  latter,  however,  as  a  rule  fill  long 
periods  of  history,  interrupted  at  most  by  individual  systolic  pulsations, 
in  order  to  prevent  complete  collapse.  The  advancing  waves  of  the  blood 
during  the  systole  of  the  heart  are  represented,  in  the  development  of 
nations  and  of  humanity,  by  the  newly  acquired  truths  and  ideas. 

A  period  of  intellectual  systole,  however,  extended  through  the  first 
two-thirds  of  the  Kith  century.  From  that  time  began  the  diastole, 
though  more  in  the  department  of  politics  than  of  the  sciences. 

The  seventeenth  century  was  the  century  of  reaction  against  the  free- 
dom of  faith  and  of  investigation  won  by  the  aid  of  the  Germans  in  the 
sixteenth,  and  which  our  nation  strove  to  preserve  by  the  sacrifice  of  its 
treasure  and  its  blood,     in  the  sphere  of  mind  too  it  attained  success  :  but 


—  471  — 

politicall}*  the  struggle  brought  humiliation  and  exhaustion.  The  historical 
consideration  of  the  former  period  will,  therefore,  awaken  hitter  reflections 
in  him  who  recognizes  its  political  and  national  influence  upon  the  subse- 
quent destiny  of  our  father-land,  its  people  and  its  culture.  Because  we 
are  accustomed  to  understand  b}T  religion,  or  that  which  the  priests  called 
religion,  almost  exclusive!}'  a  thing  of  the  heart  and  of  the  feelings,  and 
alas,  not  like  other  people,  a  thing  largeh'  of  the  understanding,  or  indeed 
of  politics  (like  the  popes  and  the  Romans),  it  brought  upon  us,  as  we  know, 
the  most  unhappy  war  which  ever  prevailed.  A  thirty  years'  religious  war 
visited  our  people,  who  were  compelled  to  fight  out  upon  their  own  soil  not 
only  their  own  religious  quarrels,  but  also  foreign  political  struggles  car- 
ried on  under  the  hypocritical  cloak  of  religion,  and  brought  them  to  the 
brink  of  destruction.  For  centuries  it  corrupted  their  very  hearts'  core, 
stamped  their  land  into  a  wilderness,  dismembered  still  further  a  people 
always  sundered  by  ancestral  dissensions  and  henceforth  by  differences  of 
creed,  and  plunged  them  into  a  pauperism  from  which,  even  to-day,  we 
have  not  entirely  recovered,  and  which  in  its  results  was  the  more  ruinous, 
because  in  this  very  century  other  nations  took  the  lead  while  we  went 
backward.  The  Netherlands  and  England  through  commerce  and  coloniza- 
tion,1 France  through  advances  in  national  economy  and  industrial  pursuits, 
as  well  as  by  conquest  (and  in  spite  of  the  internal  weakness  induced  by 
the  expulsion  of  the  Huguenots  and  the  reign  of  nyyal  mistresses),  began 
at  this  time  their  career  of  progress. 

The  Christian  faith,  instead  of  the  bearer  of  love  and  peace  (which  it  never  has 
been  and  apparently  never  will  be),  became  once  more  the  most  unhappy  apple  of 
discord.  Yet  Catholics  and  Protestants  at  that  time  differed  little  from  each  other; 
for  the  idea  of  the  Reformation  was  neither  very  widespread  nor  greatly  developed. 
Whoever,  therefore,  desires  to  acquire  a  thorough  insight  into  that  which  was  called 
the  doctrine  of  Christ,  and  to  learn  the  objects  for  which  it  was  abused,  the  results  of 
its  mutilation,  ami  the  means  by  which  it  was  effected,  to  him  the  history  of  the 
seventeenth  century  offers  the  best,  as  well  as  the  saddest,  opportunity.  It  might 
readily  suggest  the  view  that  the  Christian  religion,  or  rather  that  pretended  religion 
which  the  priests  in  universal  history  have  always  designated  as  Christian,  has  injured 
mankind  internally  and  externally,  spiritually  and  corporeally,  socially  and  politi- 
cally, more  than  all  the  horrors  of  political  wars  and  all  unavoidable  calamities  taken 
together.  In  Germans  especially,  such  a  consideration  of  the  history  of  the  seven- 
teenth century  must  awaken  peculiar  sadness,  since  our  fatherland  was  specially 
chosen,  even  from  the  time  of  the  conversion  of  the  Saxons  by  Charlemagne  (indeed 
it  seems  at  all  periods  to  have  been  looked  upon),  as  the  theatre  of  so-called  religious 
wars,  while  other  countries  and  other  peoples,  by  their  unity  and  their  energy,  have 
been  able  for  the  most  part  to  preserve  themselves  from  a  similar  fate.  On  the  other 
hand,  they  will  also  learn  to  admire  the  vitality  of  their  countrymen,  who,  in  spite  of 
every  wretchedness  and  the  Thirty  Years'  War,  have  remained  upon  the  stage  of 
history  and  have  become  honored  as  they  are  to-day  ! 

The  ravages  of  the  Thirty  Years'  War,  the  diseases  and  plagues,  the  poverty  and 

1.    The  noblest  and  most  important  colonies  of  England,  in  both  the  history  of  civili- 
zation and  of  the  world,  were,  of  course,  those  founded  in  North  America. 


—  472  — 

"want  and  depopulation,  the  boundless  and  unbridled  barbarity  and  immorality  etc. 
resulting  therefrom,  make  the  seventeenth  century  (especially  its  earlier  half)  the 
most  mournful  epoch  of  German,  indeed  probably  of  all,  history.  ''In  every  hamlet 
the  houses  are  filled  with  dead  bodies  and  carcasses,  men,  women,  children  and  ser- 
vants, horses,  hogs,  cows  and  oxen,  beside  and  beneath  each  other,  slain  by  hunger 
and  the  plague,  devoured  by  wolves,  dogs,  crows  and  ravens,  because  there  was  no 
man  to  bury  them."  As  late  as  the  year  1 7i>2  there  were  still  in  Saxony  535  wasted 
and  extinct  villages,  the  relics  of  the  Thirty  Years'  War.  The  city  of  Frankenthal 
after  1634,  of  18,000  inhabitants,  preserved  —  324;  Hirschberg  of  900  retained  —  60; 
Wurtemberg of  400,000  had  left  —  48,000!  (  Haeser,  vol.  II.)  "  The  religious  animosity 
of  the  people  goaded  to  the  highest  pitch,  the  selfish  designs  of  the  princes,  the  evil 
influences  from  without,  the  barbarous  manners,  maintained  the  general  misery 
.  .  .  .  Under  the  pretext  of  defending  the  faith  and  liberty,  the  struggle  was 
carried  on  for  superstition,  avarice  and  revenge,  with  unbounded  passion  .... 
Of  the  disturbances,  the  dingers  and  the  distress  arising  from  the  demands  of  an 
insolent  soldiery,  of  the  desperation  induced  by  conflagration,  robbery  and  deeds  of 
violence,  of  the  misery  resulting  from  the  plague,  of  the  most  disgusting  imprints 
made  by  the  rudest  outbursts  of  Pennalism,1  of  the  malignant  struggles  concerning 
religious  opinions  and  partisan  objects,  those  now  living  have  no  conception."  (Marx.) 
What  the  Thirty  Years'  War  had  left  us,  the  French  toward.-  the  end  of  the  century 
destroyed. 

Among  the  people  too  there  prevailed,  not  only  in  Germany  but  elsewhere  also, 
poverty,  superstition  and  great  rudeness  of  manners,  while  their  tulers,  with  crass 
absolutism,  practised  almost  everywhere  the  greatest  prodigality,  plunged  into  frivolity 
and  became  slaves  of  the  most  refined  sensuality.  All  this  was  united  with  disgusting 
piousness,  the  superstition  of  alchemy  etc.  The  continuance  of  the  trial  of  witches 
and  of  the  Inquisition  or  Jesuitism,  which,  along  with  the  decay  of  Protestant  freedom 
of  faith,  ruled  this  century,  formed  the  natural  correlatives  in  the  departments  of  the 
Church  and  of  jurisprudence. 

If  tlie  sixteenth  century  was  for  our  culture  an  epoch  of  joj'ous  growth 
and  high  activity,  the  seventeenth,  for  all  the  reasons  mentioned,  was  not 
only  for  our  developing  civilization,  but  also  for  our  industries,  our  commerce, 
in  a  word  for  our  prosperity,  an  epoch  of  saddest  quiescence.  This  doubly 
fatal  century  condemned  out  people  to  continued  impotence  and  to  the 
scorn  of  other  nations  !  And  that  which,  in  this  unfortunate  period  and 
shortly  after,  was  taken  from  us,  we  in  this  century  and  in  our  own  day  have 
been  able  for  the  first  time  to  partially  recover ;  so  that  substantially  a 
partial  retribution  is  now  first  taken  for  the  injuries  and  the  ignominy 
inflicted  upon  our  country  and  our  people  during  this  long  period  of  suf- 
fering. 

In  the  scientific,  but  more  strikingly  in  the  medical  department,  Ger- 
many in  the  seventeenth  century  lost  the  rank  which  she  had  acquired  in 
the  sixteenth,  and.  while  other  countries  were  able  quietly  to  enlarge  their 
scientific  borders,  for  German}'  alone  was  confirmed  the  truth  of  the  maxim 

1.  That  barbarous  and  tyrannical  system  under  which  the  younger  students  of  the. 
universities  were  subjected  to  the  abuse  and  even  cruelty  of  their  elders. 
Singularly  enough  the  system  seems  to  have  been  confined  to  German  and  Protes- 
tant universities.  Its  echo  still  remains  to  us  in  the  English  "fagging''  and 
American  "  hazing  "  oi  ''  training  '*.     (H.) 


—  473  — 

that  when  arms  clash  the  arts  and  sciences  must  keep  silent.  Even  the 
Protestant  theology  was  no  longer  developed  in  the  spirit  of  the  earl}'  days 
of  the  Reformation,  but  lapsed  into  Realism,  i.  e.  into  faith  in  the  letter  of 
the  law  and  cant.  Poetry,  in  which  the  Germans  have  always  taken  refuge 
when  life  was  oppressive,  and  chiefly  spiritual  or  religious  poetry,  together 
with  the  social  romance  (to  both  of  them  the  wretchedness  of  the  age 
served  as  a  background)  and  satire,  alone  pointed  to  a  better  future,  since 
the  foundation  was  laid  for  that  advance  which  the  following  century 
brought  forth,  while  the  rant  and  jejuneness  of  fashionable  poetry  excited 
opposition.  On  the  other  hand,  as  we  shall  see,  great,  indeed  undying 
service  was  performed  for  the  sciences,  even  in  Germany. 

The  English,  Italians  and  Netherlander's,  however,  who  took  very 
little  part  in  the  warlike  struggles  of  this  century,  acquired,  in  place  of  the 
Germans,  the  leadership  in  medicine,  while  the  French  constantly  lent  their 
aid,  though  in  a  less  degree. 

[The  remarkable  development  of  the  natural  sciences  and  medicine  in  England 
during  the  16th  century  can  scarcely  be  ascribed  to  the  quietude  of  an  age  which 
witnessed  in  its  early  years  the  long  and  bitter  strug>:le  between  constitutional  and 
personal  government,  culminating  in  the  "  Civil  War"  (1642),  the  trial  and  execution 
of  Charles  I.  (I(i4!>),  the  "Commonwealth"  (1649-165:5),  the  "Protectorate"  (1653- 
1659),  the  "  Restoration"  (1660),  the  "Great  Plague"  (1665),  the  "Popish  Plot" 
(  1 6 7 s )  and  finally  the  transfer  of  the  throne  to  the  house  of  Hanover  in  1688.  Indeed 
scarcely  any  century  of  English  history  presents  a  scene  of  greater  internal  disturb- 
ance than  that  upon  which  we  are  now  entering.  The  sudden  upgrowth  of  an  extra- 
ordinary interest  in  scientific  matters  in  this  period  was  doubtless  due  to  a  leaction 
against  the  exaggerated  religiousness  of  the  Puritans,  with  their  unending  and  barren 
theological  disputes.  The  belter  minds,  surfeited  with  the  barren  polemics  of  theology, 
began  with  delight  to  turn  their  attention  to  the  stud}'  of  nature,  which  invited  them 
into  the  pleasant  paths  of  experiment  and  offered  the  reward  of  certain!}"  in  their 
labor.  After  the  Restoration,  science  in  London  (as  ancientlj-  in  Alexandria)  became 
too  the  "  fashion  ".  All  the  Stuart  kings  of  England  manifested  an  inclination  towards 
science,  and  Charles  II.,  who  was  himself  something  of  a  chemist  and  interested  in 
navigation,  formed  no  exception  to  this  rule.  An  epidemic  pf  scientific  interest 
.seized  upon  the  court,  and,  as  Green  says,  "The  Duke  of  Buckingham  varied  his 
freaks  of  rhyming,  drinking  and  fiddling,  by  fits  of  .devotion  to  his  laboratory",  while 
the  glass  toys  called  "Prince  Rupert's  drops"  bear  witness  to  the  scientific  amuse- 
ments of  that  fiery  old  cavalry  officer.  Of  course  the  courtiers  spread  their  sails 
to  the  favoring  breezes  of  science,  which  even  the  better  minds  enjoyed  and 
utilized.    (H.)] 

The  harvest,  in  which  our  father-land  took  relatively  so  little  part,  was 
in  man}-  respects  a  permanent  one.  For  its  collection  there  arose  in  this 
century  ever  increasing  aid  in  the  sciences  of  chemistry,  physics,  optics 
and  mathematics,  and  the  natural  sciences  in  general,  as  well  as  in  the 
realistic,  inductive  and  experimental  principles  brought  forward  for  these 
sciences. 

The  seventeenth  century,  in  contrast  to  the  idealistic  sixteenth,  was 
the  birthday  of  modern  Realism  in  almost  all  departments  of  thought. 
Medicine  particularly,  by  an  adoption  of  the  accessory  natural  sciences  in 


—  474  — 

some  respects  extravagant,  or  at  least  often  precipitate,  furnished  the  first 
examples  of  what  we  are  accustomed  to-day  to  distinguish  as  the  ':  exact " 
method.  Hence  this  century  has  become  of  the  greatest  importance  in 
the  history  of  the  development  of  medicine.  The  simple  accessory  sciences 
began  to  acquire  the  preponderance  over  medicine  proper,  although,  even 
at  that  time,  most  of  the  acquisitions  and  views  which  originated  in  them, 
and  which  were  considered  "imperishable",  proved  in  the  end  to  be  quite 
ephemeral.  Physicists  and  chemists  began  to  have  something  to  say  in 
medicine,  more,  however,  to  the  detriment  than  the  profit  of  the  latter 
science,  since  its  practical  object,  the  cure  of  disease  and  the  possible 
methods  of  such  cure,  were  frequently  henceforth,  as  they  had  been  in  pre- 
ceding ages,  entirely  lost  sight  of. 

The  chief  excitement  in  the  science  of  medicine  during  the  seventeenth 
century  was  created  by  three  notable  medical  systems  —  the  pietisticall}' 
colored  Paracelsism  of  Van  Helraont,  the  chemical  system  of  Sylvius  and 
the  iatromechanical  system  of  the  physicist  and  mechanician  Borelli. 

One  great  practitioner,  however — Sydenham — renders  this  century 
imperishable  in  the  history  of  practical  medicine. 

Surgery  in  the  seventeenth  century  assumed  a  less  brilliant  form  than 
in  the  sixteenth.  Still  it  made  some  practical  advances  worthy  of  notice 
in  numerous  observations  and  new  procedures,  and  in  the  invention  of  the 
tourniquet  and  other  mechanical  aids. 

Transfusion  too  belongs  to  the  surgery  of  this  century.  The  first  transfusion  of 
lamb's  blood  in  Germany  was  performed  by  Matth.  Gottfr.  Purmann  and  Balthasar 
Kaufmann  at  Frankfort-on-the-Oder,  in  a  case  of  leprosy  in  1668. 

Midwifery,  on  the  other  hand,  profited  greatly  b}7  the  gradual  transfer 
of  the  higher  branches  of  the  art  into  the  hands  of  men  and  of  educated 
physicians,  as  well  as  by  the  elevation  of  the  lower  practitioners  of  that 
art  through  improved  methods  of  instruction.  The  memorable  invention 
of  the  obstetric  forceps  also  falls  in  this  century. 

The  acquisitions  of  this  epoch  in  the  sphere  of  the  facts  of  medicine 
were  extraordinary,  and  the  importance  of  the  results  of  this  century  is,  on 
the  whole,  at  least  equal  to  that  of  our  own  age,  which  has  also  so  greatly 
advanced  this  very  side  of  medicine.  In  some  respects  it  even  surpassed 
the  present  century.  In  this  connection  we  need  only  mention  the  regen- 
eration of  physiology  by  the  great  physiological  discovery  of  the  circula- 
tion, the  elucidation  of  the  fundamental  laws  of  generation  and  develop- 
ment in  man  and  the  lower  animals,  the  reformation  of  the  theories  of 
vision,  respiration  and  perspiration,  digestion  etc.,  the  anatomical  discove- 
ries in  the  department  of  the  lymph  and  chyle  vessels,  and  of  the  thoracic 
duct  with  its  place  of  discharge,  the  bymphatic  glands  etc.,  in  general  the 
increasing  comprehensiveness  of  anatomy  resulting  from  its  closer  union 
with  physiology  —  in  all  of  which  advances  the  <Termans  had  at  least  some 
little  share. 


—  475  — 

1.    INFLUENCE  UPON  MEDICINE  OF  PHILOSOPHY,  THE  NATURAL  SCIENCES, 
TECHNICS  AND  THE  ARTS. 

In  the  culture  of  the  17th  century,  as  in  that  of  the  present  age,  arnong 
all  the  departments  of  scientific  investigation,  the  natural  sciences  unques- 
tionably furnished  the  most  brilliant  picture,  although  its  brilliancy  was 
still  dimmed  here  and  there  by  the  superstition  of  the  Middle  Ages. 
Accordingly  that  method  of  reasoning  which  we  are  in  the  habit  of  regard- 
ing as  the  scientific  and  only  permissible  method  in  medicine,  began  to 
manifest  its  domination  also  in  this  science,  always  so  largely  dependent 
upon  the  general  intellectual  tendencies  of  the  age.  We  refer  to  the  induc- 
tive method,  the  exclusive  employment  of  which  (as  it  prevails  to-day)  cer- 
tainly implies  great  one-sidedness,  and,  from  the  imperfection,  incompleteness 
and,  indeed,  uncertainty  of  many  of  the  principles  to  be  acquired  by  this 
method,  results  in  losing  oneself  (not  to  sa}'  taking  the  wrong  direction) 
in  a  labyrinth  of  facts,  without  a  guide  or  a  leader.  In  this,  as  in  almost  all 
points  relating  to  medicine,  the  seventeenth  century  was  undoubtedly  the 
scientific  predecessor  of  our  own.  Yet  the  deductive  method,  in  some 
degree  at  least,  still  maintained  its  equality  with  its  rival.  It  is,  how- 
ever, only  when  the  results  of  both  methods  correspond  that  we  ma}r 
hope  to  be  near  the  truth.  The  union  of  the  two  methods  is  yet  to  be 
accomplished. 

The  tendencies  of  the  sciences  in  the  seventeenth  century,  whose 
influence  may  be  recognized  in  the  medicine  of  that  day,  were  partly,  of 
course,  continuations  of  the  views  of  the  preceding  century  (for  a  sharp  line 
of  division  between  the  views  of  this  and  the  following  century  did  not 
exist),  and  partly  new  developments.     Chief  among  these  was 

Skepticism,  founded  in  the  preceding  century  by  a  Montaigne  and 
continued  in  the  philosophy  of  Pierre  Charron  (1541— 1G03).  the  chaplain 
of  queen  Margaret  of  Navarre,  who  declared  all  religion  opposed  to  healthy 
human  reason  —  certainly  a  remarkable  freedom  from  prejudice!  Skep- 
ticism was  also  notably  developed  in  the  philosophy  of  the  Portuguese 
physician  Francesco  Sanchez  (1562-1632),  professor  at  Toulouse,  where, 
however,  it  was  mixed  with  the  principles  of  the  ancient  Empirics.  This 
mode  of  reasoning  finally  reached  the  point  of  doubting  the  capacity  of  the 
human  mind  to  do  anything  else  but  recognize  error  (and  not  truth  also  in 
itself).  Such  was  the  idea  of  Pierre  Bayle  (1647-1706  ;  Dictionnaire 
Historique  et  Critique),  who  offered  the  alternatives  of  either  universal 
doubt  or  blind  faith.  On  the  other  hand,  Francois  de  la  Mothe  le  Vayer 
(1586-1672),  with  greater  justice,  affirmed  that  man  must  acquire  religious 
(so-called)  truths  rather  by  the  aid  of  special  divine  illumination  and  firm 
faith  (Credo  quia  absurdum),  than  comprehend  them  by  pure  reason  ;  the 
utmost  certainty  was  only  doubt. 

Opposed  to  skepticism  was  the  supernatural  (theosophistic,  Cabalistic, 
mystic)  philosophy.     To  this  school  belonged   Jacob  Bohme  (1575-1624), 


—  476  — 

the  son  of  a  Silesian  peasant  and  a  shoemaker,  a  man  entirely  uneducated 
and  therefore  awkward  in  expression,  but  highl}-  gifted  and  a  profound 
thinker.  He  was  the  philosophical  busiuess  colleague  of  the  '•  Meister- 
singer"  Hans  Sachs  (149-4- 1576),  whom,  however,  he  far  surpassed  in 
power  of  fancy  and  profundity  of  thought.  The  English  clergyman  and 
physician.  John  Pordage  (died  1097),  is  to  be  classed  among  his  followers, 
for  then,  as  well  as  now,  religious  mysticism  in  general,  together  with  the 
utmost  freedom  of  thought,  found  numerous  advocates  in  England- 
Among  these  were  bishop  Samuel  Parker  (died  1688),  Ralph  Cudworth 
(died  1688),  professor  in  Cambridge,  and  Henry  More  (died  1687).  Even 
the  French,  who  are  by  no  means  inclined  to  the  supernatural,  at  that 
period  embraced  in  considerable  numbers  the  same  philosophy.  The  great 
Jansenist,  mathematician  and  discoverer  of  the  decrease  of  atmospheric 
pressure  in  elevated  localities,  Blaise  Pascal  (1623-1662),  and  his  contem- 
porary  Nicolas  Malebranche  (1638-1715),  were  the  most  prominent  of  these, 
after  whom  we  must  place  Pierre  Poiret  (died  1719)  and  his.  odious  but 
(as  is  frequently  the  case)  enthusiastically  religious,  friend  Antoinette 
Bourignou  (1616-1680)  of  Lille.  Johannes  Amos  of  Komna  (hence  called 
Comenius.  1592-1671).  founder  of  the  system  of  "Pictorial  Instruction"1 
and  a  native  of  Moravia,  was  a  theosophist  and  "pansophist',  and  a  very 
different  man  from  the  protean  Van  Helmont  and  his  son  Frauciscus 
Mercurius  Van  Helmont  (1618-1699),  who  was  ingenious  enough  to  unite 
in  one  system  the  doctrines  of  Christ,  Plato  and  the  Cabala. 

An  intermediate  position  between  the  preceding  and  following  phil- 
osophical S3-stems  was  taken  by  the  Dominican  Thomas  Campanella  (1568- 
1639  i.  who  considered  the  foundations  of  knowledge  to  be,  on  the  one 
hand,  supernatural  revelation,  on  the  other,  perception  by  means  of  the 
senses.  He  was  a  native  of  Stilo  in  Calabria,  the  author  of  a  "  Civitas 
Solis''  (a  communistic  social  state  after  the  Platonic  model),  and  a  martyr 
to  his  views,  in  consequence  of  which  he  was  punished  with  the  rack  and 
imprisoned  for  thirty  years  on  the  charges  of  heresy  and  an  understanding 
with  the  Turks. 

Tiie  doctrines  of  Francis  Bacon,  Lord  Verulam  (1561-1626  ;  the  law 
of  the  transmission  and  reflection  of  sound,  1024,  is  one  of  his  few  dis- 
coveries), a  man  who  showed  himself  as  exalted  in  mind  as  he  was  mean  in 
personal  character,  were  of  the  greatest  importance  in  the  development  of 
philosophy,  the  natural  sciences  and  medicine.  Bacon  was  one  of  those 
men  who  form  landmarks  in  the  history  of  civilization  ;  the  chief  defender 


Anschauungsunterricht.  By  his  "Orbis  Sensualium  Pictus  ",  which  was  trans- 
lated into  eleven  languages  and  continued  unsurpassed  down  even  to  Goethe's 
time,  he  contributed  largely  to  the  education  of  the  masses,  while  his  "Janua 
Lingaarum  Reserata",  translated  into  12  European  tongues  (besides  the  Arabic 
Persian,  Turkish  and  Mongolian  .  formed  a  valuable  aid  to  higher  education. 
[The  "Orbis  Pictus'',  which  appeared  in  1658,  was  the  original  child's  picture- 
book.     HI.)] 


—  477   — 

and  eulogist  of  the  modern  realistic  tendencies,  i.  e.  the  inductive  phil. 
osophy.  He  himself,  however,  contributed  very  little  to  the  advancement 
of  the  natural  sciences  by  his  own  discoveries  and  inventions,  though  he 
valued  them  so  highly.  He  adopted  sensible  experience,  observation  and 
experiments,  upon  which  he  laid  great  stress,  for  the  sole  foundation  (but 
not  the  ultimate  object)  of  knowledge,  and  induction  as  the  way  and 
method  of  obtaining  knowledge.  In  order,  however,  to  avoid  the  tedious- 
ness  and  difficulty  of  acquiring  knowledge  in  this  way,  he  admits  expe- 
riences and  cases  of  special  purity  —  "prerogative  instances"  —  as  types, 
and  permits  a  comparison  of  similar  phenomena  and  things  —  conformable 
instances  —  as  guides  upon  the  road  to  knowledge.  Knowledge  will  lead 
to  inventions,  which  increase  the  power  of  man.  —  "  Knowledge  is  Power  '\ 
This  practical  result  made  the  most  manifest  impression  upon  him.  Bacon, 
as  Griin  says,  was  the  philosopher  of  patents  and  profit.  The  compass 
gunpowder,  printing  etc.  he  recognized  as  great  inventions,  while,  on  the 
other  hand,  he  placed  little  value  upon  the  discovery  of  Copernicus,  as  he 
had  little  comprehension  of  mathematics  in  general.  He  thought  that  we 
might  go  from  the  general  to  the  individual  in  order  to  attain  discoveries, 
but  not  always  conversely.  The  method  of  abstraction,  however,  he  gen- 
erally rejected.  Bacon's  style  too  often  reminds  us  of  Theophrastus  von 
Hohenheim.  though  it  does  not  possess  the  profundity  of  the  latter.  Many 
of  his  ideas  are  also  obscure  fancies  and  ruminations.  —  Thomas  Hobbes 
(15S8-1679)  went  still  further  into  realistic  philosophy,  attaining  complete 
materialism  and  holding  everything  incorporeal  as  unreal  ;  while  the  phy- 
sician John  Locke  (1632-170-1)  was  an  exponent  of  the  purest  empiricism. 
Some  of  his  views  approximate  very  remarkably  to  the  mechanical  theory 
of  heat.  According  to  him,  heat  is  a  very  lively  commotion  of  the  most 
minute  particles  of  a  body,  which  produces  the  -sensation  of  warmth  ;  it 
also  depends  upon  motion.  According  to  Dr.  Scholz-Bremen,  Locke  is 
also  "the  first  who,  in  opposition  to  the  mediaeval  scorn  of  the  bod}* 
(Luther's  "Madensack"),  insisted  upon  regimen  as  a  matter  of  essential 
importance  in  the  harmonious  development  of  the  mind  —  a  genuine 
pedagogic  reform.  In  this,  of  course,  he  onl}'  imitated  the  Greeks,  though 
he  thei'eby  led  Rousseau  and  the  philanthropists  to  think  upon  rational 
hygiene."  Joachim  Jung  (1587-1657)  of  Liibeck,  like  the  recent  Hartmann, 
a  philosopher  from  the  military  profession  ;  Pierre  Gassendi  (1592-1655), 
who  held  that  knowledge  proceeded  from  the  senses,  that  matter  consists 
of  atoms  and  is  eternal  etc.;  Isaac  Newton  (1642-1727),  though  in  his  old 
age  he  brooded  over  the  Apocalypse,  and  Francis  G-lisson  (1597-1677), 
professor  in  Cambridge,  all  likewise  followed  more  or  less  pure  realistic 
principles.  The  latter  also  devoted  himself  to  metaphysical  and  mystical 
speculations,  for  realism  or  materialism  and  religiousness  and  mysticism 
have  continued  to  be  a  genuine  English  medley  since  the.  days  of  Hobbes, 
Locke  etc. 

The  opposite  method  of  investigation,  deduction,  was  embraced   by 


—  478  — 

Rent'  Descartes1  (Cartesius,  1596-1650).  the  discoverer  of  the  laws  of  re- 
fraction of  light,  the  explanation  of  the  rainbow  etc.,  and  author  of  the 
famous  proposition  :  Cogito,  ergo  sura.  * "  Flesh  and  bone  and  blood  are 
accidents,  hindrances  of  nature.  But  the  man  himself  is  thought,  the 
invisible  Ego.  This  is  the  ultimate  fact  of  our  existence,  the  secret  of  life  : 
I  am  a  thing  which  thinks!''  Accordingly  he  allowed  true  existence  to 
conscious  thought  alone,  and  considered  the  latter  the  starting  point  of 
investigation,  the  objects  of  which  were  God  and  nature,  the  eternal  and 
the  temporal,  spirit  and  reality.  In  this  investigation  lie  preferred  math- 
ematics and  the  mathematical  method.  In  explanation  of  the  existence 
and  constitution  of  the  material  world  he  assumed  that  motion  emanated 
from  God  in  the  form  of  -vortices"  (assumed  by  Demoeritus  and  other  of 
the  oldest  philosophers),  and  that  it  brought,  and  still  brings,  together  the 
smallest  particles,  and  likewise  conditions  the  functions  of  bodies.  Des- 
cartes was  an  eminent  mathematician  and  physicist,  and,  with  Francois 
Viete,  the  inventor  of  algebra.  In  opposition  to  him  the  noble  Jew  Baruch 
Spinoza  (1632-1677  .  who  was  expelled  by  the  Sanhedrim  from  the  com- 
munity of  fanatical  Jews  to  the  sound  of  the  trombone,  assumed  the  one 
principle  only  of  the  eternal  God.  though  this  conception  he  apprehended 
pantheistically  or  monistically.  God  is  the  sole  being  and  the  Almighty 
Creator  (Nemo  contra  Deum,  nisi  Deus  ipse).  That  which  proceeds  from 
this  one  being  is  the  world  :  hence  God  and  the  world  are  identical,  a  view 
subsequently  adopted  by  Schelling.2 

If  philosophy  in  earlier  epochs  indicated  more  than  an}-  other  phenom- 
enon in  the  sphere  of  mind  the  general  tendency  of  thought,  which  in  the 
other  sciences  was  often  more  concealed,  since  the  seventeenth  century  the 
natural  sciences  have  become  almost  equally  a  mirror  of  this  tendency. 
In  the  17th  century  they  passed  through  their  period  of  reformation  and 
emancipated  themselves  from  the  Ancients,  supernaturalism,  philosophy 
and  the  authority  of  the  Bible.  As  the}-  had  nothing  to  do  with  salvation) 
one  was  at  liberty,  as  Galilei  thought,  to  consult  in  their  study  not  the 
Bible,  but  the  perceptions  of  the  senses  and  necessary  evidences.  Hence- 
forward they  were  founded  upon  observation  and  experiment,  and  hence- 
forth too  they  gained  the  preponderance  as  an  expression  of  the  tendency 
of  the  age.     Their  position    for  the   time  being   became  more    and  more 

1.  Descartes,  like  Regius,  held  the  pineal  gland  (hypophysis)  to  be  the  seat  of  the 

soul:  that  it  communicated  with  the  cerebral  ventricles,  the  fluids  of  which  he 
regarded  as  the  substratum  of  the  "spiritus",  and  that  it  could  on  its  part  act 
upon  the  latter,  as  these  could  act  upon  it.  As  it  is  the  only  azygous  organ  in  the 
brain  it  must  he  the  seat  of  the  soul.  Recently  it  has  been  established  by  Stieda, 
Leydig.  II.  de  Graaf  and  Baldwin  Spenceri  that  it  was,  at  all  events  originally,  an 
organ  of  the  mind,  and  indeed  one  of  its  outposts,  a  so-called  vertical  eye,  which 
exists  still  in  the  lower  animals  (mollusca  etc.),  but  in  man  is  a  mere  stunted 
rudiment. 

2.  Schelling  was  a  physician.     Spinoza's  teacher  van  den  Ende,  Ludwig  Meyer,  the 

editor  of  his  writings,  and  his  friend  Lucas  were  also  physicians. 


—  47!»  — 

authoritative  in  medicine,  and  in  fact  their  control  was  finally  manifested  in 
the  same  degree  as  had  been  the  case  with   philosoplry  in  ancient  medicine. 

Zoology  and  botany  in  the  seventeenth  century  were  extended  by 
numerous  discoveries,  as  well  as  by  dissection  and  systematic  arrangement. 
In  the  former  science  Wilhelm  Piso  (died  after  1648),  John  Johnston 
(1603-1675),  Olaus  Worm  (died  1654),  Jan  Swammerdam  (1637-1680), 
a  famous  naturalist,  savant,  physiologist,  linguist  and  poet;  Franc.  Redi 
(1626-1697),  Antonio  Vallisnieri  (died  1730),  Martin  Lister  (1638-1711), 
ordinary  physician  of  queen  Anne  of  England  (1664-1714),  and  Maria 
Sibylla  Graff,  m'e  Merian  (1647-1717),  among  others,  were  active  and  zeal- 
ous in  the  study  of  entomology,  or  that  portion  which  relates  to  the  history 
of  development ;  while  in  botany  Joachim  Jung,  Nehemiah  Grew  (1641- 
1712  :  "  The  anatomy  of  vegetables  etc.".  London,  1672),  John  Ray  (1627- 
1705),  Joh.  Vesling  (1598-1649),  Robert  Morison  (1620-1683),  Aug.  Quirin 
Rivinus  (1652-1723),  professor  in  Leipzig,  Paul  Hermann  (1640-1695)  of 
Halle  and  the  merchant  Georg  Eberhard  Rumpf  (Plinius  Indicus,  1637- 
1706)  of  Laasphe  near  Giessen,  according  to  others  of  Hanau,  both  of  whom 
had  long  resided  in  Dutch  India,  Pierre  Magnol  (1638-1715),  Jos.  Pitton 
Tournefort  (1656-1708),  who  classified  plants  in  accordance  with  their 
flowers  and  differentiated  their  species  more  correctly  than  his  predecessors, 
and  Malpighi,  distinguished  themselves.1  In  both  departments  a  zealous 
use  was  made  of  the  microscope,  though  chiefly  of  the  simple  instrument, 
for  a  compound  microscope  constructed  about  this  time  turned  out  to  be 
so  large  as  to  be  quite  unwieldy. 

With  the  aid  of  the  microscope,  the  author  last  mentioned  and  Grew, 
after  the  introduction  of  the  term  "cell"  by  Hooke  in  1667,  were  the 
founders  of  the  cell-doctrine,  which  has  been  so  much  extended  in  our  own 
century. — The  two  accessor}'  sciences  of  botany  and  zoology  just  mentioned 
did  not  remain  without  influence  upon  the  theoretical,  nosological  and 
nosographical  views  of  medicine  in  the  17th  century,  inasmuch  as  the  dis- 
covery of  microscopic  animals  awakened  the  same  inclination  to  the  patho- 
logia  animata,  as  the  study  of  the  doctrine  of  the  fungi  has  produced  in 
our  own  age.  The  first  efforts  at  the  classification  of  plants  too,  which 
were  made  in  the  17th  century,  undoubtedly  led  Sydenham  to  study  dis- 
eases as  distinct  species,  a  principle  of  which  Schoenlein  in  our  day  has 
made  the  widest  use. 

Astronomy  in  this  epoch  discovered  high  and  unforeseen  laws,  which 
in  truth  changed  the  course  of  the  world.     Among  its  cultivators,  after  the 

1.  To  the  names  in  the  text  we  may  add  those  of  Mathieu  de  Lobel  (Lobelias,  1538- 
1616),  botanist  of  James  I.,  whose  activity,  however,  was  chiefly  displayed  in  the 
16th  century  ;  William  Howe  (1619-1656),  editor  of  certain  of  the  works  of  Lobelins 
in  1655;  Thomas  Johnson  (died  1644).  who  edited  Gerarde's  "Herbal"  in  1633; 
Leonard  ITukenet  ("Phytographia"  etc.,  1691)  and  John  Parkinson  (Paradisus  in 
Sole,  born  1657 1,  apothecary  to  James  I.  of  England  and  botanicus  regius  primaiius 
to  Charles  L,  one  of  the  best  of  the  old  Herbalists,  whose  "  Theatrum  Botanicum" 
appeared  in  1640.     (H.) 


—  480  — 

earlier  Nie.  Kopernicus  (Kopperuik,  1473-1543),  whom  even  Luther  de- 
clared a  fool  who  wished  to  stand  astronomy  upon  its  head,  appear  the 
brilliant  names  of  Johann  Kepler  (1571-1630),  Galileo  Galilei  (1564-1642), 
the  defender  of  the  Copernican  system  which  had  been  interdicted  (!)  in 
1646,  and  the  persecuted  discoverer  of  the  law  of  falling-bodies,  the  ther- 
mometer, the  telescope,  Jupiter's  moons,  the  vis  inertias  etc. ;  and  Sir 
Isaac  Newton  (1642-1727),  whose  doctrine  of  the  action  of  gravity,  which 
apppeared  in  1665,  marks  an  era  in  the  history  of  natural  science  and  is 
said — so  simple  are  often  the  roots  of  great  truths — to  have  been  suggested 
by  the  falling  of  an  apple. 

Olaf  Romer  (1644-1710)  of  Aarhuus,  from  the  eclipse  of  Jupiter's 
moons,  calculated  in  1675  the  velocity  of  light;  Christ.  Hu}*ghens  (1627- 
1695;  polarization  of  light,  pendulum  clock,  the  satellites  of  Saturn)  ;  James 
Gregory  (the  telescope  with  a  metallic  concave  mirror,  1663)  ;  the  weight 
of  the  air  was  established  in  1643  by  Torricelli  (Torricellian  vacuum,  baro- 
meter). Mathematics  (logarithms  invented  by  Napier  in  1700)  and  experi- 
mental physics,  the  almost  characteristic  inventions  of  this  age,  attained 
by  their  development  an  influence  not  only  upon  philosophy,  but  likewise 
in  medicine.  Indeed,  so  great  was  their  influence  that  an  entire  medical 
school  was  named  after  them,  since  the  methods  and  results  of  these 
sciences  were  employed  by  it  in  medicine.  Optics  or  the  microscope,1  an 
invention  of  the  spectacle-maker  Jan  Lippersheim  in  Midclelburg  (1608), 
was  also  of  the  greatest  influence  in  the  medicine  of  the  17th  century. 
According  to  other  authorities  the  microscope  was  invented  by  Zacharias 
Jansen  in  1620,  immediately  offered  for  sale  b}T  Cornells  Drebbel  (1572- 
1634),  and  perfected  with  better  objectives  by  Robert  Hooke  (1635-1702). 
The  micrometer  was  invented  by  Gascoigne  in  1639. 

A  permanent  influence  upon  medicine  was  secured  in  the  seven- 
teenth century  by  chemistry,  which  in  the  course  of  this  period 
developed  energetically  from  its  origin  in  alchemy  into  an  independent 
science,  no  longer  devoted  solely  to  the  transmutation  of  metals  or  the 
preparation  of  medicines.  It  called  into  existence  the  medical  sect  of  the 
"  Iatrochemists  ",  and  also  influenced  very  considerably  the  theorist  Van 
Helmont,  to  whom  it  owes  the  establishment  of  the  existence  of  gaseous 
bodies  (he  was  acquainted  with  the  inflammable  hydrogen  gas,  carbonic 
acid,  and  its  property  of  extinguishing  flame)  ;  to  Joh.  Rud.  Glauber 
(1604-1688  ;  Glauber's  salt,  1658)  it  is  indebted  for  an  improvement  in 
analysis  ;  to  Robert  Boyle  (1626-1691),  who  was  particularly  influential  in 
the  generalization  of  the  inductive  method  and  is  also  lauded  by  the 
English  as  the  discoverer  of  the  so-called  law  of  Mariotte.  it  owes  a  scien- 

1.  In  179"!  a  lugnly  deserving  savant,  Metzger,  remarked  with  reference  to  this  instru- 
ment :  "We  would  reckon  magnifying  glasses  too  among  the  great  aids  to  the 
advance  of  anatomy,  were  their  advantages  not  equivocal,  and  had  not  more  false 
conclusions  and  errors  than  truth  been  already  introduced  into  science  by  their 
use."     With  considerable  limitations  the  same  statement  is  true  to-day. 


—  481    — 

tific  foundation  for  analysis  in  his  refutation  of  the  doctrine  of  the  elements 
taught  by  the  Ancients  and  by  Paracelsus.  The  peripatetic  Johann  Kunkel 
von  Lowenstern  (1630-1703)  of  Rendsburg  discovered  phosphorus,  in- 
vented red  glass  and  discarded  the  alkahest  (universal  solvent)  and  the 
tincture  of  gold  ;  while  chemistry,  through  Ray  and  Joh.  Joachim  Becher 
(1635-1682)  of  Spe}Ter,  a  physician,  chemist,  political  economist,  colonial 
politician  and  philologist,  whom  Stahl  followed  in  many  points,  by  means 
of  the  assumption  of  an  earthy  combustible  matter,  received  the  earliest 
hint  towards  the  discover}-  of  the  true  theory  of  combustion,  the  basis  of 
scientific  chemistry,  the  theory  of  respiration  etc.  The  introduction  of 
chemistry  into  France,  a  country  which  subsequently  showed  itself  so 
fertile  a  field  for  this  science,  was  accomplished  by  Nicolas  Lemery  (1645- 
1715 1.  an  Iatrochemist  of  Paris,  and  Wilhelm  Homberg  (1651-1715). 
Lemery  was  the  first  to  demonstrate  the  existence  of  iron  in  the  blood. 
Chemical  action  upon  objects  in  order  to  investigate  them  microscopically — 
microchemistr}'  — was  first  employed  by  Domenico  Gagliardi,  professor  in 
Rome,  who  treated  preparations  of  bone  with  acids.  Even  at  that  time 
Kunkel  estimated  the  value  of  chemistry  to  the  physician  very  highly. 
"Medicine  enjoys  no  slight  benefit  from  this  art.  A  medicus  cannot 
possibly  recognize  diseases  and  their  origin  by  means  of  anatomy  if  he  is 
not  experienced  in  chemistry.  Still  less  can  he  know  the  peculiarities  and 
effects  of  medicines,  or  recognize  the  functions  of  the  body"  etc. 

Besides  the  universities,  of  which,  through  the  rivalry  of  princes  to 
possess  the  best  educational  institutions,  and  in  spite  of  the  wars  in  Ger- 
many and  German  lands,  many  new  ones  were  /ounded,  as  e.  g.  at  Giessen 
(1607),  Paderborn  (1616),  Molsheim  (since  1702  united  with  Strassburg), 
Rinteln  (1621),  Salzburg  (1622),  Dorpat  (as  a  Swedish  university,  1632), 
Tirnau  (1635,  subsequently  removed  to  Pesth),  Utrecht  (1636),  Herborn 
(1654),  Duisburg  (1655),  Kiel  (1665),  Innsbruck  (1677;  had  no  medical 
faculty  until  1869)  and  Halle  (1694),  the 

Scientific  societies  and  journals  which  arose  at  this  period,  made  them- 
selves of  service  to  medicine  both  directl}'  and  indirectly.  These  societies 
at  first  occupied  themselves  chiefly  with  physical  investigations,  for  which 
there  was  no  opportunit}-  in  the  universities,  since  the  latter,  even  down  to 
the  present  century,  were  simply  institutions  for  instruction,  and  not,  as  at 
present,  state  institutions  for  investigation.  As  the  Church  at  that  time 
justly  scented  danger  to  the  faith  in  everything  which  related  to  the 
natural  sciences,  they  frequently  organized  as  secret  associations,  after  the 
model  of  the  "  Academies  "  founded  in  the  preceding  centuiy  (though  most 
of  the  latter  were  public),  and  devoted  themselves  to  philosophy  or  belles- 
lettres.  Italy  was  the  place  of  origin  of  these  new  associations,  as  it  had 
been  of  the  Academies.  The  "Academia  degli  Lyncei" — so  called  from  its 
seal,  which  bore  the  image  of  a  fox  —  was  founded  at  Rome  as  earl}'  as 
1603.  An  "Academia  del  cimento",  founded  in  Florence  in  1657,  selected, 
however,  a  more  appropriate  title  from  its  t:  experiments  ".  In  London  the 
31 


—  482  — 

originally  private,  or  so-called  "Invisible  Society",  originated  chiefly  by 
Milton  and  Hartlieb  1645,  was  remodeled  by  Charles  II.  in  1662  into  the 
still  flourishing  "  Royal  Societ}'  of  the  Sciences".1  Its  object  was  the 
increase  of  natural,  in  contrast  to  supernatural,  knowledge,  and  the  society 
acquired  such  reputation  that  even  foreign  savants  like  Malpighi  sent  to  it 
their  works.  It  was  a  descendant  of  the  earlier  philosophical  society,  an 
association  of  natural  philosophers,  and  from  1645  forward,  at  the  sugges- 
tion of  Theodor  Haak  of  the  Palatinate  who  had  immigrated  to  England, 
it  held  regular  meetings.  (Schaible.)  In  France,  the  "Academie  "2  was 
founded  in  1665  by  Colbert,  but  developed  its  first  activity  in  1699  under 
the  Abbe"  Bignon,  while  in  Germany  the  "  Gesellschaft  naturforschender 
Aerzte  ",  founded  at  Schweinfurt  in  1652  by  Joh.  Lorenz  Bausch.  Joh. 
Mich.  Fehr,  G.  Balth.  Metzger  and  G.  Balth.  Wohlfarth,  was  metamor- 
phosed in  1677  into  the  still  existing  and  praiseworth}*  "  Kaiserliche 
leopoldinische  Akademie  der  Naturforscher".  The  members  of  this  society 
frequently  had  special  names,  as  was  the  fashion  in  the  silly,  mystical, 
antiquity-aping  movements  of  that  time.  Thus  Kunkel  was  called 
"  Hermes  III." 

The  British  "  Royal  Societjr  "  has  published  its  "  Philosophical  Transactions" 
since  1665  ;  the  French  "Academie",  the  "  Histoire  de  1'  Academie"  and  "  Memoires" 
since  1699,  and  the  German  society,  the  "  Ephemeriden"  since  1C70.  To  these  official 
journals,  as  we  maj'  call  them,  were  added  in  the  seventeenth  century  the  "Journal 
des  Scavans"  (published  since  1665:  its  first  editors  were  Dion,  des  Salles  and  Abbe 
Gallois) ;  The  "Acta  Eruditorum  "  of  the  Leipzig  professor  Otto  Menken,  published 
since  1682;  the  "Nouvelles  de  la  Republique  des  Lettres"  of  Pierre  Bayle,  published 
since  1648;  the  "  Nouvelles  Decouvertes  sur  toutes  les  Parties  de  la  Medeeine  "  of 
Nicolas  de  Blegny  (1697),  and  the  "Collectanea  Medico-physica"  of  Stephan  Blankaart, 
published  at  Amsterdam  since  1680.  The  number  of  printed  books,  even  in  this 
century,  was  so  large  that  Leibnitz  himself  complained:  "In  consequence  of  the 
innumerable  new  books  even  the  greatest  literati  cannot  survey  the  whole  field. 
Our  scientific  life  has  become  a  mere  slop-shop!"  What  if  the  man  had 
lived  to-day  ! 

1.  "The  war  (civil)  had  not  reached  its  end  when,  in  1645.  a  little  group  of  students 

were  to  be  seen  in  London,  men  'inquisitive,'  says  one  of  them,  'into  natural 
philosophy  and  other  parts  of  human  learning,  and  particularly  of  what  had  been 
called  the  new  philosophy.'  .  .  .  Foremost  in  the  group  stood  Doctors  Wallis 
and  Wilkins,  whose  removal  to  Oxford,  which  had  just  been  reorganized  by  the 
Puritan  visitors,  divided  the  little  company  in  1648  into  two  societies,  one  at  the 
university,  the  other  remaining  at  the  capital.  The  Oxford  society,  which  was 
the  more  important  of  the  two,  held  its  meetings  at  the  lodgings  of  Dr.  Wilkins, 
who  had  become  warden  at  Wadham  college,  and  added  to  the  names  of  its 
members  that  of  the  eminent  mathematician  Dr.  Ward,  and  that  of  the  first  of 
English  economists,  Sir  William  Petty"  (Green).  After  the  "Restoration" 
the  two  branches  of  the  society  were  reunited  and  chartered  by  Charles  II. 
under  the  title  of  "Royal  Society  of  London  for  the  Promotion  of  Natural 
Knowledge".  (H.) 

2.  The  "Academie  des  Sciences",  not  to  be  confounded  with  the  "Academie  Francaise" 

founded  by  Richelieu  in  lti35  with  the  object  of  refining  the  French  language  and 
style.     (H.) 


—  483  — 

The  political  daily  press  also  took  root  in  tlie  17th  centur}-.  The  first  newspaper 
appeared  at  Antwerp  in  1605  under  the  editorship  of  A.  Verhoeven ;  the  first  in 
Germany  ("Frankfurter  Postamtszeitung")  made  its  appearance  in  1615,  and  was 
followed  by  the  "  Zeitung  aus  Deutschland"  etc.  The  "  London  Weekly  News"  began 
its  career  in  1620, '  under  a  system  of  censorship  more  strict  than  in  other  lands. 

The  arts,  with  painting  at  their  head,  also  followed  the  realistic  tendency  of  the 
century.  Here  the  realistic  genre  and  landscape  painting  predominated,  in  contrast 
to  the  religious  idealism  of  the  16th  century.  "The  soulless  idealism  was  opposed 
by  a  decided  naturalism.  The  Realists  accordingly  recognized  only  reality.  They 
gave  to  genre  its  rights.  This  was  parallel  with  the  upgrowth  of  physical-scientific 
movements  at  that  time"  (Dohme).  In  this  century  too  painting,  and  particularly 
engraving,  stood  in  close  relations  with  medicine,  and  especially  with  anatomy. 
The  Netherlands  school  is  to  be  regarded  as  the  chief  representative  of  the  realistic 
painting  of  the  17th  century.  At  its  head  stood  Peter  Paul  Rubens  (1577-16-10)  of 
Siegen,  and  Rembrandt,  the  former  still  preserving  sympathy  with  the  idealism  of  the 
16th  century,  while  the  latter  already  points  to  the  excesses  of  the  new  tendency. 
This  realism  has  been  called  a  Protestant  principle,  and  idealism  the  Catholic,  though 
the  justice  of  this  distinction  is  doubtful,  for  the  Italians.  Spanish  and  French  were 
not  untouched  by  the  former.  In  architecture  the  st}-le  of  the  renaissance  was 
exchanged  for  the  more  substantial  barocco,  and  in  music  the  realistic  opera  took  the 
place  of  the  church-music  of  the  16th  century.  In  polite  literature  the  realistic 
romance  and  the  drama  were  developed.  In  one  direction,  however,  the  realistic 
17th  century  differed  considerably  from  our  own:  the  former  inclined  to  polymath}', 
the  latter  tends  to  specialism.  The  polymathy  of  the  17th  century  may  be  looked 
upon  as  the  first  step  towards  the  universalism  of  the  18th.  In  politics,  however,  the 
grossest  absolutism  and  selfishness  prevailed,  though  the  English  revolution  mirrored 
forth  by  anticipation  the  revolutionary  and  republican  acquisitions  of  the  following 
century.  For  while  in  every  century  the  present  is  chiefly  at  work,  yet  the  future  is 
also  prepared  in  all  departments  of  activity. 

While  the  preceding  remarks  exhibit,  on  the  whole,  the  bright  side 
of  the  seventeenth  century,  we  must  add  that  the  deepest  shadows  too  were 
not  wanting.  All  kinds  of  superstition,  especially  alchem}-,  witchcraft 
{against  which  the  noble  Friedrich  Spee  took  up  arms  frankly,  though  at 
first  in  vain),  and  the  follies  of  the  Rosicrucians  were  in  full  bloom  !  A 
•;  Collegium  Rosianum"  was  formed  in  France  at  this  period,  and  consisted 
of  three  adepts,  of  whom  one  had  the  duty  of  preserving  the  universal 
medicine,  another  the  secret  of  the  transmutation  of  metals,  the  third  that 
of  the  perpetuum  mobile  —  all  of  course  absolute  nonsense  !  However  it 
could  not  well  be  otherwise,  when  even  professors  like  Sebastian  Wirdig 
(died  1687)  spoke  in  behalf  of  divining-rods  and  necromancy,  and  his 
Serene  Highness  at  Homburg  in  the  year  1699,  out  of  care  for  his  subjects, 
found  it  necessary  to  recommend  on  occasion  of  an  impending  eclipse  of  the 
sun  "that  the  cattle  shall  remain  in  the  stall  that  the  foul  air  may  not 
injure  them,  since,  during  such  great  darkness,  apoplexy,  malignant  fevers, 
pestilence  and  all  sorts  of  unknown  diseases  threaten  them"  (A.  Griin). 

1.  The  "  Weekley  Newes"  made  its  first  appearance  May  23,  1622,  under  the  editor- 
ship of  Nathaniel  Butters,  Nicholas  Bourne  and  a  few  others.  In  France  the 
"Gazette  de  France"  of  TheophrasteRenaudot  appeared  May  :;<),  1631.     ill  ) 


—  -484  — 

2.  PHENOMENA  OF  TRANSITION  AND  SYSTEMS.  ADVANCES  AND  LA bORS 
IN  THE  PRACTICAL  BRANCHES. 

a.    Medicine. 
a.  The  Arabians  and  Greeks. 

The  preponderating  influence  of  the  Arabians  in  the  sixteenth  century 
had  become  broken,  although  even  in  the  seventeenth  century  it  still  con- 
tinued to  display  some  activity,  as  e.  g.  with  Charles  Patin  (1633-1699),  son 
of  the  famous  Guy  Patin,  and  in  certain  of  the  universities  (oath  of  the 
professors  at  Helmstadt)  etc.  Ou  the  other  hand,  the  Greeks  asserted  their 
power,  especially  iu  Italy  and  Spain,  though  more  quietly,  and  mainly  within 
judicious  limits.  Among  the  Ancients.  Hippocrates,  through  the  influence 
of  Sydenham,  attained  well-deserved  estimation  in  practice. 

Galen's  doctrine  of  qualities,  and  even  the  theory  of  the  descent  of  corrosive 
mucus  from  the  brain  into  the  intestines  still  found  their  votaries,  e.  g.  in  the  famous 
Santoro  and  others.  Among  the  Galen ists  belong  also  the  Spaniards  A.  Ponce  de 
Santa  Cruz  idied  18.30)  and  Gasparo  Caldera  de  Heredia,  the  former  professor  in 
Valladolid,  the  latter  in  Seville.  Hippocrates  and  Galen  found  an  eminent  commi  n- 
tator  and  translator  in  Rene  Chartier  '  1572-1654  i,  professor  and  physician-in-ordinary 
at  Paris,  who  spent  forty  years  and  an  entire  fortune  on  his  edition  of  these  two 
authors  in  thirteen  volumes  folio.  Galen  found  a  similar  advocate  in  Phil.  Labbe 
,(1660);  Hippocrates,  in  the  Italian  Prospero  Martiano  at  Rome  (1627),  and  in  the 
Netherlander  Joh.  Antonides  van  der  Linden  (1609-1664),  professor  at  Franecker 
and  Leyden.  The  Scotchman  Thomas  Burnet1  (died  1715i  published  an  ab.-tract  of 
the  works  of  Hippocrates.  In  Germany  Kasper  Hofmann  (1572-1648)  of  Gotha 
devoted  himself  with  self-sacrificing  perseverance  to  Galen.-  and  the  same  devotion 
to  the  Ancients  in  general  was  displayed  by  the  Iatro-chemist  Thomas  Reinesius 
(1587-1667,  died  in  Leip/.igi,  burgomaster  and  physician-in-ordinary  at  Altenburg, 
who,  even  in  the  eleventh  year  of  his  age.  understood  Greek  and  Latin;  Heinrich 
Meiboin  at  Helmstadt;  the  great  savant  and  famous  physician  Hermann  Conring,  and 
others.  The  anatomy  of  the  Ancients  found  a  worthy  laborer  at  Konigsberg  in 
Professor  Ph.  Jac.  Hartmann  (1648-1707)  of  Stralsund,  while  Philip  Gruling  (1594- 
16G7)  in  1665  wrote  a  "  Florilegium  Hippocrateo-Galeno  Chemieum  Novum".  The 
medicine  of  our  German  forefathers  was  discussed  by  Gottfried  Welsch  in  ltii  3. 

,1.  Paracelststs. 

In  the  practical  branches  the  seventeenth  century  was  connected  with 
the  sixteenth  by  an  abundant  aftermath,  which,  however,  produced  far  more 
tares  than  wheat.  We  refer  to  the  degenerations  and  amalgamations  of  the 
genuine  doctrines  of  Paracelsus.      In  tact  the  latter  in  their  corruptions  and 

1.  A  brother  of  the  famous  bishop  Gilbert  Burnet.     He  was  born  in  1632,  studied  at 

Cambridge  ami  became  one  of  the  royal  physicians  and  a  member  of  the  Royal 
College  of  Physiciansof  Edinburgh.  His  work,  to  which  reference  is  made  in  the 
text,  was  entitled  "  Hippocrates  Contractus",  1685.    (H.) 

2.  The  manuscript — 35  volumes  folio,  the  work  of  20  years — was  sold  in  England 

for  about  so  florins.  In  Germany  no  publisher  for  it  could  be  found,  for  "there 
existed  in  Germany  neither  a  literature  nor  literary  protectors.  War,  the  plague, 
famine  have  desti'oyed  everything"  complains  Hofmann  as  early  as  k;;5-  Marx). 
Yet  this  frightful  war  still  continued  for  ten  full  years. 


—  485   — 

offshoots  attained  greater  popularity  in  this  century  than  did  the  genuine 
doctrines  themselves  in  that  which  gave  them  birth.  Indeed,  as  a  rule,  the 
seed  of  evil  contained  in  the  doctrines  of  Paracelsus  always  produced  a  more 
abundant  harvest  than  the  good  germs  found  therein.  The  doctrines  of 
Zoroaster,  the  Cabala  and  the  '-Hermetic  books"  were  revived  in  these 
corruptions,  and  the  fanciful,  speculative  German  race  furnished,  alas,  the 
chief  contingent  in  the  support  of  such  absurdities. 

Resides  Fludd,  who  lias  been  already  mentioned  and  who  was  still  prominent  in 
the  seventeenth  century,  Sir  Kenelin  Digby  (1603-1665),  the  king's  chamberlain,  made 
himself  particularly  famous  among  the  English  as  a  (Rosicrucian)  Paracelsist.  He 
gave  vogue  to  a  sympathetic  powder1  for  wounds,  and  wore  himself  out  in  the  search 
for  a  medicine  to  prolong  life  for  all  eternity,  while  William  Maxwell,  with  his  "  De 
medicina  magnetica"  (1679),  was  a  titular  predecessor  of  Mesmer.  (His  work  found 
no  publisher  in  England,  but  was  published  in  Germany  by  Georg  Frank  von  Franke- 
nau,  who  taught  "The  Restoration  "of  Burned  Plants  from  their  Ashes").  Maxwell 
taught  some  very  curious  things,  e.  g.  that  a  hen's  rump,  stripped  of  its  feathers  and 
laid  upon  the  place  where  a  viper  had  inflicted  a  bite,  would  draw  out  the  poison 
(Waldmann).  Besides  these,  a  common  Irish  soldier,-  Valentine  Greatrakes  (1628- 
1666),  attained  great  reputation  as  a  layer-on  of  hands,  and,  by  the  use  of  his  saliva  to 
cure  deafness  and  the  employment  of  carrots  and  subsequent  pressure  of  the  abscesses 
in  scrofula,  came  to  be  regarded  as  a  better  miracle-worker  than  the  king  of  England 
himself. 

This  degeneration  of  the  doctrines  of  Paracelsus  existed  in  Germany  also,  where 
it  found  its  representatives  and  propagators  in  the  Wirdig  already  mentioned,  in' 
Rudolph  Goclenius  (1577-1028)  professor  in  Marburg  (weapon-salve);  the  savant  and 
Jesuit  —  the  Jesuits  practised  everything.,  even  medicine  —  Athanasius  Kiicher  (1598- 
1680);  Andr.  Tentzel  (about  1629);  Andreas  Rlidiger  (1673-1781),  professor  at  Leip- 
zig; indeed  in  the  later  and  justly  famous  Christian  Thomasius  ( 1655-1T28),  and 
others  — Paracelsist-!  of  the  better  class,  in  addition  to  Aug.  Sala  already  mentioned, 
were  Raimund  Minderer  (died  1621),  of  Augsburg,  who  first  employed  sulphuric  acid 
and  the  acetate  of  ammonia  (spiritus  Mindereri),  and  wrote  in  1620  a  "Medicina 
militaris ";  Johann  Hartmann  (1568-1631),  of  Amberg.  the  first  special  German  pro- 
fessor of  Iatro-chemistry  —  a  synonym  of  Paracelsian  pharmacy — in  Marburg;  the 
famous  Daniel  Sennert  (1572-1637),  who  wrote  six  folios  and  vibrated  between  the 
chemical  doctrines  of  Paracelsus  and  Galen,  and,  in  accordance  with  the  spirit  of  his 
time,  believed  in  compacts  with  the  devil  and  witchcraft ;  Heinrich  Lavater  (about 
1610),  who,  however,  was  rather  a  follower  of  Galen  than  Paracelsus;    Hiob  Korn- 

1.  See  page  406,  note. 

2.  Greatrakes  came  of  a  very  good  family,  was  a  lieutenant  of  cavalry  under  the  earl 

of  Orrery  in  the  army  of  Cromwell,  and  subsequently  a  Justice  of  the  Peace,  a 
position  in  which  lie  acquitted  himself  with  credit.  Undoubtedly  at  the  outset 
he  was  rather  an  enthusiast  than  an  impostor.  To  the  list  of  Spagyrists  and 
charlatans  given  in  the  text  we  may  add  the  names  of  Thomas  Vaughan  (1621- 
1666,,  a  Rosicrucian  devoted  to  the  writings  of  Agrippa  von  Nettesheim;  Robert 
Murray  (died  1673),  who,  though  a  President  of  the  Royal  Society,  was  yet  a 
Rosicrucian  ;  Arthur  Dee  ( 1597-1651 ),  son  of  the  famous  John  Dee  (1527-1608),  and, 
like  his  father,  a  devotee  of  astrology,  cabalisra  and  kindred  absurdities  ;  Simon 
Forman  ( l  ").")2-1611 )  and  his  pupil  Richard  Napier  (1559-1634) ;  and  the  famous 
Francis  Anthony  (1550-1623  ,  whose  assertion  of  the  ineffable  virtues  of  bis  aurum 
potabile  elicited  a  quarto  volume  in  reply  from  the  pen  of  Matthew  Gwinne,  the 
first  professor  of  medicine  in  Gresham  College,     ill.) 


—  48(5  — 

thaner  (about  LK22) ;  Claudius  Deodatus  (about  1629),  a  bishop  and  physician-in-ordin- 
ary at  Basel;  Adrian  Mynsiclit  (about  1631),  ordinary  physician  of  Mecklenburg  and 
1  he  discoverer  of  tartar  emetic :  and  finally  the  enlightened,  versatile  and  famous 
professor  Werner  Rollfink  (1599-167:!  i  of  Jena,  who  declared  against  the  transmuta- 
tion of  metals,  vegetable  quicksilver  etc.  A  pious  opponent  of  Paracelsus,  and 
above  all  of  Sennert,  was  .loh.  Freitag  (1581-1641 )  in  Groningen,  whose  chief  weapon 
was  the  Bible. 

In  France  the  first  Iatro-chemieal  chair  at  Montpellier  was  filled  by  Lazarus 
Riverius  (la  Riviere,  1589-1655).  Among  the  followers  of  Paracelsus  belong!  d  also 
the  Paris  physician  Theophraste  Renaudot  (1584-1653),  of  greater  importance  as  the 
founder  of  French  journalism,  pawn-shops  and  intelligence-offices,  than  as  a  physician. 
He  was  followed  in  all  his  "  specialties"  by  his  son  Isaac.  Riverius  was  opposed  by 
Pierre  de  la  Poterie  (Peter  Poterius)  of  Angers,  ordinary  physician  at  Bologna 
(about  1645),  who  took  a  middle  course  between  Paracelsus  and  Galen.  The  same 
was  done  among  the  Italians  by  Pietro  Castelli  (died  1656i,  professor  at  Bologna, 
where  Fabrizio  Bartoletti  (1581-1630)  also  taught  the  principles  of  Paracelsus.  '1  he 
Spaniard  Gasp.  Bravo  de  Sobremonte  Ramirez  ( born  1613),  professor  at  Vail;. r(d:d. 
physician  to  the  Inquisition  and  ordinary  physician  to  the  king,  was  at  least  a 
follower  of  the  therapeutics  of  Paracelsus. 

The  doctrines  of  Paracelsus  received  a  new  form  in  the 

,-.  System  of  Joh.  Bapt.  van  Helmont, 

which    may    be   regarded   as   a   peculiar    remodeling   of  the   pantheism    of 

Paracelsus  into  a  mystic  and  pietistic  system  based  upon  chemical  princi- 
ples. As  a  savant  and  thinker  van  Helmont  (1578—1644)  was  the  embodi- 
ment of  doubt  in  the  human  understanding  and  human  knowledge,  the 
inadequacies  of  which,  in  accordance  with  his  pietistic  disposition,  he 
considered  so  many  moral  evils  to  be  carefully  avoided.  Hence  he  vacil- 
lated from  one  calling  to  another,  from  one  science  to  another,  without 
finding  complete  satisfaction  in  any  of  them.  An  enthusiastic  and  fantastic, 
but  upright,  friend  of  the  truth,  in  spite  of  his  pietistic  anil  ascetic  veir> 
which  he  owed  to  the  general  tendency  of  his  age  and  to  his  nationality,  he 
was  still  a  partisan  of  the  theosophic  and  al'chemistic  views  of  the  preced- 
ing century,  particularly  those  of  Paracelsus,  to  whom  he  was  greatly 
indebted.  He  was  an  important,  versatile,  and  in  the  department  of  chem- 
istry a  fertile  genius,  but  not  a  great  and  independent  spirit,  outrunning  his 
age  or  impressing  upon  it  the  stamp  of  his  own  individuality  :  not  a  man 
whom  the  masses  feel  constrained  to  follow  even  into  error.  Hence  it  was. 
doubtless,  that  he  left  behind  no  "School''  of  followers.  Many  of  his 
ideas,  though  under  different  names,  were  revived  at  a  later  period,  as  e.  g. 
thai  of  the  inseparableness  of  force  and  matter,  that  of  the  ferments  etc. 

Van  Helmont  was  the  genuine  son  of  his  century,  at  once  a  mystic  and  a  realist. 
The  youngest  son  of  a  noble  family  of  Brabant,  the  lords  of  Merode.  Royenboieh, 
Oorschoot  and  Pellines,  he  was  born  in  Brussels  and  lost  his  father  in  the  second 
year  of  his  life.  A  precocious  child,  while  yet  a  mere  boy  he  entered  the  university 
of  Lou  vain,  where  at  the  age  of  seventeen  he  had  completed  his  studies  in  mathematics. 
astronomy,  astrology  and  philosophy,  and  would  even  have  received  the  degree  of 
Magister,  had  he  not  arrived  at  the  conclusion  that  this  title  would  be  frivolous,  and 
above  all  that  he.  who  was  yet  a  student,  could  not  be  entitled  to  such  an  honor.      He 


—  487  — 

now  went  to  the  Jesuits,  who  at  that  time  taught  even  magic,  but  speedily  abandoned 
them  and  devoted  himself  to  the  study  of  the  Stoic  philosophy.  Under  the  false  idea 
that  the  Capuchin  friars  (mere  lascivious  gluttons,  who  consider  even  washing  un- 
christian) were  the  true  Christian  Stoics,  he  next  wished  to  become  one  of  them. 
Once  more,  however,  he  abandoned  the  Capuchins  and  resumed  his  studies  in  law, 
botany  and  medicine.  In  the  latter  science  Helmont  was  as  little  pleased  with  its 
practice  as  with  its  theory,  since  it  proved  totally  unable  to  rid  him  of  the  itch,  con- 
tracted from  the  glove  of  a  scabious  maiden,  which  he  had  inadvertently  drawn  on. 
At  least  he  lapsed  away  to  the  mystics  Joh.  Tauler  (1200-loGl)  and  Thomas  a  Kempis 
(recently  specially  recommended  again  by  Leo  XIII.),  by  whom  he  was  led  to  the 
conclusion  that  wisdom,  like  the  grace  of  God,  was  attainable  only  by  fasting,  suppli- 
cation and  prayer  and  in  poverty.  Hence  he  scorned  a  rich  canonicate  offered  him 
(since  he  was  unwilling  to  live  and  acquire  wealth  from  the  sins  of  the  people)  and 
declined  the  office  of  imperial  physician.  On  the  contrary  he  chose  the  poverty  of 
Christ,  giving  to  his  sister  all  his  fine  earthly  possessions,  for  which  he  considered 
himself  already  indemnified  by  rich  heavenly  visions,  in  one  of  which  he  saw  his  own 
soul,  like  a  great  empty  bladder,  floating  over  a  dark  abyss.  Next  he  started  upon 
his  travels  and  practised  medicine  as  a  labor  of  love,  being  unwilling  to  accept  money 
from  his  sick  fellowmen  in  return  for  so  doubtful  an  art.  He  had  received  his  degree 
of  doctor  in  1599.  During  the  course  of  his  travels  he  had  made  the  acquaintance 
of  a  pyrotechnist,  by  whom  he  was  introduced  to  the  writings  of  Paracelsus.  These 
he  studied  zealously,  though  not  with  blind  devotion;  indeed,  he  rather  disparaged 
them,  though  he,  undoubtedly,  borrowed  much  from  them.  Finally,  after  ten  years, 
he  returned  home,  laid  aside  once  more  the  poverty  of  Christ,  which  seems  to  have 
been  no  longer  a  source  of  pleasure,  and  contracted  a  discreet  marriage  with  a  rich 
heiress,  byT  whom  he  had  several  children,  including  the  editor  of  his  writings,  his 
son  Franz  Mercurius.  The  latter  was  a  greater  theosophist  than  even  his  father,  and 
also  devoted  his  attention  to  the  physiology  and  pathology  of  speech  (Marx).  In 
Vilvorde,  where  van  Helmont  settled,  he  occupied  himself  with  the  practice  of 
medicine,  with  chemistry1  and  with  his  writings,  and  died  here  of  pleurisy.  His  post- 
humous masterpiece  bore  the  title  of  "  Ortus  Medicinse,  id  est  Initia  Physicae  Inaudita. 
Progressus  Medicina*  novus"  etc. 

The  system  of  Helmont  is  not  free  from  contradictions  and  obscuri- 
ties of  reasoning,  independent  of  its  conception  and  its  principles  so  repug- 
nant to  our  taste.  It  contains  also  unintelligible  definitions  and  many- 
curious  words  of  his  own  coinage,  in  the  style  of  Paracelsus  and  difficult 
of  comprehension.  Hence,  as  with  Paracelsus,  the  various  interpretations 
of  his  writings  vary  greatly  from  each  other.  Like  almost  all  "  Systems  " 
of  medicine,  that  of  van  Helmont  is  valuable  011I3-  as  an  expression  of  the 
spirit  of  the  age,  i.  e.  of  the  pathogenetic  and  pathological  ideas  and 
knowledge  prevailing  at  that  period. 

In  his  doctrine  of  the  elements  Helmont  differs  as  well  from  the  Ancients  as  from 
Paracelsus,  agreeing,  on  the  other  hand,  with  the  Bible.  Thus  he  regards  air  and 
water  as  elements,  though  he  assigns  to  the  former  only  a  subsidiary  role.  From 
water  everything  upon  the  earth  takes  its  origin.  — The  world  is  a  creation  of  God, 
but  is  not  to  be  understood  as  something  complete  in  itself  and  finished,  but  rather  as 
continually  originating  and   decaying.  — From   God  springs   primarily  the  spirit  of 

1.    He  also  investigated  mineral  springs,  and  found  in  the  water  of  Spaa  e.  g.  :  a 
mineral  water  and  a  mineral  vitriol,  an  acid  salt,  immature  sulphur  etc. 


—  488  — 

m;in,  which,  alas,  became  by  the  Fall  so  greatly  corrupted  and  enfeebled  that  the 
principle  next  mentioned  attained  the  upper  hand,  though  it  was  and  is  subordinate 
to  the  spirit.  Beneath  the  latter  in  rank  stands  the  perceptive  and  concupiscent  soul, 
under  which  again  is  the  Archeus.  The  former  belongs  to  man  and  animals  only, 
the  Archeus,  to  natural  objects  also.  Besides  the  Archeus  there  is  also  "Gas",1 
which  arises  as  an  aeriform  body  by  the  influence  of  the  Archeus  upon  water,  and 
represents  the  active  principle  in  the  origin  of  things  and  of  life,  while  "Bias" 
represents  the  principle  of  motion  of  the  stars,  and  corresponds  to  the  "  Leffas"  of 
plants,  as  well  as  the  "Bur"  of  metals. — The  Archeus  of  man  and  animals,  as  a 
whole,  is  like  the  soul  as  it  became  after  the  Fall  through  Eve,  and  is  called  the 
Archeus  influus.  Regarded  as  the  faculty  of  appetite  it  has  its  seat  in  the  spleen  ; 
but  viewed  as  creative,  active  thought,  it  resides  in  the  stomach-.  The  spleen  and  the 
stomach  form  the  duumvirate  of  the  body.  The  former  presides  over  the  abdomen, 
the  sexual  organs  etc. ;  the  latter  ovr  sleep,  waking,  folly  etc.  The  Archei  insiti  are 
portions  of  the  Archeus  influus.  and  each  organ  possesses  its  own.  According  to 
Helmont  the  active  principle  of  the  Archeus,  in  both  healthy  and  diseased  conditions, 
is  called  ferment.  This  is  the  special  generative  and  creative  principle  in  nature  and 
man,  and  the  basis  of  life  After  death,  and  during  decay,  it  escapes  fiom  the  body, 
in  order  to  beget  new  bodies.  It  exists  also  lie/ore  the  semen,  bus  an  odor,  which 
attracts  the  Archeus  and  excites  it  to  activity,  and  acts  upon  the  ovum,  but  can  also 
generate  without  such  an  organism.  It  is  likewise  the  "  magnum  orpotet",  which 
even  from  vegetable  food  passes  into  animals,  and  thus,  as  the  result  of  imperfect 
assimilation,  or  through  the  deposit  of  injurious  material  in  the  body,  also  occasions 
diseases.  The  "ferment'  is  the  chief  agent  in  digestion,  adheres  to  the  acid  of  the 
stomach  and  obeys  the  commands  of  the  Archeus.  Of  the  six  different  grades  of 
digestion  (corresponding  to  the  six  days  of  creation)  which  van  Helmont  assumes, 
the  duumvirate  possesses  the  first;  the  second  takes  place  in  the  duodenum  by  means 
of  the  bile;  the  third,  in  the  vessels  of  the  mesentery;  the  fourth,  in  the  heart;  the 
fifth,  in  the  brain  and  the  whole  body,  and  consists  in  the  conversion  of  the  arterial 
blood  into  vital  spirits;  while  the  last  takes  place  in  the  individual  parts,  each  of 
which  by  its  aid  specially  prepares  and  appropriates  its  nutriment.  The  Archeus 
directs  th  •  regular  course  of  digestion  by  controlling  the  pylorus  so  that  it  opens  and 
closes  at  the  right  time  Helmont  also  supposes  in  the  blood  a  peculiar  "latex"',  a 
fluid  free  from  the  saline  constitution  of  the  blood,  and  which  about  coiresponds  to 
the  serum. 

[n  accordance  with  these  cosmogenetic  and  physiological  views,  Helmont  in  his 
general  pathology  considers  disease  something  active,  not  simply  an  impairment  or 
lo<s  of  health.  The  general  cause  of  disease  is  the  Fall  of  Man.  As  regards  special 
pathology,  disease  depends  upon  a  perverted  action  of  the  Archeus,  upon  mo'bid 
ideas,  or  upon  errors  of  the  Archeus,  as  th<©result  of  which  it  sends  the  ferment  of  the 
stomach  to  improper  places  (the  error  loci  of  Erasistratus ! ).  These  morbid  ideas  of 
the  Archeus  arise,  however,  from  its  anxiety,  dread,  hate,  terror,  anger,  passion  etc. 
The  Archeus  influus  causes  general  diseases,  the  Archei  insiti,  local  di.-eases  The 
former,  as  special  diseases  of  the  Archeus,  do  not  necessarily  presuppose  an  external 
cause  for  their  origin  ;  the  latter  originate  in  the  occasional  causes,  to  be  mentioned 
hereafter,  and  are  practically  more  important  than  the  former,  since  general  diseases 
require  no  artificial    aid.     Accordingly   fever  is   an   expression   of  the  sensibility   of 

1.  It  is  not,  perhaps,  generally  known  that  we  owe  this  word  ''gas"  to  van  Helmont's 
fondness  for  coining  new  words.  On  the  Darwinian  theory  of  the  survival  of 
the  fittest  it  seems  to  have  maintained  its  existence,  while  its  companions 
■'bias",  "leffas"  and  "bur"  perished  without,  so  far  as  I  know,  leaving  a 
trace.     (H.) 


—  48n  — 

the  Archeus  injured  by  the  cause  of  the  fever.  The  period  of  chill  is  the  expression 
of  its  passion  or  terror;  the  stadium  of  heat,  that  of  its  fury.  On  the  other  hand, 
inflammation  originates  in  a  "spina"  (irritation),  which  springs  from  excitation 
of  the  Archeus,  or  from  external  causes.  — Among  the  occasional  causes  of  diseas.es 
van  Helmont  ranks  demons,  witches,  ghosts,  necromancers  etc.,  whom  he  assigns 
to  the  ^etiological  class  of  "  Recepta",  which  includes  also  the  "  Concepta"  (mental 
causes),  the  "  Suscepta"  (external  mechanical  injuries),  and  the  "Inspirata" 
(troubles  arising  from  the  respiration).  To  the  class  of  the  "  Retenta  "  belong  the 
"Assumpta"-  causes  acting  from  without  through  the  digestion — and  the  "Innata" 
—  the  products  of  disease. 

Van  Helmont' s  special  aetiology  gives  e.  g.  as  the  cause  of  dropsy,  hindrance  to 
the  excretion  of  urine  by  the  enraged  Archeus  In  inflammation  of  the  chest,  where 
the  blood  coagulates  outside  of  the  vessels,  the  Archeus  sends  the  acid  secretion  of  the 
stomach  into  the  lungs;  in  gout,  into  the  joints  etc.  In  catarrh  the  mucus  is  formed 
from  the  remnants  of  the  food  sticking  to  the  palate ;  vesical  calculi  originate  in  a 
deposit  of  the  urinary  salts  etc.  "Putrefaction"  in  the  closed  lumen  of  the  vessels 
he  does  not  recognize  as  the  cause  of  disease  in  fevers.  Although  van  Helmont  made 
local  diseases  so  very  prominent  in  his  system,  and  therefore  desired  to  improve  the 
condition  of  pathological  anatomy,  still,  like  Paracelsus,  he  placed  no  value  upon 
normal  anatomy.  — Surgery  he  claimed  to  be  inseparable  from  medicine.  He 
referred  the  origin  of  syphilis  to  sodomy  with  glandered  horses.     (Proksch.  i 

Although  in  therapeutics  van  Helmont  laid  great  weight  on  universal  medicine, 
conjurations,  charms  and  prayer  (so  nearly  related  to  charms),  and  in  his  pious  style 
claimed  God's  mercy  —  certainly  necessary  for  many  of  our  drugs  to-day  too  —  as 
the  basis  of  the  efficacy  of  medicines,  yet  he  did  not  despise  earthly  remedies,  whose 
"sapores",  or  active  principles,  are  contrasted  with  the  "salia",  or  chemical  constitu- 
ents. He  gives  opium  (to  the  stimulant  effect  of  which  he  called  attention),  mercury, 
antimony,  wine  in  levers  (alcoholic  treatment  of  fevers)  etc.,  and  makes  frequent  use 
of  Arcana.  The  latter,  in  his  view,  are  to  be  considered  specifically  active  against 
the  wrathful,  or  in  any  way  excited,  Archeus.  against  whose  discontent  and  ill-humor 
and  morbid  ideas  in  general,  all  therapeutics  were  to  be  directed;  while  the  remedies 
first  mentioned,  especially  those  of  metallic  origin,  act  in  a  similar  way,  only  not  spe- 
cifically. In  general  he  lays  stress  upon  simple  chemical  remedies,  and  abhors  bleed- 
ing because  of  its  tendency  to  debilitate,  a  tendency  to  which  he  first  called  attention. 
In  the  colossal  abuse  of  bleeding  which  prevailed  at  this  time,  his  caution  on  this  sub- 
ject merits  every  commendation.  In  the  calendars  bleeding,  according  to  the  rules 
of  astrology,  was  preached-up  as  a  general  prophylactic  until  the  opening  of  the  pres- 
ent century. 

Kunkel  gives  us  the  following  comparison  of  Helmont  and  Theophrasfus  von 
Hohenheim:  "Had  both  lived  at  the  same  time,  Helmont  would  have  treated  his 
patients  with  causes  and  reasons,  while  Theophrasfus,  on  the  other  hand,  would  have 
employed  direct  remedies.  Helmont  would  have  seen  few  patients,  but  he  would 
have  called  Theophrasfus  rash  in  his  promises,  inexperienced  in  the  plague,  fickle  in 
the  use  of  medicines"  etc. 

If  the  dynamic  system  of  van  Helmont  lacked  the  ingenious  concep- 
tion, the  independence  and  the  deep  impress  of  a  strong  individuality, 
which  distinguished  the  system  of  Paracelsus,  }-et  for  this  reason  it  is 
more  consistent,  more  free  from  contradictions  and  based  upon  a  certain 
sum  of  realities  ;  so  that,  regarded  as  a  system  and  compared  with  that  of 
Paracelsus,  it  involves  an  actual  advance  in  scientific  knowledge.  In 
richness  of  ideas   it   also  towers  conspicuously  above  the  systems  which 


—  490  — 

follow. — As  regards  its  author,  we  must  bear  witness  that  he  was  a  man  of 
importance  and  of  elevated  aspirations.  Especially  in  his  conception  of 
the  medical  profession  was  he  one  of  the  noblest  men  who  ever  lived  —  a 
man  to  be  measured  not  by  the  sober  standard  of  the  present  day.  but  rather 
by  the  spirit  of  the  age  in  which  he  reasoned. 

The  only  absolute  follower  of  van  Helmont  was  Franz  Oswald  Grembs  (about  1657), 
ordinary  physician  in  Salzburg,  to  whom  we  might  perhaps  add  Jean  Pierre  Favre 
(about  1656),  a  physician  of  Castelnaudar}-  in  Languedoc.  in  some  few  of  his  ideas 
he  was  also  followed  by  Walter  Charlton  (1619-1707)  and  Job.  Jak.  Wepfer.  The 
Englishman  John  Rogers  (about  1664)  accepted  only  five  kinds  of  digestion,  while 
the  Jesuit  Job.  Robertas  (died  1651)  was  an  opponent  of  van  Helmont' s  magnetic  and 
magic  treatment. 

The  second  theory  of  the  seventeenth  century,  a  theory  of  the  fluids 
—  humoral  —  which,  in  opposition  to  the  preceding  dynamic  system,  neg- 
lected the  vital  forces,  was  the  so-called 

d.  Iatrochemical  or  Chemical  System 
of  Francois  de  le  Boe  (Sylvius,  1614-1672),  a  Netherlander, 
whose  family,  belonging  to  the  emigrated  nobility,  resided  at  the  time  of  his  birth  in 
Hanau.  He  pursued  his  studies  in  Paris,  Sedan.  Leyden  and  Basel,  where,  at  the  age 
of  23,  he  received  his  doctor's  degree.  Subsequently  he  practised  with  great  success 
— he  possessed  in  an  eminent  degree  the  "eloquence  of  a  fine  person"  and  wealth,  with 
sociability  and  an  amiable  modesty! — in  Hanau,  Leyden  and  Amsterdam,  until  called 
in  1660  to  a  professorship  in  Leyden.  Here  he  attracted  a  great  number  of  pupils, 
chiefly  by  the  clinical  method  of  his  instruction  and  the  convenience  of  his  system 
with  its  corresponding  therapeutics.  He  died  of  the  results  of  petechial  fever,  which 
prevailed  in  Leyden  in  1668  (and  was  described  by  him!),  and  which  had  already 
carried  off  his  wife  and  only  daughter. 

The  "  System  "  of  Sylvius,  which,  like  others,  might  rather  be  called 
a  systematic  phantasv,  is  based  upon  the  elements  of  chemistry — iatro- 
cheraistry  was  the  improved  successor  of  alchemy  and  the  first  step  toward 
genuine  chemistry  —  the  new  knowledge  of  the  circulation  and  the  closer 
acquaintance  with  the  chyle  and  lymph  vessels,  the  pancreas  and  the  lym- 
phatic glands,  which  had  been  acquired  in  this  period,  as  well  as  upon  the 
old  doctrine  of  the  "spiritus",  the  "  calor  innatus  "  of  the  heart  etc.  The 
latter  Sylvius  even  claimed  to  have  felt  with  his  finger.  His  system, 
although  its  author  always  professes  to  accept  only  "experience  by  means 
of  the  senses  ",  is  constructed  far  less  upon  experience,  than  upon  false 
conclusions  drawn  from  experimental  observations,  whose  connexion  with 
his  theory  is,  on  the  whole,  arbitrary  and  forced. 

The  humoral  physiology  of  Sylvius,  instead  of  the  four  cardinal  fluids,  adopts  the 
"triumvirate"  of  the  saliva,  the  pancreatic  fluid  and  the  bile.  Instead  of  the  varieties 
of  the  pneuma,  it  accepts  the  collective  idea  of  the  "  vital  spirits  ",  which  from  this  time 
forward  played  one  of  the  most  prominent  parts,  and  occasioned  the  greatest  con- 
fusion, in  the  theoretic  views  of  medicine.  The  forces  were  compelled  to  give  place  to 
the  chemical  process  of  fermentation  and  effervescence,  the  qualities,  to  acid  and  alkali 
(originating  in  the  acid  or  alkaline  salt).  Saliva  and  pancreatic  fluid  are  acid,  the 
bile  is  alkaline;  the  first  effects  stomach-digestion,  while  the  two  latter  accomplish  the 
ii     of  the  ch37me  into  chyle   and    fa?ces.     In  this  process  an  effervescence 


—  491  — 

occurs  and  produces  a  kind  of  gas,  which,  in  the  form  of  volatile  spirit,  with  a  delicate 
oil  and  a  salt  neutralized  by  a  weak  acid,  enters  into  the  composition  of  the  chyme. 
Such  a  spirit  of  fermentation  is  also  transmitted  from  the  spleen  to  the  blood  and  per- 
fects the  latter.  Hence  the  importance  of  the  spleen  (with  which  the  glands  are  con- 
nected in  importance  and  action)  becomes  perfectly  clear.  Tho  blood  is  the  head- 
quarters for  the  development  of  the  processes  of  healthy  and  of  morbid  life.  Normally 
it  contains  the  bile  already  pre-formed.  This  is  separated  in  the  gall-bladder,  but 
again  partially  mixed  in  the  liver  with  the  blood,  whose  fluidity  it  serves  to  maintain. 
The  blood  and  bile  then  proceed  to  the  right  side  of  the  heart,  where  both  (together  with 
the  ch37le)  bring  about  a  vital  fermentation  by  means  of  the  innate  heat  of  the  latter 
organ.  In  the  lungs  the  blood  of  the  right  heart  is  again  cooled,  and  passes  to  the 
left  side  of  the  heart,  which,  on  its  part,  is  dilated  by  a  new  "effervescence"  of  the 
blood.  The  contraction  of  this  half  of  the  heart  is  now  excited  by  means  of  the  vital 
spirits,  and  the  olood  is  driven  into  the  greater  circulation.  These  vital  spirits,1  com- 
parable in  their  nature  to  alcohol,  are  distilled  in  the  brain  (still  regarded  as  a  gland- 
ular organ)  from  the  blood  unappropriated  in  nutrition,  and  are  carried  by  the  nerves 
(at  that  time  supposed  to  be  hollow)  to  the  whole  body,  in  order  to  facilitate  sensa- 
tion. The  vital  spirits  which  reach  the  glands,  by  means  of  the  access  of  an  acid 
developed  from  the  blood  in  them,  undergo  here  their  metamorphosis  into  lymph. 
Under  the  form  of  lymph  they  return  once  more  to  the  blood,  passing  from  the  glands 
into  the  brain,  thus  forming  a  circulation  distinct  from  that  of  the  blood.  The  milk, 
however,  which  is  related  to  lymph,  originates  from  the  blood,  which,  through  the  in- 
fluence of  a  mild  acid  prepared  in  the  mammary  gland,  changes  its  color  in  that  organ, 
just  as  vegetable  colors  are  changed  b}-  the  action  of  acids. 

According  to  the  general  patholog}-  of  Sylvius,  health  consists  in  the  undisturbed 
performance  in  the  body  of  the  process  of  fermentation,  without  the  appearance  of  the 
acid  or  alkaline  salt. 

If,  however,  one  of  the  two  latter  salts  becomes  prominent,  it  gives  rise  to  an 
acridity  (ammonia)  and  furnishes  the  cause  of  diseases.  The  individual  diseases  are 
divided  into  two  groups  :  those  depending  upon  an  acid  acridity,  and  those  originat- 
ing in  an  alkaline  acridity.  The  two  varieties  of  acridity,  however,  are  subject  to 
numerous  modifications,  and  thus  arise  subordinate  classes  of  the  above  groups 
of  diseases.  Hence  these  varieties  of  acridity  are  assigned,  quite  arbitrarily,  both  as 
causes  of,  and  a  principle  of  classification  for,  all  individual  diseases.  The  bile  is  an 
example  of  the  principal  humors;  if  it  is  alkaline,  it  occasions  ardent  and  con- 
tinued fever;  if  acid,  it  is  the  cause  of  engorgements.  The  pancreatic  juice  in  a  con- 
dition of  acidity  is  the  cause  of  intermittent  fever;  if  it  effervesces  imperfectly  with 
bile,  as  most  frequently  is  the  case,  in  consequence  of  the  generation  of  acrid  "vapors" 
(halitus),  it  occasions  epilepsy,  swooning,  palpitation  etc.  The  lymph  —  he  was  ac- 
quainted with  the  lymphatics  of  the  liver— being  similar  to  pancreatic  juice,  in  condi- 
tions of  acid  acridity  occasions  the  itch,  drops}",  small-pox,  urinary  calculus,  leucorrhcea, 
syphilis  etc.  The  saliva  jiives  rise  to  hectic  fevers,  hence — they  always  manifest 
exacerbations  after  eating.  The  vital  spirits  also  occasion  diseases  (nervous  diseases), 
because  they  are  disturbed  by  the  acid  or  alkaline  "  halitus",  effervesce  imperfectly, 
are  totally  wantinsr,  or  become  too  watery.  He  brings  all  diseases  under  two  classes: 
diseases  of  the  fluids  and  diseases  of  the  solid  parts.  But  with  respect  to  the  individ- 
ual fluids  (blood,  bile  etc.)  and  solids  he  carries  out  his  classification  in  such  a  way, 
that  he  arranges  the  changes  occurring  in  either  so  as  to  be  cognizable  by  either  the 

1.  'Sphitus",  nervous  spirits,  which,  now  that  they  had  been  banished  by  Harvey 
from  the  blood,  were  located  in  the  nerves  alone.  The  latter  were  thought  to  be 
hollow,  and  the  "spiritus"  were  regarded  as  fluid  and  volatile. 


—  492  — 

simple  senses  (sight,  hearing,  smell,  feeling,  taste),  or  by  the  combined  activity  of  the 
senses  and  tlie  intellect  (changes  of  mass,  place,  time,  motion). 

J  n  regard  to  the  semeiology,  diagnostics  and  therapeutic  principles  or  indications 
of  Sylvius  the  following  passage  furnishes  us  some  clues  :  "As  often  as  the  whole  blood 
appears  black,  it  indicates  that  acidity  predominates;  if  the  blood  is  redder,  it  shows 
that  the  bile  in  it  is  superabundant.  In  the  first  case  the  acid  in  the  body  and  in  the  blood 
must  be  diminished;  in  the  second  the  bile  must  be  lessened  and  its  power  broken.  If 
the  blood,  which  normallj^is  free  from  odor  and  of  a  sweetish  taste  (especially  the  serum), 
tastes  salty,  the  alkali  in  the  body  is  too  pure,  and,  when  brought  into  contact  with 
the  acid  spiritus,  engenders  a  humor  of  a  saline  taste  and  prejudicial  to  the  body  ; 
for  such  a  taste,  though  milder,  may  pass  into  the  urine,  but  not  into  the  serum  or 
its  products,  the  lymph,  the  pancreatic  juice  and  the  saliva.  This  saline  taste  indicates 
a  re  lu  -i  on  and  correction  of  the  alkali.  Ifi  respect  to  time  too  the  blood  may  be 
faulty,  e.  g.  when,  for  some  reason,  the  menstrual  blood  flows  too  late,  after  the  expira- 
tion of  a  month,  or  after  the  fourteenth  year,  or  when  it  makes  its  appearance  too 
■early."      Fever  is  diagnosticated  hy  the  pulse,  not  by  the  heat  of  the  body. 

Accordingly,  therapeutics  has  two  extremely  simple  duties:  to  get  rid  of  the 
acid  or  the  alkali.  The  first  is  accomplished  by-  the  administration  of  alkalies,  the 
latte",  by  the  prescription  of  acids.  The  "effervescence  of  the  bile"  and  the  diseases 
flowing  therefrom  are  removed  by  cathartics.  Sylvius  recommended  too  verj-  highly 
the  diaphoretic,  heating  method,  absorbents,  emetics  etc.,  but  reprehended  bleeding. 
Opium  is  of  service  against  both  acid  and  alkali,  since  it  tempers  equally  both  acrid- 
ity and  effervescence!  The  general  objects  of  therapeutics  (never,  alas,  to  be 
accomplished)  are  "  to  maintain  the  strength,  to  remove  diseases,  to  mitigate  symp- 
toms and  to  remove  their  causes."  —  The  stereotyped  theory,  and  especially  the 
stereotyped  therapeutics  of  Sylvius  gained  for  him  a  large  following;  but  they  also 
procured  him  numerous  opponents,  especially  in  later  times,  when  his  therapeutics 
were  reproached  with  having,  during  their  prevalence,  cost,  on  the  whole,  as  many 
human  lives  as  the  Thirty  Years'  War.  This,  under  any  circumstances,  is  an 
exaggerated  estimate,  for  nature,  from  the  most  remote  ages  down  to  the  present  daj', 
has  preserved  the  sick,  at  least  in  the  majority  of  cases,  from  the  worst  consequences 
of  the  healing  art  of  infatuated  theorists  and  corrupt  or  incapable  practitioners. 
Zimmermann  calls  Sylvius  (as  well  as  Helmontand  Paracelsus)  an  ass,  in  accordance 
with  whose  maxims  "the  retorts  of  innumerable  men,  the  retorts  of  his  children  and 
his  own  retort  too,  were  burst"  (Rohlfs). 

The  followers  of  these  views  awakened  by  the  advances  in  the  science 
of  chemistry,  so  convenient,  especially  in  therapeutics,  because  they 
demanded  little  reflection,  so  fantastic  and  leaving  so  much  room  for  the 
play  of  personal  interpretation  of  morbid  processes,  and,  besides  all  this,  set 
forth  in  the  form  of  a  "System"  by  a  famous,  beloved  and  eloquent  teacher 
arc  known  collectively  as 

THE  IATROCHE.MICAL   SCHOOL. 

To  this  school  is  also  assigned  Thomas  Willis  (1022—1 675)  of  Oxford, 
ordinary  physician  of  Charles  II.. 

la  man  who,  like  Sylvius,  rendered  eminent  service  to  anatomy,  and  especially  the 
anatomy  of  the  nervous  system)  although  he  set  forth  a  theory  of  his  own,  which  had 
only  a  few  points  of  contact  with  that  of  Sylvius.  Originally  destined  to  theology,  in 
consequence  of  the  unfavorable  conditions  of  that  age  for  theological  science,  Willis 
turned  his  attention  to  medicine,  and,  on  the  completion  of  his  studies,  received  the 
professorship  of  philosophy  in  the  university  of  Oxford.     This  position,  however,  he 


—  493  — 

resigned  and  tamed  his  talents  towards  practice,  which  he  pursued  with  great  success 
in  London  until  the  time  of  his  death. 

Willis  accepted  five  elements,  some  of  which  belong  to  the  Ancients, 
some  to  the  doctrine  of  Paracelsus  and  some  to  that  of  Helmont.  These 
elements  were  water,  earth,  salt,  sulphur,  and  spiritus.  In  this  he  differs 
from  Sylvius,  whose  "fermentation"  etc.,  on  the  contrary,  he  adopts  — 
almost  without  any  acid  and  alkali.  He  assigns,  however,  to  fermentation 
all  corporeal  activity  and  every  internal  movement,  and,  although  its  seat 
is  in  the  stomach  and  spleen,  he  holds  that  it  is  effected  b}T  the  vital  spirits 
generated  in  the  brain,  which  latter  correspond  for  the  most  part  with  the 
mercury  that  (according  to  Paracelsus)  volatilizes  bodies.  He  sharply 
distinguishes  the  animal  soul  from  the  mind  proper,  whose  diseases  he 
considers  often  dependent  upon  those  of  the  former.  He  ascribes  diseases, 
especiall}'  those  of  the  blood,  to  " fermentation "  and  "effervescence",  in 
which  the  "  vital  spirits  "  play  the  chief  part.  Nervous  diseases  also  he 
discusses  on  similar  principles,  ascribing  hysteria  e.  g.  to  a  union  of  the 
spiritus  with  a  blood  imperfectly  purified  in  the  spleen,  and  to  the  false 
fermentation  and  derangement  of  the  spiritus  resulting  therefrom.  He 
advanced  semeiology  by  a  better  investigation  of  the  urine— he  recognizes 
e.  g.  the  sweet  taste  of  the  latter  in  diabetes.  In  therapeutics  Willis 
opposes  the  "  spiritus "  with  diaphoretics,  cordials,  visceral  remedies,, 
emetics  and  venesection. 

How  far  even  the  most  capable  minds  had  sunk  at  this  time  into  hoary  theory  is 
shown  by  Nathaniel  Highmore  (1613-1685),  who  quarreled  with  Willis  over  the  seat 
of  hysteria  and  hypochondriasis,  the  former  of  which  he  referred  to  filling  up  of  the 
]ungs  with  blood  inflated  to  actual  rigidity! — Besides  these,  the  following  English 
phj-sicians  were  also  partisans  of  the  chemical  doctrines:  John  Mayow  (1645-1679), 
who  indentified  the  vital  spirits  with  the  nitrogenous  (nitro-aereus)  particles  (oxygen), 
and  ascribed  fever  to  the  passage  of  these  from  the  air  into  the  blood  ;  William 
Croone1  (about  1664),  who  defended  similar  views.  Francis  Cross  (about  16(58),  John 
Betts  (about  1669),  Walter  Harris2  (1651-1725),  John  Jones  (about  1683),  John  Flojer 
(1619-1734),  who  introduced  the  minute  watch  as  a  means  for  determining  more 
accurately  the  rate  of  the  pulse,  and  endeavored  thus  to  determine  its  frequency  under 
various  conditions  of  age  and  sex,  and  even  in  regard  to  mode  of  life  and  time  of  day. 
Indeed  he  even  estimated  the  relation  of  the  frequency  of  the  pulse  to  that  of  respira- 
tion.3 Daniel  Duncan  (1649-1735),  a  Frenchman  by  birth;  Nathaniel  Hodges  (1638- 
1684),  George  Thomson  (about  1670\  Martin  Lister  (1638-1711),  ordinary  physician 
of  queen  Anne,  William  Coward  (about  1695),  Charles  Leigh  (1650-1710),  William 
Musgrave  (1657-1721),   Clopton   Havers,  who,  like  Leigh,  instituted  researches  into 

1.  Founder  of  the  "  Croonian  Lectures  "  in  the  Royal  College  of  Physicians  and  the 

"Royal  Society".     He  died  1684.     (H.) 

2.  Author  of  a  valuable  treatise  on   the  diseases  of  children  entitled  ''Uemorbis 

acutis  infantum  ",  London,  16S<).     ill.) 
."».    Harvey  had  already  employed  it  in  physiological  researches.     From  this  period 
the  minute  watch  maintained  its  position  in  England  as  an  accessory  means  of 
diagnosis,  though  it  did  not  come  into  ordinary  use  among  other  people  until 
the  end  of  the  18th  and  beginning  of  the  19th  century. 

Floyer's  work  was  entitled  "The  physician's  pulse-watch",  London,  1707.  (H.) 


—  494  — 

artificial  digestion,  ami  made  some  valuable  researches  upon  the  structure  of  the 
bones  (Haversian  canals,  1691),  and  other  prominent  physicians  far  into  the  following 
century,  embraced  chemical  views  more  or  less  altered.  —  The  system  of  Sylvius  or 
Willis  did  not  lack  powerful  opponents  too  in  England.  Among  these  Robert  Boyle, 
who  disputed  the  theory  from  a  chemical  stand-point,  was  especially  prominent,  while 
from  a  practical  point  of  sdew  Henry  Stubbes  (1631-1676)  attacked  the  Sylvian 
doctrine  of  bleeding.  Archibald  Pitcairn  (1652-1713),  a  famous  professor  at  I.eyden 
and  Edinburgh,  demonstrated  that  the  circulation  was  incompatible  with  a  fermen- 
tation with  effervescence,  but  disputed  on  very  weak  grounds  the  doctrine  of  digestion 
with  Thomas  Boer,  a  contemporary  professor  at  Aberdeen.  Finally  John  Freind 
(1675-1728)  also  entered  the  lists  in  opposition  to  the  Sylvian  doctrine  of  ferment. 

In  Holland,  the  land  of  its  birth,  the  chemical  school  found  numerous 
followers,  and  the  system  was  looked  upon  with  favor  by  the  "  Mynheers  ". 
The  fact  that  it  helped  them  to  a  thriving  business  in  tea,  coffee  and 
chocolate  contributed  no  little  to  its  popularity.  One  of  the  most  famous 
physicians  of  that  day, 

Cornelius  Bontekuf. 
(Buntekuh,  a  name  derived  from  that  of  his  father's  inn,  his  proper  name  was 
Dekker,  1647-169.5),  received  from  the  East  India  Company  a  reward  for  his  promotion 
of  the  tea-trade,  inasmuch  as  he  directed  his  patients  to  "wash  away  the  mire  of  the 
pancreas",  and  with  this  object  recommended  the  drinking  of  fifty  cups  of  tea  (or  of 
coffee  in  cases  of  necessity)  at  once,  or  of  one  hundred  cups  in  the  course  of  the 
day!1  Moreover  this  philanthropic  tea-speculator,  who  was  called  from  Holland  to 
become  physician-in-ordinary  of  Brandenburg  and  subsequently  professor  at  Frank- 
fort-on-the-Oder,  recommended  constant  tobacco-smoking,  in  addition  to  the  use  of 
opium,  and  —  as  a  proof  of  what  one  may  venture  to  offer  mankind  under  the  name 
of  therapeutics  —  had  his  numerous  clientele,  and  indeed  his  medical  followers. 
Among  the  latter  was  Job.  Abraham  Gehema,  his  successor  in  the  office  of  physician- 
in-ordinary  of  Brandenburg. 

The  same  opinions  were  embraced  by  Theodor  van  Craanen  (1620-1689),  who 
was  also  Brandenburg  physician-in-ordinary  and  established  the  systole  of  the 
pulmonary  artery.  Other  partisans  of  the  doctrine  of  Sylvius  were:  Jac.  van  Hadden 
(about  1660),  Paul  Barbette  and  Friederich  Dekker  (1648-1730),  who,  according  to 
Leube,  was  the  discoverer  of  albumen  in  the  urine;  Florentius  Schuyl  (1619-1669), 
professor  in  Leyden,  who  had  seen  with  his  own  eyes  the  effervescence  of  bile  and 
pancreatic  juice;  Wolferd  Senguerd  (about,  1681),  Jan  Muys  (about  1682);  ^Egid. 
Daelmans,  who  built  up  ''the  newly  composed  ait  of  healing  upon  the  basis  of  alkali 
and  acid"  (1694);  Heidenryk  Overkamp,  who  in  1681  declared  Aristotle  a  "  Hocus- 
pocusmeester"  and,  according  to  Proksch,  ascribed  the  origin  of  syphilis  to  the  inter- 
course of  Indians  with  beasts;  and  Stephan  Blankaart  (about  1691).  who  considered 
thickening  of  the  humors  the  root  of  all  evils,  and  therefore  favored  the  zealous 
drinking  of  tea.  —  Opponents  of  this  system  appeared  in  Martin  Schook  (1614-1660), 
professor  in  Groningen;  Jac.  le  Mort  (about  1650-1718),  professor  in  Leyden,  who 
opposed  it  from  a  chemical  stand-point;  Jan  Broen  (about  1700);  Philipp  Verheijen 
(1648-1710),  professor  of  anatomy  in  Louvain ;  Bernhard  Swalve  (about  1664), 
Anton  Deusing  (1612-1666),  professor  in  Groningen;  Andreas  Caesius  (about  1668); 
Willem  Parent  (about  1671),  and  most  important  of  them  all  Hermann  Boerhaave. 
The  importance  of  Holland  in  the  department  of  medicine  again  coincided  with  the 


1.   Of  the  numerous  works  of  Bontekoe  his  "  Tractaat  over  net  excellente  Kruyd 
Thee  "  (1678)  discusses  particularly  the  virtues  and  uses  of  tea.    (H.) 


—  495  — 

general  culmination  of  its  power  and  culture  in  the  age  of  Hugo  Grotius  (1583-1645), 
an  age  in  which  the  painter  Miris  enunciated  the  maxim  :  "  The  legal  foundation  of 
property  is  labor".  This  maxim  gives  us  a  more  favorable  idea  of  the  ethical  eleva- 
tion of  his  compatriots,  than  that  of  Proudhon  :  "  Property  is  theft"  (La  propiiete, 
c'  est  le  vol). 

In  Germany,  which  at  that  time  stood  in  intimate  relations  with 
Holland,  the  chemical  theory  found  at  first  followers  eminent  both  in 
number  and  importance.  At  last,  however,  it  met  here  its  ablest  and  most 
successful  opposition. 

One  of  the  most  curious  partisans  of  Sylvius  was  the  Hessian  physician-in- 
ordinar}-  Joh.  Dolaus  (1651-1707),  according  to  whose  doctrines  amalgamated  with 
the  ideas  of  Helmont,  no  disease  could  originate  without  the  stomach-king  (gaster- 
anaxj  and  the  heart-king  (cardimelech).  Fever  is  a  false  crasis  of  the  blood, 
coinciding  witli  the  wrath  of  these  kings!  The  Marburg  professor  Joh.  Jac.  Wald- 
schmidt  (1644-1689)  of  Rudelsheim  in  the  Wetterau,  saw  "fermentation  "  everywhere, 
while  Mich.  Etniiiller  (1644-1683),  professor  in  Leipzig  and  a  less  fanatical  follower 
of  Sylvius,  contributed  greatly  to  the  diffusion  of  his  system.  The  same  statement  is 
also  true  in  a  high  degree  of  Georg  Wolfgang  Wedel  (1645-1721  ),  a  famous  professor 
in  Jena.  Besides  these  we  must  mention  Giinther  Christian  Schellhammer  (1649- 
1712);  the  able  chemist  (he  discovered  the  Berlin  blue  and  "  IHppel's  animal  oil  ") 
and  chemical  enthusiast  Jos.  Conrad  Dippel  (1672-1734)  of  Frankenstein  near 
Darmstadt,  in  the  vicinity  of  which  city  a  farm1  still  preserves  his  memory ;  Eccard 
Leichner  (about  1676);  the  practitioners  Martin  Kerger  (about  1663)  in  Liegnitz  ; 
Rosinus  Lentilius  (1657-1733),  physicus  in  Nordlingen;  Hermann  Grube  (about 
1669)  of  Liibeck;  Eberhard  Gockel  (born  1636)  of  Ulm,  who  opposed  the  doctoring 
of  wines  with  sugar  of  lead;  J.  W.  von  Peima,  Baron  von  Beintema  (17th  and  18th 
centuries),  imperial  physician-in-ordinary ;  Heinrich  Screta  in  Schaffhausen  and 
others.  All  of  these  furnish  evidence  that,  even  as  late  as  the  second  third  of  the 
eighteenth  century,  this  theory  continued  to  maintain  its  popularity  in  widely  differ- 
ent countries.  Even  in  Norway  a  ph}-sician  Olaus  (Ole)  Borch  (Borrichius,  1626- 
1G!>0,  died  of  lithotomy),  professor  at  Copenhagen,  appeared  as  a  defender  of  the 
chemical  system. 

Among  the  opponents  of  the  system  were  the  Heidelberg  professor  Joh.  Conr. 
Brunner  (1653-1727),  who  by  ligation  of  the  pancreatic  duct  proved  the  superfluous- 
ness  of  the  pancreatic  fluid,  and  demonstrated  further  that  it  was  not  of  an  acid 
nature;  Joh.  Xikol.  Pechlin  (1646-1706),  professor  at  Kiel  and  physician-in-ordinary 
of  Holstein  ;  the  famous  savant  and  Doctor  of  all  four  Faculties,  Hermann  Coining 
(1606-1681),  professor  in  Helmstelt,  sun  of  a  clergyman  of  Xorten  in  Fast  Friesland, 
educated  in  Helmstedt  and  Leyden,  and  equally  eminent  as  a  jurist,  philosopher  and 
theologian;  the  famous  Johann  Bohn  (1640-1719)  in  Leipzig,  who  chose  the  path  of 
experimentation,  and  greatest  of  all,  Friedrich  Hoffmann,  who  was  originally  a 
partisan  of  the  system  of  Sylvius. 

Among  the  people  of  the  Romanic  tongue,  in  France  only  did  Iatro- 
chemistry  acquire  any  considerable  following. 

The  chemical  remedies  alone,  however,  had  so  powerfully  excited  the  younger 
Jean  Riolan  (1577-1657),  a  genuine  son  of  his  father,  and  his  associate  Guy  Patin3 

1.  The  still  existing  "  Dippelshof  ",  from  which  was  derived  the  material  for  Goethe's 

"Erlkonig". 

2.  Patin  was  the  first  who  observed  a  case  of  tubal  pregnancy,  ascribing  it  to  a  stray- 

ing of  the  ovum. 


—  4!  IG  — 

( 160 1—1 672 ;  he  said  of  Riolan  that  he  would  rather  give  up  a  friend  than  an  as6er 
tion),  also  a  professor  in  Paris,  together  with  Charles  Guillemeau  (about  1648)  and 
Antoine  Menjot,  the  esquires  of  Patin,  that  they  even  moved  Parliament  in  order  to 
procure  a  decision  in  favor  of  Galen.  Parliament,  however,  left  the  decision  to  ihe 
Faculty,  and  the  latter  ( most  remarkably  for  that  period  >,  under  the  presidency  of 
Vignon,  decided  for  the  chemical  remedies  (166H)  by  92,  voices.  The  opposition  to 
the  chemical  system  proper  too  on  the  part  of  Louis  Levasseur  (about  1668)  and 
Charles  Drelincourt  (about  1680)  met  with  no  more  success.  In  fact  the  number  of 
its  followers  was  rather  increased  thereby!  Among  these  followers  we  may  claf  s  : 
Jean  Bonet  (1615-1688)  of  Lyons;  the  eminent  practitioner  and  private  teacher  of 
Montpellier,  Charles  Barbeirac  (1629-169!));  Francois  Bayle  (1622-1709!,  professor  in 
Toulouse;  Nicolas  de  Blegny  (1652-1724),  originally  a  porter,  founder  of  a  chemical 
academy  at  Paris;  Francois  de  St.  A  mire,  professor  at  Caen,  and  the  distinguished 
chemical  author  Jacques  Minot ;  Francois  Calmette  (about  1677),  the  first  to 
recommend  a  soluble  mercury;  Jacques  Massard  of  Grenoble;  Jean  Pascal;  the 
physicist  Pierre  Sylvain  Regis  ( 165!!-1707),  fellow  of  the  Academie;  Dominique 
Beddevole  and  Jean  Viridet,  both  of  Geneva  ,  Reymond  Vieussens,  who  engaged  in 
a  violent  dispute  with  Pierre  Chirac  (1650-1 7:12 ),  originally  a  theologian,  then  a 
physician,  and  as  such  a  professor  at  Montpellier.  next  an  army-surgeon  and 
travelling  physician  one  after  the  other,  and  finally  physician-in-ordinary  at  Paris: 
Jean  Astrtic  (1684-1766),  professor  in  Montpellier;  Noel  Falconet  (1644-17:54)  of 
Lyons,  a  thorough  partisan  of  Sylvius  although  a  pupil  of  Patin  ;  finallj-  Johann 
Friedrieh  Helvetius,  and  numerous  others.  In  France  also  the  chemical  system 
long  outlived  the  seventeenth  century. 

Ill  Italy  the  doctrines  of  Sylvius,  like  those  of  Paracelsus,  found  very 
little  favor.  The  doctrines  of  the  Ancients,  here  still  in  vogue,  were 
especially  opposed  to  the  new  system.  Wherever  the  chemical  doctrines 
found  a  reception,  an  effort  was  made  to  bring  them  into  harmony  with 
the  Ancients,  and  thus  to  render  them  acceptable,  so  that  properly  speak- 
ing only 

Otto  Tachen  (Tachenius,  about  16C6)  of  Herford  in  Westphalia, 
an  apothecary,  who,  in  consequence  of  theft,  had  become  a  fugitive  and  had  then 
studied  medicine  in  Padua  and  settled  in  Venice,  represented  the  pure  doctrine  of 
Sylvius.  Beside  him  we  may  range  Mich.  Ang.  Andriolli.  Luc.  Ant.  Portio  (about 
1682),  professor  in  Rome,  declared  against  bleeding,  regarding  it  as  an  injurious 
operation.  The  following  physicians  endeavored  to  reconcile  the  opposing  views : 
Luc.  Tozzi  (1640-1717),  professor  at  Naples  and  papal  physician-in-ordinary;  Carlo 
Musitano  (  1635-1714),  an  arrogant  and  coarse  priest  (Proksch)  and  professor  at 
Naples,  while  Pompej.  Sacchi,  professor  at  Parma  and  Padua,  Alessandro  Pascoli, 
professor  in  Rome,  G.  Batt.  Volpini,  a  physician  of  Asti,  and,  most  important  of  all, 
Bernardino  Ramazzini  i  1633-1714),  professor  at  Modena  and  Padua,  who,  like  Domen. 
Mistichelli  at  Rome,  applied  the  new  theory  to  epidemic  diseases,  embraced  a  purer 
chemical  doctrine.  Opponents  of  this  system  were  Domen.  Sanguinetti  (about  1699) 
of  Naples,  and  Jos.  del  Papa,  ph}-sician-in-ordinaiT  of  the  Grand  Duke  of  Tuscan}-. 
Subsequently  an  effort  was  made  to  bring  Iatro-chemistry  into  accord  with  Iatro- 
mechanics. 

If  there  were  need  of  any  special  proof  that  medicine  runs  through 
its  own  phases  not  separately  and  for  itself,  but  in  conformity  with  the 
spirit  of  the  age  and  its  general  scientific  services  and  acquisitions  ;  that 
it  creates  therefrom  the  views  which  from  time  to  time  control  its  develop- 


—  4D7  — 

ment,  we  might  with  special  propriety  employ  for  this  purpose  the  systems 
of  the  seventeenth  century.  The  medical  system  next  to  be  noticed  is  also 
the  reflection  of  acquisitions  of  knowledge  drawn  by  mankind  from  other 
fields.  This  time  it  was  the  advances  in  mathematics  and  physics  or 
mechanics  made  by  Galilei,  Torricelli,  Newton  and  many  others,  and  par- 
ticularly through  the  method  of  Descartes,  which  furnished  occasion  for 
the  origin  of  an 

e.  Iatro-matiiematical  (Iatro-mechanical,  Iatro-physical)  School. 

This  ''School",  in  contrast  with  the  foregoing,  in  its  physiology  de- 
voted its  chief  consideration  to  the  solid  parts  (Solidism),  whose  form  and 
functions  it  strove  to  discover  and  to  demonstrate  in  the  method  to-day 
called  "exact",  i.  e.  by  weighing,  measuring,  calculation,  physical  apparatus 
etc.  Thus  digestion  e.  g.  was  referred  to  a  mechanical  trituration  (Erasis- 
tratus  !),  and  the  absorption  of  the  chyle  was  explained  as  due  to  the  pres- 
sure arising  from  the  action  of  the  intestinal  movements  upon  the  com- 
minuted food.  In  a  similar  way  the  secretions  were  referred  to  the  resist- 
ance created  by  the  corners,  curves,  angles  etc.  of  the  vascular  system,  and 
to  the  difference  or  agreement  of  the  specific  weight  of  the  secreting  parts 
and  the  secreted  materials.  Respiration  was  based  upon  the  mechanics  of 
the  motions  of  the  thorax,  warmth  upon  friction  of  the  blood-corpuscles, 
sensation  upon  vibrations  of  the  nerves,  the  action  of  the  heart  upon  the 
mechanism  of  the  pump,  the  circulation  upon  the  laws  of  motion  of  fluids 
in  tubes,  locomotion  upon  the  action  of  levers  etc.  Health  accordingly 
consists  in  the  undisturbed  performance  of  the  physical  and  mechanical 
processes  in  the  body. 

In  pathology  these  same  explanations,  only  inversely  applied,  were 
called  in  aid.  The  ingesta  and  excreta  were  compared,  in  order  to  deter- 
mine the  existence  of  disease,  and  recourse  was  had  to  pointed  and  angular 
crystals  and  corpuscles  in  the  blood,  and  to  the  possibility  or  impossibility 
of  the  passage  of  these  through  the  pores,  as  well  as  to  a  kind  of  mechan- 
ical acridity  and  stagnation  (stasis)  etc.  Still  dynamic  and  chemical  ex- 
planations were  not  entirely  and  absolutely  excluded. 

In  therapeutics  the  Iatro-physicists  (like  all  halfway  prudent  physi- 
cians of  every  school)  managed  in  accordance  with  the  principles  of  gen- 
uine (Hippocratic)  experience,  and  at  least  kept  themselves  free  from  one- 
sidedness  —  which  cannot  be  said,  or  rather  cannot  always  be  said,  of  their 
polished  successors  of  the  present  day. 

Italians.  —  The  first  representative  of  this  tendency,  though  not  the 
founder  of  the  ''School"  based  thereupon,  was 

Santorio  Santoro  (Sanctorius  Sanctorius,  1561-1635)  of  Capo  dTstria, 
professor  at  Padua  and  subsequently  a  practitioner  in  Venice,  who  enjoyed 
a  high  reputation  among  his  contemporaries  and  among  the  greatest  physi- 
cians of  after  ages  —  a  reputation  justly  merited,  were  it  merely  for  his 
persevering  investigations  !  In  respect  to  the  insensible  transpiration 
32 


—  498  — 

(perspiration)  he  accomplished,  without  an}-  preparatory  work,  almost  the 
same  that  Harvey  did  for  the  circulation.  He  thus  deserves  great  credit 
in  connexion  with  the  doctrine  of  the  conversion  of  material.  In  persever- 
ing zeal  too  he  was  not  behind  the  Englishman  !  Only  he  did  not  point 
out  in  detail  the  exact  method  by  which  he  arrived  at  his  results,  and  he 
overlooked  several  precautions,  so  that  although  the  "first  precisian",  he 
was  blamed  by  later  precisians.  Like  our  physicians  of  the  present  day,  he 
also  taught  how  to  investigate  the  pulse  by  means  of  an  instrument  of  his 
own  contrivance,  and  how  to  study,  by  means  of  a  kind  of  thermometer1, 
the  temperature  of  the  health}-  and  the  sick.  He  also  constructed  appar- 
atus for  the  bathing  of  bed-ridden  invalids  etc.  Sanctorius,  however,  built 
up  no  system  of  therapeutics  upon  a  single  symptom  ;  otherwise  we  might 
claim  that  he  occupied  the  very  latest  stand-point  ! 

The  "Ars  de  statica  medicina"  of  Sanctorius  appeared  in  1614.  He  continued 
his  investigations  with  the  balance  for  thirty  years,  studying  the  temperature,  season 
and  time  of  day,  health  and  sickness,  diet  etc.,  but  of  the  excreta  only  the  urine  and 
faeces.  He  found  that  in  twentj'-four  hours  the  insensible  transpiration  amounted  to 
1]  kilogrammes,  a  result  which,  when  compared  with  those  of  the  present  day  deter- 
mined by  far  more  complete  apparatus,  is  only  about  \  kilogramme  too  high  —  a 
proof  how  accurately  Sanctorius  must  have  gone  to  work.  —  The  important  role  of 
the  perspiration,  which  he  pointed  out,  was  made  use  of  by  the  Iatro-chemists  to 
vindicate  their  exaggerated  sweat-cures. 

In  pathology  Sanctorius  embraced  humoral  views. 

The  proper  founder,  however,  of  the  Iatro-mathematical   school  was 

G-iovanni  Alfonso  Borelli  (1608-1679)  of  Naples.  At  first  a 
teacher  of  mathematics  in  Messina,  he  accepted  in  1656  a  call  to  Pisa,  and 
afterwards  to  a  similar  position  at  Florence,  where  he  became  a  fellow  of 
the  Academia  del  Cimento.  His  quarrelsome  disposition,  however,  led 
him  to  return  once  more  to  Messina.  Here  too  he  was  unable  to  remain, 
and  accordingly  he  betook  himself  to  Rome,  where  Christina  of  Sweden 
(1626-1689),  the  daughter  of  Grustavus  Adolphus,  who  had  surrounded 
herself  in  Rome  with  a  circle  of  savants  and  artists  and  had  become  a 
convert  to  Catholicism,  supported  him.  She  herself,  however,  soon  fell  into 
straitened  circumstances,  and  Borelli,  entering  a  monastery,  supported  him- 
self by  giving  private  instruction  in  mathematics,  or,  according  to  others,  by 
begging  in  the  streets  of  Rome.  He  had  written  for  Christina  his  work 
entitled  "  De  motu  animalium  ",  which  was  not  printed  until  after  his  death.2 
Borelli's  chief  services  relate  to  physiology,  in  which  (like  Descartes;  he  followed 
purely  mathematical  principles.  These  services  were  especially  great  as  regards  the 
subject  of  muscular  motion,  which  he  supposed  to  take  place  through  the  efferves- 
cence of  the  nervous  fluid  with  the  blood.  The  action  of  the  muscles,  however,  he 
explained  by  the  laws  of  the  lever,  and  considered  both  the  amount  of  force  employed 

1.  This  was  his  own  invention.    Drebbel  is  regarded  as  the  inventor  of  the  air 

thermometer,  and  Galilei  of  the  spirit  thermometer.    (B.) 

The  use  of  mercury  in  thermometers  is  said  to  have  been  suggested  by  Ole 
Rbmer  (1644-1710).      (H.) 

2.  It  was  published  by  his  friend  P.  Carlo  Giovanni  da  Gesu  at  Rome  in  1680.      (H.) 


—  499  — 

and  the  loss  of  power  resulting  from  unfavorable  mechanical  action  etc.  He  incor- 
rectly calculated  the  mechanical  work  of  the  heart  at  1500  kil.  per  minute,  in  which 
he  included  the  sixty-fold  resistance  of  the  small  arteries,  so  that  this  work  would  have 
amounted  in  an  hour  to  90,000  kil.,  and  in  a  day  to  1500  million  kil.  He  also 
explained  the  return  of  the  blood  to  the  heart,  not  b}-  the  vis  a  tergo,  but  by  the  aid 
of  capillarity.  The  capillaries  proper,  however,  he  did  not  yet  know.  Secretion 
and  the  nutrition  of  organs  he  referred  to  the  blond-pressure  and  to  the  diameter  of 
the  vessels,  calling  to  his  aid  even  the  fluids  in  the  nerve-tubes.  Digestion  is,  in  like 
manner,  a  purely  mechanical  process.  Inspiration  he  correctly  ascribed  to  muscular 
action,  expiration  to  simple  relaxation,  while  the  lungs  themselves  are  passive  and 
even  after  expiration  contain  air.  Sensation  and  motion  are  brought  about  by  the 
nervous  fluid  flowing  from  and  to  the  brain. 

In  pathology  Borelli  was  an  opponent  of  Iatro-chemistry,  on  the 
ground  that  it  was  demonstrable  neither  by  common  experience  nor  by 
experiment,  and  he  denies  as  well  any  evidence  that  fever  e.  g.  originates 
in  excessive  action  of  the  heart-muscle,  due  to  irritation  of  the  latter  by  an 
acrid  nervous-fluid.  There  is  no  such  thing  as  corruption  of  the  blood, 
and,  even  if  there  were,  a  stoppage  of  the  organs  of  secretion  is  rather  to  be 
assumed.  The  periodicity  of  fever  is  also  to  be  explained  by  the  defect 
last  mentioned.  —  In  his  therapeutics  Borelli  considers  purgation  and 
bleeding  ineffective  in  removing  the  acidity  of  the  nervous  fluid,  but  he 
expects  that  strengthening  the  organs  by  means  of  cinchona  and  favor- 
ing the  invisible  perspiration  will  be  the  more  effectual  in  fever.  He  alone 
too  remains  true  to  the  mechanical  theory  in   therapeutics,  while  his  pupil 

Lorenzo  Bellini  (1643-1704)  of  Florence, 
who,  at  the  early  age  of  nineteen,  became  a  professor  in  Pisa  and  subsequently 
occupied  a  similar  position  in  his  native  city,  in  his  doctrine  of  secretion,  assumes  a 
"  ferment"  in  the  glands  as  an  active  agent.  —  In  accordance  with  his  mathematical 
doctrine  of  the  enormous  increase  of  resistance  in  the  finest  vascular  plexuses,  he 
referred  fever  and  inflammation  to  a  retarded  motion  of  the  blood,  occasioned  by  its 
thickening  and  by  the  friction  of  the  blood-corpuscles,  a  theory  held  also  by  the 
Bolognese  professor  Giac.  de  Sandris.  — Upon  the  view  above  mentioned  Bellini  also 
based  the  therapeutic  doctrines  of  derivation  and  revulsion. 

As  in  our  present  cultivation  of  medicine  (which  manifests  many 
points  of  similarity  with  that  of  the  Iatro-physicians),  practice  i.  e.  thera- 
peutics is,  or  rather  was  justly,  obliged  to  strike  out  an  entirely  distinct 
road,  so  the  Iatro-mechanics  were  constrained,  in  logical  consistency,'  to 
admit  a  distinction  between  theory  and  practice.  This  distinction  was  first 
definitely  emphasized  by 

Giorgio  Baglivi  (1668-1707), 
a  pupil  of  Malpighi,  professor  at  Rome,  and  a  man  of  as  universal  education  as  he 
was  intellectually  gifted.  In  nosology  he  endeavored  to  divide  diseases  into  those  of 
the  blood  and  those  of  the  vital  spirits,  and  with  this  idea  he  combined  the  Malpighi- 
Pacchionian  doctrines  with  his  own  views.  In  therapeutics  he  was  a  follower  of 
Hippocrates,  though  in  theory  he  embraced  the  mechanical  principles  so  fully  that 
he  compared  the  lungs  to  a  pair  of  bellows,  the  heart  and  vessels  to  waterworks  and 
their  pipes,  the  teeth  to  scissors  and  the  stomach  to  a  flask.  (The  latter  comparison 
is  still  substantially  true  at  the  present  day  in  very  many  instances  in  Germany  and 


—  500  — 

elsewhere!).  Baglivi  is  the  author  of  the  often  quoted  maxims:  "  He  who  diagnostic- 
ates well  cures  well",  and  "Reasonable  thought  and  observation  are  the  chief  roots 
of  medicine;  observation,  however,  is  the  thread  by  which  the  conclusions  of  the 
physician  must  be  guided.''  Moreover:  "  Very  frequently  the  result  does  not  corres- 
pond to  the  expectations  of  the  physicians,  although  these  were  founded,  indeed, 
upon  reason  and  experience.  And  this,  not  in  consequence  of  the  defective  constitu- 
tion of  the  rules  of  our  excellent  art,  but  because  of  numerous  unexpected  encounters 
with  both  external  and  internal  conditions,  or  the  carelessness  and  faults  of  the 
patient,  the  surroundings  and  the  physician  in  prescribing  and  deciding  thofe  things 
required  for  the  cure.''  ':To  deify  and  undulj"  extol  the  Moderns  is  becoming  to  no 
reasonable  man.  Medicine  is  not  a  production  of  human  reason,  but  a  daughter  of 
time,  originating  in  long  experience."  "  The  mania  for  forming  new  words  checks 
the  beginner  in  his  successful  advances."  "The  simple  polish  of  academies  or  the 
visiting  of  libraries,  wealth  in  books  which  continue  unread,  to  shine  in  all  the 
journals,  all  these  do  not  contribute  the  least  to  the  comfort  of  the  sick."  Similar 
principles  in  both  theory  and  practice  were  advocated  by 

Giuseppe  Poxzellixi  of  Venice. 

Pomexico  GrUGLiELMiNi  (1655-1710)  of  Bologna, 
professor  at  Padua,  assumes  a  regular  and  irregular  "fermentation  of  a?thereal  and 
saline  particles "  • — the  latter  the  cause  of  fever  —  and  also  adduces  the  laws  of 
hydraulics  and  the  diameter  of  the  mouths  of  the  vessels,  in  order  to  explain  the 
processes  which  take  place  in  the  sound  and  the  diseased  body.  He  was  half  an 
Iatro-chemist  and  half  an  latro-mechanic. 

Giamb.    Scaramucci    (mechanical    medicine ;     the    motion    of    the 
blood  etc.) 

was  placed  upon  the  Index,  from  which  the  latro-mechanics  were  frequently  called 
upon  to  defend  themselves. 

Similar  compounds  of  Iatro-chemical  and  latro-mecbanical  principles 
were  represented  by 

Nicolo  Crescexzo  (about  1711)  ; 

Ferd.  Saxtaxielli  (Lucubrationes  physico-mechanica?,  Venice  1098); 

Matteo  Graxdi  (Treatise  on  man,  the  soul  and  the  bod}'.  1713); 

G.  Polexi  (Letters  to  Grandi,  1724); 

Ascanio  Maria  Bazzicaluve  (about  1700)  of  Lucca, 
who  correctly  regarded  the  blood-corpuscles  as  cells,  out  of  which  during  their  motion 
he  supposed  Eether  accompanied  with   animal  heat  to  be  disengaged  ;    the   famous 
Iatro- mathematician 

Pietro  Axtoxio  Michelotti  (about  1740)  of  Venice  ; 

Griov.  Battista  Mazini  (also  Mazzino.  about  1723)  of  Brescia. 
professor  in  Padua,  who  assigned  to  the  glands  a  systole  and  diastole,  and  considered 
the  dura  mater  the  source  of  motion  and  sensation,  while  he  referred  the  activity  of 
medicines  to  the  form  of  their  component  atoms. 

Paolo  Valcarenghi  (died  1780)  of  Cremona  ; 

Axtoxio  Fracassini  (1709-1777)  of  Verona, 
both  of  whom,  like  the  two  preceding  physicians,  belonged  to  the  eighteenth  century, 
and  others.  All  of  these  physicians  furnish  evidence  that  even  at  this  period,  and 
under  the  infallible  banner  of  mathematics,  physics  and  chemistry,  one  might  become 
mired  within  the  field  of  medical  science  in  bottomless  hypotheses,  whose  possibility 
is  conceivable  in  an  historical  point  of  view  alone,  but   which   also  demonstrate  that 


—  501   — 

later  ages,  by  special  routes  and  under  their  own  forms,  do  not  always  struggle  after 
a  better  knowledge  of  the  being,  the  development  and  the  functions  of  man,  and  that. 
«ach  age,  instead  of  the  complete  truth  which  it  seeks,  for  the  most  part  merely 
exchanges  new  errors,  or  new  forms  for  old  ones. 

Among  the  French,  as  well  as  in  Germany  and  Holland,  the  Iatro- 
mathematic  system  did  not  gain  any  considerable  number  of  followers 
until  the  eighteenth  century. 

As  early  as  the  seventeenth  centuiy,  however,  Pierre  Chirac  (1650- 
1732)  made  a  will  in  favor  of  a  chair  for  this  system  in  Montpellier,  and 
Philippe  Hecquet  (1661-1737;  of  Abbeville  in  Pieard}-,  subsequently  a 
Carmelite  monk,  was  an  equally  violent  opponent  of  male  midwifery,  the 
inoculation  of  small-pox,  bleeding  from  the  foot,  wine  and  meat  —  for  the 
last  thirty  years  of  his  life  he  abstained  absolutely  from  the  two  latter  — 
and  of  latro-ehemistry,  and  a  zealous  defender  of  the  mechanical  theory  of 
digestion.  On  the  other  hand  the  famous  architect  and  anatomist,  Claude 
Perrault  of  Paris  (1613-1688,  died  of  blood-poisoning,  the  result  of  a  wound 
received  in  the  dessection  of  a  putrid  camel,  a  rarity  in  those  days)  and 

Denys  Podart  (1634-1707,  also  of  Paris  and  a  member  of  the  Aca- 
demie),  who  for  28  years  had  proved  the  experiments  of  Sanctorius, 
explained  the  theory  of  the  voice  especially  on  Iatro-mechanical  principles. 
—  Anticipating  somewhat  we  bring  forward  from  the  eighteenth  century 
the  following  physicians,  who  were  Iatro-mathematicians  either  wholly  or 
in  part :  J.  B.  Silva  (1682-1742)  of  Bordeaux,  professor  in  Paris  ;  Antoine 
Ferrein  (1693-1769),  of  Frespech  near  Agen.  professor  of  surgery  and 
anatomy  at  Paris  (the  pyramids  of  Ferrein);  Francois  Quesna}'  (1694- 
1774),  the  first  permanent  secretary  of  the  Academy  of  Surgery  in  Paris  ; 
Hugo  Gourraigne  (about  1730),  of  the  Faculty  of  Montpellier;  finally 
Francois  Boissier  de  la  Croix  de  Sauvages,  the  follower  of  Stahl  and  a 
dynamic  physician  (in  which  capacity  we  shall  consider  him  hereafter),  and 
his  pupil  J.  Ant.  Butini. 

Next  to  Italy,  the  Iatro-mathematical  system,  rather  singularly,  won  the 
greatest  number  of  votaries  in  England.  In  fact  the  latter  country  very 
considerably  surpassed  the  former  in  Iatro-mathematical  fanaticism. 

William  Cole  of  Bristol  (about  1675) 
was  in  part  a  follower  of  Sylvius  (or  Willis).  He  considered  tension  of  the  nervous 
system,  due  to  a  deposit  of  abnormal  material  upon  the  nerve  roots,  the  usual  cause 
of  fever,  and  especially  of  the  symptoms  of  irritation  occurring  in  fever,  and  regarded 
differences  in  this  material  as  the  cause  of  modifications  of  the  disease.  He  also 
taught  the  constant  expansion  of  the  arterial  system  towards  the  capillaries.  The 
world-famed 

Archibald  Pitcairn  (1652-1713), 
who  was  been  already  mentioned,  was  likewise  a  great  Iatro-mathematician 

William  Cockburn  (about  1696) 
too  embraced  Iatro-physics  eclectic-ally.      He  was  the  author  of  a  treatise  on  syphilis' 

1.  Cockburn's  treatise  was  entitled  "The  symptoms,  nature,  causes  and  cure  of  a 
gonorrhoea".  He  also  wrote  "On  the  nature,  causes,  symptoms  and  cure  of  the 
distempers  that  are  incident  to  seafaring  people  ",  London.  HiHti.     (II.) 


—  502  — 

(1713),  in  which  he  first  located  the  seat  of  gonorrhoea  in  the  raucous  glands  of  the 
urethra,  though,  according  to  Proksch,  this  was  done  in  1709  by  Laurentius  Terraneus 
of  Turin,  Dr.  med.  et  phil.  Heretofore  the  disease  had  been  regarded  as  a  discharge 
of  corrupt  semen. 

Enthusiasm  in  calculation,  however,  really  began  with 
James  Keill  (1673-1719), 
a  physician  of  Northampton,  who  in  his  explanation  of  secretion  assumed  two  kinds 
of  attraction,  and,  in  accordance  with  the  laws  of  higher  mathematics,  computed  the 
velocity  of  the  blood-current  at  156  feet  per  minute  (too  low  a  rate),  the  force  of  the 
heart  at  five  ounces  (now  one  kil.  to  a  half  metre  of  height!,1  and  the  quantity  of 
blood  expelled  from  the  heart  at  each  pulsation  at  two  ounces  (now  six  ounces). 
while 

James  Jurin  (1681-1750). 
secretary  of  the  Royal  Society  at  London,  found  the  heart's  force  to  equal  three  pounds 
raised  one  inch  high  in  a  second.  (Keill  had  busied  himself  for  eight  years  in  repeat- 
ing the  experiments  of  Sanctorius,  and  had  found  approximately  the  same  values, 
hut  had  also  proven  the  untenability  of  the  assumption  that  suppression  of  perspi- 
ration was  a  general  cause  of  disease.) 

Alexander  Thompson  (about  1700), 
in  order  to  aid   the    heart,  claimed   that  the  arteries  also  assisted  in  the  propulsion  of 
the  blood.  —  The  famous 

George  Cheyne  (1671-1743) 
declared  the  lowering  of  the  elasticity  of  the  "fibres''  to  be  a  general  cause  of  disease, 
but  deduced  ordinary  fever  from  a  stoppage  of  the  glands  (which  played  a  great  role 
in  the  medicine  of  that  day),  and  lingering  fever  from  atony  of  those  organs.  He 
also  wrote  on  the  diseases  of  the  sea  (scurvy)  and  employed  the  thermometer.  (It 
may  be  stated  as  a  matter  of  curiosity  that  he  lived  for  sixteen  years  upon  bread  and 
milk  alone). 

Jeremiah  Wainwbjght  (about  1700) 
referred  the  viscidity  of  the  secretions  to  the  winding  course  of  the  arteries,  and  their 
liquidity,  on  the  contrary,  to  the  direct  and  more  rapid  current  of  the  blood.     In  this 
opinion 

Henry  Pemberton  (1694-1771) 
substantially  agreed. 

Bryan  (1732)  and  Nicholas  Robinson  (172.")  . 
following  Newton,  who    exercised   great    influence  in    general    upon    this    phase   of 
English  medicine,  assumed  an  animal  aether  in  place  of  the  nervous  fluid,   and   the 
latter    physician    referred    sensation  to  vibrations   of  the  tense   fibres,   and   nervous 
diseases  to  excessive  tension  of  these  fibres. 

Iatro-mathematical  text-books  were  supplied  by  Peter  Shaw  (died 
1763  ;  editor  of  the  writings  of  Robert  Boyle)  and  Charles  Perry  (1741). 

George  Martine  (1702-1743)  of  St.  Andrews.  Scotland,  affirmed  that  in 
men  greater  friction  between  the  blood-corpuscles  occurred  than  was  tin- 
case  in  women,  for  which  reason  the  male  sex  possessed  greater  warmth  of 
constitution  than  the  female  (the  reverse  is  rather  more  correct).  Other 
Iatro-mathematieians  of  the  eighteenth  century,  who  (like  some  of  those 


1.  Or  half  a  kilogrammetre  =  about  3.60  foot-pounds  English.    The  kilogrammetre 

or  French  unit  of  work  is  the  work  performed  in  raising  one  kilogramme  (2.2  lb) 
through  one  metre  (3.28  feet).     It  is  equal  to  7.233  English  foot-pounds.     (H.) 


—  503  — 

already  mentioned)  also  accepted  the  doctrines  of  Stahl,  were  :  John  Tabor, 
William  Porterfield,  Frank  Nicholls,  Thomas  Morgan,  and  the  noble 
Richard  Mead  (1673-1754)  of  London,  who  greatly  contributed  to  the 
support  of  this  system.  —  Edward  Bany  thought  that  the  age  of  a  man 
could  be  calculated  Iatro-mathematically  from  the  frequency  of  the  pulse, 
due  regard  being  paid  to  the  diet  and  other  sources  of  error,  while  Clifton 
Wintringham,  Jr.  (1710-1794)  —  his  father  bore  the  same  name  —  thought 
he  could  determine  the  subsequent  physical  conditions  of  a  man  from  the 
spermatozoa  employed  by  his  father  in  his  construction,  and  that  he  could 
compute  definitely  the  weight  of  an  individual  spermatozoon,  thus  entering 
a  department  which  the  Iatro-mathematicians  very  wisely  almost  all 
avoided. 

In  Germany,  among  the  Iatro-mathematicians,  who  here  too  were 
friendly  to  the  principles  of  Stahl,  are  reckoned  : 

Georg  Eriiardt  Hamberger  (1697-1755),  a  genuine  German  professor 
of  the  day  in  Jena,  disputations,  yet  at  last  devoted  to  the  honor  of  the 
truth,  who  carried  on  a  long  quarrel  with  Haller,  but  is  said  on  his  death- 
bed to  have  finally  declared  himself  conquered  ;  Joh.  Friedr.  Schreiber 
(1705-1760)  of  Konigsberg,  both  more  famous  than  Joh.  Gottfr.  Brendel 
(1711-1758)  of  Gottingen  (surnamed  the  "Genius  ohne  Posaune ",  and 
possessed  of  so  retentive  a  memory  that  he  knew  the  yEneid  by  heart  both 
forwards  and  backwards),  and  Joh.  Gottlieb.  Kriiger  (1715-1759)  at  Halle 
and  Helmstiidt ;  the  two  Bernoulli  in  Basel  and  Ernst  Jeremias  Neifeld 
(died  1772). 

Finally  such  devotion  to  the  physico-mathematical  theory  was  developed,  that 
even  centrifugal  machines  for  the  treatment  of  the  sick  were  proposed.  The  thermom- 
eter was  only  occasionally  employed.  The  air-pump,  however,  invented  at  this 
period  by  Otto  von  Guerike1  (1602-1688)  of  Magdeburg,  like  the  ordinary  bellows 
somewhat  altered  (with  a  manometer  similar  to  that  of  the  steam  engine),  was  left  to 
posterity  as  a  field  for  physico-therapeutic  triumphs  in  the  multiform  and  much 
abused  department  of  treatment,  and  Nathaniel  Henshaw2  accordingly  at  that  time 
(1664)  was  only  able  to  make  a  beginning  with  pneumatic  apparatus.  He  constructed 
a  "  Domicilium  "  (revived  in  our  day  as  the  pneumatic  cabinet),  in  which  he  had 
patients  suffering  from  acute  diseases  inspire  condensed  air  for  several  hours  a  day. 
while  chronic  eases  were  allowed  to  breathe  rarified  air. 

Since,  from  methods  of  research  and  investigation  correct  and  excel- 
lent in  themselves,  a  kind  of  one-sided  and  read}r-made  "  system  "  was  at 
first  rashly  upreared,  without  waiting  for  the  final  results  to  be  attained 
therefrom  before  incorporating  them  in  the  foundations  of  the  superstruc- 
ture ;  this  precipitancy  and  imperfection,  even  though  it  had  been  possible 
to  adorn  the  edifice  externally  with  some  reliable  facts,  were  compelled  to 
revenge  themselves  by  the  downfall  of  the  latro-mathematical  structure, 
which  had  benn  pushed  continually  higher  and  higher  upon  founda- 
tions internally  defective.     The  latro-mathematical  ■•  system  ",  though  not 


1.  He  was  the  first  to  exhibit  the  electric  spark  and  invented  the  first  electric  machine. 

2.  "A'e'rochalinos,  or  a  register  for  the  air",  London,  1677.     (H.) 


—  504  — 

entirely  unprofitable  to  science,  yet  proved  itself  unfruitful  in  the  advance- 
ment of  medical  practice,  that  is  to  say  the  practical  aims  of  medicine. 
The  latter  were  finally  compelled  to  be  worked  out  by  the  way.  which, 
since  the  days  of  Hippocrates,  has  been  found  the  only  reliable  one  —  the 
way  of  experience  and  observation  —  and  this  was  accomplished  in  the 
"Land  of  Common-Sense",  at  a  time  when  within  its  borders  Iatro-chemistry 
and  Iatro-mathematics  were  still  in  the  perfection  of  their  bloom,  or,  as 
was  believed  at  that  time,  were  most  completely  established.  Such  was 
the  work  of  the  great  practitioner 

X.  Sydenham. 

that  cool,  clear  and  unprejudiced  spirit,  free,  so  far  as  this  was  possible, 
from  the  influences  of  his  time,  who  in  the  golden  age  of  systems  declined 
4<  to  be  like  the  man  who  builds  the  chambers  of  the  upper  story  of  his 
house  before  he  has  laid  securely  the  foundation  walls,  for  that  is  rather 
building  castles  in  the  air  than  investigating  nature,"  and  who  sought  most 
justly  the  true  value  of  medicine  and  its  recompense  in  the  benefit  which 
it  brings  to  the  sick  in  their  cure,  without,  however,  scorning  or  entirely 
neglecting  its  scientific  side. 

Thomas  Sydenham  (1624-1689)  of  Winford  Eagle  in  Dorsetshire,  the 
son  of  a  thriving  farmer,  entered  the  university  of  Oxford  at  the  age  of 
eighteen.  His  studies  here,  however,  were  interrupted,  and  it  was  not 
until  1648,  after  a  prolonged  absence  in  camp1  and  in  London  necessitated 
by  the  civil  war,  that  he  was  able  to  resume  his  labors  as  a  student  of 
medicine.  On  the  completion  of  his  studies  at  Oxford,  Sydenham  is  said 
to  have  gone  to  Montpellier,  and  his  sojourn  here  must  have  been  as 
influential  upon  his  practical  bent  as  was  the  residence  of  Harvey  at  Padua 
upon  his  disposition  to  investigation.  Sydenham  took  his  degree  of 
Doctor  in  Cambridge,  and  then  settled  in  Westminster.  London.  In  1663 
he  became  a  member  of  the  College  of  Physicians  of  London.  He  was 
always  a  reluctant  author,  and  his  writings  were  fairly  wrung  from  him 
by  his  friends.  Sydenham  died  of  gout,  a  disease  from  which  he  had 
suffered  since  his  30th  year,  and  was  buried  in  Westminster  Abbey,  where 
in  1810  a  monument  was  erected  to  his  memor}-  by  the  College  of  Pl^si- 
cians.     With  respect  to  the  other  circumstances"   of  Sydenham's  life  we 

1.  He  was  a  soldier  on  the  side  of  Parliament  in  1(542.  while  his  elder  contemporary 

Harvey,  as  physician  of  the  king',  was.  so  to  speak,  his  antagonist,  and  finally 
attained  the  rank  of  captain. 

2.  It  is  really  remarkable  how  little  knowledge  we  have  of  the  details  of  the  life  of 

so  eminent  a  physican  as  Sydenham.  Born  at  Winford  Eagle  in  1624  he  entered 
Magdalen  College,  Oxford,  in  1642,  but  was  soon  forced  to  abandon  his  studies, 
and  is  said  to  have  received  a  commission  as  captain  in  the  Parliamentary  army. 
If  so,  he  must  soon  have  resigned  his  commission,  for  he  resumed  his  studies  at 
Oxford  in  1645  and  received  his  degree  of  Baccalaureus  in  Medicina,  April  14, 
1648.  In  the  same  year  he  received  the  appointment  of  Fellow  in  All  Souls'  Col- 
lege.    For  the  next  fifteen  years  we  know  nothing  of  Sydenham's  life  except  that 


—  505  — 

know  nothing  more  than  that  he  fled  from  London  during  the  prevalence 
of  the  plague  (an  action  which  must  not  be  condemned  too  severely,  since  it 
was  the  usual  custom  at  that  day),  and  that  he  had  children — among  them  a 
son  William,  who  was  also  a  physician.  He  was  a  very  busy,  successful 
and  distinguished  practitioner,  who  fulfilled  his  duties  to  nature  and  to  his 
patients  as  simpl}'  and  completely  as  he  did  his  obligations  to  science  by 
his  scientific  principles  based  upon  "  Nature  as  the  complex  of  natural 
causes 'V 

Sydenham's  model  was  Hippocrates,  upon  whom  he  seems  to  have 
formed  himself  almost  exclusively,  and  whose  principles,  with  some  modi- 
fications resulting  from  the  condition  of  knowledge  in  his  day  —  on  the 
whole  only  a  few  —  he  made  his  own.  In  pathology  he  was,  like 
Hippocrates,  a  Humorist  without  being  a  theorist,  and  he  defended 
himself  against  those  who  laid  this  to  his  reproach  in  almost  the  same 
words  used  by  Hippocrates.  Like  the  latter  too  (Sydenham  was  called 
the  "English  Hippocrates")  he  knew  only  one  standard — observation  and 
experience'- — -though  he  was  somewhat  skeptical  as  to  the  certainty  of 
their  results,  and  like  him  he  recognized  nature,  or  the  healing  power  of 
nature,3  as  the  sole,  ultimate,  undefined  and  undefinable.  but  (fortunately 
for  physicians)  existing  and  powerful  assistant. 

Tn  accordance  with  his  disposition  to  practical  objects,  Sydenham  laid  little 
weight  upon  anatomy  and  physiology,  a  feeling  which  he  shared  with  almost  all  great 
practitioners.  Yet  he  recognized  their  value  when  not  employed  in  the  production 
of  hypotheses  based  upon  pure  theory7.  The  latter  he  rejected,  though  he  admitted 
hypotheses  borrowed  from  practice  for  the  sake  of  elucidating  disease,  and  especially 
for  the  determination  of  curative  indications,  or  of  a  definite  therapeutics  (hypotheses 

lie  spent  some  time  in  Montpellier  pursuing  his  medical  studies.  But  June  25, 
1663,  he  was  admitted  a  member  of  the  Royal  College  of  Physicians  of  London, 
preparatory  to  settling  permanently  in  that  city.  It  was  not,  however,  until  1676 
that  he  took  his  degree  of  M.  D.  in  the  university  of  Cambridge.  His  chief  work, 
entitled  "  Observationes  Medic;e",  is  said  to  have  been  written  originally  in 
English,  and  to  have  been  translated  into  Latin  by  Dr.  John  Mapletoft,  after 
which  the  original  sheets  were  destroyed.  It  appeared  first  in  the  year  1666. 
Sydenham  died  in  London  Dec.  29,  1689.     (H.) 

1.  "Ego  enim,  quoties  natuiam  nomino,  toties  causarum  naturalium  complexum 
quendam  significari  volo." 

'2.  How  very  averse  Sydenham  was  to  all  mere  book-study  in  medicine,  may  be 
inferred  from  the  story  that  in  reply  to  Dr.  Richard  Blackmore,  who  inquired 
for  a  good  guide  in  practice,  he  sarcastically  recommended  "Don  Quixote"1 
This  work  is  certainly  adapted  to  lead  one  to  the  keenest  observation,  particularly 
of  all  the  foibles  and  phantasies  of  mankind,  and  the  advice  of  Sydenham  was 
probably  designed  to  indicate  the  special  applicability  of  such  observation  in 
medicine.  [1  suspect  Sydenham  merely  intended  to  suggest  that  to  a  physician 
who  proposed  to  guide  his  practice  by  books  alone  Don  Quixote  would  be  as  good 
as  any  other.  (H.)]  On  another  occasion  be  declared  that  the  arrival  of  a  good 
clown  exercised  a  more  beneficial  influence  upon  the  health  of  a  city  than  that  of 
20  asses  laden  with  drugs. 

3.  What  tlie  Ancients  call  "Physis"  or  "Natura"  has  much  in  common  with  what 
we  would  name  God. 


—  506  — 

based  upon  practice).  To  aid  in  the  discovery  of  the  latter,  and  for  the  determination 
of  the  long  neglected  "species  of  disease",  he  demanded  extremely  careful  observa- 
tion and  description  (for  which  he  himself,  like  almost  all  great  practitioners,  e.  g. 
Hippocrates,  Celsus,  Aretaeus  etc.,  possessed  an  artistic  aptitude),  for  he  recognizes 
as  the  supreme  and  first  need  of  practice  a  definite  and  certain  method  of  treatment, 
based  upon  species  botanically  limited  (if  such  an  expression  is  permissible).  In 
description,  however,  the  common  every-day  cases  with  which  the  practitioner  has 
mainly  to  deal,  and  the  typical  points  of  their  course,  should  be  chiefty  regarded,  not 
the  exceptional  cases  (which  improperly  play  the  chief  role  in  our  clinical  instruction 
of  the  present  day). 

Sj'denham's  conception  of  disease  is  something  active,  operative,  indeed  something- 
like  an  actual  practitioner,  the  best  of  all  physicians  (the  internal  physician  of  Para- 
celsus), for  he  regards  it  as  a  natural  effort  of  the  body  to  remove  morbid  material  from 
the  blood.  If  its  action  is  violent  and  quickly  ended,  we  have  to  do  with  an  acute 
disease,  but  if  it  progresses  slowly  and  with  difficulty,  the  conditions  are  chronic. 
Fever,  in  particular,  is  the  most  important  process  of  purification,  designed  to  remove 
the  morbid  material  of  the  blood,  and  in  his  view  is  substantially  an  "inflammation 
of  the  blood",  which  can  be  recognized  by  the  crusta  phlogistica.  It  originates 
chiefly  from  cold  or  from  epidemic  influences. 

The  causes  of  disease  are  unknown  influences  and  changes  (not  meteorological) 
of  the  atmosphere,  which  flow  from  the  "bowels  of  the  earth"  with  a  certain  regu- 
larity and  periodicity  —  this  holds  good  especiall}-  for  epidemic  and  acute  diseases 
—  or  thej^  are  defects  of  the  humors  resulting  from  an  improper  mode  of  life.  The 
latter  is  to  be  particularly  considered  in  chronic  conditions. —  From  the  same  causes, 
however,  very  different  individuals  and  phenomena  of  one  and  the  same  species  of 
disease  may  arise. 

Besides  the  constitution  of  the  season  —  he  considers  e.  g.  the  beginning  and  the 
end  of  winter  each  year  to  dispose  to  pneumonia —  Sydenham  gave  especial  promin- 
ence to  the  epidemic  constitution,  under  the  influence  of  which,  according  to  his 
observations,  all  other  diseases  occurring  during  any  occasional  epidemic  assume  a 
special  character.  Hence  he  claims  a  "stationary  fever"1  as  a  kind  of  common 
fundamental  process,  an  ens  morbi.  From  1661  to  1675  Sydenham  observed  five  such 
"  constitutiones  "  in  the  epidemics  which  he  describes.  During  the  great  epidemic  of 
plague  in  London,  however,  he  did  not  remain  at  his  post. 

In  Sydenham's  special  pathology  the  "  inflammation  of  the  blood",  already  men- 
tioned, plays  the  chief  role,  and  upon  it  depend  pretty  nearly  all  acute  diseases  and 
even  many  chronic  conditions.  A  few  only  were  ascribed  to  altered  (nerve-)  spirits, 
"spiritus"  (like  hysteria),  to  weakness  of  digestion  (like  gout),  or  to  weakness  of  the 
blood  (as  dropsy)  etc. 

Therapeutics.  —  Sydenham  arrived  at  the  healing  power  of  "  nature",  for  which 
he  made  such  great  claims  and  upon  which  he  laid  such  stress,  by  his  careful  obser- 
vation of  epidemics.  This  power,  however,  he,  like  almost  all  physicians  before  and 
since  (Hippocrates  not  excepted),  so  understood,  that  there  always  remained  a  good 
deal  for  the  physician  to  do,  and  very  often  quite  active  interference  was  required. 
Thus  in  syphilis  he  gave  mercury  until  two  kilogrammes  of  saliva  were  discharged 
daily.  This  interference  might  pass  subjective!}'  for  "  support  or  improvement  of  the 
efforts  of  nature",  though  very  often,  as  the  result,  the  health  was  ruined.  Syden- 
ham's therapeutics  manifestly,  therefore,  can  claim  the  merit  of  simplicity  only  when 
compared  with  the  great  abuses  of  preceding  ages!  And  yet  he  employs  e.  g.  eighteen 
different  herbs  in  one  prescription,  and  that  merely  an  ointment  for  inunction  !     On 

1.  Febres  stationary. 


—  507  — 

the  other  hand,  he  lays  down  the  precept  that  a  regular  and  salutary  system  of  man- 
agement cures  many  diseases  frequently  better  than  the  powders  of  the  apothecary- 
shop.  The  same  old  story,  which  remains  always  new,  that  even  a  physician  of  the 
best  principles  becomes,  and  must  become,  unfaithful  to  his  principles  in  practice,  or 
else  fall  a  victim  to  the  prejudices  of  the  public  and  —  his  colleagues! 

Sydenham  regards  not  only  the  constitution  of  the  individual,  but  also  that  of 
diseases  or  epidemics,  as  well  as  the  season,  the  cause  of  the  disease  etc.  He  is  like- 
wise a  great  advocate  of  the  antiphlogistic  method  in  almost  all  diseases,  and  employs 
with  this  object  diet,  cathartics  etc.,  and  above  all  bleeding,  which  he  practised  with 
special  frequency.  Besides  these  he  values  very  highly  the  corroborant  method. 
Still  he  believes  both  these  methods  specially  efficacious  as  therapeutic  methods  in 
acute  diseases  onljr,  and  that  in  these  their  reliability  is  confirmed  by  experience, 
while  for  chronic  diseases  such  is  not  the  case.  The  unreliability  of  the  action  of 
drugs  induced  Sydenham  to  hope  for,  and  to  rely  upon,  specifica  (like  Paracelsus), 
but  of  these  he  recognized  only  one  single  article,  the  then  newly  discovered  cinchona, 
and  in  opposition  to  all  theoretical  principles  as  well  as  to  all  those  derived  from 
Antiquity,  he  entered  the  lists  in  defence  of  this  drug  with  all  his  power.  Even  the 
effects  of  mercury  in  syphilis  he  ascribed  solely  to  its  favoring  the  evacuations. 
Among  drugs,  he  employed  especially  those  from  the  vegetable  kingdom  (jalap, 
resins,  asafoetida  etc.),  and  particularly  cinchona  and  opium  in  the  form  of  the  so- 
called  laudanum  liquidum  Sydenhamii,  which  had  been  already  brought  forward, 
however,  by  Theophrastus  von  Hohenheim.  The  latter  drug  he  considered  the 
noblest,  and  almost  the  only,  "Cardiacum"  (he  was  very  fond  of  the  so-called  car- 
diaca).     Of  mineral  remedies  he  employed  calomel,  iron,  salts  etc. 

The  great  importance  of  Sydenham,  so  far  as  his  own  age  is  concerned, 
depends  after  all  upon  the  struggle  for  the  healing  power  of  nature  and  for 
simple  observation  and  treatment,  which  he,  as  a  matter  of  fact,  rather 
inaugurated  than  fought  energetically  to  a  conclusion  against  the  over- 
grown luxuriance  of  systems  and  theories.  For  the  future,  however,  he 
became  the  chosen  standard-bearer  of  progress  in  practical  medicine,  that 
is  of  that  return  (so  often  recurring  in  the  history  of  medicine)  to  the 
Hippocratic  method  and  art  of  healing,  which  are  founded  in  the  nature 
of  things  and  in  the  limits  of  human  ability,  and  are  therefore  imperish- 
able. 

An  opponent  of  Sydenham  was  Richard  Morton  (1C35-1698), 
also  a  practitioner  in  London,  who  likewise  (like  so  many  before  and  after  him) 
professed  to  follow  nature,  when  he  really  followed  his  own  ideas  and  highly  extolled 
the  heating  system  of  therapeutics.  By  this  system  too  he  cured  the  sick  with  as 
great  success  as  did  Sj'denham  with  his  cooling  system,  and  thus  either  the  power  of 
nature  or  the  powerlessness  of  all  therapeutic  methods  (but  by  no  means  any  error  of 
his  opponent,  as  Morton  believed)  was  demonstrated.  Like  Fernel,  Morton  con- 
sidered all  diseases  a  kind  of  poisoning  of  the  "vital  spirits".  He  also  gave  a  very 
famous  description  of  small-pox,  measles,  scarlet  fever,  masked  intermittents  and 
phthisis. 

Gideon  Harvey  (died  about  1700) 
occupies  an  entirely  isolated  position  among  the  physicians  of  the  seventeenth  century, 
like  a  kind  of  Magnus  of  Alexandria  of  his  day.  [He  was  ordinan-  physician  to  king 
Charles  II.,  medical  director  of  the  army  in  Flanders  in  the  year  1659,  then  physician 
to  William  III.  (1050-1702)  and  city  physician  of  London.]  He  embraced  the 
expectant   method    (he   wrote    "  The  art  of  curing   diseases   by  expectation"   1689), 


—  508  — 

and  was  a  scourge  to  the  physicians  of  his  day,  whom  he  "designated  dung-doctors, 
who  drive  out  diseases  through  the  anus  ",l  because  most  of  them  in  febrile  diseases 
gave  a  cathartic  every  second  da}-  and  began  treatment  with  an  emetic.  Besides 
this  he  published  satirical  writings  against  physicians  ("The  Conclave  of  Physicians  ; 
detecting  their  intrigues,  frauds  and  plots  against  their  patients.") — and  it  has  there- 
fore been  his  fate  to  be  omitted  in  the  compendia.     On  the  other  hand. 

Sir  Thomas  Browne  (1605-1682)  of  London 
enjoyred,  and   still   enjoys,   great  reputation  as  author  of  the  work   entitled  "  Religio 
Medici  ",   though    he  was  so  superstitious  that  in  1G64  he  swore  that  two  condemned 
old  women  were  actual  witches.' 

rj.    THE  ADVANCEMENT  OF  PATHOLOGY  BY  INDIVIDUAL  PHYSICIANS. 

It  was  not  so  much  within  the  schools,  to  which  most  physicians 
belonged,  as  without  their  directing  influence  (so  far  as  this  was  possible 
for  those  who  lived  in  a  decided  epoch  of  schools),  that  pathology  in  the 
seventeenth  century  experienced  its  chief  enrichment  and  attained  a  secure 
foundation.  Under  the  head  of  enrichment  we  ma}-  include  the  rise  of  the 
so-called  geographical  diseases  and  of  the  pathology  of  the  trades,  with  the 
description  of  new,  or  newly  observed,  diseases.  On  the  other  hand  the 
confirmation  of  diagnosis  in  the  living  by  investigation  of  the  pathological 
anatomy  after  death  ma}'  be  reckoned  the  foundation  of  pathological 
science. 

The  seventeenth  century  exhibited  in  medicine  a  great  similarity  in 
all  respects  to  our  own.  This  is  shown  in  the  numberless  ';Observationes'' 
and  "  Casus  "  published  during  this  period,  which,  however,  appeared  in 
''Decades"  and  "Centurise"  only,  not  in  some  few  examples. 

The  corner-stone  of  geographical  and  comparative  pathology  was  laid  by  the 
travels  of  the  physicians  of  this  period,  as  well  as  by  the  more  careful  observation  of 
epidemic  diseases  in  particular,  in  which  this  century  of  wars  was  so  rich. 

In  the  subject  of  geographical  pathology  the  following  physicians  are  of  chief 
importance:  .lac.  Bontius  (Beriberi,  died  in  Batavia,  1631),  professor  in  Leyden,  and 
Wilhelm  Piso3  (Lepois,  1611-1678),  the  former  for  the  East  Indies,  the  latter  for 
Brazil ;  Engelbrecht  Kampfer  (1651-1716)  of  Lemgo,  the  famous  traveller  in  Central 
Asia,  who  was  also  twice  in  Japan  as  ship-surgeon,  and  whose  writings  until  verj- 
recently  formed  the  treasury  of  all  our  knowledge  concerning  the  latter  country  and 
the  neighboring  islands;  Andreas  Cleyer  (diseases  of  the  East  Indies  and  China)  of 
Cassel  about  1675,  a  ship-surgeon  in  the  Dutch  Indies;  Willem  G.  ten  Rhyne  of 
Deventer  (for  the  same  countries) ;  William  Cockburn  (The  diseases  of  seafaring 
people,  1696). 

1.  He  divides  the  physicians  of  his  day  into  six  classes:  ferrea,  asinaria,  jesuitica, 
aquaria,  laniaria  and  stercoraria,  according  as  their  favorite  systems  of  treatment 
were  the  administration  of  iron,  asses'  milk,  cinchona,  mineral  waters,  venesec- 
tion or  purgatives,     ill. ) 

•_'.  Browne's  "  Enquiries  into  Vulgar  and  Common  Errors",  which  appeared  in  1646, 
does  not  seem  to  have  preserved  its  author  from  the  commonest  error  of  his 
age.    (H.) 

:;.  Two  other  physicians  named  Piso  also  lived  in  this  century:  llomobomis  Piso,  an 
opponent  of  Harvey,  and  Charles  Piso  (1563-]6oi!),  who  published  some  "Observa- 
tiones".  A  Nicolas  Piso.  who  was  ordinary  physician  of  Lorraine,  died  in  the 
year  1590. 


—  509  — 

The  following  physicians,  in  addition  to  many  others,  made  themselves  prominent 
in  medicine  by  "  Observationes ",  which,  in  contrast  to  the  so-called  "Consilia", 
announced  by  their  very  title  that  their  authors  occupied  the  newest  stand-point  of 
that  day:  Isbrand  van  Diemerbroeck  (1609-1674),  professor  in  Utrecht;  Vincenzio 
Baronio,  a  physician  of  Forli  (Pleuropneumonia,  1633) ;  Zacutus  Lusitanus  (Abraham 
Zacuto,  1575-1642),  "Observationes";  J.  P.  Lotichius  (1598-1669),  petechial  typhus 
in  Hesse,  the  bubo  plajrue  etc.;  Lazar.  Riviere  (1589-1655 ;  the  "  Potio  Riverii "  is 
still  in  common  use),  "Observationes'';  Herman  van  der  Heyden  (1572-1655), 
dysentery;  the  Dane,  Joh.  Rhodius  (1587-1659),  "Observationes";  Nic.  Chf snean 
(born  1601),  an  opponent  of  Schneider  ;  Benedictus  Sylvaticus  (died  1658),  "Consilia"; 
Fred,  van  der  Mye  (about  1627),  petechial  typhus;  Arnold  de  Boot  (1606-1650), 
"Observationes";  Thomas  Willis,  who  in  1674  determined  the  sweetness  of  diabetic 
urine  by  the  taste;  Pierre  Borel  de  Castres  (1620-1689),  "Observationes";  Isaac 
Cattier,  a  physician  of  Montpellier,  "  Observationes";  J.  Morel  (about  1628),  petechial 
typhus;  Valerius  Martinins  in  Venice,  "Totius  medicina?  practical  exactissima  collec- 
tio";  Phil.  Salmuth  (died  1662),  "Observationum  medicarum  eenturia?  tres"  ;  J.  C.  Clau- 
dini  (died  1618),  "Observationes":  Guillaume  Loyseau,  "  Observationes  medicinales  et 
chirurgicales "  ;  Joh.  Jac.  Manget,  Prussian  physician-in-ordinary,  "Observationes 
chirurgicales";  Thorn.  Bartholin  and  Wolfgang  Gabelshofer  (born  1539)  "  Centurias"; 
J.  Stephanus  "Consilia";  Malachias  Geiger,  Medico-chirurg.  observationes;  J.  Dan. 
Horst  (1620-1685)  of  Giessen,  ordinary  physician  in  Darmstadt,  a  correspondent  of 
Harvej7's ;  Wolfgang  Hofer  (1614-1681),  cretinism;  Raimund  Torti  (1603-1678), 
"  Consultationes,  Responsa  et  Consilia";  Gerhard  Blasius  (died  1692),  "Observationes 
medica?  rariores";  Fried.  Lossius,  diseases  of  the  nervous  system  ;  Bernh.  Verzascha 
(born  1628),  "Observationes",  including  the  vagitus  uterinus;  Balth.  Timaeus  von 
Guldenklee  (1609-1667),  ordinary  physician  of  the  Great  Elector,  "Casus  medici- 
nales"; Corn.  Stalpaart  van  der  Wiel,  "Centuriaa";  Joh.  Nic.  Pechlin  (1646-1706), 
"Observationes";  Ido  Wolf  (1615-1693)  and  his  son  Johann  Christian;  Martin 
Lister  (died  1711);  G.  A.  Mercklin  (1644-1702);  the  elder  Mercklin,  of  the  same 
Christian  name  (also  settled  in  Nuremberg,  where  this  medical  family  still  sur- 
vives), lived  1613-1684;  C.  Van  de  Voorde  (1650-1720)  of  Amsterdam  (on  noma); 
Pieter  A.  Verduyn  of  Amsterdam  (flap  incision  in  amputation);  J.  Vergniol  and 
Van  Wlooteon  the  same  subject;  R.  Lowdham  of  Oxford,  the  first  (1679)  to  make 
this  incision,1  and  with  the  hope  of  securing  healing  by  first  intention;  he  also 
wrote  upon  this  plan  of  management;  Giov.  Battista  Cortesi  (1554-1636),  on  surgi- 
cal operations. 

Bernardino  Ramazzini  (1633-1714),  professor  in  Padua,  was  especially 
eminent  and  famous,  and  is  important  as  an  epidemiographer,  and  the  first 
student  of  the  so-called  trade-diseases,  on  which  subject  he  wrote  his 
"  De  morbis  artificum  diatriba"  (1700). 


Even  as  late  as  the  17th  century  the  practice  of  amputation  was  limited  almost 
exclusively  to  removal  of  the  fingers  and  toes,  the  hand,  foot,  forearm  and  leg. 
Amputations  above  the  knee,  and  still  more  above  the  elbow,  were  regarded  as 
extremely  venturesome  undertakings.  The  flap-operation  is  first  mentioned  in  a 
letter  of  the  English  surgeon  James  Vonge  (Young),  appended  to  his  "  Currus 
triumphalis  e  terebinthina".  which  appeared  at  London  in  167!>.  He  describes 
the  operation  as  performed  by  Lowdham  of  Oxford.  Sprengel  ascribes  the  inven- 
tion of  the  operation  to  Richard  Wiseman,  Sergeant-Surgeon  of  Charles  II.  and 
James  II.,  but  no  mention  of  it  appears  in  Wiseman's  "Several  surgical  treatises", 
published  at  London  in  1676  'Haeser).     (H.) 


—  510  — 

The  famous  Jesuit  Athanasius  Kireher  (1598-1680)  of  Fulda,  who  already  brought 
forward  the  Darwinian  maxim  "Struggle  and  counter-struggle  maintain  the  general 
life",  and  sought  in  the  microscopic  organisms  of  the  air  ("worms",  seen  with  a 
microscope  of  low  power  in  putrefying  matters,  e.  g.  the  blood  and  pus  of  plague- 
patients  etc.)  the  cause  of  infectious  diseases,  especially  the  plague.  He  also  des- 
cribed hypnotism  in  certain  animals;  Joh.  Christian  Lange and  Jean  Bapt.  Goiffon 
(1658-1730)  of  Lyons,  accepted  a  similar  pathologia  animata.  Nath.  Hodges,  who 
remained  in  London  during  the  plague  when  Sydenham  fled;  Lucas  Schacht  (1634- 
1689),  professor  in  Leyden  (scurvy),  and  Johann  Hellwig  (1618-1674)  of  Nuremberg, 
must  also  be  mentioned. 

The  following  non-epidemic  new  diseases  were  described  during  the 
course  of  the  seventeenth  century  :  Rhachitis  (the  Latinized  form  of  the 
then  popular  name  -'rickets")  03'  Francis  Glisson1  (1650);  the  Guinea- 
worm  (known  already  to  the  Ancients)  b}-  Georg  Hieron.  Welsch  (1624- 
1677),  a  ph}'sician  of  Augsburg.  The  itch-mite  was  discovered  in  the 
pustules  of  itch  by  Giovanni  Cosimo  Bonomo"  in  1687,  on  the  statement 
of  a  washerwoman  ;  yet  he  was  not  applauded  as  a  discoverer,  because 
nothing  was  seen  anywhere  but  the  popular  "  acridity  ". 

The  apothecary  Diaciuto  Cestoni  of  Livorno  had  a  share  in  the  discovery,  and  a 
certain  Isaac  Colonello  made  a  sketch  from  the  microscopic  preparation  in  question, 
which  represented  the  mite  in  the  process  of  laying  eggs.  The  mite,  i.  e.  the  animal 
and  its  existence  in  the  itch,  was  also  known  at  an  earlier  period  among  the  people. 
Jos.  J.  Scaliger  (1540-1609)  of  Leyden  described  it  (as  well  as  the  burrows)  in  1557, 
though  without  knowing  the  causative  relation  of  the  mite  to  the  eruption. 

The  Englishman  Thomas  Mouffet  (died  about  1600),  who  wrote  a  famous  book3  on 
insects  (said  by  some  to  have  been  taken  from  Gesner's  manuscript),  was  the  first  to 
give  a  plain  description  of  this  mite. 

Observations  based  upon  autopsies  were  published  by  Joh.  Jac.  Wepfer  (1620- 
1695),  archiater  at  Schaff  hausen,  physician-in-qrdinary  to  the  Duke  of  Wtirtemberg, 
(apoplexy) ;  Gerhard  Blaes  of  Amsterdam  ;  Giov.  Maria  Lancisi  (1655-1720)  of  Rome, 
a  famous  physician-in-ordinary  to  the  pope  (De  subitaneis  mortibus;  De  motu  cordis 
et  aneurysmatibus),  who  already  employed  percussion  of  the  sternum,  and  dis- 
tinguished himself  as  a  hygienist;  Seb.  Pissino  (De  cordis  palpitatione  cognos- 
cenda  et  curanda,    1G09);    Christopher   Bennet    (1617-1055)    and    Richard  Morton 

1.  Glisson  was  anticipated  by  Daniel  Whistler  (died  1684),  whose   thesis  for  the 

Doctorate  at  Leyden  in  1645  was  entitled  "  De  morbo  puerili  Anglorum,  quern 
pati'io  sermone  indigent  vocant  The  Rickets".  The  Dutchman  Arnold  de  Boot 
(1606-1653),  who  served  in  the  English  army  in  Ireland,  also  mentions  the  disease 
in  his  "Observationes  medic*  de  affectibus  omissis",  London,  1649.  The  "Fla- 
gellum  Anglht'  sen  Tabes  Anglica  "  of  Theopbilus  de  Garancieres,  published  in 
London,  1647,  and  usually  mentioned  as  one  of  the  earliest  treatises  upon  rickets, 
according  to  Drs.  S.  Gee  and  John  S.  Billings,  is  devoted  to  an  obscure  form  of 
consumption  and  not  to  the  disease  in  question.  Glisson's  "  Tractatus  de  Rachi- 
tide,  sen  morbo  puerili  Rikefcs  dicto",  London,  1650,  was,  however,  the  first  work 
which  excited  much  attention  to  the  disease  on  the  part  of  physicians.     (H.) 

2.  His  work  entitled  "  Osservazioni  in  to  in  0  a  Pellicelli  del  corpo  umano  "  appeared 

at  Florence  in  1687.    It  was  translated  into  Latin  by  Joseph  Lanzoni.     (H.) 

3.  The  work  referred  to,  entitled  "Insectorum  seu  mininiorum  animalium  Theatrum", 

was  the  continuation  and  conclusion  of  a  work  which  had  been  undertaken  by 
Conrad  Gesner,  Edward  Wotton  and  Thomas  Penn.  It  was  published  by  Turquet 
de  Mayerne  in  London,  1634,  many  years  after  the  death  of  its  author.     (II.) 


—  511   — 

(both  on  phthisis  pulmonum) ;  R.  Vieussens  (Diseases  of  the  heart) ;  Willis  (Diseases 
of  the  brain);  and  others,  whom  we  shall  learn  to  know  when  we  come  to  discuss 
pathological  anatomy  proper. 

b.    Surgery  (Ophthalmology,  Otology.  Dentistry). 

In  contrast  to  the  systems  and  schools,  which  flourished  so  luxuriantly 
in  the  medicine  of  the  seventeenth  century,  and  to  the  often  excessive 
partisanship  and  adulation  of  their  disciples,  it  is  pleasant  to  see  surgery, 
on  the  whole,  working  up  slowly  into  a  scientific  branch  free  from  specula- 
tion, and  the  better  surgeons,  most  of  whom  were  distinguished  for  their 
modest}-,  striving  more  and  more  by  study  and  observation,  even  in 
Germany,  to  acquire  for  themselves  and  their  department  a  scientific 
position,  to  elevate  it  and  place  it  upon  a  secure  basis.  The  seventeenth 
century  accordingly  is  undoubtedly  highly  important  in  the  history  of  the 
development  of  surgery  through  this  very  elevation,  attained  in  silence  and 
accomplished  within  itself,  although — and,  indeed,  as  the  result  of  the  facts 
just  stated — it  could  not  enter  into  history  distinguished  by  such  brilliant 
advances  and  discoveries  as  marked  the  centuries  preceding  and  following. 
Surgery  too  now  won  a  wider  field  for  action,  since  the  Germanic  peoples, 
the  Dutch,  English.  Germans  and  Danes,  who  had  up  to  this  time  attained 
little  prominence,  now  began  to  distinguish  themselves  also  in  this  depart- 
ment. Hence  it  is  that  the  number  of  surgeons  known  by  the  writings 
which  they  have  left  us,  or  by  their  discoveries,  is  very  large  when  com- 
pared with  that  of  the  sixteenth  century.  The  increased  scientific  activity 
in  the  surgical  department  laid  the  foundation  of  the  high  position  and 
estimation  of  surgery  and  surgeons  which  marked  the  18th  century. 

Among  the 

a.  Italians, 

who  had,  on  the  whole,  already  fallen  from  their  former  domination  in 
medicine,  we  ma}*  mention 

Santorio  Santoro, 
who,  as  we  know,  distinguished  himself  by  the  invention  of  various  instruments  (a 
trocar  for  paracentesis  abdominis,  a  speculum-like  instrument,  a  kind  of  lithotrite, 
a  self-injecting  apparatus  and  a  kind  of  shower-bath)   and  A.  M.  Valsalva,  a  good 
aurist  and  operator,  who  employed  the  ligature. 

Cesare  Magati  (1579-1647)  of  Scandiano, 
subsequently  professor  at  Ferrara,  was  particularly  prominent  as  a  surgeon,  and  must 
be  regarded  as  one  of  the  pioneers  of  surgery,  an  art  whose  entire  success  depends 
upon  the  treatment  of  wounds.  Plasters,  balsams,  poultices,  salves,  tents  etc.,  with 
all  their  resulting  uncleanness,  were  still  the  fashion,  and  against  these  abuses  Magati 
now  insisted  upon  simplification  of  the  treatment  of  wounds  and  the  infrequent  change 
of  dressings.  Instead  of  changing  the  latter  several  times  a  day,  as  was  the  custom 
he  would  have  them  renewed  but  once  in  four  days.  These  novelties  forced  him  to 
defend  himself  against  many  of  his  contemporaries,  and  at  last,  when  he  had  already 
joined  the  Franciscan  order,  compelled  him  to  reply  to  Sennert.  He  died  as  the 
result  of  a  lithotomy.  His  chief  work  was  entitled  "  De  rara  medicatione  vulnerum  " 
(Venice,  1616).     Of  equal  eminence  was 


—  512  — 

Marco  Aurelio  Severing*  (1580-1656)  of  Tarsia  in  Calabria. 
He  was  at  first  a  lawyer,  than  a  professor  at  Naples  and,  like  many  surgeons  of  this 
century,  an  important  anatomist.  He  was  fond  of  trepanning  (an  operation  at  this 
time  very  common)  and  operated  upon  hare-lip,  epulis,  empyema,  performed  bronch- 
otomy,  tied  the  crural  artery  high  up  for  aneurism  of  the  popliteal  and  recognized 
benign  tumors  of  the  breast.  Yet,  like  the  surgeon  next  mentioned,  he  was  a  special 
friend  of  the  actual  cautery,  an  offshoot  of  Gra?co-Arabian  surgery  not  speedily 
uprooted,  and  which,  as  we  know,  still  bloomed  in  our  own  century  (  Larrey,  Rust  etc.) 

Pietro  be  Marchetti  (1589-1678)  of  Padua, 
a  bold  and  versatile  operator,  was  professor  of  surgery  in  his  native  city.     We  must 
mention  also 

Giuseppe  Francisco  Borri   (1625   or  1627-1695  or  1704,  Burrhus, 
Borro)  of  Milan, 

the  son  of  a  physician  ami  specially  skilful  as  an  oculist.  He  is,  however,  better 
known  from  his  sad  fate.  In  consequence  of  his  liberal  religious  views  he  was  driven 
into  exile,  and,  having  been  delivered  up  by  Germany  on  the  requisition  of  the  papal 
nuncio,  wore  away  his  life  in  Rome,  first  in  the  prisons  of  the  Inquisition  and  then  in 
the  Castle  of  St.  Angelo,  where  the  poor  fellow  died  after  a  prison-life  of  25  years. 

Giovanni  Battista  Cortesi  (1554-1636). 
professor   of  anatomy  and   surgery   in  Bologna  and  Messina  (rhinoplasty);  Adrian 
van   Spieghel   (Spigelius   1578-1625),   who  practised  trepanning  seven  times  upon  a 
single  patient ;  Jac.  Zannaro,  eminent  in  the  rhinoplastic  art: 

Dion.  Sancassini  (1659-1738), 
whose  treatment  of  wounds  followed  the  principles  of  Magati ;  Giuseppe  Lanzoni 
( 1663-1730)  of  Ferrara  (gunshot-wounds,  wounds  of  the  head,  arteriotomy) ;  Tommaso 
Alghisi  (1669-1713)  of  Florence;  Carlo  Musitano  (1635-1714),  professor  at  Naples, 
who,  according  to  E.  Albert,  was  already  acquainted  with  the  red  color  of  the  retina 
—  Boll-Kiihne's  "  Sehpurpur";  Paolo  Manfredi  (about  1668),  professor  at  Rome,  and 
a  votary  of  transfusion  and  infusion,  which  operations  were  also  practised  at  that  time 
by  Guglielmo  Riva  (1627-1677)  of  Asti  in  Piedmont,  surgeon  in  Rome,  and  Carlo 
Fracassati.  Bernardino  Genga  of  Rome  was  also  a  surgeon  of  importance  during 
the  latter  half  of  the  seventeenth  century.     Among 

,?.  The  French, 
who,  in  the  century  of  Richelieu.  Mazarin,  Louis  X1Y..  Corneille.  Racine. 
Moliere.  Fenelon,  Lafontaine.  la  Brnyere,  Boileau.  Bossuet  etc.,  laid  securely 
the  foundation  of  that  leadership  in  surgery  which  they  were  to  hold  with- 
out a  rival  in  the  18th  century,  while  in  the  17th  they  had  rivals  even  in 
Germany,  the  surgeon  Morel,  by  his  invention  of  the  tourniquet  at  the 
siege  of  Besaneon  in  the  year  1674,  was  a  benefactor  of  the  unfortunate 
victims  of  the  knife.  That  Jean  Baptiste  Denis  (died  1704).  physician  of 
Louis  XIV..  with  the  assistance  of  the  surgeon  Emmerez,  performed  the 
first  transfusion  in  man,  cannot  be  regarded  as  any  permanent  gain  to 
surgery. 

The  transfusion  of  the  blood  of  the  young  into  the  veins  of  the  old,  in  order  to 
rejuvenate  the  latter,1  bad  for  a  long  period  been  a  pium  desiderium,  to  which  Marsi- 

1.  The  most  ancient  art  of  rejuvenation  —  for  the  Ancients  also  made  many  efforts  in 
this  direction  — was  very  different.  Thus  David  in  his  extreme  old  age  appro- 
priated  for  rejuvenating  purposes  the  most  beautiful   maiden   in   Israel,  and 


—  513  — 

lius  Ficinus  and  Hieron.  Cardanus,  among  others,  had  given  expression.  Andreas 
Libavius1  by  recommending  the  operation  (1615),  and  Giov.  Colle  (died  1631), 
professor  at  Padua,  by  his  description  of  a  method  (1628),  had  supplied  new  support. 
Richard  Lower  and  Robert  Boyle  practised  transfusion  in  dogs.  The  London  Faculty 
sought  the  value  of  the  operation  in  its  preservation  -of  life  after  excessive  hemor- 
rhages. While  the  physicians  mentioned  above  had  conducted  arterial  blood  into 
a  vein,  Edmund  King,  ordinary  physician  of  Charles  II.,  in  the  same  year  1665 
practised  a  transfusion  from  vein  to  vein.  Denis  was  the  first  to  carrjr  out  the  same 
operation  practically  with  lamb's  blood  upon  a  patient  sinking  under  an  excessive 
venesection  —  an  operation  very  generally  abused  in  the  17th  century  (even  the 
Czar  Peter  I.  had  himself  bled  once  a  year).  The  patient  became  maniacal  after  the 
operation,  urinated  blood  after  its  repetition,  and  finally  died.  Lower  and  King,* 
however,  undertook  the  operation  upon  a  healthy  person,  and  met  with  success. 
Riva,  on  the  contrary,  transfused  blood  into  a  phthisical  patient,  who  (like  most 
patients  who  undergo  direct  transfusion  in  our  own  day)  speedily  died,  while  Paolo 
Manfredi  finally  had  a  successful  result.  Since  most  of  the  operations  had  turned 
out  unfortunately  or  had  been  barren  of  results,  the  operation  itself  was  first  com- 
bated with  the  Bible  (e.  g.  by  Bart.  Santinelli,  a  physician  of  Rome),  and  then 
forbidden  by  the  Parliament  of  Paris,  whose  action  was  finally  followed  by  the  pope. 
In  our  own  century  transfusion  has  again  appeared  and  disappeared  —  another 
evidence  of  the  similar  tendencies  of  the  1 7th  and  19th  centuries. 

Of  the  French  family  of  lithotomists,  the  Colots,  Laurent  and  Philippe 
(1593-1656)  his  son,  distinguished  themselves  in  this  centur}'  as  capable 
and  popular  specialists.     The  last  member  of  this  family,  Francois,  died  in 

Mohammed,  after  the  death  of  the  aged  Kadijah,  selected  also  two  wives  aged  7 
and  8  years,  to  strengthen  his  failing  powers.  [Yet  the  ancient  Medea  seems  to. 
have  adopted  the  modern  plan  —  perhaps  because  she  was  a  woman.     (H  )] 

1.  He  seems  to  have  written  under  the  influence  of  Magnus  Pegel  (1604),  a  professor 

in  Rostock.    See  Baeser.    (H.) 

2.  The  active  rivalry  of  the  different  nations  in  the  study  and  practice  of  the  opera- 

tion of  transfusion  is  shown  by  the  fact  that  the  first  operation  of  Denis  was  per- 
formed June  15,  1667;  Edmund  King  in  England  followed  with  a  case  Nov.  23, 
1667;  Riva's  first  case  occurred  in  December  of  the  same  year  and  Purmann 
operated  in  1668.  The  operation  awakened  some  singular  questions.  Thus  Boyle 
was  curious  to  know  whether  it  could  change  the  temperament  of  the  patient, 
whether  the  transfusion  of  lamb's  blood  into  the  veins  of  a  dog  would  ultimately 
convert  the  dog  into  a  sheep  etc.,  while  Sigismund  Elsholz  of  Berlin  proposed  to 
reconcile  all  unhappy  marriages  by  the  reciprocal  transfusion  of  the  blood  of  the 
"incompatible"  consorts!  The  gossiping  Samuel  Pepys  records  in  his  diary  under 
date  of  Nov.  21,  1667:  "With  Creed  to  a  Tavern,  where  Dean  Wilkins  and  others: 
and  good  discourse:  among  the  rest  of  a  man  that  is  a  little  frantic  (that  hath 
been  a  kind  of  Minister,  Dr.  Wilkins  saying  that  he  hath  read  for  him  in  his 
church),  that  is  poor  and  a  debauched  man,  that  the  College  have  hired  for  20s.  to 
have  some  of  the  blood  of  a  sheep  let  into  his  body:  and  it  is  to  be  done  on  Satur- 
day next.  They  purpose  to  let  in  about  twelve  ounces ;  which  they  compute  is 
what  will  be  let  in  in  a  minute's  time  by  a  watch."  On  the  30th  of  the  same 
month  he  writes:  "  I  was  pleased  to  see  the  person  who  had  his  blood  taken  out. 
He  speaks  well,  and  did  this  day  give  the  Society  a  relation  thereof  in  Latin,  say- 
ing that  he  finds  himself  much  better  since,  and  as  a  new  man  ;  but  he  is  cracked 
a  little  in  his  head,  though  he  speaks  very  reasonably  and  very  well.  He  had 
but  20s.  for  his  suffering  it,  and  is  to  have  the  same  again  tried  upon  him  :  he  first 
sound  man  that  ever  had  it  tried  on  him  in  England,  and  but  one  that  we  hear  of 
in  France."  (H.) 
33 


—  514  — 

1706.  This  speciality  of  lithotomy  must  have  found  at  that  period,  to  all 
appearances,  considerably  more  material  than  would  be  the  case  to  day. 
The  field  of  general  surgery  in  France  exhibited  too  at  this  epoch  no  small 
number  of  zealous  laborers,  though  the  most  of  them  failed  to  make  their 
names  famous.  Among  these  were  Francois  TheVenin  (died  1G56);  Jean 
Vigier  (1014-1658)  ;  J.  de  Marque  (bandaging,  1618)  ;  Jean  Bienaise 
(bistouri  cached  1601-1081);  Jos.  Covillard  (properly  Couillard  ;  "  Le 
chirurgien  operateur,"  Lyon,  1633);  the  family  Verduc  (Laurent  Sr.  died 
1695,  Laurent  Jr.  died  1703,  J.  Philippe,  the  elder  brother  of  the  last 
mentioned);  Francois  Tolet  (Traite  de  la  lithotomie,  1673);  Jean  de 
Launay  (lithotomist  and  monk,  born  1649);  Goursaud,  who  survived  until 
the  18th  century  and  was  the  first  to  describe  incarceratio  stercoralis  ; 
Jean  Jacques  Manget  (1652-1742);  Jos.  Guichard  Duverney  (growth  and 
nutrition  of  the  bones  by  the  periosteum);  Augustine  (1653-1730)  and 
Michel  Antoine  Belloste  (inventor  of  the  long  famous  liquor  Bellostii);  la 
Vauguyon  (operations,  1696);  J.  de  la  Charriere  (surgical  operations. 
1696);  Daniel  le  Clerc  (1652-1728)  of  Geneva;  Jean  Ant.  Lambert  (injec- 
tions in  hydrocele);  Nicolas  Andry  of  Lyons  (1658-1742),  professor  at 
Paris,  wrote  on  orthopaedic  surgery  and  originated  the  name  "orthopedic"; 
Piei're  Dionis,  a  famous  surgeon  (died  1718),  ordinary  surgeon  of  the  queen 
of  France  and  of  the  empress  Maria  Theresa,  who  was  the  first  to  empha- 
size the  effects  of  rickets  upon  the  pelvis;  Jacques  Baulot  (Beaulieu,  1651- 
1714),  who  from  a  day  laborer  and  a  soldier  worked  himself  up  to  the  posi- 
tion of  a  famous  lithotomist,  and  was  a  surgeon  of  lasting  importance. 
After  joining  the  Franciscans  he  bore  the  name  of  Frere  Jacques,  and  under 
this  title  passes  for  the  inventor  of  lateral  lithotomy.  Barthelemj'  Saviard 
{1656-1702),  maitre-chirurgien  of  the  Hotel-Dieu,  who,  among  other  things, 
determined  the  seat  of  strangulation  to  be  in  the  neck  of  the  hernial  sack 
was  also  eminent  as  a  lithotomist  and  herniotomist.  George  Mareschal 
(1058-1736).  ordinary  surgeon  of  Louis  XIV.  and  one  of  the  promoters 
of  the  foundation  of  the  Acadt'mie  de  Chirurgie  in  the  following  century, 
was  a  rapid  lithotomist  —  stories  are  told  of  8  lithotomies  in  half  an  hour  ! 
. —  and  a  bold  surgeon,  and  is  also  famous  for  his  services  in  improving  the 
schools  of  surgery  in  France. 

In  the  seventeenth  century  ophthalmolog}'  in  France  was  especially 
advanced  and  excellently  cultivated,  though  even  yet  it  was  assigned  to 
the  despised  surgeons.  Among  the  French  oculists  and  surgeons  of  that 
day  we  must  mention,  before  all  others,  Antoine  Maitre-Jean  (Maitre-Jan, 
born  about  the  middle  of  the  17th  century),  who  disputes  with  Pierre 
Brisseau  (1631-1717)  of  Tournay,  professor  in  Douay,  (the  German  Bolfink 
has  no  share  in  it)  the  honor  of  first  recognizing  the  true  seat  of  gray 
cataract  in  the  lens,  1705.  The  Parisian  surgeons  Re  my  Lasnier  and 
Francois  Quarre  had  still  earlier  (1050)  expressed  the  same  opinion. 
Pierre  Borel  (died  1089),  Plempius,  some  decennia  earlier,  and  Jacob 
Schalling  (1615,  Opthalmia,   seu  disquisitio  hermetico-galenica  de  natura 


—  515  — 

oculorum,  Augentrost,  Erfurt,  Job.  Bischoff),  held  similar  views  in  certain 
•cases  of  cataract. 

Brisseau,  however,  was  the  first  to  demonstrate  by  dissection  that  the 
lens  is  clouded  in  cataract.  The  Acadt'mie,  to  which  he  communicated  his 
observations,  at  first  declined  to  accept  his  conclusions,  until  Jean  Mery 
(1645-1722),  the  famous  chirurgien-major  of  the  Hotel  des  Invalides  and 
surgeon  of  the  Hotel-Dieu,  had  demonstrated  before  them  the  pathological 
anatomy  of  the  disease.  With  these  may  be  joined  Jean  Baptiste  Verduc 
who  has  been  already  mentioned,  and  who  described  well  the  operations 
upon  the  eves. 

Otology,  under  the  pen  of  Jos.  Guichard  Duverney  (1648-1730), 
professor  of  anatomy  at  Paris,  who  was  the  first  to  describe  diseases  of  the 
ear  in  accordance  with  their  anatomical  seat,  grew  up  into  a  new  depart- 
ment of  science,  after  anatomy  in  his  hands  had  supplied  a  more  complete 
explanation  of  the  internal  structure  of  the  ear,  and  Giinther  Christoph 
Schellhammer  (1649-1716).  in  his  work  on  the  hearing  (1684),  had  demon- 
strated that  the  "inborn  air"  (Aer  ingenitus)  of  the  Ancients  was  not  to  be 
retained  as  the  special  instrument  of  hearing.  Dentistry  also  experienced 
some  incidental  advancement  at  the  hands  of  Pierre  Dionis,  Jean  Baptiste 
Verduc  and  other  French  surgeons.  —  Among  the 

)-.  Spaniards, 
who  in  this  century  sank  more  rapidly  than  any  other  people  of  history 
under  the  loss  of  their  political  supremacy  and  their  commerce  to  the 
Dutch  and  English,  utter  domestic  ruin  was  finally  accomplished  by  their 
■efforts  to  introduce  unity  of  the  faith.  In  these  efforts  the  industrious 
Moors  were  extirpated  under  Philip  III.  That  in  these  struggles  they  had 
no  leisure  to  devote  to  the  cultivation  of  science,  and  sunk  low  both  in 
general  culture  and  in  medicine  and  surgery,  will  be  readily  understood  by 
the  student  of  the  history  of  civilization1.  Still  Feliciano  d'  Almeida  (died 
1726)  and  Hieron.  de  Ayala  (about  1672)  are  mentioned  as  surgeons. 

d.  The  Germans 
reaped  no  such  benefits  in  the  department  of  surgery  from  the  Thirty 
Tears'  War,  as  did  the  French  in  their  wars.  That  there  were,  however, 
men  of  enlarged  experience,  independent  thought  and  careful  observation 
among  the  German  barber-surgeons  of  the  seventeenth  century,  who  still 
belonged  to  guilds  and  educated  themselves  simply  by  travel  and  private 
stud}*,  is  proven  at  a  very  earl}'  period  b}T 

Georg  Hytell,  of  Weissenfels  in  Saxony, 
who  displays  much  clearness  of  thought  in  his  medical  histories  and  marginal  notes. 
He  follows  the  surgical  principles  of  Paracelsus,  and  gives  a  few  judicious  simplifica- 
tions in  the  treatment  of  wounds,  though  he  also  subscribes  to  the  oddities  of  his  day, 

1.  In  art  alone  they  maintained  their  standing,  and,  indeed,  in  Murillo  attained  the 
acme  of  their  fame.  The  other  branches  of  intellectual 'life' stood  far  beneath 
their  level  at  an  earlier  day. 


—  516  — 

e.g.  when  he  specially  cautions  against  "  Liebesspiel",  even  in  the  most  trifling 
injuries. 

Wilhelm  Fabriz  or  Fabry  (1560-1034.  Fabricius  Hildanus)  of  Hilden 
near  Cologne 

is  specially  eminent  for  his  struggles,  his  knowledge,  his  experience  and  his  erudition. 
In  many  of  his  traits  he  reminds  us  of.  Pare,  and  his  motto  engraved  upon  a  copper- 
plate, "  Omuis  tutela  a  Deo",  so  characteristic  of  the  humble  sense  of  this  pious 
man,  recalls  to  us  the  similar  motto  of  the  great  French  surgeon.  He  had  attended, 
for  a  short  time  a  high-school  in  Cologne,  where  he  acquired  his  knowledge  of  the 
Latin  language,  which  very  many  of  the  barbers  of  that  day,  who  were  held  in  such 
little  esteem,  acquired  by  their  own  efforts.  He  then  came  as  an  apprentice  to  Geneva, 
and  was  finally  appointed  surgeon  of  the  city  and  canton  of  Berne.  His  wife  too 
was  a  skilful  midwife,  and  on  occasion  did  not  hesitate  to  take  a  hand  in  surgery  like- 
wise. His  children  he  lost  by  the  plague.  Fabriz  was  constantly  associated  with 
many  learned  physicians  of  his  time,  including  Gregor  Horst  1 1578-1636),  professor 
in  Giessen,  and  Hermann  Conring,  the  latter  of  whom  said  of  Fabricius  that  he  could 
never  think  of  him  without  silent  thankfulness.  Fabriz  von  Hilden  was  a  receptive, 
rather  than  a  productive  spirit,  like  Wurtz  and  Purmann.  He  was  distinguished  for 
a  classical  education,  quite  rare  among  the  surgeons  of  that  day  —  he  even  wrote 
Latin  —  for  his  knowledge  of  the  ancient  physicians,  his  rich  experience  and  his  skill 
in  observation.  He  was  likewise  perfectly  at  home  in  the  medical  portion  of  thera- 
peutics, and  utilized  this  knowledge  in  the  treatment  of  surgical  lesions.  In  the 
invention  of  instruments  he  was  particularly  fertile,  and  he  was  even  bold  as  an 
operator,  being  the  first  to  amputate  the  thigh,  an  operation  which  even  Pare  had  not 
ventured.  Yet  he  still  employed  a  knife-shaped  cautery  to  obviate  haemorrhage  in 
reduced  patients  (Grunder),  although  he  was  acquainted  with  ligation.  Fabricius 
was  an  enemy  of  all  novelties.  Hence  he  was  an  active  opponent  of  Wurtz,  and  a 
partisan  of  trepanning,  an  operation  greatly  abused  in  the  17th  century.  Hilden  was 
the  first  learned  German  surgeon,  generally  recognized  and  esteemed  by  the 
physicians.  He  did  not  embrace  exclusively  the  maxim  of  his  colleagues  that 
surgery  was  merely  a  matter  of  practical  dexterity,  "though  until  this  is  acquired  a 
few  hundred  peasants  must  perish".  On  the  contrary,  he  demanded  of  the  surgeon  a 
good  education,  knowledge  of  anatomy  and  the  study  of  the  ancient  physicians  and 
surgeons,  which  he  himself  zealously  pursued.  Hence  he  was  a  cautious  and  very 
fertile  author,  respected  as  an  equal  by  the  learned  physicians.  Though  he  often 
supported  obstinately  the  views  of  the  Ancients,  including  Galen,  he  was  yet  a  good 
observer  and  in  practical  life  an  able  surgeon.  He  was  also  distinguished  as  an 
oculist  and  aurist  (ear-speculum,  1580).  Among  other  things  he,  or  his  wife,  removed 
a  particle  of  iron  from  the  superficial  la}-ers  of  the  cornea  by  means  of  a  magnet. 

A  man  of  similar  principles  but  of  greater  operative  genius  and  originalitj-,   a 
born  surgeon,  was  the  intrepid 

Matthias  Gottfried  Purmann  (1048-1721)  of  Liiben  in  Silesia, 
finally  settled  in  Breslau,  of  whom  we  have  already  made  mention.  He  was  a  bold 
and  experienced  operator,  knocked  about  and  educated  in  the  field,  and  author  of  a 
military  surgery.  Thus  in  paracentesis  of  the  thorax  he  regarded  the  entrance  of  air 
as  of  no  very  great  importance,  he  trepanned  fort}'  times,  practised  transfusion, 
operated  for  aneurism,  performed  bronchotomy  etc.,  and  greatly  lamented  the  low 
state  of  surgery  in  Germany.  He  regarded  a  knowledge  of  anatomy  and  of  the 
experience  of  the  ancient  physicians  as  a  prime  requisite  for  the  surgeon.  Gunshot 
wounds  he  did  not,  like  Hilden,  consider  poisoned  ;  wounds  of  the  intestine  he  treated 
with  the  simple  suture:  he  was  acquainted  with  the  bimanual  examination  for  stone,. 


—  517  — 

was  an  earnest  opponent  of  the  maltreatment  of  wounds  by  keeping  them  open, 
frequentl}7  cleansing  etc.  He  was  also  a  skilful  oculist,  and  famous  as  a  plague- 
physician.  Proksch  has  also  recentl}'  pointed  out  the  fact  that  Purmann  employed 
the  speculum  ani  and  vagina?  in  the  diagnosis  and  treatment  of  syphilis,  though 
Ricord  prides  himself  greatly  upon  his  introduction  of  the  same  procedure,  and 
regards  it  as  a  title  of  undying  fame  for  himself. 

The  physician  and  surgeon  Johann  Scultetxs  (1595-1645)  of  Ulm, 
eon  of  a  poor  sailor  and  educated  at  Padua,  is  famous  as  a  surgical  writer  of  this 
period.     He  was  followed  somewhat  later,  and  in  the  same  department,  by 

Joseph  Schmidt, 

(lustrum,  chir.,  1649),  who  recommends  the  drinking  of  urine  in  fever,  a  remedy  still 
•employed  (instead  of  quinine)  by  the  people  along  the  Rhine.  The  author  was 
formerly  acquainted  with  a  man  who  drank  no  water,  but  simply  his  own  urine,  until 
the  day  of  his  death,  regarding  it  as  a  prophylactic  against  fever. 

Johann  von  Muralt  (1055-1733)  of  Zurich, 
■was  also  a  capable  surgeon. 

Among  the  German  surgeons  and  writers  on  surgical  subjects  in  the  seventeenth 
•century  we  must  also  mention  :  Paul  Aramann1  (1634-1691)  of  Breslau,  professor  in 
Leipzig,  who  was  willing  to  practise  castration  in  sarcocele  only;  Heinrich  Meibom 
(1590-1055),  professor  of  therapeutics,  history  and  poetry  at  Helmstedt ;  Florian 
Matthis,  who  performed  in  1002  the  first  gastrotomy  to  remove  a  knife  which  had  been 
swallowed  ;  Daniel  Schwabe,  a  lithotomist  and  surgeon  in  Konigsberg,  who  practised 
in  1635  the  second  gastrotomv-  for  the  removal  of  a  fork  ;  Georg.  Gelmann  (born  1633) 
of  Bamberg,  who  described  percutaneous  ligation  in  1652  ;  Acoluthus  of  Breslau,  who 
in  1693  practised  a  partial  resection  of  the  jaw;  Ant.  de  Heide,  established  by 
experiment  that  the  formation  of  callus  was  the  new  formation  of  bone ;  Justus  Theod. 
Schonkoff,  who  proposed  ovariotomy  in  1685;  Vohler,  who  in  1690  proposed  amputa- 
tion at  the  hip-joint,  and  executed  the  operation  upon  the  cadaver;  Mich.  Bernh. 
Valentini  (1657-1726),  professor  in  Giessen;  Johann  Helfrich  Jungken  (1648-1726), 
physicus  in  Franlvfort-on-the-Main,  who  plead  in  behalf  of  the  union  of  surgery  and 
medicine;  Abraham  Gehema,  alreadj'  mentioned,  who  deserves  credit  for  his  better 
treatment  of  wounded  soldiers  and  his  better  education  of  the  "  Feldscheerer"  (army 
surgeons).  He  was  also  a  great  eulogist  of  the  Japanese  moxa,  which  was  introduced 
into  popularity  as  a  new  remedy  by  the  Dutch  pastor  Buschof  in  1675;  C.  Horlacher, 
who  discussed  hernia  in  1695;  Johann  Freytag  of  Zurich  (about  1690),  who  attempted 
the  extraction,  and  is  regarded  as  the  discoverer,  of  capsular  cataract,  and  the  follow- 
ing surgeons,  who  belong  to  the  succeeding  century:  Ernst  Conrad  Holtzendorf, 
Surgeon-General  of  Prussia;  Job..  Friedr.  Zittmann  (1671-1757,  Zittmann's  decoction) 
and  others.  Joh.  Sigm.  Elsholz  (1623-1688)  and  Joh.  Dan.  Mayor  (1634-1693),  the 
former  in  Berlin,  the  latter  professor  in  Kiel,  occupied  themselves  with  the  venous 
injection  of  drugs  (infusion).  The  latter,  as  well  as  Georg  Abraham  Mercklin  (1644- 
1702)  and  Joh.  Christoph  Sturm  (1635-1703)  of  Altdorf,  also  practised  transfusion  in 


1.  .Not  to  be  confounded  with  the  Swiss  physician  Johann  Conrad  Amman,  who 
resided  for  a  long  time  in  Holland  and  published  in  1692  a  treatise  on  the  educa- 
tion of  the  deaf  and  dumb. 

[Amman's  work  was  written  in  Latin  and  entitled  "Surdus  loquens,  sive 
methodus,  qua  qui  surdus  natus  est  loqui  discere  possit",  but  it  was  soon  trans- 
lated into  Dutch  and  English.  Eev.  Dr.  John  Wallis  of  Oxford  also  published  a 
treatise  on  the  instruction  of  deaf-mutes  about  the  same  period,  and  George 
Dalgarno  (died  1687),  a  Scotchman  residing  in  Oxford,  published  the  first  manual 
alphabet  in  England.     (H.)] 


—  518  — 

German}'  according  to  the  principles  of  Libavius  (cMrurgia  transfusoria,  1G1.3). 
Marcus  Banzer  in  1640  proposed  the  preparation  of  an  artificial  membrana  tympanr 
from  a  tube  made  of  the  hoof  of  an  elk,  over  which  was  stretched  a  portion  of  hog's- 
bladder.  In  this  too  our  own  century  has  followed  the  lead  of  .the  17th,  for  Autenrieth, 
as  we  know,  in  1815  reproduced  these  instruments  from  the  swimming-bladder  of  the 
fish,  and  Toynbee  in  1853  from  Indiarubber.  Werner  Rolfink  should  also  be  men- 
tioned here  as  an  oculist,1  and  Brunner  for  his  participation  in  the  discussion  of  the 
question  of  the  access  of  air  to  wounds  or  its  exclusion  therefrom,  or  prima  intentio 
and  suppuration.  The  latter  process  he  no  longer  regarded  as  necessary  and  in- 
evitable, as  his  predecessors  had  done.     Among  the 

=.  Dutch, 

whose  surgery,  as  well  as  their  medicine,  enjoyed  a  high  reputation  during 
this  century,  especially  in  Germany,  Joh.  Jac.  Rau  (Ravius,  1658-1719) 
is  commonly  mentioned,  though  he  was  born  in  Baden. 

Emerging  from  the  cottage  of  the  poor,  he  became  first  a  barber,  and  in  this 
capacity  travelled  about  extensively,  until  finally  appointed  professor  of  anatom}- 
and  surgery  in  Leyden,  where  he  improved  the  methods  of  instruction  by  the  intro- 
duction of  practical  exercises  in  operating  upon  the  cadaver.  He  was  especially 
famous  as  a  lithotomist  after  the  method  of  Frere  Jacques,  and  professes  to  have  per- 
formed 100  such  operations  with  success,  though  he  gave  no  instruction  upon  this 
subject  in  his  course  of  lectures.2 

Genuine  Dutch  "  Heelmeesters  "  (as  surgeons  were  called),  some  of 
whom  were  distinguished  also  as  anatomists  were  : 

Paul  Barbette  (died  1666)  of  Amsterdam  ;  Pieter  Yerduyn  ; 

Jac.  van  Meekren  of  the  same  place. 

Cornelis  van  Solingen  (1641-1687,  according  to  Krul)  in  the 
Hague, 

who  was  the  most  important  of  the  Dutch  surgeons  and  occupied  himself  witli 
obstetrics  and  every  department  of  surgery,  including  ophthalmology  and  otolog}", 
and  exerted  himself  especially  to  improve  surgical  instruments  ; 

Hendrik  van  Roonhuysen  (about  1660)  of  Amsterdam  (operations 
for  hare-lip)  and  Roger  van  Roonhuysen,  who  purchased  Chamberlen's 
secret  ; 

Stephan  Blankaart  (1650-1702)  of  Amsterdam,  who  proposed  the 
extraction  of  cataract ; 

Cornelius  Stalpaart  van  der  Wyl  (1620-1658)  in  the  Hague  ; 

Gottfried  Bidloo  (1649-1713),  also  a  surgical  teacher  and  an  anat- 
omist, whose  "Anatomia  corporis  humani"  etc.  was  adorned  with  105 
plates  by  Gerard  de  Lairesse. 

Anton  Nuck,  professor  in  Leyden  (1650-1692),  distinguished  himself 
as  a  dentist,  oculist  and  aurist  (first  paracentesis  cornea?  among  the 
Moderns,  cauterization  of  the  antitragus  for  tooth  ache,  artificial  teeth  made 

1.  It  may  be  remarked  en  passant  that  in  "  Martins  Zeilleri  Fidus  Achates"  etc.,  Ulm, 

1675,  "Augenbrillen  wider  den  Staub"  (goggles,  protective  glasses)  are  mentioned. 

2.  It  is'  an  interesting  fact  that  the  history  of  many  lithotomies  in  the  17th  century 

was  related  in  verse  and  illustrated  with  plates.    Harvey's  vivisections  were  also 
sung  in  hexameters ! 


—  519  — 

from  the  teeth  of  the  hippopotamus,  prohibition  of  the  extraction  of  teeth  in 
pregnant  women) ;  Johann  Palfyn  (16-49-1730)  of  Ghent  (obstetric  forceps)-. 
Joh.  Munniks  (1652-1711)  and  others. 

£.  The  English 

in  this  century  for  the  first  time  enter  the  field  of  surgeiy  with  some 
important  names.  Thus  the  following  surgeons  of  this  period  are  men- 
tioned : 

Richard  Wiseman,  ordinary  surgeon  of  James  I.1  (1603-1625),  "The 
Pride  of  England  ",  a  bold  and  good  operator,  who  at  once  took  hold  of 
every  novelty,  including  the  ligation  of  Pare,  which  was  at  that  period 
little  practised.  He  always  amputated  through  the  sound  parts,  favored 
the  operation  for  strangulated  hernia  and  still  employed  the  trepan  zeal- 
ously, like  most  of  the  surgeons  of  that  da}'.  He  also  established  the 
indications  for  herniotomy  more  clearly  than  his  predecessors  had  done. 
William  Cowper  (1666-1709),  a  famous  anatomist  and  surgeon,  who  also 
did  not  scorn  dentistry;  John  Thomas  Woolhouse  (1650-1730),  a  famous 
but  ignorant  oculist,  who  travelled  from  place  to  place  (and  scarified  with 
ears  of  barley!);2  Alexander  (died  1660)  and  William  Read,  the  latter  also 
an  oculist ;  the  somewhat  later  Sir  John  Taylor3  (1708-1767,  or  according  to 
others  1703-1772  ;  died  in  Paris),  who  was  a  rank  charlatan,  and  others. 

1.  Wiseman  (1625-1686),  sometimes  called  the  "Pare  of  England  ",  was  in  the  service 

of  all  the  Stuart  kings  from  Charles  1.  to  James  11.,  and  was  appointed  ordinary 
surgeon  of  Charles  II.  in  1661.  After  an  extensive  military  experience  in  the 
Civil  War  and  upon  the  continent,  he  settled  in  London  in  1652.  According  to 
Haeser  he  favored  primary  amputation,  especially  in  gun-shot  wounds  of  the 
joints,  treated  aneurism  by  compression,  and  was  the  first  author  to  describe 
accurately,  and  to  employ  the  term,  tumor  albus.  Though  acquainted  with  the 
practice  of  ligation  of  vessels  to  control  hamiorrhage,  he  prefers  the  use  of  the 
"Royal  Styptic",  and  always  has  the  actual  cautery  in  readiness  for  use  if 
required.  Ligation  he  thinks  requires  too  much  light  and  too  many  assistants 
to  be  ordinarily  used  in  battles  on  land  or  sea.  Sprengel  says  that  Wiseman  also 
practised  flap-amputation,  and,  according  to  Rockwell  and  Mastin,  the  first 
recorded  operation  of  external  urethrotomy  for  the  relief  of  stricture  is  mentioned 
in  his  treatise  "On  the  111  Consequences  of  Gonorrhoea ".  This  operation  he  says 
was  performed  by  Mr.  Edward  Molins  in  1652.  Wiseman's  chief  work  was 
entitled  "Several  surgical  treatises",  London,  1676.     (H.) 

2.  He  used  an  instrument  which  he  called  a  "  xystrum  "  to  scarify  the  conjunctiva. 

Woolhouse  was  oculist  to  James  II.  and  William  III.,  and  atone  time  physician  t<> 
the  Hospice  des  Quinze-vingts  in  Paris,  where  he  delivered  lectures  upon  diseases 
of  the  eye.  He  is  said  to  have  proposed  the  operation  of  iridectomy  as  early  as 
1711,  though  it  was  first  performed  by  Cheselden  in  172<s.  All  his  works  were 
written  in  French.  His  "Dissertation  scavante  sur  la  cataracte  et  le  glaucome 
etc."  appeared  at  Paris  in  1696.  (II.) 
.'{.  John  Taylor,  or  "The  Chevalier  John  Taylor"  as  he  called  himself,  was  a  native 
of  Norwich,  a  fellow-student  of  Haller  under  Boerhaave,  and  a  man  by  no  means 
ignorant,  though  a  thorough  charlatan.  About  the  middle  of  the  18th  century  he 
travelled  throughout  Europe  and  part  of  Asia  in  a  coach  covered  with  painted 
eyes  and  bearing  the  inscription  "Qui  visum  dat,  dat  vitam  ",  lecturing  upon 
diseases  of  the  eyes,  and  operating  indiscriminately  upon  almost  anything  that 


—  520  — 

Sir  Christopher  Wren,  a  savant  as  well  as  an  architect,  in  the  year 
1G57  was  the  first  to  devote  attention  to  the  injection  of  medicines  into 
the  veins,  a  subject  specially  studied  in  the  seventeenth  century  and 
recently  again  essayed.  His  example  was  followed  by  Timothy  Clarke 
(1664),  Richard  Lower  (1631-1691)  and  others,  and  their  experiments 
resulted  in  demonstrating  that  the  same  effects  followed  the  administration 
of  drugs  by  this  method  as  when  they  were  given  per  os. 

[The  following  English  surgeons  and  oculists  also  deserve  mention  here  : 

John  Woodall,  Surgeon-General  of  the  East  India  Company  in  1613> 
and  one  of  the  surgeons  of  St.  Bartholomew's  Hospital  in  1615,  who  pub- 
lished in  1639  (2d  edition)  a  surgical  work  entitled  "Various  treatises", 
which  is  interesting  in  the  history  of  amputation  ; 

R.  Lowdham,  a  surgeon  of  Oxford,  who  is  said  to  have  been  the  first 
among  the  Moderns  to  practise  the  flap-method  in  amputation,  and  whose 
operation  is  described  b\*  the  surgeon 

James  Young  in  his  "Currus  triumphalis  ex  terebinthina",  published 
in  London  in  1679.  Young  was  also  the  author  of  a  treatise  on  wounds 
of  the  brain,  with  other  works  on  surgery  and  anatomy.  His  "Medicaster 
medicatus"  was  written  in  reply  to  the  "Compleat  description  of  wounds, 
both  in  general  and  particular"  of 

John  Brown  (born  1642),  ordinary  surgeon  of  Charles  II.  and  surgeon 
of  St.  Thomas's  Hospital.  The  latter  surgeon  also  wrote  on  tumors  and 
"A  compleat  treatise  of  the  muscles  as  they  appear  in  the  human  body", 
London,  1681,  with  a  treatise  "of  glandules  and  strumals,  or  king's-evil 
swellings",  relating  man}^  wonderful  stories  of  the  efficac}'  of  the  royal 
touch  in  curing- the  latter. 

John  Colbatch,  an  English  apothecary  who  had  seen  much  service  in 
the  army  and  was  finally  admitted  to  membership  in  the  College  of  Ph}T- 
sicians,  published  in  1695  "A  new  light  of  Chirurgeiy",  in  which  he  extols 
the  advantages  of  a  vulnerary  powder  and  hot  water  in  the  treatment  of 
wounds  and  haemorrhage.     He  also  wrote  on  the  gout,  alkali  and  acid  etc. 

In  1622  appeared  "A  treatise  of  113  diseases  of  the  eyes  and  eye-lids", 
usually  ascribed  to 

Richard  Banister,  though  only  the  appendix,  called  "  Banister's  bre- 
viary", belongs  property  to  this  author.  The  remainder  of  the  work  is  said 
to  be  an  English  translation  of  Guillemeau's  "Traite"  des  maladies  de  1'  oeil" 
by  A.  H.  The  "Breviary"  discusses  the  theory  of  vision  and  the  structure 
and  diseases  of  the  eye,  and  is  said  to  indicate  large  practical  experience 
rather  than  profound  knowledge  of  ophthalmology. 

offered  itself.  He  is  said  to  have  made  an  incision  through  the  lower  half  of  the 
cornea  and  then  depressed  or  removed  the  lens  with  a  plano-convex  needle.  He 
also  professed  to  cure  strabismus  by  dividiug  "the  tendon  of  the  superior  oblique 
muscle  of  the  eye".  Of  his  numerous  works,  which  were  published  in  various 
languages,  the  earliest,  entitled  "An  account  of  the  mechanisme  of  the  globe  of 
the  eye  ",  appeared  at  London  in  1730.     (H.) 


—  521  — 

William  Briggs  (1641-1704)  of  Norwich,  a  pupil  of  Vieussens,  super- 
intendent of  St.  Thomas's  Hospital  under  Charles  II.  and  ordinary  ph}r- 
sician  of  William  III.,  published  an  "Ophthalmographia"  in  1G76,  which 
■was  highl}'  praised  by  Newton  and  other  savants.     H.] 

Even  among  the 

tj.  Danes 

a  few  surgeons  gained  prominence  in  this  century.  The  peasant  Kanut 
Thorbern  became  "famous"  by  means  of  an  instrument  for  the  amputation 
■of  the  elongated  uvula  (an  operation  at  that  period  considered  very  seri- 
ous), and  the  elder  Bartholin,  who  also  occupied  himself  with  surgery, 
communicated  a  knowledge  of  it  to  the  profession.  Besides  these  and  the 
Swede  Olof  Rudbeck,  Martin  Bogdan  (born  1631)  and  Heinrich  von 
Moinichen  (about  1665)  also  devoted  themselves  to  surgery. 

c.  Midwifery,  Gynaecology  and  Diseases  of  Children. 

Midwifery  in  the  seventeenth  century  experienced  an  advancement 
'similar  to,  but  more  considerable  than,  that  of  its  mother  science,  surgery, 
from  which  it  began  now  to  emancipate  itself.  The  circumstance  that  it 
began  finally  to  pass  out  of  the  hands  of  midwives  (who,  however,  likewise 
experienced  the  benefits  of  improved  education)  into  the  care  of  men,  and 
these  simple  surgeons,  not  physicians,  contributed  not  a  little  to  this 
advancement.  In  its  scientific  aspect  it  was  promoted  by  the  acquisitions 
of  anatonry  and  physiology,  which  now  supplied  greater  light  as  to  the 
structure  and  functions  of  the  sexual  and  parturient  organs,  and  the  sub- 
jects of  generation  and  development.  On  the  other  hand,  the  invention  of 
the  obstetric  forceps  was  at  first  of  no  benefit  to  practical  midwifery,  since 
it  was  kept  secret.  The  17th  century  must  also  be  designated  the  century  of 
version,  inasmuch  as  in  it  this  operation  first  received  general  acceptance. 

That  that  most  beneficent  surgical  instrument,  the  forceps,  should  have  been  invented 
so  late,  especially  when  we  consider  that  phj'sicians  have  always  taken  pleasure  in,  and 
distinguished  themselves  by,  the  invention  of  mechanical  aids,  is  most  astonishing ! 
The  first  idea1  of  such  an  instrument,  however,  originated,  as  a  matter  of  fact,  in  the  year 
1576,  when  P.  Franco  designed  a  three-bladed  speculum  for  the  delivery  of  the  head 
without  injury.  But  it  was  in  the  Huguenot  family  of  Chamberlen,  who  emigrated  in 
1569  from  Paris  to  London,  that  the  actual  forceps  was  invented  and  first  employed. 
The  original  emigrant  was  William   Chamberlen  (died  1596),  who,  as  J.  H.  Aveling" 

1.  A  passage  in  the  writings  of  Avicenna  (980-1037)  would  seem  to  indicate  that  the 
forceps  were  used  by  that  physician  in  the  delivery  of  living  children.  If  so,  the 
instrument  never  became  common  among  the  Arabians,  and  all  knowledge  of  it 
had  disappeared  long  before  the  days  of  Chamberlen.     (H.) 

■2.  The  reader  who  desires  to  pursue  further  the  interesting  history  of  the  Chamberlen 
family  and  the  forceps,  will  find  ample  information  in  the  little  work  entitled 
"The  Chamberlens  and  the  midwifery  forceps:  memorials  of  the  family  and  an 
essay  on  the  invention  of  the  instrument",  by  J.  H.  Aveling  M.  D.F.  S.  A., 
Churchill,  London,  1882.  An  interesting  review  of  this  work  by  R.  P.  Harris 
will  aiso  be  found  in  the  "American  Journal  of  the  Medical  Sciences",  vol. 
Ixxxv,  pp.  483-494.     (II.) 


—  522  — 

showed  in  1882,  had  two  sons  of  the  name  of  Peter,  the  elder  of  whom,  born  in  Paris, 
died  in  London,  a  member  of  the  guild  of  barber-surgeons,  in  1631.  According  to  the 
statement  of  Smellie,  this  Peter  was  the  inventor  of  the  forceps.  Chamberlen's  forceps 
was  fenestrated  and  had  no  pelvic,  but  a  marked  cephalic,  curve.  The  handles  crossed 
like  those  of  shears,  whose  form  indeed  served  for  their  model.  The  vectis,  hook  and 
fillet  were  also  known  in  this  famil}-.  All  this,  however,  was  carefully  kept  secret, 
for  patents  at  that  period  were  unknown.  Hugh  Chamberlen,  Sr.  (grand-nephew  of 
Peter,  the  inventor  of  the  forceps),  indeed,  tried  to  sell  the  instrument  in  Paris  about 
1670  for  10,000  crowns,  but,  beiug  unable  to  manage  the  test-case  submitted  to  him  by 
Mauriceau,  he  returned  to  London  without  accomplishing  his  purpose.  At  a  later 
period  (1699,  having  meanwhile  acquired  a  fortune  by  his  instrument  and  again  lost 
it),  he  was  compelled  to  fly  to  Holland,  where  he  sold  an  instrument  (probablj-  merely 
the  vectis)  to  Roger  Roonhuysen.  The  vectis,  however,  had  been  already  procured 
by  Samuel  Jansen  from  Hugh  Chamberlen's  brother  Paul  in  England.1  In  this  way  it 
fell  into  the  hands  of  others,  who  on  their  part  again  supplied  it  only  for  a  high  price, 
and  in  fact  merely  furnished  the  vectis.  According  to  a  decree  of  the  Medico- 
Pharmaceutical  College  of  Amsterdam,  even  as  late  as  1746  no  physician  could  enter 
upon  practice  without  the  possession  of  this  dearty  bought2  instrument.  Finally  the 
deception  was  exposed  by  Jac.  de  Visscher  and  Hugo  van  de  Poll.3  In  England  too 
the  forceps  was  already  known  to  the  obstetricians  Drinkwater  of  Brentford  (1668- 
1728),  Chapman  and  others,  though  this  knowledge  was  by  no  means  general.4  Thus 
even  seventy-five  years  after  the  occurrence  of  the  invention,  De  la  Motte  was  driven 
to  utter  the  following  just  sentence  (expressed,  however,  conditionally  and  wrongly 
directed  against  Palfyn)  regarding  the  action  of  the  Chamberlens  and  their  associates 
in  Holland:  He  who  keeps  secret  so  beneficent  an  instrument  as  the  harmless  ob- 
stetric forceps  undoubtedly  is,  deserves  to  have  a  worm  devour  his  vitals  for  all 
eternit.y,  "for  all  human  science,  up  to  the  present  time,  has  not  been  able  to  find 
such  an  instrument !  "  Among  the 

1.  The  (probably)  genuine   Chamberlen   instruments   were    discovered    in   181:;  at 

Woodham  Mortimer  Hall,  near  Maldon  in  Essex.  They  consisted  of  four  forceps 
(of  various  degrees  of  perfection),  three  vectes,  three  crotchets  and  three  fillets. 

2.  It  cost  1500-2r00  gulden.     (H.) 

3.  This  was  in  1754,  long  after  the  Chamberlen  forceps  were  generally  known  in 

England.     (H.) 

4.  Chapman,  writing  in  17:::;,  says  :  "  The  use  of  the  forceps  (is)  now  well  known  to  all 

the  principal  men  of  the  profession,  both  in  town  and  country."  He  himself  had 
then  used  them  for  more  than  ten  years  at  all  events  ;  Drinkwater  left  a  pair  on 
his  death  in  1728,  and  Giffard  had  employed  the  instrument  in  1720.  William 
Giffard  was  the  earliest  writer  to  describe  and  depict  tin'  midwifery  forceps  in 
1734.  Chapman  mentioned  the  instrument  in  bis  work  published  in  1733,  but 
gave  no  plate  of  his  own  instrument  until  his  second  edition,  published  in  1735. 
Palfyn  exhibited  bis  forceps  before  the  Academie  des  Sciences  in  Paris  in  1721. 
His  instrument  was,  however,  extremely  imperfect  —  the  blades  were  not  fenes- 
trated and  bad  no  lock  —  and  it  was  not  until  Palfyn's  instrument  had  been  im  - 
proved  by  Duse  of  Paris  in  1735  that  it  became  of  any  practical  use.  At  this 
period  the  forceps  bad  been  employed  by  Chapman  more  than  twelve  years,  and, 
as  he  writes,  were  well  known  in  England.  It  is,  therefore,  difficult  to  understand 
how  Haeser  in  bis  last  edition  could  write  "To  the  fame  of  the  invention  of  the 
obstetric  forceps,  one  of  the  most  beneficent  inventions  ever  made,  no  one  has  any 
claim  except  Jean  Palfyn"  etc.  While  the  claims  of  the  Chamberlen  family  to- 
the  original  invention  of  the  forceps  may,  perhaps,  admit  of  question,  there  can 
be  no  doubt  that  Palfyn  was  not  the  original  inventor  of  this  merciful  instru- 
ment.    (II.) 


—  523  — 

a.  Italians 
prominent  names  in  midwifery  are  remarkable  by  their  absence  in  this  as 
in  the  preceding  century,  and  even  incidentally  little  notice  of  obstetrical 
matters  is  found  in  their  surgical  works.  The  "Libro  della  Commare" 
(Manual  for  midwives)  of  Scipio  Mercurio  should  however,  be  mentioned. 
Among  the 

/?.  Spaniards 
also  the  subject  was  abandoned  to  the  books  for  midwives  (Pedro 
Nunnez1).  Whether  the  thousand  monasteries  and  nunneries  in  Spain  at 
that  day.  by  decreasing  the  number  of  births,  had  an}"  specially  unfavorable 
influence  upon  the  development  of  Spanish  midwifery  must  remain  an  open 
question.     On  the  other  hand  the 

y.  French 

are  especially  prominent  as  promoters  of  midwifery  in  this  century,  when 
the  predominance  of  France  was  marked  even  in  the  language  of  other 
nations,  and  especially  among  the  Germans,  in  whom  national  feeling  was 
almost  entirely  lost.  The  loose  morals  of  the  court  and  in  the  higher 
circles  of  society  had  at  least  the  good  effect  of  permitting  men  to  act  as 
obstetricians  in  ordinary  cases,  and  not,  as  heretofore,  simpl}~  in  particu- 
larly bad  cases  requiring  operative  interference.  This  practice  was  diffused 
from  France  into  other  lands,  for  the  domination  of  France  in  "the  fashion" 
was  at  this  period  undisputed.  In  this  connection  we  must  mention  as  the 
successor  of  Bourgeois, 

Marguerite  (du  Tertre,  widow)  de  la  Marche,  chief  midwife  of  the 
Hotel-Dieu  and  authoress  (1G77)  of  a  catechism  for  midwives.  In  this 
hospital  too 

Francois  Maurice au  (died  171!')  of  Paris,  president  of  the  College 
de  St.  Come, 

was  educated  up  to  his  subsequent  position  as  an  eminent  obstetrician.  He  deserves 
the  utmost  credit  for  his  introduction  of  version,  for  his  management  of  placenta 
praevia  and  of  separation  of  the  head  (tire-fete),  and  for  his  teachings  regarding  the 
normal  course  of  labor  —  he  ascribed  the  more  difficult  labor  with  bojTs  to  the  greater 
size  of  the  head  —  obstetrical  examination  etc.  Mauriceau  rejected  the  still  prevalent 
assumption  of  a  separation  of  the  symphysis  during  labor,  but  was  unacquainted 
with  the  minor  pelvis.2  He,  however,  rejected  Cesarean  section  on  the  living  woman, 
a  decision  which  met  with  decided  support  from  Pierre  Dionis.  —  Still  greater  repu- 
tation was  acquired  by 

Jules  Clement  (16-49-172!n. 
obstetrician  to  Mile,  la  Valliere,  the  mistress  of  Louis  XIV.,  and  (in  imitation  of  her 
example)  accoucheur  to  the  queen  of  Spain  and  other  noble  ladies,  a  position  in 
which  he  greatly  aided  the  transfer  of  midwifery  into  the  hands  of  men.     Beside  him 
we  may  place 

1.  According  to  Eloy  it  was  Francesco  Nunnez,  doctor  of  medicine  in  Alcala,  who 

published  a  treatise  "  Del  parto  humano",  Saragossa,  1638.     (H.) 

2.  The  first  edition  of  Mauriceau's  "  Traite  des  maladies  des  femmes  grosses"  etc.. 

was  published  at  Paris  in  166S.     (H.) 


—  524  — 

Guillaume  Mauquest  de  la  Motte  (1055-1737)  of  Yalognes, 
as  skilful  a  surgeon  as  he  was  a  famous  and  unprejudiced  obstetrician.  Jn  the  latter 
capacity  he  was  a  defender  of  mild  methods  of  management,  and  especially  of  version 
in  contracted  pelves,  in  opposition  to  the  treatment  with  cutting  instruments  still  in 
vogue  during  this  period.  (He  also  recommended  vertical  elevation  in  dislocation  of 
the  shoulder). 

Philippe  Pel  (died  1707).   a  surgeon  of  Paris,  was  an  opponent  of 
Mauriceau  and  an  enemy  of  Cesarean  section. 

Paul  Portal  (died  1703), 
who  first  proposed  version  by  one  foot,  was  an  excellent  observer  and  a  defender  of 
the  powers  of  nature,  as  well  as  author  of  the  doctrine  that  face  presentations  could 
be  terminated  without  artificial  aid. 

Cosme  Viardel  (about  1671)  ;  finally 

Pierre  Amand  (died  1720), 
a  surgeon  of  Paris,  invented  a  special  machine  for  the  extraction  of  the  separated 
head,  a  matter  which  frequentty  claimed  attention  in   that  day,  when  version  by  the 
feet  was  in  its  bloom  and  the  forceps  were  unknown.     Among  the 

d.  Germans, 

with  whom,  in  spite  of  Roesslin,  the  practice  of  midwifery  was  still  denied 
to  men,  a  few  midwives  distinguished  themselves  as  independent  observers, 
particularh-  the  gifted,  capable,  simple-hearted  and  pious 
Justine  Siegemundin,  nee  Dittrichin  (about  1690), 
the  daughter  of  a  minister.  Falsehr  accused  of  pregnancy  in  her  twenty-first  year, 
she  thenceforth  devoted  herself  to  midwifery,  and,  after  years  of  practice  in  the 
country,  acquired  such  reputation  that  she  was  called  to  Berlin  as  "Court  Midwife  to 
the  Electorate  of  Brandenburg".  She  recommended  rupture  of  the  membranes  for 
the  production  of  artificial  delivery  in  haemorrhage,  and  was  an  especial  advocate  of 
bimanual  version.  How  careful  an  observer  she  was  may  be  judged  from  the  follow- 
ing extract:  "It  may,  indeed,  happen  that  two  children  are  contained  in  one  bag  of 
water,  with  one  afterbirth  and  no  caul  between  them;  but  this  is  very  rare."- — About 
1700  Anna  Elisabethe  Horenburgerin,  nee  Giildenapfel,  the  daughter  of  a  regimental 
surgeon  of  Wolfenbuttel  and  subsequently  a  midwife  in  Brunswick,  wrote  a  manual 
for  midwives.  —  Margarethe  Fusz,  nee  Schiefelbein,  (1555-1625),  court  midwife  at 
Brieg,  was  a  famous  midwife,  called  even  to  Denmark  and  Holland.  Veronika  Iberin 
and  Marg.  Keilin,  as  well  as  the  physicians  J.  G.  Sommer  in  Arnstadt,  Ch.  Volter  in 
W'urtemberg,  Wolradt  Huxholz  (born  1619)  in  Hesse,  Ph.  Schoenfelder  in  Bavaria 
and  others,  wrote  manuals  for  midwives  in  the  seventeenth  century.  What  was  the 
usual  diet  of  the  lying-in  period  is  related  by  H.  Guarinoni:  3  A.  M.,  soup  with 
3  eggs  and  spices;  5  A.  M.,  3  scrambled  eggs  with  chicken  broth;  7  A.  M.,  2  soft- 
boiled  eggs;  9  A.  M.,  yolk-soup  and  toast,  with  a  swallow  of  wine;  dinner,  a  capon, 
some  roasted  birds,  a  partridge  and  finally  some  bread  and  spiced  wine;  1  P.  M., 
confectionery  and  wine;  3  P.  M.,  roasted  capon,  fish,  bread  and  wine  (up  to  this  time 
the  infant  had  nursed  at  5  A.  M.  and  1  P.  M.)  ;  5  P.  M.,  omelette  and  wine  (the  child 
nurses  for  the  third  time) ;  then  supper  of  5-7  different  kinds  of  food  ;  7  P.  M.,  capon 
soup;  9  P.  M.,  the  child  nurses,  and  to  obviate  weakness  on  the  mother's  part  she 
receives  a  plate  full  of  confectionery,  bread  and  wine.  If  the  mother  wakens  about 
midnight  she  gets  some  more  yolk-soup.  It  will  be  observed  that  the  high  and  mighty 
mother  gets  rather  the  best  of  the  child! 


—  525  — 

In  this  connexion  it  should  be  mentioned  that  the  first  recorded 
Cesarean  section  secundum  artem  occurred  in  the  seventeenth  century. 
The  operation  was  performed  April  21,  1610  b}*  the  surgeon  Jeremias 
Trautmann  of  Wittenberg  in  a  case  of  hernia  of  the  gravid  uterus  with 
development  of  a  living  child.  The  mother,  however,  died  after  25  clays, 
and  after  the  uterine  wound  had  already  healed.     The 

e.  Dutch, 
who,  as  we  have  seen,  had  won  the  first  position  in  the  medicine  of  the 
seventeenth  century,  in  midwifery  also  took  at  least  the  second  place. 
Besides  the  two  Roonhuysens  already  mentioned  and  C.  van  Solingen, 
Samuel  Jansen  (about  1GS1)  and  his  rival  IMonysius  van  der  Steeren  (died 
1691  ;  although  a  Doctor  of  Medicine  he  practised  midwifery),  Abraham 
Cyprian  (about  1690),  professor  at  Franecker,  Gerard  Goris  at  Le3-den  and 
Jan  Bapt.  Lamzweerde  (about  1683)  are  worthy  of  mention  as  obstetricians 
("Vroedmeesters",  who  were  always  surgeons  also).  One  of  the  most  emi- 
nent obstetricians  who  ever  lived  was 

Hendrik  van  De venter  (1651-1724). 
At  the  age  of  seventeen  he  exchanged  the  art  of  the  goldsmith  for  the  pursuit  of 
medicine.  He  studied  in  Groningen,  and  practised  at  first  in  Wilwerd.  From  this 
place  he  travelled  to  Copenhagen,  and,  on  his  return,  devoted  his  entire  attention  to 
midwifery,  in  which  he  was  also  assisted  bj-  his  wife.  He  continued  to  practise  the 
obstetrical  art  at  the  Hague  until  his  death.  Deventer  wrote  (1701)  a  famous  work 
entitled  "  Manuale  Operatien"  etc.,  which  acquired  great  popularitj',  especial!}'  in 
France.  He  deserves  special  credit  for  his  observations  on  the  normal  course  of 
pregnancy  and  labor,  as  well  as  the  lying-in  period  —  he  holds  that  involution  of  the 
uterus  is  ordinarily  completed  in  eight  days — and  for  his  teachings  with  regard  to 
the  minor  pelvis  (particularly  the  importance  of  the  pelvic  curve1  —  he  does  not 
mention  the  axis)  and  the  doctrine  of  version.  As  regards  the  latter  operation  he 
recommended  especially  turning  by  the  feet,  but  employed  also  cephalic  version  before, 
or  shortly  after,  rupture  of  the  membranes,  resorting  to  direct  traction  of  the  head  until 
it  became  engaged  in  the  pelvis,  or  having  recourse,  if  necessary,  to  external  aid. 
Replacement  of  the  prolapsed  arm  he  regarded  as  always  unnecessary  etc.  He  also 
opposed  instrumental  interference  as  far  as  possible.  He  specifies  obliquity  of  the 
uterus  as  the  chief  cause  of  difficult  labor.  — Moreover,  "like  a  genuine  Dutchman  ", 
Deventer  sold  a  nostrum  to  relieve  false  pains. 

Johann  van  Hoorn  (1661-1724)  of  Stockholm  was  of  Dutch 
descent,  but  a  student  of  Holland  and  France,  and  an  eminent  obstetrical 
practitioner  in 

".  Sweden, 
especially  in  Stockholm. 

In  addition   to   other  works,  he  wrote  (1715)   a   manual  for  midwives  with  the 
curious  title  "Die  zwo  am  ihrer  Gottesfurcht  und  Treue  wohl  belohnten  Wehemutter 

1.  From  the  time  of  the  Ancients  even  down  to  the  second  half  of  this  century  the 
normal  pelvis  was  believed  to  be  too  narrow  for  the  birth  of  the  child.  A  widen- 
ing of  its  natural  proportions  to  the  required  size  by  a  separation  of  the  parts, 
and  especially  of  the  symphysis,  beginning  during  labor,  was  assumed,  a  doctrine 
to  which  even  Pare  and  Severin  Pineau  (1597)  subscribed. 


—  526  — 

Siphra  und  Pua",  and  won  for  midwifery  in  Sweden  a  position  of  respectabilitj'. 
Van  Hoorn  acquired  especial  credit  by  his  obstetrical  investigations  and  for  teaching 
the  safety  of  footling  and  face  presentations,  in  which  he  followed  the  doctrines  of 
Portal,  his  teacher.  He  likewise  regarded  the  replacement  of  the  prolapsed  arm,  for 
the  purpose  of  accomplishing  version,  always  unnecessary,  and  was  the  first  who  had 
a  correct  idea  of  placenta  praevia  as  the  cause  of  haemorrhage  during  pregnancy. 
("The  afterbirth,  which  in  the  beginning  of  pregnancy  has  seated  itself  upon  or  over 
the  mouth  of  the  womb,  and  fastened  itself  there,  to  the  great  peril  of  the  mother" 
etc. ).  — If  the 

English, 

by  the  invention  of  the  forceps,  proved  their  eminently  practical  disposi- 
tion, obstetrics  was  yet,  on  the  whole,  only  slightl}'  developed  among  them. 
W.  Salmon1  and  Nicholas  Culpeper,  towards  the  end  of  the  century,  pub- 
lished manuals  for  midwives,  and  James  Primerose,  a  book  on  the  diseases 
of  women.2  The  great  Harvey,  however,  by  his  incidental  observations  on 
the  subject,  threw  English  midwifery  into  higher  relief.  [Walter  Needham 
(died  1691)  also  wrote  a  good  treatise  entitled  '•  Disquisitio  anatomica  de 
formato  foetu",  London  1667.] 

GYNECOLOGY 

was  frequently  studied  separately,  as  well  b\T  physicians  (Herlicius,  1610, 
Joh.  Yarandaeus,  1619)  as  obstetricians.     The  same  is  true  of 

1.  William  Salmon  was,  indeed,  a  fertile  medical  writer  during  the  last  quarter  of 

the  17th  century,  but  1  do  not  find  any  obstetrical  treatise  assigned  to  him. 
Probably  the  "English  Midwife"  of  William  Sermon,  published  in  1(571  in 
London,  is  the  work  intended.  The  Chamberlen  family  were  active  obstetricians 
of  much  reputation  during  the  whole  17th  century.  Peter,  the  inventor  of  the 
forceps,  attended  Henrietta  Maria,  queen  of  Charles  I.,  in  labor  in  1628.  Peter  II. 
his  brother  (1572-1626)  ;  Peter  III.  (1601-1683),  son  of  Peter  LI.  and  generally 
known  as  "  Dr.  Chamberlen "  (be  was  an  M.  I).);  Hugh  (born  16:J0),  son  of 
Peter  III.  ;  Paul  (1635-1717)  and  John  (died  1009),  likewise  sons  of  Peter  III.,  and 
Hugh  II.  (1(364-17l'S),  son  of  Hugh  I.,  all  devoted  themselves  to  midwifery.  In 
spite  of  a  strain  of  insanity  which  seems  to  have  run  through  the  family,  they  all 
attained  more  or  less  reputation  as  obstetricians.  Hugh  I.,  as  we  have  already 
mentioned,  translated  and  published  Mauriceau's  Midwifery  in  1672,  but  we  have 
no  independent  obstetrical  writings  from  any  of  the  family.  With  the  exception 
of  Paynalde's  translation  of  Roesslin,  which  he  entitled  "  The  Pyrthe  of  Man- 
kynde"  and  published  in  1540,  the  earliest  obstetrical  work  in  the  English 
language  was  James  Woolveridge's  "  Speculum  Matricis,  or  the  Expert  Midwives' 
Handmaid,  Catechistically  Composed",  which  appeared  at  London  in  1671.  An 
earlier  edition  is  said  to  have  been  published  at  Dublin  in  1070.  Culpeper's 
•'Director  obstetricum"  was  published  in  1681.  lane  Sharp,  an  English  midwife 
and  contemporary  of  Siegemundin,  also  published  in  1671  a  manual  for  midwives 
entitled  "  The  midwive's  book,  or  the  whole  art  of  midwifery  discovered,  direct- 
ing childbearing  women  how  to  behave  themselves  in  their  conception,  breeding 
and  nursing  of  children."  The  book,  though  based  upon  a  practice  of  30  years, 
is  said  to  be  extracted  largely  from  the  writings  of  French,  Dutch  and  Italian 
obstetric  writers.     (II.) 

2.  Primerose's  "  Dc  morbis  mulierum  et  symptomatis"  appeared  at  Rotterdam  in 

1655.     (H.) 


—  527  — 

THE  DISEASES  OF  CHILDREN, 

which  were  discussed,  among  others,  by  Michael  Ettnuiller  (Valetudinarium 
infantile,  1675),  Movius  (Felix  puerpera  etc.,  1675),  Dan.  Sennert,  le  Rat 
(1680),  Denyan  (1681),  Nic.  Fontano  (1617),  Walter  Harris  (De  rnorbis 
acutis  infantum,  1689),  J.  H.  Jungken  etc. 

3.    ANATOMY  AND  PHYSIOLOGY,    PATHOLOGICAL  AND  MICROSCOPIC 

ANATOMY. 

Normal  anatomy,  to  which  the  newly  created  microscopic  (and  patho- 
logical) anatomy  was  added  in  the  seventeenth  century,  cannot  be  easily 
exhibited  apart  from  its  connexion  with  the  numerous  physiological  dis- 
coveries which  the  age  brought  forth.  Indeed,  the  seventeenth  century  is 
the  era  of  the  foundation  of  modern  physiology.  Besides  numerous  other 
discoveries,  this  century  produced  two  of  the  most  important  improvements 
and  most  brilliant  acquisitions,  which  have  ever  been  attained  in  the  field, 
not  only  of  physiological  knowledge,  but  of  knowledge  in  general — acquisi- 
tions, whose  grandeur  and  importance  for  general  medicine  have  not  been 
equalled  by  that  of  any  half  dozen  attained  during  thousands  of  years. 
We  refer  to  the  establishment  of  the  circulation  of  the  blood  and  the  proof 
of  the  development  of  the  higher  animals  from  the  egg  —  truths  whose 
influence  upon  medicine  has  been  of  incalculable  importance,  and  whose 
discovery  strangely  fell  to  the  lot  of  a  single  great  and  gifted  spirit,  who 
thereby  created  the  modern  inductive-experimental  physiology,  and,  in- 
deed, we  may  say  called  into  existence  a  new  medicine.  The  great  dis- 
coverer and  indefatigable  and  conscientious  investigator  —  he  was  no 
savant,  for  these  scarcely  ever  mark  an  epoch  in  either  science  or  culture 
in  general — -to  whom  we  owe  these  great  acquisitions,  which  to-day  appear 
to  us  so  familiar  and  so  simple,  was  the  Englishman 

William  Harvey  (April  1,  1578 — June  3,  1657)  of  Folkestone  in 
Kent.  The  eldest  of  nine  brothers  and  sisters,  at  the  age  of  ten  years  he 
attended  the  grammar-school  of  Canterbury,  and  at  fifteen  he  entered  Cam- 
bridge, and  then  visited  Padua  in  1599  in  order  to  study  medicine.  Here, 
during  the  five  years  of  his  residence,  he  was  a  pupil  of  Fabricius  ab 
Aquapendente,  Casserio  and  Thomas  Minadous  (1551—1604).  The  fact 
that  Fabricius  in  his  anatomj-  paid  little  attention  to  the  heart  was  the  in- 
direct occasion  which  led  Harve}7  to  those  special  studies  that  terminated 
in  his  ever  memorable  discovery.  Upon  his  return  to  England,  Harvey 
now  26  years  old,  married  the  daughter  of  the  ph}-sician  Lancelot  Browne 
and  was  first  appointed  physician  to  St.  Bartholomew's  Hospital  in  London 
( 1609),  and  then  professor  of  anatomy  and  surgery  [at  the  College  of  Phy- 
sicians (1615)].  He  was  also  appointed  extraordinary  physician  to  the 
learned  and  whimsical  James  L,  and  ordinary  physician  to  Charles  I.,  the 
fickle  son  of  this  theological  pedant.  To  the  latter,  who  was  subsequently 
beheaded  (Jan.  30,  1619)  in  the  English  Revolution,  Harvey  dedicated  his 


—  528  — 

chief  work.  He  was  also  a  busy  practitioner1  until  by  the  publication 
(162S)  of  his  doctrines,  which  he,  however,  had  alread}'  taught  in  the 
College  of  Physicians  since  1616,  he  lost  a  great  part  of  his  practice,  and 
was  even  regarded  as  demented.  Harvey  was  driven  from  place  to  place 
in  England  by  the  Civil  War,  and  thus  came  to  Oxford,  after  the  surrender 
of  which  to  the  Parliamentary  troops,  he  resided  in  London  and  its  vicinity 
with  his  brothers,  who  had  become  rich  b}"  commercial  pursuits,  and 
especially  with  his  favorite  brother  Eliab.  His  modest}'  led  him  to  decline 
the  high  distinction  of  the  presidency  of  the  College  of  Physicians  (offered 
him  in  1654),  but  he  was  honored  by  having  his  bust  placed  in  the  hall  of 
that  society.  He  also  visited  Germany  and  Vienna  in  the  train  of  a  noble- 
man, and  on  his  journey  endeavored  to  convince  his  opponent  Hofman  in 
Altdorf  personally  by  experiments  of  the  truth  of  his  doctrine.  He  lived 
a  modest  and  retired  life,  occupied  chiefly  with  his  studies  —  in  his  later 
years  he  busied  himself  particularly  with  mathematics  —  until  his  death  at 
a  good  old  age  in  London.  He  was  buried  on  June  26th  at  Hempstead  in 
Essex  (where  Sir  Rowland  Hill,  1795-1879,  the  reformer  of  postal  affairs, 
also  died),  the  peer  of  the  great  spirits  of  his  epoch.  A  monument  to  the 
memory  of  Harvey  was  erected  at  Folkestone  in  1881,  and  on  Oct.  18, 1885, 
his  remains  were  placed  in  a  new  marble  coffin  and  solemnly  laid  to  rest  in 
Hempstead  Church  near  Saffron  AValden. 

It  is  characteristic  of  the  fate  of  new  truths,  as  well  as  of  that  authoritj'-loving 
age,  that  Harvey's  immortal  work  ("  Exercitatio  anatomica  de  motu  cordis  et  san- 
guinis") was  unable  to  pass  censorship  in  England,  and  therefore  appeared  in  1628 
(Harvey's  50th  year)  in  a  foreign  country,  viz.  at  Frankfort-on-the-Main,  while  his 
second  treatise  on  the  same  subject,  in  reply  to  the  younger  Riolan,  was  published  at 
Cambridge  in  1649.  He  allowed  his  "Exercitatio  de  generatione  animalium"  to  be 
published  at  London  in  1651,  but  only  on  the  persuasion  of  a  friend.  The  earlier 
attacks  upon  him  had  made  him  unduly  sensitive  to  the  new  ones  which  he  anticipated. 
Other  works  from  his  pen  have  been  lost.  Some  manuscript  notes,  the  report  of  a 
dissection,  and  a  few  sketches  and  letters  from  his  pen  are  still  in  existence.2 

Refuting  the  erroneous  ideas  of  the  Ancients,  and  with  an  eye  upon 
the  teachings  of  Aristotle,  Galen.  Colombo  and  others  —  the  work  of 
Serveto  was  unknown  to  him,  while  Aristotle  and  Galen  were  cautiously 
opposed  —  but  on  all  new  points  proceeding  only  upon  purely  experimental 
methods3  Harvej-  set  forth  the  doctrine  of  the  circulation  as  it  is  held  to- 

1.  It  is  very  evident  from  Harvey's  section  on  "Parturition"  that  he  was  familiar 

with  the  practice  of  obstetrics  and  gynecology,  employing  the  speculum,  dilating 
the  uterus,  removing  moles  etc.  Aubrey  reports  that  "  My  Lady  Howard  had  a 
cancer  in  her  breast,  which  he  (Harvey)  did  cut  off  and  seared",  and  Harvey 
himself  reports  his  removal  of  a  sarcocele.     (H.) 

2.  The  manuscript  of  Harvey's  original  lectures  delivered  at  the  Eoyal  College  of 

Physicians  in  and  after  1616,  including  his  earliest  observations  on  the  heart  and 
the  circulation,  were  rediscovered  in  the  British  Museum  in  1877.  The  hand- 
writing is  said  to  be  so  crabbed  and  the  lectures  are  filled  with  so  many  abbrevia- 
tions, that  no  one  but  an  expert  could  decipher  them.     (H.) 

3.  With  this  object  he  investigated  animals  of  the  most  varied  classes,  insects  (even 

lice),  sea-animals  etc. 


—  529  — 

day.  He  divided  the  circulation  into  three  sections  :  the  lesser,  the  greater 
and  that  of  the  heart  itself.  In  his  prolonged  investigations  he  made  use 
of  both  warm  and  cold-blooded  animals,  but  differed  from  our  "exact" 
investigators  of  the  present  day  in  not  describing  minutely  each  individual 
experiment,  but  contenting  himself  with  adducing  his  results  and  leaving 
to  deduction  its  just  place.  He  computed  the  mass  of  the  blood,  and  thus 
proved  that  there  must  be  a  circulation,  for  all  the  blood  could  not  be  em- 
ployed in  nutrition,  nor  could  it  all  be  newly  supplied  by  the  absorption 
of  nutriment.  Of  "spiritus"  he  said  that  he  had  never  found  anything  of 
the  kind  in  his  dissections.  He  still  lacked,  however,  the  intermediate 
bond  of  the  capillary  zone.  In  place  of  this  he  assumed  larger  porosities 
of  the  flesh  and  vessels,  though  he  also  employed  the  term  ''capillaries". 
He  still  regards  the  heart  as  the  place  for  the  improvement  of  the  blood 
and  the  renewal  of  its  strength,  and  calls  it  "the  sun  of  the  microcosm, 
the  beginning  of  life,  the  household-god  of  the  body,  the  author  of  every- 
thing, the  foundation  of  life".  Arteries  and  veins  differ  in  use,  function 
and  thickness,  not  in  structure  ;  the  veins  contain  crude,  used-up  blood  ; 
the  arteries,  concocted,  nourishing  and  perfected  blood  :  otherwise  they  are 
alike  simple  channels  for  the  blood.  He  also  erred  in  many  subordinate 
points,  e.  g.  in  respect  to  the  quantity  of  blood  driven  into  the  arteries  at 
each  systole  of  the  heart,  which  he  assumed  to  be  half  an  ounce  ;  but  even 
if  his  anatomical  description  of  the  structure  of  the  heart  was  insufficient 
and,  indeed,  imperfect,  he  was  certainly  the  first  who  introduced  the  heart 
into  its  right  place  in  the  circulation  in  accordance  with  its  mechanical 
significance  and  action  —  an  advance  which  cannot  be  disputed  or  denied 
him.  '1  he  main  facts  of  his  exposition  remained  quite  indisputable,  al- 
though in  his  own  day  they  were  heavily  assailed,  and  these  accessary 
matters  were  eagerly  utilized  as  a  means  of  attack.  Harvey  proved  "that 
the  blood  passes  through  the  lungs  and  heart  by  the  pulsation  of  the 
ventricles,  and  is  sent  for  distribution  to  all  parts  of  the  bod}',  where  it 
makes  its  wa}T  into  the  veins  and  pores  of  the  flesh,  and  then  flows  by  the 
veins  from  the  circumference  on  every  side  to  the  center,  from  the  lesser 
to  the  greater  veins,  and  is  by  them  finally  discharged  into  the  vena  cava 
and  right  auricle  of  the  heart,  and  this  in  such  a  quantity,  or  in  such  a  flux 
and  reflux,  thither  by  the  arteries,  hither  by  the  veins,  as  cannot  possibly 
be  supplied  by  the  ingesta,  and  is  much  greater  than  can  be  required  for 
mere  purposes  of  nutrition ;  it  is  absolutely  necessaiy  to  conclude  that  the 
blood  in  the  animal  body  is  impelled  in  a  circle.  .  . ."  The  previous  doc- 
trine of  the  importance  of  the  liver,  and  of  the  "spirits"  in  the  heart,  was 
first  overthrown  by  him,  and  with  it  fell  the  four  immemorial  fundamental 
humors  and  qualities.  "Voici  Harve}-  !  Comme  an  jour  de  la  crc'ation,  le 
chaos  se  debrouille,  la  lumiere  se  separe  des  tt'nebres  !  exclaims  Darem- 
berg,  justly,  though  with  most  too  much  Gallic  magniloquence. 

That    so    important  a  discovery,  which   cleared  up    the  ancient   and 
time-honored  obscurities  and  overturned  the  whole  ph}Tsiological  and  philo- 
34 


—  530  — 

sophical  foundations  of  the  medicine  of  the  past  (including  the  speculative 
novelties  of  Theophrastus  von  Hohenheim)  by  certain  results  gained 
through  the  inductive  method,  necessarily  created  among  medical  men  both 
opponents  and  partisans  in  great  number,  is  self-evident. 

Of  course  the  opponents  were  first  in  the  field.  Two  years  after  the  appearance 
of  Harvey's  book,  which  was  founded  upon  the  researches  of  26  years,  appeared  a 
polemical  treatise  composed  in  fourteen  days  by  .lames  Primerose1  of  Bordeaux, 
practising  at  Hull  in  Yorkshire,  in  which  the  author  declared  the  impossibility  of 
surpassing  the  Ancients  and  the  younger  Riolan.  Riolan  himself,  of  course,  also 
wrote  in  opposition  to  Harvey,  and  was  the  only  one  of  his  opponents  to  whom  the 
latter  deigned  a  reply.  In  Paris,  at  the  instance  of  Riolan  and  by  a  decree  of  the 
Faculty,  the  teaching  of  Harvey's  doctrine  in  lectures  was  prohibited.  ./Emilius 
Parisanus  (died  1(34S  in  Venice)  of  Rome,  a  physician  at  Venice,  who,  like  Harvey, 
had  been  a  pupil  of  Fabricius  ab  Aquapendente,  and  who  had  been  opposed  by 
Riolan  as  an  ignoramus  in  anatomy,  joined  the  physicians  already  mentioned,  and, 
among  other  things,  declared  that  he  had  seen  the  heart  beat  when  perfectly  blood- 
less, that  blood  could  not  flow  backwards  and  forwards  at  once  in  the  arteries,  that  no 
beating  of  the  heart,  no  sound  was  to  be  heard,  as  Harvey  affirmed,  etc. 

Kasper  Hofman  (1572-1648) 
too,  the  savant  and  professor  at  the  Nuremberg  university  in  Altdorf  and  a  Human- 
istic physician,  was  not  at  first  dissuaded  from  opposition  by  even  the  personal  letters 
and  efforts  of  Harvey,  but  at  a  later  period  he  changed  his  opinion.  Hofman  was  the 
son  of  a  poor  blacksmith  in  Gotha,  and  remained  poor,  as  well  as  sick,  all  his  life. 
He  was  an  indefatigable  worker  and  a  man  of  great  love  of  the  truth,  but  rough  in 
his  manners  and  therefore  greatly  disliked. 

Vopiscus  Fortunatus  Plempius  (1601-1671)  of  Amsterdam. 
professor  in  Louvain,  on  the  other  hand,  from  an  original  opponent  of  Harvey  —  he 
wrote  against  Descartes  also,  who  agreed  with  the  new  theory  —  became  subsequently 
a  complete  and  warm  supporter  of  his  doctrine. 

Among  the  large  number  of  complete  or  partial  opponents  of  Harvey 
belong  :  Joh.  Vesling  ;  Caecilius  Foli  (Folli.  Folius,  born  at  Udine  in  1615), 
professor  in  Venice,  who  with  J.  J.  Eau.  rendered  excellent  service  in 
increasing  our  knowledge  of  the  malleus  and  the  membranous  labyrinth,  and 
called  to  his  aid  in  the  present  dispute  an  accidental  case  of  persistence 
of  the  foramen  ovale  ;  Peter  Gassend,  to  whom  a  similar  case  had  been 
shown  by  a  certain  Payan.  and  who  also  selected  it  for  the  basis  of  his 
opposition  ;.  Van  der  Linden  and  P.  J.  Hartmann.  who  took  up  the  subject 
philologically,  and  claimed  (the  former  in  27  "exercitationes")  that  Hippo- 
crates or   Solomon  possessed  a  knowledge  of  the  circulation  ;    Harvey's 


Primerose  was  of  Scotch  descent,  but  born  and  educated  in  France.  He  graduated 
in  medicine  at  Montpellier  in  1617  and  subsequently  came  to  England,  where  he 
settled  at  Hull  and  acquired  the  reputation  of  a  skilful  physician.  In  1630  he 
proposed  to  the  king  that  if  his  Majesty  would  institute  a  lecture  in  Westminster 
or  London,  he  (Primerose)  would  teach  the  same  four  times  a  week  without  pay- 
ment, because  many  were  '•constrained  to  go  out  of  the  kingdom  to  learn  Physic." 
I  do  not  find  that  his  offer  was  accepted.  Primerose's  "Exercitationes  et  Ani- 
niadversiones  in  Librum  de  motu  cordis  et  circulatione  sanguinis,  adversus  Guil- 
lelmum  Haiveum"  was  published  in  London  in  1630.  A  Duncan  Primerose  was 
one  of  the  ordinary  physicians  of  James  I.  in  1615.     (H.) 


—  531  — 

friend  Giov.  Nardi  (about  1656),  a  physician  of  Florence,  and  Olaus  Worm 
(the  Wormian  bones,  1588-165-4),  Fortunatus  Licetus  (Liceti,  1577-1657), 
professor  at  Pisa,  Bologna  and  twice  at  Padua,  with  many  others. 

At  the  same  period  when  Harvey's  first  opponent  emerged  from 
obscurity,  his  first  important  and  open  supporter  appeared.  This  was 
Werner  Rolfink  (1599-1677)  of  Hamburg,  professor  of  medicine,  anatomy, 
botany  and  chemistry  at  Jena.  He  was  subsequently  joined  by  Herm. 
Coming,  and  these  two  outweighed  a  whole  host  of  opponents.  Besides 
these  and  the  physicians  mentioned  above,  other  adherents  of  the  new 
doctrines  were  found  in  De  le  Boe  (Sylvius)  ;  Thorn.  Bartholin ;  van 
Beverwijck  (1 594-1 647) ;  Jan  de  Wale  (Walaeus,  1604-1649),  of  Koudekerke 
in  Zeland,  professor  in  Leyden.  who  based  his  acceptance  upon  his  own 
investigations  :  Roger  Drake,  under  the  auspices  of  Wale  ;  Hendrik  de  Roi 
(Regius,  1598-1679),  a  famous  professor  in  Utrecht;  Jac.  de  Back  (about 
1649),  a  physician  of  Rotterdam  :  Job.  Trullius  of  Rome  ;  George  Ent 
(1604-1689)  of  Sandwich  in  Kent,  Harvey's  best  friend  (who  saved  to  pos- 
terity his  really  grander  and  more  profound  work  on  Generation)  and  a 
physician  of  London  ;  Jean  Pecquet ;  Paul  Marquard  Slegel  (Schlegel,  1605- 
1653)  of  Hamburg,  professor  in  Jena  and  subsequently  city-physician  of 
his  native  city,  and  many  other  reputable  physicians. 

A  bond  of  union  and  intermediary  system  between  the  arteries  and 
veins,  unknown  up  to  this  time  yet  quite  essential,  was  discovered  b}-  the 
great  Marcello  Malpighi  l(i28-1694)  of  Crevalcuore  near  Bologna,  pro- 
fessor in  the  universit}'  of  the  latter  city,  subsequently  at  Messina,  and 
still  later  ordinary  physician  to  the  Pope  at  Rome.  He  discovered  the 
capillary  circulation  (1661)  in  the  lungs  and  mesentery  of  frogs,  and  in 
1665  the  blood-corpuscles.  He  likewise  discovered  the  lung-cells,  the 
cutaneous  glands  and  the  pigmentary  layer  of  the  skin  (rete  Malpighii), 
which  latter  discovery  furnished  the  first  explanation  of  the  color  of  the 
colored  races.  After  Malpighi.  William  Molvneux.  professor  in  Dublin, 
observed  the  capillary  current  in  a  lizard  (1683).  while  Anton  van 
Leeuwenhoeck  (1632-1723)  from  1688  onward  made  his  observations  on 
the  larvae  and  feet  of  frogs,  on  eels  etc.  In  these  he  was  able  to  stud}"  the 
blood-corpuscles  (including  the  white  coi'puscles)  more  thoroughly  than 
Malpighi  had  done.  Finally  William  Cowper  (1066-1709)  saw  the  passage 
of  the  arterial  into  the  venous  current  in  the  mesentery  of  the  cat  (1687). 
— The  capillary  connexion  of  arteries  and  veins  was  first  demonstrated  b}- 
means  of  injections  and  microscopic  observation  by  the  already  mentioned 
Dom.  de  Marchetti  (1626-1688)  in  Padua  (who,  b}-  the  way.  was  so  devoted 
to  trepanning  that  he  even  performed  this  operation  for  syphilitic  cephalal- 
gia), but  was  best  shown  by  Friedrieh  Ruysch1  (1638-1731).  professor  at 
Amsterdam,  the  famous  inventor  of  minute  injections  and  himself  a  skilled 

1.  Ruysch,  like  Stromeyer  in  our  own  day,  had  a  daughter  Rachel  (1664-1750),  who 
was  a  painter  of  flowers  and  also  assisted  her  father,  but  left  no  more  paintings 
than  children. 


—  532  — 

injector.  Ruysch  also  advanced  anatomy  bj'  the  formation  of  anatomical 
collections,  one  of  which  was  brought  into  Russia  by  Peter  the  Great  at  an 
expense  of  about  875,000.  The  Russian  transporters  of  the  collection, 
however,  drank  the  alcohol  in  which  the  preparations  were  preserved,  and 
a  portion  of  it  was  thus  ruined.  Ruysch  also  gave  his  name  to  the  tunica 
Ruyschiana  of  the  eye. 

The  doctrine  of  the  circulation  was  also  further  developed  by  Alexan- 
der Maurocordatus  (1037-1710),  born  of  Greek  parents  in  Constantinople, 
educated  in  Padua,  and  subsequently  Turkish  embassador  in  Vienna. 
Maurocordatus  also  investigated  the  mutual  relations  of  the  respiration 
and  circulation. 

Further  illustration  and  amplification  of  the  doctrine  of  the  circulation 
resulted  from  the  more  careful  investigations  into  the  formation  and 
structure  of  the  heart,  an  organ  which  every  one  —  including  Harvey 
himself — entangled  in  the  A'iews  of  the  Ancients,  continued  to  consider 
subordinate  to  the  liver  in  its  importance  with  respect  to  the  circulation 
and  the  appropriation  of  nutritive  material  :  for  no  one  was  entirely  free 
from  the  authority  of  Galen.  Nicolaus  Steno  (Stenson.  Stenonis,  Stenonius 
etc..  1638-1686),  at  first  a  professor  in  Copenhagen,  then  bishop  in  partibus 
of  Titiopolis  and  a  peripatetic  convertor  of  heretics,  first  proved  that  the 
heart  was  a  muscle,  and  that  consequently  it  contracted  actively  and 
expelled  the  blood.1  He  was  likewise  the  discoverer  of  Steno's  duct,  which 
he  found  during  his  residence  in  Leyden  and  Amsterdam. 

The  capacity  of  the  heart  for  contraction  under  irritation,  even  after  death,  was 
shown  by  Joh.  Jac.  Harder  (1656-1711),  professor  in  Basel,  and  by  Peyer.  In  regard 
to  the  movements  of  the  heart  and  other  animal  motor  phenomena  (including  even 
nutrition),  Glisson,  the  successor  of  Harvey  in  the  professorship  of  anatomy  and 
surgery  in  the  College  of  Physicians,  taught  an  '"irritability  of  the  fiber",  as  well  as 
of  the  fluids,  under  the  influence  of  external  and  internal  irritation  —  a  doctrine  dis- 
covered by  the  deductive  method.  These  irritants  always  elicit  motion,  but  only 
attain  to  the  consciousness  when  an  excess  of  the  irritation  of  the  fiber  upon  the 
nerve  occurs.  "  Life  expresses  itself  in  matter,  in  that  the  latter  acts,  moves.  This 
takes  place  through,  and  consists  in,  reciprocal  action.  The  ground  of  motion  is  irrit- 
ability"—  such  was  the  essence  of  his  doctrine.  In  this  theory  he  was  t lie  prede- 
cessor of  Haller.  who.  however,  went  to  work  inductively. 

Richard  Lower  (1631-1691)  of  Tranmore  in  Cornwall,  practising  in 
London  (tuberculum  Loweri),  and  Raimond  Vieussens  (1641-1716)  of 
Rouergue,  professor  in  Montpellier  (Fossa  ovalis  etc.)  indicated  more  pre- 
cisely the  position,  structure  etc.  of  the  heart,  while  Thomas  Bartholin4 
(1616-1680)  disputed  with  Olaus  Rudbeck  (1G30-1702k  professor  in 
Upsala,  the   discovery  of  the   intestinal   lymphatics   and   their   connexion 

1.  In  geology,   whose  foundation  he  laid,  Steno  was  the  first  "  Neptunist",  while 

Leibnitz  was  the  first  "  Plutonist  ". 

2.  Son  of  Casper  Bartholin  Sr.  (1585-1629),  professor  in  Basel.    The  latter's  youngest 

son,  Erasmus,  was  also  first  professor  of  geometry  and  then  of  medicine  in  the 
same  city.  Thomas  Bartholin  was  the  father  of  Casper  Bartholin  Jr.  (1655-1738), 
professor  of  physics  and  anatomy  in  Copenhagen. 


—  533  — 

with  the  thoracic  duct  and  left  subclavian  vein.  For  up  to  this  time  it 
was  the  prevailing  opinion  that  the  lymphatics  of  the  intestines  went  to 
the  liver,1  since  it  was  assumed  that  the  chyle  was  absorbed  by  the  veins  of 
the  intestine  and  flowed  through  them  to  the  liver.  This  error  was  dispelled 
by  the  triple  discovery  of  the  lymphatics  of  the  intestine  and  their  con- 
nexion with  the  thoracic  duct,  on  the  one  hand,  the  chyliferous  vessels, 
their  source,  on  the  other,  and  finally  the  thoracic  duct  itself.  The  first 
discovery  was  made  by  Rudbeck  in  1651  ;  the  second  in  1622  by  Caspar 
Aselli  (1581-1626),  professor  in  Pavia.  The  latter,  in  one  of  the  vivisections 
so  frequent  even  at  that  time,  discovered  the  chyliferous  vessels  in  the  dog, 
while  Fabrice  de  Peiresc  (1580-1637),  a  wealthy  amateur  in  medicine,  by 
the  investigation  of  the  body  of  a  highly  fed  malefactor  two  hours  after  his 
execution,  led  to  their  discover}-  in  man.  Finally  the  discovery  of  the 
thoracic  duct  and  its  termination  in  the  subclavian  vein  was  made  (also  in 
the  dog)  in  the  year  1647  by  Jean  Pecquet,  (1622-1674)  of  Dieppe,  profes- 
sor in  Montpellier,  and  Fellow  of  the  Academic,  who,  however,  thought  it 
a  vein.  Jan  van  Home  (1621-1670),  professor  of  anatomy  in  Leyden,  in  the 
year  1652.  however,  first  succeeded  in  demonstrating  the  same  vessel  in 
man.  Harvey  disputed  the  correctness  of  the  discovery  on  theoretical 
grounds.     He  too  must  bring  his  offering  to  prejudice ! 

Johann  Vesling  (1598-1649),  a  native  of  Minden  in  Westphalia  and  professor  in 
Padua,  had  discovered  the  thoracic  duct  shortly  after  Pecquet.  Jacques  Mentel 
(1599-1670)  confirmed  the  discovery  of  Aselli,  but  was  merely  a  witness  of  the  dis- 
covery of  the  thoracic  duct,  not  Pecquet's  predecessor  in  that  discovery.  The  English, 
however,  claimed  for  George  Jolyff,-  a  physician  of  Cambridge,  the  discovery  of  the 
lymphatic  vessels,  for  much  difference  of  opinion  exists  with  respect  to  the  precise 
persons  and  the  exact  dates  to  which  the  anatomical  discoveries  of  this  period 
belong. 

While,  as  we  have  seen,  the  study  by  others  of  the  doctrine  of  the 
complementary  circulation  of  the  lymph  and  chyle  was  associated  with 
Harvey's  name  and  his  doctrine  of  the  circulation  of  the  blood,  the  same 
great  investigator,  by  his  work  on  this  subject,  also  gave  the  permaneut 
foundation  to  a  new  and  fruitful  cultivation  of  another  department — the  doc- 
trine of  generation  and  development.  His  "  Exercitationes  de  generatione 
animalium"  etc.  are.  if  possible,  still  more  important  in  their  range  than 
his  work  on  the  circulation,  but  are  far  inferior  to  the  latter  in  precision  of 
thought  and  experiment,  are  not  free  from  repetitions  and  are  somewhat 
verbose.  In  this  field  he  was  the  pupil  and  successor  of  his  master.  Fabri- 
cius  ab  Aquapendente,  whose  endeavors  he  carried  to  completion.  Harvey 
not  only  investigated,  like  Fabrieius,  the  eggs  of  the  fowl,  but  also  the  em- 
bryos of  quadrupeds,  e.  g.  hinds  and  does  (on  the  latter  of  which  Bischoff  also, 

1.  Upon  this  view  Helvetius  subsequently  based  a  theory  of  inflammation,  which 

Jean  Besse  of  Rouergue  met  with  the  assertion  that  in  such  a  theory  capillary 
obstruction  only  (nowadays  ''thrombosis"  and  "embolism")  came  into  consider- 
ation. 

2.  Wharton  claimed  that  the  lymphatics  were  discovered  by  Jolyff  in  l<i.">0.     (H.) 


—  534  — 

at  a  later  period  made  new  investigations),  and  thus  finally  arrived  at  his 
famous  proposition  :  "  Ovum  esse  primordium  commune  omnibus  auimali- 
bus".1  This  proposition  was  completed  on  the  male.side,  and  the  theoiy  of 
generation  founded,  through  the  discovery  of  the  so-called  spermatozoa  (ani- 
malcula.  1677)  by  a  German  student  in  Leyden,  Ludwig  von  Hammen 
(1652-1689)  of  Dantzig,  then  onl}*  21  years  of  age.2  He  showed  them  to 
the  renowned  miscroscopist  Anton  van  Leeuwenhoeck.  originally  a  mechanic, 
subsequently  a  physician  of  Delft.  B3'  the  latter  the  semen  was  at  once 
installed  in  the  place  of  the  egg  in  Harvey's  theorem.  The  germ  of  the 
future  soul  was  claimed  for  the  spermatozoa,  and  they  themselves  were 
declared  to  be  living  animals  of  both  sexes,  capable  of  coition  etc.  For 
this  reason  the  philosopher  Leibnitz  at  once  declared  the  spermatozoa 
immortal,  while  the  truth  is  only  that  b}'  their  means  the  species  (as  we 
express  it)  becomes  immortal.  That  alteration  in  Harvey's  theorem  may 
depend  too  upon  the  actual  discovery  (made  by  Leeuwenhoeck)  of  sperm- 
cells  in  the  uterus  of  a  bitch,  while  in  the  egg  these  had  not  been  observed. 
According  to  Leeuwenhoeck,  therefore,  the  spermatozoa  are  transformed 
into  the  embiyo,  while  the  eggs  merely  supply  the  requisite  nourishment. 

Of  course  parties  (Ovists  and  Animaliculists)  arose  from  two  such 
opposite  views  (correct,  as  the  sequel  showed,  only  in  their  union),  and 
these  found  a  fruitful  subject  for  dispute  in  the  further  discussion  of  the 
history  of  development,  particularly  in  reference  to  the  mode  of  nutrition 
of  the  embryo.  Harvey  erroneously  denied  all  immediate  connexion 
between  the  embryo  and  the  maternal  bod}-,  and  endeavored  to  prove  this 
complete  separation  of  the  two  by  the  existence  of  the  egg-membranes. 
He  likewise  ascribed  little  importance  to  the  ovaries,  but,  like  the  Ancients, 
thought  that  fecundation  took  place  by  means  of  the  aura  alone.  Yet  he 
claimed  (correctly)  a  difference  in  the  pulse-beat  of  mother  and  child — at 
that  time  something  unheard  of ! 

The  egg-theory  (which  forever  deprived  the  theory  of  a  generatio 
aequivoca  of  its  previous  estimation)  was  supported  at  once  directly  and 
indirectly  by  a  number  of  important  anatomical  and  developmental  dis- 
coveries, which  gained  in  weight,  in  that  period  so  fruitful  in  new  author- 
ities, by  the  importance  in  other  directions  of  the  men  who  labored  to 
perfect  this  subject. 

Thus  light  was  thrown  upon  the  structure  of  the  testicle  by  the  famous 
anatomist  Nathaniel  Highmore  (1613-1685),  a  physician  of  London,  who 
described  more  accurately  the  so-called  corpus  Highmorianum,  the  seminal 

1.  "Omne  vivum  ex  ovo"  does  not  occur  in  his  book,  but  is  a  later  and  incorrect 

abbreviation  of  Harvey's  proposition. 

2.  According  to  the  Dutch  (who  must  have  also  an  inventor  of  printing  of  their  own), 

the  discovery  of  the  spermatozoa  was  made  by  Joh.  Ham  (died  1723),  a  Dutch 
student  of  that  day. 

[Haeser,  on  the  authority  of  Halbertsma  and  Leeuwenhoeck  himself,  says  Ham, 
a  student  at  Leyden,  was  the  real  discoverer  of  the  spermatozoa.    (H.)] 


—  535  — 

ducts  and  the  epididymis.  His  investigations  were  supplemented  by  a 
certain  Aubery  in  Florence,  while  Jan  van  Home  pointed  out  that  the 
so-called  female  testicles  were  ovaries,  a  fact  previously  affirmed  by  Stenon, 
who  also  showed  the  muscular  nature  of  the  uterus.  Jan  van  Home  must 
not  be  confounded  with  the  Swedish  obstetrician  Hoorn.  The  former  was 
born  at  Amsterdam  in  1621  and  died  in  1670  in  Lejden.  where  he  held  the 
position  of  professor  of  anatomy  and  ph}Tsiology. 

Kegner  de  (xRAAF  (1 641-1 673)  of  Schoonhoven, 
a  physician  in  Delft,  proved  (1672)  that  the  so-called  female  testicles  secrete  no 
female  semen,  as  had  been  hitherto  assumed,  but  are  ovaries  in  the  true  sense  of  that 
term,  similar  to  those  of  oviparous  animals.  Stenon  too  in  1H67  had  expressed  this 
opinion  (Lauger).  He  pointed  out  the  follicles  still  called  Graafian,  which,  after 
rupture,  form  the  corpora  lutea,  but  he  did  not  consider  them  the  eggs  proper,  because 
the  eggs  found  in  the  uterus  after  fecundation  were  always  smaller  lhan  these  follicles. 
He  believed  these  eggs  reached  the  uterus  through  the  tubes,  and  were  fecundated 
only  by  the  aura.  De  Graaf  in  1664  also  instituted  the  first  experiments  on  the 
secretion  of  glands,  by  tying  a  tube  in  the  duct  of  Wirsung  in  order  to  collect  the 
secretion  of  the  pancreas.  He  was  likewise  the  first  to  inject  vessels,  for  which 
purpose  the  physician  next  mentioned  invented  a  hardening  material. 

Jan  Swammerdam  (1637-1686), 
a  pupil  of  Home  and  friend  of  Sylvius  de  le  Boe,  also  proved  the  ovarian  character 
of  the  female  testicles,  and  supported  his  views  by  comparative  ob.<-ei  vations  in  the 
plant  and  insect  kingdoms.  He  was  the  first  to  prove  that  the  queen  bee  was  a 
female.  Special  light  was  thrown  upon  the  history  of  development  proper  by  the 
London  anatomist  and  physician 

Walter  Needham  (died  1691), 

who,  though  he  assumed  intrauterine  respiration,  taught  that  nutrition  was  effected 
by  blood  from  the  placenta,  and  distinguished  the  foetal  and  maternal  divisions  of  the 
latter  organ.  He  was  acquainted  also  with  the  umbilical  vesicle,  the  changes  of  the 
pregnant  uterus  etc.  The  great  investigator  Malpighi  too  again  utilized  the  micro- 
scope in  the  history  of  development. 

Charles  Drelincourt  (1633-1697)  of  Paris, 
professor  in  Leyden,  held  that  fecundation  took  place  in  the  uterus,  and,  in  opposition 
to   the  doctrine   of  the    Ancients,    demonstrated    the    viability   of   the    eight-months 
foetus,  while 

Nicolaus  Hoboken  (1632-1678), 
professor  in  Utrecht  and   Harderwyk   (about  166!)),  described   more  accuratel}',   and 
delineated,  the  placenta  and  envelopes  of  the  ovum. 

On  the  side  of  Harvey's  egg-theory  was  arrayed  too  the  versatile  partisan  Franc. 
Redi  (1626-1697),  naturalist,  physician  of  Cosmo  II.  of  Tuscany,  and  poet.  With 
Leeuwenhoeck  and  Swammerdam  he  opposed  the  generatio  ajquivoca.  Beside  him 
stood  Johann  Bohn,  Theodor  Kerkring  ( 1640-1693;  valvuhe  Kerkringii.  vasa  vasorum  >, 
Rolfink,  Caspar  Bartholin,  Jr  ,  who  was  the  first  to  prove  the  discharge  from  the 
female  genitalia  (heretofore  considered  female  semen)  to  be  vaginal  and  uterine 
mucus;  Claude  Perrault,  who  was  also  a  supporter  of  the  doctrine  of  Panspermism, 
Franc.  Maria  Nigrisoli  (1688-1727),  professor  in  Ferrara,  and  finally  Antonio  Vallis- 
nieri  (1661-1730),  professor  in  Padua,  whose  arguments  against  the  functions  of  the 
spermatozoa  (he  considered  them  merely  transient  visitors,  because  he  had  found 
them  in  the  discharged  vaginal  mucus)  met  with  much  sympathy  at  that  period  and 
later;  and  some  others. 


—  536  — 

Among  the  opponents  of  Harvey,  or  followers  of  Leeuwenhoeck's  seminal 
doctrine,  we  must  mention:  Nic.  Hartsoeker  (1656-1725)  of  Amsterdam,  for  a  time 
professor  in  Heidelberg,  who  held  that  the  air  was  filled  with  animalcula,  which 
settled  upon  plants,  and  passed  thence  into  infusions,  where  they  were  then  found 
with  the  microscope  ;  Francois  Plantade  (about  1699),  who  portrayed  the  spermatozoa 
in  the  form  of  homunculi ;  Martin  Lister  (1638-1711),  who  regarded  their  movements 
as  excitors  of  the  sexual  orgasm,  and  thus  of  sexual  pleasure;  llieronymus  Barbatus 
(about  1676),  who  still  clung  to  the  ancient  theory  of  the  mixture  of  the  male  and 
female  semen;  Phil.  Jak.  Hartmann;  Giov.  Maria  Lancisi ;  Girolamo  Sbaraglia 
(1641-1710),  professor  in  Bologna,  and  many  others.  Among  the  latter,  however,  we 
must  distinguish  Nicolas  Andry  (1658-1742),  who  correctly  affirmed  the  entrance  of 
the  spermatozoa  into  the  ovum,  but  erred  in  believing  that  they  developed  themselves, 
and  in  holding  that  thej7  mi^ht  penetrate  into  the  body  from  the  surrounding  air. 
He  already  observed  that  boys  before  puberty  and  patients  suffering  from  gonorrhoea 
had  no  spermatozoa. 

In  connexion  with  the  investigations  concerning  the  circulation  of  the 
lymph  and  chyle,  whose  modus  operandi  was  disclosed  through  the  discovery 
of  valves  in  the  lymphatic  vessels  by  Swammerdam,  Gerard  Blaes  (professor 
in  Amsterdam,  died  1662)  and  Ruysch,  stand  the  numerous  discoveries 
with  respect  to  the  glands.  Thus  Thomas  Wharton  (1610-1673),  professor 
in  Oxford,  who  was  almost  the  earliest  to  devote  attention  to  the  general 
theory  of  the  glands,  discovered  the  duct  called  after  him  "\Vharton"s  duct. 
He  considered  the  ligamenta  rotunda,  though  not  hollow,  the  excretoiy 
ducts  of  the  female  testicles,  and  the  tubes  as  passages  which  facilitated 
the  fecundation  of  the  female  semen  by  the  male.  Francis  Glisson  (1597- 
1671)  investigated  especially  the  liver,  though  the  same  had  been  done 
before  him  by  Adrian  van  den  Spiegbel  of  Brussels,  professor  in  Padua 
(1578-1625).  Glisson  taught,  however,  that  the  lymph  Avas  secreted  by 
the  nerves  as  well  as  by  the  smallest  arteries.  Anton  Xuck  was  the  first 
to  demonstrate  the  injection  of  the  lymphatics  with  quicksilver,  and 
studied  excellently  the  doctrine  of  the  glandular  system.  Needham  and 
Stenson  discovered  the  excretoiy  duct  of  the  parotid  :  August  Quirin 
Rivinus  (German,  Bachmann).  that  of  the  sublingual  gland,  though  the 
latter  discovery  was  also  ascribed  to  Casp.  Bartholin  Jr.  Johann  Conrad 
Fever  (1653-1712),  a  physician  of  Schaffhausen,  and  Joh.  Conrad  Brunner 
(1653-1727)  of  Regensburg.  professor  in  Heidelberg,  discovered  the  intesti- 
nal glands,  which  bear  their  names.  The  excretory  duct  of  the  pancreas 
was  discovered  in  the  dissecting  room  of  Yesalius  at  Padua  by  his  prosector 
Georg  Wirsung1  of  Bavaria  (assassinated  by  a  physician  at  his  own  door, 
in  1643)  and  Moritz  Hoffmann  (1621-1698)  of  Fiirstenwalde  in  Branden- 
burg, subsequent!}'  professor  in  Altdorf.  Hoffmann  in  1642  had  discovered 
the  so-called  duct  of  Wirsung  in  the  fowl  and  pointed  it  out  to  Wirsung, 
who  then  described  the  duct  in  man  as  his  own  discovery.  The  Roman 
professor  Antonio  Pacchioni  (1665-1726)  of  Reggio  described  the  so-called 

l.   Not  to  be  confounded  with  Christopher  Wirsung,  who  wrote  a  famous  dispensa- 
tory in  1M58. 


—  537  — 

Pacchionian  glands  :  Clopton  Havers  (about  1691),  a  physician  of  London, 
the  so-called  S3-novial  glands.  The  glands  of  the  sexual  organs  were 
described  by  William  Cowper,  though  the  so-called  Cowpers  glands  had 
been  already  seen  by  Mery  and  their  existence  had  been  confirmed  b}- 
Duverney.  Alexis  Littre  (1658-1725),  a  physician  of  Paris  and  member 
of  the  Acad6mie  (he  devised  in  1710  a  method  for  establishing  an  artificial 
anus.1  which  has  since  borne  his  name),  described  the  glands  (Tyson's), 
which  were  more  thoroughly  made  out  b}"  Edward  Tyson  (born  1651), 
professor  of  anatomy  in  London.  Caspar  Bartholin  described  the  glands 
which  bear  his  name,  though  the}'  had  been  previousby  discovered  by 
Duverne}"  in  the  cow.  By  this  discover}-  of  the  glands  of  Bartholin, 
the  long  dispute  regarding  the  female  semen,  i.  e.  the  origin  of  the  fluid 
secreted  by  the  female  during  coitus  and  regarded  as  semen,  was  at  least 
partially  settled.  Guillaume  des  Noues  in  1681  saw  the  so-called  ovula 
Nabothi,  subsequently  again  discribed  by  Martin  Naboth  (1675-1721), 
professor  of  chemistry  in  Leipzig.  Heinrich  Aleibom  (1638-1700;  of 
Liibeck.  professor  in  Helmstadt,  discovered  the  glands  of  the  eye-lids  which 
bear  his  name.  Lorenzo  Bellini  rendered  good  service  in  explaining  the 
structure  of  the  kidneys. 

Works  devoted  to  anatomical  studies  (besides  those  of  the  16th  century)  were 
still  in  vogue.  Among  the  authors  of  these  we  may  mention:  Joh.  Riolan  Jr. 
(Anatomia  sen  anthropographia  et  osteologia,  Paris,  1626,  Encheiridium  anatomicnm, 
1648);  G.  Bidloo  (Anatomia  humani  corporis,  with  105  plates,  Amsterdam,  1685. 
These  plates  were  used  by  William  Cowper  in  his  "Anatomy  of  human  bodies", 
Oxford,  1698,  Cowper  merely  supplying  the  text  and  adding  9  indifferent  plates  of  his 
own) ;  M.  Lyser  (Culter  anatomicus,  sen  methodus  humana  incidendi  corpora,  Copen- 
hagen, 1653  —  a  guide  to  dissection);  Thomas  Bartholin  (Anatomia  reformata  etc., 
1651);  Thomas  Verheyen  (Anatomia  corporis  humani,  Louvain,  1683);  Joh.  Yesling 
(Syntagma  anatomicnm.  1633);  Spieghel  (De  humani  corporis  fabrica  cum  tabulis. 
Venice,  1627);  Nathaniel  Highmore  (Corporis  humani  disquisitio  anatomica  cum  18 
tabulis,  1651);  John  Browne  (Myographia  nova  etc.,  witli  37  plates  by  R.  Whyte, 
London,  1684),  ordinary  surgeon  of  Charles  II.;  Pietcr  Paaw  (Pavius;  Primitise 
anatomic;c  de  humani  corporis  ossibus,  1615);  Leeuwenhoeck  I  Anatomia,  Lugd.  Bat., 
1687);  Ruysch  (Thesaurus  anatomicus  cum.  fig.  Ben.,  1701);  Giulio  Casserio  (Tabulae 
anatomica?  78  —  20  of  them  supplied  by  Dan.  Bucretius  of  Breslau,  Frankfort-on-the- 
Main,  Merian,  1632);  Dom.  de  Marchetti  (Anatomia,  1652);  Malpighi  (Epistola  de 
lingua,  Bologna,  1665);  Severini,  Jasolini  et  Cabrolii  varia  opuscula  anatomica, 
Frankfort,  1668.  One  of  the  most  widely  used  handbooks  of  anatomy  was  "L1  anato- 
mie  de  1'  horarae"  (Paris,  1690)  of  P.  Dionis,  which  contained  the  doctrine  of  the  cir- 
culation and  was  translated  into  other  languages,  even  into  Chinese;  Carlo  Cesio 
(Cognitione  de  muscoli  del  corpo  humano  per  il  designo  opera  di  C.  Cesio  Am.  v. 
Westerhout  formio,  Romae,  1697,  with  18  plates)  etc.  etc.  [To  whom  we  may  add 
Alexander  Read2  (The  manual   of  the   anatomy  or  dissection  of  the  body   of  man, 

1.  Colotomy,  which  was  first  performed,  however,  by  Pillore  and  Duvet  in  1776. 

2.  The  Catalogue  of  the  Library  of  the  Surgeon-General's  Office  mentions  a  work 

entitled  :  "  Read  ov  Rhead  (A.)  Itofiaroypacpia  'AvOpwTzivr).  Or  a  description  of 
the  body  of  man.  By  artificial  figures  representing  the  members,  and  fit  terms 
expressing  the  same,  n.  p.,  1616."    Is  this  an  earlier  edition  of  the  same  work  ?  (H.) 


—  538   — 

L634);  H.  Crooke  (Mixpoxofffioypapta, —  A  description  of  the  body  of  man,  Lon- 
don, 1631,  2d.  ed.);  Thomas  Winston  (1575-1655;  Anatomical  lectures  at  Gresham 
College,  1G59) ;  Robert  Bayfield  (Exercitationes  anatomical  etc.,  1660);  fc?ir  Charles 
Scarborough  (Syllabus  musculorum,  1676);  Walter  Charlton  (Three  anatomic  lectures 
etc.,  1683);  Samuel  Collins  (Systema  anatomicum  etc.,  1685);  Thomas  Gibson  (The 
anatomy  of  human  bodies  epitomized,  1684);  James  Keill  (The  anatomy  of  the  human 
body  abridged,  1698),  and  the  writers  on  special  anatomy  :  Francis  Glisson  ( Anatomia 
hepatis  etc.,  1654);  Thomas  Wharton  (1610-1673;  Adenographia,  1656);  Thomas 
Willis  (1622-1675;  Cerebri  anatome,  1664);  Clopton  Havers  (Osteologia  nova,  1691); 
Heniy  Ridley  (Anatomy  of  the  brain  etc.,  1695).     H.] 

A  highly  important  doctrine  and  discovery  buried,  alas,  in  numerous 
quartos,  but  which  should  be  considered  in  pathology  quite  equal  to  that 
of  Harvey  in  physiology,  was  brought  forward  b}'  Conrad  Victor  Schneider 
(1614-1680)  of  Bitterfeld  in  Saxony,  professor  in  Wittenberg  (after  1639), 
as  the  result  of  his  extremely  careful  investigations  of  the  mucous  mem- 
brane of  the  nose. 

He  demonstrated  anatomically  and  clinieallj'  that  it  was  not  the  brain,  but  this 
membrane,  which  secreted  the  mucus  discharged  in  disease,  and  by  this  inductive 
explanation,  which  seems  to  us  now  so  simple  and  self-evident,  overthrew  at  once 
and  forever  the  whole  doctrine  of  the  Ancients  with  regard  to  the  numerous  catarrhal 
diseases. 

The  other  departments  of  anatomy  likewise  experienced  a  more  refined  physio- 
logical elaboration,  if  such  an  expression  may  be  allowed.  On  all  sides,  however,  the 
ideas  of  the  Ancients  still  clung  to  their  ascendancy,  and  were  never  eas}-  to  set  aside,, 
while  now,  as  in  all  ages,  new  errors  appeared  frequently  in  place  of  the  old,  the  result 
of  the  doubtful  interpretation  of  new  discoveries.  Still  the  overplus  of  truth  contin- 
ued to  be  quite  considerable.  Thus  e.  g.  Willis,  who  won  for  himself  great  credit  by 
his  investigation  of  the  nervous  system,  especially  of  the  brain  (he  described  the 
ganglia),  as  well  as  by  his  comparative  study  of  the  brains  of  animals,  declared  that 
the  conduction  of  the  spirits  (in  the  form  of  a  humor  supposed  to  exist  in  the  nerves) 
belonged  to  the  nerves,  (which  were  considered  hollow),  but  that  the  secretion  of  these 
spirits  was  a  function  of  the  brain,  although  he  understood  each  special  part  of  the 
latter  (by  the  way  nothing  new)  to  be  the  seat  of  a  definite  function,  just  as  we  do 
to-daj-.  Moreover  he  greatly  advanced  our  knowledge  of  the  blood-vessels  of  the 
brain  (a  subject  also  enriched  by  Wepfer),  and  regarded  the  sinuses  as  veins,  while 
Sylvius,  on  the  contrar}',  whose  name  continues  associated  with  several  parts  of  the 
brain  even  to  the  present  day,  considered  them  direct  anastomoses  with  the  arteries. 
Diemerbroeck  still  looked  upon  the  brain  as  an  organ  for  the  secretion  of  mucus,  just 
as  the  Ancients  did,  but  Malpighi,  who  studied  the  cortical  matter  with  especial 
thoroughness  (even  with  the  microscope),  interpreting  the  ganglia  erroneously, 
declared  it  to  be  glandular  in  its  character.  Hence  he  considered  it  specially 
adapted  to  the  secretion  of  the  "vital  spirits,  spirits  and  nervous  spirits"  —  of  that 
neither  purely  fluid,  nor  yet  simply  volatile,  principle  of  life,  concerning  the  actual 
existence  of  which,  after  this  discovery  (or  false  observation)  of  Malpighi,  no  further 
doubt  ever  made  its  appearance.  Blaes  erroneously  derived  the  nerves  from  the  dura 
mater,  but  enriched  our  knowledge  of  the  spinal  cord  with  some  correct  observations. 
Swammetdam  described  more  completely  the  arachnoid  of  the  brain,  while  Leeuwen- 
hoeck,  on  the  other  hand,  who  made  use  of  the  aid  of  the  microscope,  taught  the 
recognition  of  the  great  vascularity  of  the  cortical  matter — the  Ancients  from  the 
time  of  Aristotle  had  considered  the  brain  non-vascular  ■ —  and,  misinterpreting  the 
varicosities  of  the  nerves,  believed  the  medullary  substance  to  be  composed  of  innum- 


—  539  — 

erable  globules.  The  best  and  most  complete  description  of  the  central,  and  in  part 
also  of  the  peripheral,  nervous  system,  was  furnished  by  Vieussens.  Gottfried  Bidloo 
(1649-1713),  a  physician  of  Amsterdam,  composed  some  bad  text  for  the  highly 
praised  plates  of  the  artist  Gerard  de  Lairesse.  The  latter,  as  already  remarked,  were 
made  use  of  by  Cowper,  who  did  not  sufficiently  indicate  their  source.  Glisson 
claimed  to  have  observed  that  the  nervous  fluid,  now  generally  accepted  in  the  nerves 
(which  latter  were  considered  hollow,  and  connected  with  the  brain  or  its  cavities), 
had  an  actual  existence,  while  Wharton  thought  the  nerves  and  glands  connected 
with  each  other,  and  even  reckoned  the  glands  among  the  nerves.  Henry  Ridley  (at 
the  close  of  the  century )  and  others  assigned  nerves,  as  well  as  muscles,  to  the  dura 
mater,  and  Baglivi  at  once  utilized  these  supposed  muscles  to  explain  the  movements 
of  the  brain,  while  Pacchioni  considered  the  dura  mater  a  kind  of  heart  for  the  vital 
spirits.  In  this  conclusion  Lancisi,  a  pupil  of  Riva  (1627-1677)  of  Asti,  agreed,  and 
he  even  assigned  muscles  to  the  ganglia.  It  was  believed  that  by  the  motions  of  the 
brain  the  nervous  fluid  or  vital  spirits  was  driven  into,  the  hollow  nerves,  and  that 
sensation  etc.  was  produced  by  contraction  and  relaxation,  like  muscular  movement. 
This  doctrine  of  the  movement  of  the  nerves  was  first  overthrown  by  Haller.  After 
these  investigations,  the  results  of  which  were  rashly  assumed  to  be  unquestionable, 
the  doctrine  of  the  vital  spirits  continually  acquired  greater  prevalence,  and  finally 
ruled  pathology  with  absolute  sway.  Franc.  Giuseppe  Borri  of  Milan,  who  has  been 
already  mentioned,  analyzed  the  substance  of  the  brain  (1669),  and  found  in  it  25  per 
cent,  of  fat.  How  carefully  and  thoroughly  they  went  to  work  at  these  investigations 
on  the  structure  of  the  parts  of  the  body  is  evident  from  the  fact  that  Francois 
Pourfour  du  Petit  (1664-1741),  who  belongs  chiefly  to  the  1 8th  century,  asserted  that 
in  the  brain  and  spinal  cord  the  nervous  fibres  decussate  freely.  Petit  also  in  1727 
was  the  first  to  divide  the  cervical  sympathetic  nerve  for  purposes  of  experiment. 
Helmont  was  the  first  to  remark  that  the  peripheral  motor  nerves  were  also  sensitive 
to  pain. 

In  the  investigations  of  the  organs  of  sense  also,  and  of  the  physico-physiological 
conditions  of  perception  by  means  of  these  organs,  the  same  care  is  everywhere 
manifested.  Thus  the  most  important  discoveries  relative  to  the  structure  and  function 
of  the  eye  were  made  at  this  period.  Ruysch  (tunica  Ruyschiana,  the  ciliary  nerves, 
the  vena?  vorticosae)  and  Leeuwenhoeck  (the  lens)  enriched  our  knowledge  of  the 
former,  and,  in  respect  to  its  function,  the  fundamental  laws  of  sight  were  then? 
established  for  all  time.  The  great  physician  and  astronomer  Joh.  Kepler  (1571-1630), 
of  Weil  in  Wiirtemberg,  who  found  consolation  in  poetry  for  his  material  distress, 
taught  in  1604  the  recognition  of  the  function  of  the  lens  as  a  part  of  the  optic  system 
of  the  eye,  and  thus  overturned  the  entire  doctrine  of  the  Ancients  which  had  here- 
tofore prevailed,  that  sight  took  place  by  means  of  the  lens.  He  also  explained  the 
cause  of  short  and  far-sightedness,  the  function  of  the  retina1  etc.  ;  the  Jesuit  Christoph 
Scheiner  in  Vienna  (died  1650)  demonstrated  the  image  upon  the  retina,  studied  the 
motions  of  the  pupil  and  the  changes  of  curvature  of  the  lens  in  accommodation  etc. ; 
Descartes  compared  the  eye  to  a  camera  obscura,  explained  how  objects  were  seen 
erect  and  single.  Edm.  Mariotte  (died  1684;  he  brought  forward  the  so-called 
"  Mariotte's  law"  in  1676),  prior,  and  a  member  of  the  Academie  at  Paris,  on  the 
other  hand  erroneously  located  vision  in  the  choroid  membrane  (Peiresc  had  assigned 
it  to  the  vitreous  body)  and  demonstrated  the  blind  spot.  He  was  also  the  first  to 
demonstrate  experimentally  that  the  so-called  "  Augenleuchten  "  (shining  of  the  eye) 

1.  According  to  Magnus,  Heliodorus  of  Larissa  (about  A.  D.  100),  without  any 
knowledge  of  the  retina,  taught  the  existence  of  central  and  peripheral  vision, 
and  the  direction  of  the  axis  of  the  eye. 


—  540  — 

depended  upon  reflection.  Hartsoeker  sought  the  explanation  of  upright  vision  in 
the  complementary  function  of  touch ;  Perrault  and  Pecquet  interested  themselves 
in  the  discussion  of  the  place  of  vision,  while  Plenipius  pointed  out  the  nutrition  of 
the  lens  by  its  capsule.  Giov.  Bapt.  Verla  published  at  Florence  in  1(177  an 
"Anatomia  artifiziale  dell'  occhio  umano",  which  was  translated  into  Latin  and 
appeared  at  Amsterdam  in  1680  as  "Anatomia  artificialis  oculi  humani  cum  7  tabulis." 
The  anatomy  of  the  ear  as  a  whole  was  considerably  advanced  by  Vieussens, 
Duverney  especially  (he  discovered  the  ciliary  ganglion  .  and  Schellhammer ;  that  of 
its  parts,  by  Job.  Heinrich  Glaser  (1629-1675),  professor  in  Basel,  Sylvius  (process 
of  the  malleus),  Folli,  Paolo  Manfredi,  professor  in  Rome,  Perrault  (muscles  of  the 
internal  ear,  and  the  lamina  spiralis  as  the  special  organ  of  hearing  i,  Mery  (who 
regarded  the  nervous  layers  as  specially  designed  for  hearing)  and  others. 

The  physiological  doctrines  of  respiration  and  digestion,  of  secretion  and  nutri- 
tion, motion  etc.,  as  they  prevailed  in  the  seventeenth  century,  are  laid  down  in  the 
me  Teal  systems  already  exhibited,  of  which  they  formed  the  foundation. 

John  Mayow  (1645-167!))  explained  the  process  of  respiration  as  follows: 
"Respiration  consists  in  the  separation  from  the  air  by  the  lungs,  and  the  inter- 
mixture with  the  blood-mass,  of  certain  particles  absolutely  necessary  to  animal  life, 
and  the  loss  by  the  inspired  air  of  some  of  its  elasticity.  The  particles  of  tin  air 
absorbed  during  respiration  are  designed  to  convert  the  black  or  venous  bloodinto 
the  red  or  arterial."  (See  Daremberg,  torn.  II,  p.  704).  Mayow  also  declared  the 
placenta  to  be  the  lungs  of  the  foetus,  and  knew  that  the  3rd  nerve  contracted  the  pupil. 

The  knowledge  of  the  world  of  the  infinitesimal,  microscopic  anatomy,  is  a 
creation  of  the  17th  century.  It  was  founded  by  the  self-taught  Leeuwenhoeck 
inf  isoria,  torula  cerevisiae  and,  according  to  Cohn,  the  first  bacteria  —  leptothrix  in  the 
buccal  mucus  —  in  1683),  Malpighi  (blood-corpuscles,  capillaries  rete  Malpighii  etc.), 
Hammen  (spermatozoa),  Robert  Hooke  (the  cells  of  plants.  1667),  Ruysch,  Cowper, 
Havers,  etc.,  and  at  once  took  on  a  vigorous  growth.  In  the  18th  century,  however, 
it  declined,  until  once  more  revived  and  extended  in  our  own  age. 

Pathological  anatomy  enjoyed  a  rich  increase  of  material,  as  well  from  accidental 
discoveries  in  the  dissections,  now  so  frequent,  as  from  intentional  investigations  of 
the  anatomical  changes  occasioned  by  disease.  Even  Harvey  declared  that  the 
dissection  of  a  single  phthisical  patient  was  of  more  advantage  to  medicine  than  that 
of  ten  executed  criminals. 

Besides  the  publication  of  observations  confirmed  by  the  autopsy,  to  which  we 
have  already  referred,  other  similar  reports  were  made  by  many  other  physicians,  as 
e.  g.  by  Job.  Rudolph  Salzmann.  professor  in  Strassburg,  Job.  Dan.  Horst,  Xic. 
Pechlin  (1646-1714),  Timaus  von  Giildenklee,  ordinary  physician  to  the  Great  Elector, 
Peyer,  Harder,  Felix  Platter,  Thorn.  Bartholin,  J.  Nic.  Binninjrer  (born  1628),  Job. 
Daniel  Hofmann  in  Altdorf,  Phil.  Salmuth  (died  1626),  ordinary  physician  of  the 
Prince  of  Anhalt-Kothen,  Xic.  Tulpius  (1593-1674;  he  first  observed  pulsation  of  the 

D)  in  Amsterdam,  whom  Rembrandt  van  Ryn  |  1606-1669)  immortalized,  together 
with  the  members  of  the  guild  of  surgeons  of  which  Tulpius  was  president,  in  his 
famous  ''Anatomy'';  Ruysch,  Peter  Paaw  (1564-1617),  Stalpaart  van  der  Wyl, 
Franc.  Bertoletti  (1588-1630),  Severino,  Spieghel,  Bellini  and  many  others. 

Besides  the  compendium  of  pathological  anatomy  by  Welsch,  who  has  been 
already  mentioned,  and  who  must  be  regarded  as  the  founder  of  that  science,  other 
larger  compilations  upon  this  subject  were  written.  One,  particularly  well  known, 
was  the  work  of  Theoph.  Bonet  L620  L689 ;  "  Sepulchretum  anatomicum,  sen  anatome 
practica  ex  cadaveribus  morbo  denatis '  etc.,  Geneva,  1679)  of  Geneva,  ordinary 
physician  of  the  Prince  of  Neufchatel.  Another,  more  extensive,  but  less  important, 
.had  for  its  author  Juan  Pablo  (born  1620),  who  also  published  a  work  on  the  instruc- 


—  541  — 

tion  of  deaf-mutes.     Other  works   on  pathological   anatomy  were   written   by   Just. 
Schrader  (1674)  and  Stephen  Blankaart  (1688). 

4.    STATE-MEDICINE.    PSYCHIATRY.    HISTOEY  OF  MEDICINE. 

State-medicine  in  the  seventeenth  century  already  enjcyed  much 
attention  on  the  part  of  the  physicians  of  almost  all  the  civilized  states 
of  the  period.  It  was  cultivated  partly  in  special  works  devoted  to  this 
subject,  partly  incidentally  in  other  studies.  It  too  derived  advantage 
from  the  lively  interest  in  anatomy  which  at  that  time  everywhere  pre- 
vailed ;  indeed  judicial  autopsies  came  into  vogue.  Paolo  Zacchias1  (1584- 
1659),  ordinary  physician  to  the  Pope,  wrote  an  independent  work,  famous 
for  its  medical  information  and  especially  for  the  legal  knowledge  recorded 
therein,  though  of  course  not  free  from  the  superstitious  views  regarding 
magic  etc.,  which  were  at  this  time  so  widely  diffused.  It  gives,  however, 
some  opinions  concerning  wounds  of  the  eyes.  Zacchias  may  be  looked 
upon  as  the  founder  of  legal  medicine. 

In  France  N.  Blegnj*  (1684),  Gendrie  d'Angers  (1650)  and  others 
devoted  attention  to  subjects  connected  with  state-medicine.  Still  the 
ph}"sicians  of  this  country  did  not  in  general  busy  themselves  much  with 
this  department.  In  1679,  however,  in  consequence  of  the  large  number 
of  suits  at  law  relating  to  poisoning  and  infanticide  in  the  highest 
classes,  all  such  suits  were  quashed,  (Poudre  de  succession  de  la  Vigou- 
roux  and  the  burning  of  2500  children  by  la  Voisin).2 

This  department,  however,  received  its  most  active  cultivation  at  the 
hands  of  the  Germans.  Ludwig  von  Hoernigk  (1600-1667),  who  may  be 
looked  upon  as  the  type  of  a  savant  of  the  17th  centuiy,3  wrote  in  1638  a 
work  on  the  duties  of  the  medical  profession  as  a  whole.    The  famous  Paul 


Haeser  calls  him  Zacchia.  His  "  Qujestiones  medico-legales  "  etc.  appeared  at 
Rome  in  1621.  The  "  De  relationibus  medicorum  "  etc.  of  Fortunatus  Fidelis,  a 
professor  in  Palermo,  appeared  in  1602.     (II.) 

In  3637  the  Royal  College,  of  Physicians  of  London  presented  to  the  Council  a 
"  Report  on  all  such  annoyances  as  they  conceive  likely  to  increase  the  sickness 
in  this  populous  city".  —  1.  The  increase  of  buildings,  by  which  multitudes  are 
drawn  hither  to  inhabit.  2.  Inmates  by  whom  houses  are  so  pestered  that  they 
become  unwholesome.  3.  Neglect  of  cleansing  the  common  sewers  and  town 
ditches,  and  permitting  standing  ponds  in  inns.  4.  The  uncleanness  of  the 
streets.  5.  Laystalls  so  near  the  city,  especially  on  the  north  side.  6.  Slaughter- 
houses. 7.  Burying  of  infected  persons  in  churches  and  churchyards  in  the  city. 
Overlaying  the  churches  with  burials,  so  that  many  times  they  take  up  bodies  to 
make  way  for  more  burials.  8.  Carrying  up  funnels  to  the  tops  of  the  houses 
from  privies  and  vaults.  !>.  Selling  musty  corn,  and  baking  bread  thereof,  and 
brewers  using  unsound  malt.  10.  Butchers  selling  unsound  cattle.  11.  Tainted 
fish.  They  suggest  the  formation  of  a  Commission  or  Office  of  Health,  which  has 
been  found  useful  in  Spain,  Italy  and  elsewhere  (Richards).  I  find  no  evidence 
that  this  report  was  ever  acted  upon  by  the  Council.     ( H.) 

Hoernigk  was  the  descendant  of  a  family  of  Darmstadt,  but  was  born  in  Frankfort- 
on-the-Main  and  died  in  Mayence.  He  was  a  Doctor  of  law,  medicine  and 
philosophy. 


—  542  — 

Am  man  n  (1G34-1691),  professor  in  Leipzig,  and  Hieronymus  Welsch  pub- 
lished works  on  the  mortality  of  wounds  ;  Melchior  Sebiz  (1641)  wrote  on 
the  same  subject  and  on  the  signs  of  virginity.  Job.  Friedr.  Zittmann, 
who  was  devoted  to  the  belief  in  demons  and  witches  ;  Bernhard  Suevus 
and  Job.  Bohn,  the  scientific  founder  of  state-medicine  in  Germany,  wrote 
also  on  these  subjects.  The  latter,  like  Conr.  Berth.  Behrens  (1C60-1736), 
ordinary  physician  to  the  court  of  Brunswick,  also  wrote  on  the  duties  of 
the  forensic  physician  (Gerichtsarzt).  The  same  subject  engaged  the 
attention  of  J.  N.  Pfeizer  (Nuremberg,  1668).  The  Hollander  Feltmann 
expatiated  on  the  examination  of  corpses,  and  John  Brown  (born  1642)  on 
the  mortalit}'  of  wounds. 

A  new  fact  discovered  by  Swammerdam  in  1667— the  floating  of  the 
lungs  after  respiration  has  once  taken  place — was  at  once  recommended  to 
medico-legal  application  by  Malachias  Thruston  and  especially  b}'  Carl 
Kayger.  The  conditions  limiting  the  extent  of  its  application  were  next 
supplied  by  Ph.  Jac.  Hartmann  ;  but  the  discovery  was  first  practically 
recognized  in  16S1  by  Job.  Schreyer,  a  physician  of  Zeitz.  A  peasant 
maid  of  about  fifteen  3-ears  of  age  was  accused  of  infanticide.  The  lungs 
of  the  infant,  however,  sunk,  and  Schreyer  and  Thomasius  thus  effected  her 
acquittal. 

The  pathway  of  medical  statistics  was  also  opened  at  this  period  bv 
the  Englishman  John  Graunt1  in  1662,  [and  Charles  Clermont  (Claramon- 
tius),  a  physician  of  Wales,  with  his  work  "  De  aere.  locis  et  aquis  terrse 
Angliffi"  etc.  (London,  1672),  furnished  the  earliest  medical  topography  of 
England.     H.] 

Numerous  ordinances  of  medical-police,  i.  e.  hygienic  ordinances, 
appeared  in  the  17th  century,  which  may  be  called  the  natal  era  of  state- 
police.  These  included  plague-ordinances,  ordinances  relative  to  clothing 
and  food,  the  inspection  of  provisions  etc.  etc. 

Psychiatry,  as  such,  was  not  yet  treated  in  its  entirety  or  separately, 
though  occasionally  a  few  facts  relating  to  this  subject  received  attention. 
In  this  connexion  Sydenham,  Highmore,  Baglivi,  Helmont  and  above  all 
Willis  (we  owe  to  him  our  first  information  of  dementia  paralytica)  must 
be  mentioned.  The  latter  referred  mental  disorders  to  disease  of  the 
brain. 

On  the  other  hand,  subjects  I'elating  to  the  history  of  ancient  medicine 
were  frequently  handled,  e.  g.  by  Ph.  J.  Hartmann  (anatomy  of  the 
Ancients)  Mich.  Doring,  Helmont,  Gottfr.  Mobius  (1611-1664),  Job.  Neander 
(born  1596).  The  following  physicians  belong  for  the  most  part  to  the 
seventeenth  century:    Bernhard  Albinus  (1653-1721),  an  historical  inves- 

1.  "Natural  and  political  observations  upon  the  bills  of  mortality  ",  London,  1662. 
Graunt  shows  that  in  London  one-third  of  the  infants  perish  before  attaining  the 
age  of  three  years;  the  mortality  among  puerperal  women  was  one  in  two 
hundred;  the  mortality  in  the  city  was  about  8  percent,  greater  than  in  the 
country  ;  twice  as  many  women  suffered  from  sickness  as  men  etc.     (II.) 


—  543  — 

tigator,  father  of  the  famous  anatomist  ;  Salomon  Cellarius  (1676-1700), 
author  of  the  "  Origines  et  antiquitates  medicinse";  Joh.  Conrad  Barchusen 
(1666-1723),  "Historia  medicinse"  etc.  Daniel  Le  Clerc  (Clericus  ;  1652- 
1728),  who  wrote  in  1696  an  important  and  comprehensive  work  on  the 
histoiy  of  medicine,  based  upon  a  stud)-  of  the  original  authorities,  extend- 
ing from  the  creation  down  to  Galen,1  and  distinguished  b}'  its  erudition, 
simplicity  and  completeness.  [Baldwin  Harney  (1600-1676),  an  eminent 
member  and  benefactor  of  the  College  of  Physicians  of  London,  left 
some  manuscript  memoirs  of  the  famous  physicians  of  his  day,  with  a 
treatise  "On  the  oath  of  Hippocrates",  published  posthumously  by  Littleton 
in  16SS.     H.] 

5.    VETERINARY  MEDICINE.    PHARMACOLOGY  AND  PHARMACY. 

Although  a  few  regular  physicians,  like  Ramazzini,  occupied  them- 
selves with  the  comparative  study  of  the  diseases  of  animals  —  e.  g.  with 
the  epidemic  cattle-plague  (Rinderpest)  —  yet  the  cultivation  of  veter- 
inary  medicine,  on  the  whole,  still  remained  in  the  hands  of  persons  of 
little  education.  Yet  this  science  too  made  some  advance  in  the  seven- 
teenth century,  particularly  as  regards  a  more  general  diffusion. 

In  the  first  place  there  appeared  in  1607  a  French  translation  of  the 
treatise  of  Ruini,  under  the  direction  of  his  nephew  Horatio  Francini. 
This  Avas  followed  bj*  Beaugrand  (Marechal  expert.  The  experienced 
farrier,  1619)  and  "La  connaisance  des  chevaux''  (1646)  by  de  Bouvray, 
together  with  a  work  by  de  la  Bussiniere  (1660),  who  made  use  of  numer- 
ous chemical  remedies,  including  the  lapis  divinus.  Jacques  de  Solleysel 
(1664),  who  for  a  long  time  was  regarded  as  an  international  authority  in 
the  department  of  veterinary  medicine,  is  distinguished  by  his  stud}'  of  the 
Ancients  and  his  relative  independence  in  observation,  as  well  as  by  his 
superstition,  polypharmacy  and  lack  of  anatomical  knowledge.  —  A  work 
entitled  "The  x\natomy  of  an  Horse"  ■ —  other  branches  of  animal  anatorm- 
made  ver\-  little  advance  in  this  century  —  was  written  by  Andrew  Snape 
of  London  in  1686.  The  first  German  work  on  veterinary  medicine,  which 
the  author  followed  with  several  others  containing  pictures  of  monsters, 
coitus  etc.,  was  published  by  Gr.  S.  Winter  von  Adlersfliigel  in  1668.  and 
bore  the  title  of  "Bellerophon". 

On  the  other  hand,  important  contributions  to  pharmacology  were 
made  in  the  seventeenth  century,  both  in  chemical  remedies  and  prepara- 
tions2 and  in  those  derived  from  the  vegetable  kingdom.  To  enumerate 
the  former,  however,  would  be  to  write  the  history  of  chemistry,  and  we 
therefore  content  ourselves  with  mentioning  only  a  few  of  them.  Many 
new  alkalis  and  acids  especially  were   introduced    by   the  Iatro-chemists, 

1.  lie  also  discusses  medical  histoiy  cursorily  down  to  Theophrastus  von  Hohenheim, 

whom,  however,  he  criticises  entirely  erroneously. 

2.  As  these  were  antigalenical,  the  Faculty  almost  everywhere  opposed  them  and 

demanded  their  abjuration  in  the  doctor's  oath. 


—  544  — 

and  for  a  long  time  lime-water  was  employed  as  a  remedy  (and  even  a 
secret  nostrum)  for  calculus,  a  disease  which  seems  still  to  have  been 
very  common.  Tartar  emetic  was  recommended  by  Mynsicht,  the  sel  de 
Seignette,  by  the  apothecary  Seignette  of  Rochelle  in  1672,  and  the  oxide 
of  zinc  and  Glauber's  salt  were  popularized  by  Glauber.  The  internal  use 
of  mercuiy,  arsenic  and  many  other  metallic  remedies  was  considerably 
extended. — In  opposition  to  the  earlier  and  generally  dangerous  mineral 
emetics,  ipecacuanha1  (Ruhrwurzel),  introduced  by  the  physician  le  Gras 
in  1672,  speedily  attained  great  reputation,  though  originally  employed 
solely  as  a  remedy  for  dysentery.  In  the  form  of  a  nostrum  it  was  even 
sold  to  the  French  government  by  Job.  Friedrich  Helvetius  in  1GSG  for  the 
sum  of  1000  louis  d'  or.  The  use  of  arnica,  an  herb  already  known,  was 
extended  by  Job.  Mich.  Fehr  (1610-1688)  of  Schweinfurt.  as  well  as  that 
of  opium,  digitalis  and  lichen  Islandicus  (Ole  Borch).  Finally  Wepfer,  in 
conjunction  with  Brunner  and  Harder,  instituted  experimental  studies 
regarding  the  action  of  drugs  upon  animals.  The  latter  were  vivisected 
and  dissected  in  order  to  determine  the  phenomena  and  effects  of  the  drugs 
during  life  and  after  death.  —  The  whole  medical  world,  however,  was 
divided  at  that  time,  and  even  down  into  the  eighteenth  century,  into  two 
sharply  opposed  parties  by  the  Cinchona  bark,  which  was  introduced  into 
Europe  in  1640  by  Juan  del  Vego,  ordinary  physician  to  the  Count  of 
Cinchon,  and  christened  uCinchona  or  Countess's  bark",  in  honor  of  the 
wife  of  the  Count,  who  had  been  cured  by  it.  The  motives  influencing  the 
struggle  of  its  opponents  were  borrowed  in  part  from  the  doctrine  of  qual- 
ities of  the  Ancients,  partly  from  hatred  of  the  Jesuits  (who  took  special 
pains  to  extend  the  use  of  the  bark,  simply  because  there  was  money  in 
the  business)  and  partly  from  avarice,  because  it  cured  so  speedily  as  to 
render  the  existence  of  physicians  precarious.  On  the  side  of  its  sup- 
porters2 the  verdict  of  simple  experience,  doubtless  often  too  much  influ- 
enced by  enthusiasm,  was  chiefly  relied  upon.  Sydenham  deserves  the 
greatest  credit  for  the  introduction  of  the  bark  into  England,  while  Robert 
Tabor3  sold  it  in  France  only  as  a  nostrum.     In  Germany  Peyer  and  Mich. 

1.  It  was  first  described  by  Guillaume  Le  Fois  in  his  "De  medicina  Brasiliensi ", 

1648.     (H.) 

2.  The  earliest  medical  work  to  recommend  the  use  of  the  cinchona  bark  was  the 

"Vera  praxis  ad  curationem  tertianne"  etc.  of  Fietro  Barba,  a  professor  in 
Valladolid,  which  appeared  at  Seville  in  1643.  Shortly  after  its  first  introduction 
into  Europe  the  "pulvis  comitisste  "  was  sold  literally  for  its  weight  in  gold. 
Sturmius  in  1658  says  that  he  saw  twenty  doses  of  the  powder  sold  at  Brussels 
for  sixty  florins,  and  as  late  as  1680  a  pound  of  the  bark  cost  in  London 
£8.     (H.') 

3.  Tabor  was  an  apothecary  of  Cambridge,  who  prepared  a  secret  preparation  of  the 

bark,  said  to  consist  of  cinchona,  lemon  juice  or  Rhine  wine  and  a  little  opium. 
He  settled  in  London  in  1671  and  published  in  1672  his  "  Pyretologia,  or  a  rational 
account  of  the  cause  and  cure  of  agues,  with  their  signs".  He  went  to  Paris  in 
1679,  and  was  so  successful  in  curing  the  Dauphin  and  many  other  patients  that 
the  government  purchased  his  secret  for  the  sum  of  2000  louisd'or.     (H.) 


—  545  — 

Bernhard  Valentini  (1657-1729)  of  Giessen,  professor  in  the  university  of 
that  city,  are  said  to  have  been  the  first  to  employ  it. 

We  must  not  omit  to  mention  that  in  the  seventeenth  century  several  historically 
important  articles  of  luxury  and  food  were  introduced.  Tobacco,1  already  known  in 
the  preceding  century  (1560),  gained  a  more  general  diffusion;  potatoes,  tea,  coffee5 
and  chocolate  were  also  introduced,  and  immediately  used  with  avidity  and  genuine 
enthusiasm.  Yet  some  ascribe  to  the  consumption  of  the  latter  delicacies  the  pecul- 
iarly nervous  constitution  of  our  modern  times  and  the  nervous  character  of  our 
diseases,3  and  to  the  potato,  the  wider  diffusion  of  scrofula.  In  fact  Moleschott  ascribes 
to  the  latter  the  stupidity  of  certain  peoples.  It  seems  more  probable,  however,  that 
our  "nervousness"  is  to  be  charged  rather  to  the  account  of  too  fast  living  and  too 
hasty  a  pursuit  of  gain  and  pleasure. 

Quite  as  important,  however,  as  the  introduction  of  new  remedies  was  the  origin 
of  an  effort  to  remove  from  the  pharmacies  the  old  rubbish  (for  armor  it  cannot  be 
called),  which  Daniel  Ludwig  strove  to  discard.  In  this  category  we  may  include 
the  obsolete  Water  of  Chastity,  Frog-spawn-water,  Female  Cordial,  Three-headed  Cer- 
berus, menstrual  blood,  mole's  blood,  Oil  of  Spiders,  snake's  tongue,  mouse-dung, 
Spirits  of  Human  Brain,  urine  of  a  new-born  child  etc.,  etc.* 

1.  Adolph  Occo  (1524-1604),  city-physician  of  Augsburg,  and  author  of  a  pharmaco- 

poeia, received  the  first  tobacco  leaves  from  France  in  1565,  and  their  identity  was 
established  by  Gesner.  The  17th  century,  the  age  par  excellence  of  restrictive 
legislation,  interdicted  at  once  the  "stinking  tobacco-drinking",  as  smoking  Was 
then  called.  In  1624  the  pope  threatened  snuff-takers  with  the  ban,  while  the 
Turks,  on  the  other  hand,  simply  threatened  to  stick  the  pipes  of  smokers  into 
their  noses,  though  in  1633  the  penalty  was  increased  to  death.  The  emperor  of 
Russia  surpassed  even  the  Turks,  for  he  had  the  noses  of  "  tobacco-drinkers  and 
tobacco-swillers"  slit  up,  punished  them  with  the  knout  and  banished  them  to 
Siberia.  Fines  were  often  imposed,  as  e.  g.  in  Winipfen,  where  the  penalty  for 
smoking  was  one  fiorin. 

2.  The  first  coffee  house  was  established   in  Constantinople  in  1554.      They   were 

introduced  into  Italy  in  1645,  London  1652,  Marseilles  1671,  Vienna  1683,  Hamburg 
1686  and  Stuttgart  1712.     Originally  one  pound  of  coffee  cost  112 marks  =$28. 

The  coffee-houses  in  England  became  such  resorts  for  political  meetings  and 
gossip  that  they  were  temporarily  closed  by  Charles  II.  in  1675.     (H.) 

3.  Others,  e.  g.   Henne-am-Rhyn,  date  from  the  general  use  of  these  articles  the 

abandonment  of  the  mediaeval  custom  of  eating  and  drinking  in  large  quantity, 
and  the  substitution  of  fastidiousness  in  eating  and  drinking,  which  began  in 
the  lsth  century. 

4.  What  was  old  even  in  the  seventeenth  century  (in  spite  of  the  fact  that  part  of  it 

has  been  in  later  times  again  brought  forward  as  new),  and  what  unprejudiced 
heads  there  were  even  then  in  Germany,  may  be  judged  from  the  following  views 
of  Ludwig  :  "A  universal  remedy  does  not  exist :  specifics  are  never  trustworthy. 
Cinnamon  is  effective  in  menstrual  haemorrhages.  No  one  should  without 
necessity  remain  in  the  dwellings  of  patients  suffering  from  dysentery,  especially 
in  the  place  where  the  discharges  are  placed.  The  latter  should  be  taken  to 
remote  places  and  covered  with  lime  or  ashes.  The  beds,  linen  and  clothing  used 
by  such  patients  should  all  be  carefully  washed.  Before  the  dwellings  in  which 
such  patients  have  been  living  are  again  occupied,  we  should  not  neglect  to 
fumigate  and  clean  them  thoroughly. —  He  only  is  the  judicious  physician  who 
aids  Nature,  the  Healer  of  diseases,  when  she  shows  herself  too  feeble,  but  does 
not  disturb  or  hinder  her  in  her  efforts  by  a  daily  mass  of  drugs.  The  physician 
should  not  only  cure  safely,  speedily  and  pleasantly,  but  also  with  few  and  cheap 
drugs."  This  last  humane  demand  is  too  little  respected  even  at  the  present  day. 
35 


—  546  — 

The  use  of  mineral  waters  and  baths  began  in  the  17th  century  to  be 
studied  in  accordance  with  the  chemical  system.  The  alkalinity  or  acidity 
of  the  mineral  waters  was  mentioned,  and  they  were  accordingly  prescribed 
in  the  treatment  of  suitable  cases.  In  comparison  with  the  fantastic 
theories  and  the  deception  of  the  16th  century  (much  of  which  continues 
to  exist  in  this  department  even  at  the  present  da}r),  the  indications  for 
the  use  of  mineral  waters  thus  acquired  increased  definiteness  —  which 
they  needed  —  although  at  first  they  made  no  great  gain  in  rationalit}- . 
The  prescription  of  physicians  regarding  their  employment  was  rarely 
asked.  The  arrangements  for  bathing  too  were  very  primitive,  even  as 
regards  the  shelter  of  the  guests,  who  not  infrequently  lived  in  tents.  The 
easy  accessibility-  of  the  latter  favored  immoral  practices  between  the 
sexes,  particularly  as  man}-  trips  to  the  baths  were  undertaken  at  this 
period  for  purposes  of  immoralit}-.  Gambling  too  was  extremely  popular, 
e.  g.  in  Schwalbach,  and  even  in  that  da}'  cases  were  not  wanting  where 
guests,  ruined  b}-  their  losses  at  pla}-,  committed  suicide. 

[Tn  England  too  the  study  of  the  various  domestic  mineral  waters 
received  much  attention.  As  early  as  1572  John  Jones,  a  Welsh  physician, 
wrote  a  treatise  on  "The  benefit  of  the  ancient  bathes  of  Buckstone" 
(Buxton).  He  was  followed  by  Edmund  Deane  (1626,  Knaresborough), 
Edward  Jorden  (1631),  Thomas  Gruidott  (De  thermis  Brittanicis,  1681), 
Martin  Lister  (De  fontibus  medicatis  Angliae,  1682).  Sir  Patrick  Dun  (On 
the  analysis  of  mineral  waters,  1683),  Bobert  Wittie  (died  1684,  Scar- 
borough), Samuel  Durham  (Umington,  1685),  John  Maplet  (Bath,  1694), 
Charles  Leigh  (Exercitationes  quinque  de  aquis  mineralibus,  1697),  author 
also  of  a  history  of  Virginia  (1705),  Sir  John  Elo}-er  (An  inquiry  into  the 
right  use  of  the  hot,  cold  and  temperate  baths  in  England,  1697),  Nehemiah 
Grew  (Epsom,  1698)  and  others.     (H.)] 

Pharmacy  of  course  must  have  profited  by  the  introduction  of  im- 
portant drugs,  and  still  more  by  the  equally  wide-spread  and  scientific 
study  of  chemistiy.  Hepce  a  number  of  the  most  absurd  and  polypharm- 
acal  compounds  and  plasters  disappeared,  at  least  among  the  better  class 
of  physicians,  and  simpler  forms  of  medicines  (so  far  as  one  can  speak 
of  simplicity  in  prescriptions  which  were  still  very  complex)  were  intro- 
duced in  their  place.  In  proportion  to  the  general  interest  in  the  chemical 
preparation  of  medicines  was  the  number  of  new.  or  newly  revised,  pharm- 
acopoeias. The  authors  of  these  were  chiefly  physicians  and  chemists,  or 
simple  apothecaries.  Thus,  besides  numerous  city  pharmacopoeias,  there 
also  appeared  others  by  Andr.  Libavius  (1006),  Jean  de  Eenou  (1615), 
Minderer  (1621)    "  Medicina  Militaris",  Mynsicht  (1631),  Poterie  (1622), 


Often  the  large  bills  of  the  apothecary  occasion  for  the  patients  the  want  of 
articles  most  necessary  for  their  comfort,  a  want  which  the  physician  might  have 
obviated  and  which  not  infrequently  injures  most  the  poor  children,  who  are 
thus  deprived  of  those  comforts  which  the  expensive  apothecary  has  con- 
sumed.     Sec   .Marx. 


_  547  — 

the  first  London  Pharmacopoeia  (1618) 1,  first  of  Paris  (1639).  Other 
pharmacopoeias  were  published  by  Dan.  Ludwig2  (1625-1680,  Ludovicus 
Ludovici)  of  Weimar,  ordinary  ph}<sician  to  the  duke  of  Gotha,  the  "im- 
mortal reformer  of  the  Materia  Medica",  of  whom  Stahl  said  "that  he  was 
the  first  who  ventured  to  speak  boldly  concerning  the  Materia  Medica, 
and  who  sought  in  an  incomparable  way  to  purify  the  Augean  stable"; 
Johann  Zwelfer  (1652,  "Augsburg  Pharmacopoeia");  J.  Schroder  (1600- 
166-4),  a  plvysician  of  Frankfort-on-the-Main,  whose  pharmacopoeia  (1641) 
continued  popular  for  more  than  a  century  ;  a  Universal  Pharmacopoeia  by 
Job.  Helfrich  Jiingken  (1677);  Nic.  L^mery  (1697):  Christian  Franz 
Paulini  (1643-1712)  of  Eisenach,  a  peripatetic  physician,  poet  and  histo- 
rian, best  known  by  his  "heilsame  Dreckapotheke,  wie  nemlich  mit  Koth 
und  TJrin  fast  alle,  ja  auch  die  schwerste  giftigste  Krankheiten  und  bezau- 
berten  Schiiden,  vom  Haupte  bis  zu'n  Fiissen,  innerlich  und  ausserlich 
gliicklich  curirt  werden  "  etc. 

In  this  work,  which  is  of  considerable  importance  for  our  knowledge  of  popular 
medicine  and  superstition,  it  is  stated  that  the  quintessence  of  all  the  food  is  con- 
tained in  the  faeces,  hence  their  efficacy.  The  dung  of  screech-owls  was  recommended 
against  melancholy  ;  likewise  the  dung  of  doves  and  calves  boiled  in  wine,  ox-dung  etc. 
For  gout,  dog-dung  and  fleas  boiled  with  sage  were  prescribed,  while  the  death-sweat 
was  recommended  for  warts.  Poor  humanity,  what  hast  thou  not  taken  and  had 
Tecommended  as  remedies  for  death  and  disease  !  Scourging  too  (see  J.  H.  Meibom 
and  others)  and  prayer,  music  (Fried.  Erhardt  Niedten,  1717),  the  breath  of  young 
maidens  (J.  H.  Cohausen,  1753),  all  have  been  regarded  as  means  for  prolonging  life  ! 

That  the  number  of  pharmacies,  however,  must  have  been  greatly  on 
the  increase  in  the  seventeenth  century,  so  that  no  city  of  any  note  was 
without  at  least  one,  would  follow  from  the  number  of  published  pharma- 
copoeias, even  if  the  fact  were  not  established  by  other  evidence. 

6.    EPIDEMIC  DISEASES, 

The  seventeenth  century  yields  to  no  period  of  the  Middle  Ages  in  the 
extent  , number,  mortality,  diversity  and  malignity  of  its  epidemics.  By 
these,  and  the  incessant  wars  closely  connected  therewith,  there  was  occa- 
sioned a  loss  of  human  life,  onh'  equalled  in  individual  countries  in  the 
following  century,  indeed  not  completely  rivalled  until  our  own. 

1.  The  pharmacopoeia  of  Brice  Bauderon  (1588)  of  Macon  was  translated  from  the 
French  into  Latin  by  Philemon  Holland,  and  published  in  London  in  1639. 
William  Salmon  also  published  "  The  new  London  Dispensatory  "  in  1678  and 
Hie  "Seplasium,  or  complete  English  physician,  or  the  druggist's  shop  opened", 
London,  1693.  A  "  Pharmacopoea  Bateana''  was  also  published  in  16^8  by 
J.  Skipton,  an  apothecary  of  London,  who  compiled  it  from  the  prescriptions  of 
Dr.  AVilliain  Bate  (1608-1669),  ordinary  physician  of  Charles  1.,  Cromwell  and 
Charles  II.  To  the  second  edition  of  the  " Pharmacopoea  Bateana"  (1691,  was 
appended  the  "Arcana  Goddardiana"  of  Dr.  Jonathan  Goddard  (1617-1674).  Dr. 
Walter  Harris  also  published  a  "Pharmacopeea  anti-einpirica  "  etc.  in  1683.     (11  I 

•2.  He  was  the  first  "Gallisirer"  or  "  Wine-doctorer",  inasmuch  as  he  pointed  out 
"that  a  poor  must,  by  the  addition  of  sugar  before  fermentation,  affords  a 
strong  wine  ". 


—  548  — 

Above  all  other  epidemics,  the  plague,  although  in  this  century1  it  lost 
its  predominance  in  Europe,  was  in  many  places  still  destructive.  Thus  it 
raged  in  England,  especially  in  London,  1(303-1(508,  in  Ireland  in  1(550,  and 
again  for  the  last  time  in  London  in  1665,  in  the  form  of  a  terrible  epi- 
demic, which  swept  off  69,000  human  beings.  This  epidemic,  as  well  as  the 
great  fire  of  the  following  year,  was  ascribed  to  the  Jesuits,  and  four  of  them 
were  accordingly  executed.  (Griin.)  —  In  German}'  it  prevailed  in  Silesia  in 
1656,  and  in  a  large  part  of  the  same  province  in  the  following  year.  It 
then  iu  1666  revisited  the  countries  bordering  on  the  Rhine,  appeared  in 
Vienna  in  1679  (70,000  victims),  in  Prague  1681  (83,000  victims),  then  in 
Thuringia,  Saxon)',  and  Middle  Germany  in  general  in  1682,  ever  a  dismal 
destroyer  of  human  life.  In  Magdeburg  alone  there  died  in  six  months 
4500  people,  in  Halle,  nearly  half  its  population. —  Spain  between  1677  and 
1681  was  ravaged  for  the  last  time  severely;  France  was  visited  in  the 
years  1608,  1634  and  1668;  Italy  in  1630,2  1656,  1669,  1683  and  1691  ; 
Switzerland  in  1667  and  1668  ;  in  the  north,  Denmark  in  1654  and  Sweden  in 
1657  experienced  the  ravages  of  the  disease.  The  damp  Netherlands  were 
often  ravaged  by  the  plague,  as  in  1625.  1631,  1667,  1669,  and  for  the  last 
times  in  1677  and  1680. 

The  regulations  adopted  by  the  state  and  by  communities  against  the 
introduction  and  spread  of  the  plague  were  not  rarely  as  comprehensive 
and  judicious,  as  the)*  were  (many  of  them  at  least)  expressions  of 
Draconian  authority.  On  the  outbreak  of  the  disease  in  remote  places 
these  regulations  were  at  once  put  in  force  as  a  measure  of  precaution. 
Thus  e.  g.  in  Magdeburg  in  the  year  16S0  a  physician,  surgeon,  minister, 
nurses,  24  inspectors  of  the  streets,  24  corpse-bearers  and  12  grave-diggers 
for  the  plague  were  appointed  by  the  magistrates  in  anticipation  of  its 
appearance,  and  a  plague-hospital  was  erected.  The  house  in  which  the 
first  case  of  plague  appeared  was  burned  down  —  at  all  events  a  more 
effective  means  of  disinfection  than  most  of  ours  of  the  present  day  ! 

Outbreaks  of  typhus  fever  occurred  along  with,  and  between,  the  epi- 
demics of  the  plague,  especially  during  the  Thirty  Years'  War,  a  period 
which,  as  may  be  inferred  from  the  statements  already  made,  remained 
almost  free  from  the  genuine  plague.  Typhous  epidemics  swept  off  an 
enormous  number  of  human  beings,  particularly  among  the  peoples  ravaged 
by  the  wars  of  this  sad  period,  and  these  epidemics  often  extended  over 
entire  countries.  They  are  mentioned  under  the  various  designations  of 
"  spotted  fever,  war  fever,  camp  fever,  the  plague,  the  pestilence  of  Mans- 
feld,  purpura  "  etc. 

1.  From  the  time  of   Augustus  down  to  the  year  1680  the  plague  had   appeared  7i> 

times  as  a  general  epidemic. 

2.  In  Florence  12.000  died,  in  Mantua  25,000,  in  Bologna  30,000,  in  Milan  180,000.     In 

the  latter  city  occurred  the  notorious  trial  of  the  barber  Moid  and  the  health 
commissioner  Piazza,  who  were  said  to  have  rubbed  "Plague-salve"  upon  the 
house-walls,  and  who,  after  all  kinds  of  tortures,  had  their  hands  cut  off,  were 
broken  on  the  wheel  and  then  burned.     And  this  only  25(5  years  ago  ! 


—  549  — 

Essentially  related  to  the  preceding  disease,  there  also  occurred, 
between,  and  along  with,  the  epidemics  of  typhus,  other  epidemics  of 
typhoid  pneumonia,  which  did  not  appear  everywhere,  but  in  perfectly 
distinct  groups  of  cases  and  in  certain  countries  onh\  Such  epidemics 
appeared  in  Italy  in  the  years  1602  (in  Yerona.  Urbino  and  Gualda),  1633 
(throughout  upper  Italy)  and  1606  (in  Ferrara);  in  Switzerland,  another 
favorite  resort,  in  1652  (GTlarus),  1685  (on  lake  Geneva)  and  1604-95  in 
more  general  diffusion.  Twice  during  this  century  these  epidemics  showed 
themselves  in  Germany,  at  Augsburg  in  1621  and  in  1680  in  the  Breisgau. 
The  period  of  their  prevalence  was  during  the  months  of  Spring,  which 
(with  the  early  Winter)  still  continues  the  most  favorable  season  for  the 
appearance  of  the  ordinary  semi-annual,  miasmatic  pneumonias. 

Malarial  diseases  also  in  the  seventeenth  century  (as  well  as  in  the 
sixteenth,  e.  g.  1550-1563)  frequently  assumed  a  malignant  and  pandemic 
character.  This  was  the  case  especially  in  the  second  half  of  the  century, 
in  the  years  1657-1660  and  1677-1685,  which  latter  pandemic  just  preceded 
an  epidemic  of  the  plague.  These  malarial  diseases  raged  most  fiercely  in 
EnglandJ-  and  the  Netherlands,  though  not  always  accompanied  by  a  heavy 
mortality.  and  they  usually  stamped  with  an  intermittent  character  other 
concurrent  diseases.  Toward  the  close  of  the  century  they  again  appeared 
in  a  pandemic  form,  and  were  especially  severe  in  Italy  from  1600  to  1605. 
Lancisi.  like  Varro  long  before  him.  assumed  minute  animals  in  the  air  of 
marshes  to  be  the  cause  of  these  diseases  (Loeffler). 

During  the  Thirty  Years'  War  epidemics  of  dysentery,  of  greater  or 
less  extent,  prevailed  in  different  countries.  The  most  extensive  of  these 
appeared  in  1623-25  in  Germany,  the  Netherlands  and  France.  After  the 
close  of  the  war,  however,  they  raged  still  more  fiercely.  Thus  they 
appeared  in  Middle  Germany  in  1666.  and  again  here,  as  well  as  in  the 
northern  states,  from  1676  to  1670.  The  most  important  epidemic,  however, 
appeared  in  England  between  1668  and  1672,  and  was  well  observed  and 
described  by  the  famous  Sydenham  and  Morton,  who  on  this  occasion 
furnished  anew  the  old  evidence  that  even  two  famous  physicians  cannot 
readily  hold  the  same  views  relative  to  the  therapeutics  of  one  and  the 
same  disease — a  fact  which  has  alwa}-s  led  to  medical  disputes,  rather  than 
to  the  advancement  of  science  and  the  good  of  the  patient,  inasmuch  as 
patient,  business  and  the  honor  of  the  healing  art  are  often  forgotten  in 
these  petty  quarrels. 

Ergotism  again  appeared  within  circumscribed  limits,  as  in  the  Sologne 

1.  Both  king  James  1.  and  Oliver  Cromwell  died  of  the  ague.  "At  that  time  the  soil 
about  London  was  neither  drained  nor  cultivated  during  some  months  of  the 
year.  The  marshes  of  Cambridgeshire  and  Lincolnshire  were  covered  with 
clouds  of  cranes.  Southwark  was  a  swamp,  and  at  Westminister  there  is  a  gate 
eal.led  the  Marshgate,  from  being  situated  in  a  place  where  there  was  once  a 
marsh.  Ague  was  less  prevalent  after  the  Great  Fire.  .  .  .  According  to 
Sydenham,  from  1661  to  166.".  it  was  the  most  fatal  disease  in  England."  iK.  L. 
McDonnell.)    (H.i 


—  550  — 

in  France  1030,  1650,  16G0,  1064,  1670,  1694;  in  Westphalia,  A'oigtland 
and  Hesse  in  1648-9,  1672,  1675,  1687,  1693  also  in  the  Black  Forest,  and 
in  1699  in  the  Harz  ;  in  Switzerland  in  1650  and  1674,  both  times  in  the 
same  cantons  of  Berne,  Lucerne  and  Zurich. 

Epidemics  of  influenza  likewise  prevailed  in  Germany  in  1658  and 
1675,  in  Italy  1626-27,  in  Holland  1643  and  in  America  1647,  1655,  and 
still  more  generally  diffused  in  1675  and  1693. 

Epidemics  of  hooping-cough  were  described  b}'  Willis,  Sydenham 
(1570)  and  Ettmuller  (1685). 

Diphtheria  (Garotillo)  showed  itself  in  Spain  and  Italy  only1 ;  in  the 
former  country  from  1600  to  1618,  with  only  brief  interruptions,  then  in 
1630,  1650  and  1666.  In  Italy  it  appeared  for  the  first  time  in  1610,  then 
from  1618  to  1630  ;  in  1620  and  the  following  years  to  1630,  upon  the 
islands  also,  and  in  1650  again  on  the  mainland.  The  new  epidemic  was 
described  by  a  large  number  of  writers,  including  Franc.  Noia,  Giov.  Ant. 
Foglia.  Marc.  Aur.  Severino,  and  among  the  Spanish  physicians  Juan  de 
Villareal,  Franc.  Perez  Casales,  Chr.  Per.  de  Herrera,  Marc.  Ant.  Alaymo, 
Ildefonso  Nunnez,  as  well  as  by  Thomas  Bartholin  (the  Neapolitan 
epidemic,  1622)  and  others. 

The  scarlet  fever,  which  has  recently  occurred  with  ever  increasing 
frequency  in  combination  with  the  last  mentioned  disease,  and  which  has 
been  most  fatally  influenced  thereby  so  far  as  regards  its  mortality,  also 
appeared  at  about  the  same  period  in  Europe  for  the  first  time.  At  least 
at  this  period  it  was  first  distinctly  differentiated  from  the  other  acute 
skin-diseases  of  childhood.  It  was  first  described  by  Mich.  Doering,  who 
observed  sporadic  cases  of  the  disease  in  Warsaw  and  Breslau  in  1625, 
and  an  epidemic  in  1627.  and  by  his  father-in-law  Dan.  Sennert,  who 
observed  it  at  almost  the  same  time  (1619)  in  Wittenberg.  In  the  later 
years  of  the  seventeenth  century  it  appeared  with  considerable  frequency 
(in  1642  at  Brieg  in  Silesia,  1652  in  Schweinfurt,  in  England  for  the  first 
time  in  1661.  in  Thorn  in  1665),  though  always  in  small  and  circumscribed 
epidemics  only. 

The  purples  (miliary  fever),  rijtheln  and  measles  were  at  this  period 
frequently  confounded.  The  first  was  earliest  (1652)  mentioned  as  an 
affection  especially  of  lying-in  women  by  Joh.  Hoppe  (1616-1653),  pro- 
fessor in  Leipzig,  Welsch  (1655)  and  by  Joh.  Christian  Lange2  (1655- 
1701)  also  a  professor  in  Leipzig,  though  the  disease  speedily  won  a  foot- 

1.  According  to  Jacobi,  diphtheria  appeared  in  New  England  as  early  as  16o9,  in 

which  year  Samuel  Danforth,  of  Roxbury,  Mass.,  lost  four  children  in  a  fortnight 
by  the  "  malady  of  bladders  in  the  windpipe."  An  epidemic  also  prevailed  in 
Maine  about  1671.*    (H.) 

2.  Lange,  with  Athanasius  Kircher  and  others,  was  a  defender  of  the  origin  of 

animals  from  putrefaction  and  the  pathologia  animata  of  the  17th  century,  to 
which  the  discovery  of  the  animalcula  —  infusoria  —  gave  as  great  an  impulse  as 
that  of  the  new  microscopic  fungi  has  given  to  the  similar  tendency  of  our 
own  age. 


—  551  — 

hold  in  southern  Germany  also.  Welsch  and  Sigrn.  Rupr.  Sulzberger 
already  distinguished  between  a  red  and  a  white  purples  (Friesel). 
Rotheln,  as  a  milder  form  of  measles,  was  frequently  observed,  like 
measles  itself,  but  the  two  were  never  distinguished  from  each  other. 
The  latter  diseases  were  naturalized  everywhere  in  the  seventeenth  cent- 
ury, though  they  reached  remote  Iceland  for  the  first  time  in  1664,  and 
again  in  1694. 

The  small-pox,  in  like  manner,  often  appeared  epidemically.  It  be- 
came widely  diffused  in  1614,  and  prevailed  with  some  interruptions  in 
England  between  1666  and  1675.  It  raged  also  in  many  countries  and 
even  in  America  in  the  last  year  but  one  of  the  century. 

The  improved  observation  of  this  epoch  gave  greater  prominence  also 
to  another  infectious  disease,  puerperal  fever.  This  was,  indeed,  known  to 
the  ancients  and  the  Arabians,  and  intimations  of  it  were  given  by  Syden- 
ham, Sylvius  and  even  Trincavella  and  Mercado.  It  was,  however,  first 
separated  from  other  diseases  of  lying-in  women  by  Willis1  in  1682,  who 
described  it  as  a  special  disease  under  the  designation  which  it  still  re- 
tains. Syphilis  had  already  assumed  its  forms  of  the  present  day.  Aug. 
Hauptmann  in  1650  ascribed  its  origin  to  small  insects,  and  Lange  to 
microscopic  worms.  De  la  Martiniere  (about  1664)  is  credited  with  the 
earliest  knowledge  of  gonorrhoeal  rheumatism,  and  to  Christoforo  Guari- 
noni  (about  1610)  is  ascribed  the  earliest  description  of  cerebral  gummata 
(Proksch). 

Finally  the  scurvy  was  observed  several  times  in  besieged  cities,  e.  g. 
at  Breda  in  Holland  in  1625,  at  Nuremberg  in  1631,  in  Augsburg  in  1632r 
in  the  train  of  the  Thirty  Years'  War,  an  epoch  which,  as  we  have  already 
observed,  was  in  other  respects  rather  unproductive  in  an  epidemiological 
point  of  view. 

7.    CONDITION  OF  THE  MEDICAL  PROFESSION. 

When  we  consider  the  situation  of  the  medical  profession  in  the 
Middle  Ages,  we  find  it  characterized,  among  other  things,  by  the  dis- 
appearance for  a  long  period  of  all  official  positions  and  of  all  state 
authority.  After  the  thirteenth  century  this  was,  indeed,  gradually 
changed.  The  change,  however,  did  not  become  general  and  plainly  mani- 
fest until  the  seventeenth  century,  the  century  of  governmental  science,, 
i.  e.  of  absolutism  and  police  regulation.  At  this  period  most  of  the 
higher  physicians  assumed  either  fixed  offices  or  positions  guaranteed  by 
the  state,  and  in  the  great  majority  of  cases  were  settled  in  permanent 
residences,  which  was  not  the  case  with  the  mass  of  physicians  even  in  the 
sixteenth  century.  Through  the  influence  of  this  change  the  reputation 
of  the  entire  profession  began  to  improve,  an   evidence  that  judicious  pro- 

2.  Willis  divided  "'Febres  Puerpeiaium"   into  "Febris  lactea",  "Febris  putrida", 
and  "Febris  symptomatica".     (H.) 


—  552  — 

tection  by  the  state,  without  petty  guardianship,  is  adapted  to  elevate, 
while  unlimited  license  and  so-called  freedom  of  practice,  as  it  prevailed 
in  the  Middle  Ages,  can  onh-  injure  its  credit,  especially  as  unregulated 
competition  lends  support  to  those  natural  vices  of  the  profession  — 
jealous}-,  thirst  for  money  and  fame  and  the  lack  of  colleagueship. 

The  clerical  element  too.  after  this  century,  disappeared  almost  entirely 
from  the  ranks  of  the  public  physicians,  or  at  most  dabbled  actively  in 
certain  surgical  specialties  and  among  the  lower  classes,  as  it  does  indeed 
to-day.  After  the  Thirty  Years'  War  the  clerical  profession  lost  its 
supremacy,  and  its  place,  even  in  literary  matters,  was  taken  by  the  nobil- 
ity '  The  higher  elements  of  the  profession  were  becoming  also  more 
numerous,  while  the  lower  were  better  divided  and  organized,  although 
beside  them  both  we  still  find  a  superabundance  of  quacks  and  adven- 
turers. Moreover  complete  freedom  of  intercourse  prevailed  almost  every- 
where, not  only  between  different  states  of  the  same  language,  but  also  as 
regards  foreign  countries. 

A  special  characteristic  of  the  physicians  of  the  seventeenth  century, 
in  addition  to  their  unmistakable  and  general  zeal  for  science,  is  found  in 
their  frequent  and  intimate  occupation  with  chemistry,  mathematics  and 
natural  philosophy.  In  these  branches,  which  were  regarded  entirely  as 
children  (not  as  yet  entirely  emancipated,  nor  of  full  age)  of  their  mother 
Medicine,  and  by  no  means  as  the  mistresses  of  that  science  (the  popular 
idea  at  the  present  day),  physicians  formed  the  masters  and  instructors. 
Yet  the  seventeenth  century  was  also  the  special  age  of  medical  alchemists 
and  of  impecuniosity.  the  latter  a  curse  which  even  the  best  men  strove  to 
relieve  by  the  methods  of  alchemy  ! 

What  the  medical  profession  was,  and  how  numerous  and  mixed  it  still  was.  may 
be  judged  simply  from  the  following  catalogue  which  adorns  the  title  of  a  compendium 
of  state-medicine.  Thus  even  the  titles  of  books  of  this  period,  although  not  designed 
to  attract  attention  by  excessive  oddity  or  wit.  may  claim  some  value  in  the  history 
of  culture.  Such  a  title  becomes  the  shortest  possible  epitome  of  the  relations  and 
organization  of  the  medical  profession  in  the  seventeenth  century.  One  of  these 
works  enumerates  the  following  practitioners  of  medicine: 

1.     The  Medical  Profession  proper. 

a.  Medici  in  general,  commissioned  court,  field,  hospital  and  plague  medici ; 

b.  Surgeons,  barbers,  regimental  surgeons  i  Feldscheerer),  oculists,  herniotomists, 
lithotomists,  bath-keepers. 

c.  Superior  sworn  midwives,  ordinary  midwives.  inferior  midwives,  nun 

d.  Apothecaries,  druggists,  confectioners,  grocers. 

'1.     Sundry  Impostors  and  pretended  Physicians. 

Old  women,  village  priests,  hermits,  quacks,  uroscopists.  Pseudo-Paracelsists, 
pyrotechnists   ( Ofensc-hwarmer '.   Jews,    calf-doctors   i  emetic-peddlers),    executioners, 

1.  According  to  Paulsen,  the  academies  for  young  noblemen  (Eitteracademieen)  took 
their  ri>e  at  this  period,  and  at  the  close  of  the  century  began  the  custom  of 
conferring  titles  and  nobility  upon  savants,  a  fruitful  source  of  vanity  in  tha 
universities,  maintained  even  to  the  present  day. 


—  553  — 

crystallomancers,1  mountebanks,  vagrants,  magicians,  exorcists,  monsters,  wood-her- 
mits (Waldheintzen),  rat-catchers,  bankrupts,  jugglers,  gipsies  etc.  To  these  must  be 
added  Professors  and  veterinary  physicians. 

Instruction  in  the  medical  branches  in  the  seventeenth  century  as- 
sumed in  general  a  better  direction  and  form.  "While,  however,  until  the 
close  of  the  sixteenth  century  Italy  served  as  the  model  for  educational 
arrangements,  this  country  now  lost  its  supremacy  in  medicine,  —  the 
influence  of  Jesuitical  tutelage  here  banished  more  and  more  free  investiga- 
tion and  liberal  tendencies  —  and  was  compelled  to  yield  precedence  to  the 
Netherlands  and  to  France,  whose  universities  at  Levden,  Paris  and  Mont- 
pellier  became  now  the  goal  of  all  those  who  desired  to  acquire  the 
highest  education  of  the  day  in  this  department  of  science.  Most  of  the 
German  schools,  in  consequence  of  the  unfortunate  war,  stood  behind  the 
others.  It  was  strictly  enjoined  upon  the  professors  to  follow  closeh"  in 
their  teachings  the  doctrines  of  the  Ancients  and  the  Arabians.  Thus  the 
statutes  for  the  professors  at  HelmsUidt  e.  g.  ran  as  follows  :  "We  desire 
the  medical  art,  even  as  it  was  rightly  and  wholly  fixed  and  handed  down, 
under  the  guidance  and  direction  of  God,  by  the  inspired  artists  Hippoc- 
rates, Galen  and  Avicenna,  to  be  preserved  and  diffused  by  teaching.  We 
recommend  that  all  Empirics  and  the  "  Tetralogies"  of  Paracelsus,  with 
other  corruptions  of  medicine  not  agreeable  to  the  doctrines  of  Galen  and 
Avicenna.  be  banished  entirely  from  our  Academy."  (See  Marx.)  It  was 
not  until  1G55  that  the  abjuration  of  the  use  of  antimom-  and  mercury  was 
expunged  from  the  doctors'- oath  at  Heidelberg.  Theosophy,  as  well  as  the 
Aristotelian  or  scholastic  philosophy,  continued  in  full  bloom.  Moreover 
physicians  proper  (the  so-called  medici  puri)  and  surgeons  were,  of  course, 
still  carefully  separated  in  their  education.  Yet  the  despised  and  '-un- 
learned" surgeons,  almost  alone,  urged,  and  struggled  for.  the  association 
of  the  two  branches.  Not  a  few  of  them  too  studied  medicine  for  them- 
selves, although  no  physicians  devoted  themselves  in  earnest  to  surgery. 

With  the  exception  of  the  universities  of  the  Netherlands,  the  method 
of  instruction  was  everywhere  still  the  same.  The  teacher  gave  simple 
theoretical  lectures  and  dictated  appropriate  prescriptions.  The  basis 
of  these  lectures,  as  mentioned  above,  was  in  almost  all  colleges  the  writ- 
ings of  Galen  and  the  ancient  physicians  ;  indeed,  in  the  beginning  of  the 
century  the  Arabians  also  were  yet  in  common  use  —  as  e.  g.  with  Rolfink 
at  Jena.  The  ordinary  language  of  the  colleges  was  still  Latin  (in  spite 
of  the  patriotic  example  of  Theophrastus  von  Hohenheim,  who  could  en- 
dure as  little  as  Bismarck  the  foolish  pride0  of  the  Germans  in  displaying 
their  knowledge  of  foreign  languages),  and  a  veritable  storm  was  stirred  up 

1.  From  the  17th  century  down  earnest  efforts  have  been   made  to  get  rid  of  this 

rabble,  but  success  has  been  so  slow  that  they  have  lasted  down  to  the  present 
century.  Crystallomancers  were  a  class  of  people,  chiefly  Italians,  who  sought 
after  crystals,  particularly  in  Thuringia,  and  besides  this  dabbled  in  medicine, 
like  the  pyrotechnists,  cauterizers,  moxa-setters  and  alchemists. 

2.  "Bedientenstolz  ". 


—  554  — 

in   university  circles  at  the  close  of  the  century  (168S),  when  the  great 
Thomasius  ''ventured"  to  deliver  lectures  in  German. 

Although  here  and  there  certain  physicians,  e.  g.  Blaes,  had  private 
institutions  for  instruction,  still  the  universities  were  the  normal  schools 
for  physicians.  The  more  zealous,  and  especiall}-  the  more  wealthy 
students  usually  attended  several  of  them,  and  particularly  finished  their 
course  in  the  then  flourishing  universities  of  the  Netherlands  and  France, 
where  the  instruction,  especially  clinical  and  anatomical  instruction,  was 
better  than  elsewhere. — The  number  of  students  was  not  large,  particu- 
larly during  the  Thirty  Years'  War.  Ingolstadt  e.  g.  in  1629  had  only 
nine,  in  1633  only  three,  in  1647  two  and  even  one.  In  1648  it  had  again 
16,  and  later  20.  Between  1612  and  1631  the  total  number  of  students 
attending  the  university  of  Strassburg  was  13  ;  1632-1648  it  was  four,  and 
from  this  time  to  the  close  of  the  century,  six. 

Practical  colleges,  where  the  professors  permitted  the  students  to 
examine  patients,  examined  them  themselves,  made  the  diagnosis  in  the 
presence  of  the  students  and  prescribed  suitable  treatment,  were  introduced 
as  an  experiment  by  Willem  van  der  Straten  (1593-1681),  burgomaster  of 
Utrecht  in  the  year  1636  ;  in  the  same  }'ear,  by  Otto  Heurnius  (1577-1650) 
and  Ewald  Schrevelius  (1575-1647),  and  then  in  1648  by  Albert  Kyper 
(died  1655)  of  Konigsberg.  professor  in  Le}"den.  They  were  however 
abandoned  as  unsuitable  for  students.  "  The  students  preferred  simply  to 
have  the  diseases  explained  to  them  and  the  prescriptions  given,  rather 
than  to  be  examined  with  reference  to  their  own  knowledge.''  In  Prague 
too  Cassini  in  1690  and  a  Dr.  Tudetino  in  1699  permitted  the  students  to 
attend  the  evening  visitation  of  patients,  but  they  made  very  little  use  of 
this  permission.  The  most  influential  professor  there,  however,  Joh.  Fried. 
Loew  von  Ersfeld  (1618-1727),  lectured  only  upon  theoretical  medicine. 
(Hasner. )  Sylvius,  in  consequence  of  his  estimation  and  reputation,  first 
introduced  in  1658  the  complete  clinical  method  at  Leyden,  thus  acquiring 
historical  importance  for  himself  and  erecting  a  monument  to  his  nation. 
By  his  great  talent  as  a  teacher  he  obtained  such  success  that  students 
flocked  to  him  in  great  numbers  from  all  lands,  including  even  Italy.  It  is 
worthy  of  remark  that,  in  contrast  with  Italy,  where  in  the  preceding 
century  the  students  were  still  expected  to  take,  and  actually  did  take,  the 
initiative  in  the  arrangement  of  the  curriculum,  in  this  century  the  initia- 
tive proceeded  from  a  professor,  although  the  management  of  the  univer- 
sities was  in  other  respects  still  the  same  as  before.  Since  this  time  the 
controlling  influence  of  the  students  has  been  lost,  having  received  its 
weightiest  blow  from  the  Netherlands.  In  England  too  from  the  middle 
of  the  17th  century  (until  1868),  all  students  were  required  to  be  members 
of  a  college  or  hall,  to  reside  there  and  to  receive  their  instruction  thence — 
a  restriction  which  did  not  exist  before  this  period.  The  clinical  instruc- 
tion was  of  course  given  in  hospitals,  and  thus  the  suitable  and  healthful 
arrangement  of  these  came  finally  to  be  discussed,  and  then  improved. 


—  555  — 

Anatomy  was  now  studied  more  frequently  upon  human  bodies  and 
promoted  by  the  predilection  of  princes,  particularly  in  Italy,  so  that  at 
least  occasional  dissections  were  made  in  most  of  the  universities.1  This 
was  more  especially  the  case  in  the  non-German  institutions,  to  which  for 
this  reason  the  students  flocked  in  great  numbers.  Most  of  the  universities 
had  already  anatomical  theatres,  and  received  a  larger  number  of  bodies- 
than  in  earlier  times,  so  that  Vieussens  e.  g.  was  able  alone  to  dissect 
500  of  them.  There  was  also  in  Dresden  as  earby  as  1617  an  "Anatomie- 
kammer",  as  the  dissecting  room  was  called  most  too  characteristically  in 
German  at  that  time  and  subsequently.  In  these,  stuffed  birds  —  at  that 
time  a  great  rarity  —  and  similar  curiosities  were  also  preserved.3  Yet 
in  Germany  the  stud}'  of  anatomy  at  this  period  was  generally  at  a  low 
ebb,  so  that  when  Rolfink  at  Jena  —  in  the  beginning  of  the  17th  century 
the  most  popular  of  the  German  universities  — in  1029  arranged  two  pub- 
lic dissections  upon  "executed  malefactors",  this  was  considered  such  an 
event  that  the  very  highest  authorities  (who  now  in  Germany  and  Eng- 
land, as  of  old  in  Alexandria  and  in  the  16th  century  even  in  Italy,  in- 
terested themselves  in  anatomy)  were  present  thereat.  In  Ingolstadt  too, 
the  laity  were  permitted  to  be  present  at  the  single  annual  dissection 
which  was  allowed,  so  that  this  concession  seems  to  have  been  the  general, 
rule.  Among  the  peasants  of  the  vicinity,  however,  such  an  unheard-of 
"fashion",  and  the  fear  that  all  the  bodies  in  the  cemeteries  would  now  be 
stolen  by  the  students,  awakened  such  terror  and  such  caution,  that  the 
fresh  graves3  were  watched  by  night,  so  that  the  corpses  might  not  be  dug 
up  and  "Rolfinked "!     From   1631  on,  however,  the  same  Rolfink  managed 

1.  Cruel  anatomical  investigations  were  also  made  upon   living  dogs,  and  Coining 

even  declared  such  studies  the  favorite  occupation  of  his  leisure  hours. 

2.  John  Evelyn,  who  visited  Leyden  in  1641,  makes  the  following  record  in  his  diary: 

"1  was  much  pleased  with  a  sight  of  their  Anatomy  schole,  theater,  and  reposi- 
tory adjoyning,  which  is  well  furnish'd  with  natural  curiosities  ;  skeletons  from 
the  whale  and  eliphant  to  the  fly  and  spider,  which  last  is  a  very  delicate  piece 
of  art,  to  see  how  the  bones  (if  I  may  so  call  them)  of  so  tender  an  insect  could 
be  separated  from  the  mucilaginous  parts  of  yt  minute  animal.  Amongst  a  great 
variety  of  other  things,  I  was  shew'd  the  knife  newly  taken  out  of  a  drunken 
Dutchman's  guts  by  an  incision  in  his  side,  after  it  had  slipped  from  his  fingers 
into  his  stomach.  The  picture  of  the  chyrurgeon  and  his  patient,  both  living, 
were  there."    (II.) 

3.  In  England,  even  as  late  as  the  beginning  of  the  present  century,  anatomical 

material  was  supplied  almost  exclusively  by  grave-robbers.  Bodies  were  also 
stolen  by  the  students.  In  America  too  —  in  imitation  of  the  English  custom  — 
purveyors  of  anatomical  material  existed  a  short  time  ago.  In  both  countries 
crimes  were  committed  in  order  to  secure  "material".  The  providing  of  ana- 
tomical institutions  with  bodies  was  regulated  by  law  in  England  in  1832. 
[Unfortunately  grave-robbing  and  even  the  crime  of  "  Burking  "  are  not  entirely 
unknown  to  our  criminal  courts  to-day.  Most  of  the  states  have  some  excuse  for 
an  "Anatomy  Law",  though  between  the  defects  of  the  laws  themselves  and  the 
inefficiency  of  their  administration  the  situation  of  practical  anatomy  in  the 
United  States  is  far  from  satisfactory.  Pennsylvania,  however,  secured  an 
excellent  "Anatomy  Act"  in  1883  and  Illinois  a  similar  one  in  18^5.     (II.)] 


—  556  — 

to  have  annual  dissections  in  the  dissecting  room  at  Jena,  and  Conring 
was  treated  to  the  very  characteristic  charge  of  prosecuting  anatomy  and 
vivisections  (at  that  time  as  much  practised  almost  as  to-day)  usque  ad 
nauseam.  Indeed  he  himself  was  so  "  inspirited  "  by  these  dissections  that 
he  felt  able  to  charge  Hippocrates  with  being  a  bungler  and  an  ignoramus 
in  anatomy  —  at  that  time  a  heresy  much  more  dangerous  than  it  is  to-day 
to  fail  to  swear  by  the  clinicians  and  their  voluminous  corpora  medicinae. 

Vienna  did  not  acquire  a  skeleton  until  1658  :  Strassburg  obtained  a 
male  skeleton  in  1671.  and  several  years  later  the  skeleton  of  a  female.  In 
Edinburgh  an  anatomical  theater  was  first  erected  in  ''Surgeons'  Hall"  in 
1697.  It  ma}-  be  remarked  here  that  anatomical  plates  designed  to  be 
lifted  off  in  layers  existed  even  at  this  period,  e.  g.  the  "Catoptri  mic- 
rocosmici  visio  prima,  secunda  et  tertia  etc.'.  1613.  cut  by  Stephen 
Michelspacher. 

Occupation  with  practical  anatomy  was.  of  course,  still  regarded  by 
the  higher  physicians  as  a  business  unworthy  of  them.  The}-,  therefore, 
left  it  to  the  inferior  surgeons,  and  merely  pointed  out  and  explained 
themselves  with  a  staff  what  the  surgeon  had  exposed.  Thus  it  occurred 
that  many  surgeons  of  this  period  were  the  best  anatomists  and  teachers 
of  anatomy.  Thus  too  may  be  explained  the  story  that  in  Heidelberg, 
about  the  middle  of  the  century,  there  arose  at  the  bedside  of  the  margrave 
of  Baden  a  difference  of  opinion  between  two  learned  professors  and  the 
ordinary  physician  —  at  all  events  also  a  medicus  purus  —  whether  a 
plaster  for  the  illustrious  margravian  heart,  in  order  to  cover  that  organ, 
should  be  placed  in  the  middle  of  the  chest,  according  to  Galen,  or  upon 
the  left  side.  The  dispute  was  settled  by  opening  before  the  eyes  of  the 
noble  patient  —  a  hog,  by  means  of  which  it  was  demonstrated  that,  as  a 
matter  of  fact,  the  heart  of  the  hog  lay  on  the  left  side.  This  evidence  so 
firmly  convinced  His  Excellency  that  his  own  internal  arrangements  were 
quite  the  same  as  those  of  the  hog,  that  he  at  once  dismissed  from  his  posi- 
tion as  ordinary  physician  his  own  attendant,  who  had  held  the  contrary 
opinion  as  to  the  position  of  a  nobleman's  heart. 

How  rare  dissections  were  in  Germany  may  be  learned  from  the  fact  that  in 
Frankfort-ontbe-Main  they  were  given  in  the  seventeenth  centiny  only  in  the  years 
1615,  1619,  lG4(i,  167.3,  1677,  1678,  L680  the  last  three  by  Irenams  Vehr,  died  1710), 
and  1683 -by  Bernh.  Albinus.  They  were  always  accompanied  by  festivities  which 
lasted  several  days.1     Not  only  physicians,  but  also  other  professors  and  students. 


1.  John  Evelyn  records  in  hi-  diary  for  the  year  1G46  :  "  Three  day-  after  this  Itooke 
my  leave  of  Venice  and  went  to  Padoa,  to  be  present  at  the  famous  Anatomie 
Lecture,  which  is  here  celebrated  with  extraordinary  apparatus,  lasting  almost  a 
whole  moneth.  During  this  time  1  saw  a  woman,  a  child  and  a  man  dissected  with 
all  the  manual  operations  of  the  chirurgeon  on  the  humane  body;  The  one  was 
performed  by  Cavalier  Yestlingius  and  Dr.  Jo.  Athelsteinus  Leonsenas,  of  whom 
I  purchased  those  rare  tables  of  Veines  and  Nerves,  and  caus'd  him  to  prepare  a 
third  of  the  Lungs,  Liver  and  Nervi  sexti  par,  with  tin-  Gastric  Veines,  which 
I  sent  into  England,  and  afterwards  presented  to  the  Royall  Society,  being  the 
first  of  that  kind  that  had  been  seen  there,  and  for  aught  I  know  in  the  world, 


—  557  — 

together  with  the  laity  of  high  position,  took  part  in  them.  On  the  occasion  of  the 
dissection  in  1619  it  was  said  that  the  vena  azygos  was  found  to  empty  into  the  excre- 
tory duct  of  the  left  kidney,  "whereby  it  is  clear  that  diuretics  are  suitable  for  persons- 
with  pleurisy,  and  that  pus  may  be  discharged  by  the  urinary  passages."  ■ —  In  1H75  a 
child-murderess  was,  in  accordance  with  the  law,  sewed  up  in  a  sack  and  drowned. 
From  her  body7  the  "  Pharmakopous  '  collected  twenty  kilogrammes  of  fat.  Jn  the 
year  1678  the  dissection  of  another  child-murderess  took  place,  and  it  is  mentioned 
that  the  subject  had  very  fat  buttocks  and  wonderfully  stout  breasts.  She  had  gall- 
stones also,  and  her  skeleton  was  preserved.  —  For  the  repair  of  the  "  Anatomiekam- 
mer"  and  the  restoration  of  an  anatomical  theatre,  the  Elector  in  1684  gave  100' 
Thaler;  the  remainder  Albinus  furnished  from  his  own  pocket.  Strassburg  received 
her  first  professor  of  anatomy  in  the  person  of  Joh.  Albert  Sebiz  in  1652,  and  a  horri- 
ble hole  was  assigned  for  an  "Anatomiekammer ".  (Until  a  short  time  before  the 
medical  course  of  the  author  of  this  work,  a  similar  hole  for  the  study  of  anatomy 
existed  at  Giessen.) 

Botanic  gardens  and  chemical  laboratories  for  purposes  of  instruction 
existed  in  many  universities.  One  was  established  in  Strassburg  in  1619, 
and  Oxford  received  the  first  in  England  in  1622.1  The  chemical  labora- 
tories, however,  were  mostly  the  private  property  of  the  teachers.  The 
famous  Kunkel  e.  g.  had  one  when  he  was  in  Wittenberg  and  delivered  the 
"collegium  chymicum",  which  up  to  this  time  had  been  lacking  there. 

His  account  of  his  own  experience  furnishes  us  a  glance  into  the  condition  of  the 
universities  of  that  day.  He  says:  "Therefore  1  was  permitted  to  establish  such  a 
collegium,  and  I  also  received  a  considerable  number  of  studiosos  medicinse,  among 
whom  Christ.  Vater  (1651-1735;  father  of  the  anatomist  Abraham  Vater,  1084-1751, 
professor  in  Wittenberg)  was  the  most  curious,  zealous  and  grateful.  1  likewise  found 
that  it  was  a  sour  morsel  of  bread  (hard  task)  to  support  oneself  bjr  studiosis.  Part 
of  them  imagined  that  the  conditions  in  this  collegio  were  the  same  as  in  others,  where 
the  instruction  consists  in  transcribing  words  (!);  nay,  but  care  and  labor  belong  to  it. 
Among  them  there  were  not  more  than  three  of  these  ....  The  longer  also  I  con- 
tinued in  the  work,  the  more  disgusted  I  became,  and  I  saw,  and  found  in  my  con- 
science, that  I  could  not  henceforth  with  justice  accept  money  from  the  parents  of 
such  people  "  —  a  conscientiousness  rare,  but  worthy  of  imitation  ! 

The  general  barbarity  of  the  seventeenth  century  and  the  immorality,  especially 
among  the  upper  classes,  which  toward  the  end  of  the  century  spreading  from  France 
had  become  naturalized  in  both  Germany  and  England,  extended  even  to  the  univer- 
sities, the  professors  and,  of  course,  to  the  students.  The  life  of  the  latter  during  this 
period  was  accordingly  more  vulgar  and  rude  than  ever  before,  although  subsequently 
it  was  in  some  respects,  and  in  some  places,  about  as  bad.  At  this  time  Pennalism 
and   its   results  were   in    full   bloom,    that,   is   to   say  barbarity  towards   the  younger 

tho'  afterwards  there  were  others.  When  the  Anatomie  Lectures,  which  were  in 
the  mornings,  were  ended,  I  went  to  see  cures  don  in  the  Hospitals;  and  cer- 
tainly as  there  are  the  greatest  helps  and  the  most  skilfull  physitians,  so  there 
are  the  most  miserable  and  deplorable  objects  to  exercise  upon.  Xor  is  there 
any,  I  should  think,  so  powerful!  an  argument  against  the  vice  reigning  in  this 
licentious  Country,  as  to  be  spectator  of  the  miserie  these  poore  creatures  undergo. 
They  are  indeede  very  carefully  attended,  and  with  extraordinary  charity." 
The  anatomical  plates  referred  to  were  presented  to  the  Koyal  Society  by  Evelyn 
on  his  birthday,  Oct.  31,  1667.  (Hi.) 
1.  The  botanical  garden  of  Edinburgh  was  established  in  1680,  and  the  apothecaries' 
garden  at  Chelsea  in  1686.     (II.) 


—  558  — 

students  —  Pennalen  —  on  the  part  of  the  elder  —  Schoristen  —  was  unbounded,  and 
its  outbreaks,  even  in  the  lecture  rooms  during;  the  daily  duties,  were  of  such  a  nature 
that,  in  spite  of  many  echoes  of  this  system  in  our  universities,  we  can  to-day  no  longer 
form  a  correct  conception  of  them.  The  state  authorities  were  at  last  compelled  to 
interfere  against  them  —  but  in  vain!  Altdorf  was  scourged  by  this  moral  epidemic. 
"  The  plague,  the  horrible  Pennalism,  afflicted  the  university  of  Altdorf  in  lb'2:->,  and 
resulted  in  the  highest  grades  of  wantonness,  immorality,  frivolity  and  barbarity,  so 
that  it  could  not  be  exterminated  by  all  the  dissuasion,  warnings  and  punishments 
exerted  against  it."  This  shamelessness  of  the  scholars  and  students  grew  to  such  a 
pitch  that  those  whose  duty  it  was  to  study,  to  learn,  to  be  obedient  to  their 
well-wishers,  railed  against  their  teachers,  listened  to  them  very  little  and  valued 
them  still  less  ....  Scarce]}-  a  public  lecture  was  delivered  anywhere  without  inso- 
lent and  unstinted  interruptions  by  hissing,  whistling  and  abominable  noises.  There 
was  such  a  bellowing,  shouting  and  howling  that  a  passer-by  would  swear  it  was  no 

lecture-room  for  men,  but  a  resort  for  dogs,  oxen  and  birds  of  prey The  vices 

which  had  crept  in,  the  marching  about  the  streets,  the  drinking  by  day  and  by  night, 
the  shouting,  duelling,  murder,  fornication  and  all  such  evils  and  highly  reprehensible 
abuses,  kept  open  all  the  windows  of  the  academies  of  the  students."  At  this  period 
such  conduct  was"  bully"  ("forsch")!  (Marx.)  The  ceremony  of  "Deposition" 
continued,  and  degenerated  still  more  in  these  rude  times.  "  In  this  ceremony  the  hide 
and  horns  of  an  ox  were  thrown  over  the  'Bean'  (bee  jaune,  novice);  the  horns  were 
then  sawed  off.  Previously',  however,  the  hair  of  the  neophyte  was  pulled  out  with  great 
wooden  shears:  'Since  thou,  0  shaggy  buck,  canst  dispense  with  much  hair,  I  must, 
therefore,  for  decency's  sake,  shave  thine  head.'  His  ears  were  now  cleaned  with  a 
spoon:  'I  purify  thine  ears  for  instruction  and  not  as  a  bad  trick.'  His  '  Bacchant- 
tooth'  was  pulled  out:  '  Let  thy  Bacchant-tooth  of  slander  be  drawn;  calumniation 
slialt  thou  ever  shun  like  hell  itself.'  His  nails  were  filed  with  a  huge  file:  '  I  file 
thine  hands  to  signify  that  with  them  thou  shalt  work,  as  is  fair.'  A  large  moustache 
was  painted  upon  his  lip:  'I  paint  thee  a  beard  that  henceforth  thou  mayest  behave 
like  a  beardless  child.'  Now  followed  the  hand-kissing.  Salt  was  placed  in  the 
mouth  of  the  neophyte  and  wine  was  poured  upon  his  head:  'Let  him  receive  the 
salt  of  wisdom,  let  him  take  the  wine  of  pleasure!  May  God  multiply  upon  you,  ye 
students,  both  wisdom  and  joys!'  Of  course  a  banquet  followed,  in  mockery  of  all 
pres  ribed  regulations."  (K.  Griin,  Culturgeschichte  des  17en  Jahrhunderts.)  These 
were  degenerations  of  mediaeval  guild-ceremonies  and  outbursts  of  youthful  wanton- 
ness and  rudeness,  which  simply  outgrew  their  age.  "In  the  villages  the  students 
crowded  into  the  pulpits,  drowned  the  voice  of  the  preacher  with  boastful  words, 
preached  in  a  state  of  deep  intoxication,  raised  a  laugh  among  the  peasants  by  their 
odd  pranks,  ordered  bag-pipes  and  shawms,  dragged  the  Gretchens  and  Elsies  out  of 
the  pews  into  the  dance,  danced  jigs  etc.  etc.  —  At  weddings  they  drank  up  all  the 
beer  and  broke  the  ribs  of  the  guests,  or  stabbed  them  with  the  sword.  The  wearing 
of  straight  swords,  pikes  and  fire-arms,  in  consequence  of  the  continual  duelling,  was 
always  prohibited,  but  always  without  results.  As  early  as  1570  the  Elector  of  Saxony- 
was  compelled  to  confirm  a  statute  of  the  senate  designed  to  restrain  murder  among 
the  students,  lest  the  universities  should  become  alarm-posts,  rendezvous  for  fighting 
and  slaughter-houses."     (1.  c.  I 

Numerous  learned  societies  labored  in  the  prosecution  of  scientific 
pursuits,  and  in  supplementing  the  instruction  of  the  universities. 

A  large  proportion  of  the  professors  of  medicine  too  were  highly 
learned  men,  frequently  marvellous  savants,  whose  knowledge  and  their 
perrukes  in  this  rococo  age  were  equall}7  extensive.     For  a  disposition  to 


—  559  — 

scholastic  erudition,  embracing  everything  in  its  scope,  ruled  the  17th 
century,  so  that  we  might  call  maivy  of  these  savants  the  last  of  the 
Scholastics.  The  medical  men,  however,  were  not  simple  compilers  and 
savants,  but  frequently  also  very  zealous  investigators,  and  withal  touch}' 
and  some  of  them  disputatious  (as  the}*  are,  indeed  to-day),  so  that  while 
they  usually  conducted  themselves  with  great  learning,  they  were  not 
always  over-polite.  The  latter  fault,  however,  was  characteristic  of  the 
manners  of  the  time.  They  themselves,  like  their  language  —  almost  all 
of  them  wrote  Latin  only,  or  more  rarely  a  German  mixed  with  Latin  — 
were  cosmopolitan  in  their  scientific  intercourse,  though  this  was  less  the 
case  than  in  the  sixteenth  century.  Not  rarely  too  they  changed  their 
positions,  especially  as  a  large  part  of  them  were  still  not  permanently 
settled,  but  were  appointed  merely  for  a  certain  term  of  years.  The  Thirty 
Years1  War  too  drove  them  frequently  as  --Exiles''  from  their  previous 
positions  and  residences  for  a  shorter  or  longer  period.  Moreover  one  and 
the  same  savant,  with  the  utmost  versatility,  often  represented  the  most 
different  branches,  e.  g.  medicine,  history  and  poetry,  like  Meibomius.  or 
philosophy,  philology,  archaeology,  geometry  and  medicine,  like  one  of  the 
"Bartholins.  Besides  these  branches  they  occupied  themselves  with  special 
frequency  with  chemistry.  Many  of  them  were  distinguished  mathemati- 
cians and  physicists.  Some  were  microscopists,  for  in  this  century  the 
general  method  of  investigation  was  almost  entirely  the  so-called  exact 
method.  Some  of  the  professors  were  physicians-in-ordinary,  frequently 
with  considerable  salaries.1  —  Thus  Conring  e.  g.  was  offered  9000  marks  to 
become  physician-in-ordinary  in  Sweden.  The  salary  of  professors,  how- 
ever, was  generally  small  —  as  a  rule  hardly  200  marks  ($50),  at  most  1000 
marks  ($250).  The  more  famous  and  popular  physicians  frequently  gave 
consultations  by  letter  to  patients  in  foreign  countries.  Many  had  valuable 
private  collections,  as  e.  g.  Ruysch,  who  sold  his  anatomical  collection  to 
Peter  the  Great  for  the  enormous  sum,  for  that  day,  of  51300  marks.  This 
occurred  just  at  the  beginning  of  the  eighteenth  century. 

Instruction  in  surgery  was  well  regulated  nowhere  but  in  France,  for 
this  was  the  only  country  which  possessed  a  surgical  college  proper,  and 
maintained  an  entirely  independent  surgical  faculty.  Thf  earlier  privileges 
of  the  surgeons  were   restored,  and   in    1671    separate  localities   for   the 


The  usual  salary  of  the  Physician-in-ordinary  to  the  king  in  England  during  the 
17th  century  seems  to  have  been  £100,  though  it  varied  somewhat,  probably  in 
accordance  with  the  celebrity  of  the  individual.  The  famous  Theodore  Turquet 
de  Mayerne,  who  was  appointed  Physician-in-ordinary  to  both  the  king  and 
queen  in  1611,  received  £400  per  annum,  and  an  annuity  of  £200  was  settled  upon 
his  wife.  Mayerne  was  also  exempted  from  all  taxation,  and  received  the  honor 
of  knighthood  in  1624.  Wiseman's  salary  as  Surgeon-in-ordinary  in  1661  was 
£150,  though  Ant.  De  Choqueux  in  1665  received  only  £80.  In  1626  Dr.  John 
Collins  was  appointed  ''Physic  Professor"  in  the  university  of  Cambridge  with 
a  salary  of  £40.  In  1067  the  king  had  eight  physicians,  and  four  [surgeons- in- 
ordinary.    (H.) 


—  560  — 

lectures  of  the  professors  of  surgery,  and  permission  to  perform  dissections, 
were  also  granted.  Moreover  the  dispute  of  the  Paris  faculty  about  pre- 
cedence and  the  barbers  had  at  this  time  entered  upon  a  new  phase,  though 
it  was  not  finally  concluded. 

Such  jealous  disputes  about  competency  between  physicians  and  surgeons,1  and 
even  between  surgeons,  barbers  and  hair-dressers  (for  the  latter,  like  the  specialists 
for  diseases  of  the  hair  to-day,  were  also  counted  members  of  the  medical  faculty),  in 
which  the  physicians  often  played  the  more  melancholy  role,  were  very  frequent. 
They  were  carried  on  during  the  whole  centur}7,  not  only  in  France,  which  in  this 
respect  undoubtedly  "illumined  the  way  in  the  struggle  for  the  highest  good  of 
civilization",  but  also  in  almost  all  countries,  in  England,  Germany,  Denmark  —  in 
the  latter  country  the  dispute  related  to  practice  only.  In  Italyr  alone  they  are  not 
mentioned,  either  in  this  or  the  preceding  century.  In  the  latter  country  the 
surgeons  never  occupied  a  position  utterly  and  entirely  separate  from  medicine,  and 
thus  in  the  seventeenth  century  the  professorship  of  surgery  in  the  universities  was 
everywhere  filled  by  the  most  distinguished  professors,  especially  those  of  anatomy, 
which  branch  and  surgery  in  the  succeeding  century  too  were  everywhere  regarded  as 
almost  necessarily  dependent  upon  each  other.  Hence  too  it  resulted  that  German 
physicians,  educated,  however,  in  Italy,  were  the  first  to  devote  themselves  to  practical 
surgeryr  in  their  own  home.  Tn  fact  in  German}7  also  professors  of  anatomy  occupied 
the  chair  of  surgery,  e.  g.  Rolfink:  yet  Wundarzte  and  inferior  surgeons  for  the  most 
part  followed  the  course  of  instruction  of  their  guild.  Accordingly  the  most  import- 
ant German  "  Wundarzte  "  —  so  the  best  educated  surgeons  were  called  —  of  the 
seventeenth  centurj-  still  came  from  the  barber-shops  alone,  and  supplemented  their 
defective  medical  and  general  education  by  self-instruction,  or  chiefly  by  travelling 
from  city  to  city,  and  from  one  famous  practitioner  of  their  art  to  another  if  possible 
still  more  celebrated.  These  higher  Wundarzte  were  mostly  by  nature  men  of  special 
talent  in  their  branch,  who  had  chosen  it  from  love  of  its  duties  and  to  gain  a  better 
social  position,  and  thej'  devoted  themselves  with  enthusiasm  to  the  study  of  their 
art,  in  circumstances  and  situations  often  of  great  difficulty.  Many  of  these  men, 
worthy  of  the  highest  respect  and  often  springing  from  hovels  of  the  deepest  poverty, 
struggled  after  learning  and  gained  its  rewards,  while  want  and  bitter  hunger  were 
fellow-students  and  companions  on  their  journeys. 

In  the  seventeenth  centurj*  practical  instruction  in  midwifery,  as  a 
branch  distinct  from  surgery,  was  not  yet  imparted  to  men.  At  most  they 
merely  studied  it  theoretical!}-.  Daily  practice,  then  as  now,  was  often  com- 
pelled, at  the  expense  of  the  patients,  to  fill  the  place  of  a  supplementary 
teacher,  and  to  supply  the  want  of  preceding  personal  management  under 
the  guidance  of  a  teacher  and  the  lack  of  the  observation  of  nature.  The 
sole  public  institution  in  which  practical  instruction  in  midwifery  was 
imparted,  the  obstetric  section  of  the  Hotel-Dieu  at  Paris,  was  firmly 
closed  against  men.     Yet,  in  spite  of  this,  many  surgeons  were,  and  became 

1.  We  must  not  blame  either  party  too  severely,  for  in  the  century  of  long  perrukes 
both  bloodless  and  bloody  dissensions  prevailed  at  the  French  court  over  the 
question  which  of  the  lords  or  ladies  should  offer  to  the  king  bis  napkin,  or  to  the 
queen  her  chemise  —  characteristic  matters  of  historical  importance  for  this  curl- 
flourishing,  rococo-age,  and  noble  productions  of  the  absolute  doctrine  of  God's 
grace  !  Among  physicians  and  surgeons  too  pecuniary  interest  (which  as  we  know 
puts  an  end  to  all  good-feeling  and  fellowship)  played  a  part,  not  mere  servility 
as  among  courtiers. 


—  561  — 

by  their  private  practice,  distinguished  obstetricians, — accoucheurs,  as  they 
called  themselves  after  the  famous  accouchement  of  La  Valliere — and  they 
also  displayed  scientific  ability. 

Practical  instruction  for  midwives  was  imparted  in  Paris  alone,  in  the 
special  institution  just  mentioned,  and  by  superior  midwives,  who  not  in- 
frequently were  also  authoresses  in  their  own  department.  The  course 
lasted  three  months,  six  weeks  of  which  were  employed  in  the  learning  and 
practice  of  the  practical  portions  of  the  art.  —  In  Germany  the  old  method 
of  guild1  instruction  still  prevailed  for  the  most  part ;  that  is  old  midwives 
took  the  young  under  their  teaching,  or  the  (city)  ph}'sicians  and  surgeons 
imparted  instruction  to  them.  The  latter  were  the  chief  practitioners  of 
operative  midwifery  in  difficult  cases.  The  instruction  was  given  in  ac- 
cordance with  the  numerous  manuals  for  midwives  which  already  existed, 
under  the  direction  of  the  magistrates  and  by  order  of  the  city.  In  many 
places  the  nurses  were  compelled  to  pass  an  examination  by  the  city  phy- 
sician, and,  if  successful  in  this,  were  then  sworn  into  service.  — The  same 
method  prevailed  also  among  the  other  Germanic  peoples,  with  whom  mid- 
wives  almost  exclusively  everywhere  practised  midwifery.  —  That  among 
these  many  were  still  extremely  ignorant,  is  manifest  from  the  fact  that 
one  of  them  took  the  inverted  uterus  for  the  placenta  —  a  mistake'  which 
might  undoubtedly  occur  to-day  also  —  and  simply  cut  it  off — which 
could  scarcely  happen  at  the  present  day.  —  After  the  publication  of  a 
medical  ordinance  in  1685,  the  midwives  in  the  electorate  of  Brandenburg, 
like  the  barbers  and  bath-keepers,  were  examined  by  the  professors  at 
Frankfort-on-the-Oder. 

The  barbers  continued  to  receive  their  instruction  from  the  guild- 
masters.  In  Saxony  after  1641  they  were  required  to  pass  an  examination 
before  the  four  oldest  masters  and  the  city-plrysician  (Stadtphysicus  >.  in 
which  examination  they  were  questioned  upon  the  treatment  of  gun-shot 
wounds,  like  militar}-  physicians.  Before  admission  to  the  examination 
they  must  bring  evidence,  of  course,  of  the  legitimacy  of  their  birth,  that 
they  had  studied  three  years  and  had  for  three  years  travelled  as  appren- 
tices. The  examination  was  followed  by  the  ':  Meisterstiick"  (masterpiece) 
and,  of  course,  the  "  Meisteressen  "  (masters'  banquet),  in  accordance  with 
the  immemorial  custom  of  the  guild  (Frolich).  In  spite,  however,  of  all 
the  improvements  of  the  examinations  (and  there  were  others  than  that 
just  mentioned),  it  is  said  of  the  barbers  :  "Most  of  them  trouble  them- 
selves very  little  with  anatom}-  and  surger}*,  and  if  the}'  can  onlj'  attend 
to  customers,  cut  hair  a  la  mode  and  shave  the  beard  properly,  it  is  quite 
enough."     Besides  these  duties,  however,  they  also  supplied  surgical   aid 

1.  Peter  Chamberlen  (II)  endeavored  to  effect  the  incorporation  of  the  English  mid- 
wives  in  1616,  and  his  son  Peter  (III)  vainly  attempted  the  same  thing  in  1634. 
The  opposition  of  the  physicians,  and  even  of  the  midwives  themselves,  proved 
insuperable,  nor  was  the  character  of  the  advocate  of  the  project  s\ich  as  to  render 
his  advocacy  very  influential.  (H.) 
36 


—  562  — 

(as  they  did  long  after  this  period),  and  had  establishments  (Schwitzstuben) 
•of  their  own,  where  they  treated  syphilis  with  mercurial  fumigations  and 
sweating.  Inunctions  for  the  production  of  salivation  the}-  performed  at 
home,  or  at  the  houses  of  the  patients  themselves. 

Instruction  in  pharmacy  was  imparted  by  the  master-apothecaries. 
The  examination,  however,  took  place  generally  before  a  mixed  commission 
of  physicians  and  apothecaries  —  in  the  electorate  of  Brandenburg  after 
1G85  before  the  professors  —  and  a  masterpiece  was  required.  In  France 
the  master-apothecaries  were  examined  by  the  Faculty,  but  in  some  cities 
several  years'  service  in  a  hospital  exempted  them  from  examination.  As 
at  an  earlier  period,  this  examination  consisted  of  three  parts,  viz.  that  for 
the  apprentices,  the  assistants  and  the  masters.  In  France  it  consisted 
in  the  reading  of  formula?,  an  examination  on  simples  and  the  masters' 
examination.  The  examinations  were  purely  dogmatic,  not  only  in  Ger- 
man}-, but  likewise  in  France.  Moliere,  as  we  know,  ridiculed  the  vicious 
methods  of  examination  in  the  latter  country. 

The  expenses  of  graduation  of  a  medical  student  were  very  great,  and  the  public 
act  of  graduation  was  generally  celebrated  with  much  ceremony.  Often  there  was 
music  etc.  for  two  days.  Hence  in  lGSo  appeared  the  following  edict  and  mandate: 
"  Frederick  William,  by  the  Grace  of  God  Margrave  of  Brandenburg,  Arch-chamber- 
lain of  the  Imperial  Roman  Empire,  Elector  of  Prussia,  Magdeburg,  Jiilich  etc. 

Imprimis.  —  To  my  worthy,  high  and  well  instructed,  trusty  and  beloved  lieges, 
gracious  greeting,  Upon  what  grounds  we  have  been  induced  to  reduce  the  expense 
of  the  promotiones  of  licentiates  and  doctors,  heretofore  by  custom  far  too  high,  ye 
maj'  see  from  the  enclosed  original  document;  and  we  hereby  graciously  charge  you 
to  keep  this  our  ordinance  entirely  and  without  any  objections,  decently  and  inviol- 
ably, which  we  most  graciously  expect  of  you,  and  bear  to  j'ou  a  gracious  benevolence. 
Given  at  Potsdam,  July  14,  168!!.     Frederick,  Elector-Prince. 

By  His  Serenity,  the  Electoral  Prince  of  Brandenburg  etc.  —  It  has  come  to 
the  notice  of  our  most  gracious  Prince  that  in  the  promotionibus  licentiatorum  et 
doctorum  in  the  juristic  and  medical  Faeultj'  at  Frankfort-on-the-Oder,  by  reason  of 
the  expensive  convivia  many  students,  although  they  lay  there  the  foundation  of  their 
studies,  betake  themselves  to  foreign  and  distant  places,  where  the}'  ma}7  attain  at 
less  cost  the  honores  academicos,  while  others  who  have  not  the  means  to  travel  to 
other  places  omit  their  grade  because  they  cannot  sustain  so  great  expense:  therefore 
His  Serenity  etc.  has  thought  that  this  burden  should  be  reduced. 

1.  When  a  Solennis  Promotio  Doctoralis  is  celebrated  in  the  churches,  the  con- 
vivium  shall  be  so  reduced  that:  1.  It  shall  continue  for  one  evening  meal  only,  and 
no  person  shall  be  invited  on  the  next  da}'.  2.  No  ladies1  shall  be  invited  thereto. 
.°>.  No  more  than  ten  kinds  of  food,  pastry  included,  shall  be  embraced  in  the  bill  of 
fare,  and   4.  Confectionery  shall  be  entirety  excluded. 

2.  When  there  are  one  or  two  candidati  for  the  gradum  Doctoris,  but  it  becomes 
burdensome  to  furnish  the  sumptus  which  must  be  employed  in  a  solemn  graduation 
in  the  churches  and  otherwise  in  accordance  with  the  directions  of  the  statutes;  then 
one  of  each  Faculty  above  named  shall  be  at  liberty  to  publickly  proclaim  such  can- 
didatos  as  Doctores  in  the  Auditorio  majori,  after   the  confirmation  of  his  Electoral 


1.  Euphemistically  for  women  of  easy  virtue,  who  were  very  common  at  the  universi- 
ties, where  all  sorts  of  vice  prevailed. 


—  563  — 

Highness  has  been  obtained,  and  after  passing  the  examinations  customary  in  solemn 
graduation,  so  that  only  half  the  otherwise  customary  munera  may  be  offered  to  the 
professors  in  all  Faculties.  However,  in  this  case  the  distribution  of  gloves,  as  well 
as  the  convivium  doctorale,  shall  be  omitted,  unless  the  Doctorandi  invite  some  few 
professors  to  a  very  modest  repast,  which  shall  be  left  to  their  discretion. 

3.  The  Renuntiationes  Licentiatorum,  after  the  conclusion  of  the  Examinum 
and  in  the  Disputatione  publica  inaugurali,  heretofore  usually  held  in  facultate 
juridica,  may  in  future  take  place  in  facultate  medica  privatim  in  consensu  facultatis, 
in  order  that  thus  the  expensive  convivium  may  be  avoided  :  provided,  however,  that 
in  all  cases  the  confirmation  of  the  Elector  for  each  of  the  Candidatorum  shall  be 
first  obtained. — Wherefore,  most  highly  informed,  His  Princely  Serenity  charges  the 
University  of  Frankfort-on-the-Oder  herewith  most  graciously  and  also  earnestly  to 
keep  this  his  most  gracious  ordinance  rigidly,  strictly  and  inviolably.  Signatum 
Potsdam,  July  14,  1683.     Friedrich,  Elector. 

A  very  interesting  insight  into  the  scientific  relations  of  this  age  of  perruques 
and  into  the  authority  of  the  universities,  is  given  by  the  transactions  relating  to  the 
well-known  book1  of  Justine  Siegemundin,  midwife  of  Brega,  and  by  certain  of  its 
inquiries.  "In  1681  Justine  Siegemundin,  a  midwife  of  Brega  in  Silesia,  asked  the 
Faculty  :  1.  Whether  it  was  not  an  offence  against  the  rules  of  medicine  for  the  nurse 
to  give  S3Trupus  corallorum   to  a  feeble,    but  otherwise   healthy,   new-born   infant? 

2.  Whether  it  should  be  reckoned  the  fault  of  the  nurse  when,  in  case  of  sudden 
hasmorrhage  on  the  part  of  the  parturient  woman,  she  orders  aqua  bursas  pastoris  to 
be  taken,  and  aqua  carbunculi  to  be  laid  upon  the  wrists  of  the  patient,  but  the  latter 
in   her   absence  takes   the   aqua  carbunculi    instead   of  the   aqua  bursas  pastoris? 

3.  Whether  the  nurse,  according  to  her  own  judgment,  could  separate  the  afterbirth 
before  the  birth  of  the  child  without  danger  to  the  mother  and  infant?  4.  Whether 
an  immature  child,  thus  forcibly  delivered,  could  live  in  health  until  its  third  year,  and 
whether,  if  it  subsequently  died,  that  hastening  of  its  birth  could  be  the  cause  of  its 
subsequent  death?  To  all  four  inquiries  the  answer  was  No.  The  Faculty  was 
further  asked  whether  a  person  affected  with  chronic  gonorrhoea  should  be  permitted 
to  enjoj'  coitus,  and  whether  such  a  person  was  capable  of  begetting  children.  This 
book  of  Justine  Siegemundin,  especially  as  it  was  written  in  German,  met  with  great 
opposition,  and,  although  it  had  passed  the  censorship  of  the  university  of  Frankfort, 
it  gave  rise  to  a  thesis  at  Leipzig,  maintaining  that  many  procedures  which  were 
praised  in  the  work  depended  upon  empty  speculation  and  in  practice  were  absurd  ; 
so  that  the  writer  could  not  understand  how  it  had  passed  the  censorship.  Justine 
complained  of  this,  and  several  academic  papers  were  published  by  the  university  of 
Frankfort  in  opposition  to  this  thesis. 

Before  we  attempt  an  exposition  of  the  practical  relations  of  the  medical  pro- 
fession, it  should  be  mentioned  that  in  France  a  thorough  change  was  undertaken  in 
hospital  affairs,  which  could  not  but  exercise  a  beneficent  influence  upon  the  piactice 
of  that  county.  In  1656  and  1662  the  horrible  leprosy -hospitals  in  that  country, 
with  their  endowments,  were  finally  abolished  by  Louis  XIV.,  and  by  means  of  the 
money  thus  obtained  hospitals  were  erected  upon  a  definite  system  throughout  France. 
The  latter,  too,  were  bad  enough.  Some  conception  of  the  great  wealth  and  the 
number  of  these  houses  may  be  formed  when  we  learn  that,  as  the  result  of  this 
ordinance,  hospitals  were  erected  in  1130  municipalities.  The  account  of  a  patient 
who  in  1657  was   sick  in  the  Hotel-Dieu   in   Paris,  says  that  in  each  ward  were  four 

1.  "Die  Chur-Brandenburgische  Hoff-Wehe-Mutter,  das  ist :  Ein  hochst  nothiger 
Unterricht  von  schweren  und  unrecht-stehenden  Geburten,  in  einem  Gesprach 
vorgestellet"  etc..  Colin  a.  d.  Spree,  1690.     (H.) 


—  564  — 

rows  of  beds,  and  each  ward  contained  also  an  altar  and  a  dining-table.  A  single 
apothecary-shop  provided  for  all  the  patients,  and  H00  nuns  furnished  the  hospital 
with  nurses.  Besides  these,  there  were  nine. priests,  six  apothecary's  apprentices, 
eight  barber's  apprentices,  women  to  take  care  of  the  pregnant  and  lying-in  patients, 
servants  in  the  kitchen,  bakery,  wash-house  and  apothecary-shop.  Before  the  recep- 
tion of  a  patient  he  was  examined,  if  a  man.  by  a  barber,  if  a  woman,  by  a  nun,  and 
then  carried  away  to  a  priest,  who  wrote  his  name  etc.  in  a  book  and  tied  a  card  with 
this  information  written  upon  it  upon  the  patient's  left  hand.  He  was  then  assigned 
to  a  bed  with  two  other  patients,  and  the  first  thing  he  was  expected  to  do  was  —  to 
confess.  If  he  was  a  Protestant  and  would  not  confess,  he  was  subjected  to  all  sorts 
of  questionings  and  proselytism.  About  7  A.M.  bread  and  wine  were  administered; 
about  8  A.  M.,  soup  and  eggs:  about  12  M.,  soup,  meat  and  barley-water.  The  latter 
was  also  freelj"  supplied  for  drink  by  day.  and  stewed  prunes  were  furnished  at  night. 
The  treatment  consisted  in  venesection  —  on  our  present  patient  performed  twenty 
times  —  and  enemata.  and  medically,  in  various  bowls  of  medicine  furnished  by  the 
apothecary's  servants.  Women  from  the  city  furnished  pleasant  drinks  and  con- 
fectionery. Moribund  patients  were  placed  in  a  bed  by  themselves  and  extreme 
unction  administered,  or  as  our  naive  tailor's  apprentice  expresses  it  —  they  were 
greased.  The  dead  were  tied  in  a  sack,  all  collected  into  one  wagon,  borne  to  a 
common  grave  cast  into  it  and  covered  with  lime.  Those  who  got  well  received  their 
clothing  according  to  their  cards,  and  went  their  way.  Our  patient  says  of  the 
surgeons  that  they  were  very  ready  in  amputating  limbs,  and  that  many  of  their 
victims  died,  while  many  were  discharged  with  one  leg  etc. 

The  medical  ordinances,  now  quite  numerous,  were  usually  combined 
with  others  relating  to  apothecaries  ;  for  the  seventeenth  century  presents 
us  with  numerous  examples  of  police  regulations.  Thus  in  1607  the  dukes 
of  Saxony  published  a  ••renovated  and  improved  ordinance  for  physicians 
and  apothecaries":  in  1685  the  electorate  of  Brandenburg  issued  similar 
regulations,  and  many  other  larger  and  smaller  states  and  cities  followed 
these  examples. 

Permission  to  practise,  however,  continued  to  be  granted  by  the  Fac- 
ulties alone,  and  it  was  not  until  the  following  century  that  this  right  was 
restricted  by  the  state  (Prussia).  Whoever  had  received  permission  to 
practise  from  one  of  the  German  universities  was  always  accredited  to  the 
entire  German  nation.  Complete  liberty  to  emigrate  also  prevailed  without 
any  ceremony,  though  in  many  of  the  free  cities,  e.  g.  Frankfort,  permission 
must  first  be  applied  for. 

Through  the  protection  of  the  state,  now  more  effectively  afforded, 
the  profession  of  physicians,  as  such,  attained  greater  respect,  and  the  high 
consideration  which  physicians  enjoyed  in  the  eighteenth  century  was  thus 
prepared  in  the  seventeenth.  Indeed,  in  a  general  way.  the  seventeenth  cen- 
tury may  be  called  the  century  of  aggrandizement  of  physicians,  i.  e.  a  century 
characterized  by  the  improvement  of  their  position  in  the  eyes  of  the  public. 

The  physicians  proper  ( medici  puri  |  of  the  seventeenth  century  were 
still  persons  of  the  profoundest  gravity,  with  fur-trimmed  robes,  perrukes, 
cane  and  sword  (when  matters  were  prosperous),  who  for  their  life  would 
do  nothing  more  than  write  prescriptions  in  the  Galenic,  iatro-chemical. 
iatro-mathematical  or    spagyric    st3'le.     Everything    else  they    considered 


—  565  — 

beneath  their  dignity  —  as  they  do  in  England  even  at  the  present  day. 
On  the  other  hand,  however,  they  demanded  to  be  called  into  every  case, 
even  though  they  knew  nothing  about  it.  In  this  way  alone  they  claimed 
that  all  would  go  straight,  and  even  in  operations  by  the  surgeons,  barbers 
and  mid  wives,  whether  surgical  or  obstetrical  in  character,  and  of  which 
they  knew  nothing  at  all,  they  yet  demanded  that  a  physician  should  be 
called  in.  In  dangerous  cases,  however,  e.  g.  in  the  plague,  they  allowed 
themselves  to  send  the  surgeons  alone  to  the  sick,  while  they  merely  looked 
at  the  latter  through  the  panes  of  glass.  If,  however,  they  were  compelled 
to  visit  such  patients  even  once,  they  were  advised  by  Minderer  each  time 
to  repeat  beforehand  the  22d  Psalm,  a  performance  which,  if  the  physician 
had  a  tolerably  large  practice,  must  have  consumed  considerable  time.  In 
spite  of  these  peculiarities  they  were  generally  esteemed,  and  were  often,  in 
some  wa\*  or  another  (usually  for  a  definite  term  of  years  only),  commis- 
sioned either  as  city  (or  state)  physicians,  or  as  court-physicians  in  the 
greater  or  lesser  courts  at  that  period  so  numerous,  or  as  physicians-in- 
ordinary.  As  state-physicians,  the  first  mentioned  class  frequently  offici- 
ated also  in  colleges  ad  hoc,  in  times  of  the  plague  or  other  epidemics,  in 
medico-legal  cases  etc.  In  France,  however,  these  officials  had  quite  un- 
heard-of duties,  in  addition  to  those  already  mentioned.  Among  these  was 
e.  g.  the  "exact"  proof  of  the  sexual  potency  of  men,  which  question  was 
decided  upon  the  declaration  or  sensations  of  a  female  expert  in  the  form 
of  an  old  woman  or  a  midwife  (!),  who  submitted  herself  to  the  proof  in 
presence  of  (! !)  the  physicians  or  surgeons  —  a  scandal  which  was  not 
abolished  until  1677  by  an  act  of  Parliament. 

The  "  state-physicians  "  (Staatsarzte)  of  later  times  manifestly  descended  from 
these  salaried  and  commissioned  city-physicians  (Stadtarzte) ;  for  the  subsequent 
designation  of  the  former,  i.  e.  "Physici",  was  originally  borne  by  the  city -physicians. 
Thus  e.  g.  in  1607  there  were  in  the  free  imperial  city  of  Wimpfen  two  physicians, 
a  "Physicus"  and  a  "Medicus"  (besides  two  apothecaries).  The  "  Physicus " 
received  an  annual  salary  of  four  malters  of  corn,  four  cords  of  wood,  a  free  residence 
and  68  marks.  In  the  course  of  the  century  this  salary  often  changed,  so  that  it  rose 
as  high  as  103  marks,  and  fell  as  low  as  42  marks,  8.5  marks  for  house-rent  and  four 
malters  of  spelt,  the  latter  in  the  year  165:1  The  "Medicus"  was  what  is  to-day 
called  a  simple  practising  physician.  This  memorandum  of  salary  and  other  infor- 
mation with  reference  to  the  physicians  of  Wimpfen  is  one  of  the  earliest  examples 
of  a  marked  distinction  between  the  Physicus  and  Medicus.  in  the  more  modern  sense, 
i.  e.  of  the  transfer  of  the  title  "Physicus"  (given  in  the  Middle  Ages  to  all  the 
higher  physicians)  to  such  physicians  only  as  possessed  definite  commissions.  Since 
this  makes  its  appearance  as  early  as  the  beginning  of  the  seventeenth  century,  we 
may  conclude  that  this  distinctive  title  had  been  formed  much  earlier.  It  would 
seem,  however,  that  special  state-physicians,  with  regular  and  permanent  commissions 
and  assignment,  did  not  exist  in  Germauy  during  the  seventeenth  century,  for  even 
the  medical  ordinance  of  Brandenburg  in  the  year  1685  does  not  designate  such  with 
any  definiteness  In  Frankfort  there  were  medici  ordinarii  and  sworn  physicians. 
The  youngest  medicus  was  called  medicus  pestilentiarius,  and  was  required  to  attend 
patients  suffering  from  the  plague.  It  should  also  be  mentioned  that  very  many 
physicians  were  skilled  astrologers.     Even  Kepler  was  compelled  to  officiate  in  this 


—  566  — 

capacity!     The  manufacture  of  almanacs  too  was  still  often  placed  in  the  hands  of 
physicians. 

That  physicians  were  also  involved  in  the  religious  entanglements  of  this  century 
is  readily^  understood.  Thus  in  Vienna  it  was  decreed  that  all  physicians  must 
become  Catholics  ins /a  liter,  and  those  who  did  not  were  to  leave  the  city  at  once. 

In  consequence  of  the  universally  prevalent  belief  in  astrology  and 
alchemy,  and  the  rage  for  searching  after  the  philosophers'  stone  and  the 
transmutation  of  baser  metals  into  gold,1  the  physicians-in-ordinary  were 
usuall}T  taken  from  the  ranks  of  those  who  were  likewise  chemists  (a  very 
common  thing  among  the  plrysicians  of  this  century,  so  devoted  to  the 
natural  sciences),  and  in  fact  from  among  the  pure  Adepts,  as  they  were 
called.  Thus  e.  g.  Mynsicht2  was  appointed  physician-in-ordinary  in  1631, 
with  a  salary  of  900  marks,  a  free  residence  and  two  loads  of  charcoal  for 
use  in  distilling.  So  Becher,  physician-in-ordinary  at  Mavonce  and  then  at 
Munich,  received  a  good  laboratory  (almost  every  prince  and  high  lord  had 
such  a  laboratory);  Dr.  Geo.  Krembs  (died  16-18)  received  a  salary  of  850 
marks  ($212)  as  court  physician  etc.3  Many  ph3'sicians,  probably  with  a 
view  to  public  and  private  health,  were  also  appointed  to  non-medical  posi- 
tions, especially  that  of  burgomaster,  an  arrangement  which  is  uncommon 
at  the  present  day.  Some  also  occupied  the  position  of  teachers,  directors 
etc.  of  the  Gymnasia,4  and   in  Holland  they  even  became  Presidents  of  the 

1.  The  latter  pursuit  was  designed  to  till  the  purses  of  the  numerous  potentates, 

which  had  been  emptied  by  the  war  and  the  dissoluteness  of  court  life  ;  but  it 
really  served  merely  to  while  away  their  time  in  "[curious"  experiments  at  the 
expense  of  their  dear  bought  gold. 

2.  He  was  "Pfalzgraf  ",  a  rank  corresponding  to  that  of  the  Roman  "Comes",  and 

including  the  authority  to  legitimise  illegitimate  children  (except  those  of  princes, 
counts  and  barons),  to  confer  the  lower  and  higher  academic  grades  up  to  Doctor 
inclusive  —  the  recipient  was  then  styled  Dr.  bullatus  —  to  exercise  guardianship 
over  minors,  to  crown  poets  etc.  —  What  sums  were  consumed  in  the  curious 
hobbies  of  the  princes  of  the  17th  century,  and  what  fees  the  chemists  received, 
may  be  judged  from  the  fact  that  Kunkel  e.  g.  for  the  invention  of  red  glass 
received  from  the  elector  Frederick  William  a  present  of  100  ducats.  The  first 
cup  made  of  this  glass  —  it  weighed  about  24  pounds  —  cost  the  elector  of  Cologne 
2,400  marks  ($?(>00),  and  the  glass-cutters  paid  12  marks  for  half  an  ounce  of  the 
material. 

3.  In  1660  Nicholas  LeFevre  was  appointed  to  the  office  of  Professor  of  Chemistry 

and  Apothecary  in  Ordinary  to  the  Royal  Family  of  England  at  a  salary  of  £150. 
The  salary,  however,  seems  to  have  been  very  difficult  to  obtain,  for  in  1663  he 
petitions  for  the  wages,  allowances  etc.  due  him  since  1(560,  "of  which  he  has  as 
yet  received  nothing."     (H.) 

4.  For  example  :  Georg  llenisch  (1549-1618)  of  Bartfelden  in  Hungary,  was  a  physician 

and  professor  of  mathematics  in  the  gymnasium  of  Augsburg;  Tobias  Andrea' 
(16:58-1685),  professor  of  philosophy  in  Bremen  and  Franecker  ;  Chr.  Friedrich 
Orocius  (1623-1673),  professor  of  the  oriental  languages  in  Bremen  ;  Til.  J.  Alme- 
loveen  (1657-1712),  professor  of  medicine  and  oratory;  H.  Arnisaus  (died  1636), 
professor  of  medicine  and  philosophy;  Jac.  Bartsch  (died  1633),  physician  and 
professor  of  mathematics  ;  Heinr.  Fabricius  (died  1612),  physician  and  director  of 
the  gymnasium ;  Jacob  Folius,  physician  and  school-director  etc.  (Marx). 
Paul  Flemming  'died  1640),  a  physician  and  poet  of  Hamburg,  belonged  among 
the  numerous  disciples  of  /Esculapius  endowed  with  poetic  genius. 


—  567  — 

Admiralty.  Bath-physicians,  in  our  modern  sense  of  the  term,  seem  still 
to  have  been  few  in  number.  Yet  physicians  were  often  entrusted  with 
the  examination  of  mineral  waters  (with  very  artless  results),  and  domestic 
practitioners  were  interrogated  by  patients  as  to  the  effect  of  the  waters. 

The  statements  of  Dr.  M.  R.  Buck  regarding  the  customs  of  the  bathing  resorts 
in  the  1 7th  century  are  very  interesting.  Life  at,  the  baths  was  very  free  and  easy, 
and  a  "  cure"  ordinarily  lasted  32  days,  of  which  124  hours  were  passed  in  the  bath. 
A  shorter  course  lasted  only  16  days,  though  precisely  the  same  number  of  hours 
was  passed  in  the  bath.  Of  course  during  such  prolonged  sojourns  in  the  water  an 
abundance  of  food  was  furnished  the  patients  —  it  was  supplied  every  two  hours  — 
and  very  naturally  the  bathers  amused  themselves  by  gossip  and  even  singing.  Even 
delicate  ladies  ate  up  to  25  eggs  a  day,  and  drank  in  addition  6  to  S  quarts  of  wine 
On  the  other  hand,  cupping  and  venesection  were  energetically  employed,  even  out 
of  friendship  and  to  gratify  another.  Venesection  was  looked  upon  as  a  prophylactic 
and  derivative  against  bad  humors,  The  period  when  the  "cure"  was  concluded  was 
a  sort  of  festival,  and  terminated  with  a  little  sport.  A  countess  Walkenstein  about 
1635  paid  the  bath-keeper  ordinarily  4  marks  for  venesection  and  1.20  marks  for 
cupping.  In  Petersthal  there  were  apartments  for  common  people,  and  others  for 
patients  of  higher  social  position.  The  former  paid  for  these  12  to  24  pfennige  (?>  to 
6  cents)  per  week;  the  latter,  for  a  sitting-room  and  bed-room,  3.60  marks  per  week, 
or,  if  occupied  by  several  persons,  5.10  marks.  The  price  of  each  room  was  affixed 
to  the  door  A  precise  diet  was  fixed  upon  by  the  authorities,  and  polite  behavior 
was  likewise  prescribed.  Religious  conversation,  i.  e.  disputes,  was  prohibited,  as  it 
was  in  other  bathing  resorts  and  is  to-day  in  Leuk.  There  were  likewise  directions 
for  the  bath-physicians  and  a  complete  bath-ordinance,  which  was  designed  to  protect 
them  from  the  jealousy  of  rivals.  In  spite  of  all  regulations,  however,  magnificence 
and  ostentation  in  dress  could  not  be  guarded  against,  any  more  than  immorality  etc. 
The  latter  surpassed  in  luxuriance  even  the  gambling  bathing-resorts  of  our  own 
century.  Petersthal  in  the  Black  Forest  had  too,  as  early  as  1H86,  regular  mail 
communication  three  times  a  week. 

Most  of  the  German  physicians  enjoyed  merely  moderate  prosperityT 
although  (perhaps  rather  because)  tariff  ordinances  existed  everywhere,, 
while  in  France  and  England  some  individual  physicians  had  immense 
incomes,  a  fact  which  we  do  not  find  stated  of  any  German  doctor.  Thus 
Mead's1  practice  e.  g.  brought  in  £3750  annually,  and  Harvey  before  him,. 

1.  Mead,  whose  activity,  however,  belongs  chiefly  to  the  18th  century  (be  was  born  in 
1673  and  died  in  17541,  enjoyed  for  several  years  an  income  of  £5,000  to  £6  000. 
During  one  year  his  income  rose  to  £7,000.  His  regular  fee  for  an  office  consulta- 
tion was  one  guinea,  and  for  visits  to  the  houses  of  persons  of  rank  and  good 
condition,  two  guineas.  Like  many  of  the  eminent  physicians  of  his  day,  he  had 
also  regular  hours  for  consultation  in  some  of  the  coffee-houses  of  the  metropolis, 
where  he  was  consulted  by  the  apothecaries  concerning  their  patients,  and  wrote 
prescriptions  for  them  at  the  rate  of  half  a  guinea  apiece.  The  famous  gold- 
headed  cane  of  the  Jacobite  physician  and  bon  vivant,  John  Radcliffe,  passed  into 
the  hands  of  his  favorite  and  protege,  Mead,  and  thence  into  those  of  Askew, 
Pitcahn  and  Baillie,  to  be  deposited,  on  the  death  of  the  latter  in  182:!.  in  the 
library  of  the  College  of  Physicians,  where  it  is  still  to  be  seen.  —  The  "  Levamen 
Infirmi",  published  in  1700,  says:  "To  a  graduate  in  physick  his  due  is  about 
ten  shillings,  though  he  commonly  expects  or  demands  twenty.  Those  that  are 
only  licensed  physicians,  their  due  is  no  more  than  six  shillings  and  eight-pence, 
though  they  commonly  demand  ten  shillings.     A  surgeon's  fee  is  twelve-pence  a 


—  568  — 

who  had  no  veiy  large  income  according  to  English  ideas,  possessed  at  his 
death  an  estate  of  £20,000,  in  spite  of  the  fact  that  he  had  already  spent 
much  money  on  charitable  objects.  By  the  way,  it  may  be  remarked  that 
Harvey  made  his  professional  visits  on  horseback,  as  was  the  custom  in 
London  at  that  period,  and  that  a  servant  carrying  his  instruments  rode  a 
short  distance  behind  him.  Conring,  when  he  went  to  Sweden  as  actual 
physician-in-ordinary  (he  already  held  the  title  of  that  office),  is  said  to 
have  received  in  the  year  1658  an  annual  salaiy  of  3000  rix-dollars,  and  as 
Danish  Counsellor  of  State  he  enjoyed  a  salaiy  of  1000  thalers  ;  while  as 
early  as  1650  the  sum  of  1600  thalers  was  offered  him  in  vain  when  he  was 
in  Sweden  at  the  solicitation  of  queen  Christina.  From  Louis  XIV  too  he 
received  when  at  home  a  "pension,  such  as  was  given  to  many  other  famous 
persons  at  that  time."  Doubtless,  as  Marx  states,  at  that  period  —  and 
we  may  add  also  long  afterwards  —  the  patriotism  of  the  Germans  was  not 
so  highly  cultivated  as  it  is  to-daj' ;  and  j'et  Conring  was  desirous  of  pro- 
tecting himself  against  charges  of  want  of  patriotism  :  ':  I  hope  that  on 
this  account  no  adverse  suspicion  may  be  aroused  :  otherwise  I  would 
never  touch  the  money."  And  this  was  said  in  spite  of  the  fact  that  the 
man  had  eleven  children  and  was  himself  a  sufferer  from  stone  —  certainly 
good  evidence  of  patriotic  feeling.  The  latter  was  more  developed  in  Leib- 
nitz, who  deeply  mourned  the  influence  upon  G-ermany  of  French  money. 
French  mistresses  and  the  passion  for  imitating  foreign  manners,  which,  as 
we  know,  Bismarck  also  stigmatized. 

How  highly  the  duties  and  the  office  of  the  physician  were  estimated  by  the 
better  physicians  of  the  seventeenth  century  may  be  readily  inferred  from  the 
requirements  of  this  same  Conring:  "Only  a  few  upright,  talented  individuals,  gifted 
with  a  natural  inclination  toward  medicine  should  be  admitted  to  that  science."  .  .  . 
"  Wide-awake,  industrious,  daring,  philanthropic,  agreeable  persons,  genteel  and 
ready  at  all  hours,  were  best  fitted  for  the  practice  of  medicine.  Pure  empiricism 
was  out  of  the  question,  for  reflection  and  comparison,  the  adjustment  of  the  causes 
of  health  and  disease,  reasoning  from  the  known  to  the  unknown,  were  indispensable. 
In  life  certainly  we  do  not  find  it  a  simple  matter  of  theory,  but  of  practical,  active 
study.     Those  physicians  who  exerted  themselves  solely  for   the   sake  of  knowledge 

were  rare;   for  most  of  them  gain  and  external  honors  were  the  motives The 

separation  of  medicine  and  surgery  has  been  of  incredible  injury.  The  physician 
does  not  need  to  be  a  surgeon  himself,  any  more  than  an  architect  to  be  a  carpenter 
bra  mason;  but  he  should  possess  a  knowledge  of  surgery."  (Marx.)  Yet  it  was 
a  common  matter  of  business  to  sell  the  title  of  doctor  in  the  universities  of  almost 
all  countries,  as  well  in  Germany,  France  etc.  as  in  Spain.  Cervantes  in  his  Don 
Quixote  derides  the  graduates  of  Siguenza  and  says  that  in  Spam  the  small  univers- 
ities for  the  sum  of  two  doubloons  make  a  doctor  out  of  an  ass. 

The  pay  of  physicians  at  this  time  was  regulated  in  most  places  in 
accordance  with  a  definite  tariff  of  prices,  in  which  the  process  of  cutting 
down  the  physician's  honorarium  by  the  state  to  the  pay  of  a  day-laborer 


mile,  be  his  journey  far  or  near:  ten  groats  to  set  a  bone  broke  or  out  of  joint: 
and  for  letting  blood  one  shilling  ;  the  cutting  oft  or  amputation  of  any  limb  is 
five  pounds,  but  there  is  no  settled  price  for  the  cure  "  ( Jeaffresoni.     (H. ) 


—  569  — 

continually  progressed,  until  in  the  19th  centur}'  it  has  fallen  below  the 
bounds  of  decency.  The  rates  of  the  ordinance  of  1668  for  Frankfort-on- 
the-Main  and  the  first  Prussian  "ordinance"  1685  (see  the  account  of  med- 
ical relations  in  the  18th  century)  may  be  considered  the  average  tariff  for 
Germany.  These  ordinances  were  published  "because  the  medical  art 
through  its  abuse  has  fallen  into  derision,  scorn  and  abasement." 

Hesse  had  such  an  ordinance  as  early  as  161(1  Family  physicians  had  a  sum  in 
lump.  Thus  the  phj'sician  of  a  countess  in  Munich  received  100  marks  ($25)  annu- 
ally. The  city  phj'sicians  had  a  fixed  salary.  Thus  Malachias  Geiger,  who  succeeded 
his  father  Tobias  in  1638,  received  340  marks  ($85),  and  as  remuneration  for  the 
visitation  of  the  three  city  pharmacies,  171  marks  in  addition.  Many  of  the  "  Pest- 
physicians  "  received  large  salaries,  as  e.  g.  B.  Low  in  Prague,  who  had  2000  marks 
($500)  per  month. — The  number  of  physicians  cannot  longer  be  called  inconsider- 
able, as  it  was  in  the  16th  century.  In  the  middle  of  the  17th  century  there  were  in 
Basel,  all  together,  nine  professors  and  doctors  of  medicine,  besides  18  surgeons  and 
barbers;  in  Munich  there  were  17  physicians  (besides  16  bath-keepers),  of  whom  five 
belonged  to  the  collegium  medicum.  The  physicians  of  Munich  too  visited  patients 
suffering  with  the  plague  protected  by  a  mask,  examined  them  with  averted  face  and 
had  a  light  burning  between  them  and  the  patient!  —  According  to  the  Frankfort 
medical  ordinance  testimonials  must  be  presented  before  reception  among  the  city 
physicians.  No  physician  was  permitted  to  prepare  medicines,  under  a  penalty  of  17 
marks.  An  office  visit  cost  40  pfennige  (10  cents)  ;  a  visit  at  the  patient's  house  1.35 
marks  (33  cents);  in  chronic  cases  the  patient  paid  1.70  marks  (41  cents)  per  week. 
In  consultation  cases  each  physician  received  for  the  first  visit  one  gold-gulden 
(about  $1.75),  and  for  each  succeeding  visit  85  pfennige  (21  cents).  A  night  visit 
cost  1.70  marks  (41  cents).  If  the  patients  were  foreigners  the  fee  was  one-half  more. 
Visits  to  other  cities  were  paid  for  at  the  rate  of  1.50  marks  per  mile  as  travelling 
expenses,  and  6  marks  per  diem.  The  wealthy  paid  ad  libitum.  For  being  present 
at  a  post  mortem  and  rendering  an  opinion  thereon,  each  physician  received  7  marks 
(1.75).  These  rates,  as  we  see,  are  high,  and  are  an  evidence  of  the  high  esteem  of 
the  physician's  calling  at  that  period,  as  compared  with  our  own  time.  In  Fiance, 
on  the  other  hand,  the  rates  of  medical  fees  are  said  to  have  been,  in  the  provinces, 
as  low  as  those  of  veterinary  physicians  in  England.     (Buckle.) 

Moreover  the  German  physicians,  at  this  period  at  least,  like  the 
English  down  to  the  present  time,  seem  to  have  possessed  a  noteworthy 
esprit  du  corps,  which  led  them  to  distinguish  themselves  from,  and  to 
guard  themselves  against,  spurious  physicians.  With  this  purpose  in  view, 
they  frequently  associated  themselves  into  "Colleges"  (Collegia  medica),  as 
e.  g.  the  physicians  of  Augsburg  (who  as  early  even  as  1582  had  formed  a 
union),  those  of  Strassburg  in  1675,  of  Munich  and  the  newly  founded 
association  in  Schweinefurt.  These  colleges  had  the  settlement  of  con- 
troversies, rendered  opinions  with  regard  to  faults  in  treatment  etc. 

Surgeons  of  the  best  stamp,  most  of  whom  were  zealous  and  eager  for 
knowledge  and  even  eminent  authors  and  highly  esteemed  socially  (Stadt- 
chirurgen,  Leibchirurgen),  were  always  rare  in  German}-  during  the  seven- 
teenth centuiy.  In  this  respect  Germany  presented  a  marked  contrast 
with  other  countries,  e.  g.  France.  Some  of  the  surgeons  enjoyed  the 
advantages  of  a  higher  education,  as  e.  g.  Fabricius  Hildanus  ;  most  of 
them,  however,  were  self-instructed,  so  far  as  even-thins;  outside  the  limits 


—  570  — 

of  guild-surgery  was  concerned.  On  the  other  hand,  as  regards  ability 
they  were  practically,  and  often  excellently- ,  educated  (judged  by  the  rule 
of  their  day)  by  extensive  guild-travels,  in  war  etc.,  and  not  infrequently 
the}'  were  ingenious  fellows  and  daring  operators.  Although  subordinated 
to  the  oversight  of  the  physicians,  in  this  century  they  became  more  and 
more  independent  of  them  (if  not  de  lege  at  least  de  facto),  even  in  con- 
servative England.  The  social  emancipation  of  surgeons,  which  was  com- 
pleted in  the  following  century,  was  prepared  in  the  17th,  and  the  lower 
surgeons  of  that  period  were  the  "fathers  of  our  modern  surgery".  The 
ordinary  barbers  (and  to  some  extent  the  bath-keepers  also)  continued  to 
flourish.  The  former  were  appointed  "Pest-barbers"  with  special  frequency, 
and  of  course  there  was  no  lack  of  city'  and  court  barbers.  Many  of  these 
fellows  were  capable  and  reputable  surgeons  to  boot.  Most  of  them  had 
travelled  extensively  before  permanently  settling  themselves,  and  had  gone 
even  as  far  as  Dutch  India,  or  joined  expeditions  to  the  whale-fisheries, 
though  their  qualifications  were  not  materially  increased  by  the  latter 
experience.  "  Some  are  still  more  venturesome  and  join  expeditions  to 
Batavia,  India,  or  even  to  Greenland,  in  order  to  see  a  whale  or  the  boiling 
of  blubber.  But  what  is  the  use  of  all  this?"  Among  the  itinerant  prac- 
titioners the  lithotomists  were  particularly  prominent,  especially  in  France. 
Often,  however,  indeed  most  commonly,  these  were  empirics  of  the  clerical 
order. 

It  was  .still  usual  to  make  a  "masterpiece".  In  Frankfort  the  barbers  were  per- 
mitted to  shave  and  bleed,  and  also  to  treat  ordinary  wounds,  syphilis,  fractures,  dis- 
locations etc.  In  bad  cases,  however,  they  were  required  to  call  in  a  medicus,  and 
under  no  circumstances  were  they  to  administer  purgatives.  The  consulting  medicus 
received  a  fee  of  3  5  marks:  for  a  broken  arm  the  barber  received,  when  one  bone 
was  broken,  10.5  marks,  when  two  bones  were  broken,  20.5  marks.  For  the  treatment 
of  a  broken  leg  in  old  persons,  whether  one  or  both  bones  were  broken,  he  received 
30  marks,  85  pfennige;  in  children  12.5  marks.  For  a  (partial!  dislocation,  5.15 
marks:  for  a  complete  dislocation.  10  marks.  15  pfennige;  for  a  dislocation  of  the 
elbow  or  knee,  ;>0.85  marks,  or  if  the  result  was  not  good,  the  half  of  this  sum.  For 
the  treatment  of  ordinary  Mesh-wounds  he  was  allowed  1.70  marks  :  for  severe  wounds, 
7.10  marks,  large  wounds  of  the  nerves  and  arteries,  8.5  marks  etc.  Cases  of 
syphilis  were  paid  for  according  to  the  generosity  of  the  patients.  The  first  visit  to 
a  patient  suffering  from  the  plague  cost,  including  medicine.  1.70  marks;  each  sub 
sequent  visit  (including  medicine,  the  dressing  of  wounds  and  even  two  visits  a  day 
if  necessary  i.  1.70  marks  per  diem.  A  seton  and  its  treatment  until  free  suppuration 
set  in  cost  2.60  marks.  Amputation  of  the  arm  cost  Ml  marks;  of  the  leg  with  its 
treatment,  41  marks,  or,  if  the  patient  died,  half  these  prices.  Raising  a  blister  cost 
1.70  marks.  Oculists,  herniotomists  and  lithotomists,  whether  foreign  or  domestic, 
were  required  to  obtain  a  license  from  the  resident  authorities  of  the  guild  before 
operating,  and  in  severe  eases  they  must  call  in  a  physician.  Lithotomy  cost  51 
marks,  or,  if  the  patient  died,  half  that  sum  (according  to  the  Hessian  tariff  of  1865, 
also  51  marks!).  Operations  for  cancer  cost  41  marks;  for  cataract,  on  one  eye  17 
marks,  on  both,  125  marks:  for  hydrocele,  25  marks;  herniotomy,  51  marks:  for 
hare-lip,  11.5  marks  etc.       Strieker.) 

The  business  of  nursing  the  sick,  particularly  in  times  of  epidemics, 


—  571  — 

still  lay  mostly  in  the  hands  of  the  religious  orders.     In  Protestant  locali- 
ties these  were  replaced  by  the  barbers,  bath-keepers  and  midwives. 

That  there  was  then,  as  thei*e  is  now  (or  l-ather  soon  will  be,  as  the 
result  of  reopening  the  medical  "trade"  to  everyone),  in  both  the  lower  and 
upper  strata  of  society,  a  large  number  of  active  charlatans  and  swindlers, 
is  manifest  from  the  catalogue  quoted  above,  as  well  as  from  the  efforts 
of  physicians  in  their  own  defence,  to  which  reference  has  also  been  made. 
However,  a  preliminary  examination  at  least  was  then  required  in  case  of 
public  and  open  practice,  and  a  license  was  granted  only  upon  the  ground 
of  this  examination  and  the  payment  of  market-fees  and  booth-fees  into 
the  treasury  of  the  community,  the  guild  etc.  In  case  of  bad  results  of  the 
operations  of  these  itinerant  physicians,  they  were  liable  to  penalties, 
which  were  often  very  severe.  Thus  e.  g.  a  certain  Hans  Vohrl  in  1G59 
was  required  to  pay  a  fine  of  455  marks  ($114),  and  with  the  money  the 
practical  Suabians  built  a  wall  about  their  churchyard.  The  city  treasury 
did  not  often,  however,  transact  such  profitable  business,  and  the  regular 
fee  for  a  license  was  85  pfennige  to  1.70  marks  (21-41  cents).  These 
strolling  mediaeval  characters,  handed  down  from  ancient  times,  were  the 
plrysicians  of  the  masses,  and  operated  for  hernia,  couched  cataracts,  ex- 
tracted teeth  etc.  Their  business  was  occasionally  very  extensive  and 
methodically  organized.  Thus  one  of  these  itinerant  "physicians"  ap- 
peared accompanied  by  fourteen  assistants,  whom  he  distributed  among 
the  different  hamlets  lying  around  his  own  head-quarters.  Buffoonery, 
rope-dancing,  theatrical  representations,  dancing  bears,  monkeys,  "ladies" 
and  such  nonsense  were  matters  of  course.  The  favorite  period  for  the 
appearance  of  these  wonder-workers  was  the  annual  fair  season,  and  the 
place  of  their  exhibition,  a  booth  in  the  most  eligible  square  to  be  found. 
All  kinds  of  jests,  even  those  of  an  Abraham  a  Sta.  Clara  (1642-1709). 
rebounded  from  the  stupidit}-  and  superstition  of  the  masses.  The  plays 
and  representations  of  these  itinerant  doctors  were  degenerations  of  the 
mediaeval  Mysteries  (Mysterienspiele).  After  Innocent  III.  in  1210  had 
forbidden  the  clergy-  to  participate  in  these  plays,  secular  theatricals, 
jugglers  etc.  took  their  place.  The  latter  "also  practised  quackery  and 
sorcery",  and  at  last  had  for  their  main  object  the  procuring  of  patients 
for  the  itinerant  doctors  and  miracle-workers.  The  masses  were  attracted 
by  their  tricks  to  become  patients,  and  thus  the  tricks  assumed  a  profes- 
sional character.1  —  To   the  official    medical  corps,  if  such   an  expression 


These  "mountebanks",  as  they  were  called,  were  equally  common  in  England. 
We  learn  from  the  "State  Papers"  that  in  1665  a  license  was  granted  to  George 
Moretto,  "in  consideration  of  his  skill  in  medicines  and  surgery,  to  practise  in 
any  part  of  the  Kinsr's  dominions,  and  to  expose  his  medicines  for  sale  publickly, 
by  erecting  a  stage  in  the  Market  Place,  or  any  other  mode  which  he  deems  con- 
venient, without  molestation  to  himself  or  servant."  — Endorsed  "Mountebank ". 
This  Moretto  calls  himself  "  His  Majesty's  Surgeon"  in  his  petition  for  a  license. 
In  1664  one  Charles  Turland  was  also  appointed  "Bone  setter  in  Ordinary"  to 
the  Kins !    Similar  licenses  were  granted  in  1667  to  the  mountebanks  Joannes 


—  572  — 

may  be  allowed,  belonged  even  yet  the  executioner  and  the  hangman,  since 
they  might  now  and  then  take  part  in  the  investigation  of  cases  of  poison- 
ing, and  might  demand  54  marks  for  their  services,  while  the  barber  in  the 
same  case  received  only  45  marks  !  To  send  any  one  to  the  hangman 
meant  then,  as  well  as  now,  the  same  as  to  send  him  to  the  physician  !  — 
The  hangmen  of  Nuremberg,  J.  Mich.  Widmann  (born  1IJ42)  and  his  son 
of  the  same  name  (born  1675),  were  very  famous,  and  patients  flocked  to 
consult  them  as  they  do  now  to  many  •'natural-physicians"  (Naturaerzte). 
Shepherds  also  supplied  surgical  aid  !  —  That  in  this  natal  age  of  secret 
societies  a  great  number  of  Eosicrucians.  Spagyrists  and  Adepts  practised 
medicine  need  only  be  mentioned,  though  doubtless  these  fellows  were  not 
always  deceivers  and  not  infrequently  deceived  themselves  quite  as  much 
as  others  !  These  itinerant  physicians  were  called  "Doctores  teutonici", 
because  they  understood  no  Latin,  whence  probably  originated  the  English 
expression  "High-German  Doctor'"  in  the  sense  of  charlatan,  an  expression 
still  commonly  employed,  though  no  longer  justifiable  by  facts. 

The  surgeons  of  the  seventeenth  century,  particularly  in  France,  began 
to  assume  a  position  of  especial  honor  as  obstetricians,  and  in  fact  from 
this  period  onward  were  even  called  upon  to  attend  ordinary  cases  of  mid- 
wifery. This  change  was  very  largely  the  result  of  fashion,  for  after  La 
Valliere  had  been  attended  in  lb'rJ3  by  J.  Clement,  the  princesses  of  the 
period  also  hastened  to  place  themselves  under  the  care  of  male  obstetri- 
cians, so  that  the  French  accoucheurs  found  themselves  much  engaged  in 
travelling  to  cases  of  midwifery,  as  e.  g.  Clement,  who  went  three  times  to 
attend  the  wife  of  Philip  V.  of  Spain  etc.1 

In  spite  of  the  bitter  struggle  made  against  male  midwifery  by  the 
midwives  and  the  physicians,  the  practice  henceforth  remained  established. 
Indeed  in  Italy,  as  early  as  the  beginning  of  the  seventeenth  century,  male 
midwifery  was  customary  :  yet  in  a  general  way  it  first  dates  from  the 
famous  accouchement  referred  to  above,  so  that  practical  midwifery  owes 
its  great  advancement,  which  began  at  this  period,  directly  to  the  mistress 
of  a  king.  In  Holland  the  state  appointed  male  midwives,  and  even 
regular  physicians  (as  the  example  of  van  der  Steeren  proves)  devoted 
attention  to  surgical  or  obstetrical  operations,  though  of  course  against 
the  opposition  of  the  guild-surgeons.  In  this  country,  indeed,  every  bride 
of  consequence  received  one  of  Deventer's  delivery-stools  as  a  portion  of 
her   dowry. —  In    Germany   alone  the  women  resisted    to   the   utmost  the 

Michaphilo,  John  Riissell  and  Toussain  Le  Jond.    Such  itinerant  practitioners 
were  also  called  "Merry  Andrews",  from  the  jokes  and  buffoonery  which  they 

employed  to  attract  the  masses.  I II.  i 
1.  The  imitation  of  mistresses,  however,  was  not  the  limit  of  the  loyalty  of  this  age, 
for  courtiers  even  went  so  far  as  to  permit  themselves  to  be  operated  upon,  like 
the  king,  who  was  cut  for  fistula  in  ano  by  Ch.  Francois  Felix  (died  1703)  with  a 
bistowi  royal  invented  for  this  special  operation  ;  and  this  although  they  them- 
selves had  no  fistula?  !  A  curious  evidence  of  courtesy  in  a  still  more  curious 
place  in  this  gallant  and  elegant,  age  ! 


—  573  — 

admission  of  male  assistance  in  such  cases.  If  such  aid,  however,  was  at 
last  called  in  from  "necessity,  it  was  frequentl}-  done  secretly  and  with  curious 
and  excessively  modest  procedures.  Obstetrician  and  patient  tied  each  one 
end  of  a  sheet  about  their  necks,  so  that  though  the  view  of  both  parties 
was  unobstructed  above  this  guard,  the  female  to  be  operated  upon  was 
protected  from  male  observation  as  far  as  concerned  her  nether  regions. 

That  the  midwives  —  especially  in  Germany  and  England  —  admin- 
istered -'abortive"  drugs  and  performed  operations  (German  "handwirkten"' ') 
lustily,  and  systematically  disparaged  male  assistance  etc.  to  the  married 
women,  need  only  be  mentioned. 

A  few  of  them,  however,  did  their  duty  honorably,  and  won  respectable  positions 
as  "  midwives-in-ordinary  ".  In  France  the  midwives  also  called  themselves  ''accou- 
cheuses", after  the  style  of  the  men.  It  may  be  remarked  here  too,  that  in  the  latter 
country  the  Huguenot  midwives  (as  well  as  the  physicians  and  even  the  patients  in 
hospital)  were  required  after  1680  to  renouuce  their  faith  if  they  wished  to  continue 
their  business.  In  Holland,  however,  the  midwives  still  held  the  patient  upon  their 
lap  (Schoos),  and  hence  they  were  here  called  simply  "  Schoossers". 

Apothecaries,  on  the  whole,  still  occupied  the  same  position  as  in  the 
sixteenth  century,  except  that  they  were  now  trusted,  if  possible,  still  less 
than  before.  The}-  were  regarded  as  cunning  rascals,  and  complaints  were 
made  of  their  high  charges  etc.  Hence  arose,  of  course,  many  new  tariff 
ordinances,  and  inspections  were  also  more  frequent. 

In  France  there  were  still  apothecary -surgeons,  as  there  are  in  England  to-day. 
Even   the   regular  clergy  were  apothecaries,  and  the  grocers2  were  in  constant  com- 

1.  The  surgeons  belonged  among  the  mechanics   (in   Austria  even  to  very  recent 

times1,  while  the  physicians  were  counted  among  the  free  artists.  "  Handwerk" 
is  the  literal  translation  of  the  Greek  x~tP0UPY''a-  [The  same  may  be  said  of  the 
English  "Surgery"  =  "  Chirurgery  ".     H.] 

2.  In  England  the  apothecaries  were  separated  from  the  grocers  in  1617  by  king 

James  I.,  but  the  arrangement  was  strongly  opposed  by  both  parties,  and  as  late 
as  1624  the  king  was  forced  to  explain  to  the  Lord  Mayor  and  Aldermen  of 
London  that  "he  passed  the  patent  to  the  Apothecary  Company  from  his  own 
judgment,  for  the  health  of  his  people,  knowing  that  the  Grocers  are  not  com- 
petent judges  of  the  practice  of  medicine.  He  intends  to  make  good  his  well- 
founded  act.  and  his  intentions  are  to  be  made  known  to  the  Speaker,  that  his 
Majesty  may  preserve  his  proper  right  to  take  care  for  the  good  of  his  people." 
The  apothecaries,  besides  compounding  and  dispensing  medicines,  claimed  also 
the  right  of  prescribing,  and  a  chronic  dispute  relative  to  this  subject  was  carried 
on  with  the  physicians  until  the  question  was  finally  settled  in  favor  of  the  apo- 
thecaries by  the  House  of  Lords  in  1721.     Apothecaries'  Hall  was  built  in  1670. 

John  Wolfgang  Rumler  was  appointed  apothecary-in-ordinary  to  Charles  I.  in 
Hi")  with  a  salary  of  £40.  which  seems  to  have  been  the  ordinary  salary  before 
the  Restoration.  In  1663,  however.  John  Jones,  apothecary  to  the  Household  of 
Charles  II.,  received  a  salary  of  £60  and  £12  board  wages. 

A  bill  of  Thomas  Hickes.  apothecary,  for  medicines  furnished  to  Edward 
Nicholas  in  1633,  gives  the  following  articles  and  prices  : 

A  dose  of  purging  pills  ...  2s.  6d.. 

A  purge  for  your  son        -  -  -  -     3s. 

A  purge  for  your  worship       ...  3s.  6d.. 

A  glass  of  chalybeate  wine  -  -  -      4s. 


—  574  — 

petition  with  the  hitter.  Hence  arose  long  and  frequentl}'  amusing  disputes  as  to  who 
was,  properly  speaking,  the  true  apothecary,  and  who  should  continue  to  hold  that 
position.  At  last  the  grocers  were  compelled  to  yield,  and  the  clergy  were  forbidden 
to  dispense  medicines.  —  Moreover  there  were  already  numerous  court-apothecaries, 
and,  what  is  more  important,  professors  of  pharmacy  in  France. 

It  was  a  general  complaint  that  the  apothecaries  dabbled  too  much  in  the 
practice  of  the  physicians,  and,  in  regard  to  the  prescriptions  which  they  put  up,  that 
the}7  did  not  watch  scrupulously  enough  whether  these  were  prescribed  by  persons 
authorized  to  write  them.  Hence  arose  frequent  disputes  between  physicians  and 
apothecaries  (especially  in  the  quarrelsome  Faculty  of  Paris),  in  which  the  latter  were 
finally  in  despair  compelled  to  yield. 

Many  apothecaries  were  also  capable  chemists-  Annual  trips  to  Frankfort-on- 
the-Main,  the  commercial  metropolis  of  Germany,  were  usuall}'  made  for  the  purpose 
of  purchasing  drugs. 

The  age,  however,  was  still  very  favorable  for  the  apothecaries  ;  for,  while  they 
were  in  the  habit  (as  at.  the  present  day)  of  giving  nothing  to  customers  who  were  bad 
pay,  on  the  other  hand,  their  drugs  often  sold  at  fabulously  high  prices  (which  is  not 
the  case  to-day),  and  money  could  be  had  for  the  veriest  "filth",  and  even  for  ex- 
crement, of  all  kinds.  The  latter  was  still  to  be  found  in  the  pharmacies  during  the 
eighteenth  century,  e.  g.  peacock's  dung,  cow-dung  and  cow's  brain,  horse's  testicles, 
goat's  penis  etc.  The  so-called  wolf's-heart  (used  in  epilepsy),  wolf's  brain  (in 
paralysis),  genuine  asinus,  the  curative  virtue  of  which  depended  upon  the  fact  that 
the  withdrawal  of  J(esus)  left  sanus,  all  brought  their  price!  The  efficacy  of  varieties 
of  dirt  was  considered  demonstrated,  among  other  reasons,  by  the  circumstance  that 
Christ  healed  the  blind  men  with  mud.  The  same  thing  was  indicated  by  the  sojourn 
of  mankind  in  the  womb  for  nine  months  between  dung  and  urine,  as  well  as  by  the 
fact  that  the  cardinals  seat  the  hoi}7  father  upon  a  commode,  to  remind  him  of  the 
humility  so  necessarj7  to  him,  and  St.  Bernard  called  man  a  dung-sack  etc. 

The  reading  and  writing  of  prescriptions  too  was  no  easy  task  in  that  day,  for  a 
great  number  of  alchemistic  and  chemical  sig'ns  and  symbols  existed  for  one  and  the 
same  remed}'.  "Thus  e.  g.  there  were  19  different  signs  for  sulphur,  21  for  tin,  22 
for  cinnabar,  25  for  subcarbonate  of  iron,  sal  ammoniac,  saltpeter,  26  for  alum,  28 
for  rock-salt,  29  for  cooking  salt,  31  for  argol,  34  for  gold,  35  for  arsenic  and  borax, 
30  for  antimony,  89  for  quicksilver  etc.  The  symbol  for  gold  was  ©,  that  for  silver 
j)  .  for  mercury  £  ;  in  accordance  with  which  the  first  was  called  sol,  the  second 
luna,  the  third  Mercurius.  Tin  was  called  Jupiter,  copper  Venus,  iron  Mars"  etc. 
I  Marx.) 

Grocers  were  also  allowed  to  sell  drugs,  though  in  Frankfort-on-the-Main  this 
concession  was  limited  to  quantities  of  not  less  than  four  ounces.  They  were,  how- 
ever, prohibited  from  selling  composita,  Frankfort  pills  and  —  adulterated  articles! 
Traders  (Kramer)  and  confectioners,  who  at  this  period  also  belonged  in  some  sort 
to  the  pharmaceutical  faculty,  were  equally  prohibited  from  preparing  and  selling 
composita. 

The  veterinary  faculty  continued  the  same  as  in  the  preceding  century. 
As   an  indemnification,  however,  for  the  subordinate,  and   often  disreput- 

and  in  1635  : 

A  dose  of  pills  for  night  for  Mrs.  Nicholas  is. 

A  purge  potion        -  -  -  -  -     3s.  6d., 

An  emplaster  for  the  neck     -  -  -  Is.  6d., 

A  preparative  apozeme  (decoction)       -  -     2s.  6d., 

A  powder  to  fume  the  bedclothes    -  -  4s.         (Richards.)     (H.) 


—  575  — 

able,  social  position  of  its  proper  practitioners,  it  once  more  enjoyed  in 
its  department  at  least  workers  of  high  position  and  mostly  of  noble 
birth. 

The  subject  of  military  hygiene  also  we  find,  on  the  whole,  in  the 
same  condition  as  in  the  preceding  century.  The  pictures  of  the  sanitary 
condition  of  the  armies  during  the  Thirt}'  Years'  War  are  truly  horrible. 
In  the  camps,  as  well  as  after  the  battles,  the  wounded  and  sick,  in  the  lack 
of  any  regular  care,  perished  miserably  in  crowds.  Among  the  mercenary 
troops,  as  compared  with  the  lansquenets,  everything  was  much  worse  ! 
In  France,  military  hospitals  and  field  pharmacies  at  least  increased  in 
number.  There  was  still  a  "medicus"  beside,  and  having  control  of,  the 
surgical  faculty  —  often  only  one  for  the  entire  army  —  and  complete 
separation  of  the  medical  contingent,  with  all  the  disadvantages  of  this 
arrangement.  The  "  Feldmedici"  carried  a  baculus  nodosus,  after  the  style 
of  the  civil  physicians,  and  always  bore  it  with  them  as  a  symbol  of  their 
rank.  The  troops  of  the  German  empire  present  us  with  a  field-plrysician 
(Feldmedicus)  and  a  staff-surgeon  (Stabschirurg)  forming  the  chief  author- 
ity, to  whom  the  regimental  surgeons  (Regimentsfeldscheerer),  with  pay 
of  20  marks  per  month,  and  the  company  surgeons  (Compagniefeldscheerer) 
were  subordinate.  Upon  the  staff  of  the  artillery  was  placed  a  surgeon- 
major  (Feldscheerermajor),  whose  pay  was  28  marks  per  month,  and  who 
had  his  assistants  (Gesellen).  The  subordinates  were  expected  to  report 
to  the  superior  medical  authorities  daily,  and  every  eight  da}-s  there  was  a 
general  report.  A  very  bad  picture  was  drawn  of  the  character  of  the 
-  Feldscheerer"  of  that  day. 

Pay  of  Military  Physicians  in  Brandenburg'  during  tlie  17tli  Century. 

Years  1630-32,  Surgeon  of  the  Lifeguard,  monthly    -  22  M.  50  Pig. 

1635,         "  "         Company,         "  -  14  M.  40  Pfg. 

1638,  "          "         Regiment,        "           ....  30  M.  —  Pfg. 
The  Surgeon 14  M.  40  Pfg. 

1639,  Regimental  surgeon  (from  searcitj'  of  money),  monthly,   15  M.  —  Pfg. 
Company  surgeon  of  Cavalry,     monthly,  -         -         11  M.  40  Pfg. 

Infantry,  "         -        -        -     10  M.  80  Pfg. 

From  April  1655,  Regimental  Wundarzt,  Cavalry  Staff,  monthly     -         27  M.  —  Pfg. 
Regimental  surgeon,  Infantry  Staff,  -     27  M.  —  Pfg. 

Company  surgeon  of  Cavalry,    monthly.        -         -         27  M.  —  Pfg. 
Company  surgeon  of  Infantry,  -         -  15  M.  —  Pfg. 

In  permanent  camp  ami  while   resting  in  the  country 
no   pay   was  given  from  scarcity  of  money,  but  sub- 
sistence alone  was  furnished. 
From  Dec.  1655  Wundarzt  on  the  Cavalry  Staff,  monthly,         -         -         27  M.  — Pig. 

Infantry  Staff,      "  ...     21   M.  —  Pfg. 

"         of  the  Dragoons,  -        -         21  M.  —  Pfg. 

"       Company  of  Cavalry,  monthly.         •     21  M.  — Pfg. 

Infantry,         "    "        -         15  M.  50  Pfg. 

If  forage  and  subsistence  were  furnished  9:   7.50:  6:  4.50. 


—  576  — 

THE  fiUARD. 

Surgeon  of  the  Bodyguard,  monthly,         -         -     21  M.  —  Pfg. 

Year         1676,  Surgeon  of  the  Halberdier  Bodyguard,     "  -         -         48  M.  —  Pfg. 

1685,  The  surgeon  of  a  regiment,  "...     52  M.  80  Pfg. 

"      1635-85  Surgeon  of  the  Grand-Mousquetairs,  composed  of  French  officers 

of  the  reformed  faith,  fugitives  from  their  country,         90  M.  —  Pfg. 
Surgeon    of  the   German   Noble    Guard,   on    the    contrary, 

only  - 24  M.  —  Pfg. 

In  Prussia  there  were  also  higher  Regiments-  or  Stabsfeldscheerer  and 
Compagniefeldscheerer.  who  maltreated  the  soldiers  when  sick  and  shaved 
them  (for  the  stipulated  "Seifengroschen")  twice  a  week  when  well. 

The  Great  Elector  (1620-1688)  also  appointed  physicians  and  surgeons 
in  garrison  (Grarnisonsmedici,  Garnisonsfeldscheerer).  The  army  of  the 
Electorate  of  Saxony  too,  as  early  as  1613,  had  in  each  regiment  of  infantry 
eight  Feldscheerer,  whose  pay  was  about  33  marks  per  month.  They 
ranked  between  a  quartermaster  and  a  gunsmith.  —  In  war  one  Medicus 
was  allowed  to  3000  men.  Most  of  these  Feldscheerer  possessed  no  med- 
ical knowledge  as  to  the  treatment  of  the  sick,  but  were  "as  well  suited  to 
such  duty  as  an  ass  to  dance."  Yet  even  the  "officers''  preferred  the 
Feldscheerer  to  the  Medicus,  although  the  former  "prattled  a  heap  of  un- 
profitable boasting  to  the  credulous  patient  and  made  him  feel  safe",  and 
besides  "treated,  martyred,  tortured  or  even  killed  in  most  barbarous  style 
with  indiscreet,  highly  injurious,  dangerous  and  cruel  poisons,  such  as 
bleeding,  purging,  cooling  drinks,  or  all  kinds  of  chemical  and  insufficiently 
tried  medicaments."  (Richter.)  The  soldiers  generally  relied  mainly  on 
the  art  of  rendering  themselves  bullet-proof,  on  amulets  etc.,  and  placed 
no  great  confidence  in  the  skill  of  the  Feldscheerer.  The  cane  too  was  still 
the  instrument  of  correction  for — all  classes  of  military  physicians,  the 
Medicus  not  excepted.  The  regimental  commander,  and  even  lower  mili- 
tary officials,  prescribed  both  the  place  for  its  application  (back,  buttocks 
etc.),  the  method  (switches  etc.)  and  the  number  of  blows.1 

1.  No  standing  army  existed  in  England  before  the  Restoration,  and  that  of  Charles  II. 
scarcely  exceeded  5,000  men.  Hence  our  information  as  to  the  position  and  pay 
of  medical  officers  in  the  English  army  at  this  period  is  very  scanty.  It  is  probable 
that  before  the  Restoration  such  physicians  and  surgeons  as  were  required  for  the 
emergency  were  either  pressed  into  the  service,  or  engaged  for  a  definite  period 
upon  terms  which  varied  in  accordance  with  their  position,  reputation  and  other 
circumstances.  Under  the  Commonwealth  in  1650  it  was  ordered  that  a  physician 
should  be  attached  to  the  Northern  Garrisons  at  a  salary  of  Ss.  8d.  per  diem,  and 
in  the  same  year  the  Council  of  State  resolved  "that  the  Surgeons  of  each 
regiment  of  horse  may  have  £10  apiece  to  furnish  themselves  with  horses  and 
furniture  to  carry  their  chests ;  and  the  same  pay  for  each  horse  as  private 
Troopers.  Each  Surgeon  to  have  an  additional  sum  of  £5  for  furnishing  their 
chests  with  medicine,  the  present  allowance  being  about  £10  for  each  chest."  In 
1627  we  read  "  The  Master  of  the  Company  of  Surgeons  of  London  has  imprested 
six  of  the  Company  to  go  down  to  Portsmouth  Some  of  them  are  to  go  to 
Portsmouth  and  some  to  Plymouth,  to  attend  the  wounded  men  from  the  expedi. 
tion  to  Rhe."  The  pay  of  surgeons  was  apparently  very  small.  In  1653  the 
Commissioners  for  sick  and  wounded  "request  the  Admiralty  Commissioners  to 


TMedical  advertising  seems  to  have  been  very  well  understood  in  Eng- 
land even  at  this  early  period,  and  Richards  furnishes  us  with  several  pages 
of  examples.     From  these  I  quote  : 

"The  Scotch  Pills. 

Whereas  Dr.  Anderson  or  the  Scotch  Pills  have  been  daily  abused  by  dangerous 
counterfeits  since  the  decease  of  Mrs.  Katherine  Anderson.  These  are  to  certih'e  for 
the  Publick  good,  That  the  true  Pill  is  faithfully  prepared,  and  for  the  future  to  be 
sold  with  printed  directions  only  by  Mrs.  Isabel  Inglis,  of  Edinburgh,  in  Scotland, 
now  living  at  the  Hand  and  Pen,  near  the  King's  Bagnio,  in  Long  Acre,  and  in  no 
other  place  in  or  about  the  city  of  London." — London  Gazette,  1(589. 

"  Old  Dr.  Mosse. 

At  the  Golden  Ball,  in  St.  J  one's  Court,  near  Clarkenwel  lives  Doctor  Mosse,  who 
bath  Obtained  the  only  most  Sovereign  and  excellent  Cure  for  the  Gout,  viz.  A 
Balsam  which  in  a  moment's  time  takes  away  the  Pain,  be  it  never  so  exquisite  and 
intolerable,  strengthening  and  restoring  the  Joynts  or  Members  Afflicted,  to  their 
perfect  Vigour,  Form  and  Motions,  the  said  Balsam  with  a  Box  of  Pills  being  the 
most  Absolute  Specificks  for  Curing  and  Defending  both  Internal  and  External  Parts 
from  that  Miserable  Distemper,  ever  yet  'published  or  made  manifest  by  any." — 
Athenian  Mercury,  Nov.  :>.,  l(i!)4.    (H.)] 


[Medicine  In  the  English  Colonies  of  North  America.     Foundation  of 
American  Medicine.1 

The  seventeenth  century  is  of  peculiar  interest  to  the  American  med- 
ical profession,  as  it  witnessed  the  foundation  and  early  struggles  of  what 
may,  perhaps  without  presumption,  be  now  called  American  Medicine. 

The  earliest  medical  practitioners  in  the  American  colonies  were 
naturally  the  medical  officers  of  the  companies  by  whose  direct  agency 
these  colonies  were  established,  or  the  surgeons  of  emigrant  and  trading 
vessels  which  arrived  at  the  new  settlements.  Thus  Dr.  Thomas  Wootton, 
Surgeon-General  of  the  London  Company,  accompanied  the  fleet  under 
Captain  Newport  which  founded  at  Jamestown,  Virginia,  May  13,  1607, 
the  first  permanent  settlement  within  the  limits  of  the  present  United 
States.  In  1608  Dr.  Walter  Russell  accompanied  Capt.  John  Smith  in  his 
exploration  of  Chesapeake  Bay  and  the  Potomac  river,  and  in  the  same 
year  Anthony  Bagnall  was  surgeon  of  the  fort  at  Jamestown.  Some  idea 
of  the  novel  circumstances  under  which  medicine  was  practised  in  the 
infant  colony  at  this  period  may  be  formed  when  we  read  that  Dr.  Woot- 

pay  £8  Is.  to  Wm.  Hayworth,  surgeon,  for  175  days'  services  with  the  sick  and 
wounded  at  Ipswich,  from  June  10  to  December  2."  In  the  following  year 
£16  14s.,  "being  ten  groats  a  day  each",  was  paid  to  John  Skinner  and  Robt. 
Seaman,  Surgeons,  of  Harwich,  for  services  from  Aug.  7  to  Sept.  26.  (See 
Richards  passim.)  (H.) 
1.  In  the  following  section  the  translator  takes  pleasure  in  acknowledging  his  obliga- 
tions to  the  writings  of  Drs.  Joseph  M.  Toner  of  Washington,  Stephen  Wickes  of 
Orange,  New  Jersey,  Samuel  Abbott  Green  of  Boston  and  John  R.  Quinan  of 
Baltimore. 

37 


—  578  — 

ton  was  compelled  to  live  for  a  considerable  period  upon  crabs  and  stur- 
geon from  the  James  river,  and  that  surgeon  Bagnall,  on  one  of  his 
professional  visits,  received  an  Indian  arrow  through  his  hat.  The  so- 
journ of  all  these  medical  men  in  the  new  colony  seems,  however,  to  have 
been  quite  transient,  for  in  the  following  year  Capt.  Smith,  who  had  been 
accidentally  wounded,  was  compelled  to  return  to  England  for  treatment, 
"for  their  was  neither  chirurgeon  nor  chirurgery  at  the  fort."  In  1610, 
however,  Dr.  Lawrence  Bohun,  an  alumnus  of  one  of  the  universities  of 
the  Netherlands,  arrived  in  Virginia,  and  in  the  following  year  is  men- 
tioned as  the  Physician-General  of  the  colony.  The  illness  of  Lord 
Delaware,  who  was  compelled  to  sail  to  the  West  Indies  for  his  health, 
withdrew  Dr.  Bohun  from  the  infant  settlement  in  the  same  year,  and  he 
was  soon  after  killed  in  an  engagement  with  a  Spanish  man-of-war.  The 
position  of  Physician-General,  thus  vacated,  was  soon  after  filled  by  the 
arrival  of  Dr.  John  Pot,  who  became  a  permanent  settler  of  the  new 
colony,  and  thus  enjoys  the  honor  of  having  been  the  first  permanent 
resident  physician  in  the  United  States.  Dr.  Pot  seems  to  have  been  a 
man  of  very  considerable  merit,  as  he  was  elected  temporary  governor  of 
Virginia  in  1628. 

On  Sept.  3.  1600,  Henry  Hudson  in  the  -Half  Moon''  first  cast  anchor 
in  the  waters  of  New  York  Bay.  It  was  not.  however,  until  1623  that  any 
serious  effort  was  made  to  colonize  New  Netherlands,  as  the  new  colon}' 
was  called,  and  in  1626  Peter  Minuit,  the  new  Director-General,  purchased 
the  island  of  Manhattan  from  its  aboriginal  proprietors  for  the  sum  of 
about  $24.  The  germ  of  our  present  commercial  metropolis  at  this  period 
consisted  of  thirty  houses,  and  its  population  in  1628  numbered  270  souls, 
•'including  Dutch,  Walloons  and  slaves  from  Angola." 

The  earliest  physicians  whose  names  are  mentioned  in  connection 
with  the  colony  of  New  Netherlands  are  Hermann  Mynderts  van  de 
Bogaerdet.  surgeon  of  the  ship  Endragh.  trading  with  the  colon}'  in  1631, 
and  William  Deeping,  chirurgeon  to  the  ship  William  of  London,  in. 1633. 
In  1637.  however,  arrived  the  first  permanent  medical  settler  in  the  city 
of  New  Amsterdam  of  whom  we  have  any  record.  This  was  Dr.  Johannes 
La  Montagne,  a  Huguenot  physician,  whose  ability  soon  rendered  him  a 
prominent  man,  both  professionally  and  politically,  in  the  new  colony.  In 
1638  Wilhelm  Kieft.  the  new  Director-General  of  the/  colony  of  New 
Netherlands,  arrived  in  New  Amsterdam,  bringing  in  his  train  two  surgeons, 
Gerrit  Schult  and  Hans  Kiersted.  The  latter  married  a  daughter  of  Dr. 
La  Montagne.  and  was  a  popular  practitioner  in  the  colony  at  least  as  late 
as  1661.  Other  prominent  medical  practitioners  in  the  colony  of  New 
Netherlands  were  :  l>r.  Abraham  Staats,  a  native  of  Holland,  settled  at 
Fort  Orange  (now  Albany)  prior  to  1650.  whose  house  at  Claverack  was 
burned  by  the  Indians  in  1664,  his  wife  and  two  sons  perishing  in  the- 
flames  ;  Drs.  Jacob  Hendrickson  A'arvanger.  Jacob  L'Orange,  Jacob  D. 
Commer,  J.  Hughes.  Jan  du  Parck,  Alexander  C.  Curtis.  Peter  Jansen  van 


—  57y  — 

-den  Bergh,  Hermann  Wessels,  Gysbert  van  Imbroeck  (another  son-in-law  of 
Dr.  La  Montague),  who  practised  at  Wiltwyck,  and  others. 

Among  the  fortj'-one  "Pilgrim  Fathers",  who  with  their  families  con- 
stituted the  102  emigrants  of  the  ';Ma\flower"  and  founded  the  colony 
at  Plymouth  in  1620,  was  Dr.  Samuel  Fuller,  the  first  physician  of  New 
England.  He  continued  in  active  practice  among  the  colonists,  and  was 
held  in  the  highest  esteem  both  as  a  man  and  a  physician  until  in  1633 
he  fell  a  victim  to  his  professional  zeal.  Other  reputable  physicians  of 
Massachusetts  during  the  17th  century  were  :  Dr.  Giles  Firman  (1634) 
and  Dr.  William  Gager  (1630)  of  Boston  ;  Dr.  John  Fisk  (1637)  of  Salem  ; 
Dr.  Comfort  Starr  (1637)  of  Cambridge,  subsequently  of  Boston  ;  Dr.  Mat- 
thew Fuller  (1640)  of  Plymouth;  Dr.  Thomas  Oliver  (1640)  of  Boston; 
and  the  surgeons  Thomas  Starrs  (1640)  of  Yarmouth  and  Samuel  Seabury 
(died  1680)  of  Duxbury. 

It  would  of  course  be  both  useless  and  wearisome  to  enumerate  in 
•detail  the  names  of  all  the  early  medical  men  of  the  numerous  settlements 
established  in  the  United  States  during  the  17th  centuiy.  Sufficient  has 
been  said  to  show  that  the  early  colonists  were  by  no  means  deprived  of 
medical  assistance  in  the  various  diseases  with  which  the  infant  settle- 
ments were  speedily  visited. 

Nor  is  it  to  be  hastily  assumed  that  the  medical  pioneers  of  this 
■countn'  were  men  lacking  in  either  personal  character  or  professional 
ability.  It  cannnot  of  course  be  expected  that  eminent  European  practi- 
tioners and  teachers  would  abandon  the  comforts,  honors  and  privileges 
of  European  civilization  for  the  poverty  and  hardships  of  a  pioneer's  life. 
But  it  may  be  safely  asserted  that  the  early  medical  settlers  of  the 
American  colonies  were  the  peers  of  the  average  European  physician  of 
their  day.  Dr.  Pot,  as  we  have  seen,  became  governor  of  Virginia  ;  Dr. 
La  Montagne  was  a  member  (and  the  only  one)  of  Kieft's  council,  and 
filled  with  honor  other  positions  of  trust ;  John  Winthrop  Jr.  (1606-1676), 
an  alumnus  of  Dublin  and  an  able  physician,1  was  the  first  governor  of 
Connecticut  and  one  of  the  founders  of  the  Boyal  Societ}-  of  England,  to 
which  he  found  leisure  to  transmit  several  communications  ;  Dr.  Matthew 
Fuller  of  Barnstable  was  Surgeon-General  of  the  provincial  forces  in  1673, 
and  we  shall  have  occasion  to  mention  others  who  became  eminent  in  var- 
ious fields  of  activity  during  the  17th  century. 

The  sources  of  supply  for  the  medical  profession  of  the  growing 
colonies  were  twofold,  foreign  and  domestic.  During  the  course  of  the 
17th  century  numerous  educated  European  physicians  emigrated  to  Amer- 
ica and  cast  their  lot  with  the  hardy  founders  of  western  civilization. 
Besides  those  already  noticed,  we  may  mention  Dr.  John  Clark  of  Boston 
(1638),  whose  son  and  grandson  of  the  same  name  were  eminent  members 


The  senior  John  Winthrop  (1587-1619  ,  Governor  of  Massachusetts,  though  a 
lawyer -by  profession,  is  said  to  have  also  possessed  considerable  medical  skill, 
and  was  in  the  habit  of  distributing  charitably  the  remedies  of  Van  Uelniont. 


—  580  — 

of  the  medical  profession,  and  whose  portrait  is  now  in  the  possession  of 
the  Massachusetts  Historical  Society  ;  Dr.  Robert  Child,  an  alumnus  of 
Padua,  who  settled  in  Hingham  as  early  as  1644  and  was  described  by 
Gov.  Winthrop  as  "a  man  of  quality,  a  gentleman  and  a  scholar";  Dr. 
Thomas  Thacher,  a  minister  and  physician  who  came  to  New  England  as 
early  as  1635,  and  was  the  author  of  the  earliest  contribution  to  medical 
literature  in  America  ;  Dr.  Johannes  Kerf  byle,  a  native  of  Holland  and  an 
alumnus  of  Le3-den,  who  practised  in  New  York,  and  in  1691  made  one  of 
the  earliest  autopsies  recorded  in  this  country  ;  Dr.  Abraham  Peirson,  an 
alumnus  of  Cambridge,  who  immigrated  to  Boston  in  1639  and  was  one 
of  the  earliest  physicians  of  New  Jerse}7,  where  he  removed  in  1667;  and 
many  others. 

Of  the  indigenous  practitioners  of  medicine  in  the  colonies,  a  certain 
number,  after  acquiring  at  home  such  preliminary  education  as  the  country 
afforded,  went  to  Europe  for  the  purpose  of  studying  medicine  in  the 
European  universities.  The  most  popular  of  these  among  American 
students  were  those  of  Leyden  Oxford,  Cambridge,  Aberdeen,  Paris  and 
Padua.  That  the  American  colonists  were  by  no  means  insensible  to  the 
advantages  of  education  is  manifest  from  the  fact  that,  at  the  very  first 
colonial  assembly  held  in  Virginia  in  1619,  measures  were  adopted  looking 
"toward  the  erecting  of  a  university  or  college".  In  New  England  too,  in 
1642  a  law  was  passed  requiring  "that  none  of  the  brethren  shall  suffer  so 
much  barbarism  in  their  families  as  not  to  teach  their  children  and  appren- 
tices so  much  learning  as  ma}T  enable  them  perfectly  to  read  the  English 
tongue",  and  in  1647,  "To  the  end  that  learning  may  not  be  buried  in  the 
graves  of  our  fore-fathers",  it  was  ordered  in  all  the  Puritan  colonies  "that 
every  township,  after  the  Lord  hath  increased  them  to  the  number  of  fifty 
house-holders,  shall  appoint  one  to  teach  all  children  to  read  and  write  ; 
and  where  any  town  shall  increase  to  the  number  of  one  hundred  families, 
the}'  shall  set  up  a  grammar  school,  the  masters  thereof  being  able  to 
instruct  youth  so  far  as  they  may  be  fitted  for  the  university."  A  public 
school  had  been  already  established  by  the  general  court  at  Cambridge  in 
1637,  and  when  in  1638  Rev.  John  Harvard  bequeathed  to  it  his  library 
and  one  half  his  fortune,  it  was  christened  Harvard  College.  The  educa- 
tional efforts  of  the  Virginia  colonists,  however,  bore  no  permanent  and 
important  fruits  until  about  half  a  century  later,  when  William  and  Mary 
College  was  chartered  in  1693.  Harvard  College  has  thus  the  honor  of 
being  the  earliest  institution  for  higher  education  established  in  the  United 
States,  and  the  earliest  but  one  in  the  western  hemisphere.1  Nor  were  the 
colonists  indifferent  to  the  cause  of  special  medical  education.  As  early  as 
1629  the  Governor  and  Deputy  of  the  New  England  Company  sent  to 
Governor  Endicott  a  "Chirurgjon",  Lambert    Wilson,  who  was  to  continue 


1.   The  University  of  San  Marcos  at  Lima  in  Peru  is  said  to  have  been  chartered  by 
the  Emperor  Charles  V.  in  1551. 


—  581  — 

in  the  service  of  the  colony  for  three  years,  and  in  their  letter  of  instruction 
thej*  provide  further  :  "And  moreover  hee  is  to  educate  &  instruct  in  his 
Art  one  or  more  youths,  such  as  you  and  the  said  Councell  shal  appoint 
that  may  bee  helpfull  to  him,  and  if  occasion  serve,  succeed  him  in  the 
Plantacion,  wch  youth  or  youths  fitt  to  learn  that  profession  lett  bee  placed 
wth  him  etc."  In  1647  John  Eliot,  the  "Apostle  to  the  Indians",  writes  to 
the  minister  of  Cambridge,  expressing  the  desire  that : 

"Our  youm:  Students  in  Physick  maybe  trained  up  better  than  yet  they  bee, 
who  have  onely  theoreticall  knowledge,  and  are  forced  to  fall  to  practise  before  ever 
they  saw  an  Anatomy  made,  or  duely  trained  up  in  making  experiments,  fur  we  never 
had  but  one  Anatomy  in  the  Countrej'  which  Mr  Giles  Firman  (now  in  England)  did 
make  and  read  upon  very  well"  etc. 

In  the  same  year  the  General  Court  published  the  following  recom- 
mendation : 

"We  conceive  it  vei'3*  necessary  yt  such  as  studies  physick  or  chirurgery  may 
have  liberty  to  reade  anotomy  &  to  anotomize  once  in  foure  yeares  some  malefactor, 
in  case  there  be  such  as  the  Courte  shall  alow  of." 

It  is  not  improbable  that  the  anatomical  lectures  of  Giles  Firman, 
which  were  delivered  prior  to  1647  and  are  the  earliest  example  of  public 
medical  instruction  in  the  United  States,  were  given  at  Harvard  College. 
At  all  events  Edward  Johnson,  in  his  "  Wonder-Working  Providence " 
published  at  London  in  1654,  speaking  of  this  college  says  :  "some  help 
hath  been  had  from  hence  in  the  study  of  Physick",  and  the  majority  of 
early  colonial  students,  who  went  abroad  to  receive  their  medical  educa- 
tion, had  already  taken  a  more  or  less  complete  course  at  Harvard  College. 
Among  the  latter  we  may  mention  Samuel  Bellingham  and  Henrj*  Salton- 
stall,  graduates  of  Harvard  at  her  first  commencement  in  1642  ;  Leonard 
Hoar,  an  alumnus  of  Harvard  in  1650  and  president  of  the  college  in  1672; 
John  Glover  (Harvard,  1650),  who  studied  medicine  at  the  universitj'  of 
Aberdeen  and  settled  in  Roxbury ;  John  Rogers  (Harvard,  1649),  who, 
however,  was  chiefly  active  as  a  minister,  and  was  also  president  of 
Harvard  College  from  1682  to  1684  ;  Samuel  Megapolensis  (Harvard, 
1661  ?),  who  studied  both  theology  and  medicine  at  the  university  of 
Utrecht  and  settled  in  New  Amsterdam. 

By  far  the  larger  number  of  domestic  physicians,  however,  were  com- 
pelled to  depend  for  their  education  upon  the  very  defective  educational 
arrangements  of  the  colonies  themselves.  The  vast  majority  of  medical 
students,  without  any  pretence  of  preliminary  education,  at  the  age  of 
14-18  3-ears  entered  the  office  of  some  medical  practitioner  in  their 
vicinity,  under  indentures  of  apprenticeship  for  the  term  of  3-7  years. 
In  this  position   they   had  access  to  their  master's  very  limited   libraiy,1 


An  inventory  of  the  effects  of  Dr.  John  Clark,  who  died  in  Boston  in  1664,  values 
his  "  books  and  instruments,  with  several  chirurgery  materials  in  the  closet,  £60; 
medicines  and  drugs,  £10;  and  a  pocket  watch,  £3."  The  libraiy  of  Dr.  Matthew 
Fuller,  Surgeon-General  of  the  provincial  forces  in  1673,  was  valued,  in  an  inven- 
tory of  his  effects,  at  £10;  his  surgeon's  chest  and  drugs  at  £16.     This  was  probably 


—  582  — 

and  learned  to  pulverize  drugs,  prepare  ointments,  plasters,  tinctures  etc.. 
to  extract  teeth,  cup  and  perform  venesection  and  many  of  the  operations 
of  minor  surgery.  In  addition  the}'  were  expected  to  discharge  the  menial 
duties  of  sweeping  out  the  •'office'',  caring  for  their  master's  horse,  keeping 
in  order  his  limited  stock  of  instruments  etc.  As  the  student  advanced 
in  years  and  instruction  he  accompanied  his  master  to  the  bedside  of  his 
patients  and  listened  to  the  words  of  wisdom  which  fell  from  his  lips,  or 
even  attended  himself  to  night-calls  and  less  important  cases.  Possibly  a 
happy  accident  might  supply  him  with  a  human  limb  for  the  study  of 
practical  anatomy,  but  this  was  a  contingency  far  too  rare  to  be  of  any 
practical  benefit.  At  the  expiration  of  his  term  of  apprenticeship  the 
newly  fledged  "physitian'.1  with  no  further  evidence  of  a  medical  education 
than  perhaps  the  certificate  of  his  preceptor,  plunged  at  once  into  the 
duties  of  his  profession,  and  relied  upon  bis  own  skill  and  energy  for  his 
future  success. 

The  practical  results  of  such  a  system  of  education  must,  of  course, 
have  depended  largely  upon  the  capacity  of  the  master  and  the  aptitude 
of  the  student.  At  best  they  could  be  only  very  imperfect.  Doubtless, 
in  very  many  cases  the  so-called  education  was  little  more  than  a  farce. 
Yet  it  is  not  to  be  inferred  that  all  students  of  this  system  were  ignorant 
and  incapable  practitioners.  Native  talent  and  industry  often  make  large 
amends  for  defective  education,  and  man}-  of  these  apprentices  doubtless 
proved  as  successful  physicians  (and  success  is  our  usual  test  of  merit) 
as  some  of  their  more  fortunate  colleagues  who  boasted  an  M.  D.  of  Ley- 
den,  Aberdeen  or  Cambridge  and  slew  their  patients  seciauhim  artem.  We 
may  fairly  infer  that  the  vile  decoctions  of  domestic  roots  and  herbs  and 
the  "Indian  cures''  of  these  indigenous  practitioners  were  quite  as  useful 
as.  and  far  less  dangerous  than,  the 

•Clysterium  donare, 

Postea  seignare. 

Ensuita  purgare" 
of  the  "regular"   Faculty.     By  the  latter,  however,  these   domestic  physi- 
cians were  naturally  looked  down  upon  with   scorn  and    contempt,  and  re- 

considerably  above  the  average.     The  inventory  of  Samuel  Seabury,  a  surgeon  of 
Duxbury  who  died  in  16W,  gives  the  items  of  his  library  as  follows  : 
Nicholas  Culpepper's  Practice  of  Physic    ....     4T  4s.  Od. 
Ditto  Anatomy  ....  3s.    — 

Reed's  Practice  of  Surgery 1-.   6d. 

Physician's  Practice is.    - 

Latin  Herbal  £1   10s.  — 

Art  of  Distillation,  by  John  French 2s.    — 

£3  IS.    6d. 
The  "surgeon's  instruments"  of  the  same  surgeon  were  valued  at  12s.,  and  an 
"Antimonial  cup"  (?),  at  as. 
1.    According   to  Toner   the   term   "Doctor"   was   not   applied   to   practitioners   oi 
medicine  ill  the  colonies  until  about  1769. 


—  583  — 

garded  as  mere  "quacks'".  This  will,  perhaps,  account,  at  least  partially, 
for  the  unfavorable  picture  of  medical  affairs  in  the  colonies  drawn  by 
contemporary  writers,  most  of  whom  were  ''regular',  i.  e.  regularly  edu- 
cated physicians,  or  other  persons  whose  own  educational  advantages  led 
them,  possibly,  to  undervalue  the  practical  ability  of  their  less  fortunate 
colleagues  and  colonists.1  Fortunately  too  the  sturdy  constitutions  of  the 
early  settlers  proved  often  more  than  a  match  for  the  ignorance  and  in- 
competence of  their  medical  advisers,  and  beneficent  Nature  made  ample 
amends  for  the  deficiencies  of  art. 

The  conditions  of  practice  in  the  new  colonies  too  differed  toto  ccelo 
from  those  which  prevailed  in  the  Old  World.  The  physician,  with  a 
scanty  and  defective  stock  of  drugs  and  a  still  less  complete  armamen- 
tarium of  instruments,  was  called,  perhaps  at  midnight,  to  ride  many  miles 
through  an  almost  pathless  forest,  and  to  treat  not  only  cases  of  disease, 
but  fractures,  dislocations,  arrow-wounds,  gun-shot  wounds  and  all  the 
accidents  incident  to  frontier  life.  Hence  he  was  required  to  be  above  all 
a  ready  man,  willing  and  able  to  render  prompt  assistance  in  all  sorts  of 
emergencies.  In  the  lack  of  regular  medicine  he  was  often  compelled  to 
experiment  with,  and  to  rely  upon,  indigenous  remedies,  and  to  devise 
surgical  apparatus  of  the  homeliest  pattern.  All  this  stimulated  that 
tendency  to  "practical"  objects,  which  has  become  in  recent  times  the 
chief  glory  of  American  Medicine. 

According  to  Wickes,  "An  act  for  regulating  the  fees  and  Accounts 
of  the  Practicers  of  Phisic",  passed  by  the  Assembly  of  Virginia  in 
the  year  163G,  provided  that  "  Surgeons  and  Apothecaries,  who  have 
served  an  apprenticeship  to  those  trades ",  should  be  permitted  to 
charge  five  shillings  for  each  visit  and  prescription  in  town,  or  within  the 
distance  of  five  miles  thereof.  On  the  other  hand,  ''to  those  persons  who 
have  studied  ph3-sic  in  any  university,  and  taken  any  degree  therein  ". 
it  was  permitted  to  charge  ten  shillings  for  the  same  service.  These 
were  about  the  same  fees  allowed  in  the  mother  country  at  the  same 
period.  Medical  fees,  however,  were  largely  (often  entirely)  paid  in  articles 
of  barter,  e.  g.  corn,  tobacco,  wampum,  skins,  powder  and  lead  etc.  The 
same  is  true  of  the  salaries  of  ministers  and  teachers.  Bancroft  says 
"once  at  least  every  family  in  each  of  the  colonies  gave  to  the  college  at 
Cambridge  (Harvard)  twelvepence,  or  a  peck  of  corn,  or  its  value  in  un- 
adulterated wampum  peag  ;  while  the  magistrates  and  wealthier  men  were 
profuse  in  their  liberality.*'  In  New  England  the  ordinary  medium  of  ex- 
change was  corn  ;  in  the  southern  colonies,  tobacco.  Indeed,  as  we  know, 
the  price  of  a  wife  in  Virginia  about  1020  was  120-150  pounds  of  tobacco. 
Besides  this,  medical  fees  were  then  (as  now)  proverbially  uncertain. 
Hence  it  was  very  common  for  one  person  to  fulfill  the  functions  of  min- 

1.  Certainly  it  would  have  been  impossible  to  rival  in  the  American  colonies  any 
such  catalogue  of  irregular  practitioners  as  adorns  (?)  page  552  of  the  present 
work . 


—  584  — 

ister  and  physician,  or  even  minister,  physician  and  teacher,  in  order  to 
gain  a  more  certain  support  by  a  multiplicity  of  employments.  The  com- 
bination of  minister  and  physician  was  especially  frequent  in  New  England) 
where  many  of  the  clergy,  in  anticipation  of  their  future  experience,  had 
studied  medicine  as  well  as  theology,  in  order  to  be  prepared  to  administer 
to  the  physical  as  well  as  spiritual  needs  of  their  fellow-colonists.  Thus 
several  of  the  physicians  already  mentioned  were  also  highly  esteemed  as 
ministers,  e.  g.  Dr.  John  Fisk,  who  was  also  a  teacher,  Leonard  Hoar,  Isaac 
Chanc}*,  John  Rogers  and  others.  In  New  Netherlands  the  same  arrange- 
ment seems  to  have  prevailed  to  some  extent,  though  in  the  more  southern 
colonies  it  was  less  common.  The  reason  of  its  special  frequency  in  New 
England  is,  doubtless,  to  be  found  in  the  intense  religious  feeling  which 
prompted  the  foundation  of  those  colonies,  and  pervaded  all  their  social 
and  political  institutions. 

Of  medical  literature  in  the  colonies  during  the  17th  century  we  can 
scarceby  speak.  The  first  printing-press  was  introduced  at  Cambridge  in 
1639,  and  in  the  same  year  appeared  the  "Freeman's  Oath"  and  "An 
Almanack".  In  1640  was  published  "for  the  comfort  and  edification  of  the 
saints"  a  rude  translation  of  the  Psalms  of  David  in  metre,  a  volume  of 
300  octavo  pages  —  the  first  book  issued  from  the  American  press  north 
of  the  City  of  Mexico.  Eliot's  Indian  Bible  appeared  in  1660-63. 
Presses  were  established  at  Boston  in  1674,  Williamsburg,  Ya.,  1681,  Phil- 
adelphia, about  1685,  and  in  New  York  in  1693. — ■  The  earliest  newspaper 
was  the  "  Publick  Occurrences"  of  Benj.  Harris,  the  first  and  only  number 
of  which  appeared  at  Boston  Sept.  25,  1690.  No  permanent  journal,  how- 
ever, was  published  in  the  colonies  until  the  appearance  of  the  "Boston 
News  Letter",  April  24,  1704.  This  journal  survived  for  72  years,  in  spite 
of  the  fact  that  for  the  first  fifteen  years  of  its  existence  its  subscription 
list  did  not  exceed  300. 

The  onl}T  medical  publication  of  the  colonies  during  the  17th  century 
was  the  "Brief  Rule  to  Cluide  the  Common  People  of  New  England  how 
to  Order  themselves  and  theirs  in  the  Small  Pocks  or  Measels",  printed 
and  sold  by  John  Foster,  Boston,  1677.  This  pioneer  of  the  overwhelming 
medical  literature  of  the  United  States  in  the  19th  century  was  printed 
upon  one  side  of  a  single  sheet  of  paper  15^  by  10^  inches  in  size,  in 
double  columns  like  a  modern  poster,  and  was  the  work  of  Dr.  Thomas 
Thacher  of  Boston.  Dr.  Thacher  was  born  in  England  May  1,  1620.  and 
received  at  home  merely  an  ordinary  school  education.  Declining  to  visit 
Oxford  or  Cambridge,  as  his  father  desired,  he  emigrated  to  New  England 
in  1635,  and  soon  after  placed  himself  under  the  instruction  of  Dr.  Charles 
Chaunc)',  who  in  1654  was  appointed  president  of  Harvard  College.  Under 
the  guidance  of  this  eminent  scholar  Dr.  Thacher  acquired  considerable 
knowledge  of  Hebrew  and  Arabic,  with  the  excellent  medical  principles 
which  in  after  life  he  found  occasion  to  employ  in  practice.  In  1644  he 
was  ordained  pastor  of  the  church  in  Weymouth,  but  removed  in   1669  to 


—  585  — 

Boston,  where  he  assumed  the  pastoral  charge  of  the  "Old  South  Church" 
and  devoted  much  of  his  time  to  the  practice  of  medicine.  In  the  latter 
sphere  he  is  said  to  have  enjoyed  considerable  reputation.  Dr.  Thacher 
died  in  Boston  October  15,  1678.  Of  his  writings,  besides  the  "Brief 
Rule",  a  Hebrew  lexicon  and  a  catechism  are  said  to  have  been  printed, 
each,  however,  occupying  only  a  single  sheet  of  paper. 

The  "Brief  Rule"  declares  smallpox  and  measles  diseases  of  the  blood  "en- 
deavoring to  recover  a  new  form  and  state.  This  nature  attempts  I.  By  Separation 
of  the  impure  from  the  pure,  thrusting  it.  out  from  the  Veins  to  the  Flesh.  2.  By 
driving  out  the  impure  from  the  Flesh  to  the  Skin."  The  first  separation  takes  place 
in  the  first  four  days  "by  a  Feaverish  boyling  (Ebullition)  of  the  Blood":  the  second 
separation  occupies  the  remaining  period  of  the  disease.  Dr.  Thacher's  treatment  is 
very  judicious  and  evidently  modelled  upon  that  of  Sydenham.  Before  the  fourth 
day  he  would  administer  no  medicine,  and  he  cautions  particularly  against  a  heating 
regimen,  "Cordials,  as  Diascordium,  Gascons  powder  and  such  like".  He  would 
have  the  patient  abstain  from  meat,  wine  and  open  air,  use  "small  Beer  warmed  with 
Tost"  for  drink,  and  water-gruel,  water-pottage  and  the  like  for  food.  The  room 
should  be  kept  comfortably  cool,  and  the  bed-clothing  should  be  light.  After  the 
fourth  day  "warm  milk  (not.  hot )  a  little  dy'd  with  Saffron  ma}- be  >:iven  morning 
and  evening  till  the  Pustules  are  come  to  their  due  greatness  and  ripeness."  When 
the  pustules  begin  to  dry  "  four  or  five  spoonfuls  of  Malago  wine  tinged  with  a  little 
Saffron  "  may  be  administered  night  and  morning.  The  symptoms  of  the  stage  of 
invasion  are  well  described,  and  the  evil  omen  of  an  imperfect  or  delayed  eruption, 
black,  "blewish"  or  green  pustules,  diarrhoea,  hematuria  and  haemorrhages  generally, 
is  carefully  recorded.  On  the  whole  the  paper  does  credit  to  both  the  head  and 
heart  of  the  worthy  and  reverend  doctor,  though  certain  sections  are  almost  literal 
translations  of  Sydenham.      He  could  scarcely  select  a  better  model! 

During  the  early  years  of  the  colonies  the  European  distinction 
between  physician  and  surgeon  was  still  partially  preserved,  especially 
in  the  larger  towns  and  among  medical  practitioners  of  foreign  education. 
But  the  exigencies  of  the  new  surroundings  soon  put  an  end  to  such 
distinctions  in  the  colonies,  and  the  vast  majority  of  medical  men  prac- 
tised indiscriminately  medicine  and  surgery,  as  they  do  in  the  United 
States  to-day. 

The  chronic  and  hereditary  quarrel  between  barbers  and  surgeons  crops  out  once 
more  in  the  following  ordinance  adopted  by  the  Dutch  authorities  of  New  Amsterdam 
in  1652 : 

"On  the  petition  of  the  chirurgeons  of  New  Amsterdam,  that  none  but  they  alone 
be  allowed  to  shave;  the  director  and  council  understand  that  shaving  doth  not 
appertain  exclusive!}'  to  chirurgery,  but  is  an  appendix  thereunto;  that  no  man  can 
be  prevented  operating  on  himself,  nor  to  do  another  the  friendly  act,  provided  it  be 
through  courtesy  and  not  for  gain,  which  is  hereby  forbidden.  It  was  then  further 
ordered  that  ship-barbers  shall  not  be  allowed  to  dress  any  wounds  nor  administer 
any  potions  on  shore  without  the  previous  knowledge  and  special  consent  of  the 
petitioners,  or  at  least  of  Doctor  La  Montasrne."  —  (Med.  Register  N.  V.  City,  1865.) 
Apothecaries  also  existed  in  the  larger  towns,  some  of  whom  also 
practised  medicine  as  in  England.  But  physicians,  as  a  rule,  kept  and 
prepared  their  own  drugs. 

Midwifery,  as  in  Europe,  remained  in  the  hands  of  women,  physicians 


—  586  — 

being  called  in  only  in  difficult  and  protracted  cases.  Even  the  names 
of  some  of  the  early  midwives  of  New  England  have  been  preserved  to  us, 
and  among  these  we  may  mention  the  wife  of  Dr.  Samuel  Fuller,  one  of  the 
pilgrims  of  the  Mayflower  ;  Mrs.  Hutchinson  of  Boston  (1637).  who  was. 
however,  banished  from  the  colony  for  her  political  heresies,  and  Ruth 
Barnaby,  likewise  of  Boston,  who  died  in  1765  at  the  advanced  age  of  lul 
years.  It  is  very  doubtful  whether  an}-  of  these  women  had  received  any 
special  education  for  the  performance  of  their  duties,  personal  experience 
of  maternit}-  being  considered  then  (as  it  generally  is  now)  amply  suffi- 
cient to  qualify  them  for  their  office.  Even  female  physicians  were  not 
unknown.  The  first  person  executed  in  the  colony  of  Massachusetts  Bay 
was  Margaret  Jones,  a  female  physician  accused  of  witchcraft,  "malignant 
touch"  etc. 

Daniel  Porter  was  a  celebrated  "bone-setter"  in  Connecticut  about 
1670.  who  seems  to  have  occupied  some  public  position,  for  his  "salary' 
was  raised  in  the  year  mentioned,  on  the  implied  condition  that  he  should 
"  instruct  some  meet  person  in  the  art  for  which  he  was  so  distinguished.-' 

It  is  worthy  of  remark,  amid  the  wholesale  charges  of  quackery  in  the 
American  colonies  at  this  period,  that  we  read  nothing  of  those  itinerant 
lithotomists,  herniotomists  and  oculists,  who  found  in  Europe  so  fertile  a 
field  for  their  activit}*.  Probably  the  hardships  of  colonial  life  presented 
no  attractions  to  such  gentr}-,  whose  sole  object  was  money,  and  to  whose 
success  an  extensive  clientele  was  necessary. 

It  redounds  too  to  the  credit  of  the  physicians  of  New  England  that 
their  names  are  conspicuously  absent  in  the  scandalous  histoiy  of  the 
delusion  known  as  the  "Salem  Witchcraft",  which  ran  its  brief  career  in 
1692,  and  in  which  Cotton  Mather  and  Samuel  Parris,  both  ministers,  the 
one  an  alumnus,  and  the  other  a  student,  of  Harvard  College,  played  so 
melancholy  a  role. 

In  the  province  of  state  medicine  we  read  that  Henry  Taylor,  a  sur- 
geon of  Boston,  had  his  taxes  remitted  in  1669,  in  consideration  of  his 
agreement  to  attend  the  sick  poor,  and  in  1671  Dr.  Samuel- Stone  agreed 
to  attend  "the  town's  poor  for  twenty  shillings  in  money  and  a  remittance 
of  taxes."  The  earliest  hospital  within  the  limits  of  the  United  States  was 
probably  erected  in  New  York  between  1650  and  1680,  for  in  the  latter 
year  the  governor  sold  an  institution  known  as  the  ••  Old  Hospital  or  the 
Five  Houses"  for  the  sum  of  £200,  its  place  having  been  taken  by  better 
and  more  serviceable  buildings.  In  times  of  epidemics  the  sick  were 
usually  placed  in  "pest  houses"  on  the  outskirts  of  the  town,  and  cared  for 
by  their  friends  or  b}T  hired  attendants. 

A  writ  de  ventre  inspicie?ido .  authorizing  a  jury  of  matrons  to  decide 
whether  one  Judith  Catchpole,  accused  of  infanticide,  had  been  pregnant, 
is  recorded  in  Maryland  in  1656.  The  earliest  autopsy  and  verdict  of  a 
coroner's  jury  of  which  I  have  been  able  to  find  any  record  occurred  also 
in   Maryland    in    1(557.     The   subject  of  the  autopsy   was  a  negro.    Henry 


—  587  — 

Gouge,  who  it  was  suspected  had  met  foul  play  at  the  hands  of  his  master. 
The  court  ordered  Mr.  James  Veitch,  with  two  chirurgeons,  Mr.  Rd.  Mad- 
docks  and  Mr.  Emperor  Smith,  and  as  many  neighbors  as  could  be  con- 
veniently procured,  to  investigate  the  case.  The  report  of  this  jury  was 
rendered  to  the  court  Sept.  24,  1(357,  and  its  Dogberry  st}de  is  worth  quo- 
tation.    It  runs  as  follows  : 

"  Whereas,  according  to  the  order  of  the  court,  we  have  proceeded  and  diligent]}' 
viewed  the  head  of  the  corps  of  Henry  Gougue  and  laid  open  to  us  by  the  chirurgeons, 
which  was  ordered  by  the  court  to  view  and  lay  open  to  us: 

"We  detest  under  our  hands  that  we  can  see  nor  find  nothing  about  the  said  head, 
but  only  two  places  of  the  skin  and  flesh  broke  on  the  light  side  of  the  head,  and  the 
scull  perfect  and  sound  and  not  anything  can  or  doth  appear  to  us  to  be  any  cause 
of  the  death  of  the  said  Gouge,  and  also  we  do  detest  that  we  did  endeavor,  what 
possible  in  us  lay,  to  search  the  bod}-  of  said  corps  and  could  not  possibly  doit,  it  being 
too  noysome  to  us  all  and  being  put  at  first  into  the  ground  without  anything  about  it, 
as  the  chirurgeons  and  the  sheriff  can  satisfie  vou,  this  is  the  tiuth  and  nothing  but  the 
truth,  as  witness  our  hands  and  seals  this  24  day'Sept.  1657.  And  according  to  the 
order  we  have  delivered  the  said  head  in  the  hands  of  the  sheriff." 

The  head  of  the  corpse  was  brought  into  court  for  inspection,  and 
several  of  the  witnesses  at  the  trial  deposed  that  "the  corps  bled  afresh 
when  Dandy  (the  master)  touched  it.'' 

The  surgeons  were  allowed  by  the  court  one  hogshead  of  tobacco  as 
their  fees  for  "dissecting  and  viewing  the  corps". 

Other  early  autopsies  are  recorded  in  Mainland  in  1670,  Massachusetts 
1674  and  New  York  1691.  The  last- mentioned  was  performed  by  Dr. 
Johannes  Kerf  by  le  and  five  other  ph}*sicians  upon  the  body  of  Gov. 
Sloughter  of  New  York,  who  had  died  suddenly  under  circumstances  sug- 
gesting the  suspicion  of  poisoning. 

Coroners  were  appointed  for  each  county  of  Maryland  in  1666. 

Medical  legislation  in  the  colonies  during  the  17th  century  was  largely 
devoted  to  the  regulation  of  medical  fees,  which  seem  to  have  been  fre- 
quentl}'  regarded  as  exorbitant.  The  earliest  law  relating  to  medicine  of 
which  I  find  any  record  was  passed  by  the  Assembly  of  Maryland  in  1638, 
and  was  entitled  "An  Act  for  settling  artificers'  wages''.  It  authorized 
the  county  courts  "to  moderate  the  bills,  wages  and  rate  of  artificers, 
laborers  and  Chirurgeons,  according  to  the  most  recent  rate  of  tobacco, 
proportioned  to  the  rate  of  the  price  of  the  same,  or  the  like  art.  labour 
or  workmanship  in  England."  In  1630  the  Assembly  of  Virginia  passed 
an  act  providing  "that  it  should  be  lawful  and  free  for  any  person  or 
persons  in  such  cases  where  they  should  conceive  the  acco't  of  the  phy- 
sitian  or  chirurgeon  to  be  unreasonable,  either  for  his  pains  or  for  his 
druggs  or  medicines,  to  arrest  the  said  physitian  or  chirurgeon  either  to 
the  quarter  court  or  county-court  where  they  inhabitt,  where  the  said 
phisitian  should  declare  upon  oath  the  true  value,  worth  and  quantity 
of  his  druggs  and  medicines  administered  to  or  for  the  use  of  the  pit. 
(patient),  whereupon  the  court  where  the  matter  was  tryed  was  to  adjudge 


—  588  — 

and  allow  to  the  said  phisitian  or  chirurgeon  such  satisfaction  and  reward 
as  they  in  their  discretions  should  think  fitt."  The  earliest  attempt,  how- 
ever, to  regulate  the  practice  of  medicine  in  the  colonies  of  which  I  find 
any  record  is  the  law  of  Massachusetts  passed  in  1G49.  This  runs  as 
follows  : 

"  Chirurgions,  Midwives,  Phj'sitians.  —  Forasmuch  as  the  law  of  God  allowes  no 
man  to  impaire  the  life  or  limbs  of  any  person,  but  in  a  judicial  way  :  It  is  there- 
fore ordered,  That  no  person  or  persons  whatsoever  im ployed  at  any  time  about  the 
bodyes  of  men,  women  or  children  for  preservation  of  life  or  health  as  chirurgions, 
midwives,  physitians,  or  others,  presume  to  exercise  or  put  forth  any  act  eontran'  to 
the  known,  approved  Rules  of  Art  in  each  Mystery  and  occupation,  nor  exercise  any 
force,  violence  or  cruelty  upon  or  towards  the  bod}-  of  any,  whether  young  or  old  (no 
not  in  the  most  difficult  and  desperate  cases)  without  the  advice  and  consent  of  such 
as  are  skillfull  in  the  same  art  (if  such  may  be  had),  or  at  least  of  some  of  the  wisest 
and  gravest  then  present,  and  consent  of  the  patient  or  patients  if  they  be  mentis 
compotes,  much  less  contrary  to  such  advice  and  consent,  upon  such  severe  punish- 
ment as  the  nature  of  the  fact  may  deserve;  which  law,  nevertheless,  is  not  intended 
to  discourage  any  from  all  lawfull  use  of  their  skill,  but  rather  to  encourage  and 
direct  them  in  the  right  use  thereof,  and  inhibit  and  restreine  the  presumptuous 
arrogancy  of  such  as  through  presidence  of  their  own  skill,  or  any  other  sinister 
respects,  dare  boldly  attempt  to  exercise  any  violence  upon  or  towards  the  bodyes  of 
young  or  old,  one  or  other,  to  the  prejudice  or  hazard  of  life  or  limbe  of  man  woman 
or  child." 

This  law  was  substantially  adopted  in  New  York  in  the  Duke  of  York's 
grant  of  1665.  In  the  city  of  New  Amsterdam  an  ordinance  was  adopted 
by  the  "sellout,  burgomaster  and  schepens"  in  1G57  giving  notice  "  To  all 
chirurgeons  of  the  city  that  when  the}-  are  called  to  dress  a  wound,  the}' 
shall  ask  the  patient  who  wounded  him,  and  that  information  thereof  be 
given  to  the  schout."  An  act  "to  better  prevent  the  spreading  of  infectious 
sickness"  was  also  adopted  in  Massachusetts  in  1699. 

Syphilis  is  said  to  have  made  its  first  appearance  in  Boston  in  1646, 
and  was  such  a  novelty  to  both  physicians  and  laity  that  no  one  succeeded 
in  curing  the  patient  until  a  }Oung  surgeon,  who  was  familiar  with  the 
disease,  arrived  in  port  from  the  West  Indies  ! 

Epidemic  diseases  of  greater  or  less  extent  and  severity  aftiicted  the 
colonists  frequently  during  the  17th  century.  Small-pox  was  especially 
frequent  in  New  England,  and  is  said  to  have  ravaged  the  Indian  tribes  of 
this  vicinity  in  1618,  two  3-ears  before  the  arrival  of  the  "Pilgrims". 

According  to  Toner  it  prevailed  as  a  general  epidemic  in  New  Eng- 
land in  1618,  1G22,  1638  ;  in  Salem,  1633  ;  Boston,  1631,  1633,  1639,  1645, 
1647,  1649,  1666,  1677-8,  1689;  in  Pennsylvania  1661,  1663  and  in 
Charleston,  S.  C,  1699. 

Yellow  fever  first  appeared  in  New  York  in  1G68.  It  prevailed  at 
Boston  in  1G91  and  1G93  ;  and  in  Philadelphia  and  Charleston,  S.  C,  1699. 
Influenza  appeared  in  Massachusetts  in  1647  and  1G55,  and,  according  to 
Jacobi,  diphtheria  occurred  in  Roxbury,  Mass.,  as  early  as  1G59.     (H)] 


-■  589  — 

THE  EIGHTEENTH  CENTURY 

is,  in  every  point  of  view,  one  of  the  most  important  in  both  the  history  of 
culture  in  general,  and  in  that  of  the  sciences  in  particular. 

If  the  16th  century  was  the  age  of  reforming  Idealism  directed  against 
mediaeval  faith  and  thought,  an  Idealism  for  which  the  15th  century  had 
prepared  the  way,  and  if  the  17th  was  the  epoch  of  realistic  reaction 
against  this  latter  movement,  which  expressed  itself  in  the  departments 
of  state  and  church  by  a  struggle  concerning  the  real  authority  and  power, 
and  in  the  special  department  of  medical  science  by  the  domination  of  the 
inductive  philosophy,  which  had  been  introduced  and  at  once  put  in  prac- 
tice ;  so  the  18th  century,  in  its  most  conspicuous  phenomena,  showed 
itself  again  a  continuation  of  the  idealistic  tendency  of  the  16th,  save  that 
in  Germany  the  18th  century  forced  into  a  richer  and  more  luxuriant 
bloom  the  intellectual  seed  of  the  16th.  The  Idealism  of  the  18th  century 
was  no  longer,  however,  humanistic  and  reformative,  but  avowedly  human- 
itarian and  revolutionary.  From  this  revolutionary  Idealism  sprung,  and 
to  it  corresponded,  that  storm}-  realization  of  conclusions,  whose  mightiest 
development  in  the  department  of  politics  ma}-  be  considered  the  American 
revolution  and  the  French  revolution  of  1789  (whose  guiding  ideas  were 
based  upon  the  former),  with  their  interpretation,  and  their  attempted 
attainment,  of  the  so-called  rights  of  man.1  In  the  department  of  letters, 
on  the  other  hand,  this  Idealism  expressed  itself  in  the  boldest  criticism 
and  transformation  of  almost  all  the  sciences,  and  in  art,  by  the  establish- 
ment of  new  and  renovated  principles.  A  necessary  result  of  this  too  was 
the  cosmopolitism  of  the  last  century. 

The  18th  century  by  this  tendency  released  the  masses,  in  theory, 
though  not  actually,  from  the  bonds  which  had  hitherto  confined  them  on 
all  sides  and  in  all  departments,  and  established  the  principles  of  inde- 
pendence, the  free  right  of  development  and  the  equality  of  all  before  the 
law  —  principles  diametrically  opposed  to  the  existence  of  castes,  hereto- 
fore so  flourishing,  to  the  "privileges"  of  cities  and  of  corporations  and  to 
the  absolutism  of  sovereigns.  The  first  three  of  these  it  swept  away. 
Philosophers  created  the  new  political  and  social  doctrines,  and  never,  even 
in  Greece,  had  they  so  great  and  so  immediate  an  influence  upon  the  life 
of  their  age  as  in  the  18th  century.  We  need  recall  only  the  effects  of  the 
teachings  of  a  Montesquieu,  a  Turgot  and  a  Rousseau,  the  latter  of  whom 
awakened  a  revolution  in  politics  and  education.  Sovereigns  too.  like 
Joseph  II.,  even  a  Catharine  II.,  were  their  followers,  and  became  ideal- 
istic revolutionists  ;  indeed,  pi-elates  and  priests  embraced  their  doctrines. 

1.  It  is  very  interesting  to  note  that  the  doctrine  of  popular  sovereignty  was  set  forth 
in  modern  times  by  the  Council  of  Trent,  or  rather  by  the  Jesuits  (Jacob  Lainesz, 
Bellarmin),  and  first  introduced  into  practical  life  by  the  Netherlander  (Hiiusser). 
Accordingly  neither  the  Americans  nor  the  French  were  really  the  authors  of  the 
doctrine  of  the  rights  of  man,  but  the  Jesuits,  though  of  course  the  latter  acted  in 
the  interest  of  the  papacy,  not  of  the  people. 


—  590  — 

Even  skeptics  and  materialists  strove  for  the  ideal  aim  of  general  ;'en- 
lightenment"',  and  became,  as  we  know,  the  proper  authors  of  the  great 
revolution,  and  thus  of  the  social  regeneration  of  the  so-called  third 
estate. 

Enlightenment  was  certainly  necessary  !  For  example,  a  passage  in  the  com- 
mission of  the  vice-president  of  the  Berlin  academy  in  the  year  1732  ran:  "since 
there  is  a  standing  tradition  that  considerahle  treasures  lie  buried  in  the  electorate, 
particularly  in  the  neighborhood  of  Leubus,  Lehnau  and  Visneck,  and  certain  monks, 
Jesuits  and  such  vermin  (the  Jesuits  were  so  hated  in  the  18th  century  that  they  were 
banished  even  from  Catholic  states)  and  offal  from  Rome  come  to  search  for  them, 
and  to  know  whether  they  really  exist,  the  vice-president  must  keep  a  careful  eve  on 
this  pack  of  priests,  and  trace  out  the  treasures  by  means  of  charms,  witches  and 
divining-rods,  for  which  purpose  the  magic  books,  like  the  Speculum  Salomonis,  shall 
be  sent  to  him  from  our  archives!"  And  when  in  1740  the  "  Judengasse"  in 
Frank  for  t-on-the-Main  was  entirely  burnt  up,  the  fire  was  quite  generally  ascribed 
to  the  circumstance  that  a  Rabbi,  while  imparting  some  cabalistic  instruction,  had  set 
fire  to  a  pile  of  wood  for  experimental  purpose  in  his  house,  and  then,  by  an  oversight, 
had  invoked  the  spirits  of  fire  instead  of  those  of  water.  The  physician  Senckenberg, 
indeed,  make  great  sport  of  this  superstition,  though  he  himself  was  by  no  means 
exempt  from  superstitious  ideas.  In  1742  the  administration-,  recommended  the 
preservation  of  the  wooden  trenchers  which  were  inscribed  on  Friday,  that  they 
might  be  cast  into  the  fire  in  the  name  of  God  during  conflagrations,  in  order  to 
deaden  the  flames.  The  pest-ordinance  of  Prussia  in  1709  declared  the  plague  a 
just  punishment  for  past  sins,  and  ordered  fasts,  penitential  days  and  days  of  prayer, 
as  well  as  daily  prayers  in  the  churches,  to  combat  it. 

But  for  this  purpose  the  overthrow  of  existing  institutions  was  necessary,  especially 
in  our  own  land,  where  the  worst  effects  of  the  so-called  Middle  Ages,  as  well  as  of 
the  Thirty  Years'  War  and  the  wars  of  Louis  XIV  — poverty  and  the  exaggerated 
influence  of  the  noble,  as  contrasted  with  the  citizen,  element,  together  with  the 
ascendancy  of  France  and  her  morals  —  made  themselves  felt. 

Among  the  so-called  highest  and  higher  classes,  especially  in  France,  extravag- 
ance and  immorality  generally  prevailed.  The  peasant  and  the  citizen,  on  the  other 
hand,  paid  taxes,  labored  and  suffered  wan^  if  (as  was  not  rarely  the  case)  they  did 
not  actually  starve.  In  Germany  the  majority  of  the  innumerable  potentates  were 
spoilers  of  the  people,  and  some  even  sold  their  subjects.  Thus  Hesse-Cassel  sold  to 
the  English  16,992  men,1  Brunswick  5,72o,  Hesse-Hanau  2,422,  Anspach  1,644  etc.! 
Life  and  education  were  thoroughly  un-German.  The  higher  classes  of  society  aped 
the  French,  who  in  hordes  still  afflicted  the  land  like  parasites,  especially  at  the 
numerous  greater  and  lesser  courts  of  the  princes,  where  even  a  Casanova2  became 
possible.  They  spoke  French,  and  even  Frederick  II— a  fault  which  history  will  ever 
emphasize  more  strongly  —  wrote  too  in  French,  despised  Lessing,  called  the  Nibe- 
lungen  paltry  trash  etc.  National  feeling  was  almost  everywhere  lost.  Petty 
sectional    politics   ( Kirchthnrmpolitik)    were  generallj-   in  vogue,  and  Frederick   II. 

1.  Many  of  these  mercenary  troops  were,  as  we  know,  employed  by  the  British 

government  in  their  effort  to  subjugate  the  American  colonies,  and  their  numer- 
ous atrocities  awakened  in  the  hearts  of  our  Revolutionary  sires  a  hatred  and  an 
abhorrence  which  has  descended  to  us  in  the  vituperative  epithet  "Hessian", 
that  is  mercenary  cut-throat.    (H.) 

2.  Giovanni  Giacomo  Casanova  de  Seingalt  (1725-1798),  an   Italian  adventurer,  who 

was  a  familiar  character  at  many  European  courts  during  the  last  half  of  the 
istb  century.     He  left  some  autobiographic  memoirs,  published  in  1S22.     (II. | 


—  591  — 

again,  in  contrast  to  a  portion  of  his  predecessors,  considered  everything  not 
Prussian  to  be  foreign.  Emperor  and  empire  were  obsolete  ideas.  Almost  every 
"sovereign"  —  in  the  beginning  of  the  18th  century  there  were  still  about  1800  of 
them  —  celebrated  his  expensive  and  demoralizing  gala-days,  had  his  Versailles,  and, 
where  possible,  his  Sevres,  incurred  expenses  and  built  magnificent  edifices,  totally 
disproportianed  to  the  size  of  his  petty  kingdom  and  not  infrequently,  out  of  pure 
caprice,  misplaced  these  palaces  in  barren  and  waterless  districts,  and  yet  surrounded 
them  with  pleasure-grounds,  which  were  then  supplied  a  la  Versailles  with  water 
brought  from  a  remote  region  by  water-works  etc.,  etc.  Mistresses  too  squandered 
and  devoured  the  blood-money  of  the  peasant  at  many  (even  spiritual)  courts,  so  that 
what  little  prosperity  the  ravages  of  the  preceding  wars  had  spared,  for  the  most  part 
fell  a  sacrifice  to  the  frivolous  practices  of  princes  and  noble  priests  and  lords. 
Almost  every  hamlet  had  its  feudal  lord,  frequently  several  of  them,  in  which  event 
the  process  of  extortion  was  practised  by  each  in  turn.  Yet  scarcely  one  of  these 
village  tyrants  could  read.  The  conceptions  of  justice  and  the  barbarity  of  its  ad- 
ministration are  best  illustrated  by  the  fact  that  the  newly  published  Constitutio 
criminalis  Theresiana  of  17fH)  contained  17  copperplate  engravings  to  supply  the 
necessary  illustrations  of  the  various  modes  of  torture,  e.  g.  how  the  axillary  cavity 
should  be  burned  with  eight  tallow-candles  tied  together  etc.  Of  course  a  "Tortur- 
arzt"  was  always  present,  to  watch  how  far  the  torture  could  safely  proceed  —  cer- 
tainly7 a  "humane"  occupation.  Frederick  II.  and  Joseph  II.  were  the  first  to  reform 
this  matter.  Yet  the  Constitutio  Carolina  has  been  enforced  frequently  even  down 
into  the  present  century,  so  that  it  was  not  until  1869  that  torture  was  last  practised 
in  the  Swiss  canton  of  Zug. 

In  the  presence  of  such  lavish  expenditure  of  the  products  of  the  labor  of  the 
common  people,  of  course  nothing,  or  next  to  nothing,  remained  for  the  social  eleva- 
tion, and  the  improvement  of  the  education,  of  the  masses.  Commercial  restrictions 
worthy  of  the  negro  potentates  of  Africa  restrained  commerce  of  all  kinds,  and 
principles  such  as  were  laid  down  by  Adam  Smith  (died  1790)  in  his  "Wealth  of 
Nations"  (1776)  remained  without  results  in  his  own  day.  Scarcely'  anywhere  could 
anything  classical  be  found  in  the  life  of  the  people;  rather  wanton  barbarity, 
poverty,  filthiness  and  rudeness  prevailed  almost  universally.  Famines  were  not 
unusual  in  some  countries,  for  agriculture  too  was  in  a  condition  of  depression,  and  a 
grain-trade  was  scarcely  possible.  Turgot  estimated  the  entire  international  grain- 
trade  at  only  11  millions  of  hectolitres  (to-day  it  is  over  200  millions).  The  con- 
sequences were  the  plague  and  famine-typhus,  direct  results  of  bad  political-economy. 
The  free  cities  alone  formed  an  exception  to  the  rule,  for  in  their  citizen  class,  under 
the  influence  of  greater  freedom  and  self-government,  morality,  education  and  pros- 
perity had  preserved  a  place  of  refuge  and  flourished.  Money  to  build  roads,  to  pave 
streets  etc.  was  wanting,  so  that  intercourse  was  burdened  with  endless  difficulties, 
and  almost  every  journeyr  was  at  the  risk  of  one's  life  —  a  condition  which  Haller, 
Zimmermann,  Gothe  and  others  have  well  described.  Popular  education  and  similar 
luxuries  stood  entirely  in  the  background.  Indeed  the  children  of  peasants,  many  of 
whom  were  still  bondmen,  could  never  acquire  a  higher  education,1  even  if  they  had 
had  a  desire,  and  plenty  of  money,  to  do  so.  This  right  (in  spite  of  innumerable  special 
privileges)  was  denied  to  them  in  a  few  petty  states  even  as  late  as  the  first  quarter 
of  the  present  century.  In  fact  men,  even  whole  regiments  of  them,  were  sold,  as 
already  remarked,  to  foreign  belligerents  and  in  remote  parts  of  the  world,  an  indel- 
ible  disgrace   which  burdens  none  of  the  princes  of  other  people.     Nothing  but  the 

3.   Even  as  late  as  1831  a  peasant's  son  in  the  electorate  of  Hesse  was  required  to 
petition  for  permission  to  study  at  a  university. 


—  592  — 

long-suffering  and  deeply  religious  bent  of  the  German  character  permitted  the  poor 
creatures  to  bear  their  crushing  yoke  and  their  misery  which  not  infrequently  sunk 
into  actual  starvation,  without  making  a  bloody  effort  at  defence. 

No  wonder  too  that  the  French  Revolution  was  hailed  with  jubilation  in  Germany, 
and  especially  along  the  Rhine,  where  it  swept  from  the  soil  at  one  blow  all  the  petty 
princes  and  counts,  barons,  lords,  sovereign  abbots  and  bishops,  and  all  such  blood- 
suckers of  the  people.  Finally  it  introduced  a  fresh  and  respirable  air,  which  kindled, 
even  in  the  long-suffering  peasants,  a  higher  spirit,  and  gave  them  a  foretaste  of  the 
honor  of  a  freeman.  The  emancipation  of  the  people  also  gave  to  the  Revolution  its 
undying  significance  in  the  history  of  culture.  Henceforth  the  bondmen  or  slaves 
of  the  Middle  Ages  disappeared.  With  the  close  of  this  Revolution,  therefore,  the 
new  epoch  should  commence.  For  it  was  first  able,  though  not  completely  or  imme- 
diately, to  do  away  with  the  thraldom  and  the  mould  of  the  so-called  Middle  Ages  ! 
Before  it,  and  alas,  here  and  there  long,  long,  after  it,1  gallows  projected  everywhere 
into  the  air,  not  only  for  the  numerous  bands  of  thieves  and  robbers,  but  also  for  the 
petty  crimes  of  the  common  people  and  the  Jews,  who  lived  outside  of  the  pale  of  the 
law  and  in  want.  But  there  were  none  for  the  nobles,  whose  game  often  trampled  and 
devoured  the  crops  of  the  peasants.  Not  a  few  communities  still  retain  from  that 
period  their  gallows-field.  —  All  this  the  Idealism  of  the  18th  century  (often  at  the 
present  day  so  bitterly  reviled)  made  away  with  forever!  It  was  an  age  which  showed 
a  wonderful  mixture  of  insight  and  narrow-mindedness,  of  free  thought  and  supersti- 
tion, of  despotism  and  humanity,  a  constant  fermentation  of  all  the  strength  and 
weakness  of  the  human  mind,  while  the  products  of  that  fermentation  were  not  per- 
fected and  separated  until  our  own  century-. 

The  numerous  wars  of  the  centur}-  had  no  great  influence  upon  the 
development  of  medical  culture,  except  in  surgeiy.  Upon  the  other 
departments  of  medicine  they  produced  either  no  effect,  or  at  least  results 
much  less  conspicuous. 

The  18th  century  is  also  important  in  the  history  of  culture,  inasmuch 
as  by  its  skeptical  and  critical,  or  "enlightening"  tendencj'  it  laid  the  axe 
to  the  roots  of  religion.  This  began  among  the  higher  and  the  highest 
circles  of  society,  whose  members  at  that  time  certainly  did  not  dream 
that  they  were  thus  necessarily  preparing  the  lower  classes  to  finall}-  oppose 
all  authority,  even  political  authority,  skeptically  and  aggressively,  as  was 
done  in  the  18th  century  by  the  commons,  and  is  done  to-day  by  the  Social 
Democrats  and  Anarchists,  a  result  which  all  the  power  of  their  adversaries 
can  no  longer  prevent.  For  the  mind  and  social  development  are  stronger 
than  bayonets  !  The  18th  century  was  revolutionaiy  also  in  the  religious 
department,  and  introduced  freedom  of  thought  in  place  of  the  freedom 
of  creed  won  during  the  Kith  century,  a  religion  of  knowledge  in  place  of 
the  religion  of  creed. 


"To  the  right  appeared  a  second  gallows  of  wood.  From  it  hung  the  blackening 
remains  of  its  victim.  1  myself  saw  him  hanging  there  in  my  twelfth  year (181 6). 
He  had  not  committed  murder  :  he  had  merely  stolen,  and  something  not  very 
great  at  that  "—in  Prussia  10  Thaler  was  sufficient  to  get  one  hanged  —  "  but  he 
had  stolen  frequently,  and  had  been  condemned  to  be  hanged  in  chains.  For 
10  years  at  the  least  (until  1826)  his  remains  continued  visible."  (Stromeyer, 
"Erinnerungen".)  The  bones  of  one  hanged  were  a  favorite  remedy  among  the 
common  people  ! 


—  593  — 

The  former  expression  involves  a  contradiction  in  terms,  for  faith  and  knowledge 
never  did,  and  never  could,  coincide,  and  when  an  effort  has  been  made  to  combine 
them,  they  have  either  transformed  themselves  into  mystical  caricatures,  or  have 
made  more  sharply  prominent  their  contradictions,  placing  on  the  one  side  irreligion, 
manifesting  itself  first  in  the  higher  classes  and,  with  historical  necessity,  transmitted 
during  the  present  century  to  the  lower;  and  upon  the  other  professional  (if  such  an 
expression  is  permissible)  or  priestly  side  ranging  bluff  faith  in  the  letter  of  the  law, 
from  which  we  are  to-day  suffering. — In  the  department  of  medicine  the  tendency  re- 
ferred to  above  expressed  itself  finally  in  thrusting  aside  all  other  sources  of  knowledge 
except  the  senses.  In  consequence  of  the  "  irreligious  "  tendency  of  the  18th  centurjr, 
clerical  physicians,  however,  for  the  first  time  disappeared  completely  from  the  ranks 
of  the  medical  profession.  Yet  during  this  period  some  of  these  still  officiated  as 
lithotomists  and  operative  oculists,  though  only  in  isolated  cases,  like  e.  g.  Frere 
Come  and  Joachim  Wrabetz  (born  1740),  the  latter  of  whom  was  even  a  professor  in 
Prague. 

In  the  other  departments  of  thought  pure  Idealism  everywhere  as- 
serted its  power  and  its  supremac}- ;  in  philosophy  —  we  need  mention 
only  Leibnitz  and  Kant  —  in  the  natural  sciences  —  here  the  deductive 
teachings  of  Stahl,  Linnaeus,  Lavoisier  and  others  must  be  noticed  —  in 
the  department  of  politics  as  cosmopolitism  and  the  so-called  enlightened 
despotism  — -  above  all  in  literature  and  art.  For  us  it  created  the  golden 
age  of  German  thought. 

An  abundance  of  poetical  works  developed  among  almost  all  people,  as  the 
highest  expression  of  the  idealistic  tendency  of  the  18th  century.  Among  these 
works  we  may  unhesitatingly  claim  the  first  place  for  the  German,  without  danger  of 
being  guilty  of  national  exaggeration  in  our  decision.  And  this  too  occurred  in  spite 
of  the  fact  that  at  the  beginning,  indeed  until  the  middle,  of  the  last  century,  we  pos- 
sessed only  a  language  almost  disagreeable  in  its  character,  crowded  with  foreign 
words,  to  which  at  most  German  terminations  had  been  applied,  and  which  was  never 
employed  bj"  the  learned.  Of  the  tongue  of  Luther  and  Paracelsus,  and  of  the 
national  spirit  of  the  16th  century,  the  unfortunate  17th  century  had  left  us  nothing. 
It  is  the  fault  of  this  interruption  of  development  of  the  German  mind,  effected  by  the 
religion  of  the  churches,  that  our  literature  has  become,  in  great  part,  not  a  literature 
constructed  organically  upon  that  national  foundation,  but  far  more  a  German- 
antique  or  German-Hellenic  literature,  which  has  never  kept  in  actual  touch  with 
German  culture,  but  owes  its  structure  and  its  form  often  almost  entirely  to  the 
Ancients  and  to  foreign  influences,  to  a  far  greater  degree  than  that  of  any  other 
people  And  how  could  it  be  otherwise  ?  The  Thirty  Years'  War  deprived  us  of 
that  which  without  it  must  have  come,  the  struggle  for  that  which  has  furnished  in 
itself  an  immovable  support  for  other  people  —  a  single  and  powerful  native  land. 
Instead  of  this  we  preserved  God  knows  how  many  father-lands  and  land-fathers, 
whose  petty  politics  were  suited  only  to  smother  the  remains  of  national  feeling. 
The  florescence  of  our  literature,  which  developed  in  the  18th  century,  stands,  how- 
ever, almost  alone,  and  distinguished  from  that  of  all  other  people  by  the  fact  that  it 
unfolded  itself  before  the  period  of  political  greatness  of  our  country;  that  it  paved 
the  way  for  that  greatness,  and,  indeed,  by  a  revival  of  the  national  spirit,  created  it. 
In  the  arts  too,  after  the  Thirty  Years'  War  had  as  it  were  extinguished  our  art, 
artistic  work  etc.,  heretofore  so  vigorous  in  its  development  and  so  intrinsically 
important,  a  return  was  made  to  the  idealistic  tendency  of  the  16th  century.  In  this 
connexion  we  need  only  recall  Asmus  Carsten  (1754-1798),  Raph.  Mengs  (1728-1798), 
Cornelius  (born  1783),  Ranch  (both  the  latter  offspring  of  the  18th  century)  etc.; 
38 


—  594  — 

in  music  Bach,  Handel,  Haydn,  Gluck.  Mozart,  Beethoven,  who,  like  Goethe,  was 
half  a  so-called  Realist,  and  Weber,  in  whom  this  realistic  tendency  was  still  more 
prominent.  Poetry,  as  well  as  the  histrionic  art,  assumed,  as  we  know,  the  same 
tendency  to  the  ideal  in  the  hands  of  Conrad  Ekhof  (1720-1778)  and  others. 

In  this  century  the  ascendanc}'  and  the  lead  in  medicine  fell  to 
Germany. 

The  LSth  century,  as  the  century  of  idealistic  thought,  which,  so  long  as  tie 
Germans  have  enjo3red  any  culture,  has  been  eminently  characteristic  of  them,1 
matured  a  large  number  of  medical  systems,  and  not  a  few  purely  theoretic  thera- 
peutic methods.  In  fact  one  system  closely  pursued  another,  one  method  followed 
close  upon  the  heels  of  another.  An  effort  was  made  to  meet  the  demands  of  science 
and  of  practice  deductively,  as  attempted  in  the  17th  and  the  present  century  by  the 
analytical  method  —  a  thing  which  seems  impossible  bjr  either  method  exclusively, 
since  science  and  art  make,  and  are  required  to  fulfil,  different  requisitions. 

In  the  department  of  medicine,  therefore,  the  most  conspicuous  and 
also  the  most  enduring  services  were  rendered  by- the  Germans,  instead  of 
the  Italians  and  English,  as  in  the  17th  century.  As  regards  permanence, 
we  need  recall  here  only  the  revival  of  experimental  physiology,  the  dis- 
covery of  percussion  and  the  scientific  cultivation  of  statistics  ;  for  brill- 
iancy we  may  mention  the  systems  of  Stahl,  Hoffmann  and  Boerhaave.  to 
say  nothing  of  many  others. 

Although  in  our  age  German  medicine  has  gained  in  comprehensiveness 
and  real  substance,  the  18th  century  was,  on  the  whole,  the  zenith  of  its 
gloiy  :  for  at  this  period  it  supplied  the  impulse  for  all  people,  while  in  the 
present  century  the  impulse  originated  with  the  French,  though  the  Germans 
follow  it  very  closely. 

The  inductive  efforts  and  acquisitions  in  the  departments  of  anatom}*, 
physiology  and  pathological  anatomy  must,  however,  be  considered  the 
medium  of  scientific  connexion  between  the  18th  and  the  17th  centuries. 
The}-  likewise  represent  the  bond  of  union  with,  and  the  germs  of,  that 
analytic  method  which  has  been  revived,  and  has  attained  undue  predom- 
inance in  the  19th  century.  (Even  surgeons  pursued  a  realistic  bent). 
Thus  from  the  16th  century  onward  the  past  and  the  future  have  stood 
beside  each  other  in  historical  sympathy  at  the  bottom,  while  on  the  surface 
of  the  sea  of  thought  Idealism  and  Realism  have  alternated  with  regular 
ebb  and  flow,  following  each  other  after  periods  of  centuries,  as  the  tides 
in  periods  of  a  da)-. 

1.    INFLUENCE  UPON  MEDICINE  OF  PHILOSOPHY  AND  THE  NATURAL  SCIENCES. 
SOME  SPECIAL  INSTITUTIONS  AND  LEARNED  CORPORATIONS. 

Philosophy  in  the  18th  century  acted  more  upon  the  general  condition 
of  culture,  than  specially  upon  the  direction  of  medical  science.     Its  open 

1.  Our  Eealism  and  Materialism  of  the  present  day  have  come  to  us  from  France  and 
England,  or  rather  from  the  scientific  tendency  which  these  countries  assumed 
as  early  as  the  last  century,  and  have  merely  been  built  up  among  us  into  a 
system  and  dogma. 


—  595  — 

influence  upon  some  of  the  branches  of  the  latter  during  the  course  of  this 
century  diminished  more  and  more,  and  conversely  the  natural  sciences, 
towards  the  close  of  the  century,  began  to  exercise  a  controlling  influence 
upon  philosophy  itself.  Under  the  shield  of  enlightenment  so-called, 
philosophy,  however,  effected  some  practical  benefit  by  the  elevation  of 
medical  instruction  and  the  improvement  of  institutions  for  instruction. 

At  the  head  of  the  systems  of  philosophy  which  gained  extended  influence  in  the 
18th  century  stands  the  first  German  system  of  importance,  the  Monadology  of 
Baron  Gottfr.  Wilhelm  von  Leibnitz  ( 1646—1 716),  a  universal  genius  who  won  the 
greatest  reputation  also  as  a  mathematician  (he  invented  the  differential  and  integral 
calculus)  and  a  statesman.  His  philosophy,  which  originated  in  the  17th  century, 
did  not  become  known  and  active  until  the  eighteenth.  He  himself  did  not  advance 
it  as  a  complete  theorem.  As  such  it  was  first  published  by  his  pupil  Christian  Wolff 
(1678-1754),  who  thus  reaped  a  considerable  harvest  of  Leibnitz's  fame,  especially  as 
he  expounded  his  doctrines  in  German,  while  Leibnitz  had  written  in  French  and 
Latin  only.  Leibnitz  was  the  inventor  of  the  so-called  mathematical  method  of 
reasoning,  which  gained  wide  diffusion  during  the  last  century  and  even  made  its 
appearance  in  sermons  from  the  pulpit.  Wolff's  pupil,  Alex.  Gottlieb  Baumgarten 
( 1714-1762),  was  the  creator  of  aesthetics. 

The  doctrine  of  Leibnitz  is  dualistic.  Matter  is  created,  but  after  creation  has 
no  further  need  of  the  Creator.  It  and  its  powers  are  permanent,  and  it  is  subject  to 
the  laws  of  mechanics.  As  regards  the  world  of  spirit,  the  basis  of  the  Leibnitz- 
Wolffian  S3'stem  is  formed  bj'  the  assumption  of  minute,  indivisible,  intelligent  beings, 
the  so-called  monads,  which  as  such  are  capable  of  forming  conceptions,  and  are 
constituents  of  all  bodies  and  of  all  beings.  Within  these  bodies,  bj-  means  of  the 
monads,  develop,  in  regular  gradation,  slumbering  souls,  animal  souls  and  reasoning 
souls,  as  well  as  being  and  thought.  To  the  clearness  of  the  conceptions  of  these 
monads  corresponds  the  grade  of  intelligence  of  the  corresponding  being.  The 
monads  of  man  have  the  clearest  conceptions,  and  therefore  man  is  capable  of  the 
highest  intelligence.  The  individual  soul-like  atoms  or  automata  are  emanations  of  a 
central  monad,  who  is  nothing  else  than  God  himself,  and  they  stand,  as  regards  each 
other  and  with  respect  to  this  central  monad,  in  "pre-established  harmony"  (Harmo- 
nia  praestabilita).  To  this  likewise  corresponds  the  assumption  that  everything  which 
is,  is  always  the  best  possible  under  the  circumstances  (Optimism).  Leibnitz  in 
1695  was  the  first  who  laid  down  the  principle  of  the  vital  force. 

If  Leibnitz,  in  consequence  of  the  language  in  which  he  wrote,  had  substan- 
tially only  a  national  influence,  it  was  very  different  with  the  so-called  Pietists, 
who  are,  in  a  certain  sense,  to  be  classed  as  philosophers  —  in  their  capacity  as 
skeptics,  opposed  to  the  orthodox  dogmatic  and  consistorial  theology  of  the  17th 
century.  They  stood  —  a  Phil.  Jac.  Spener  (1635-1705),  Aug.  Herm.  Francke 
(1663-1727)  and  Arnold  —  in  manner  and  language  squarely  on  national  German 
grounds. 

Higher  still  in  the  last  respect  stands  Christ.  Thomasius  of  Leipzig  (1655-1728), 
the  intrepid  and  indefatigable  champion  of  light  and  freedom,  and  the  immortal 
opponent  of  witchcraft  (everywhere  still  flourishing)  and  the  highly  criminal  justice 
of  the  rack.  He  was  the  model  of  a  university  teacher,  in  which  position  he  never 
humbled  himself  to  become  the  servant  or  tool  of  a  part}-  or  clique,  or  of  the  existing 
authorities,  but,  under  the  hatred  and  the  persecution  of  these  and  of  his  servile 
colleagues,  he  ever  bore  aloft  the  banner  of  mental  and  moral  progress  unprofaned, 
like  a  genuine  knight  of  the  spirit.  It  must  never  be  forgotten  that,  after  Paracelsus, 
he  was  the  first  among  his   colleagues  petrified  in   scholastic   Latin   and  profound 


—  596  — 

pedantry,  who  selected  the  German  tongue  for  the  delivery  of  his  lectures.1  Compelled 
by  persecution  to  emigrate  to  Halle,  he  was  also  indirectly  the  occasion  of  the 
foundation  in  that  city  of  the  university,  which  acted  long  and  energetically  as  a 
rock  of  emancipation  from  the  domestic  and  foreign  intellectual  yoke,  a  work  which 
the  universities  originally  considered,  and  should  consider  still,  their  task. 

In  England,  which,  so  far  as  regards  faith  and  morals,  is  slow  to  disturb  the 
ancient  usages,  the  assault  upon  the  old  ideas  was  made  at  first  with  concealed 
weapons  and  more  in  jest  than  in  earnest.  Hence  it  had  no  particular  effect  upon 
either  the  outer  life  or  upon  science.  Among  the  champions  of  this  kind  of  warfare 
belong  the  aristocratic  skeptics  and  followers  of  Locke,  Anthony  Ashley  Cooper, 
Earl  of  Shaftesbury  (1671-1713),  and  Viscount  Henry  St.  John  Bolingbroke  ( 1678— 
1751).  Much  deeper,  however,  was  the  influence  of  the  philosopher  and  historian 
David  Hume  (1711-1776),  to  whom,  in  contrast  with  the  Epicureans  of  high  life  just 
mentioned,  truth  in  itself  had  some  value.  If  for  Hume  nothing  existed  outside  of 
the  senses,  the  physician  David  Hartley  (1705-1757)  and  the  clergyman  Joseph 
Priestley  (1733-1804)  went  still  further,  the  former,  like  the  materialists  of  the 
present  day,  declaring  the  brain  to  be  an  organ  for  the  secretion  of  thought. 

The  English  philosophers  stood  in  intimate  relations  with  the  French  (who- 
adopted  their  hints  and  ideas),  especially  through  the  doctrines  of  Montesquieu 
(1686-1755),  Voltaire  (1694-1778)  and  Rousseau  (1712-1778),  the  latter  the  author  of 
the  following  maxim:  "  If  the  sick  man  trusts  to  himself  alone,  his  sole  hope  is- 
indeed  in  Nature,  but  he  has  too  only  his  disease  to  dread."  They  occupied  similar 
relations  with  the  "  Encyclopaedists",  whose  leader  was  Diderot  (1713-1784).  Among 
the  latter  d'Alembert  (1717-1783),  who  wrote  the  introduction  to  the  "  Encyelopedie", 
was  the  most  important.  Part  of  the  contributers  to  this  work  were  materialists,  like 
Holbach  (1723-1789)  of  Heidesheim  in  the  Palatinate,  Diderot,  Condorcet  (1743-1794), 
Claude  Adrien  Helvetius  (1715-1771),  Marmontel  (1723-1799),  and  undoubtedly  this 
tendency  of  theirs  gained  some  influence  upon  the  eourse  of  medical  views,  though 
chiefly  at  a  later  period.  Jul.  OfFroy  de  la  Mettrie  (1709-1751)  was  the  earliest  of  the 
French  materialists.  The  sensualistic  doctrines  of  the  abbe  Condillac  (1715-1780), 
who  introduced  and  popularized  in  France  the  idea  that  the  Baconian  method  of 
experience  and  induction  was  essential  to  the  correctness  of  the  results  of  thought, 
and  the  teachings  of  the  physician  Pierre  Jean  George  Cabanis  (1757-1808),  who 
developed  his  views,  had  a  very  important  influence  upon  medical  ideas,  especially 
those  of  the  French.  Cabanis  was  author  of  the  maxims  "  Medicine  is  a  conjectural 
science"2  and  "  The  nerves  constitute  the  entire  man  ".  The  influence  of  these  views 
was  displayed  particularly  in  the  school  of  Montpellier  and  even  by  Bichat. 

The  bare  and  putative  "enlightenment',  nourished  by  French  refuse,  was- 
defended  in  Germany  by  Nicolai  (1733-1811),  while,  on  the  other  hand,  the  religious 
or  mystic  tendency  was  represented  by  Hamann  (1730-1783)  and  Lavater  (1741-1801) ; 
criticism  and  the  conception  of  poetry,  religion  and  history,  as  elements  of  the  history 
of  civilization,  by  Herder  (1744-1803),  whom  it  has  recently  been  endeavored  to  make 
a  predecessor  of  Darwin  ;  artistic  and  religious  criticism,  most  nobly  by  Lessing 
(1729-1781),  one  of  the  intellectual,  and  indeed  political,  reformers  of  Germany,  and 

1.  Matters  had  gone  so  far  in  Germany  that,  according  to  Luther,  a  German,  towards 

the  close  of  the  17th  century,  could  say  that  he  had  written  his  essay  in  German 
because  it  was  not  dedicated  to  eternity,  and  accordingly  no  one  ought  to  blame 
him  for  it ! 

2.  Celsus  says:  "Ilia  tamen  moderatius  subjieiam  :  conjecturalem  artem  esse  medi- 

cinam,  rationemque  conjectura  talem  esse,  ut  cum  ssepius  aliquando  respondent, 
interdum  tamen  fallat."     (11.) 


—  597  — 

the  greatest   man   among  the   great  spirits  of  the  last  century.      His  struggle  for 
religious  toleration  (even  of  the  Jews)  is  worthy  of  special  remembrance. 

Influential  too  upon  medicine  were  the  doctrines  of  the  greatest  philosopher  of 
the  18th  century,  the  critic ]mr  excellence,  the  "  Sage  of  Kbnigsberg",  Immanuel  Kant 
(1724-1804).  He  claimed  even  the  understanding  as  an  object  of  critical  investiga- 
tion, and  by  the  method  of  internal  observation  of  self,  or  experience,  denned  its 
limits.  He  was  willing  to  allow  to  the  natural  sciences  and  particularly  to  medicine 
nothing  but  &  priori  or  mathematical  reasoning  as  the  method  and  way  of  obtaining 
a  knowledge  of  nature,  and  thus,  if  he  had  acquired  greater  immediate  influence  on 
the  course  of  medical  science  in  his  day,  he  would  have  made  theorizing  still  more 
popular  in  medicine. 

In  accordance  with  the  spirit  of  the  age,  the  deductive  method  prevailed  also  in 
jurisprudence,  that  is  to  say  this  science  endeavored  to  lay  down  on  d priori  principles 
a  system  of  natural  law,  which  might  claim  authority  for  all  times  and  people,  and 
by  which  a  revolt  from  the  existing  law  might  be  inaugurated  and  a  sort  of  legal 
revolution  effected. 

In  educational  matters  too  a  "Return  to  Nature"  was  preached  (and  even 
practised),  a  subject  in  which,  indeed,  Rousseau  took  the  initiative.  This  doctrine 
brought  with  it  as  great  extravagances  as  advantages.  In  German}'  Basedow 
("  Philanthropin ")  and  Salzmann  (Schnepfenthal)  had  the  chief  and  permanent 
influence  upon  pedagogy. 

If  the  postulate  of  a  purely  deductive  method  in  medicine  has  proved 
historically  as  unsatisfactory  as  that  of  the  purely  analytic  system  of  the 
present  day,  on  the  other  hand  the  former  displayed  its  brilliant  side  in  the 
chemistry  of  the  18th  century. 

For  unquestionably  chemistry  attained  to  the  high  grade  of  scientific  develop- 
ment which  it  reached  during  the  last  century  solely  by  following  the  deductive 
method.  Under  any  other  system  it  would,  from  the  very  mass  of  accumulated  facts, 
have  fallen  into  such  a  chaos  as  that  in  which  medicine  finds  itself  at  the  present  day. 
The  revolution  in  chemistry  was  brought  about  by  Stahl's  doctrine  of  the  "phlogiston", 
a  principle  assumed  a  priori,  as  well  as  a  peculiar  substance  in  all  combustible 
bodies,  which,  almost  as  a  matter  of  course,  was  at  once  employed  in  medicine  to 
establish  a  theory.  For  whatever,  in  the  course  of  ages,  admits  of  being  so  emplo^'ed, 
cannot  (as  we  have  already  seen  sufficiently,  and  shall  often  see  again)  ever  escape 
such  a  fate.  This  occurred  in  the  present  instance  when,  after  the  discovery  of  oxygen 
by  Karl  Willi.  Scheele  (1742-1786)  and  Joseph  Priestley  (1783-1804)  in  the  year  1774, 
the  correct  theory  of  combustion  (and  respiration),  as  opposed  to  the  so-called  "anti- 
phlogistic" theory  of  Stahl,  was  deduced  by  Antoine  Laurent  Lavoisier  (the  founder 
of  quantitative  analysis;  born  1743,  guillotined  in  1794)  from  the  discovery  that  bodies 
increase  in  weight  during  combustion.  Lavoisier  also  taught  the  indestructibility  of 
matter  and  demonstrated  that  air  consisted  of  oxygen  and  "  moufette" — nitrogen, 
and  that  it  was  not  an  elementary  bodjT.  Henry  Cavendish  (1731-1810)  and  James 
Watt  (1736-1819)  were  the  first  to  demonstrate  in  1781  the  non-elementary  character 
of  water,  by  showing  that  it  was  a  product  of  the  combustion  of  hydrogen.  A  large 
number  of  elements  were  discovered  in  the  18th  century:  arsenic  and  cobalt  by 
Brandt,  to  whom  the  discovery  of  phosphorus  in  1669  has  been  also  ascribed ;  Chlor- 
ine and  fluorine  by  Scheele;  chromium  by  Vauquelin  ;  nitrogen  by  Rutherford  ;  plati- 
num and  molybdenum  b}-  Wood;  nickel  by  Cronstedt;  uranium  and  zirconium  by 
Klaproth:  manganese  by  Gahn  etc.  Antoine  Francois  de  Fourcroy  (1755-1809), 
however,  furnished  the  first  medico-chemical  investigations  upon  organized  bodies. 
«.  g.  milk,  chyle,  bile  etc. 


—  598  — 

In  the  department  of  physics  and  mathematics,  which  enjoyed  a  more  profound 
scientific  cultivation  at  the  hands  of  the  immortal  Edm.  Halley  (1656-1742)  of  Oxford, 
who  by  the  first  calculation  of  the  orbit  of  a  comet  gave  to  astrology,  or  the  super- 
stition of  the  influence  and  portent  of  comets  in  regard  to  diseases  etc.,  a  blow  similar 
to  that  of  the  earlier  Copernicus  and  Kepler;  Jean  Bernoulli  (thesis  of  the  conserva- 
tion of  vital  force,  1735);  Dollond  (achromatic  telescope  etc.,  1758);  van  Muyschen- 
broeck  (1B92-1761)  of  Le3den;  Dionis  Papin,  professor  of  physics  in  Marburg  (first 
steamboat,  Papin's  digester);  the  famous  Leonhard  Euler  (1707-1783)  of  Basel, 
Fahrenheit  (1686-1736),  a  mechanician  of  Dantzig  (determination  of  the  zero  point  of 
rnercun-  in  melting  snow  and  saltpeter);  Andr.  Celsius  (1701-1744)  of  Upsala  (con- 
stancy of  the  melting  point  of  iron,  1730)  ;  Reaumur  (1683-1757;  constancy  of  the 
boiling-point  of  water,  1742);  Joseph  Black  (specific  and  latent  heat,  1759;  causticity 
of  the  alkalis)  of  Bordeaux,  professor  in  Edinburgh;  la  Condamine  (1701-1774  I, 
Laplace  (1749-1827)  and  many  others,  it  was  particularly  the  phenomena  of  magnet- 
ism and  electricity,  discovered  or  specially  studied  by  Luigi  Aloysio  Galvani  (1737- 
1798;  Galvanism,  1791)  of  Bologna,  Count  Alessandro  Volta  (1745-1827),  Prokop 
Diwisch  (1696-1765;  first  lightning-rod)  —  anticipating  Benj.  Franklin  (1706-1790), 
Nicholson,  Count  Rumford  (who  came  near  the  mechanical  theory  of  heat) ;  Dufay 
(negative  and  positive  electricity,  1773);  Graj*  (conductors  and  non-conductors  of 
electricity,  1727),  and  others,  which  exercised  an  influence,  not  alwaj'S  wholesome, 
upon  the  theon-  and  practice  of  medicine. 

The  18th  century  too  brought  forward  that  invention,  which,  in  its  further  develop- 
ment in  our  own  centuiw,  has  effected  a  revolution  in  technics  and  commerce  —  the 
steam  engine.  Dionis  Papin  as  early  as  1707  travelled  between  Cassel  and  Minden 
upon  a  vessel  propelled  b}'  steam,  .lames  Watt  in  1784  improved  the  steam  engine 
so  greatly  that  he  may  almost  be  considered  as  its  inventor.  The  American  Robert 
Fulton  11765-1815)  invented  our  present  steamboat  (1803  or  1807),  and  George 
Stephenson  (1781-1848)  of  Wylam,  near  Newcastle,  the  locomotive.  By  means  of 
these  inventions  of  men  of  the  last  century  the  civilization  of  our  own  centuiw  was 
directed  into  paths  heretofore  entirely  unheard-of.  They  likewise  became  indirectly 
serviceable  to  medicine,  and  especially  to  military  sur^eiw. 

Meteorology  was  freed  as  far  as  possible  from  astrology  and  made  subservient  to 
medicine  (and  agriculture).  In  this  department  special  service  was  rendered  by  the 
court-canon  Jac.  Hemmer  (1733-1790),  of  Hornbach  near  Zweibrlicken,  who  even  at 
this  period  erected  meteorological  stations,  and  in  each  monthly  report  published 
statistics  of  diseases  and  deaths,  and  Retz  (inventor  of  the  quill  hygrometer  and 
author  of  "  Meteorologie  applique  a  la  medecine  et  1'  agriculture".) 

The  systematic  cultivation  too  of  botany,  and   the  discovery  of  numerous  new- 
plants,  which  were  made  known  and  in  part  introduced  into  therapeutics  by  the  two 
Forsters,  Condamine,  Juan  and  Antonio  Ulloa,  Karl  Peter  Thunberg  ( 1743—1  ■'- _ - 
Stephen    Hales   (1677-1761;    first  hsemodynamometer,    1733),  Job.   Jak.    Scheuchzer 
(1672-1733), '  professor  in  Ziirich,  and  his  brother  Johann,  Job.  Jak.  Dillenius  (1687- 

1.  He  believed  be  had  found  the  skeleton  of  a  man  in  the  diluvium.  In  like  manner 
in  the  thirties  of  the  18th  century  Mercati  declared  the  so-called  thunder-stones 
(Donnerkeile)  to  be  stone  implements  of  prehistoric  man.  In  the  last  third  of 
the  18th  century  Esper  found  human  hones  in  the  diluvium,  in  addition  to 
diluvial  bones  of  animals,  though  Cuvier  opposed  this  view  with  the  assumption 
that  man  first  began  his  existence  in  the  alluvial  period.  He  believed  the 
diluvial  and  alluvial  eras  separated  by  a  revolution  of  the  earth,  a  view  which 
maintained  vogue  down  to  Lyell,  who  in  1859  advanced  the  now  generally 
accepted  theory  of  the  slow  transformation  of  the  earth.  Darwin  taught  the 
same  thing  regarding  the  animal  kingdom.     The  existence  of  diluvial  man  was 


—  599  — 

1747),  professor  in  Giessen  and  finally  in  Oxford,  Heinrich  Bernh.  Rupp  (died  1719 
in  poverty  at  Jena)  of  Giessen,  Jacquin  (after  1768  in  Vienna)  and  many  others,  did 
not  remain  without  influence  upon  medicine,  though  this  was  only  conspicuous  in  a 
few  cases.  Physicians  especially  were  excited  (though  only  to  futile  investigations 
of  the  same  kind)  by  the  systematic  labors  of  the  immortal  Karl  von  Linne  (1707- 
1778)  of  Rashult  in  Smaland,  his  pupil  Johann  Christian  Daniel  von  Schreber  (1739- 
1810),  professor  in  Erlangen,  subsequently  imperial  counsellor,  physician-in-ordiimiy 
and  "  Hofpfalzgraf,"  Bernard  and  his  nephew  Antoine  Laurent  de  Jussieu  (1748 
1831),  and  at  the  same  period  an  ever  increasing  number  of  physicians  acquired  a 
knowledge  of  this  important  accessary  branch,  which  supplied  a  favorite  field  for 
recreation  to  many  of  them  during  the  18th  century. 

The  same  fortune,  at  least  in  the  same  degree,  did  not  befall  the 
department  of  mineralogy, 

which  in  the  18th  century  was  transformed  into  a  science  by  the  labors  of  Joh.  Gott- 
schalk  Wallerius  (1709-1785),  Torbern  Bergmann  (1735-1784),  Axel  Friedr.  Cronstedt 
(1722-1765),  all  three  Swedes,  but  particularly  through  the  labors  of  the  famous 
Abraham  Gottlob  Werner  (1750-1817)  of  Freiburg.  The  latter  also  elevated  geology 
(a  German  creation)  into  a  science.  In  France  Rome  de  1'  Isle  (1736-1790)  and  the 
famous  crystallographer  Hauy  (1743-1822)  distinguished  themselves  in  an  eminent 
degree. 

Finally  zoology,  which  enjoyed  a  number  of  laborers  quite  unrivaled  in 
the  history  of  the  sciences, 

exercised  an  active  influence  upon  medicine  and  especially  upon  anatomy.  We 
mention  only  the  names  of  count  George  Louis  Leclerc  Buflbn  (1707-1788),  of 
d'  Aubenton,  Vicq  d'  Azyr,  Charles  Bonnet  de  Lacepede  (1756-1828),  Lazaro  Spal- 
lanzani  (1729-1799)  professor  in  Pavia;  the  Dane  O.  F.  Miiller  first  described  care- 
fully and  classified  the  "  Infusoria''  of  Linnaeus,  giving  plates  of  them  in  his  pioneer 
work  entitled  "Animalcula  infusoria"  etc.,  1786;  Joh.  Christ.  Daniel  von  Schreber, 
Jac.  Christ.  Schaffer,  superintendent  in  Regensburg,  and  the  most  famous  of  zoologists- 
next  to  Bufifon,  George  Leopold  Christian  Friedrich  Dagobert,  Baron  von  Cuvier  (1769— 
1831)  of  Montbeliard,  at  that  time  still  in  Wiirtemberg,  after  Schiller  the  most  famous 
pupil  of  the  ''  Karlschule",  by  whom  comparative  anatomy  was  first  elevated  to  a 
science.  Cuvier's  activity  in  this  department  falls  mostly  within  the  present  century. 
From  the  foregoing  it  is  sufficiently  manifest  what  an  active  and  successful  cultiva- 
tion the  natural  sciences  enjoyed  in  the  18th  century.  It  follows  partly  from  what 
has  been  already  said,  and  it  will  be  further  shown  in  the  following  exposition  of  the 
theories  of  this  period,  that  certain  branches  of  natural  science  began  to  lay  the 
foundation  of  that  influence,  which  they  have  attained  in  so  high  a  degree  during  the 
present  century. — It  may  be  remarked  in  this  place  that  in  the  18th  century  the 
natural  sciences  belonged  in  the  programme  of  "  enlightenment",  as  they  now  belong 
in  the  department  of  "  education  ". 

In  the  18th  century,  quite  in  contrast  to  our  own  which  delights  only 
in  itself,  the  stud}'  of  the  ancient  physicians  found  numerous  votaries  and 
cultivators,  for  philology,  as  such,  also  made  as  great  an  advance  in  this 

demonstrated  by  discoveries  in  Abbeville,  the  "Sclmssenquelle  "  in  Wiirtemberg, 
the  robbers' cave  near  Regensburg  etc.,  and  Boucher  de  Perthe  proved  that  the 
stone  wedges  etc.  of  the  diluvial  valley  of  the  Sonnne  were  the  implements  of 
men  (1834).  At  the  present  day  the  existence  of  diluvial  man  is  regarded  as 
established.  Scheuchzer  was  the  first  to  raise  the  question,  and  deserves  great 
credit  for  his  penetration  (Job.  Ranke). 


—  600  — 

period,  as  it  had  done  in  the  16th  century.  We  may  mention  only  a  few 
names  Fr.  A.  Wolf,  Heyne,  Klotz,  Ernesti,  Adelung.  K.  A.  Buttger,  Anne 
Daeier,  Count  Caylus  etc.  From  the  number  of  physicians  who  occupied 
themselves  with  literary  studies  we  will  distinguish  the  Orientalist  Joh. 
Jac.  Reiske  (1716-1774),  D.  W.  Triller  in  Wittenberg,  the  famous  investi- 
gators J.  C.  W.  Moehsen  in  Berlin,  Ph.  Gabr.  Hensler,  Ch.  G.  Ackermann 
in  Altdorf,  C.  G.  Gruner  in  Jena,  E.  G.  Baldinger,  professor  in  Jena,  GOt- 
tingen  and  Marburg,  the  great  Sprengel,  and  J.  F.  Blumenbach.  — ■  In 
France  it  w;is  the  Greek  Adamantios  Koraes  (Cora}',  died  1833),  who  there 
awakened  his  ancient  countiymen  to  new  life.  In  Ital}',  besides  Morgagni, 
Ant.  Cocchi  in  Florence  (died  1758)  Giov.  L.  Bianconi  (1717-1781)  in 
Borne,  and  finally  Leonardo  Targa  (1730-1815)  in  Verona,  were  eminent 
in  this  department. 

Among  the  universities  founded  in  the  18th  century 
(Breslau  1702,  Fulda  1711,  Bonn  1771,  Stuttgart  1781,  Pesth  1794  and  others,  some 
of  which  have  perished),  Gottingen,  founded  by  George  August  II.  in  1737  (its  first 
professors  were  Haller,  G.  Gottl.  Richter  and  Joh.  A.  Segner  of  Pressburg),  Erlangen, 
founded  in  1743  by  Friedrich,  margrave  of  Bayreuth,  and  Miinster,  1780,  were  im- 
portant nurseries  of  medical  science  almost  from  their  foundation. 

In  addition  to  all  these,  medicine  found  continued  cultivation  in  the 
learned  societies,  which  constantly  arose  in  increasing  numbers. 

The  following  were  established  during  the  course  of  the  centurj' :  the  earliest  in 
Germauy  was  that  founded  in  the  year  1700  by  Frederick  I.,  at  the  suggestion  of 
Leibnitz,  who  was  also  its  first  president  —  the  "Konigliche  Gesellschaft  der  Wissen- 
schaften  und  freien  Klinste  zu  Berlin",  in  addition  to  which  a  "  Neue  gelehrte 
Gesellschaft"  appeared  in  the  course  of  the  same  year.  Both  were  united  in  the  year 
1744  by  Frederick  the  Great  into  the  "  Konigliche  Academie".  The  "Konigliche 
Gesellschaft  der  Wissenschaften  zu  Gottingen"  was  then  foundod  in  1751  through 
the  influence  of  Haller.  Besides  these  two  exceedingly  famous  societies,  there  were 
founded  in  the  father-lands,  at  that  time  so  numerous,  the  "  Churbaierische  Akademie 
der  Wissenschaften  "  of  Munich  (1759),  the  "  Churpfalzische  Akademie  der  Wissen- 
schaften" of  Mannheim  ( 1763),  the  "  Churmainzische  Akademie  "  of  Erfurt  (1754), 
and  an  "  Oekonomische  Gesellschaft"  of  Leipzig  (1765).  Switzerland,  which  had 
long  lost  its  high  rank  in  the  cultivation  of  the  medical  sciences,  received  a  new 
impulse  through  the  ''Gesellschaft  der  Aerzte  und  Naturforscher "  of  Basel  (1751) 
and  the  "  Naturforschende  Gesellschaft"  of  Zurich  (1757),  and  to  a  less  degree 
through  the  "  Schintznacher  patriotische  Gesellschaft  fur  alle  Schweizer-Aerzte ''. 
As  regards  foreign  countries,  in  France  the  "  Societes  Royales  des  Sciences"  of  Bor- 
deaux (1714),  Montpellier  (1706),  Lyons  (1724),  Dijon  (1725)  and  other  places  were 
called  to  life,  and  the  "Societe  Royale  de  Medicine"  of  Paris  was  founded  by  Lassone 
(1717-1788),  while  England  received  in  1757  its  "  Society  of  Physicians"  of  London, 
and  in  Edinburgh  a  society  of  similar  name  was  formed  as  early  as  the  year  1 731. J 
Besides  these  were  established  the  "Imperial  Russian  Society  "  of  St.  Petersburg 
(1724),  "Royal  Swedish  Academies"  at  Stockholm   (1739)  and  Upsala  (1740),  the 


1.  1  am  not  quite  certain  to  what  associations  tbese  titles  refer.  The  only  medical 
societies  of  importance  founded  in  Great  Britain  during  the  18th  century  with 
which  I  am  acquainted  are  ''The  Royal  Medical  Society  of  Edinburgh  ",  founded 
in  1737  and  chartered  in  1778,  "The  Medical  Society  of  London",  founded  1773 
and  "The  Abernethian  Society  of  London",  founded  in  1795.     (H.) 


—  601  — 

"  Hollandse  Maatschappy  der  Weetenschappen  "  at  Haarlem,  Vlissingen  and  Rotter- 
dam, the  "  Royal  Danish  Society"'  of  Stockholm,  the  "  Institute  of  the  Sciences  and 
Arts"  at  Bologna,  the  "  Royal  Society  "  at  Turin  etc. 

In  addition  to  the  cultivation  of  the  sciences  in  the  "Akten",  "Abhand- 
lungen",  "Memoires",  "Commentarien",  "Anzeigen",  "Transactions",  "Hand- 
linger'',  "Skrifter"  etc.,  published  b}T  these  societies,  the  efforts  at  criticism 
were  specially  promoted  by  the  "  Commercium  norimbergense",  which 
enjoyed  an  international  importance;  by  the  "allgemeine  deutsche  Bibli- 
othek",  which,  as  early  as  the  close  of  the  century,  could  point  to  100 
volumes  ;  by  the  "Gottingen'schen  gelehrten  Auzeigen",  which  enjoyed 
special  advantages  in  the  co-operation  of  Haller  ;  by  the  "Jena'sche  all- 
gemeine  Literaturzeitung "  and  numerous  exclusiveh'  medical  journals 
under  the  titles  of  "Bibliotheken",  "Magazines"  etc.,  etc. 

The  famous  weekly  journal,  "Der  Arzt",  of  the  talented  and  philoso- 
phic Unzer  was  calculated  rather  for  the  great  mass  of  readers.  It  was 
designed,  according  to  the  programme  of  the  century,  to  serve  the  cause  of 
"enlightenment",  to  which  a  large  number  of  books  and  treatises  of  the 
popular  sort  were  dedicated  b}'  Tissot,  Zimmermann  and  others. 

The  journalism  of  the  18th  century  displayed  too  an  entirel}'  peculiar 
character :  it  went,  on  the  whole,  carefull}'  into  the  selection  of  its  matter, 
was  not  interlarded  with  so-called  interesting  cases,  easy  to  be  found  and 
long-winded,  or  manufactured  to  order  and  stupidly  utilized,  and  was  not 
to  an  excessive  degree  in  the  bonds  of  individual  publishers  and  literaiy 
speculators,  but  was  under  the  control,  and  in  some  cases  the  actual 
property,  of  eminent  savants.  From  the  fact  that  the  language  of  these 
journals  was  still  Latin,  their  influence  was  more  international  than  it  is 
to-day. 

It  is  self-evident  that  even  in  the  18th  century,  in  spite  of  all  the 
efforts  and  institutions  devoted  to  the  service  of  "enlightenment",  every- 
thing was  not  thoroughly  "enlightened".  The  famous  de  Haen  e.  g. 
defended  the  existence  of  demons,  and  a  professor  of  theology,  Angel. 
Miirz,  as  late  as  1760  discussed  witches  and  magic  in  a  book  devoted  to 
this  subject.  (Something  of  the  same  kind  has  been  done  recently  by 
Perty  of  Berne).  The  burning  of  witches,  which  occurred  in  Glarus  as  late 
as  1783,  casts  still  stronger  lights  and  shadows  upon  the  18th  centuiy. 
Witches  were  burned  in  Mexico  too  as  late  as  1877,  and  in  1821  there  was 
still  a  statute  regarding  witches  in  Ireland.  Vilmar,  about  the  middle  of 
this  century,  again  defended  the  belief  in  witches.  All  this,  in  addition  to 
other  evidences,  proves  that  the  mark  which  the  most  eminent  spirits  of 
any  age  place  before  themselves,  can  be  attained  by  a  small  number  only, 
never  by  the  mass,  and  that  error  and  delusion  affect  the  masses  much 
more  quickly,  and  stick  to  them  infinitely  more  closely,  than  their  oppo- 
sites. 

How  else  can  we  explain  the  order  of  the  Illuminati,  and  such  phenomena  as  the 
attainment  of  a  great  following  by  an  Immanuel  Swedenborjz  (1689-1772),  a  Father 
Joseph  Gassner  (1727-1779)  and  an  inn-keeper  Schropfer  of  Leipzig  (he  shot  himself 


—  602  — 

in  1774),  of  whom  the  former  employed  the  aid  of  celestial  mysticism,  the  latter  that 
of  exorcisms,  in  cases  of  disease?  How  else  can  we  consider  possible  the  impostures 
of  a  Count  Alessandro  Cagliostro  (1 74:>-17!)5 ),  of  a  St.  Germain  (whose  so-called 
"  Lebensthee  ",  a  purgative  tea,  still  exists  in  our  pharmacology),  or  the  miracles 
performed  at  the  grave  of  Francois  de  Paris  in  the  years  1727-1732?  To  occupy 
oneself  with  such  superstitions1  belonged,  even  in  the  century  of  enlightenment,  to  the 
noble  passions,  and  even  distinguished  physicians,  like  Fried.  Hoffmann  and  still 
more  de  Haen,  were  defenders,  or  perhaps  believers,  of  such  trumpery.  Hereafter 
we  shall  also  meet  with  a  Mesmer,  whose  influence  has  descended  to  our  own  day. 
As  late  as  the  year  1 7 7-">.  he  who  drew  out  of  the  water  a  man  drowning  or  drowned, 
and  he  who  killed  a  dog  in  self-defence,  was  regarded  among  laborers  as  "  dis- 
honored ". 

But  opposed  to  these  stand  more  agreeable  phenomena  !  From  the 
bloom  of  belles-lettres  German  medicine  drew  an  advantage  which  must 
not  be  underestimated.  The  zeal  thereby  aroused  for  art  in  general,  and 
for  the  art  of  language  in  particular,  brought  it  about  that  the  Latin 
tongue,  which  until  late  in  the  century  had  been  alone  considered  worthy 
of  a  savant  and  particularly  of  a  professor,  was  no  longer  employed  by  a 
few  of  the  most  eminent  physicians  in  aivy  of  their  works,  and  by  others 
was  discarded  at  least  in  many  of  them.  Moreover  physicians  devoted 
themselves,  so  far  as  circumstances  would  admit,  to  the  cultivation  of 
rhetorical  forms.  The  official  language  of  the  universities,  however,  was 
not  as  3'et  German.  From  this  struggle  after  versatility  of  accomplish- 
ments there  arose  in  medicine  during  the  18th  centuiy  a  group  of  classical 
writers.2  small  indeed,  but  on  this  account  to  be  estimated  only  the  more 
highly,  in  whom  artistic,  moral  and  scientific  perfection  were  equall}' 
united. 

2.    MEDICAL  SYSTEMS  AND  THEORIES  OF  THE  I8TH  CENTURY. 

If  the  17th  century  was  the  age  of  medical  schools,  the  18th  was  the 
age  of  systems  and  theories.  None  of  the  preceding  centuries  exhibits, 
even  approximately,  so  great  a  number  of  the  latter  ;  indeed  all  preceding 
history  is  scarcely  so  rich  in  such  developments.  They  sprung  up  with 
premature  luxuriance  from  the  soil  of  medicine,  saturated  with  the  im- 
mature and  as  yet  insufficiently  digested  material  derived  from  the 
natural  sciences  —  a  material  conceived  d  priori,  in  opposition  to  the 
method  of  the  preceding  centuiy  —  and  thoroughly  steeped  in  its  own 
newly  acquired  stores  of  knowledge.  But  they  appeared  onby  to  wither 
and  pass  awa}'  even  more  rapidly  almost  than  they  arose,  or  perhaps 
mereby  to  struggle  for  a  time  with  some  rival  for  a  brief  existence  — -  a 
struggle  in  which  both  stimulated  into  utter  corruption  the  germ  of  deca}' 
which  the)-  contained  from  their  birth. 

1.  And  what  shall  we  say  of  the  so-called  "Christian  Science",  "Faith  cures"  et  id 

omne genus,  which  disgrace  the  "enlightenment"  of  the  great  19th  century.     (H.) 

2.  Compare  Heinrich  Rohlfs  (born  in  1827  at  Vcgesack,  near  Bremen),  "Die  medicini- 

schen  Klassiker  Deutsch lands,   Ferd.   Enke,   Stuttgart,    1875",   and   Hirschfeld, 
Leipzig. 


—  603   — 

If  we  wished  to  prove  the  barrenness  and  untenability  of  systematic- 
elaborations  of  medicine,  which  are  based  for  the  most  part  only  upon 
some  few  facts,  and  these  interpreted  by  enthusiasm,  the  history  of  the 
medical  systems  of  the  18th  centmy,  in  their  day  so  highly  valued  on  the 
one  side,  and  so  strongly  opposed  on  the  other,  would  alone  almost  suffice. 

That,  in  addition  to  the  new  systems,  those  of  the  Iatro-chemists 
and  Iatro-mathematicians  of  the  17th  century  could  still  show  numerous 
followers  until  far  into  the  18th  century,  we  have  already  shown,  for  the 
sake  of  completeness,  in  our  preceding  account  of  these  systems.  Thus 
also  the  two  centuries  remained  in  unbroken  connexion.  Into  some  of 
these  new  S3rstems  even  the  doctrines  of  the  former  systems  were  trans- 
ferred, or,  under  new  names  and  with  a  few  changes,  the  whole  S3'stematie 
basis  of  the  old  systems  was  adopted  by  the  new,  as  will  become  manifest 
in  our  account  of  the  latter.  Frequently  too  old  ideas  under  new  names 
and  denominations  came  into  prominence  and  popularity  ;  for  most  so- 
called  new  systems  have  always  been  in  the  main  revivals  of  the  old,  made 
to  appear  new  by  some  few  additions. 

Moreover  the  medicine  of  the  18th  century  received  from  the  systems 
which  crowded  so  rapidly  upon  each  other  a  leaven,  always  active  and 
constantly  renewed,  so  that  it  drew  from  them  continually  that  benefit 
which  active  interchange  of  ideas  and  thoughts  ever  brings  in  all  depart- 
ments. For  it  has  always  been  the  fact  that  systems  have  'permanently 
disturbed  and  arrested  the  development  of  medicine  onby  when,  like  the 
Dogmatic  and  the  Galenic,  they  have  too  long  preserved  an  undisputed 
ascendancy.  Besides,  the  rage  for  systems  of  medicine  in  the  18th  century 
did  not  degenerate  into  pure  theory,  but  beside  and  within  these  systems 
the  art  of  observation  was  cultivated  in  a  prominent,  though  not  the  so- 
called  exact  way,  and  was  always  practised  carefully  and  soberly,  with  the 
sole  aid  of  reason  and  the  natural  senses.  But  bad,  alas,  worse  than  bad, 
was  the  final  influence  of  theories  upon  therapeutics  (an  apparently  nec- 
essary result  even  down  to  the  present  day),  although  this  is  precisely  the 
department  which  ought  least  to  lapse  into  theory.  For  otherwise  enthu- 
siasm, harmless  in  itself,  becomes  converted  not  rarely  into  actual  murder, 
and  murder  which  involves  the  additional  horror  of  resulting  from  the 
good  intentions  of  a  humane  art.     The  first  purely 

a.  Eclectic  System, 
similar  to  that  of  Galen,  with  whom   its  author  too  has  been  (certainly 
falsely)   compared,  originated  with 

Hermann  Boerhaave  (Boerhaaven.  1G68-1738),  the  most  famous 
physician,  not  only  of  the  18th,  but  probabh*  of  any  modern  century. 
The  eldest  son  of  a  clergyman  of  the  village  of  Voorhout  near  Lejden,  who,  like 
ministers  generally,  was  blessed  with  thirteen  children,  Boerhaave  was  originally 
intended  for  the  profession  of  his  father,  and  with  this  view  had  studied  philosophy, 
history,  lojjic,  metaphysics,  philology  and  theologj',  as  well  as  mathematics,  with  great 
zeal.     He  was  first  led  to  turn  his  attention  to  the  study  of  medicine  because  the 


—  604  — 

Protestant  "Guard  of  Zion  "  (Zionswaehter)  believed  that  the  purity  of  the  doctrine 
of  Christ  (which,  as  we  all  know,  stands  under  the  protection  of  the  Protestant  uniform) 
was  endangered  by  Boerhaave,  a  follower  of  Spinoza  (lie  had  been  denounced  as  such 
by  one  of  the  pupils  of  the  latter),  and  accordingly  wished  to  withhold  that  dress  from 
him.  Mathematics  he  declared  the  most  important  of  the  sciences  accessor}-  to 
medicine  (Rohlfs).  He  first  studied  thoroughly  chemistry  and  botany,  both  of  which 
branches  he  subsequently  advanced,  especially  chemistry.1  He  then  pursued  anatomy 
and  the  theory  of  medicine  under  Drelincourt  and  Nuck.  In  the  other  branches  he 
was  his  own  instructor.  Graduating  in  1693  (his  thesis  was  upon  the  alvine  evacua- 
tions), he  practised  in  Leyden  with  such  success  that  he  was  offered  the  position  of 
ordinary  physician  to  the  king.  He,  however,  declined  this  position  and  became  a 
private  teacher  at  Leyden.  After  the  death  of  Hotton  (1709),  he  received  the  chair 
of  medicine  and  botany,  and  in  1714  was  given  also  the  chair  of  the  practice  of 
medicine,  in  place  of  the  deceased  Bidloo.  Subsequently  (1718,  on  the  death  of 
Lemort)  he  acquired  also  the  professorship  of  chemistry,  in  which  position  he  likewise 
displayed  great  capacity,  and  by  his  text-book  aided  in  securing  for  this  science 
general  diffusion  and  greater  acceptance.  He  was  the  first  who  asserted  the  affinity 
of  heterogeneous  substances,  and  by  his  improvement  of  the  process  for  preparing 
vinegar  he  showed  himself  a  technological  chemist.  As  a  clinical  teacher  (after  1714) 
he  lectured  extempore,  and  in  this  position,  to  which  he  brought  the  rarest  talent,  he 
attained  such  reputation  that  he  attracted  to  Leyden  hearers  from  all  quarters  of  the 
world,  so  that  no  lecture-room  in  the  university  could  contain  them.  Boerhaave  was 
the  first  who  gave  separate  lectures  on  the  subject  of  ophthalmology,  and  who 
employed  the  magnifying  glass  in  the  examination  of  the  eye.  As  a  practitioner  he 
was  no  less  popular,  as  may  be  judged  from  the  fact  that,  although  he  was  not  sparing 
of  money  in  the  acquisition  of  fine  editions  of  books  and  in  the  advancement  of 
scientific  objects,  he  yet  left  an  estate  of  two  millions.  Boerhaave  was  so  famous 
that  a  Chinese  official  once  sent  him  a  letter  addressed  simp]}'  "To  the  most  famous 
physician  of  Europe."  He  made  Peter  the  Great  too  wait  one  night  to  see  him, 
because  he  made  no  distinction  in  his  patients,  and  did  not,  like  many  of  our  modern 
professors,  regulate  his  visiting-list  by  the  purses  of  his  clientele.  His  conclusion 
with  regard  to  physicians,  however,  ran  as  follows:  "If  we  compare  the  good  which 
a  half  dozen  true  sons  of  zEsculapius  have  accomplished  since  the  origin  of  medical 
art  upon  the  earth,  with  the  evil  which  the  immense  mass  of  doctors  of  this  profession 
among  the  human  race  have  done,  there  can  be  no  doubt  that  it  would  have  been  far 
better  if  there  had  never  been  an}-  physicians  in  the  world."  Boerhaave  succumbed 
to  the  gout,  which  had  afflicted  him  from  1722  and  as  early  as  1729  had  compelled 
him  to  resign  his  position.  Of  his  four  children,  one  daughter  alone  survived  him. 
His  most  eminent  pupils  were  Haller,  van  Swieten,  de  Haen,  Gaub  and  Cullen. 

Boerhaave  was  a  person  extolled  (somewhat  like  Hufeland  in  our  own 
century)  as  a  great  savant,  physician  and  man.  by  all,  almost  without 
exception,  during  the  whole  of  the  last  century.  Such  a  phenomenon, 
doubly  striking,  and,  indeed,  astonishing,  in  a  physician,  could  proceed 
only  from  his  mediatorial  position  in  science  and  art,  and  still  more  from 
his  benevolent  and  pure  character,  from  which  even  fame  (the  rock  upon 
which  so  many  small  minds  founder)  did  not  take  awa}T  the  modesty  of  a 
truthful  thinker  and  a  great  savant.  He  was  free  from  all  the  disputa- 
tiousness  and  vanity  of  the  savant,  a  virtue  especially  striking  when  we 
compare  it  with  the  pugnacity  displayed  b}T  even  the  most  famous  physi- 

1.    According  to  Rohlfs  he  was  the  first  who  made  chemical  investigations  of  urine. 


—  605  — 

cians  of  the  same,  or  a  little  later  age.  None  of  his  pupils  was  ungrateful 
to  him,  though  none  further  elaborated  his  doctrines  —  a  thing  fundamen- 
tally impossible  in  consequence  of  his  eclecticism.  The  most  important 
of  them  changed  his  s}Tstem  in  many  respects  ;  others,  like  van  Swieten, 
sought  only  to  explain  and  to  comprehend  his  views.  Many  of  his  often 
oracular  aphorisms  to-day  seem  rather  ambiguous  than  profound,  and  not 
infrequently  they  are  unacceptable,  while  his  maxim  "  Simplicity  is  the 
seal  of  truth"  is  never  manifested  in  his  treatment.  He  already  employed 
the  thermometer  (in  the  axilla),  the  simple  lens  etc.  in  the  examination 
of  his  cases,  adopting  them  from  the  Iatro-physicists  of  the  17th  century. 
The  latter  are  the  predecessors  of  the  fashion  so  popular  with  us.  and 
which  is  in  many  respects  only  a  revival  (frequently  an  unconscious  one) 
of  the  theory  and  practice  of  the  more  important  physicians  of  that  sect. 

The  doctrines  of  Boerhaave  do  not  form  anj^  intrinsically  new  system, 
but  rather  comprehend  many  ideas  of  the  earlier  systems.  It  is  difficult 
to  discover  a  leading  principle  in  the  expositions  of  them  which  we  have 
received.  No  selection  from  an}^  one  of  the  earlier  systems  prevails, 
but  rather  an  effort  to  collect  and  combine  what  is  good  in  all  of  them, 
like  that  of  Galen  without  bringing  forward  a  strict  system.  Boerhaave 
proceeds  neither  by  synthesis  alone,  nor  yet  by  simple  analysis,  but  employs 
both  methods. 

First  we  find  the  well-worn  doctrine  of  "laxum  and  strictum"  of  the 
Methodists,  only  it  is  employed  with  the  simulation  of  greater  precision 
obtained  by  the  use  of  the  microscope  and  a  so-called  "fibre",  tense  fibre? 
relaxed  fibre.  Debility  is  also  added  as  a  third  communit}',  weak  fibre 
(fibrse  debilitas).  With  Boerhaave  we  find  again  too  the  "putridity" 
(putredo)  of  the  Pneumatics,  denned,  however,  more  precisely  as  that  pro- 
cess within  the  fluids,  by  which  they  exhale  much  water.  He  also  emplo}Ts 
the  Hippocratic  "enormon"  as  the  cause  of  "motion",  which  latter  is,  in 
his  view,  the  highest  principle  and  identical  with  life,  i.  e.  the  reciprocal 
influence  upon  each  other  of  the  body  and  spirit.  The  "enormon"  is 
regarded  as  an  unknown  something,  which  is  neither  matter  nor  spirit 
alone,  and  is  not  cognizable  by  the  senses,  but  which  occasions  the  percep- 
tions of  the  senses  and  "motions". 

As  in  the  foregoing  exposition  the  pathological  ideas  of  Solidism  and 
of  the  D}mamic  School  predominate,  so  in  what  follows  we  find  those 
of  the  Humorists  and  the  Iatro-mechanics.  Thus  we  observe  the  doctrines 
of  obstruction  and  the  error  loci  of  Erasistratus  and  the  Iatro-phj'sicists, 
only  the  basis  of  the  process  is  placed  in  the  newly  discovered  blood- 
corpuscles,  which  remain  sticking  in  the  smallest  vessels,  in  consequence 
of  a  too  smoolh,  too  bulky,  too  angular,  too  sharp-cornered  etc.  constitu- 
tion. The  iatro-chemical  acridities  of  the  fluids  (he  received  the  latter 
into  his  s}rstem  as  the  humoral  element)  also  play  with  Boerhaave  a  most 
important  role,  almost  more  important  than  with  the  Iatro-chemists. 
There  are  acid,  saline,  oleaginous,  glutinous,,  alkaline  and  mixed  "acridi- 


—  60G  — 

ties"  (acrimonise).  These  are  the  commonest  causes  of  disease  :  they 
originate  from  the  food  and  are  especially  active  in  chronic  diseases.  The 
latter,  with  the  inflammatory  diseases,  he  handles  particularly  well 
(Rohlfs).  The  Iatro-mechanical  principle  (belonging  properly  also  to 
Erasistratus)  of  the  friction  taking  place  between  the  stagnant  fluids 
(stasis  of  the  new  Vienna  school)  and  those  still  in  motion,  serves  him  in 
the  explanation  of  inflammation.  —  Plethora  likewise  receives  a  place 
among  his  causes  of  disease. 

According  to  Boerhaave,  disease  is  that  condition  in  which  the  bodily 
';  actions  m  are  disturbed  or  unsettled,  and  take  place  onby  with  difficulty. 
The  reverse  of  this  condition  furnishes  his  conception  of  health.  Fever  is 
the  effort  of  nature  to  ward  off  death.  Hence  the  nervous  fluid  flows  too 
quickly  into  the  muscles  and  the  heart  contracts  too  rapidly,  so  that  the 
blood  flows  too  rapidly  in  the  capillaries. 

Digestion,  like  the  circulation,  is  explained  on  mechanical  principles. 
Boerhaave's  most  important  works  are  the  "Aphorismi"  and  "Institutiones". 

The  following  extract  will  enable  us  to  form  an  idea  of  the  views  and 
the  style  —  he  writes  a  good  Latin  —  of  Boerhaave,  as  well  as  of  his 
therapeutic  principles. 

"The  antecedent  causes  of  this  acid  acridity  are:  1.  Food  consisting  of  farina- 
ceous, acid  and  juicy  (succulentis  acidis),  fresh,  raw,  fermenting  or  fermented  portions 
of  vegetables:  2.  The  want  of  good  blood  in  the  body  which  receives  this  nutriment: 
3.  Debility  of  the  fibrous  tissue  (fibrosa?  compagis),  the  vessels  and  intestines:  4.  Lack 
of  animal  motion. 

Primarily  it  has  its  seat  chiefly  in  the  localities  of  primary  digestion  (prima? 
digestionis  officinas),  whence  it  slowly  infects  the  blood  and  finally  all  the  humors. 
It  occasions  acid  eructations,  hunger,  pain  in  the  stomach  and  bowels,  flatulence, 
spasms,  sluggishness  of,  and  various  changes  in  the  bile,  acid  chyle  and  sour-smelling 
faeces.  In  the  blood  it  produces  pallor,  acid  chyle,  and  hence  in  women  acid  milk,  or 
rather  milk  too  prone  to  acidity,  sour  perspiration,  acid  saliva,  and  thus  itching, 
obstructions,  pustules,  ulcers,  too  rapid  curdling  of  the  milk,  and  perhaps  also  of  the 
blood  itself,  whereby  the  latter  becomes  less  fitted  for  circulation,  then  excitement  of 
the  brain  and  nerves  with  resulting  convulsions,  disturbance  of  the  circulation,  and 
finally  death.  From  these  symptoms  we  recognize  the  present,  future  and  past 
tendency  to  acidity.  Hence  its  effects  may  be  perfectly  predicted  and  the  mode  of 
cure  ma}'  be  known.  The  cure  is  effected:  1.  By  animal  and  vegetable  food  opposed 
to  acidity  :  2.  By  the  fluids  of  birds  of  prey  (avibus  rapacibus!),  which  fluids  resemble 
good  blood:  3.  B3-  strengthening  remedies:  4.  By  active  movement:  5.  By  medicines 
which  absorb,  dilute,  weaken  or  change  the  acid.  The  selection,  preparation,  dose 
and  timely  employment  of  these  remedies  depend  upon  the  judgment  of  the  physician 
as  to  the  disease,  its  seat,  the  condition  of  the  patient  etc.  Hence  it  is  clear  why 
this  disease  is  so  common  in  boys,  the  indolent,  j"oung  women  and  certain  artisans." 
How  greatly  views  have  changed  since  Boerhaave's  da}-,  and  how  differently  we  look 
at  things  now,  may  be  judged  from  a  perusal  of  the  foregoing  extract,  and  we  may 
likewise  infer  that  the  same  thing  may  readil}'  happen,  some  day  or  another,  to  our 
own  ideas.  Such  things  must  be  looked  at  in  an  historical  light  in  order  to  avoid 
condemning  them  too  hastily. 

1.   Actiones  vitales,  naturales,  vel  et  animales. 


—  607  — 

In  therapeutics,  besides  his  efforts  to  sweeten  the  acid,  to  purify  the 
stomach,  to  get  rid  of  the  acridities  etc.,  Boerhaave  claimed  Hippocrates 
and  Sydenham  as  his  models,  but  without  being  by  any  means  exempt  from 
hypotheses  in  his  determination  of  the  indications.  He  was,  however,  for 
his  time  comparatively  simple  in  his  actual  therapeutic  prescriptions, 
although  the  latter  were  often  enough  odd  in  their  character,  e.  g.  the 
blood  of  birds  of  prey.  His  medicines  were,  at  all  events,  less  effective 
than  his  personal  presence,  which  indeed  is  true,  mutatis  mutandis,  of  all 
treatment. 

It  was  Boerhaave  who  first  permanently  established  the  clinical 
method  of  instruction,  and  its  diffusion  was  due  to  his  pupils,  particularly 
Haller  and  van  Swieten.  His  influence  in  a  medico-historical  point  of  view 
is  greater  than  his  real  scientific  importance  would  warrant. 

The  adherents  of  Boerhaave  —  he  had  no  school  of  followers  —  incline  for  the 
most  part  to  dynamic  or  vitalistic  principles.     This  was  the  case  with 

Abraham  Kaauw  Boerhaave  (1715-1758), 

his  nephew,  who  extended  the  doctrine  of  the  "enormon"  (which  he  named  "Impetum 
faciens")  and  was  likewise  addicted  to  alehemistie  and  pietistic  deductions.  He  was 
the  first  since  the  days  of  Erasistratus  to  emphasize  once  more  the  distinction  between 
nerves  of  motion  and  of  sensation.  —  Of  greater  reputation  and  importance  was  Boer- 
haave's  favorite  pupil  and  successor  the  Eclectic 

Hieronymus  David  Gaub  (1705-1780)  of  Heidelberg,  professor  in 
Leyden  from  1731,  who  was  inferior  only  to  Boerhaave  himself  in  his  fame 
as  a  teacher.  He  wrote  the  first  complete  work1  on  the  exclusive  subject 
of  general  pathology,  in  which  he  shows  himself  a  follower  of  the  Dynamic 
School.  Among  the  defects  of  "  fibre  "  he  adopted  from  Boerhaave  only 
tension  and  feebleness,  omitting  laxit}*,  while  he  maintained  the  existence 
of  an  independent  "  vital  force  ",  to  which  he  assigned  energy  and  recept- 
ivity, and  which  has  its  seat  in  the  solid  parts  alone.  These  defects  might 
increase  into  irritability,  or  sink  away  into  torpor.  To  irritability  he 
assigns  sensation  and  motion,  but  considers  both  the  result  of  irritation. 
In  this  respect  he  approaches  the  doctrine  of  Haller.  Besides  these  con- 
ditions of  solid  pathology  taken  quantitatively,  Gaub  admits,  however, 
defects  of  the  fluids  also.  These,  however,  he  thinks  originate  onh*  in 
diseases  of  the  solid  parts.  In  like  manner  he  concedes  to  the  fluids  a 
concealed  vital  force. 

In  general  therapeutics  he  considers  the  healing  power  of  nature 
amply  sufficient  to  remove  sickness,  which  latter  he  declares  just  as 
natural  as  life  and  death.  This  healing  power,  however,  he  credits  some- 
times to  the  soul,  sometimes  to  the  bod}'.  —  Gaub's  views  continued  to 
prevail  for  a  long  period. 

Joh.  VON  Gorter  (1689-1762), 
professor  at  once  of  medicine,  surgery,  and  the  natural  sciences  at  Harderwyk,  for- 
sook  Boerhaave's  theory  of  inflammation,   and   finds   the  latter  occasioned   by  an 

1.   The  "  Institutiones  pathologic  niedicinalis",  Leyden,  1750.     (H.) 


—  608  — 

irritation  acting  upon  the  smallest  vessels,  which  are  endowed  with  vital  motion. 
Neglecting  purely  mechanical  explanations,  he  distinguishes  from  each  other  a  soul 
and  an  independent  force  of  living  parts,  which  he  concedes  even  to  plants,  and 
designates  as  "vital  movement".  It  is  independent  of  the  nerves  or  vital  spirits,  and 
is  different  from  elasticit}'. 

Boerhaave's  principles  were  mainly  followed  by  Christian  Strom ;  Hermann 
(1672-1744)  and  Joh.  Oosterdyk  Schacht  (1704-1791),  professor  in  Utrecht;  Job. 
Theod.  Eller,  ordinary  phj-sician,  and  the  surgeon  Sam.  Schaarschmidt,  both  of  Ber- 
lin ;  Gottlieb  Christian  Ludwig  (1709-1773),  professor  in  Leipzig;  Rud.  Augustin 
Vogel  (1724-1774),  a  well  known  teacher  in  Gottingen,  and  others.  Van  Swieten, 
de  Haen  and  Haller  were,  however,  his  most  eminent  pupils. 

In  complete  opposition  to  the  theoretical  variety  of  Boerhaave's  system 
and  to  the  mixed  system  of  Hoffmann,  still  to  be  considered,  the 

b.  System  of  Georg  Ernst  Stahl 

is  distinguished  by  its  strict  consistency  in  carrying  out  its  principles  and 
by  the  utmost  independence.  Stahl  (1660-1734)  was  one  of  the  most 
important  Sj^stematists  of  the  18th,  and  indeed  of  any,  century,  a  thinker 
as  profound  as  he  was  earnest,  and  has  already  been  introduced  to  us  as 
a  pioneer  chemist. 

He  was  born  in  Ansbach  and  studied  in  Jena  under  the  famous  Iatro-chemist 
G.  W.  Wedel.  Graduating  at  the  age  of  twenty-five,  he  at  once  began  lecturing  at 
the  university  of  Jena,  until  at  the  expiration  of  two  years  he  was  called  to  Weimar 
as  physician-in-ordinary.  From  thence,  on  the  recommendation  of  Fr.  Hoffmann,  he 
came  in  1694  to  Halle  as  professor  of  pathology,  dietetics,  physiology,  pbarmacoh igy 
and  botany.  At  first  he  lived  on  friendly  terms  with  Hoffmann,  but  subsequently 
thej-  became  estranged.  At  the  age  of  fifty-six  he  was  appointed  ordinary  physician 
in  Berlin,  a  position  which  he  held  until  his  death.  Stahl,  like  his  converted  name- 
sake in  our  century,  was  a  great  pietist  and  a  man  of  stiff  and  rough  manners, 
unchangeably  true  to  his  laboriously  acquired  convictions,  and  bitter  and  reserved  at 
their  non-acceptance.  For  he  held  these  convictions  to  be  as  important  as  a  revela- 
tion from  God  (an  expression  of  pietistic  pride),  and  in  fact  regarded  them  as  such  a 
revelation.  The  success  of  another  seemed  also  a  personal  injury  to  himself,  and 
accordingly  from  a  hypochondriacal  croaker  he  became  gradually  a  confirmed  misan- 
thrope, until  finally  his  morbid  reserve  and  gloom}'  moroseness  ended  in  actual 
melancholj\  Pecuniary  profit,  however,  he  never  sought,  and  its  pursuit  he  scorned. 
He  is  regarded  as  one  of  the  chief  promoters  of  medical  teleology  among  the  Moderns. 
Stahl's  numerous  works  are  written  partly  in  German,  partly  in  Latin.  In  the  former 
the  language  is  broad  and  clums}',  the  expressions  often  unusual  and  obscure,  the 
composition  cramped  and  long-winded,  and  the  sense  not  rarely  ambiguous  from  his 
coinage  of  new  terms.  His  most  important  work  (Latin)  is  entitled  "Theoria  medica 
vera"  etc.     (Halle,  1707.) 

The  system  of  Stahl  is  dynamico-organic,  pietistic  and  antagonistic. 
He  makes  the  "  soul "  (anima)  the  supreme  principle.  It  is  the  special 
life-giving  and  life-preserving  principle,  not  to  be  confounded  with  spirit, 
but  about  the  same  thing  as  the  "  Physis  "  and  "  Natura  "  of  other  authors. 
It  imparts  life  to  dead  matter,  is  active  in  generation,  as  well  on  the  side 
of  the  father  as  of  the  mother,  on  the  one  hand  provides  for  itself  the  bodyr 
and  on  the  other  counteracts  the  constant  tendency  of  the  latter  to  decay 


—  609  — 

and  corruption,  which  actually  enter  only  when  this  principle  voluntarily 
abandons  the  body  to  death.  It  is,  however,  something  entirely  independ- 
ent, self-conscious  and  self-creative.  In  the  preservation  of  the  body  the 
soul  acts  through  "  motion  ",  which  takes  care  of  the  reception,  as  well  as 
the  excretion,  of  material,  processes  which  are  the  basis  of  life.  It,  how- 
ever, does  not  invariably  effect  orderly,  regular,  "  tonic  ",  i.  e.  sometimes 
contracting  sometimes  relaxing,  movements  (which  represent  "  health  "), 
but  is  in  some  cases  hindered  or  obstructed,  and  this  obstruction  may  even 
proceed  from  the  bod}'  or  its  organs.  If  such  is  the  case,  "health "  is 
changed  into  '•  disease  ",  which  latter  again  is  nothing  but  an  effort  of  the 
soul  to  restore  these  tonic  movements  in  the  organism.  With  this  object 
it  is  frequently  compelled  to  make  powerful  exertions.  As  the  soul  ordi- 
narily employs  the  circulation  and  the  capacity  of  the  parts  of  the  body 
for  contraction  and  relaxation  (tonus),  as  the  route  and  instrument  of  its 
influence  upon  the  bod}*,  so  also  in  disease,  where,  in  consequence  of  the 
necessarily  hastened  and  increased  activity  of  the  soul,  either  the  pulse  is 
accelerated,  the  temperature  rises  etc.,  in  a  word  "fever"  makes  its  appear- 
ance, or  spasmodic  movements,  "  convulsions ",  are  developed.  In  the 
false  movements  within  the  organism  lies  also  the  main  cause  of  sick- 
nesses, but  not  in  the  numerous  external  influences  assumed  by  others 
Were  the  latter  the  case,  the  frequency  of  sickness  and  the  number  of 
diseases  would  necessarily  be  much  greater  than  they,  in  fact,  are. 

Since  too  the  soul  governs  the  organism  chiefly  by  way  of  the  circu- 
lation, disturbances  and  stagnation  in  the  latter  are  also  main  causes  of 
disease.  These  disturbances  arise  most  frequently  from  "plethora", 
which  plays  an  important  role  in  the  system  and  the  therapeutics  of  Stahl. 
To  get  rid  of  this  plethora  the  soul  employs  the  means  mentioned  above  ; 
either  fever,  with  its  heat,  by  which  the  blood  is  imperceptibly  driven  out 
or  dissolved,  or  convulsive  movements,  by  which  the  blood  is  driven  into 
certain  parts  and  there  visibly  discharged. 

In  childhood  plethora  produces  a  pressure  of  blood  toward  the  head, 
and  the  soul,  as  a  compensation  for  this,  provides  a  haemorrhage  from  the 
nose.  During  youth  this  blood-pressure  is  directed  rather  towards  the 
chest,  and  is  equalized  by  haemoptysis  and  pneumorrhagia,  while  at  the 
period  of  sexual  maturity  in  like  manner  arise  monthly  discharges  and 
"the  piles"  ("goldene  Ader"),  which  Stahl  considers  a  safety-valve  of  the 
utmost  importance.  From  this  time  dates  the  very  high  estimation  of 
"  haemorrhoids",  the  ■'  hemorrhoidal  impulses",  the  "  hemorrhoidal  flow", 
which  prevailed  among  physicians  until  a  very  recent  period,  and  is  the 
rule  among  the  laity  even  at  the  present  day.  When  this  hemorrhoidal 
flow  stagnates,  it  is  by  all  means  to  be  again  started  up.  In  the  stoppage 
of  this  flow  lie  the  chief  causes  of  hypochondria  and  melancholy,  as  well 
as  of  all  chronic  diseases.  The  vena  porta?,  as  we  know,  is  the  trunk  of 
the  hemorrhoidal  veins  ;  hence  the  famous  aphorism  :  vena  porte  porta 
malorum  1 

39 


—  610  — 

Fever,  as  we  have  seen,  was  for  Stahl  a  salutary  effort  of  the  soul  to 
preserve  the  body.  This  was  true  even  of  intermittent  fever,  and  accord- 
ingly he  never  suppressed  this  disease  with  cinchona.  On  the  other  hand, 
inflammation  was,  in  his  view,  a  stagnation  of  the  blood  (an  Iatro-mechan- 
ical  idea  —  and  such  ideas  are  accepted  by  him  also  in  other  directions) 
under  the  forms  of  erysipelas,  phlegmon  and  its  suppuration. 

Stahl  scorned  anatonry  and  physiology,  was  an  enemy  of  erudition 
and  its  authorities,  and  swore  boldly  by  the  maxim  that  good  theorists 
(among  whom  he  was  one  of  the  chief)  may  be  bad  practitioners. 

"The  structure  of  the  meandering  passages  in  the  oar,  of  the  anvil,  the  hammer, 
mid  the  stirrup,  and  —  what  a  noble  discover}- !  —  the  round  ossicle,  if  it  were  unknown 
would  render  the  physical  knowledge  of  the  body  very  defective.  But  medicine  (i.  e. 
practical  medicine)  profits  by  this  knowledge  precisely  as  much  as  by  the  knowledge 
of  the  snow  which  fell  ten  years  ago." 

This  has  been  said,  as  we  know,  by  several  of  the  greatest  physicians 
besides  Stahl.  Though  one  of  the  most  eminent  chemists  of  any  age  — 
he  liberated  chemistry  from  the  stain  of  alchemy  and  from  its  servitude 
to  pharmacy,  and  transformed  it  into  an  independent  science  —  Stahl 
spoke  warmly  against  the  employment  of  this  science  in  medical  theory, 
and  in  general  against  the  over-estimation  of  the  natural  sciences  in  the 
latter.  He  likewise  raised  a  note  of  warning  against  favoring  the  branches 
subsidiary  to  medicine  to  the  prejudice  of  the  mother  science,  a  warning 
renewed  at  the  present  day  from  quite  as  competent  authority.  "  If  in 
the  bocVy  ",  which  Stahl  taught  should  be  regarded  as  a  living  organism, 
•'■  chemical  laws  are  active,  then  it  must  fall  into  corruption  ",  was  his  view. 

In  therapeutics,  Stahl  placed  at  the  head  the  healing  power  of  nature, 
which  is  identical  with  his  ''  soul  ".  "It  is  the  simple  truth  that  man  has 
his  physician  in  himself,  that  nature  is  the  physician  of  diseases,  and  offers 
a  better  prospect  of  curing  diseases  than  the  most  successful  apparatus 
of  our  art."  For  the  rest,  he  follows  his  system  here  too  with  the  utmost 
strictness.  The  soul,  as  it  is  the  cause  of  all  diseases,  so  is  it  that  which 
cures  them  all.  Therapeutics  can,  or  rather  should,  act  upon  this  alone, 
that  is  upon  the  "movements  "  occasioned  by  it.  If  too  strong  they  must 
be  restrained ;  if  too  feeble  or  utterly  wanting,  we  must  endeavor  to 
strengthen  them  or  to  call  them  forth.  Venesection,  of  which  Stahl  made 
excessive  use  in  acute  as  well  as  in  chronic  cases,  is  to  be  considered  the 
main  check  upon  these  movements.  He  even  recommended  venesection 
as  a  preventive  measure  —  twice  a  year  —  and  by  it  the  people  have  been 
served  and  injured  down  to  our  modern  times.  Beside  venesection  he 
ranked  care  to  re-establish  the  hemorrhoidal  flow  by  the  use  of  irritating- 
drugs,  which  Stahl  in  other  circumstances  discarded.  To  these  measures 
were  added  his  "  balsamic  pills  "  (aloes,  hellebore  etc.),  Stomach-powder, 
Essentia  alexipharmaca  etc.,  nostrums  which  brought  him  a  lucrative 
business.  In  addition,  Stahl  gave  purgatives  and  emetics,  diaphoretics 
and  especially  alteratives,  including   his  favorite  saltpeter.      He  discarded 


-  (ill  — 

however,  many  effective  drugs  (and  particularly  the  poisons),  above  all 
the  Cinchona  (because  Iry  its  astringent  properties  it  suppressed  the  febrile 
state,  which  was  in  itself  sanative),  opium  (because  it  restrained  the 
-•movements"),  ferruginous  preparations  and  mineral  waters,  because 
Hoffmann  recommended  them  etc.  On  the  whole  he  professed  to  follow 
the  principle  of  Hippocrates,  according  to  which  the  duty  of  the  physician 
frequently  consists  in  careful  expectant  observation,  but.  on  the  other  hand, 
in  treatment  at  the  right  time. 

Stahl's  doctrine  has  been  called  -Animism'',  it  was  the  reaction 
against  the  exclusive!}'  mechanical  and  chemical  theories  of  the  17th 
century  —  and  has  fulfilled  its  mission  in  the  history  of  culture. 

"It  was  enough  for  Stahl,  in  contrast  to  his  contemporaries,  who  were  all  too 
prone  to  utilize  the  laws  of  mechanics  then  alone  known,  and  the  trifling  chemical 
knowledge  of  that  period,  of  which  they  were  proud,  and  which  they-  employed 
entirely  too  extensively  in  the  explanation  of  the  phenomena  of  life —  it  was  sufficient, 
I  say,  for  Stahl  to  have  rescued  life  as  a  specific  active  force,  at  least  for  organized 
beings  "      (Spiess. ) 

Stahl  obtained  no  inconsiderable  number  of  followers,  though  some  of 
them,  indeed,  departed  widely  from  his  doctrines  and  preserved  merely  the 
fundamental  principles  of  Vitalism,  though  under  other  names. 

In  the  judgment  of  Stahl  himself  Joh.  Sam.  Karl  (1676-1757]  <>!  Oehringen, 
physician-in-ordinary  first  at  Isenburg  and  then  in  Denmark,  was.  according  to 
Juncker,  his  most  faithful  pupil.  He  differed,  however,  from  his  master  in  regard  to 
preventive  venesection,  and  also  considered  horse-dung  useful  to  drive  out  the 
small-pox.  Georg.  Dan.  Coschwitz  (1679-1729),  professor  in  Halle,  and  Joh.  Dan. 
Gohl  (whose  pseudonym  was  Crsinus  Wahrmund,  1675-1731),  a  phjsician  in  Berlin 
and  resident  physician  at  the  springs  of  Freyenwald  :  Michael  Alberti  1 1682-1757), 
professor  in  Altdorf-Nurnburg:  Andr.  Ottomar  Goelicke  i  1671-1714).  professor  in 
Frankfort  on-the-Oder;  Johann  Juncker  (1680-1759)  of  Londorf,  near  Giessen,  pro- 
fessor, and  the  first  clinical  professor  in  Halle;  Georg.  Phil.  Nenter,  professor  in 
Strassburg;   Christian  von  Hellwich  (1663-1721)  in  Erfurt,  were  all  followers  of  Stahl. 

To  these  should  be  added  the  eminent  physiologist  of  the  nervous 
system  (centripetal  and  centrifugal  nervous  conduction  etc.)  Joh.  Aug. 
Unzer  (1727— 1799),  a  practising  physician  in  Hamburg  and  subsequently 
professor  in  Rinteln.  He  strongly  distinguished  the  mechanical  phenomena 
of  the  body  from  the  workings  of  the  soul,  and  held  that  the  nervous 
influence  was  brought  about  b}-  the  power  of  the  latter,  which  he  identified 
with  :-  Irritability  and  Sensibility  "  and  "  Vital  force ".  Unzer  too,  like 
Graub,  defended  the  Stahl-Hallerian  doctrines.  As  a  popular  author  of 
taste  and  spirit  he  also  obtained  wide  esteem,  popularity  and  posthumous 
fame  in  professional  circles,  particularly  b}-  his  journal  "  der  Arzt ",  which 
made  its  appearance  in  1759  and  survived  for  12  years.  Unzer,  like  the 
physician  next  mentioned  and  many  others,  furnishes  an  example  how  in 
the  last  century  practising  physicians  took  a  controlling  or  at  least  an  im- 
portant position  in  science,  and  possessed  the  courage  of  their  own  convic- 
tions and  experience. 


—  612  — 

All  the  physicians  just  mentioned  followed  more  or  less  strictly  the  soul  doctrine 
of  Stahl.  Friedr.  Casimir  Medicus  (1736-1808),  a  physician  of  Mannheim,  who  placed 
the  "vital  force"  beside  the  soul,  but  also  accepted  the  Iatro-mechanical  doctrines, 
was,  however,  already  strongly  influenced  bj-  Vitalistic  principles.  He  held  that  the 
ganglia  are  the  cause  why  the  vital  functions  take  place  without  the  influence  of  the 
consciousness  and  the  will,  and  thought  that  both  were  restrained  by  the  former. 
The  "  last  champion"  of  the  doctrines  of  Stahl  was  Ernst  Platner  (1744-1818),  pro- 
fessor in  Leipzig  and  the  ablest  mind  among  his  partisans.  The  best  known,  how- 
ever—  and  also  the  wealthiest — among  them  was  the  inventor  of  the  "Halle 
Remedies",  Christian  Friedrich  Richter  (1676-1711)  of  Sorau,  whose  "  Hochstnothige 
ErkUntniss  des  Menschen,  sonderlich  nach  dem  Leibe  und  naturlichen  Leben  "  survived 
seven  editions.     One  of  his  wealthy  heirs  was  David  Samuel  Madai  (1709-1780). 

Besides  the  physicians  alread}'  introduced  by  anticipation  among  the 
Iatro-mechanicians  of  England  in  our  account  of  the  17th  century,  but  who 
are  to  be  reckoned  in  the  18th  centurv,  and  who  favored  the  principles  of 
Stahl,  we  must  mention  as  still  purer  followers  of  that  phj-sician  : 

Robert  Whytt  (1714-1766),  professor  in  Edinburgh,  an  adroit  defender  of  Stahl. 
and,  as  we  shall  see,  an  opponent  of  Haller;  William  Porterfield,  (invented  and 
named  the  first  optometer,  1759),  also  about  the  middle  of  the  century  in  Edinburgh: 
Thomas  Simson,  about  the  same  period  professor  at  the  university  of  St.  Andrew's  in 
Scotland:  Samuel  Farr  (1721-1795)  of  Taunton ;  Thomas  Lawrence  (1711-1783); 
James  Mackittrick  and  others. 

Among  the  French  the  doctrines  of  Stahl  gained  popularity  especially 
through  the  labors  of 

Francois  Boissier  de  la  Croix  de  Sauvages  (1706-1767),  the  fore- 
runner of  Pinel  and  an  opponent  of  pure  mechanics^  who  animated  the 
latter  system  with  Stahl's  "  soul  ",  which  he  considered  the  cause  of  the 
mechanical  actions  in  the  bod}'.  He  was  accordingly  an  animistic  mechan- 
ician. This  was  the  age  of  artificial  "  systems  ",  and  hence  Sauvages  in  his 
'•'Nosologia  Methodica"  supplied  a  s}-stem  which  contained  10  "classes  "  of 
diseases,  each  of  which  again  had  several  "  orders  "  —  some  as  many  as 
seven  —  295  "genera",  and  2400  "species". 

Linnaeus  had  325  genera  of  disease.  Other  classifications  were  framed  b}-  David 
Macbride  (1727-1778):  R.  A.  Vogel ;  Job.  Ernst  Hebenstreit  (1701-1757),  professor 
in  Leipzig;  Cullen  (4  classes  with  149  genera);  J.  B.  Sagar  (1702-1781),  12  classes 
and  815  genera;  Nietzky;  Chr.  Fr.  Daniel  (175o-l79S)  of  Halle;  van  den  Heuvel ; 
Selle;  Ploucquet  of  Tubingen. 

A  system  opposed  to  that  of  Stahl  from  motives  of  hostility  to  both 
his  person  and  his  ideas,  was  published  in  the  year  1718  by  Friedrich 
Hoffmann,  who  had  before  embraced  the  chemical  S3Stem,  that  of  Boerhaave. 
and  finally  the  doctrines  of  Stahl.  The  iatro-mechanical  foundation  of  this 
system  approximated  it  most  nearly  to  the  ideas  of  Boerhaave.  "iEther  " 
was  introduced  into  the  system  of  Hoffmann  as  adynamic  but  materiaL 
principle,  accordingly  not  equivalent  to  the  "  soul "  of  Stahl.  From  this 
resulted  a  mixed,  and  not  very  logical 


—  613  — 

c.  Mechanico-Dynamic  System, 

which  was  held  in  high  honor  by  the  most  eminent  physicians  and  the 
better  minds  of  the  last  century,  and,  indeed,  was  prized  by  even  Sprengel 
as  the  most  excellent  of  all  the  systems. 

Friedrich  Hoffmann,  the  son  of  a  physician  of  the  same  name,  was  born  in  Halle 
in  1660.  Before  attending  the  university  lectures  he  had  devoted  much  attention  to 
mathematics.  During  his  university  course  the  Iatro-chemist  Wedel  was  his  chief 
teacher.  He  graduated  as  early  as  his  twenty-first  year,  and  went  as  a  practising 
physician  to  Minden.  Thence  he  travelled  in  Holland  and  England,  where  he  studied 
under  the  direction  of  Robert  Boyle,  the  Iatro-mechanic,  who  was  likewise  equally 
famous  as  a  chemist.  Returning  to  Germany  he  was  in  1688  appointed  to  the 
"Physikat"  of  Halberstadt,  whence  six  years  later  he  was  called  to  the  newly 
founded  university  of' Halle  as  professor  of  anatomy,  surgery  and  practice,  as  well  as 
of  physics  and  chemistry.  As  a  chemist  he  acquired  lasting  reputation  by  his 
numerous  analyses  of  mineral  waters,  as  well  as  by  his  investigations  of  the  ethereal 
oils.  In  these  studies  he  made  the  discovery  of  some  special  remedies,  with  which, 
like  Stahl,  he  carried  on  a  lucrative  business  (Liq.  anodynus  H.,1  Elixir  viscerale  H., 
Balsamum  vitae  H.,  Pilulae  balsamicse  H.  etc.).  He  was  one  of  the  most  famous 
professors  of  his  day,  easier  understood  than  Stahl  (who  was  a  more  profound  mind), 
and  accordingly  brought  his  youthful  university  into  a  most  flourishing  condition. 
All  praised  his  fluent  diction  and  personal  amiabilitj'.  In  1709  he  was  called  away  to 
Berlin  as  ordinary  physician  to  king  Frederick  I.,  but  met  a  downfall  through  the 
machinations  of  the  physicians  of  Berlin,  and  particular!}'  of  a  certain  Gundelsheimer, 
whose  name  has  survived  in  history  as  the  representative  of  a  bad  colleague.  He 
returned  to  Halle  as  professor,  and  scarcely  left  there  until  his  death  in  1742. 
Hoffmann  was  an  extremely  fortunate  and  busy  practitioner,  whom  even  Boerhaave 
declared  his  own  equal.  As  the  result  of  this  declaration  he  recovered  his  reputation 
at  the  court  of  Berlin,  and  to  such  a  degree  that  Frederick  William  I.  sent  his  tall 
soldiers  to  him  for  treatment,  and,  on  the  occasion  of  the  death  of  Hoffmann's  wife, 
wrote  him  an  autograph  letter  of  consolation,  saying  that,  after  all,  it  was  better  that 
she  should  die  than  he,  for  that  he  could  certainly  do  more  good  in  the  world  than  his 
wife  could  have  done.  Hoffmann  was  an  extraordinarily  voluminous  writer.  An 
edition  of  his  Latin  works  comprises  27  octavo  volumes.  His  chief  work  was  entitled 
"  Medicina  rationalis  systematica"  (1718-1740). 

The  train  of  thought  in  Hoffmann's  system  is  as  follows  :  our  knowledge 
is  finite,  rooted  in  the  senses  and  limited  to  what  is  perceptible  by  the  senses  : 
all  final  causes,  however,  are  inscrutable.  Forces  and  influences  beyond  the 
range  of  the  senses,  cognizable  by  metaphysical  speculation,  lie  without  its 
limits.  Forces  are  inherent  in  matter  and  express  themselves  as  mechan- 
ical movements,  determinable  by  mass,  number  and  weight,  an  idea  which 
has  recently  attained  an  extremely  extended  confirmation.  In  the  body 
also  these  forces  express  themselves  by  movement,  as  action  and  reaction, 
contraction  and  relaxation,  ';  tonus  ".  Life  is  movement,  especially  move- 
ment of  the  heart :  death,  the  cessation  of  the  movements  of  this  organ, 
as  the  result  of  which  putrefaction  begins.  Death  and  life  are  mechanical 
phenomena.     Health  is    sjmonomous  with   the  regular  occurrence  of  the 

1.    This  was  first  extolled  as  a  panacea  by  the  apothecary  Martmeyer  in  1710,  and 
retains  its  reputation  among  the  masses  even  at  the  present  day. 


—  614  — 

movements;  disease,  a  disturbance  of  the  same.  The  contractions  of  the 
heart,  the  blood-vessels  and  animated  fibres  or  tubules  of  Ruysch.  set  in 
motion  the  circulation  of  the  blood,  and  effect  regular  secretion  and 
excretion,  the  chief  phenomena  of  health.  Digestion  is  the  solution  of 
food  by  means  of  the  saliva  and  warmth,  perspiration  an  effect  of  heat 
alone,  and  takes  place  not  only  through  the  pores,  but  also  through  the 
smallest  vessels  of  the  skin.  The  body  is  precisel}*  like  an  hydraulic 
machine.  Its  movements  are  effected  and  maintained  by  that  dynamico- 
material  principle,  of  fluid,  but  extremely  volatile,  constitution,  "the  aether  " 
(synonomous  with  nervous  aether,  nervous  spirit,  "  sensitive  soul  ",  the 
pneuma  of  the  ancient  physicians).  This  acts  in  accordance  with  the  laws. 
not  of  ordinary  mechanics,  but  of  a  higher  and  still  uninvestigated  science, 
and  is  in  very  small  part  derived  from  the  atmosphere,  but  chiefly  secreted 
from  the  blood  in  the  brain.  The  ''movements"  of  the  latter  organ  drive 
it,  by  way  of  the  nerve  tubules,  throughout  the  whole  body.  This  motor 
principle  possesses  conception  and  sensation,  and  is  the  perceptive  soul.  Tt 
forms  and  maintains  the  bod}r  in  accordance  with  its  idea,  and  each  special 
particle  of  it,  like  the  monads  of  Leibnitz,  has  a  conception  of  the  compo- 
sition and  mechanism  of  the  body.  The  chief  reservoir  and  center  of  the 
aether  is  the  medulla.  It  also  circulates  with  the  blood  in  the  body.  There 
is  too  a  double  circulation  of  the  aether.  The  center  of  one  is  the  brain,  its 
periphery  being  formed  by  the  nerves  :  the  heart  forms  the  center  of  the 
other,  and  the  vessels  form  its  peripheral  organs.  Both,  however,  are 
intimately  associated.  Disease  may  consist  in  too  feeble,  or  too  strong, 
tonus.  Atony  and  spasm  are  the  consequences,  the  latter  expressed  by 
pain  in  the  nervous  parts.  Spasm  arises  from  too  strong,  atony  from  too 
feeble,  an  influx  of  the  nervous  aether.  Plethora  too  is  one  of  the  most 
frequent  causes  of  disease.  The  latter  act  chiefly  upon  and  from  the  prima* 
viae,  especially  from  the  stomach,  which  displays  special  "sympathy",  <>n 
the  one  hand,  with  the  intestinal  canal,  and  on  the  other,  with  the  whole 
body.  Hence  it  should  be  an  object  of  constant  watchfulness  on  the  part 
of  the  physician.  Fever,  whose  source  Hoffmann  seeks  in  the  spinal  cord, 
is  a  spasm  of  the  arteries  and  veins,  in  fact  a  general  spasm,  a  complete 
disease,  not  usually  a  salutary  action,  as  Stahl  taught.  Occasional!}-,  how- 
ever, its  effect  is  accidentally  salutary. 

"To  excite  a  too  strong,  spasmodic  contraction  of  the  coats  of  the  stomach  and 
intestines  by  an  emetic  or  cathartic,  is  in  itself  neither  advantageous  nor  salutaiy. 
It  is  even  a  thoroughly  unnatural  action,  and  therefore  a  disease,  which  often  pro- 
duces vei'3r  bad  results.  But  when  it  carries  off  from  these  parts  impure  fluids,  slimy 
and  corrupt,  it  becomes  in  this  way  somewhat  salutary.  The  same  is  the  case  also 
with  internal  spasms,  which  occasion  spontaneous  haemorrhages.  They  may  have  a 
salutary  effect  when  there  is  too  much  blood,  and  when  they  remove  only  tin- 
superfluity.  But  in  itself  this  movement  too  is  not  healthful,  for  it  frequently 
occasions  fatal  haemorrhages.  So  it  is  also  with  fever.  In  itself  considered,  it  should 
not  be  called  beneficial  or  salutary,  for  it  slays  one-half  the  human  race.  But,  under 
certain  circumstances,  it  may  be  healthful,  since  it  restores  complete  health,  in  so  far 
as  it  removes  the  impurities  which  the  patient's  body  contains. 


—  615  — 

In  like  manner  inflammation  depends  upon  spasm,  and  indeed  spasmodic 
arrest,  of  the  circulation  in  the  inflamed  part. 

Hoffmann  s  therapy  was  simple  and  designedly  poor  in  drugs  (accord- 
ing to  the  ideas  of  that  time),  but  by  no  means  free  from  theoretical  views. 
The  physician  has,  before  all  else,  to  regulate  the  disturbed  movements,  for 
nature  is  frequently  not  able  to  do  this.  But  there  are  diseases  which 
cure  other  diseases  ;  e.  g.  fever  cures  spasms.  Hoffmann  divided  drugs 
(which  he  held  worked  under  mechanical  laws)  into  those  which  strengthen 
or  weaken,  alter  or  evacuate.  He  was  especially  partial  to  the  use  of  his 
own  remedies  and  wine,  particularly  Hochheimer,  which  he  considered  the 
best  of  all  wines  —  as  the  English,  at  his  instance,  do  at  the  present  day. 
Camphor  he  strongly  recommended;  likewise  mineral  waters,  cold  water, 
Seidlitz  salt,  cinchona  and  iron.  He  often  practised  venesection,  and  laid 
great  stress  upon  the  observance  of  prescribed  diet,  e.  g.  absolute  diet, 
milk  diet,  wine  diet,  exercise  etc.  Poisons  he  in  general  rejected  :  the 
preparations  of  lead  he  absolutely  discarded  for  internal  use,  and  desired 
to  limit  the  emplo3Tment  of  opium  etc.  How  necessary  at  the  present  day 
is  such  an  apostle  against  our  poisons  and  drug-poisoning,  particularly 
those  regarded  as  antifebrilia !  Evacuation,  both  upward  and  downward, 
he  practised  with  the  milder  drugs  only.  His  success  at  the  sick-bed,  and 
his  reputation  as  a  skilful  physician,  depend  upon  the  simplicity  of  his 
therapeutics. 

Among  the  followers  of  Hoffmanns  system  the  professors  of  Halle,  in  regular 
succession,  are  particularly  prominent.  Of  these  the  trustiest  and  most  eminent  was 
Joh.  Heinrich  Schulze  ( 1687-1745),  at  first  of  Altdorf,  then  in  Halle;  Heinrich  Bas&i ; 
Andr.  Elias  Biichner  (1701-1769),  successor  of  Schulze;  Ernst  Anton  Nicolai  i  1722- 
1802),  professor  in  Halle;  Joh.  Peter  Eberhard,  of  the  same  university;  finally  Adam 
Nietzky  (1714-1780),  who  followed  the  same  road  as  Schulze  from  Altdorf  to  Halle. 
The  aether  hypothesis  —  Pietro  Paolo  Molinelli  (1702-1764)  thought  he  had  demon- 
strated the  existence  of  the  nervous  fluid  by  the  swelling  of  the  nerves  after  ligation 
: — was  especiallj-  defended  by  Christ.  Mart.  Burchart  (1680-1742),  professor  in  Rostock, 
who  made  use  of  Leeuwenhoeclc  s  view  of  the  nerve-tubules ;  Joh.  Phil.  Burggrav  of 
Darmstadt  (1700-1775),  professor  at  Frankfort-on-the-Main,  the  family  physician  of 
Gothe's  father,  who  based  upon  the  nervous  fluid  a  kind  of  humoral  pathology;  and 
Joh.  Ludwig  Apinus  (1688-1730)  of  Altdorf,  who  marched  into  the  field  with  the 
Bible.  The  doctrine  of  the  sympathies  was  especially  elaborated  in  Holland  by 
Hendrik  Joseph  Rega  (1690-1754),  of  Louvain,  and  by  Nic.  Malcolm  Flemyng,1  par- 
ticularly as  regards  the  stomach.  In  England  Browne  Langrish  (died  1759)  was 
devoted  to  Hoffmann's  doctrine,  while  in  Italy  Thorn.  Brini  of  Bergamo  and  Luigi  de 
(Jlarellis,  professor  in  Naples,  combated  it.  Giov.  Thorn.  Rosetti,  professor  in  Venice, 
combined  Hoffmann's  doctrine  with  the  Hippocratic  idea  of  the  "enormon",  in 
opposition  to  which  Charles  Ferapie  Dusieu  and  the  notorious  J.  Paul  Marat  (1744- 
1793)  stood  by  Hoffmann. 

In   relation  with  the   system   of   Hoffmann   and    Haller's   doctrine   of 


1.  Flemyng  was  an  English  physician  of  Kington  in  Yorkshire,  and  a  fellow-student 
of  Haller  in  Leyden.  His  "  Neuropathia,  sen  de  morbis  hypocliondriacis  et 
liystericis  libri  111."  was  published  in  1740.     (H.) 


—  616  — 

irritability,  which  immediately  after  its  origin  was  applied  to  theoretical 
medicine,  there  arose  a  system  of  pure  pathological  solidism,  the 

d.  Nervous  Pathology 
of  William  Cullen  (1712-1790),  of  Lanarkshire  in  Scotland. 

Cullen  was  one  of  the  first  of  those  great  English  physicians  who  worked  up  from 
the  deepest  povertj-,  and  whom  posterity  admires  for  their  love  of  science  and  their 
services.  First  a  barber,  he  then  became  an  apothecary,  next  a  ship-surgeon,  then 
the  surgeon  of  a  small  village,  and  finally  alternated  with  William  Hunter  as  a  prac- 
tising physician  in  Hamilton.  As  both  these  surgeons  were  in  equally  needy  circum- 
stances, they  agreed  (the  solitarj-  example  among  physicians!),  in  order  to  gain  the 
higher  education  at  which  they  aimed,  that  while  one  should  by  practice  earn  the 
necessary  means,  the  other  should  attend  the  university.  In  this  way  Cullen  was 
enabled  to  graduate  in  1740.  Six  years  later  he  became  professor  of  chemistry  in 
Glasgow,  in  five  years  more  professor  of  medicine,  and  again  after  five  years  he  came 
to  Edinburgh,  to  pass  through  the  same  succession  of  positions.  He  continued  there 
an  active  and  famous  teacher  as  long  as  he  lived,  but  died,  as  he  had  begun  his  career, 
in  poverty.  His  chief  works  were  entitled:  "  Synopsis  nosologia?  methodic**?" 
(Edinburgh,  1769);  "Physiology  for  the  use  of  the  students  in  the  University  of  Edin- 
burgh" (Edinburgh,  1785);  "First  lines  of  the  practice  of  Physic"  etc.  (London, 
1777;  written  in  English  and  therefore  taxed  with  heterodoxy);  "A  treatise  of  the 
Materia  Medica"  (Edinburgh,  1789);  "Clinical  Lectures."  Cullen  was  a  very 
charitable  man,  supported  the  widow  of  Robert  Burns  and  published  his  poems.  He 
was  the  father  of  modern  Solidism,  which  he  founded  upon  pure  deductive  principles. 

The  main  foundation  of  Cullen's  system  is  formed  by  the  living  solid 
parts  of  the  bod}*,  not  the  fluids  :  the  chief  agent  are  the  nerves.  An 
undefined  dynamic  something,  which  is  different  from  Hoffmann's  material 
aether  and  the  supernatural  soul  of  Stahl,  and  which  Cullen  calls  "  the 
nervous  force",  "nervous  activity",  "the  nervous  principle",  is  the  proper 
life-giving  element.  He  also  calls  this  principle  "the  animal  force"  or 
•  energy  of  the  brain  ",  in  which  he  also  includes  the  spinal  cord. 

"An  immaterial,  reasoning  substance  or  soul  exists  in  the  living  man,  and  every 
thought  must  be  considered  a  faculty  of  the  soul  alone.  But  this  immaterial  and 
reasoning  part  of  man  is  united  with  the  material  and  corporeal  part,  and  especially 
with  the  nervous  system,  in  such  a  way  that  the  movements  called  forth  in  the  latter 
beget  thoughts.  But  thought,  however  generated,  occasions  new  movements  in  the 
nervous  system.  This  reciprocal  influence  I  consider  a  fact,  but  I  cannot  explain 
how  it  takes  place.  Likewise  the  brain  is  the  sensorium  or  corporeal  organ,  indis- 
solubly  united  with  the  soul."     (See  Daremberg. ) 

The  nervous  principle  produces  spasm  and  atony.  The  former  is  not, 
however,  always  dependent  upon  increased  nervous  activit}-,  but  may  also 
originate  from  feebleness  of  the  brain,  the  center  of  nervous  activity.  The 
nerves  are  the  conductors  of  the  activity  of  the  brain.  Everything  is 
effected  through  the  brain  and  the  nerves,  and  everything,  including  the 
causes  of  disease,  works  upon  both  of  these.  The  causes  of  disease  are 
chiefly  of  a  debilitating  character,  but  they  awaken  reaction  and  the  healing 
power  of  nature.  Fever  is  such  a  reparative  effort  of  nature,  even  in  its 
cold  stage,  and  its  cause  is  diminished  energy  of  the  brain,  often  united 


—  617  — 

with  a  kind  of  insanity  (delirium)  due  to  a  contemporaneous  spasm  of  the 
extremities  of  the  vessels,  which  produces  a  reflex  acceleration  of  the  heart 
and  a  stimulation  of  the  arteries.  The  blood  pla}Ts  no  part  in  fever,  which 
is  excited  by  weakening  influences,  e.  g.  fright,  cold,  intemperance,  the 
emanations  of  marshes  or  human  beings  etc.  Besides  the  spasm  of  the 
vascular  extremities  and  the  feebleness  of  the  brain,  there  is  also  an 
accessory  atony,  which  is  propagated  by  sympath}'  to  the  tunics  of  the 
stomach  and  occasions  the  loss  of  appetite  associated  with  all  fevers. 
Both  spasm  and  atony  continue  until  the  brain  has  recovered  its  ordinary 
activity,  a  result  due  to  the  increased  activity  of  the  heart,  and  recognized 
by  the  establishment  of  perspiration.  Fevers  are  divided  into  the  follow- 
ing classes  : 

1.  T}7phus,  in  which  debilit}'  predominates  ; 

2.  Synocha,  in  which  reaction  predominates  ; 

3.  Synochus,  characterized  by  a  mixture  of  both  the  foregoing  varieties. 
Like  fevers,  Cullen  divides  all  internal  diseases  into  three  categories. 

1.  Pyrexias  (fevers,  phlegmons,  exanthems,  haemorrhages)  ;  2.  Comata 
(adynamia,  spasms,  delirium);  3.  Marcores.  A  fourth  class  is  formed  by 
surgical  diseases.  This  nosology  was  the  cause  of  Cullen's  reputation, 
especially  in  England.1 

Cullen's  explanation  of  the  gout  was  famous.  According  to  his  view, 
this  disease  depends  upon  an  atony  of  the  stomach  or  organs  of  digestion, 
against  which  is  set  up  periodically  a  reparative  effort  in  the  form  of  an 
inflammation  of  the  joints.     Gout. is  a  general  disease,    but  there  is  no 

1.  Cullen  is  said  to  have  been  the  first  professor  who  delivered  his  lectures  in  the 
English  language.  Bard  informs  us  that  he  also  established  a  system  of  catechet- 
ical instruction,  similar  to  what  at  the  present  day  we  call  a  "professor's  quiz". 
His  ''Synopsis"  appeared  at  Edinburgh  in  1769,  with  many  later  editions.  An 
American  edition  before  me  bears  the  imprint  'America?  (?),  excudebat  Abiah. 
Hodge,  1783."  Cullen's  complete  classification  of  diseases  is  perhaps  worthy  of 
quotation,  particularly  as  the  reader  would  gain  a  very  imperfect  idea  of  it  from 
the  text.     It  is  as  follows  : 

Classis  I.  Pyrext.e.  Classis  111.  Cachexia. 

Ordo  I.      Feb  res.  Ordo  I.      Marcores. 

Ordo  II.    Phlegmasia?.  Ordo  II.    Intumescentia?. 

Ordo  III.  Exanthemata.  Ordo  111.  Impetigines. 

Ordo  IV.  Hsemorrhagise. 
Ordo  V.     Profiuvia. 

Classis  II.  Neuroses.  Classis  IV.  Locales. 

Ordo  I.       Comata.  Ordo  I.      Dysesthesia?. 

Ordo  II.     Adynamia?.  Ordo  II.     Dyscinesia?. 

Ordo  III.  Spasmi.  Ordo  III.  Apocenoses. 

Ordo  IV.  Vesaniu'.  Ordo  IV.   Epischeses. 

Ordo  V.     Tumores. 
Ordo  VI.   Ectopia?. 
Ordo  VII.  Dialyses. 
Febres  are  divided   into   Iiitermittentes   (tertiana,   quartana,    quotidiana)   and 
Continuse  (synocha,  typhus,  synochus).     (H.> 


—  618  — 

gouty  material.  In  scrofula,  however,  Cullen  assumed,  in  contradiction  to 
his  nervous  pathology,  a  peculiar  acridity,  and  in  putrid  fever,  a  putridity 
of  the  humors  etc. 

His  therapeutics  were  simple,  and,  from  his  renunciation  of  the 
previous  abuse  of  venesection,  they  were  very  salutary.  "It  is  worthy  of 
notice  how  valuable  a  good  practitioner  is  in  comparison  with  a  bad  theorist, 
when  we  distinguish  the  therapeutic  prescriptions  of  Cullen  from  his 
theoretical  explanations."  He  is  fond  of  recommending  strengthening  and 
stimulating  remedies  (wine,  cinchona  etc.)  and  antispasmodics  (opium  etc.) 
against  "  spasm ",  frequently  acting  in  contradiction  to  his  theory,  which 
may  perhaps  have  been  the  secret  of  his  success  in  practice. 

The  theory  of  Cullen,  like  most  systems,  soon  acquired  numerous  followers. 
Some  of  these,  however,  departed  at  once  and  considerably  from  the  views  of  their 
master,  a  kind  of  Nemesis  with  which  all  theories  meet,  and  which  is  increased  by 
the  fact  that  pupils,  for  the  most  part,  develop  one  side  only  of  the  doctrines  of  their 
master.  The  theory  of  Cullen  spread  far  and  wide,  even  into  Spain.  Prominent 
supporters  of  it  in  England  were  David  Macbride  (1726-1778),  professor  in  Dublin  ; 
Samuel  Musgrave  (died  1782),  an  acute  physician;   the  very  eminent 

James  Gregory1  (1758-1822)  of  Edinburgh,  the  successor  of  Cullen 
and  a  professor  from  his  eighteenth  year.  He  was  of  the  greatest  import- 
ance in  the  development  of  English  medicine.  He  considered  the  muscles 
and  nerves  together  a  nervous  element,  which  was  excited  by  the  blood. 
In  spite  of  the  fact  that  he  discarded  the  acid  and  alkaline  acridities,  he 
appropriated  some  chemical  ideas,  adopting  the  theory  of  putrefaction  etc. 
John  Gardiner  (about  1784)  and  others  also  embraced  the  doctrines  of 
Cullen. 

[Probably  the  most  eminent  pupil  of  Cullen  in  America  was  Dr.  Samuel 
Bard  of  New  York  (1742-1821),  of  whom  we  shall  have  occasion  to  spealc 
hereafter.     H.] 

In  Italy  Cullen's  system  was  followed  by  Fr.  Vacca  Berliughieri  (1732-1812)  of 
Pisa  ;  in  the  Netherlands  by  C.  G.  van  den  Heuvel :  in  Switzerland  by  F.  G.  de  la  Roche 
(1743-1813)  of  Geneva;  in  Germany,  above  all,  by  the  very  famous  Albrecbt  Timer 
(1752-1828),  who,  to  avoid  living  in  constant  contradiction  with  his  conscience  in 
consequence  of  professional  fibs,  abandoned  the  practice  of  medicine,  because  it 
promised  more  than  it  could  perform,  and  often  accepted  more  pay  than  was  propor- 
tioned to  the  service  rendered,  and  became  the  "  Father  of  Husbandry."  Chr.  Fr. 
Eisner  (died  1820),  professor  in  Kbnigsberg,  also  held  the  views  of  Cullen. 

1.  The  eminent  Scotch  family  of  Gregory  deserves  a  passing  notice.  James  Gregory, 
F.  R.  S.  (163S-i()75),  was  an  eminent  mathematician,  professor  of  mathematics  in 
St.  Andrew's  and  Edinburgh,  and  the  inventor  of  the  reflecting  telescope  in  1(562. 
His  nephew  David  Gregory,  M.  D.,  F.  R.  S.  (1661-1701),  was  also  professor  of 
mathematics  in  Edinburgh  and  subsequently  Savilian  professor  of  astronomy  in 
Oxford.  His  grandson  .John  Gregory,  M.  D.  (1724-177:1',  was  professor  of  mathe- 
matics and  experimental  physics  in  the  University  of  Aberdeen.  James,  the  son 
of  the  last  mentioned,  was  the  eminent  physician  mentioned  in  the  text,  and  his 
son  William  (1803  1853)  was  the  famous  professor  of  chemistry  in  Edinburgh. 
The  "Conspectus  medicinse"  etc.  of  Prof.  James  Gregory  was  published  at 
Edinburgh  iu  1770.     (II.  i 


—  619  -- 

Jon.  Ulricii  Gottlieb  Schaffer  (1753-1826)  of  Regensburg, 
son  of  Joh.  Gottlieb  Schaffer,  a  physician  of  the  same  place,  showed  himself  a  more 
independent  Solidist  or  nervous  pathologist.  He  distinguished  in  fever  a  stadium  of 
excitement  from  a  stadium  of  depression,  regarding  the  former  as  corresponding  to 
the  stadium  of  crudity,  the  latter  to  that  of  coction.  He  also  considered  the  so-called 
crises  not  as  critical  phenomena,  but  as  results  of  the  latter,  and  combated  the  theory 
of  metastases,  especially  metastases  of  the  milk.  He  accepted  Haller's  doctrine 
of  irritation,  sensibility  etc. 

Besides  this  system  of  pathological  Solidism,  humoral  views  were  not 
wanting,  though  they  were  neither  elaborated  everywhere  into  a  system, 
nor  did  they  remain  perfectly  pure.  A  union  of  the  doctrines  of  Hippoc- 
rates, Sydenham  and  Boerhaave  was  represented  by  the 

e.  Old  Vienna  School, 

whose  connexion  with  the  political  advancement1  of  Austria  during  the 
reigns  of  Maria  Theresa  and  Joseph  II.  deserves  at  least  mention.  Its- 
founder  was  baron  Gerhard  van  Swieten  (1700-1772)  of  Leyden. 

Van  Swieten  was  descended  from  a  noble  (Jansenist)  Catholic  family  of  the 
Netherlands,  which  at  that  time  were  united  with  Austria  by  a  personal  union,  if  such 
an  expression  is  permissible.  At  the  age  of  sixteen  he  attended  the  university  of 
Louvain  with  the  idea  of  educating  himself  for  the  public  service,  but  returned  thence 
to  Leyden  and  began  to  study  medicine  under  Boerhaave,  whose  favorite  pupil  he 
became.  As  the  result  of  overwork  he  for  a  long  period  was  subject  to  melancholy, 
and  was  unable  to  graduate  until  1725.  Although  he  had  received  a  call  to  London 
with  an  annual  salary  of  £1000,  he  remained  at  Leyden  as  a  physician  and  private 
teacher  (for  as  a  Catholic  he  could  hold  no  public  professorship),  chiefly  on  account 
of  Boerhaave,  until  the  death  of  the  latter  in  his  native  city.  When  the  archduchess 
Maria  Anna  of  Austria  had  suffered  an  abortion  he  was  called  to  her  assistance,  and 
gave  such  satisfaction  by  his  skill  that  he  was  recommended  by  her  to  the  empress 
Maria  Theresa,  her  sister,  who  up  to  this  time  had  remained  childless.  To  the  husband 
of  the  latter  he  gave  advice  (related  by  Hyrtl),  which  resulted  in  sixteen  successive 
pregnancies,  and  as  the  result  of  his  success  came  to  Vienna  in  1745  as  ordinary 
physician  and  president  of  the  General  Medical  Department  of  Austria.  He  was  also 
appointed  censor,  a  position  in  which  he  incurred  much  enmity,  including  that  of 
Voltaire  and  especially  that  of  the  Jesuits,  whom  he  robbed  of  their  influence. 
Besides  all  this  he  was  made  a  baron,  and  became,  next  to  Kaunitz,  the  most  influen- 
tial counsellor  of  the  empress. 

His  chief  care  —  without  holding  the  position  of  a  professor  he  taught  for  nine 
whole  years,  and  brought  about  the  introduction  of  clinical  instruction  —  from  the 
outset  was  dedicated  to  the  elevation  of  medical  affairs  in  Austria,  and  especially  to 

1.  The  most  brilliant  fruit  of  this  was  undoubtedly  the  Vienna  school  of  music  of  this 
period,  with  Haydn  and  Mozart  at  its  head  !  Literature,  on  the  other  tiand,  pre- 
sented a  rather  bare  appearance.  In  return  —  and  it  is  a  charaetei  istic  of  German 
development  to  manifest  its  florescence  in  different  localities  — literature  in  North 
Germany  attained  at  this  period  its  highest  development  in  Lessing,  Goethe, 
Schiller  (Bach  remained,  indeed,  without  immediate  influence).  The  condition 
has  been  reversed  in  our  century  from  1830  downward  :  music  has  displayed  a  new 
bloom  in  North  Germany  (Weber,  Mendelssohn,  Spohr,  Wagner  etc.),  literature 
in  Austria  (Grillparzer,  Lenau,  Anastasius,  Griin  etc.).  Bach  was,  as  it  weie'' 
newly  discovered  by  Mendelssohn. 


—  620  — 

the  improvement  of  the  medical  faculty.  He  had  just  attained  his  object  when  he 
died  of  senile  gangrene,  with  the  reputation  of  a  great  physician  and  a  benefactor  of 
Austria,  especially  of  the  poor.  His  chief  work  was  entitled  "  Commentaria  in 
Hermanni  Boerhaave  Aphorismos"  etc.,  upon  which  he  labored  for  thirty  years. 
Van  Svvieten  was  of  great  service  also  in  improving  the  treatment  of  syphilis,  in  which 
he  (after  the  example  of  Theophrastus  von  Hohenheim  and  others)  recommended  the 
internal  use  of  the  sublimate.  This  recommendation,  however,  depended  more  upon 
Maximilian  Locher,  physician  to  the  St.  Marcus  Hospital,  than  upon  van  Swieten's 
own  personal  experience  (Proksch). 

Concerning  the  priority  in  the  use  of  this  sublimate  treatment  (it  was  customary 
among  the  common  people  of  Siberia  even  in  the  17th  century)  a  dispute  arose 
between  van  Swieten  and  the  Portuguese  Anton  Nunnez  Ribeiro  Sanchez  (1699—1788), 
whose  life  was  one  continual  adventure.  In  his  youth  he  ran  away  from  his  uncle, 
who,  with  the  object  of  giving  him  the  hand  of  his  daughter,  wished  to  keep  him  away 
from  medicine.  Subsequently  he  studied  in  Coimbra  and  Salamanca  at  the  expense 
of  a  physician.  Practising  for  a  time  in  his  home  until  he  could  endure  it  no  longer, 
he  went  to  Genoa,  London,  Paris  and  Montpellier  to  continue  his  studies,  and  finally 
came  to  Leyden.  From  this  place  he  was,  at  the  instance  of  Boerhaave,  called  to 
Russia.  Here  he  was  at  once  appointed  a  military  physician,  aud  sustained  himself 
in  the  position  of  physician-in-ordinary  (for  syphilis?)  under  the  dangerous  rule  of 
various  amorous  empresses,  until  he  too  finally  experienced  a  fall.  He  went  next  to 
Paris,  where  he  continued  to  live  in  retirement  until  his  death. 

More  eminent  as  a  physician,  than  for  his  personal  character  was 
Anton  de  Haen  (1704-1770),  of  the  Hague.  He  also  was  a  pupil  of 
Boerhaave,  who  was  the  only  plvysician  whom  de  Haen  did  not  abuse,  while 
despising  almost  everyone  else.  At  the  suggestion  of  van  Swieten  he 
was  called  in  1754  to  Vienna  as  president  of  the  clinic  in  the  cit}'  hospital, 
which  contained  six  beds  for  men  and  six  for  women!  De  Haen  was  the 
proper  founder  of  the  so-called  old  Vienna  School,  whose  chief  merit  —  in 
striking  contrast  to  the  so-called  New  School  —  is  to  be  sought  in  its 
practical  and  diagnostic  services,  as  well  as  in  its  generally  sober  obser- 
vation. All  these  existed,  it  is  true,  in  the  mother-school  of  Boerhaave 
(if  we  can  speak  of  such  a  school),  and  were  derived,  like  its  founder, 
from  that  school.  Still  the  daughter  at  Vienna  was  more  sober  and  kept 
herself  more  exempt  from  systematic  tendencies  than  did  the  mother  in 
Leyden. 

Thus  the  simplest  possible  treatment,  united  with  careful  observation, 
was  the  fundamental  principle  with  de  Haen.  Like  Hippocrates,  he  laid 
great  weight  upon  Semeiology,  and  also  followed  this  model  e.  g.  in  the 
frequent  prescription  of  barley-water  and  oat-meal  gruel  ("ptisan")  in 
fevers,  as  well  as  in  the  administration  of  acidulated  drinks  and  drinks 
prepared  with  hone}',  in  absolute  diet,  cool  surroundings,  good  air  etc. 
Nature  was  not  to  be  disturbed  by  medicines  of  a  powerful  action.  Hence 
de  Haen  would  administer  emetics  and  cathartics  only  rarely  and  "  at  the 
right  time  ",  an  improvement  so  much  the  greater  as  at  that  period  it  was 
customary  to  begin  the  treatment  of  all  febrile  deseases  with  the  exhibi- 
tion of  an  emetic,  followed  by  a  cathartic  every  second  day.  In  a  practical 
point  of  view  he  divided  diseases  into  benignant  and  malignant,  enumer- 


—  (521    - 

ated  the  varieties  of  both  classes,  determined  the  individual  character  of 
each,  adopted  the  doctrine  of  critical  da}-s,  but  conceded  that  "with  the 
exception  of  ephemeral  fever,  every  disease  might  be  malignant,  and 
except  the  plague,  every  one  might  be  benign."  He  warmly  embraced 
hygienic  and  prophylactic  views,  and  accounted  medicine  quite  as  useful 
to  the  state  as  to  individual  patients.  Like  Pettenkofer  too,  de  Haen  cal- 
culated the  gain  or  loss  to  the  social  economy  of  each  state  accruing  from 
the  health  or  sickness  of  its  citizens.  He  likewise  reintroduced  the 
thermometer,  and  demonstrated  that  in  the  cold  stage  of  fever  an  elevation 
of  temperature,  often  very  considerable,  occurred.  His  spirit  of  contradiction, 
which  impaired  the  influence  of  such  doctrines  and  his  personal  reputation, 
was  the  secret  of  de  Haen's  opposition  to  inoculation  and  to  Haller's 
doctrine  of  irritability.  His  defence  of  the  existence  of  witchcraft,  on 
which  he  wrote  a  special  treatise,  sprung  from  his  own  superstition  and 
that  of  his  age.  His  chief  work  was  entitled  "Ratio  medendi  in  nosocomio 
practico  "  etc.,  15  volumes  (Vienna.  1758-1769). 

As  de  Haen  quarrelled  like  a  savant  with  everjone,  of  course  he  could 
not  fail  to  do  so  with 

Anton  Stoerck  (1740-1803),  the  successor  of  van  Swieten  in  the 
direction  of  the  Austrian  Medical  Department. 

Stoerck,  a  native  of  Sulzbaeh  in  Swabia  (the  son  of  a  blacksmith,  whose  brothers 
Melchior  and  Matthams  were  also  physicians  in  Vienna),  was  never  a  teacher  but 
simply  an  official  and  a  bureaucratist,  and  as  such  bound  medical  instruction  in  the 
fetters  of  the  strictest  educational  red  tape. —  In  practical  medicine  he  made  himself 
specially  serviceable  b}r  his  careful  investigations  and  experiments  in  pharmacology 
and  toxicology  (like  William  Alexander,  a  contemporary  in  Edinburgh,  who  also 
instituted  the  proving  of  drugs  upon  healthy  persons).  Stoerck  was  a  follower  of 
the  views  of  De  Haen. 

Maximilian  Stoll  (1742-1787),  also  a  Suabian  and  a  famous  clinical 
teacher,  departed  widely  from  these  views,  so  that  he  might  be  called  the 
"  Systematist "  of  the  old  Vienna  School.  He  was  especially  an  epidemi- 
ologist. 

Stoll,  the  son  of  a  poor  village  barber  of  Erzingen  in  Suabia,  was  to  have  been 
educated  (as  was  the  usual  custom  of  the  guilds  in  the  18th  century)  from  his  9th 
year  in  the  same  calling.  But  he  took  an  insuperable  repugnance  to  this  arrange- 
ment, and  so,  after  a  preparatory  course  of  four  years  in  the  Latin  school  of  his  native 
town,  gained  admittance  into  the  school  of  the  Jesuits  at  Rottweil,  where  he  was  per- 
suaded to  enter  the  Jesuit  order  (1761).  He  was  at  once  sent  as  a  teacher  to  Ingol- 
stadt  and  subsequently  to  Hall  in  the  Tyrol,  but  in  consequence  of  his  liberal  views 
was  transferred  thence  to  Eichstadt.  In  17G7  he  abandoned  the  order,  and  went  first 
to  Strassburg  and  then  to  Vienna  to  study  medicine.  Here  he  became  a  pupil  of 
de  Haen  and  graduated  in  1772,  whereupon  he  went  to  Hungary  as  a  practising 
physician  and  remained  there  until  in  1776  he  was  appointed  the  successor  of  his  old 
teacher.  In  Hungary  he  had  discovered  that  the  treatment  of  "gastric  fever"  by 
venesection  was  inferior  to  that  by  emetics,  and  upon  this  he  founded  his  gastric 
theory:  In  his  new  position  he  lectured  with  great  popularity,  until  in  1784,  upon  the 
completion   of  the   "Allgeineines   Krankenhaus",   he   fell    into    the   background    and: 


—  (J22  — 

received  ten  beds  ill  two  rooms  in  a  little  outhouse  in  the  court  yard.1  He  was  still 
subjected  to  the  intrigues  of  his  enemies,  and  his  wife  too  embittered  his  life:  in  fact 
the  vixen  had  him  buried  in  the  dress  of  a  Jesuit  in  order  to  injure  bis  reputation  even 
after  death.  His  chief  works  were  entitled:  "Ratio  medendi  etc"  (1779-00), 
"Aphorismi  de  cognoscendis  et  curandis  febribus",  "  Praelectiones  in  diversos  morbos 
chronicos"  (1788  i. 

Stoll  too  did  not  form  a  complete  system,  for  be  laid  too  great  weight 
upon  careful  observation.  Hence,  like  Sydenham  whom  he  highly 
esteemed,  he  made  the  epidemic  constitution  a  matter  of  very  great 
importance.  The  results  of  his  therapeutics,  however,  led  him  to  the 
view  that  faulty  humors,  especially  in  the  prima?  vise,  so-called  "gastric". 
and  above  all  "  bilious  impurities",  were  the  chief  causes  of  disease.  He 
divided  fevers  into  stationary,  annual  and  semiannual,  bilious,  inflamma- 
tory, intermittent,  epidemic,  milk  fever,  mucous  fever,  hectic  etc.  Chronic 
diseases  were  also  the  subject  of  his  careful  observation.  For  the  removal 
of  the  supposed  "  gastric  impurities  "  —  with  which  the  later  gastroenterite 
of  Broussais  is  in  remarkable  accord  —  Stoll  made  extensive  use  of  emetics 
as  well  as  laxatives,  in  order  that  these  impurities  might  not  pass  into  the 
blood  ("  antigastric  method  ").  Moreover  he  called  in  the  aid  of  so-called 
"  concealed  inflammations  ".  because  (probably  partly  us  the  result  of  his 
therapeutics)  he  often  found  such  in  the  bodies  of  his  patients,  without 
their  having  been  demonstrable  during  life.  In  the  detection  of  these 
inflammations  he  laid  great  weight  upon  pathological  anatomy,  which  de 
Haen  had  already  recognized.  —  How  little  of  the  Dogmatist  there  was  in 
his  composition  may  be  inferred  from  the  fact  that  when,  in  consequence  of 
a  change  in  the  ':  constitution  of  disease  ",  his  original  therapeutics  became 
no  longer  useful,  towards  the  close  of  his  life  he  abandoned  them  entirely. 

Still  his  therapeutic  S3rstem  flourished  for  a  long  time  in  ordinary  practice,  which 
the  farther  it  limps  behind  the  position  of  actual  knowledge,  the  more  readily  it  ever 
adapts  itself  to  each  short-lived  fashion.  The  Skoda  of  the  Old  Vienna  School  was 
Auenbrugger,  whom  we  shall  consider  in  another  connexion,  for,  with  the  exception 
of  Stoll,  this  school  entirely  ignored  him. 

Well  known  physicians  of  the  "Old  Vienna  School"  were:  Stoll's  successor 
Jacob  Reinlein,  who  came  from  the  school  of  surgery  to  the  university ;  Job.  Georg 
Hasenohrl  (Lagusi,  1729-1796)  of  Vienna;  Adam  Chenot  (1721-1789)  of  Luxemburg: 
Melchior  Storck  (died  1754);  Cranz  (materia  medica,  medical  botany,  mineral  waters); 
Marcus  Anton  von  Plenciz  (1705-1786),  of  Salcan  near  Gorz,  and  his  son  Joseph 
Plenciz  (1752-1785),  professor  in  Prague;2  Jos.  Sautter;  Pasc.  Jos.  Ferro  (1753-1809) 
of  Bonn,  in  Vienna;  Wenzel  Trnka  von  Krzowitz  (1739-1791),  professor  in  Ofen  ; 
Stephan  Weszpremi  and  others. 


Stoll  proposed  a  number  of  small  hospitals,  Qitarin  one  large  one  only.  Quarin 
was  victorious,  and  received  the  position  of  director  in  advance  of  the  completion 
of  the  "  Krankenhaus". 

The  elder  Plenciz  was  a  supporter  of  a  eontagium  animatum,  hut  assumed  for  each 
individual  disease  a  special  "seminium  verminosum" ,  with  varieties  which  pro- 
duced the  individual  forms  of  the  same  diseases.  Only  in  this  way  could  the 
diffusion  of  contagious  diseases  through  the  air.  their  stadia  etc.  be  ex- 
plained (Loeffler). 


If  the  system  of  Stoll  occupied  itself  especially  with  the  bile  and  mucus  of  the 
old  Dogmatists,  in  the  equally  humoral 

f.  Theory  of  Christoph  Ludwig  Hoffmann 

( 1721—1807 ),  of  Rhoda  in  Westphalia,  first  ordinary  physician  at  Cologne,  then  in 
Mayence,  the  irritability  and  sensibility  of  Glisson  and  Haller  were  intimately 
mingled  with  the  "putridity"  of  the  Pneumatists  and  the  "acridities"  of  Sylvius  and 
Boerhaave,  though  the  two  latter  were  the  predominant  principles.  As  the  method 
of  Stoll  was  called  the  antigastric,  so  we  may  speak  of  Hoffmann's  as  the  "  antiseptic  ". 
He  assumes  in  conditions  of  health  ten  different  srrades  of  irritation,  besides  combin- 
ations of  these  and  reflexes  to  the  internal  organs,  e.  g.  the  intestines,  bladder  etc. 
In  diseases,  and  especially  in  fevers,  septic  or  acid  products  of  decomposition  in  the 
blood  (and  the  septic  particularly)  act  as  irritants  to  the  solid  parts.  In  man  every- 
thing is  "septic",  the  urine  of  healthy  persons,  the  sweat,  the  air  of  respiration,  the 
faeces  etc.  These  are  excreted  in  order  that  a  man  may  remain  in  health.  In  disease 
also  this  acid  putrescence  is  removed,  a  conclusion  which  we  may  draw  from  the  sour 
odor  of  the  mouth  in  invalids.  In  scorbutus  the  putridity  has  its  seat  in  the  bones; 
in  the  hypochondriac,  in  the  intestinal  canal  etc.  The  treatment  and  the  remedies 
should  both  be  antiseptic  etc.  Hoffmann  was  very  famous  in  his  day,  so  that  even 
Goethe's  friend  Karl  August  von  Weimar  submitted  to  his  "  antisepfic  "  treatment 
(for  syphilis  or  gonorrhoea!),  and  praised  him  very  highly. 

Immense  use  of  the  humoral  views  was  made  in  the  clyster-theory,  which  deserves 
notice  merely  in  an  historical  point  of  view  as  one  which  would  have  become  the 
mediaeval  or  old  Indian  midwives,  but  which  illustrates  equally  well  the  thoughtless- 
ness of  the  public  and  the  ready  credulity  of  physicians.  I  refer  to  the  theory 
known  as 

g.  The  Doctrine  of  Infarctus. 

This  had  its  origin  with  the  Hesse-Homburg  pbysician-in  ordinary, 
Johann  Kampf  (died  1753J,  or  ins  son  of  the  same  name  (lived  1726-1787), 
who  published  the  "  doctrine  "  of  his  father  about  1780. 

By  "  infarctus"  Kampf  understood  substantially  impacted  fasces,  which  he  thought 
originated  in  thickening  of  the  humors  in  the  portal  vessels  and  intestine,  "when  the 
former  become  filled,  stuffed  and  distended,  universally  or  in  places,  by  the  blood 
delayed  in  its  circulation  and  finally  stagnant,  coagulated,  badly  mixed,  variously 
corrupted,  robbed  of  its  fluidity,  thick,  viscous,  polypous  and  solidified,  or  when  the 
thickened  serum  of  the  same,  in  the  glands,  the  cellular  tissue  and  the  digestive 
passages,  accumulates,  putrefies,  dries  and  takes  on  many  kinds  of  decomposition." 
There  are  two  kinds  of  "infarctus",  the  black-bilious  and  the  mucous.  These  are 
of  varying  consistency,  from  soft  as  mucus  to  firm  as  flesh,  or  indeed  as  hard  as  stone, 
and  they  are  so  dangerous  that  they  must  be  expelled,  even  if  this  should  require  for 
years  three  daily  efforts  infra  et  u  /ergo  in  the  form  of  the  appropriate^  named 
"visceral-clysters".  From  this  theory  a  wide-spread  clyster-fashion  developed. 
Lords  and  ladies  vied  with  each  other  in  belaboring  their  infarctus  and  in  practising 
visceral  ctysterization.  We  cannot  deny  to  the  author  of  this  doctrine  at  least  an 
extensive  knowledge  of  human  nature.  He  supplied  a  universal  remedial  procedure, 
and  gratified  the  apothecaries1  by  the  bulkiness  of  the  herbs  required  for  its  practice. 

1.  In  "  Lemalade  imaginaire  "  Argan  finds  in  his  apothecary's  bill  the  following  item: 
"  Un  petit  clysteie  insiiiuatif,  preparatif  et  remollient,  pouvamollir  et  rafraiclui- 
les  entrailles  de  monsieur"  —  a  refinement  of  clysterization  quite  equal  to  the 
theory  of  Kampf.      Phillippe    furnishes   us  with    much    amusing   information 


—  624  — 

The  preparation  and  administration  of  clysters  afforded  technical  "  work "  for  the 
hands  of  the  laity,  furnished  them  occupation  and  diversion,  concentrated  attention 
also  upon  the  one  partie  honteuse ;  mucus  etc.  from  a  rectal  catarrh,  the  result  of 
protracted  clysterization,  or  a  "  hardened "  ball  of  faeces  could  result  only  in  the 
triumph  of  the  theory,  unless  the  patient  bade  adieu  to  all  things  temporal  under  the 
influence  of  his  favorite  clysters  ! 

Besides  the  son  of  Kampf  already  mentioned,  Dan.  Emil  Koch,  Jos.  Georg 
Schmid,  Theodor  Brotbeck,  W.  L.  Kampf  and  others  wrote  on  the  subject  of  infarctus. 
Tissot  and  Zimmermann  also  —  the  latter,  indeed,  induced  only  by  his  own  suffering 

—  found  the  method  good  at  the  least. 

h.  The  School  of  Montpellier, 

the  representative  of  so-called  "  Vitalism  ",  struck  out  an  entirely  different 
path  from  that  of  the  Vienna  school.  This  system  was  inaugurated  by 
Theophile  de  Borden  (1722-1776),  although  he  did  not  yet  employ  the 
term  Vitalism. 

Bordeu  was  born  at  Iseste  in  Beam  and  studied  in  Montpellier,  where  he  gradu- 
ated in  17J4.  Afterwards  he  taught  anatomy  in  Pau,  but  speedily  removed  to  Paris. 
In  1749  he  was  appointed  director  of  the  Pyrenean  baths,  but  he  returned  to  Paris 
in  1752,  where  he  began  a  quarrel  with  the  famous  Faculty  of  Paris,  by  which  the 
honorable  men  Bouvart  and  Thierry  finally  succeeded  in  having  him  turned  out  of 
that  body,  on  the  charge  of  having  robbed  a  patient.  Thus  the  Faculty  preserved 
its  traditions,  and  Parliament  was  again  compelled  (1764)  to  indemnify  Bordeu  for 
its  sentence.  He  died  in  the  enjoyment  of  a  great  reputation,  but  without  having 
become  reconciled  with  his  'colleagues".  Bordeu  belonged  to  the  most  zealous 
defenders  of  inoculation.  His  chief  works  were  entitled  "Recherches  anatomiques 
sur  les  differentes  positions  des  glandes  et  sur  leur  action  "  (Paris  1752) ;  "  Chylifica- 
tionis  historia";  "Recherches  sur  le  pouls  par  rapport  aux  crises";  "Dissertation 
sur  les  ecrouelles"  etc. 

Bordeu  maintained  the  existence  of  a  general  life  of  the  body,  which 
resulted  from  the  harmonious  working  of  the  individual  lives  and  indi- 
vidual powers  of  all  its  orgaus.  The  organs  of  the  bod}'  are  associated 
with  each  other,  but  each  has  its  definite  functions  as  well  as  position, 
and  is,  as  it  were,  a  creature  within  a  creature,  a  sort  of  archseus.  The 
most  important  organs,  however,  are  the  stomach,  the  heart  and  the  brain 

—  the  "Tripod  of  Life".  These  regulate  the  life  of  the  other  orgaus. 
From  them  proceed  sensibility  and  motion,  the  two  chief  phenomena  of 
life,  by  which  the  animal  organism  is  widely  separated  from  inanimate 
objects,  and  to  them  also  return  these  qualities  after  the  completion  of 
their  circulation  throughout  the  body. 

The  nerves  are  the  chief  organs,  which,  in  union  with  the  brain  as  their  center 
and  supplied  by  it  in  the  best  manner  possible  with  vital  force,  distribute  and  regulate 
motion  and  sensation  throughout  the  body,  but  do  not  work  in  conformity  with 
chemical  and  physical  laws.  The  stomach  presides  over  nutrition,  the  heart 
propels  the   blood  and  chyle  throughout  the  body.      Health  is  the  undisturbed  cir- 

relative  to  syringes  and  clysterization,  among  the  rest  the  following  witty  epitaph 
upon  an  apothecary : 

"Ci-git  qui  pour  un  quart  d'  ecu 
S'  agenouillait  devant  un  cu."  (H.) 


—  625  — 

culation  ot  motion  and  sensation  from  and  to  the  three  centres  of  the  bod}'.  There 
is,  however,  no  such  thing  as  absolutely  perfect  health,  for  it  fluctuates  from  moment 
to  moment.  There  is  only  as  near  an  approximation  as  possible  to  a  uniform  cir- 
culation of  the  kind  mentioned.  The  greater  or  less  perfection  of  this  circulation 
occasions  in  individuals  the  differences  of  temperament.  Secretions  and  excretions, 
sleep  and  waking,  muscular  activity,  the  employment  of  the  external  and  internal 
senses,  all  are  subordinated  to  these  three  chief  organs,  and  are  sustained  and  main- 
tained by  these.  —  The  glands  are  of  special  importance  in  the  economy  of  the  body. 
Their  secretion  always  originates  from  a  nervous  excitation  ;  indeed  the  nerves  close 
and  open,  as  it  were,  the  pores  of  the  glands. 

In  pathology  Bordeu  laid  great  weight  upon  the  crises.  Every 
disease,  having  passed  through  the  stadium  of  irritation  and  coction,  is 
decided  by  such  a  crisis.  Corresponding^,  therefore,  diseases  may  be 
compared  with  glandular  activity.  Crises  too,  for  the  most  part,  proceed 
from  the  glands.  From  the  importance  which  Bordeu  ascribed  to  the 
latter  organs  he  was  led  to  lay  down  the  existence  of  salivary,  milk, 
bilious,  urinary,  spermatic,  lachrymal,  perspiratory  etc.  cachexia?. 
Bordeu's  theory  of  the  pulse  is  worth)-  of  remark. 

It  was  influenced  by  that  of  the  Spaniard  Franc.  Solano  de  Luquez  (1685-1738), 
born  at  Montilla  near  Cordova,  died  a  practising  physician  in  Antequera.  The 
latter  had  discovered  the  "dicrotic"  pulse,  which  he  considered  prognostic  of  nasal 
haemorrhage.     His  doctrine  was  made  known  by  James  Nihell,1  a  physician  of  Cadiz. 

Bordeu  laid  down  a  critical  and  non-critical,  a  simple-critical  and 
compound-critical  pulse.  Next  he  distinguished  a  superior  and  an  inferior 
pulse,  separated  by  the  diaphragm.  The  superior  again  is  divided  into 
nasal,  tracheal  and  thoracic ;  the  inferior  into  gastric,  renal,  uterine, 
seminal  etc.  The  uterine  pulse  indicates  the  approach  of  menstruation  ; 
the  renal,  speedy  urination  etc. 

Of  course  even  such  doctrines  found  their  followers,  as  well  as  hearty  opponents, 
and  the  latter  were  the  special  occasion  of  Bordeu's  expulsion  from  the  Facultj-. 

Bordeu's  therapeutics  aimed  at  the  promotion  of  the  crises,  which,  in 
chronic  diseases,  where  they  do  not  so  readily  appear  of  themselves  as  in 
acute,  he  favored  by  the  use  of  stimulants,  among  which  the  mineral 
waters  of  the  Pyrenean  springs  were  particularly  useful. 

Bordeu's  most  intimate  friend,  the  Gascon  Louis  de  la  Caze  (1703—1765),  found 
in  the  diaphragm  and  the  membrances  of  the  brain,  and  generally  in  the  cellular 
structures  to  which  Bordeu  ascribed  "  tonus',  the  chief  seat  of  vital  activity,  and  he 
held  that  from  Adam  down  the  semen  contained  the  archetype  of  mankind,  just  as 
Bouchut  has  done  in  more  recent  times,  though  the  latter  gives  another  name  to  the 
matter.  Henri  Fouquet  ( 1727-1806)  elaborated  especially  Bordeu's  doctrine  of  the 
pulse  and  even  assumed  a  "  skin-puke ",  which  indicated  sweating,  The  same 
doctrine  was  professed  by  Ign.  Jos.  Wetsch  (1737-1779),  a  professor  in  Moscow,  and 
even  by  C.  G.  Gruner. 

The   god-father,    as    well   as    the   most   important   representative   of 

1.  James  Nihell  was  an  Irishman,  practising  in  Cadiz,  who  had  familiarized  himself 
with  the  views  of  Solano,  and  published  them  (London,  1711)  in  a  treatise  dedi- 
cated to  Richard  Mead.     (H.) 
40 


—  (!2G   — 

"  Vitalism  ",  was  Paul  Jos.  Bartbez  (1734-1806)  of  Montpellier,  a  man  of 
as  ingenious  gifts  as  he  was  eager  for  knowledge  and  desirous  of  truth. 

In  the  preparatory  schools  Barthez  at  the  age  of  ten  years  had  proven  himself 
more  than  a  match  for  his  teachers,  so  that  he  was  compelled  to  leave  them.  He 
first  studied  theology,  but  in  his  sixteenth  3-ear  exchanged  this  for  medicine,  which 
he  studied  first  in  his  native  city  and  then  in  Paris.  At  the  close  of  his  course  he 
went  on  a  military  campaign,  was  then  made  editor  of  the  "Journal  des  Savants", 
and  at  the  age  of  twenty-seven  became  a  professor  at  Montpellier,  whose  medical 
faculty  acquired  great  reputation  from  his  presence.  Dissatisfied  with  medicine. 
Barthez  next  devoted  his  attention  to  the  law,  and  in  1780  had  attained  the  position 
of  counsellor  of  justice,  when  he  abandoned  this  career  also  and  turned  his  energies 
next  to  the  study  of  philosophy.  In  1785,  however,  he  accepted  the  position  of 
chancellor  at  Montpellier,  an  office  which  ministered  to  his  vanity  and  inordinate 
ambition.  During  the  Revolution  he  associated  himself  with  the  aristocratic  party, 
and  when  the  Faculties  gave  place  to  the  Schools  he  was  not  reappointed,  so  that  he 
practised  until  1796  in  Xarbonne  and  Toulouse.  Subsequently  he  returned  to 
Montpellier  and  was  appointed  consulting  physician  by  Napoleon  in  1802.  In  1805 
he  went  to  Paris,  where  he  died  the  year  after  his  arrival.  Barthez  was  the  de  Ha'e'n 
of  the  school  of  Montpellier.  His  chief  works  were  entitled:  '  Oratio  de  principio 
vitali  hominis"  (1773);  "  Nouveaux  elemens  de  la  science  de  1'  homme":  "  Nouvelle 
mecanique  des  mouvemens  de  1'  homme  et  des  animaux  ":  Traite  des  maladies 
goutteuses".      He  was  a  voluminous  writer. 

Barthez  names  "vital  principle"  simply  ■•  the  cause  of  the  phenomena 
of  life  in  the  human  body ".  Its  nature  is  unknown,  but  it  is  endowed 
with  motion  and  sensibilit}-  and  is  different  from  the  thinking  mind.  He 
considers  it  something  abstract,  but  3'et  allows  to  it  also  the  properties 
of  something  real,  and  endeavors  to  demonstrate  its  existence  (as  Bouchut 
did  that  of  his  "  vitalis  agens  " )  by  the  a  posteriori  method.  Plants  like- 
wise possess  it.  This  "  vital  force  "  is  found  .everywhere  and  in  all  parts 
of  the  body,  but  cannot  work  separately  for  any  considerable  period  in 
any  one  of  those  parts,  being  transferred  speedily  by  S}-mpath3'  to  all  the 
others.  From  it  originate  "the  muscular  and  tonic  forces,  the  general  and 
special  sensitive  forces,  animal  heat  and  the  sympathies.' 

Disease  is  the  result  of  an  affection  of  the  vital  force.  Every  disease, 
however,  is  divisible  into  certain  ••  disease  elements  ",  viewed  as  parts  of  a 
whole,  which  we  call  disease.  These  elements  again  are  divisible  into 
"  secondaiy  elements  ".  Thus  inflammation  e.  g.  may  have  even  an  element 
of  a  complicated  fever,  another  element  of  pain,  another  of  irritation  etc. 
These  primary  elements,  considered  in  themselves  and  not  as  parts  of  the 
whole,  i.  e.  "the  disease'",  are  called  "status  or  etat  ".  and  thus  we  speak 
e.  g.  of  the  bilious,  inflammatory,  dynamic  etc.  status.  Descending  to 
details.  Barthez  explains  nervous  diseases  by  an  enfeeblement  "  of  the 
whole  system  of  powers  of  the  vital  principle  ".  On  the  other  hand,  the 
•  putrid  fevers  "  are  "  specific  vital  fermentations  tending  to  corruption" — 
an  explanation  in  which  humoral  views  manifest  themselves.  The  inter- 
mittent fevers,  on  the  other  hand,  are  ascribed  to  the  lack  of  a  special 
force  called  the  "stability  of  energy",  and  finally  the  dangerous  or  malig- 


—   627  — 

naut  diseases  exhibit  a  diminution  or  absolute  loss  of  this  force.  —  Barthez 
laid  great  weight  upon  the  indications  ;  indeed,  in  his  view,  medicine  itself 
is  merely  the  science  of  indications.  Thus  he  became  necessarily  the 
creator  of  the  :'  natural,  analytic,  and  empiric  method  of  treatment".  The 
first  of  these  consists  in  following  the  hints  of  nature,  e.  g.  giving  an 
emetic  in  cases  of  nausea  ;  the  second  in  seeking  out  the  "  elements  of  the 
disease"  and  treating  each  of  them  separately;  the  third  removes  diseases 
by  means  of  remedies  learned  from  experience,  including  here  the  specifics. 
The  last  method  is  to  be  employed  when  the  reparative  efforts  of  nature 
cannot  effect  the  cure,  and  when  the  analysis  into  the  "  elements  "  does  not 
succeed. 

Jean  Charles  Marguerite  Guillaume  deGrimaud  (1750-1789)  of  Nantes,  professor 
at  Montpellier  and  teacher  of  Charles  Louis  Dumas  (17G5-1S13)  of  Lyons,  also  a 
professor  at  Montpellier,  was  a  pupil  of  Haller  and  Barthez  He  assumed  three 
fundamental  forces:  the  vital,  the  assimilating  and  the  opposing.  He  divides 
diseases  into  those  which  originate  from  modifications  of  these  three  forces,  from 
chemical,  physical  or  vital  changes  in  the  fluids  and  solids,  and  those  which  arise 
from  constitutional  predisposition.  The  surgeon  Anthelme  Balthasar  Richerand  and 
Franc.  Chaussier  (1746-1828),  professor  of  physiology  and  a  popular  practitioner  in 
Paris,  were  "  vitalists  ",  though  the  latter  became  subsequently  a  partisan  of  Broussais. 
Finally  Cabanis  was  also  a  vitalist  in  Barthez' s  sense  of  the  term. 

In  Germany  the  chief  representative  of  the  so-called  vitalistic  theory, 
which  comes  frequently  into  collision  with  the  materialism  (force  and 
matter)  of  the  present  da}',  was  the 

i.  Doctrine  of  Vital  Force. 

which  the  ingenious  and  versatile  Joh.  Christian  Reil  (1759-1813)  elabor- 
ated into  a  system,  though  he  was  not  the  first  to  advance  it. 

Reil  was  born  at  Rhaude  in  East  Friesland,  where,  after  finishing  his  studies  in 
Halle  and  Gbttingen,  he  practised  for  several  years.  He  then- — it  is  said  in  con- 
sequence of  disappointment  in  love  —  went  to  Halle,  and  there  qualified  himself  for 
the  office  of  a  privatdocent.  Here  in  1787  he  became  professor  of  medicine,  and 
continued  to  hold  this  chair  until  called  in  1810  to  the  same  position  in  Berlin.  In 
1813  he  undertook  the  management  of  the  military  hospitals  at  Halle  and  Leipzig,  but 
soon  succumbed  to  typhus  fever.  His  chief  works  were:  "Exercitationum  anatomica- 
rum  fasciculus  I.  de  structura  nervorum  "  ;  "Uber  die  Lebenskraft "  ;  "  Eutwurf  einer 
allgemeinen  Pathologie" ;  ''  Leber  die  Eigenschaften  des  Gangliensystems  und  sein 
Verhaltniss  zum  Centralsystem "  ;  "Ueber  das  polarische  Auseinanderweichen  der 
urspriinglichen  Naturkrafte  in  der  Gebarmutter  zur  Zeit  der  Schwangerschaft  und 
deren  Umtauschung  zur  Zeit  der  Geburt  ";  "Archiv  fiir  Physiologie "  etc.  Reil's 
son  was  a  physician  in  Cologne,  though  he  did  not  practice  but  devoted  his  whole  life 
to  experiments,  after  the  manner  of  Santoro. 

According  to  Reil's  doctrine,  the  "vital  force'"  is  connected  with  form, 
composition  and  original  diversity  of  matter,  and  is  inseparable  from  the 
latter.  By  reason  of  this  dependence  upon  form  and  composition,  and 
during  the  activity  of  the  organs,  it  is  subject  to  constant  changes  accord- 
ing to  age,  season,  the  time  of  da}',  habits  etc.  Each  organ  has  its  own 
special   force,   but  it   is   united   by  sympathy  with  the  rest  of  the  bod}' 


—  628  — 

Besides  the  force  inherent  in.  and  flowing  out  of,  matter,  there  exists 
nothing  but  ideas.     The  final  cause  of  both,  however,  is  inscrutable. 

'The  foundation  of  all  the  phenomena  of  the  animal  body  which  are  not  ideas, 
or  which  are  hot  associated  with  ideas  as  cause  or  effect,  lies  in  animal  matter,  in  the 
original  diversity  of  its  fundamental  substance,  and  in  its  composition  and  form. " 

But  to  call  forth  the  phenomena  of  vital  force  matter  demands  certain 
—  imponderables  —  such  as  heat,  light,  electricity  and  other  unknown  sub- 
stances, which  unite,  but  are  not  intimately  mixed,  with  it  and  are  simply 
accidentia.  Organic  nature  has  the  pre-eminence  over  inorganic,  because 
it  possesses  the  capacity  for  generation  and  regeneration.  The  body 
assimilates  foreign  matter  and  gives  to  it  the  appropriate  form.  A  genus 
always  creates  the  same  genus  and  the  kind  is  immortal.  Individuals 
alone  change.  The  formation  of  the  animal  body  begins  in  a  formative 
germ,  as  the  result  of  "  animal  crystallization  "  and  attraction.  The 
fundamental  form  of  .crystallization  is  the  •fibre',  to  which  belongs 
••  irritability  ".  that  is  to  say  that  property  of  animal  matter  by  which,  as 
the  result  of  external  irritation,  it  of  its  own  motion  changes  its  present 
condition.  The  cause  of  irritability  is  again  form  and  composition.  The 
irritations  for  each  organ  must  be  specific,  corresponding  to  the  powers  of 
the  organ.  The  grade  of  irritability  atone  varies.  Disease  is  an  aberration 
of  form  and  composition. 

"  Changes  of  composition  are  the  basis  of  all  the  manifold  phenomena  in  con- 
ditions of  health  and  disease,  and  in  these  lies  the  proximate  cause  of  diseases. 
Remedies  are  effective  only  so  far  as  they  remove  the  morbid  changes  of  composition 
and  establish  healthy  ones." 

Red's  theory  of  fever — febrile  in  his  view  was  synonomous  with  "acute  — is 
still  recognized  at  the  present  day.  He  also  rendered  service  to  the  theory  of  inflam- 
mation, which  latter  he  declared  a  disease  of  the  blood-vessels,  that  is  of  the  capil- 
laries and  vascular  plexus  found  between  the  larger  arteries  and  veins.  His  chief  and 
most  enduring  service,  however,  was  rendered  to  psychiatry,  especially  its  practical 
department,  inasmuch  as  he  pleaded  for  the  abolishment  of  mediaeval  maltreatment. 
In  later  days  he  changed  over  to  natural-philosophical  views,  of  which  the  ideas 
already  adduced  must  be  considered  the  precursors.  He  then  identified  the  vital 
process  with  galvanism:  it  is  a  potentized  galvanism.  Irritability  and  sensibility 
correspond  to  the  poles,  the  former  to  the  positive,  the  latter  to  the  negative  pole. 
Every  organ  manifests  "polarity".  The  diaphragm  is  the  indifferent  point  of  the 
body.  "Tension"  prevails  everywhere  between  organic  and  inorganic  matter  ai:d 
beings,  and  between  these  and  the  external  world.  Death  arises  from  an  electric 
shock,  by  which  a  neutralization  of  the  "tensions"  is  accomplished  etc. 

A  number  of  the  doctrines  of  Stahl,  Hoffmann.  Haller,  Brown  and  of 
the  vitalistic  system  are  found  in  the 

k.   System  of  E.  Darwin, 

which  appeared  in  1794.     Erasmus  Darwin  (1731-1802) 

was  born  in  Nottinghamshire,  and  studied  in  Edinburgh.  Subsequently  he  practised 
in  Lichfield,  Radbourne  and  Derby,  and  distinguished  himself,  not  only  as  a  physician, 
but  also  as  a  poet,  philosopher  and  physiologist.  He  was  the  friend  of  James  Watt, 
the  creator  of  our  modern  industrial  and  commercial  advancement  (and  of  modern 


—  629  — 

pauperism).  Darwin  in  17SS  sung  Watt's  labors  as  those  of  a  new  Columbus:  'Soon 
will  the  power  of  steam  bear  the  fleet  carriage  along  the  road,  soon  will  it  bear  the 
bark,  with  certain  course,  through  the  billows.  Probably  too  it  will,  like  the  eagle, 
bear  a  new  car  through  the  kingdom  of  air  on  the  nimble  pinions  of  the  wind  to 
remote  bounds",  all  of  which  has  been  literally  fulfilled.  Of  Darwin's  life  it  is  said 
that  by  his  practice  and  two  fortunate  marriages  he  became  wealthy,  "  ate  much  and 
drank  nothing  but  water  .  His  chief  work  was  entitled  "  Zoonomia,  or  the  Laws  of 
Organic  Life''  (1794  . 

According  to  Darwin  there  are  two  fundamental  substances  :  spirit 
and  matter.  The  principle  of  life  is  motion,  of  which  there  are  three  kinds: 
vital  movements  due  to  external  irritation,  e.  g.  the  movement  of  the  blood 
and  locomotion  :  primordial  movements  :  chemical  movements.  In  the 
body  there  exist  sensorial  and  fibrous  movements.  The  former  include 
the  senses  and  the  nerves,  as  well  as  the  movements  of  the  vital  spirit, 
which  are  not  lacking  even  in  plants,  and  express  themselves  as  irritability 
(whose  action  is  irritation),  sensibility  (sensation),  will-power  (volition)  and 
the  power  of  association  (association).  The  fibrous  movements  may  be 
movements  of  irritation,  sensation,  volition  and  association.  The  varieties 
of  disease  are  homonymous  with  these  four  categories,  and  each  of  them 
has  again  subordinate  divisions.  Remedies  are  divided  into  those  which 
sustain  the  movements  of  irritation,  those  which  increase  them,  those 
which  restore  them,  and  finally  those  which  diminish  them. 

A  degeneration  of  the  doctrine  of  vital  force,  or  rather  an  illusion  genetically 
dependent  upon  the  latter,  and  (where  any  effect  is  manifest  I  to  be  referred  to  hypno- 
tism or  hysteria,  is  the  silly  theory  of 

1.  Animal  Magnetism. 

which  attained  among  the  great  and  small,  the  educated,  or  rather  miseducated  and 
uneducated,  a  following  which  would  be  incomprehensible,  did  we  not  know  the 
tendency  of  mankind  to  the  marvellous.  It  must  be  ascribed  to  that  inclination 
which  finds  its  highest  expression  in  religious  extravagances,  its  most  common  mani- 
festation in  such  cognate  and  silly  phenomena  as  animal  magnetism.  Witchcraft 
and  magic,  thousand-formed,  thousand-armed,  "widely  diffused  and  old  as  the  human 
race,  as  they  were  the  first,  so  will  they  be  also  the  last  forms  of  the  healing  art  T 
They  are  continually  renewed  under  new  forms  adapted  to  the  time  —  for  us  under 

the  guise  of  science  and  called  Mesmerism Even  in  the  family  of  the 

educated  physician  the  private  advice  of  the  old  washerwoman  possesses  more  value 
than  his  own  art"  (Chemissoi.1  Such  expressions  from  time  to  time  rise  to  the  pro- 
portion of  spiritual  epidemics.  They  have  always  appeared  especially  during  and 
after  periods  of  political  disturbance,  misfortune,  over-excitement  and  miseducation 
in  the  higher  strata  of  society,  and  spread  thence  to  the  masses,  and  have  always 
-tood  too  in  causative  connexion  with  the  internal  development  of  the  life  of  the  people. 
Franz  Anton  Mesmer  (1734-1815),  of  the  village  of  Itznang.  near  Radolfzell  on 
the  Lake  of  Constance,  was  originally  (like  almost  all  such  enthusiasts'  merely  a 
partial  victim  of  this  romantic  yearning.     Subsequently,  however,  he  posed  as  the 

1.  An  earlier  remark  of  the  same  author  is  still  true  :  li  I  wish  to  give  offence  to  no 
one  :  but  who  will  deny  that  even  to-day.  in  an  enlightened  city  like  Berlin, 
more  diseases  are  treated  with  charms  or  sympathetic  and  miraculous  remedies, 
than  are  entrusted  to  the  care  of  the  scientific  physician?''    Ueise  um  die  Welt  . 


—  630  — 

apostle  of  a  new  doctrine,  designed  to  furnish  a  living  for  its  founder,  and  finally 
ended  as  a  simple  "impostor".  He  had  studied  in  Vienna,  where,  in  his  graduating 
thesis  (probably  at  the  mystic  suggestion  of  de  Ha'en),  he  had  already  occupied  him- 
self with  the  influence  of  the  planets  upon  man  and  with  the  use  of  the  natural 
magnet.  The  latter  he  subsequently  employed  in  his  practice,  but  he  likewise  found 
that  the  simple  hand  was  effective  —  a  member  which,  as  an  organ  of  sense,  the 
theurgic  professor  Leupoldt  of  Erlangen  believed  to  be  associated  with  the  mind,  and 
therefore  specially  adapted,  not  only  for  blessing  and  the  imposition  of  hands,  but 
also  for  the  strengthening  of  personal  relations,  particularly  between  individuals  of 
different  sexes,  with  or  without  reference  to  sexual  life.  Mesmer.  on  the  other  hand, 
held  that  the  magnetic  "fluidum"  (seminale?)  existing  everywhere  throughout  the 
world,  and  of  course  in  man  likewise,  overflowed  from  the  hand  with  a  healing 
influence  upon  others,  and  that  the  sick  were  peculiarly  susceptible  to  this  influence. 
In  the  year  1774  he  published  his  experiments  and  travelled  in  the  prosecution  of'his 
studies.  Returning  from  his  travels,  he  erected  a  private  institution,  where  in  the 
beginning  he  discreetly  treated  only  fidgety  and  blind  maidens  and  old  simpletons. 
His  deception,  however,  was  unmasked  by  a  commission  appointed  by  Maria  Theresa, 
and  he  was  compelled  to  leave  Vienna  within  24  hours.  This  martyrdom  recom- 
mended him  in  Paris,  where  he  came  in  1778.  Here  he  had  the  good  fortune  to  win 
over  to  his  views  d'  Eslon,  ordinary  physician  of  the  count  d'  Artois,  and  a  member 
of  the  Faculty,  who,  to  Mesmer's  chagrin,  began  at  once  to  magnetize  on  his  own 
account.  The  thing  became  fashionable,  and  an  effort  was  now  made  to  obtain  a 
number  of  suitable  witnesses  by  all  sorts  of  underhand  practices.  This  plan,  however, 
proved  a  failure,  and  the  two  companions  fell  out  with  each  other.  Mesmer  went  for 
a  long  time  to  Spaa,  but  returned  when  a  respectable  number  of  students  had  been 
obtained  in  Paris.  These  he  undertook  to  instruct  in  magnetization  at  the  rate  of 
100  louisd'or  a  head.  For  the  elevation  of  the  whole  he  founded  the  "  Order  cf 
Harmony"  and  established  so-called  "baquets",  i.  e.  magnetic  tubs,  half  filled  with 
sulphurated  water  and  all  kinds  of  ingredients,  from  which  projected  iron  conductor?. 
Upon  these  conductors  hung  a  ring,  with  which  the  conclave,  whose  members  joined 
hands,  placed  themselves  in  contact.  D'  Eslon  had  similar  tubs  and  a  "Crisis  Hall". 
At  these  seances  Mesmer  was  clad  in  lilac-colored  clothing  and  reinforced  the  action 
of  the  tub  by  looks,  gestures,  playing  upon  the  harmonica  and  touching  the  patients 
with  a  wand  or  with  his  fingers.  If  any  one,  '  chiefly  a  lady  ",  had  a  "  crisis",  she 
was  at  once  borne  to  the  crisis-chamber  by  Mesmer  himself,  and  during  these  feminine 
crises  he  alone  was  permitted  to  enter  the  room,  as  he  only  had  success  in  their 
"treatment".  The  seances  were  very  popular,  and  in  a  short  time  brought  Mesmer 
in  40,000  francs.  The  charlatan  was  able  to  deceive  even  the  queen,  and  when  he 
threatened  to  deprive  France  of  his  presence  she  had  him  offered  a  salary  of  40,000 
francs  to  instruct  physicians  in  his  art.  But  the  wily  fellow  declined  to  enter  into  the 
bargain.  In  the  year  1783  an  old  simpleton  again  wrote  an  article  extolling  Mesmer 
as  a  worker  of  miracles,  the  result  of  which  was  that  the  commission  of  investigation, 
so  often  desired  by  his  ill-wishers,  was  appointed,  and  its  adverse  decision,  together 
with  some  important  preliminaiy  events,  drove  Mesmer  from  the  field.  During  the 
Revolution  he  lost  part  of  his  wealth,  and  in  1798  he  returned  again  to  Paris.  But  his 
day  had  passed,  and  thenceforth  until  his  death  he  lived  forgotten,  sometimes  at  Frauen- 
feld  in  Thurgau,  sometimes  in  Constance,  and  finally  in  Meersburgon  Lake  Constance. 
Just  as  the  lustre  of  animal  magnetism  began  to  appear  two  noble  brothers 
Puysegur,  — faith  and  superstition  are,  indeed,  aristocratic,  for  they  maintain  ignor- 
ance and  obedience — established  in  southern  France  a  mongrel  sort  of  magnetisation, 
practised  after  the  style  of  the  Druids  in  the  open  air  beneath  the  dense  foliage  of  the 
forests.     They,  however,  made  no  effort  to  produce  violent  crises,  but  sought  by  gentle 


—  631  — 

"  manipulations  to  produce  agreeable  frames  of  mind  ",  terminating  finally  in  clair- 
voyance. In  1785  they  also  established  branch  associations  in  Strassburg.  In  France 
Virey,  Lombard  and  others  were  opponents  of  the  delusion. 

Two  years  later,  through  the  "  prophet"  Lavater,  the  craze  reached  Germany. 
Here  the  physicians  of  Bremen,  including  especially  Arnold  Wienholt  (1749-1804) 
and  Olbers  (1758-1840),  the  discoverer  of  the  asteroids  "Pallas"  and  "Vesta", 
headed  the  line.  They  were  followed,  among  others,  by  Eberh.  Gmelin  (,1753-1809), 
J.  N.  Pezold,  Joh.  Heinnecken,  Joh.  Lor.  Bockmann,  who  even  edited  an  "Archiv 
fiir  thierischen  Magnetismus"  (even  Alex,  von  Humboldt  inclined  to  this  theory), 
A.  E.  Kessler  (born  1784),  who  asserted  the  polar  behavior  of  the  magnetiser  to  the 
somnambulist,  in  which  the  former  represented  the  positive  and  active,  the  latter,  the 
negative  and  passive  pole;  C.  Chr.  Wolfart,  (1778-1832),  professor  A.  F.  Kluge  (a 
special  Berlin  authority  on  animal  magnetism,  whose  "Versuch  einer  Darstellung  des 
animalen  Magnetismus"  was  printed  as  often  as  Virchow's  "Cellularpathologie") 
and  Hufeland  in  Berlin  ;  the  natural-philosophical  physicians  Eschenmayer,  Kieser 
and  Nasse,  the  former  of  whom  even  driveled  about  a  "spiritual  generation"  between 
the  magnetiser  and  the  magnetised;  Walther,  professor  in  Landshut,  the  eminent 
surgeon  J.  Ennemoser  (1787-1854),  who,  however,  took  up  the  matter  more  from  the 
physical  stand-point ;  J.  C.  Passavant  in  Frankfort-on-the-Main  ;  Ritgen  in  Giessem 
who  "magnetized"  young  nurses  particularly;  Franz.  Ant.  Nick  (1780-1832)  in 
Stuttgart;  Joh.  Jul.  Voss  (1768-1832),  and  many  others  down  to  the  very  assistants 
of  the  apothecaries.  Gothe  thought:  "The  matter  is  neither  entire  nonsense,  nor  yet 
absolute  deception.  Only  the  men  who  devote  their  attention  to  it  are  very  suspicious 
characters  to  me:  mountebanks,  great  lords,  prophets,  all  men  who  like  to  boast  on 
very  slight  grounds  "  etc. 

Among  the  opponents  of  magnetism  were  the  judicious  Stieglitz,  one  of  the 
clearest  heads  that  ever  cultivated  the  medical  sciences;  Hensler,  Pfaff  etc.,  including 
the  best  physicians.     Stieglitz  was  answered  by  Wolfart  and  J.  E.  L.  Ziermann. 

These  mystic  medical  doctrines  were  continued  by  Justinus  Kerner  (1 78(3-1862), 
Christ.  Gottf.  Nees  von  Esenbeck  (1776-1858),  of  Erbach  in  the  Odenwald,  and  Joh. 
Nepom.  von  Ringseis  (1785-1880)  of  Munich,  an  ingenious  man,  but  sunk  in  the 
mysticism  of  the  18th  century  and  the  romance  of  the  19th,  and  through  the  influence 
of  both  a  devoted  Catholic,  who  thought:  "Since  disease  is  originallj"  the  result  of 
sin,  it  is  incomparably  safer  (though  according  to  experience  not  always  indispens- 
able) that  the  physician  and  patient  should  purify  themselves  before  beginning 
treatment",  and  the  Church  accordingly  supplies  the  necessary  disinfectants  in 
auricular  confession  etc.  In  a  somewhat  extensive  practice,  however,  these  measures 
cannot  be  very  well  employed.  We  should  also  mention  Albert  Steinbeck,  Werner 
and  others  —  proof  enough  that  even  down  to  our  own  skeptical  age  the  spirit-world 
has  haunted  medicine.  Under  this  head  falls  too  the  "Od"  of  baron  Karl  von  Reichen- 
bach  (died  1869),  the  discoverer  of  paraffin  and  creasote.  The  "Od"  was  something 
between  magnetism  and  electricity,  appreciable  only  through  the  nerves.  The  most 
recent  manifestation,  however,  is  the  modern  "Spiritualism",  which  counts  its  follow- 
ers even  to-day  among  nobles,  humbugs  (an  Austrian  archduke  in  1884  outdid  both) 
and  even  professors.     Hence  the  rehabilitation  of  Mesmerism1  in  the  form  of  "  metal- 

1.  The  "Hypnotism  "  of  the  present  day  is  but  a  rehabilitation  of  Mesmerism,  in  so 
far  as  it  is  recommended  therapeutically  (for  male  and  female  hysteria,  nocturnal 
incontinence  of  urine,  onanism,  sexual  excesses,  dipsomania,  the  abuse  of  tobacco 
etc.).  Since  it  has  heen  employed  to  prevent  the  interruption  of  laying  in  hens, 
it  will,  doubtless,  ere  long  prove  itself  efficacious  against  sterility  in  women.  It 
is  even  recommended  in  educational  matters  (De  la  suggestion  et  de  ses  applica- 
tions a  la  pedagogie,  Paris,  1888,  Berillon). 


—  632  — 

loscopy",  according  to  the  claim  of  the  physiologist  Schiff  (1879),  put  on  the  airs  of  a 
"  science  ". 

[In  England  the  vagaries  of  Mesmer  at  first  excited  little  attention.  James 
Graham,  a  physician  of  Edinburgh,  did,  indeed,  establish  in  1780  a  gorgeous 
"  Templum  yEsculapio  Sacrum"  or  "  Temple  of  Health  "  in  London,  and  for  some 
time  carried  on  successfully  a  gigantic  system  of  impostures.  But,  on  the  bursting  of 
this  bubble,  the  subject  of  animal  magnetism  seems  to  have  been  relegated  to  the 
limbo  of  other  delusions.  In  France,  however,  at  the  instance  of  M.  Foissac,  a  new 
commission  to  investigate  the  subject  was  appointed  in  1825.  and  their  report,  which 
gave  a  qualified  endorsement  to  the  claims  of  the  advocates  of  animal  magnetism, 
was  published  in  1831.  This  report  was  translated  into  English  and  published  by 
J.  C.  Colquhoun  in  1833,  and,  with  the  "  Isis  revelata"  of  the  same  author,  published 
in  1836,  served  to  arouse  the  attention  of  English  physicians  to  the  subject.  John 
Ashburner  of  London  studied  the  subjects  of  animal  magnetism  and  spiritualism  in 
1834.  Herbert  Mayo,  the  eminent  physiologist  and  surgeon  of  Middlesex  Hospital, 
wrote  an  "magnetic  sleep"  in  1837,  and  advocated  mesmerism  with  an  enthusiasm 
which  cost  him  his  position  and  finally  drove  him  from  London,  and  John  Elliotson 
(1788-1868),  professor  of  medicine  in  the  London  University,  was  forced  from  the 
same  cause  to  resign  his  position  in  1838.  The  great  revival  of  interest  in  the  subject 
of  animal  magnetism  was  due,  however,  to  the  researches  of  James  Braid  (1795-1860) 
of  Manchester,  whose  experiments  were  published  in  1842,  and  whose  work  entitled 
"Neurynnology"  etc.  appeared  in  1843.  To  him  we  owe  also  the  word  "hypnotism", 
a  condition  the  phenomena  of  which  were  subsequently  called  by  Durand  de  Gros 
"Braidism".  —  Among  the  more  important  writers  upon  this  subject  in  England  we 
may  mention  :  Daniel  Noble  of  Manchester  (1845);  the  eminent  savant  and  arctic 
explorer  Rev.  Dr.  William  Scoresby  (1790-1857),  whose  "  Zoistic  Magnetism" 
appeared  in  1849;  John  Forbes  (1845)  ;  William  Gregory  (1803-1853),  the  eminent 
professor  of  chemistry  in  Edinburgh,  who  translated  in  1850  the  "Physikalisch- 
phvsiologische  Untersuchungen  liber  die  Dynamide  des  Magnetismus"  (1849)  of 
Baron  Reichenbach  ;  John  Hughes  Bennett  (1812-1875),  professor  of  medicine  in 
Edinburgh;  Andrew  Buchanan;  Alexander  Wood;  and  still  more  recently  the 
eminent  physiologist  William  B.  Carpenter  (died  1885)  and  Henry  Maudsley. 

In  the  United  States  the  subject  has  apparently  aroused  little  professional 
interest,  though  it  has  been,  of  course,  exploited  by  popular  lectures  and  "cranks"  of 
hijih  and  low  degree.  — It  is,  however,  worth}''  of  mention  that  Robert  Wilson  Gibbes 
<  1*09-1866),  professor  of  chemistry  and  geolog}7  in  the  University  of  South  Carolina, 
published  a  lecture  on  "The  magnetismus  of  the  human  body"  in  1843.     (H.)] 

The  following  theories  must  be  regarded  as  the  direct  precursors  of 
the  systems  and  schools  of  the  19th  century.  We  shall  first  exhibit  briefly 
the 

m.  Chemical  and  Physical  Theories. 

»..  The  Phlogistic  Theory 

is  merely  a  theory  of  animal  heat.  According  to  this  theory  the  free  heat  existing 
in  the  inspired  air  is  incorporated  with  the  body  byr  means  of  respiration,  and  at  the 
same  time  Stahl's  "phlogiston"  is  withdrawn  from  the  blood.  Heat  is  also  sub- 
stituted for  the  "  phlogiston  ".  The  skin  effects  the  same  interchange.  —  Diseases, 
according  to  this  theory,  originate  from  the  appropriation  of  too  much  or  too  little 
heat,  or  from  too  great  or  too  little  excretion  of  phlogiston.  Pure  i.  e.  "dephlogistic- 
ated  "  air  was  recommended  as  a  remedy. 

This  view  was  taught  —  for  chemists  already  claimed  a  voice  in    medicine  —  by 


—  633  — 

Joseph  Priestley  and  Adair  Crawford  (1749-1795).  On  the  other  hand,  Edward  Rigby 
(1747-1821)  transferred  phlogistification   to  the  stomach,  and  held  that  in  digestion 

free  heat  originated,  which  was  exhaled  by  the  skin.  If  this  exhalation  was  disturbed 
skin  eruptions  etc.  occurred.     To  this  theory  was  opposed  the 

t'i.  Antiphlogistic  Theory 

■of  Christoph  Girtanner  (1760-1800),  professor  in  Gottingen,  a  famous,  but  not  entirelj- 
reliable  author  on  syphilis.  According  to  this  theory,  the  newly  discovered  oxygen 
—  medical  systematists  never  leave  anything  new  unutilized — as  the  proper  "prin- 
ciple of  irritability",  passed  for  the  "  vital  force".  Disease  depends  upon  the  appro- 
priation of  too  much  or  too  little  oxygen.  The  causes  of  disease  disturb  the  normal 
relations  of  this  appropriation.  From  lack  of  oxygen  appropriated  in  respiration, 
and  whose  action  in  the  body  Lavoisier,  as  we  know,  had  identified  with  combustion, 
arise  scorbutus  (according  to  Th.  Trotter,  1761-1832,  of  Edinburgh),  putrid  fever, 
syphilis,  obesity,  lethargy  etc.:  from  its  excess,  consumption  (according  to  Th. 
Beddoes,  1754-1808,  professor  of  chemistry  in  Oxford).  Hence  he  recommended 
breathing  foul  (!)  air  (of  stables),  an  idea  which  still  haunts  the  heads  of  patients  and 
even  of  some  physicians.  (At  the  present  day  it  is  the  fashion  to  send  tuberculous 
patients  to  mountainous  regions,  where  they  die  a  little  more  slowly).  G.  Christian 
Reich  (1769-1848),  professor  of  medicine  in  Berlin,  in  1800  constructed  his  theory  of 
fever  upon  "  an  abnormal,  general  separation  and  reunion  of  the  simplest  constituents 
•of  the  body,  effected  by  unnatural,  absolute  or  relative,  local  or  general  diminution 
of  the  oxygen".  A  universal  remedy  for  fevers  was,  therefore,  to  be  found  in  the 
acids.  On  the  other  hand  Jac.  Fidelis  Ackermann  (1765-1815)  of  Rudesheim,  pro- 
fessor in  Mayence,  Jena  and  Heidelberg,  sought  in  his  later  years  the  fundamental 
•cause  of  life  in  the  exchange  of  oxygen,  carbon  and  caloric.  Ackermann  was  a 
pupil  of  Sommering,  and  in  1804  was  called  from  Jena  to  Heidelberg.  At  the  outset 
he  was  an  unprejudiced  physician,  free  from  all  tendency  to  theories.  In  Heidelberg 
he  organized  an  ambulatory  clinic  and  a  policlinic.  He  improved  the  instruction  in 
anatomy,  and  from  1807  forward — he  was  also  leacher  of  anatomy1 — he  had  dissec- 
tions performed,  a  thing  which  had  not  been  customary  in  Heidelberg  before  his  day. 
Samuel  Latham  Mitchill  (1764-1831)  of  New  York  believed2  all  "infectious,  and 
several  other  diseases"  dependent  upon 

y.  Oxidized  Nitrogen  Gas 

("gaseous  oxyd  of  azote  or  nitrogene"),  in  opposition  to  whom  in  1798  (after  Ant. 
Francois  Fourcroj-,  1755-1809,  had  made  a  more  judicious  use  of  chemistry)  J.  B.  T. 
Baumes  (died  1815,  "  Essai  d'  un  systeme  chimique  de  la  science  de  1'  homme"),  pro- 
fessor in  Montpellier,  in  his 

').  Generalized  Chymismus. 

adopted  five  classes  of  diseases:  the  oxygenated,  calorified,  hydrogenized,  nitrogen- 
ized  and  phosphorized,  with  the  subordinate  classes  of  super-oxygenated  (inflamma- 
tory and  convulsive  conditions),  super-calorified  (ha?morrhages  etc.),  de-oxygenated 
(diabetes,  rickets,  scurvy,  chlorosis  etc.),  de-calorified  (diseases  which  produce  weak- 
ness and  debility)  etc.,  etc.  An  especial  influence  upon  the  medical  theory  of  the 
natural-philosophical  school  of  the  19th  centurj-  (as  we  have  already  seen  in  the  case 
of  Reil)  was  obtained  by  electricity  or  the  newly  discovered  (17s;); 

1.  Tiedemann  was  called  to  Heidelberg  in  1816  as  the  first  pure  professor  of  anatomy 

and  physiology.    It  was  not  until  1847  that  a  new  anatomical  institute  was  erected, 
after  Henle  had  succeeded  Tiedemann  as  anatomist  in  1844. 

2.  His  views  were  published  in  1795.    (H.) 


—  034  — 

e.  Galvanism. 

It  was  considered  the  genuine  "  vital  force " :  the  positive  pole  was  identified  with 
"irritability",  the  negative  with  "sensibility",  and  the  theory  was  carried  so  far  as 
to  declare  man  the  irritating  and  active  pole,  woman  the  sensitive  and  passive. 
Galvani  himself  had  located  the  seat  of  electricity  in  the  brain,  and  held  that  by 
means  of  the  nerve-tubes  (the  nerves  were  at  that  time  believed  to  be  hollow)  it 
reached  the  whole  body  and  especially  the  muscles,  producing  in  them  contraction 
analogous  to  the  accidentally  discovered  twitchings  of  the  frog.  Disturbance  of  the 
currents  occasioned  disease.  Galvanistic  views  were  embraced  by  C.  H.  PfafF,  who? 
first  showed  the  influence  of  the  direction  of  the  current  upon  the  activity  of  the 
frog's  leg,  if  electrically  excited  through  the  nerve;  Alex,  von  Humboldt  (1769-I859)r 
who  demonstrated  that  the  animal  organs  were  sources  of  electricity;  J.  W.  Ritter 
(1776-1810),  professor  in  Munich,  and  others.  The  exaggerated  (natural-philosophical) 
theoretic  estimation  of  the  pole  etc.  was  the  work  of  Reil;  Christian  Leopold  Reinhold 
(1769-1809),  Georg  Prochaska  (1749-1820),  who  was  the  first  to  assert  the  distinction 
between  the  centrifugal  or  motor,  and  the  centripetal  or  sensitive,  nerve-roots,  a  fact 
afterwards  established  b}7  Sir  Charles  Bell;  Joach.  Dietrich  Brandis  (1762-1846),  first 
physician  to  the  baths  in  Duisburg,  then  a  professor  in  Kiel,  and  finally  ordinary 
ph}rsician  in  Copenhagen;  Chr.  Ludw.  Treviranus  (died  1864)  in  Bonn,  and  others. 
C.  H.  E.  Bischoff  (1781-1861;  father  of  the  anatomist,  physiologist  and  famous 
embryologist  Th.  L.  W.  von  Bischoff,  1807-1882,  professor  in  Heidelberg,  Giessen  and 
Munich),  originally  of  Berlin,  then  a  mystic,  pietistic  professor  and  natural  philoso- 
pher in  Bonn,  and  C.  J.  C.  Grapengieser  (Versuch  den  Galvanismus  zur  Heilung 
einiger  Krankheiten  anzuwenden,  Berlin,  1801  ;  so  that  Bemak  revived  the  use  of 
galvanism,  but  was  not  the  first  to  introduce  it  into  practice)  wrote  on  the  practical 
employment  of  galvanism. 

From  its  brilliant  consistency,  its  ingenious  employment  of  certain 
vital  phenomena  and  observations,  its  apparently  complete  novelty  and  its- 
ease  of  practical  application, 

n.  The  Brunoiiian  System  (1780), 

of  all  the  systems  which  arose  in  the  18th  century,  was  at  all  events  that 
which  exercised  the  most  prolonged  influence  upon  the  19th. 

John  Brown  (1735-1788),  in  spirit,  character  and  fate  a  comrade  of  his  country- 
man Robert  Burns  —  the  son  of  a  poor  weaver  of  Dunse  (Lintlaws  or  Preston),  a 
village  of  Berwickshire,  Scotland,  even  as  a  child  manifested  brilliant  endowments. 
At  the  age  of  seven  years  he  already  understood  Latin,  but  at  ten  he  began  to  learn 
the  trade  of  his  step-father.  In  consequence  of  his  high  attainments,  however,  Brown 
at  the  age  of  thirteen  was  sent  to  the  Latin  school  in  Dunse,  but  was  compelled  again 
to  leave  school  for  a  long  period  in  order  to  earn  his  daily  bread  as  a  reaper.  Soon 
after  he  received  the  appointment  of  an  usher  in  Dunse,  and  discharged  the  duties  of 
this  position  until  his  18th  year,  when  he  took  the  post  of  a  private  tutor.  This? 
position  after  a  short  time  he  exchanged  (1755)  for  that  of  a  tutor  in  Edinburgh,  in 
order  that  he  might  be  able  to  study  theology  also.  Here  he  fell  into  such  straits 
theologically  and  financially,  that  in  1758  he  was  forced  to  return  to  his  original 
position  as  assistant  teacher  in  Dunse.  But  in  1759  he  returned  once  more  to  Edin- 
burgh. Here  he  had  at  one  time  translated  a  thesis  into  Latin  for  a  medical  student,. 
and  by  means  of  this  work  was  led  to  the  conclusion  to  become  a  student  of  medicine 
himself.  In  order  to  earn  money  for  his  maintenance  he  at  first  continued  his 
translations,  and  subsequently  composed  dissertations,  while  he  also  gave  instruction 


—  635  — 

in  Latin  and  held  medical  '"quizzes".  He  was  permitted  to  attend  lectures  iree  or 
all  expense.  In  1761  he  became  a  fellow  of  the  medical  society,  but  this  fact,  as  well 
as  his  continual  poverty,  did  not  prevent  him  from  living  a  rather  dissolute  life,  and 
indeed  from  marrying  in  1765  to  boot.  He  now  opened  a  boarding  and  lodging-house 
for  students,  but  became  no  more  respectable  in  his  habits,  and  accordingly  fell  into 
utter  destitution.  In  this  condition  he  was  assisted  by  Cullen,  who  had  sprung  from 
equal  poverty,  and  to  whom  Brown  made  himself  useful  by  his  knowledge  of  Latin, 
so  that  Cullen  took  him  as  teacher  for  his  children  and  gave  him  private  instruction 
with  his  pupils.  A  position  in  the  university,  Which  Brown  hoped  to  obtain  through 
his  influence,  Cullen  could  not  or  would  not  procure  for  him,  and  as  the  result  of  this, 
through  the  fault  of  both,  anger  and  aversion  at  once  separated  teacher  and  pupil, 
protege  and  benefactor  (1770).  Brown  now  advanced  in  private  lectures  his  theorj", 
to  which  he  had  been  led  by  one  of  his  own  attacks  of  gout  that  disappeared  under 
the  use  of  stimulants,  while  heretofore  they  had  always  become  worse  under  a  weak- 
ening treatment.  These  lectures  were  delivered  at  first  to  a  few  dissolute  but  talented 
students  (1772).  Soon,  however,  Brown  began  to  laugh  at  the  doctrines  of  Cullen  and 
others,  made  loud  boasts,  divided  the  students  into  two  camps  who  did  not  hesitate  to 
belabor  each  other  with  cudgels,  and  yet  lived  still  more  dissolutely,  in  spite  of  the 
fact  that  he  had  established  a  lodge  of  Freemasons,  had  twice  I  1766  and  1780)  held 
the  presidency  of  the  medical  society,  and  had  received  (1779)  the  degree  of  M.  D. 
from  a  university  (St.  Andrew's).  At  last  he  was  thrown  into  prison  for  debt  (1786). 
His  pupils  bailed  him  out.  Next  Brown  removed  to  London,  where  fortune  at  first 
seemed  to  smile  upon  him.  He  gained  reputation  and  practice  and  was  on  the  point 
of  receiving  a  call  to  Berlin  as  physician-in-ordinary,  and  to  Padua  as  a  teacher. 
This,  however,  was  prevented  by  his  enemies,  in  whose  hands  Brown  himself  placed 
the  lever,  for  he  continued  his  preceding  dissolute  life,  and  again  fell  into  prison  for 
debt.  Once  more  his  pupils  and  friends  set  him  at  liberty,  but  he  soon  after  died 
from  the  effects  of  opium,  to  the  inordinate  use  of  which  he  was  a  slave,  and  which 
he  also  prized  so  highty  as  a  stimulant  that  his  drunken  expression  "Opium,  mehercle, 
nonsedat!"  was  given  to  him  as  a  motto.  Brown  left  in  absolute  poverty  to  the 
charit.y  of  others  a  widow,  four  sons  (including  William  Cullen  Brown)  and  four 
daughters.  He  was  manifestly  a  man  of  high  mental  gifts,  but  morally  deserving  of 
the  severest  condemnation ;  one  whose  poverty  did  not  render  him  worthy  of  pity,  for 
he  had  brought  it  upon  himself  and  transmitted  it  to  his  family.  His  chief  work  was 
entitled  "Elementa  Medicinas"  (1780). 

According  to  Brown,  life  is  not  a  natural  condition,  but  an  artificial 
and  necessary  result  of  irritations  constantly  in  action.  All  living  beings, 
therefore,  tend  constantly  towards  death.  That  irritations  can  compel  life 
is  their  characteristic.  Living  beings  too  are  capable  of  excitabilit}7,  which 
is,  indeed,  inscrutable  in  its  nature,  but  its  seat  in  the  muscles  and  the 
medulla  of  the  nerves  may  be  demonstrated.  Like  its  action,  i.  e.  excite- 
ment, it  is  indivisible  and  undivided.  The  latter  is  the  cause  of  the  pro- 
cesses which  take  place  in  the  body,  whether  sound  or  diseased,  and  conse- 
quentl}'  of  life  itself. 

Irritations  are  of  two  kinds,  external  and  internal'.  To  the  external 
belong  food,  blood,  the  fluids  in  general,  warmth,  air  etc.  :  the  functions  of 
thought,  feeling,  muscular  activit}'  etc.  are  to  be  considered  internal  irrita- 
tions, which  have  the  same  action  as  the  external.  Moreover  irritations- 
are  general  or  local.      General   irritations   arouse  excitement   in   the  whole 


—  636  — 

body  :  the  local  act  first  of  all  upon  an  individual  part,  and  subsequently 
upon  the  whole  body. 

Health  is  an  intermediate  grade  of  excitement :  disease,  too  high  or 
too  low  a  grade.  The  two  are  not  conditions  substantially  different,  but 
simple  gradations  of  one  and  the  same  action  upon  the  excitability. 

Diseases  are  divided  into  general  and  local.  General  diseases  extend 
over  the  whole  body,  are  general  from  the  outset,  and  arise  from  an  injury 
of  the  general  excitabilit}-.  Local  diseases  are  limited  to  one  part,  aud,  at 
least  as  a  rule,  remain  thus  limited.  The  latter  too  are  distinguished 
especially  by  the  fact  that  they,  unlike  general  diseases,  are  not  preceded 
by  a  predisposition  ("diathesis"',  "  opportunitas  ").  By  a  predisposition 
is  to  be  understood  a  condition  which  deviates,  indeed,  from  health,  but  yet 
simulates  the  latter. 

"  Local  diseases:  1.  Organic  diseases,  limited  to  a  part  and  not  accompanied  by 
a  general  lesion;  e.  g.  burns,  local  poisonings,  laceration  of  the  nerves,  wounds. 
2.  Organic  diseases  of  the  internal  or  external  parts,  which  have  a  general  lesion  for 
their  consequence;  e.  g.  gastritis,  cystitis,  enteritis,  hysteria,  abortion,  difficult  labor, 
deep  wounds.  3.  General  diseases  which  have  degenerated  into  topical  or  local;  e.g. 
suppuration,  pustules,  anthrax,  bubo,  gangrene,  sphacelus,  scrofulous  swelling  and 
abcess,  scirrhous  tumor.  4.  Local  diseases  in  which  the  poison  spreads  over  the  body 
and  has  no  influence  upon  the  excitement.  5.  Diseases  in  which  a  poison  penetrates 
internally  and  disorganizes  the  organs. 

Excitement  is  divided  into  different  grades  according  to  the  degree  of 
action  of  the  irritation.  The  extreme  grades  of  this  scale  are  like  the 
exhaustion  and  accumulation  of  irritability  as  the  result  of  too  great  or  too 
little  power  of  the  irritants,  and  are  death.  The  intermediate  result  is 
ordinarily  weakness  (asthenia),  either  direct  or  indirect.  Direct  asthenia 
depends  upon  the  presence  of  an  excess  of  excitability,  according!}'  upon 
too  great  an  accumulation  of  excitabilit}'  the  result  of  a  deficiency  of  irri- 
tation. It  is  to  be  removed  by  new  irritations,  which  reduce  that  excess 
to  the  normal  proportion  of  health.  Indirect  asthenia  is  to  be  referred  to 
an  excess  of  irritation,  by  which  excitability  becomes  exhausted.  It  is  to 
be  relieved  by  opposing  a  weaker  irritation  to  the  too  strong  causative 
irritation.  The  grades  of  excitability  are  always  in  inverse  proportion  to 
the  excitement.  Most  diseases  are  dependent  upon  asthenia.  Sthenia  is 
more  rarely  a  cause  of  disease,  and  is  the  result  of  a  less  powerful  irritation. 

Diseases  are  divided  into  Sthenic  and  Asthenic. 

"Sthenic  diseases  are  those  which  are  truly  inflammatory :  a.  Pyrexia;:  peri- 
pneumonia, phrenitis,  small-pox,  measles,  scarlatina,  quinsy,  catarrh,  erysipelas, 
rheumatism,  synocha:  —  b.  Apyrexiae:  mania,  insomnia,  obesity  etc. —  (Pyrexia?  are 
those  diseases  in  which  the  pulse  is  irregular.) 

Asthenic  diseases  are  the  following,  viz.:  a.  Direct  asthenic  :  leanness,  restless- 
ness, itch,  diabetes,  rhachitis,  ha?morrhage,  diarrhoea,  worms,  atrophy,  scorbutus, 
hysteria,  gout,  cough,  asthma,  colic,  spasms,  dropsy,  epilepsy,  paralysis,  apoplexy, 
trismus,  tetanus,  fever  from  the  mildest  up  to  the  plague,  b.  Indirect  asthenic  :  the 
plague,  malignant  small-pox.  angina  gangramosa,  typhus,  hydrothorax,  consumption, 
•dysentery"  etc. 


—  637  — 

Brown's  diagnosis  requires  no  special  symptomatology,  but  simply  a 
consideration  of  the  antecedent  injuries  and  the  earlier  condition  of  the 
health,  without  any  distinction  between  local  and  general  diseases.  It 
demands  only  the  determination  of  the  grade  of  diseases  in  accordance 
with  the  strength  or  weakness  of  the  acting  irritation.  For  this  purpose 
some  pupils1  of  Brown  drew  up  a  kind  of  barometer  of  disease. 

It  has  been  said  of  the  Brunonian  system  of  therapeutics  that  it 
sacrificed  more  human  beings  than  the  French  Bevolution  and  the  wars  of 
Napoleon  combined,  a  statement  which  would  be  credible  only  if  nature 
did  not,  for  the  most  part,  make  up  for  the  faults  of  the  physician.  Like 
the  system  of  Asclepiades,  with  whose  views  (Methodism)  Brown's  doctrine, 
setting  aside  its  change  of  terms,  has  the  greatest  similarity,  the  Brunonian 
S}'stem  held  substantially  the  position  that  it  is  not  nature  which  cures 
diseases,  but  the  physician.  The  latter  must  continue  to  irritate  or  weaken 
until  the  medium  height  of  the  barometer  of  irritation  is  again  reached. 
Of  all  the  therapeutic  methods,  that  of  Brown  is  the  one  most  deeply 
sunken  in  theory,  from  which  even  the  nearby  allied  system  of  Asclepiades 
was  more  exempt.  It  was  a  fatal  principle  when  applied  to  practice  !  For 
how  could  one  recognize,  and  by  what  means  could  he  bring  about,  the 
medium  height  of  the  barometer  of  irritation  ?  One  should  always  aim  at 
general  effects  and  not  desire  those  of  a  local  character,  and  with  this  object 
in  view  he  should  not  limit  himself  to  a  single  remedy,  but  rather  employ 
several,  that  "  the  excitabilit}'  ma}'  be  attacked  generally  and  uniformly  ". 
The  materies  morbi  furnishes  no  indications  for  the  treatment.  The 
physician  need  not  work  for  its  expulsion,  but  merely  allow  it  time  to  leave 
the  bod}'.  The  art  of  the  physician  consists  in  adjusting  the  right  propor- 
tion of  strengthening  or  weakening  remedies,  i.  e.  their  doses.  Among 
the  former  are  to  be  reckoned  opium,  ether,  aromatics,  wine,  exercise,  meat 
diet  etc.  ;  among  the  latter,  venesection  (before  all  others),  emetics,  cathar- 
tics, fasting,  i.  e.  abstinence  from  food  (elevated  to  the  guiding  principle  in 
febrile  diseases  by  Brown  especially),  rest,  cold,  sweating  etc.  All  remedies 
are  irritating,  and  it  is  only  the  varying  quantity  which  gives  to  them  differ- 
ent efficacy  and  effect.  For  example  :  "  Suppose  that  the  sthenic  diathesis 
has  risen  to  the  grade  of  60  on  the  scale  of  irritation  We  must  then 
endeavor  to  remove  20  degrees  of  the  excess  of  irritation,  and  for  this 
purpose  we  must  employ  remedies  whose  stimulus  is  sufficiently  weak. 
Such  remedies  are  then  not  contra-stimulant,   but  weakening. 

The  pure  Brunonian  system,  in  comparison  with  other  far  less  logical  and 
ingenious  theories,  won  immediately  after  its  announcement  only  a  few  partisans  and 
opponents,  however  great  was  the  attention  which-  it  aroused  on  its  publication. 
Perhaps  the  important  occurrences  of  the  period  may  have  been  partial]}-  responsible 
for  this  —  an  explanation  which  applies  with  particular  force  to  France  —  but  the 
disagreeable  characteristics  of  its  founder  and  the  countermining  of  his  enemies 
(especially  the  highly  esteemed  Cullen),  contributed  their  share. 

1.   Particularly  Samuel  Lynch.     (H.) 


—  638  — 

In  sober  England,  above  all.  the  system  found  few,  indeed  no  important,  follow- 
The  better  known  of  these  were  Robert  Jones  (1782),  Samuel  Lynch  and 
Robertson.  Among  its  opponents  were  J.  F.  Latrobe  of  London,  who  wrote  his  disser- 
tation against  Brown  from  Jena  in  1795,  Trotter,  Robert  J.  Thornton  and  Beddoes, 
-who  has  been  already  mentioned,  and  even  ten  years  after  its  publication  it  was  diffi- 
cult to  find  supporters  of  his  system  in  Brown's  native  land.  John  Herdman  (died 
1842)  too  was  an  eminent  opponent  of  the  Brunonian  system. 

In  America  the  noble  Benj.  Rush  (1745-1813),  a  professor  in  Philadelphia,  dis- 
tinguished himself  as  a  follower  of  Brown. 

Among  the  Spanish  the  system  of  Cullen  enjoyed  the  precedence;  still  A.  Man- 
rzona,  Miljavila  y  Fisonel  and  others  were  partisans  of  the  Brunonian  doctrine. 

To  France,  which  at  this  period  was  introducing  into  politics  and  popular  life  a 
much  more  lasting  theory  of  irritation,  and  had  more  important  duties  to  perform 
than  to  attend  to  the  novelties  of  medical  S3"stems,  and  besides  was  beginning  prepara- 
tions for  a  new  system  of  her  own  in  medicine,  the  knowledge  of  the  Brunonian 
system  was  brought  by  Rud.  A.  Schieferli  (died  1837),  professor  of  surgery  and  mid- 
wifery in  Berne  (according  to  Reimarus  he  employed  belladonna  as  a  mydriatic),  and 
-iilj-equently  by  Bertin  and  Fouquier.  The  latter  translated  Brown's  "  Elementa  ". 
On  the  whole,  however,  Brown's  theory  attracted  little  notice. 

In  Italy,  on  the  other  hand,  Brown  found  numerous  and  important  followers. 
From  among  the  large  number  of  these  we  mention  :  the  kindred  of  J.  Peter  Frank; 
his  son,  the  most  renowned  and  important,  Joseph1  (1771-1841),  professor  in  Wilna 
and  Pavia,  who  in  1803  introduced  at  Vienna  with  good  success  the  cold  water  treat- 
ment of  typhus:  Peter's  nephews  Franz  and  Ludwig;  then  Scarpa  and  originally 
Rasori.  who  subsequently  founded  a  system  of  his  own;  Massini,  Pietro  Moscati 
(173G-1824)  in  Milan,  Brera,  Monteggia.  Opponents  of  the  system  were,  above  all, 
Vacca  Berlinghieri  and  Gaetano  Strambio,  Polidori  (his  pseudonym  was  Giac.  Sacchi) 
and  others  of  prominence. 

In  Germany,  the  far  famed  land  of  theories,  whither  the  Brunonian  system  found 
its  way  from  Italy,  the  theoiy  of  Brown  found  a  second  home,  after  it  had  been  origi- 
nally introduced  here  by  Girtanner  under  his  own  banner.  The  latter,  however,  was 
unmasked  by  M.  Ad.  Weikard  (1742-1803),  professor  in  Fulda,  then  ordinary  physi- 
cian of  the  famous  Catharine  II.  of  Russia,  and  finall}r  a  private  savant  and  the  great- 
est of  fanatics  in  Brunonianism.  The  so-called  "  Theory  of  Irritation  ",  however,  a 
modification  of  the  theorj'  of  Brown,  of  which  we  shall  speak  in  our  account  of  the 
19th  centur}",  produced  more  excitement  among  the  most  considerable  savants  of  our 
native  land. 

German  opponents  of  Brown  were  :  Stieglitz,  Chr.  Heinrich  Pfaff  and 
others,  especially  Hahnemann.     The  original  founders  of 

o.  Realism, 

which  attained  an  influential  development  in  the  19th  centur}',  were  of 
French  origin,  and  both  in  spirit  and  time  sous  of  the  great  Revolution. 
This  theory  was  first  laid  out  by 

Philippe  Pinel  (1745-1826),  of  the  hamlet  St.  Paul  in  the  dep:irt- 
ment  of  the  Tarne. 

Born  and  raised  in  poverty  as  the  son  of  a  village  physician,  Pinel  was  originally 

1.  His  monument,  erected  by  himself,  stands  on  Lake  Como.  It  has  certainly  failed 
to  preserve  his  remembrance  as  long  as  the  name  of  his  wife,  for  whom  Haydn 
wrote  the  rule  of  "Gabriel  "  in  his  "  Creation  ". 


—  639  — 

designed  for  the  Catholic  ministry,  and  it  was  not  until  he  hecame  thirty  years  of  age 
that  he  was  able  to  study  medicine  in  Toulouse  and  Montpellier.  This  he  did  with 
great  success.  When  he  subsequently  emigrated  to  Paris  he  was  at  first  compelled 
to  support  himself  by  teaching  geometry  and  by  preparing  translations,  until  in  the 
year  1792  he  received  an  appointment  to  the  HGpital  Bicetre  and  subsequently  to  the 
Salpetriere.  Doubtless  his  own  distress  had  warmed  his  heart  to  the  trials  of  others 
and  thus  facilitated  the  achievements  which  he  performed  in  behalf  of  the  suffering. 
Next  he  was  made  professor  of  hygiene  (in  the  French  medical  police)  and  soon  after 
professor  of  pathology  in  the  Ecole  de  Medecine  at  Paris.  In  1822  he  was  dismissed. 
Pinel  was  led  to  the  study  of  mental  diseases  and  their  treatment  (a  department  in 
which  his  name  marks  an  epoch)  by  the  accidental  circumstance  that  one  of  his 
friends,  who  had  become  insane,  escaped  into  the  forests  and  was  there  devoured  by 
wolves.  In  his  efforts  to  improve  the  lot  of  the  insane  he  turned  first  to  the  public 
authorities,  who  treated  him  as  a  "conservative"  and  "aristocrat",  names  at  that 
time  almost  equivalent  to  the  death  sentence.  Unterrified  at  this  l-eception,  he 
appeared  before  the  Common  Council  of  Paris  and  with  renewed  warmth  requested 
authorization  for  his  reforms.  "  Citizen",  said  Couthon  to  him,  "I  will  visit  thee  in 
the  Bicetre  to-morrow  morning,  and  woe  to  thee  if  thou  hast  deceived  us  and  conceal- 
est  enemies  of  the  people  among  thy  madmen."  Couthon  actually  came,  the  cries 
and  howls  of  the  insane,  concerning  whom  he  wished  to  make  inquiries,  soon  dis- 
gusted him,  and  he  said  to  Pinel:  "Ah,  citizen,  art  thou  thyself  a  madman,  that  thou 
desirest  to  turn  such  cattle  loose?  I  greatly  fear  thou  wilt  become  thyself  a  victim  of 
thy  preconceived  opinions!"  Still  Pinel  began  his  undertaking  the  same  day,  and 
struck  off  the  chains  of  a  number  of  his  patients.  (Griesinger.)  Was  not  this  a  most 
wonderful  courage  of  self-sacrificing  philanthropj-,  the  glory  of  which  reflects  upon 
our  whole  profession  ! 

Pinel  became  of  great  importance  in  the  development  of  general 
medicine  by  his  principle  of  substituting  exclusively  the  analytic,  or  so- 
called  natural-scientific,  method  for  the  s}rnthetic  method  heretofore  in 
vogue.  He  sought  to  determine  diseases  by  a  diagnosis  carefully  con- 
structed from  the  symptoms,  a  thing  which  he  considered  easy.  He  desired 
further  to  classif}7  them  in  accordance  with  their  pure  symptoms,  a  matter 
which  he  regarded  as  practicable,  inasmuch  as  he  considered  "  disease  "  a 
simple,  indivisible  whole,  composed  of  chief  symptoms,  following  each  other 
with  perfect  regularity,  and  varying  only  in  unessential  collateral  phenom- 
ena, and  capable  of  classification  like  the  objects  of  the  natural  sciences. 
Perhaps  the  artificial  classifications  of  Linne  and  others  may  have  supplied 
him  with  models.  Pathological  anatomy  he  subordinated  to  the  symptoms. 
Pinel,  accordingly,  regarded  even  fever  as  something  essential.  His  classes, 
in  the  second  place,  are  arranged  according  to  the  tissues.  He  divides 
diseases  into  fevers,  inflammations,  active  congestions,  neuroses,  diseases 
of  the  lymphatics  and  the  skin  and  undetermined  diseases.  Inflammations 
again  are  divided  into  those  of  the  mucous  membranes,  the  serous  mem- 
branes, the  muscles,  the  skin,  the  cellular  tissue  and  the  parenchyma. 
Fevers,  into  those  of  the  gastro-intestinal  coats,  mucous  membrane,  nervo- 
glandular  and  inflammatoiy  fevers,  fevers  with  atonj-  of  the  muscular  fibres 
and  ataxic  fever. 

The  depreciation  of  the  practical  aim  of  medicine,   subsequently  so 


—  640  — 

very  prevalent,  Pinel  already  unduly  promoted,  since  as  be  said  :  "  True 
medicine,  which  consists  much  less  in  the  prescription  of  drugs  than  in  the 
deeper  knowledge  of  diseases,  must  be  again  taken  up  and  cultivated  like 
a  branch  of  the  natural  sciences".  "  In  this  way  therapeutics  loses  much, 
and  (clinical)  pathology  gains  nothing"  (Daremberg). 

Although  Pinel  was  a  pupil  of  Barthez,  the  vitalistic  system  was 
placed  bjT  him  far  in  the  background.     On  the  other  hand 

Francois  Xavier  Bichat,  the  rarely  gifted  and  eminent  creator  of 
general  anatomy  (in  which  role  we  shall  learn  to  know  him  better  hereafter), 
embraced  this  system  in  all  its  completeness,  but  sought  to  found  it  upon 
a  realistic  or  analytic  basis.  He  completed  the  influence  of  Pinel  upon 
later  medicine  on  the  side  of  pathological  anatomy,  a  branch  held  in  slight 
esteem  by  the  latter.  Indeed  he  considered  the  observation  of  S3-mptoms 
alone  unfruitful,  provided  a  knowledge  of  their  anatomical  seat  was  wanting. 
The  principles  of  Pinel  — scientific  cultivation  of,  and  diagnosis  from,  the 
symptoms,  with  the  neglect  of  therapeutics  —  and  those  of  Bichat  —  the 
preponderance  of  pathological  and  microscopic  anatomy  —  were  subse- 
quently combined  into  the  new  medicine  of  the  19th  century,  without  taking 
into  further  consideration  the  forces  of  Bichat's  doctrine  —  The  tendency 
to  localize  diseases  was  common  to  both,  and  it  was  this  tendency  too  which 
assisted  French  medicine  in  obtaining  its  controlling  leadership  in  the 
following  age.  Bichat  denied  the  applicability  of  physical  laws  to  the  pro- 
cesses of  the  body. 

Bichat  calls  sensibility  and  contractility  (the  latter  a  term  for  Haller's 
irritability)  "vital  properties".  These  two  are  divided,  in  accordance  with 
the  two  kinds  of  life  set  forth  b}-  him  —  to  wit  :  "organic  life,  common  to 
animals  and  plants,  and  "  animal  "  life,  peculiar  to  animals  —  into  (a)  organic 
or  unconscious,  and  animal  or  conscious,  sensibility,  and  (b)  organic,  un- 
conscious (tonicity),  and  animal,  conscious  (irritability)  contractility.  These 
properties  are  active  for  a  considerable  period  onby,  and  this  period  of  their 
activity  we  call  life.  Life  is  a  constant  struggle  of  its  powers  against 
death,  not  (as  with  Brown)  something  extorted  by  force,  but  a  condition  of 
defence.  The  ultimate  limit  of  the  activity  of  these  properties  is  death. 
Besides  this  limited  term  of  activity,  the  invariability  of  the  laws  of 
inorganic  nature  is  not  inherent  in  them,  and  consequently  they  are  not 
amenable  to  estimation,  like  the  latter.  Hence  the  bodily  processes  cannot 
be  considered  from  the  same  point  of  view  as  chemical  and  physical  pro- 
cesses, since  the}'  are  separated  by  the  wide  chasm  which  lies  between 
constancy  and  inconstancy.  To  each  tissue,  as  we  shall  subsequently  learn 
them,  Bichat  too  assigns  a  special  kind  of  sensibility  and.contractility.  In 
the  glands  e.  g.,  and  the  serous  and  cutaneous  surfaces,  both  of  these  are 
unconscious.  The  cellular  tissue  possesses  no  animal,  but  organic  sensi- 
bilit}',  and  sensible  and  insensible  contractility.  The  nervous  system 
possesses  animal  sensibility,  but  no  animal  and  organic  contractility.  The 
arterial  vascular  system' has  no  animal,  sensible  contractility,  rarely  very 


—  641  — 

marked  insensible,  organic  contractility  and  sensibility.  The  venous  system 
has  no  animal  sensibility  and  contractility  etc.  Each  of  these  tissues 
draws  from  the  blood  the  materials  related  to  its  special  powers. 

Though  Bichat  embraced  chiefly  the  pathological  views  of  Solidism, 
still  he  was  not  partial,  but  allowed  to  the  blood  or  the  fluids  a  certain  role, 
and  even  vitality. 

"Almost  all  the  phenomena  of  disease  point  to  the  solids,  but  the  causes  may- 
lie  in  the  fluids  as  well  as  the  solids.  An  example  will  make  this  manifest:  the  heart 
may  contract  abnormally  1.,  because  the  organic  sensibility  is  elevated,  while  the 
blood  remains  normal:  2.,  because  the  blood  is  increased,  as  in  plethora,  or  altered, 
as  in  putrid  fever  etc.,  while  the  organic  sensibility  is  unchanged.  Should  the  excita- 
tion be  doubled,  or  the  organ  be  twice  as  susceptible  as  usual,  the  effect  is  always  the 
same:  there  is  an  acceleration  of  the  pulse.  It  is  always  the  solids  which  play  the 
primary  role  in  disease.  It  is  impossible  to  sa}r  what  '  vitality  of  the  fluids'  is,  but 
nevertheless  it  exists,  and  the  chemist  who  analyses  the  fluids  has  only  their  corpse,, 
as  the  anatomist  has  only  the  cadaver  of  the  solids." 

Diseases  he  declared  to  be  alterations  of  the  vital  properties.  The  "  vital  prop- 
erties" of  each  individual  tissue,  however,  differ  from  those  of  every  other  tissue. 
Hence  the  morbid  alteration  of  each  individual  tissue  must  differ  from  that  of  all' 
others,  so  that  in  every  living  organism  composed  of  different  tissues,  one  of  these 
tissues  may  be  diseased  while  the  rest  continue  sound. 

The  task  of  therapeutics  is  to  restore  to  its  normal  condition  the 
proper  vitality  of  the  parts.  Bichat's  last  project  was  to  submit  the 
materia  medica,  the  weapons  of  the  physician,  to  an  extended  and  thorough 
proof. 

The  foregoing  consideration  of  the  greater  and  lesser  systems,  the 
theories  and  schools  of  the  18th  century,  certain!}-  awakens  at  first  a  feel- 
ing of  respect  for  the  men  (most  of  them  possessed  of  intellectual  import- 
ance), who  desired  to  win  for  medicine,  as  had  been  done  for  the  other 
sciences,  the  benefit  of  an  adaptation  and  mastery  of  the  immense  material 
and  the  ever-changing  phenomena  of  healthy,  and  especially  of  diseased, 
life,  by  means  of  one  or  more  principles  utilized  in  the  formation  of  a 
system.  On  the  other  hand,  there  arises  too  at  once  a  feeling  of  dis- 
appointment, that  such  great  intellectual  power  and  intellectual  labor 
should  have  been  employed,  if  not  fruitlessly,  at  least  without  an}-  corres- 
ponding and  permanent  benefit  to  science,  and  above  all  to  life  ;  that, 
indeed,  these  should  have  been  sacrificed  in  that  strife,  which  in  medicine 
seems  unable  to  lead  to  an}-  equivalent  result.  For  medicine,  as  the  science 
of  both  healthy  and  morbid  life,  like  life  itself,  cannot  be  compressed  into 
a  system.  Its  very  essence,  like  that  of  life,  is  development.  Hence  neither 
is  adapted  to  any  rigid  system  of  reasoning  which  aims  at  absolutism. 
This  fact  is  very  strikingly  shown  in  the  history  of  the  theories  of  the 
18th  century. 

Two  other  lessons,  however,  are    furnished   us  by  the  systematizing 

struggles  of  the  physicians  of  the  last  century.     The  first  is  this  :  that,  as 

we  emphasized  at  the  outset,  in  almost  all  "new"  systems  old  principles 

exclusively,  or  at  least  chiefly,  reappear.     The  second  is  that  in  the  hurry 

41 


—  642  — 

and  work  of  the  day,  histoiy,  and  particularly  medical  history,  is  never,  or 
at  least  never  deliberately,  consulted,  in  order  to  guard  against  the  repeti- 
tion of  by-gone  theories  and  fruitless  efforts  —  a  fact  which  we  observe 
even  at  the  present  day.  And  yet  history  is  the  subliraest  of  all  experi- 
mental sciences,  to  which  in  medicine  certainly  the  view  should  be  always 
and  everywhere  directed.  But  u  physicians  seem  to  be  condemned  to  the 
fate  of  rarely  discovering  the  golden  via  media  of  truth  between  the 
by-paths  of  error."     (Hecker  Sr.) 

3.    PHYSICIANS  EMINENT  AS  PRACTITIONERS.  CULTIVATORS  OF  PRACTICAL 
SUBJECTS,  MEDICAL  GEOGRAPHERS  AND  HISTORIANS. 

Besides  the  long  list  of  Systematists  already  mentioned,  and  their  still 
more  numerous  followers,  there  towers  up  a  number  of  physicians  who 
shunned  the  ostentation  of  creating  s}-stems  and  did  not  yield  allegiance, 
or  at  least  yielded  no  unconditional  allegiance,  to  any  of  the  existing 
systems,  though  the}*  enriched  science  and  advanced  practical  medicine  in 
a  greater  or  less  degree.  Among  these  belong,  above  all,  quite  a  number 
of  important  practising  physicians,  who  in  general  occupied  during  the 
18th  century  a  much  higher  and  more  respectable  (because  a  more  inde- 
pendently scientific)  position  than  is  the  case,  on  the  whole,  in  our  own 
age,  where  university  influences  predominate.  That  fame  which  some  of 
these  men  were  compelled  to  do  without  among  their  systematizing  con- 
temporaries, posterity  has  given  them  in  abundance.  This  fate  befell, 
above  all  (and  in  a  way  not  even  remotely  anticipated  by  himself),  that 
modest  Viennese  practitioner  and  great  inventor  —  not  accidental  discoverer 
—  of  thoracic  percussion,  -■  the  true  compass  of  medicine  ", 

Leopold  Auenbrugger,  a  nobleman  of  Auenbrugg.  We  place  him  at 
the  head,  because  to  him  is  due  a  great  part  of  the  advancement  of  modern 
diagnosis.  In  Auenbrugger  too  was  approved  that  law  of  historical  culture, 
that  it  is  not  the  most  learned,  but  ever  the  most  gifted  alone,  who  enrich 
science  through  new  discoveries  which  impress  their  stamp  upon  the  future. 

Of  Auenbrugger' s  life  our  knowledge  is  only  fragmentary.  He  was  the  offspring 
of  the  union  of  the  well-to-do  inn-keeper  Sebastian  Auenbrugger  and  Maria  Theresa, 
nee  Kaschutnik,  both  of  Graz  in  Stej^ermark.  He  was  born  Nov.  19,  1722.  He  had 
several  sisters,  of  whom  nothing  further  is  known.  He  lost  his  father,  a  respectable 
and  charitable  man,  in  the  j'ear  1743.  Auenbrugger  studied  the  humanities  and 
philosophy  in  his  native  city.  His  special  professional  studies  he  pursued  in  Vienna, 
where,  after  their  completion,  he  occupied  himself  for  several  years  as  a  simple 
practising  physician.  In  the  year  1751  he  received  the  charge  of  the  Spanish  military 
hospital  and  the  hospital  of  the  Hoi}'  Trinity,  without  at  first,  however,  obtaining  any 
salary  for  his  labor.  He  accepted  the  position  only  to  be  able  to  apply  himself  to  his 
independent  studies  better  than  was  possible  in  private  practice.  His  marriage  with 
the  beautiful  Marianne  von  Priestersberg,  twenty-four  years  of  age,  took  place  Nov. 
18,  1754.  From  this  union  descended  two  daughters,  one  of  whom  died  early,  while 
the  other  married  a  baron  of  Zois-Edelstein,  of  whose  two  daughters  one  again  died  in 
early  life.  Some  descendants  of  Auenbrugger's  granddaughter  are  still  living. 
Auenbrugger  himself  died  of  senile  asthenia  May  9,  1809,  aged  87  years. 


—  643  — 

His  invention,  so  pregnant  with  results  (Inventum  novum  etc.,  17G1)  and  which 
5ie  tested  for  seven  years  before  its  announcement,  was  made  during  the  period  of  his 
activity  in  the  Spanish  hospital.  During  his  lifetime,  at  least  during  that  portion  of 
it  in  which  he  was  capable  of  active  work,  it  remained  unnoticed,  misunderstood  and 
-even  designedly  opposed,  and  of  course  de  Haen  was  at  the  head  of  this  opposition. 
The  only  notable  exceptions  to  this  statement  were  Stoll  and  his  pupil  Eyerell. 
Nothing  good  is  done  in  a  hurry,  and  whatever  is  quickly  recognized  and  at  once 
-adopted  with  enthusiasm,  is,  as  a  rule,  of  but  short  duration —  such  are  the  teachings 
of  the  history  of  medicine.  But  had  not  Corvisart  in  1808  translated  his  treatise  into 
French  —  Rossiere  de  la  Chassagne  had  done  the  same  as  early  as  1770  —  and  above 
all  had  he  not  maintained  Auenbrugger's  right  of  possession,  and  elevated  his  inven- 
tion by  the  prestige  of  his  own  name  and  position,  the  name  of  the  German  would 
probably  be  known  only  as  that  of  a  man  who  ventured  to  have  a  fruitful  idea  in 
advance  of  a  famous  Frenchman.  We  quote,  therefore,  to  Corvisart's  honor,  his 
•expression  on  this  point:  "I  know  very  well  how  little  reputation  is  allotted  to  trans- 
lators and  commentators,  and  I  might  easily  have  elevated  myself  to  the  rank  of  an 
author,  if  I  had  elaborated  anew  the  doctrine  of  Auenbrugger  and  published  an 
'independent  work  on  percussion.  In  this  way,  however,  I  should  have  sacrificed  the 
name  of  Auenbrugger  to  my  own  vanity,  a  thing  which  I  am  unwilling  to  do.  It  is 
he,  and  the  beautiful  invention  which  of  right  belongs  to  him,  that  I  desire  to  recall 
:to  life.  Such  unreserved  acknowledgement  on  the  part  of  an  eminent  French  phy- 
sician cannot  be  sufficiently  contrasted  with  the  disparagement,  the  envy,  the  mis- 
conception and  the  stupidit.y  of  the  German  medical  specialists  of  that  day  and  their 
following!  Auenbrugger  too  foresaw  it  all:  "I  have  very  well  foreseen  that  I  shall 
meet  with  great  opposition  as  soon  as  I  have  published  my  invention,  for  envy, 
malevolence,  hatred,  jealous  disparagement  and  even  slander  have  never  been 
•wanting  to  men  who  have  either  glorified  or  perfected  the  sciences  and  arts  by  their 
discoveries." 

As  regards  the  character  of  Auenbrugger,  all  accounts  agree  that  he  was  an 
indefatigable  worker,  always  kindly  disposed  and  charitable,  so  that  many  a  poor 
student  owed  to  him  his  success.  He  was  a  great  friend  of  music  and  the  arts  in 
general,  and  had  himself  written  an  opera  "Die  Rauchfangkehrer  "  (The  Chimney- 
sweeps). The  following  is  an  eminently  characteristic  trait.  When  Auenbrugger  in 
1768  resigned  his  duties  in  the  Spanish  hospital,  he  was  offered  his  choice  between  an 
annual  pension  of  400  marks  ($100)  and  elevation  to  the  nobility.  He  chose  the 
former.  Subsequentl}',  indeed,  he  received,  at  his  own  request,  a  patent  of  nobility 
from  the  emperor  Joseph  II.  But  we  may  conjecture  rather  that  his  wife  and 
•daughter  were  the  occasion  of  this  request,  than  assume  that  he  himself  was  foolish 
enough  to  have  the  slightest  desire  for  nobility.  For  he  had  already  attained  the 
truest  nobility  b^y  his  discover^-. 

Posterity  too  has  created  for  him  a  monument,  not  of  glittering  metal,  but  one  in 
his  own  opinion  much  more  valuable.  In  his  home,  years  ago  —  under  the  lead  of 
Franz  Clar,  professor  of  general  pathology  and  pharmacology  in  Graz,  a  man 
deserving  of  fame  for  this  action — an  "Auenbrugger  Stiftung"  was  founded,  from 
the  interest  of  which  needy  students  of  medicine  and  physicians  are  supported,  and 
Piorry,  the  inventor  of  the  pleximeter,  has  to-day  no  occasion  to  remark  that  had 
Auenbrugger  been  a  Frenchman  a  monument  would  have  been  erected  long  ago  to 
his  memory.  The  debt  of  the  whole  German  people  has  been  discharged  by  the 
German  Austrians! 

While  the  surgical  diagnosis  of  the  Ancients  employed  (as  we  have 
-seen  with  Paul  of  JEgina  and  others)  sounds,  specula  etc.,  their  internal 


—  G44  — 

diagnosis  was  limited  almost  exclusively  to  the  simple  employment  of  the 
unarmed  senses.  The  latter,  even  as  early  as  the  Hippocratists.  were 
specially  cultivated  for  this  very  purpose,  particularly  the  senses  of  sight 
and  feeling.  Whether  magnifying  glasses  too  were  employed  by  them  for 
diagnostic  purposes  is  uncertain.  Santoro  was  the  first  to  use  the  balance, 
an  enumerator  of  the  pulse,  and  a  sort  of  thermometer  and  hygrometer  ; 
Boerhaave  employed  the  thermometer  in  the  axilla  and  made  use  of  the 
simple  lens  ;  John  Floyer.  and  after  him  Haller.  utilized  even  the  watch 
marking  seconds.  The  ear  had  been  earh-  employed  in  auscultation  and  in 
the  percussion  of  tympanites  and  ascites.  Indeed  the  Salernian  physicians, 
basing  their  action  upon  the  Ancients,  had  thus  utilized  the  hearing.  But 
a  diagnosis  of  diseases  of  the  great  viscera  had  never  been  attempted  in 
this  way.  until  finally  Auenbrugger  independently  brought  to  light  an 
ingenious  use  of  the  .ear,  which  opened  the  way  for.  and  gave  the  impulse 
to.  a  clearness  in  the  recognition,  especially  of  diseases  of  the  chest  and 
abdomen,  heretofore  unattained  and  unattainable.  This  method  was  tapping 
against  the  chest,  percussion.  He  made  the  simple  observation  that  "  the 
chest  of  the  healthy  man  resounds  when  it  is  percussed  ".  tested  his  idea 
for  seven  years,  and  then  wrote  in  17G1  his  "Inventum  novum  ex  percus- 
sione  thoracis  humani  ut  signo  abstrusos  interni  pectoris  morbos  detegendi  ", 
in  which,  among  other  things,  he  says  with  great  simplicity  : 

••  I  lay  before  you,  benevolent  reader,  a  new  sign  for  the  elucidation 
of  the  diseases  of  the  chest,  discovered  by  me.  This  consists  in  the  percus- 
sion of  the  human  thorax,  by  the  varying  resonance  of  whose  tones  (ex  cujus 
sonituum  resonantia  varia)  a  judgment  may  be  formed  as  to  the  internal 
condition  of  this  part.  ...  I  have  written  what  I  have  again  and 
again  proved  by  the  testimony  of  the  senses  with  much  labor  and  fatigue  : 
nor  have  I  ever  given  place  therein  to  seducing  self-love." 

Like  a  great,  and  consequently  a  humane,  physician,  he  concludes  his 
work  as  follows  : 

•'  May  what  I  have  written  conduce  to  the  comfort  of  the  unfortunate 
sick,  and  to  the  advantage  of  the  true  cultivators  of  medical  art.  Such  is 
my  desire  !  " 

His  invention  was  thus  designed  above  all  to  benefit  the  sick,  not  to 
become  merely  a  subject  of  study  in  itself,  a  degradation  which  a  later  age, 
involved  in  French  precision  (so-called),  objectivity,  and  therapeutic  help- 
lessness, and  forgetful  of  the  design  of  all  diagnosis  and  of  all  medical 
knowledge  and  investigation — the  cure  and  alleviation  of  disease  — 
stamped  upon  it. 

Other  writings  of  Auenbrugger  were:  "  Ueber  die  stille  Wuth  oder  den  Trieb  zuni 
Selbstmord,  als  einer  wirklichen  Krankheit."  Dessau,  1773  ;  "  Experimentura  nascens 
de  remedio  specifieo  in  mania  virorum.     Vienna?,  1776. 

During  the  last  century  Auenbrugger's  invention  attained  but  sparing  recognition. 
Even  in  lbf>:>  Sprengel  wrote  "  It  is  scarcely  credible  that  he  —  Auenbrugger — could 
have  diagnosticated  any  diseases  of  the  lungs  and  thorax  by  means  of  the  resonance.' 
—  Besides  the  physicians  already  mentioned  and  the  ingenious  Uuzer, 


—  645  — 

Johann  Ernst  Wichmann  (1740-1802)  of  Hanover,  author  of  "  Ideen 
zur  Diagnostik "  and  creator  of  the  scientific  department  of  diagnosis, 
must  be  classed  among  those  who  bestowed  some  attention  upon  the  new 
acquisition,  although  he  did  not  recognize  its  significance.  Wichmann  was 
the  first  (in  1786)  to  designate  the  itch-mite,  or  rather  its  transfer  from 
man  to  man,  as  the  cause  of  the  contagiousness  of  the  itch,  a  fact  which 
he  demonstrated  upon  himself,  after  Bonomo,  a  hundred  3-ears  before,  had 
called  attention  to  it  as  a  fact  observed  by  the  common-people. 

Wichmann's  father  was  a  Wundarzt,  and  lie  was  himself  destined  for  this  calling; 
in  tact  he  had  already  flourished  the  barber's  bowl  when  be  entered  the  gymnasium. 
He  went  to  Gottingen  in  1759  and  graduated  in  1762.  After  remaining  for  a  long 
time  in  Paris  he  became  disgusted  with  French  medicine  and  went  to  London,  where 
the  eminent  physician  John  Prinjile  (1707-1782)  was  his  teacher.  In  1764  Wichmann 
returned  to  Hanover,  but  it  was  a  considerable  time  before  he  and  Werlhof  succeeded 
in  practice.  At  an  early  age  too  he  became  somewhat  deaf.  After  he  had  been 
court-physician  for  23  years  without  pay,  on  the  death  of  Zimmermann  he  was 
appointed  second  physician-in-ordinary.  Wichmann  was  highly  esteemed  as  a 
physician  and  writer,  and,  like  the  Hanoverian  ordinar}'  physicians  to  be  mentioned 
hereafter,  he  was  famous  as  a  great  practitioner. 

The  following  extracts  from  the  already  mentioned  work  of  Rohlfs  on  the  medical 
classical  writers  of  Germany  ma}'  serve  to  exhibit  Wichmann's  method  of  observation 
and  thought.  They  are  partially  applicable  too  to  the  present  day,  and  show  the 
judgment  of  the  past  upon  our  "  modern  "  methods.  "  There  are  fashions  in  medicine, 
to  which  ever}'  physician  must  be  a  slave,  unless  he  is  willing  to  be  considered  old- 
fashioned,  or  to  be  laughed  at  by  his  colleagues.  The  only  trouble  is  that  these 
fashions  of  physicians,  like  other  fashions,  are  changeable,  though  they  seem  to  be 
profitable,  for  they  come  into  vogue.  .  .  .  Eighteen  years  ago  it  was  the  fashion 
in  all  Europe,  as  it  is  again  to-da}',  to  employ  electricity  upon  paralyzed  patients,  but 
the  fashion  lasted  only  nine  years.  Medical  fashions  in  general  have  also  this 
similarity  to  others,  that  they  usually  recur  every  nine  or  ten  years."  —  "It  is  not 
simply  the  exanthematous  diseases  that  are  contagious.  There  are  many  which 
infect  more  slowly  through  association  in  rooms  and  beds,  as  gout,  diarrhoea,  whoop- 
ing-cough, intermittent  fever,  through  the  breath  or  sweat  in  beds.  This  cannot 
surprise  us.  Even  the  expired  air  of  a  man  acts  as  a  poison.  In  this  way  consump- 
tion is  communicated.  We  observe  it  most  common]}'  in  married  persons.  From 
Galen  to  Maret '"  (father  of  the  subsequent  Duke  of  Bassano)  "in  1779,  consumption 
has  always  been  considered  infectious.  Morton  even  maintained  infection  from 
coitus.  Undoubtedlj-  a  susceptibilitj'  is  always  associated  with  it."  —  Wichmann 
engaged  in  testing  the  cutaneous  sensibility  bj"  means  of  pieces  of  gold  or  other 
metals,  a  procedure  subsequently  styled  "  metalloscopy  ",  particularly  by  the  French 
physician  Dr.  V.  Burq  (1823-1884),  who  rediscovered  the  method  towards  the  close 
of  the  forties  and  built  upon  it  a  system  of  "  metallotherapy  ".1 

Before  Wichmann,  and  for  a  long  period  contemporary  with  him,  there  also  lived 
in  Hanover  the  eminent  observer,  far-famed  practitioner  and  poet  —  "one  of  the  most 
distinguished  physicians  of  his  time"  (Sprengel) — 

Paul  Gottlieb  Werlhof  (1699-1767)  of  Helmstiidt, 
where  he  had  studied.     At  the  age  of  twenty  years  he  settled  in  Peine,  near  his  birth 
place,  to  test  by  practice  what  he  had  learned.     After  five  }ears,  however,  he  went  to 

1.  "Metallotherapie,  nouveau  traitement  par  les  applications  metalliques",  Paris,  1853. 


_  646  — 

Hanover,  where  the  two  physicians  Hugo  and  Plohr  assisted  him,  like  genuine 
colleagues;  for  at  that  time  to  be  a  colleague  was  not  to  be  an  enemy.  In  this  way 
he  speedily  attained  practice,  and  declined  a  professorship  in  his  native  city  because 
a  practical  career  was  more  valuable  to  him  Accordingly  he  was  appointed  court- 
physician.  He  had  already  distinguished  himself  as  a  writer.  Though  he  was  a 
German  poet,  he  wrote  all  his  scientific  works  in  Latin  because  this  tongue  alone 
was  respected  by  savants.  He  knew  how  to  handle  the  Latin  in  a  masterly  manner, 
and  was  also  a  complete  master  of  English,  French  and  Swedish.  This  knowledge  of 
modern  languages  was  decidedly  exceptional  among  the  savants  of  that  day.  In 
1743,  after  making  the  campaign  which  was  decided  by  the  victory  near  Dettinjren  on 
the  Main  (June  27),  Werlhof  was  appointed  physician-in-ordinary  to  George  II.  In 
this  position  he  attained  world-wide  fame  as  a  practitioner  and  writer,  and  was  inde- 
fatigable in  his  exertions  to  elevate  science.  His  relations  with  Haller  were  active 
and  friendly.  In  his  old  agche  was  long  tormented  by  the  gout,  and  he  died  finally 
of  apoplexy. 

Werlhof  s  fame  has  been  preserved  to  us  until  recently  b}-  the  name 
of  the  morbus  maculosus  Werlhofii,  which  he  first  described.     He  merits 
high  honor  for  his  early  struggle  to  establish  in  Germany  the  use  of  the- 
cinchona,  and  in  the  last  century  he  was  esteemed  an  historian  and  a  prac- 
tical writer  of  the  first  rank. 

The  most  widel}T  known  among  the  Hanoverian  physicians,  particularly  by  his 
works:  "  Ueber  die  Erfahrung  in  der  Arzneikunst" ;  "  Leber  die  Einsamkei/t" ; 
"Leber  den  Nationalstolz"  etc.,  was  undoubtedly 

Joh.  Georg  Zimmermann  (1728-1795),  of  Brugg  in  the   canton  of 
Berne. 

The  son  of  a  German-Swiss  senator  and  a  French-Swiss  mother,  both  of  whom 
belonged  to  this  well-known,  dual-tongued  canton,  Zimmermann  himself  like  almost 
all  the  German  inhabitants  of  this  canton  to-day,  spoke  and  wrote  as  good  German 
as  French.  At  the  age  of  fourteen  he  came  to  Berne,  and,  after  acquiring  the  requisite 
preliminary  education,  attended  the  university  of  Gottingen,  where  his  great  country- 
man Haller  was  teaching.  The  latter,  in  accordance  with  a  good  old  Swiss  custom,. 
assisted  his  young  countryman  in  ever}-  possible  way,  and  under  his  direction 
Zimmermann,  at  the  expiration  of  four  years,  wrote  his  dissertation  "De  irritabihtate". 
Six  months  later  he  visited  Holland  and  Paris,  and  in  1752  came  to  Berne,  whence 
he  removed  as  Physicus  to  his  native  city.  Here  he  formed  a  lifelong  friendship  with 
Tissot.  His  widely  famous  works  also  originated  during  his  residence  in  Brugjr.  As- 
the  result  of  his  writings  Zimmermann  became  a  fellow  of  many  learned  societies, 
received  a  call  to  become  ordinary  physician  to  the  famous  premier  of  Mayence, 
Count.  Stadion,  and  afterwards  to  Poland  and  Soleure.  At  the  latter  place,  however, 
some  doubt  was  entertained  whether  Zimmermann,  being  a  Protestant,  would  hold' 
his  patients  to  timely  confession  and  the  communion  of  the  actual  body  of  Christ, 
and  his  removal  here  was  accordingly  broken  off.  Instead  he  went  in  the  year  1 7GS- 
to  Hanover  as  ordinarj'  phvsician  and  the  successor  of  Werlhof.  In  this  position, 
which  he  had  always  desired,  Zimmermann  likewise  did  not  find  entire  satisfaction. 
He  suffered  continually  from  Swiss  homesickness,  and  was  also  visited  by  severe 
bodily  suffering.  An  operation  for  hernia,  undertaken  in  1770,  and  in  which  the 
opposition  of  Schmucker  and  Theden  is  said  to  have  proved  serious  in  its  resulis  to 
Zimmermann,  did  not  help  him  in  these  troubles.  In  1782  he  married  for  the  second 
time.  Misfortune  and  disease,  however  (combined  perhaps  with  hereditarj-  tenden- 
cies), at   last  brought  his   misanthropy  to  an  open  outbreak.     In  character  Ziramer- 


—  647  — 

mann  was  fickle  and  stubborn,  and,  like  an  American,1  vain  of  the  highest  acquaint- 
anceship. "  What  saj7  you,  my  dear  friend,  to  this  correspondence  with  a  lady 
(Catharine  II.),  who  just  now  orders  250,000  men  to  march  against  the  Turks?" 
"As  knight  of  the  third  class  I  am  associated  with  princes,  admirals,  generals  etc." 

Zimmermann  was  a  man  of  ingenious  endowments,  and  a  physician 
who,  like  Boerhaave  and  Werlhof,  enjo3"ed  a  world-wide  reputation.  In 
medical  science  he  merits  our  special  regard  from  the  fact  that  he  endeavored 
to  free  it  among  the  public  from  the  reputation  of  a  secret  art,  a  reputation 
which  it  still  retains  among  the  laity. 

Another  among  the  Hanoverian  physicians-in-ordinary, 

L.  F.  Benjamin  Lentin  (1736-1804), 
had  distinguished    himself,  before    his  installation    in    office  and  during   his  earlier 
residence  at    Klausthal,  as  a  writer  on  practical  subjects  and  as  an  observer.     (His 
son  Jac.  Fried.  Ludwig,  1776-1803,  was  also  a  physician).     The  following  physicians 
are  also  worth}'  of  notice: 

Balth.  Ludwig  Tralles  (1708-1797)  of  Breslau, 
to  whom  Hensler  addressed  liis  famous  letters  on  inoculation,  and  who  was  indiscreet 
enough  to  write,  like  a  blockhead,  in  opposition  to  Lessing; 

Joseph  von  Qtjarin  (1734-1814), 

son  of  Peter  Quarin  (until  1794  professor  of  medicine  in  Vienna)  and  ordinary 
physician  of  Joseph  II.,  and  (a  matter  of  course  in  Austria)  likewise  a  count. 
Graduating  at  Freiburg  in  Breisgau  as  early  as  his  18th  year,  he  came  to  Vienna 
and,  on  the  completion  of  the  general  hospital,  was  made  its  phj'sician-in-chief. 
Even  in  the  choice  of  his  physicians  Joseph  II.  had  no  success.  —  Quarin  wrote 
"Animadversiones  practicse  in  diversos  morbos";  "Commentatio  de  curandis  febribus 
et  inflammationibus  "  etc. 

Other  physicians  eminent  for  their  practical  and  scientific  ability  were  : 
Rud.  Augustin  Vogel  (1724-1774)  ;  Karl  Strack  (1726-1806),  who  dis- 
tinguished himself  by  his  observations;  Sam.  Gottl.  Vogel  (1750-1837), 
originally  in  Gottingen,  then  ordinary  physician  of  Mecklenburg,  and 
author  of  a  famous  text-book  on  diagnosis  ;  the  elder  Job.  Chr.  Stark  (1753- 
1811)  of  Jena,  distinguished  for  his  "  Dissertatio  de  tetano";  Marcus  Herz 
(1747-1803),  a  famous  physician  of  Berlin  ("  Briefe  an  Aerzte  ",  "  Versuch 
iiber  den  Schwindel  "  etc.),  who  was  himself  a  friend  of  Kant,  and  his  wife 
Henriette  —  a  characteristic  of  the  time  —  the  "  bosom  friend  '"  of  Schleier- 
macher  ;  Christian  Gottlieb  Selle  (1748-1800)  of  Berlin,  ordinary  physician 
and  president  of  the  medico-chirurgical  college  ;  Job.  Ludwig  Formey 
(1766-1823),  likewise  a  famous  practitioner  in  Berlin.  Chr.  G.  Gruner  must 
also  be  mentioned  here  as  the  author  of  an  excellent  treatise  on  semeiology, 
and 

Karl  Aug.  Wilhelm  Berends    (1759-1826)  of  Anklam, 
professor  in  Frankfort-on-the-Oder,   Breslau  and   Berlin  ("  Vorlesungen    iiber   prak- 
tische  Arzneiwissenschaft",   1827,  published  by  Karl  Sunderlin).  —  Equally  great  as 
a  man,  a  teacher  and  a  physician,  and  still  more  eminent,  if  possible,  for  his  steady 
observance  of  the  objects  of  practice,  was  the  ingenious  pioneer 

I.   How  comforting  to  find  American  "toadyism"  shared  by  even  a  "fickle  and 
stubborn  "  Swiss  !    (H.) 


—  648  — 

Joh.  Peter  Frank  (1745-1821), 
the  founder  of  medical  police  as  a  distinct  department  of  science,  and  a 
man  sprung  from  povert}',  want,  and  the  varied  limitations  of  rustic  sim- 
plicity. His  ideas  and  aims  are  exhibited  in  the  following  characteristic 
passage  more  fairly  than  could  be  done  by  most  teachers  :  "This  I  quietly 
remarked,  and  it  conduced  to  my  great  happiness  to  be  able  to  convince 
myself,  that  my  pupils  did  not  swear  by  the  words  of  their  teacher,  but 
dubiously  and  with  an  anxious  desire  for  knowledge,  betook  themselves  to 
the  sick-bed  as  to  a  trusty  touch-stone.  Proved  by  this,  not  only  I  myself, 
but  also  these  pupils  of  mine,  have  for  man}'  years  recognized  much  of  that 
which  had  been  esteemed  as  genuine  gold  to  be  base  metal  and  of  bad 
standard.  Thus  doubt  upon  doubt  grew  up  among  my  hearers,  and  when 
the}'  had  gradually  and  imperceptibly  abandoned  the  profitless  swarm  of 
hypotheses,  a  short  time  before  so  highly  prized,  then  first  they  became 
that  which  I  wished  them  to  be,  friends  of  the  truth,  not  of  learned  ostentation, 
unwearied  and  eager  for  each  new  ray  of  light,  whatever  its  source.  Hence 
too  it  was  rare  for  my  pupils  to  abandon  my  views."  The  character  of  a 
truth-loving  practitioner  is  shown  in  his  remark  that  in  his  younger  years 
his  patients  dreaded  him,  but  that  now,  in  his  old  age,  he  himself  dreaded 
his  patients. 

Born  in  the  little  hamlet  of  Rodalben,  in  the  present  Bavarian  Palatinate,  Frank, 
at  the  age  of  nine  months,  was  literally  cast  before  the  door  of  a  merchant  by  his 
cruel  father  who  was  irritated  by  his  cries,  and  at  the  age  of  four  years  was  almost 
smothered  by  a  crowd  of  bo}rs  falling  upon  him.  When  nine  years  old,  the  pupil  of 
a  Piarist  school  at  Rastadt,  he  was  to  have  been  sent  to  Italy  and  there  castrated 
because  he  had  a  fine  voice.  From  this  fate  he  luckily  escaped,  and  subsequently 
studied  at  Pont  a  Mousson  near  Metz,  in  Heidelberg  and  Strassburg.  At  the  age  of 
24  Frank  was  made  court  and  garrison  physician  in  Rastadt,  three  years  later 
ordinary  physician  at  Bruchsal,  and  in  1784  a  professor  in  Gottingen.  In  the  follow- 
ing year,  however,  he  went  thence  to  a  similar  position  at  Pavia,  and  in  1786  was 
made  Protophysicus  and  general  director  of  sanitary  affairs  in  Lombardy.  In  1795 
he  came  in  a  similar  capacity  to  Vienna  to  direct  army  medical  affairs,  was  made  an 
aulic  counsellor  and  director  of  hospitals.  Here  too,  in  conjunction  with  his  pro- 
sector, Aloys  Rud.  Vetter  (born  1765),  subsequently  professor  of  anatomy  and 
physiology  in  Krakau,  he  founded  a  museum  of  pathological  anatomy.  In  1804 
Frank,  disgusted  with  bureaucratic  chicanery,  removed  to  Wilna  as  clinical  professor, 
then  went  to  St.  Petersburg  as  ordinary  physician  and  counsellor  of  state,  but  in  1808 
allowed  himself  to  be  pensioned  in  order  to  devote  himself  to  his  muse  in  the  glorious 
and  unrivalled  Freiburg  in  Brisgau.  But  in  Freiburg  too  be  was  not  permitted  to 
remain  long.  In  1811  he  returned  to  Vienna,  and  died  there  a  practitioner  as  he  had 
begun. —  His  pupils  were  enthusiastically  devoted  to  him,  and  the  famous  surgeon 
Walther,  his  younger  countr3'man,  said  of  him:  "No  one  made  so  elevating  and 
permanent  an  impression  upon  me  as  J.  P.  Frank.  His  teachings  fell  upon  sus- 
ceptible minds  like  the  moistening  dew.  It  was  not  simply  the  mass  of  learning 
which  we  acquired  but  the  stimulus  to  independent  investigation  and  the  inner  un- 
folding of  the  mind,  bursting  as  it  were  its  fetters,  which  we  owe  to  him."  He 
founded  in  his  home  an  institution  for  the  care  and  education  of  poor  children. — 
His  chief  works  were  his  "Epitome  de  curandis  morbis"  (often  printed  in  spite  of 
its  six  volumes,  and  translated  into  French  by  Gaudereau)  and  his  ingenious  system 


—  649  — 

•of  medical  police  ("  System  einer  vol  1  standi  gen  medicinischen  Polizey"),  of  which 
•we  shall  speak  hereafter. 

It.  is  related  of  Frank  that,  in  accordance  with  his  mental  characteristics,  he  did 
not  forget  his  humor  even  beside  the  bed  of  death.  On  one  occasion  eight  physicians 
were  sitting  upon  the  bed  of  a  dying  patient,  when  Frank  remarked:  "This  reminds 
me  of  the  grenadier  of  Wagram,  who,  when  hit  by  eight  balls,  cried  out  'Sapperment! 
It  takes  eight  bullets  to  kill  a  French  grenadier!"  On  another  occasion  when  greater 
economy  in  the  management  of  his  hospital  patients  had  been  prescribed  to  him,  he 
wrote  back  :  "  Economy  of  men  is  always  the  chief  of  all  varieties  of  political 
•economy",  and  "  Mothers  in  lying-in  hospitals  cannot  be  fed  on  water,  Epsom  salts 
and  arcanum  duplicatum." — Frank's  style,  strong,  original  and  warm  as  it  always  is, 
often  offends  against  the  rules  of  accuracy  and  clearness  through  his  efforts  to 
unite  sudden  inspirations  of  thought  with  brevity  of  expression. — On  the  whole  Frank 
must  be  looked  upon  as  one  of  the  most  pronounced  and  important  prodigies  of 
modern  medical  history. 

Christian  Eberhard  Kapp  (1739-1824) 
is  usefully  distinguished  as  the  author  of  a  collection  of  select  treatises,  which  he 
translated  for  the  use  of  practical  physicians.     The  Frankfort  physician 

Johann  Christian  Senckenberg  (1707-1772,  killed  by  a  fall  from 
the  tower  of  his  own  institution),  deserves  a  place  here  not  because  of  his 
own  great  services  to  science,  but  b}'  reason  of  his  agency  in  the  scientific 
■education  of  others  and  his  services  to  humanity. 

For  the  well-known  "  Senckenberg'sche  Stiftung"  to-day  serves  both  purposes, 
and  is  likewise  the  only  example  of  such  noble  charity  on  the  part  of  a  physician  in 
German}'.  It  is  worthy  of  comparison  with  the  Radcliffe  Library  of  Oxford  (founded 
1737),  established  by  the  English  physician-in-ordinary  John  Radcliffe  (1650-1714). 
Yet  by  his  practical  precepts  and  his  freedom  from  prejudice  Senckenberg  stands 
above  the  ordinary  mass  of  physicians,  though  both  of  the  qualities  mentioned  are 
flavored  somewhat  strong]}'  with  Pietism. 

"Abstinence  and  moderation"  thought  he  "are  a  certain  means  of  securing 
corporeal  and  mental  health.  Nature  possesses  within  herself  the  opportune  means  of 
guarding,  maintaining  and  restoring  the  health."  This  he  said  in  opposition  to  the 
medical  fashion  of  prescribing  riding  for  hygienic  purposes,  and  he  thought  the 
fashionable  "  Recipe  caballum  "  of  physicians  quite  superfluous  Doubtless  too  he 
had  made  extensive  study  of  the  history  of  medicine  to  enable  him  to  criticise  the 
fashion  justly.  He  was  also  opposed  to  the  bare  study  of  books,  and  thought  "The 
patient  is  the  best  book.  Simple  knowledge  inflates,  and  incapacitates  one  for 
distinguishing  the  right  course.  He  cures  with  greater  certainty  who  is  filled  with 
love  from  God,  who  beholds  nature  with  a  simple  heart  and  eye,  and  from  her  draws 
his  wisdom." — An  active  and  versatile  writer  on  practical  subjects  was  the  Swedish 
physician-in-ordinary 

Nils  Rosen  von  Rosenstein  (1706-1773), 
iilso  a  professor  in  Stockholm.     Following  in  the  footsteps  of  Lars  Roberg  (1664- 
1742),  he  naturalized  in   Sweden  clinical  instruction  in  medicine,  and  his  "Diseases 
of  children  "  maintained  its  popularity  for  a  long  period.     The  Dane 

Fr.  Ludwig  Bang  (1747-1820)  of  Copenhagen  was  eminent  for  his 
hospital  observations. 

England,  the  peculiar  education  of  whose  physicians  rendered  her  a 
congenial  home  for  men  of  this  character,  was  distinguished  by  a  number 


—  650  — 

of  eminent  observers,  and  independent,  capable  and  successful  practi- 
tioners. We  have  already  mentioned  Mead  and  Gimme,  the  former  of 
whom,  like  most  of  those  who  follow,  was  eminent  as  a  man  and  worthy  of 
the  highest  respect.  The  works  of  these  English  physicians  were  speedily 
disseminated  throughout  Germany  by  means  of  translations.1 

The  chemical  physician  John  Huxham  (1694-1768)  of  Plymouth,  an 
eminent  observer,  advanced  our  knowledge  of  putrid  dissolution  of  the 
blood  —  a  condition  first  asserted  by  him  —  and  of  epidemic  diseases. 
His  "Essay  on  fevers"  etc.  (London,  1739)  survived  six  editions.  Francis 
Home  [professor  of  materia  medica  in  the  university  of  Edinburgh]  per- 
formed a  similar  service  for  croup  [in  his  "  Inquiry  into  the  nature,  causes 
and  cure  of  croup",  Edinburgh,  1765.]  Superior  to  Huxham  in  import- 
ance, and  next  to  him  in  point  of  time,  stood 

Sir  John  Pringle  (1707-1782), 

a  popular  practitioner  and  ordinary  physician  in  London,  who  maintained 
intimate  relations  with  several  German  physicians  and  lived  for  a  long  period  in 
Goftingen,  in  order  to  rid  himself  of  his  doubts  with  respect  to  the  interpretation  of 
the  Bible.  He  was  also  a  pupil  of  Boerhaave.  As  the  chief  of  the  English  army 
medical  department  (from  1742-1758)  he  rendered  himself  extreme!}*  useful,  and 
likewise  became  very  famous  in  the  role  of  an  author  on  military  medicine  by  his 
work  "Observations  on  the  diseases  of  the  army  in  camp  and  garrison  ",  Lond.  1752. 
Pringle  did  much  for  the  improvement  of  hospitals  by  the  introduction  of  ventilation 
into  the  wards  for  the  wounded  etc.,  [and  it  is  said  that  we  owe  to  him  the  recogni- 
tion of  the  neutrality  of  army  hospitals.]  The  different  forms  of  dysentery  he  proved 
to  be  varieties  of  one  and  the  same  disease. 

.  As  Pringle  distinguished  himself  in  military  hygiene,  so 
John  Howard  (1726-1790)  of  London 
rendered  eminent  service  in  the  improvement  of  English  prison  arrangements,  and 
must  be  regarded  as  their  medical  reformer.  And  such  a  reform  was  needed;  for 
"  the  prisons  were  a  breeding-place  of  vice  and  brutality.  Old  castles  and  customs- 
prisons,  with  damp,  cold  dungeons  or  confined  cells  were  used.  Beneath  the  narrow, 
iron-barred  windows  were  placed  boxes,  into  which  the  charitable  public  cast  their 
alms  for  the  support  of  the  incarcerated;  for  if  the  friends  and  relatives  of  the  con- 
victs did  not  take  care  of  them,  hunger  was  added  to  their  other  miseries.  In  these 
over-crowded  holes  diseases  were  rife,  riot  fermented  and  the  worst  vices  prevailed. 
It  was  a  hell  upon  earth.  Three  hundred  offences  and  crimes  were  punished  by 
hanging,  e.  g.  stealing  a  fowl."  (Elizabeth  Fry.)  Howard  travelled  extensively  in 
order  to  study  the  arrangement  of  prisons,  and  died  at  Cherson  in  the  Crimea, 
whither  he  had  gone  to  observe  the  plague  in  its  very  home.  [His  works  were 
entitled  "State  of  the  Prisons  in  England  and  Wales"  etc.,  London,  1777,  and  "An 
Account  of  the  Principal  Lazarettos  of  Europe",  London,  1789.] 

William  Heberden  (1710-1801) 

was  an  extremely  popular  London  physician,  and  the  first  to  describe  varicella  and 
angina  pectoris  (asthma  Heberdenii,  1766).     His  chief  work  was  entitled  "  Commen 


Tli<'<e  translations  have  been  characterized  as  emanations  of  an  "Anglomania". 
The  view  that  they  became  naturalized  in  such  numbers  as  a  natural  counterpoise 
to  the  German  rage  for  systems  during  the  18th  century  seems,  however,  better,, 
warranted. 


—  651  — 

tarii  de  Morborum  Historia  et  Curatione",  [London,  1802,  published  posthumously  by 
his  son,  and  distinguished  for  the  almost  classic  style  of  its  Latinity.  It  was  chiefly 
upon  Heberden's  suggestion  that  the  "  Medical  Transactions  of  the  Royal  College  of 
Physicians  first  appeared  in  1768.] 

George  Armstrong  (died  1781)  of  London, 
who  in  1769  opened  the  first  children's  hospital  in  Europe,  was  the  pioneer  of  the 
improvement  in  the  management  of  children's  diseases.  [His  "Essay  on  the  Diseases 
most  fatal  to  Infants"  appeared  at  London  in  1768.  George  Armstrong  is  not  to  be 
confounded  with  his  brother  John,  who  was  likewise  a  physician,  but  is  better  known 
as  a  poet.] 

John  Fothergill  (1712-1780)  of  London, 
acquired  a  justly  famous  name  by  his  observations  on  angina  gangrasnosa,  and  partic- 
ularly upon  neuralgias  (malum  Fothergillii),  hydrocephalus,  and  nervous  diseases  in 
general.  He  was  one  of  the  most  fortunate  of  physicians  and  one  of  the  greatest 
benefactors  of  the  poor  (he  was  a  Quaker),  and  the  latter  class,  so  far  as  concerns  the 
attainment  of  a  good  practice,  he  looked  upon  "as  bridges  to  the  pockets  of  the  rich", 
though  a  part  of  what  he  gained  from  the  latter  he  returned  to  their  less  fortunate 
fellows.  He  is  said  to  have  given  away  to  the  poor  during  his  lifetime  £200,01)0- 
sterling.  [Fothergill  founded  at  Upton  in  Essex  in  1762  a  garden  for  the  cultivation, 
of  exotic   and  especially  of  medical  plants.] 

William  Fordyce  (1724-1792) 
wrote  on  gangrsenous  angina  and  the  venereal  disease  etc.,  while  [his  nephew] 

George  Fordyce  (1736-1802)  of  London, 
educated  in  Leyden,  distinguished  himself  as  a  practitioner  and  chemist.     He  made' 
investigations  on   the  temperature  of  animals,  described  intermittent  and  continued 
fevers,  and  wrote  "Elements  of  the  Practice  of  Physic",  London,  1768. 

[To  whom  we  may  add  : 

John  Radcliffe  (1650-1714), 
an  eminent,  witty  and  successful  physician  in   London,  author  of  the  wise  remark 
that  "  When  a  young  practitioner  he  possessed  twenty  remedies  for  ever}*  disease, 
and  at  the  close  of  his  career  he  found  twenty  diseases  for  which  he  had  not  one 
remedy:"   his  protege,  the  "noble" 

Richard  Mead  (1673-1754), 
whose  success  as  a  physician   was  warranted  at  least  by  his  character  as  a  man. 
Mead  was  a  prolific  author,  but  his  "  Monita  et  praecepta  medica"    (London,  1751), 
which  survived   numerous  editions,  is  perhaps  his  best  known  work.     Mead  was  also- 
the  author  of  the  first  quarantine  regulations  adopted  in  England. 

Sir  Richard  Blackmore  (died  1729), 
who,   in   spite  of  Sydenham's   contemptuous  advice   and   his   mediocrity  as  a  poet, 
became  an  eminent  and  successful  physician  in  London  and  wrote  on  inoculation, 
phthisis,  hysteria,  gout,  rheumatism  etc. 

Sir  Hans  Sloane  (1660-1753), 

President  of  the  Royal  Society  (1727),  whose  extensive  museum  and  library  formed 
the  nucleus  of  the  present  British  Museum  : 

Sir  George  Baker  (1722-1809), 
physician-in-ordinary  to  George  III.  and  nine  times  president  of  the  College  of  Physi- 
cians, who  wrote  on  the  Devonshire  colic,  dysenter}'  and  inoculation  :  and  the  genial, 
benevolent  Quaker, 


—  652  — 
John  Ooakley  Lettsom  (1744-1815), 

the  busiest,  most  philanthropic  and  most  successful1  physician  of  his  day,  as  well  as  a 
Teady  writer. 

Thomas  Dover  (died  1741) 
deserves  mention  as  the  inventor  of  our  popular  "Dover's  powder",  and  by  his  dis- 
covery of  the  famous  Alexander  Selkirk,  whom  he  brought  bach  to  England,  gave 
occasion  to  the  composition  of  Daniel  Defoe's  (1661-1731 )  well-known  romance  "The 
-adventures  of  Robinson  Crusoe",  which  appeared  in  1719.  Robert  James  (1703-1776), 
&  physician  of  Loudon,  was  the  inventor  of  the  famous  febrifuge  "James's  powder", 
by  the  sale  of  which  as  a  nostrum  he  acquired  a  large  fortune.  He  likewise  wrote  on 
hydrophobia,  a  "Modern  practice  of  physic"  (1746),  and  "A  short  treatise  of  the 
disorders  of  children"  (London,  1780).     (H.)] 

In  France,  when  compared  with  the  countries  just  mentioned,  medicine 
was  languishing  during  the  first  three  quarters  of  the  18th  century,  and  did 
not  begin  to  flourish  until  after  the  founding  of  the  "  Society  Royale  de 
Medecine  ". 

In  the  "Memoires"  of  this  society  an  interest  was  taken  by  the  following 
physicians:  Lepecq  de  la  Cloture  (1736-1804)  of  Rouen  ;  Caze  (epidemic  diseases); 
Paulet  (epizootica);  L.  Jean-Marie  Daubenton  (1716-1799);  J.  B.  Fr.  Carrere  (1740— 
1802);  Chabert;  Saillant;  Chabrol ;  R.  P.  Colle;  Lieutaud  ;  Jean  Noel  Halle  (1754- 
1822),  physician  to  Napoleon  I.,  who  rendered  service  in  the  introduction  of  vaccina- 
tion, and  is  known  for  his  courageous  petition  for  the  liberation  of  Lavoisier,  who  was 
not  permitted  to  live  even  long  enough  to  complete  an  analysis  which  he  had  alreadj' 
begun;  Thouret,  who  introduced  Jennerian  vaccination  ;  Abbe  le  Noble;  J.  J.  le  Roux 
(1749-1832);  Vicq  d'  Azyr  (1748-1794),  the  ordinary  physician  of  Marie  Antoinette, 
and  others. 

Among  the  French-Swiss  physicians 

Samuel  Aug.  Andr,  Dav.  Tissot  (1728-1797)  was  eminent  for  his 
services. 

He  came  from  Grancy  in  the  canton  Vaud,  was  a  physician  in  Lausanne,  for  a 
short  time  a  professor  in  Pavia,  a  friend  of  Zimmermann  and  Haller,  and  one  of  the 
most  popular  physicians  of  the  18th  century.  He  rendered  himself  prominent  by 
his  writings  on  nervous  diseases,  epilepsy  etc.,  and  particularly  as  a  popular  author. 

The  Italians  possessed  in 

Francesco  Torti  (1658-1741), 
professor  in  Modena  and  pln'sician-in-ordinary,  a  distinguished  promoter  of  practical 
medicine  and  pharmacology,  inasmuch  as  he  introduced   the  cinchona  into  Italy, 
and  in 

Giov.  Batt.  Borsieri  de  Kanilfeld  (1725-1785), 

professor  in  Pavia,  an  eminent  clinician,  who  studied  particularly  the  symptoms  and 
course  of  disease  in  the  manner  of  the  mother-school  of  Vienna.  He  was  the  author 
of  a  famous  work  on  special  pathology. 

1.   Lettsom's  practice  sometimes  brought  him  in  £12,000  a  year,  yet  a  large  part  of  his 
practice  was  gratuitous,  and  he  gave  away  immense  sums  in  charitable  contribu- 
tions.   He  is  said  to  have  been  the  author  of  the  well-known  quatrain  : 
"  When  patients  sick  to  me  apply 
1  physics,  bleeds  and  sweats  'em. 
Sometimes  they  live,  sometimes  they  die  : 
What's  that  to  me?    1.  Lettsom."  (H.) 


._  653  — 

Michele  Sarcone  of  Naples 
obtained  considerable  reputation  by  his  history  of  Neapolitan  diseases,  while 

Piquer  (1711-1772)  the  Spaniard,  who  translated  Hippocrates  into  Spanish,  dis- 
tinguished himself  as  a  laborer  on  practical  subjects,  particularly  the  doctrine  of 
fevers.  He,  however,  denied  the  circulation  of  the  blood,  a  subject  upon  which  most 
Spanish  physicians  of  that  day  were  entirely  ignorant.  Gaspar  Casal  was  the  first 
describer  of  the  Rose  or  Pellagra  in  Spain. 

Other  Spanish  physicians  of  reputation  were: 

Ant.  Franseri ;  Jose  Ignacio  de  Torres,  a  syphilographer ;  Ignacio  Luzuriajra, 
(colic  of  Madrid) ;  Masdeval  (putrid  fever) ;  Alcinet;  Ant.  Capdevilla,  a  very  learned 
physician  who  was  associated  with  Haller;  Lafuente,  Salva  and  Arejuala  (yellow  fever); 
besides  the  two  last  mentioned,  A  mar  and  Gil  were  disseminators  of  inoculation.  The 
Spaniards,  almost  all  of  whom  were  yet  devoted  to  the  ancient  medicine,  discussed 
the  doctrine  of  bleeding  in  the  18th  century  with  corresponding  activity,  and  this 
doctrine  was  the  basis  of  the  comic  reputation  of  Sangrado  in  Gil  Bias.  Corral  dis- 
tinguished himself  as  a  champion  of  frequent  venesection,  a  practice  which  even  in 
the  most  recent  times  flourishes  in  Spain  to  such  an  extent  that  man}-  of  the  cases- 
of  blindness,  which  are  so  frequent  in  that  country,  are  ascribed  to  the  abuse  of  this 
operation.  On  the  other  hand  the  practice  was  opposed  by  Don  Miguel  Marcellino 
Boix  y  Moliner.  The  Spanish  ^sculapii  too  were  particularly  fond  of  devoting  their 
attention  to  the  medicine  of  the  Ancients,  i.  e.  of  Galen  and  Hippocrates. 

The  physicians  already  mentioned,  most  of  whom  —  particularly  the 
Germans  and  English  —  showed  themselves  genuine  successors  of  Hippoc- 
rates, as  such  honored  in  their  patient,  before  all  things,  the  man.  Besides, 
their  special  professional  education,  most  of  them  were  likewise  equipped 
with  a  general  education,  and  the}*  threw  into  the  scale  at  the  sick-bed  their 
entire  moral  personality ;  in  a  word  they  united  genuine  humanity  with  a 
high  general  and  special  scientific  education.  Some  of  them  proved  them- 
selves discoverers  and  productive  minds,  and  cultivated  the  department  of 
monography  with  constant  regard  to  the  practical  aim  of  medicine. 

Besides  these,  man)-  other  capable  physicians  of  the  18th  century 
furnished  treatises  upon  separate  branches  of  medicine.  In  general  since 
this  century  the  custom  of  discussing  medical  subjects  in  monographs  has 
become  more  common  than  had  been  heretofore  the  case,  a  fact  explicable 
by  the  constantly  increasing  extension  of  medical  science. 

Diseases  of  the  skin,  with  the  exception  of  the  acute  exanthemata  and  certain 
subordinate  forms,  were  studied  only  incidentally  and  (save  their  nomenclature) 
scantily  by  the  Greeks,  Arabians  and  later  physicians;  for  since  the  days  of  Hippoc- 
rates they  had  been  regarded  as  mere  incidental  expressions  and  results  of  internal 
diseases,  or  as  critical  and  desirable  discharges  of  morbid  matters.  This  continued 
to  be  the  case  down  to  the  time  of  Mercurialis  and  the  Ulm  physician  Samuel  Hafen- 
reffer  (died  1660;  "  Nosodochium,  in  quo  cutis  affectus  traduntur"),  and  even  the 
investigations  of  the  Englishman  Daniel  Turner  (1667  -1741,  "  Treatise  on  the  diseases 
incident  to  the  skin  ",  London,  1714)  and  Astruc  continued  incomplete.  The  first 
classification,  after  the  method  of  Linnaeus,  into  macula?,  pustnla?,  vesicula?,  bullae, 
papula?,  crusta?,  squama',  callositates,  excrescences,  ulcers,  parasites,  and  diseases  of  the 
nails  and  hair  was  introduced  by  J.  Jac.  von  Plenck  (1732-1807  ;  "  Doctrina  de  morbis 
cutaneis",  1776),  professor  in  the  "  Josephinum  "  at  Vienna.  Anne  Charles  Lorry 
(1725-1785),  professor  in  Paris  and  a  busy  practitioner,  then  introduced  better  obser- 


—  654  — 

rations  and  methods  of  treatment,  and  Cotugno,  the  elements  of  the  pathological 
anatomy  of  the  skin.  The  famous  Robert  Willan  (1757-1812)  of  London  was,  however, 
the  first  to  lay  down  more  careful  principles  of  classification  (similar  to  those  of 
Plenck)  and  to  furnish  plates  of  the  various  diseases.  His  work  ("Description  and 
Treatment  of  Cutaneous  Diseases",  1798),  before  the  completion  of  which  Willan 
■died,  was  continued  by  Thomas  Bateman  (1778-1821),  also  of  London.  This  system 
recognized  the  classes  of  papulae,  squamae,  exanthemata,  bullae,  pustular,  tubercula 
and  maculae.  These  two  physicians  are  now  considered  the  pioneers  in  the  depart- 
ment of  skin  diseases,  while  the  German  Plenck  has  been  compelled  to  resign  this 
reputation.  Among  the  rarer  skin-diseases  described  in  the  18th  century  we  may 
mention  selerodermia  (Curzio,  1752)  and  ichthyosis  (Henry  Baker,  1775,  and  Tilesius 
in  Leipzig,  "  Stachelschweinmenschen  ",  1802). 

Diseases  of  the  intestines  enjoyed  only  a  comparatively  slight  cultivation,  for  the 
haemorrhoids  and  portal  stagnation  of  Stahl,  and  the  doctrine  of  infarctus  were  still 
too  strongly  accepted.  Friedrich  Hoffmann  led  the  way  in  the  study  of  diseases  of  the 
(esophagus,  pancreas  and  liver. 

[The  poet  Mark  Akenside  (1721-1770)  wrote  on  dysentery  (1764),  and  Matthew 
Baillie  of  Edinburgh  was  the  first  writer  to  describe  accurately  (1793)  the  morbid 
anatomy  of  gastric  ulcer.     (H.)] 

On  the  diseases  of  the  peritoneum  (up  to  this  time  not  recognized  as  independent 
diseases)  a  monograph  was  written  in  1785  by  Joh  Gottlieb  Walter,  after  the  subject, 
like  so  many  others,  had  been  already  studied  by  Morgagni,  who  gave  the  impulse  to 
so  many  special  investigations.  The  latter  had  already  studied  the  diseases  of  the 
urinary  apparatus  or  the  kidneys,  when  Michele  Troja  undertook  the  discussion  of 
the  same  subject. 

On  the  diseases  of  the  lungs,  with  which  in  our  own  century  physicians  occupied 
themselves  almost  exclusively  for  more  than  a  generation,  until  diseases  of  the  nervous 
system  began  to  serve  as  the  peculiar  sphere  of  activity  of  its  second  half,  there  still 
prevailed  great  obscurity  during  the  last  century,  and  "dropsy-  of  the  chest",  "asthma" 
etc.  played  a  specially  great  role  among  the  older  physicians,  as  indeed  the}-  did  far 
down  into  the  present  century.     Under  the  head  of  asthma  was  classed  al.-o 

Pseudocroup,  which  John  Millar1  (hence  the  name  asthma  Millari  down  to  the 
present  day)  and  Chr.  Friedrich  Eisner,  professor  in  Konigsberg,  described.  True 
croup  had  been  carefully  investigated  by  Home,  and  in  1778  by  Christian  Fr.  Michaelis 
(1754-1814),  professor  of  surgery  in  Marburg,  and  tracheotomy"  was  recommended 
after  the  ineffectual  employment  of  emetics  and  blistering  plasters.  Boerhaave  gave 
hints  upon  oedema  glottidis  in  his  inflammation  "in  musculo  albo  glottidis",  and  like- 
wise furnished  evidence  how  little  clearness  there  was  at  that  time  in  the  anatomical 
views  of  even  the  most  famous  physicians. 

Under  the  head  of  "  Dropsy  of  the  chest"  was  classed  a  considerable  number  of 
diseases  not  as  yet  thoroughly  differentiated  from  each  other,  as  e.  g.  emphysema, 
concerning  which  Morgagni  offered  some  explanations. 

Catarrhs  of  the  lungs  and  bronchi  were  not  as  yet  distinguished  (indeed  there 
were  still  opponents  of  Schneider),  and  the  same  was  the  case  with  regard  to  pleuritis 
and  inflammation  of  the  lungs,  both  of  which  were  called  "  peripneumonia",  as  in  the 
days  of  Hippocrates.  Morgagni  was  again  the  first  to  advocate  the  separation  of 
these  two  diseases,  though  it  was  opposed  b}-  Haller,  Tissot  and  Stoll.  These  diseases 
were  discussed  by  Huxham,  Sam.  Gottl.  Vogel,  Borsieri,  Stoll  and  others. 

1.  Millar  was  a  Scotch  physician  who  settled  in  London  about  1768.  His  "  Observa- 
tions on  asthma  and  on  the  whooping-cough"  appeared  at  London  in  1769.     (H.) 

.  According  to  Gordon  Holmes,  the  double  cannla  was  introduced  by  Geo.  Martin, 
at  the  suggestion  of  a  nurse. 


—  655  — 

Phthisis,  so  often  divided  from  the  days  of  antiquity  down,  was  enriched  by 
the  "  laryngeal  and  bronchial  tuberculosis",  first  brought  forward  by  Borsieri.  Chronic 
pulmonary  tuberculosis  was  called  "  nodular  or  ulcerative  phthisis",  and  was  studied 
by  Boerhaave  and  van  iSwieten,  and  particularly  by  Sauvages,  who  adduced  a  very 
large  number  of  "species". 

[In  England  the  disease  was  discussed,  among  others,  by  Sir  Richard  Blackmore 
(1724),  Sam.  F.  Simmons  (1781),  Thomas  Reid  (1782),  Michael  Ryan  of  Kilkenny 
(1788)  and  the  famous  Thomas  Beddoes  (1754-1808),  professor  of  chemistry  in  Oxford, 
■  subsequently  a  practitioner  in  Bristol.  The  latter  ascribed  the  disease  to  an  excess 
of  oxygen  in  the  lungs,  and  proposed  to  antagonize  it  by  the  inhalation  of  carbonic 
acid.  Indeed  he  erected  in  Bristol  a  pneumatic  hospital  for  the  inhalation  of  gases 
in  various  diseases.     (H.)] 

Diseases  of  the  heart  were  very  carefully  studied  by  the  Iatro-mechanic  Hipp. 
Franc.  Albertini  (1661-1738)  of  Crevalcuore,  and  the  famous  Pierre  (Jean  Bapt.)  Senac 
(1693-1770),  of  Lombez  in  Gascony,  a  province  which  was  the  birthplace  of  several 
important  French  physicians  during  the  last  century.  Senac  was  roj'al  physician, 
and  distinguished  himself  by  calling  attention  to  the  uncertainties  of  diagnosis  in 
cardiac  affections.  His  "  Traite  de  la  structure  du  coeur"  etc.  (1749)  was  founded 
unon  observation  and  pathological  anatomy,  and  is  the  first  work  to  recommend  punc- 
ture of  the  pericardium,  an  operation  first  performed,  however,  bjr  Larrey.  Diseases 
of  the  arteries,  especially  aneurisms,  were  studied  b}'  Morgagni  and  the  French 
surgeon  Pierre  Foubert  (1696-1766).  According  to  Proksch,  Morgagni  was  acquainted 
with  syphilitic  lesions  of  the  aorta  etc.,  and  even  of  the  cerebral  arteries. 

Diseases  of  the  nervous  S3rstem  enjoyed  equal  attention.  Thus  neuralgia  of  the 
infraorbital  nerve,  already  known  to  the  Arabians,  was  rediscovered  by  Nic.  Andre 
(1756),  a  surgeon  of  Versailles,  and  observed  by  Sauvages  and  several  times  by 
Fothergill.  Blunt  already  employed  electricity  "  with  success"  in  its  treatment. 
■Sir  Henry  Halford  (1766-1844)  also  wrote  upon  this  subject.  Ischias  was  described 
03-  Cotugno  (hence  the  name  malum  Cotunnii). 

The  doctrine  of  diseases  of  the  brain,  like  that  of  the  lungs,  was  still  burdened 
b}r  such  general  terms  as  "phrenitis"  etc.  Morgagni  was  the  first  to  speak  of 
"meningitis",  while  Robert  Whytt  (1768,  Whytt's  disease)  of  Edinburgh,  to  whom 
science  owes  so  much,  and  Fothergill  studied  the  subject  of  hydrocephalus  acutus 
internets  under  this  title,  and  the  subject  was  also  discussed  by  Edward  Ford  and  in 
1794  by  K.  Fr.  Bader  (Geschichte  der  Wassersucht  der  Gehirnholen).  Hoffmann  and 
his  pupil  Biichner  cleared  up  the  subject  of  "  apoplexy"  by  demonstrating  the  extrava- 
sation of  blood.  Finally  Chr.  Gottlieb  Ludwig  (1709-1773),  professor  in  Leipzig,  led 
the  way  in  the  study  of  diseases  of  the  spinal  cord,  and  Richard  Powell  (1766-1834) 
■discussed  diseases  of  the  brain  and  nerves.  Among  the  convulsive  diseases  we  have 
already  pointed  out  that  epilepsy  was  studied  by  Tissot.  The  same  thing,  however, 
had  been  already  done  by  van  Swieten,  while  a  monograph  had  been  written  on 
•catalepsy  by  the  famous  surgeon  P.  Dionis.  Eclampsia,  particularly  puerperal 
eclampsia,  which  Sauvages  first  distinguished  as  a  special  form  of  convulsion,  was 
frequently  discussed,  especially  by  the  great  obstetrician  Denman,  by  J.  C.  Gehler  in 
Leipzig,  by  the  Frenchman  Blaud,  and  by  G.  C.  Petri  (1633-1718)  in  Erfurt.  The 
picture  of  St.  Vitus's  dance  was  again  carefully  sketched  b}-  Sauvages  and  Cullen, 
and  the  disease  was  described  at  length  by  G.  Spangenberg  in  Gottingen.  Hysteria 
was  discussed  by  Fr.  Hoffmann,  Astruc,  Tissot,  Alex.  Wilson  and  by  Joh.  Gottlob 
Leidenfrost  (1715-1794),  of  Ortenberg  in  upper  Hesse,  professor  in  Duisburg. 

In  addition  to  such  books  as  Becher's  "  Medicinische  Schatzkammer  "  etc  ,  1700; 
Loew's  "  De  morbis  infantum",  1719;  especially  Nils  Rosen  von  Rosenstein's  "  De 
morbis  infantum",  1752;   Geo.  Armstrong's  "An  account  of  the  Diseases  most  inci- 


—  656  — 

dent  to  children ", '1777  *,  C.  J.  Mellin's  "  Der  Kinderarzt",  1783;  C.  Girtanner's 
"Abhandlung  liber  die  Krankheiten  der  Kinder",  1794;  M.  Underwood's  "Treatise 
on  the  Diseases  of  Children",  1784,  which  was  long  so  highly  esteemed,  even  in 
Germany,  that  it  was  reprinted  down  to  very  recent  times;  Alex.  Hamilton's  "A 
treatise  of  Midwifery  etc.",  Edinburgh,  1780,  and  William  Cadogan's  "Treatise  on 
the  Feeding  of  Children  until  the  Third  Year  of  Life"  (1748);  J.  J.  Mastalier  (died 
1793)  and  A.  Golis  (1764-1827  ;  "  Praktischen  Abhandlungen  iiber  die  vorzliglichsten 
Krankheiten  des  Kindesalters",  Vienna,  1815)  in  Germany,  rendered  eminent  service 
in  the  discussion  of  the  practical  treatment  of  children. 

Our  knowledge  of  chlorosis  was  first  improved  by  Friedrich  Hoffmann,  and  that 
of  scrofula  by  Bordeu,  the  surgeon  Faure,  Baumes,  Alexis  Pujol  of  Pujol  (born  1739) 
and  finally  by  Karl  Georg  Theodor  Kortiim  (1765-1818),  physicus  in  Stollberg  and 
Aachen,  and  not  to  be  confounded  with  the  author  of  the  "Jobsiade ",  Carl  Arn. 
Kortiim  (born  in  Miilheim  on  the  Ruhr  1745,  died  1824;  the  Jobsiade1  appeared  in 
1784)  a  physican  of  Bochum.  [In  England  the  subject  of  scrofula  was  discussed  by 
Richard  Russell  in  1750  and  by  Thomas  White  in  1784.     (H.)] 

The  famous  James  Lind  (1736-1794),  Ludw.  Rouppe  and  Poissonier  Desperrieres 
wrote  upon  the  scurvy  ;  William  Grant  (died  1786)  and  others  on  the  gout.  [Scurvy 
received  considerable  attention  from  English  physicians,  and  to  Lind  we  may  add 
Antony  Addington  (1753),  Charles  Bisset  (1756),  Nathaniel  Hulme  (1768),  David 
Macbride  (1778),  Sir  Francis  Milman  (1782),  and  above  all  Thomas  Trotter  (1785), 
who  also  wrote  a  "  Medicina  nautica",  or  general  treatise  on  the  diseases  of  seamen. 
Gout  too  was  studied  in  England  with  a  truly  national  predilection.  Among  the 
numerous  treatises  upon  this  subject  we  may  add  those  of  Wm.  Musgrave  (1703), 
Francis  Clifton  (1714),  the  eminent  Geo.  Cheyne  (1720),  William  Stukeley  (1734), 
Thos.  Thompson  (1740),  Dale  Ingram  (1743),  John  Cheshire  (1747),  David  D'Escherny 
(1760),  Will.  Cadogan  (1764),  William  Stevenson  (1779),  John  Gardiner  (1792),  George 
Wallis  (1798)  and  Clifton  Wintringham  Sr.  (1714).     (H.)] 

The  subject  of  syphilis  was  carefully  studied  by:  Boerhaave,  Dan.  Turner  (1724), 
Astruc  (according  to  Proksch,  he  wrote  a  text-book  of  "wonderful  thoroughness" 
upon  this  subject,  the  "  De  morbis  veneriis  libri  novem  ",  2d  ed.  Paris,  1740.  in  which 
he  also  treats  of  the  bibliography  of  the  disease);  Morgagni,  Dom.  Cirillo,  Carl  Wilh. 
Nose  (1780),  Sanchez,  Van  Swieten,  Girtanner,  who,  according  to  Lefebure  de  St. 
Ildefont,  published  an  important  bibliographical  work  on  syphilis  (Proksch) ;  John 
Hunter,  Franz  X.  Swediaur  (1748-1824;  graduated  in  Vienna  in  1772),  a  physician 
of  London  and  Paris;  J.  J.  Gardane;  the  eminent  John  Andree  (1779),  professor  of 
surgery  and  anatomy  in  London,  who  described  accurately  the  characteristics  of  the 
true  chancre  before  Hunter,  and  pointed  out  the  seat  of  the  so-called  gonorrhceal 
orchitis  in  the  epididj-mis.  He  also  pointed  out  the  inflammation  of  the  spermatic 
cord  (Proksch);  J.  J.  Plenk;  William  Dease  (1789),  a  surgeon  of  Dublin;  John 
Douglas  (died  1759);  Francisco  X.  Balmis  in  Madrid;  Andr.  Vacca  Berlinghieri  in 
Pisa;  Pietro  Ant.  Perenotti  di  Cigliano;  Jesse  Foot  (1792)  of  London  and  others. 

The  syphiloid  disease  (Radesyge,  Spedalskhed,  Frambcesia,  Yaws,  Pian)  was 
described  by:  Roland  Martin;  Joh.  L.  Odhelius;  Wilh.  Gg.  Pfefferkorn ;  Ed.  Thomas; 
Godf.  W.  Schilling;  Friedr.  Kusemiiller;  Bern.  Peyrilhe  (cf.  Proksch ;  "  Ueber  die 
Leistungen  auf  dem  Gebiete  der  Syphilidologie  im  18.  Jahrh.",  sep-Abdr.,  Wien,  1887, 
Bergmann  u.  Comp). —  A  Dr.  Conton  invented  the  so-called  "condom",  but  was  forced 
to  change  his  name  and  residence  in  order  to  escape  the  enmity  of  his  colleagues 
and  fellow-citizens  (L.  c). 

1.  "Die  Jobsiade,  ein  komisches  Heldengedicht  in  drei  Theilen  ".  The  first  part 
appeared  in  1784,  the  last  two  in  1799.  A  very  well-known  comic  epic  in 
Germany.     (H.) 


—  657  — 

Haller,  by  the  injection  of  putrefying  matters  into  the  veins,  proved  the  existence 
of  "septic"  poisons,  and  prepared  the  way  for  the  doctrine  of  septicaemia. 

Pole  in  1775,  and  Matthew  Dobson  in  the  same  year,  demonstrated  the  existence 
of  grape-sugar  in  the  urine,  and  John  Rollo  [of  Woolwich,  an  English  naval  surgeon] 
wrote  an  extended  monograph  upon  this  subject  ( " An  account  of  two  cases  of  diabetes 
mellitus  etc.,  London,  1797).  Peter  Biichner  pointed  out  the  softening  of  the  bones 
in  rhachitis,  in  which  he  was  followed  by  Vacher  de  la  Fleutrie,  while  the  difference 
between  rhachitis  and  cretinism  was  pointed  out  by  the  anatomists  Jos.  and  Carl 
Wenzel.  Cretinism  was  described  bjr  Jacob  Fid.  Ackermann,  and  then  in  1796  by 
Franc.  Emman.  Fodere  (died  1835),  the  famous  professor  of  legal  medicine  in 
Strassburg,  and  by  Phil.  Gottfr.  Michaelis.  —  By  the  injection  of  water  into  the 
veins  and  the  production  of  dropsy  Stephen  Hales  (1733)  offered  a  contribution  to 
experimental  pathology,  and  Donald  Monro  (1756)  furnished  a  monograph  also  on 
drops}7. 

The  comparative  pathology  of  men  and  animals  was  called  into  existence  by 
J.  P.  Frank  (1790)  and  the  Harburg  physician  Bergmann  (1804),  and  this  branch  was 
subsequently  amplified  by  Heusinger. 

The  doctrine  of  euthanasia  was  introduced  as  something  new  in  1794  by  the 
Hollander  Paradijs. 

In  addition  to  monographs,  collections  of  observations  appeared  from  the  pens 
of  Lentin,  Pascal,  Jos.  Ferro  (1749-1809)  in  Vienna,  a  writer  on  the  plague,  and  by 
the  famous  surgeons  A.  G.  Richter,  Mursinna  and  others. 

A  second  new  branch  was  founded  in  the  18th  century  by  a  German 
practitioner  in  his  famous  book  entitled  "  Versuch  einer  allgemeinen 
medicinisch-praktischen  Geographie ",  3  vols.,  Leipzig,  1792-95.  The 
author  of  this  work  was 

Leonhard  Ludwig  Finke  (1747-1828),  physikus  and  professor  in 
Lingen.  In  it  the  geographical  location  of  diseases,  upon  which  Hippoc- 
rates had  laid  such  great  weight,  was  again  taken  into  merited  consider- 
ation, and  at  the  same  time  medicine  was  brought  into  closer  relation  with 
the  general  sciences,  from  which,  by  the  establishment  of  the  barriers  of 
distinct  departments,  it  had  been  disunited  since  the  days  of  the  Ancients 
(and  is  again  to-da}-).  The  renewal  of  this  union,  however,  achieved  its 
greatest  success  through  the  cultivation  of  the 

History  of  Medicine, 

a  branch  properly  speaking  created  b}'  the  Germans  in  the  18th  century, 
or,  at  all  events,  if  this  statement  is  not  accepted,  a  branch  which  since 
that  period  has  fallen  more  and  more  into  the  hands  of  the  Germans,  so 
that  until  recently  medical  history  was  to  be  called  a  peculiarly  German 
department  of  science. 

At  the  head  of  this  department  we  name  the  most  important  medical 
historian  of  the  English  down  to  the  present  day, 

John  Freind  (1676-1728), 
who  has,  indeed,  been  surpassed  in  many  respects,  and  yet  is  very  reliable  and  con- 
scientious.     He  begins  with   the   age   of  Galen   (where  le  Clerc  had   stopped)   his 
"  History  of  Physic  from  the  time  of  Galen  to  the  beginning  of  the  Sixteenth  Century", 
42 


—  658  — 

London,  1725-26.  This  work  was  often  translated.1  Like  an  Englishman,  Freind 
considers  the  history  of  medicine  from  the  standpoint  of  the  practitioner.  He  fell 
into  a  bitter  quarrel  with  le  Clerc's  brother  John  in  consequence  of  some  of  his  o]  in- 
ions.  Freind  was  also  a  zealous  Iatro-mechanic,  and  in  this  theory  discussed  even 
the  doctrine  of  "menstruation".  The  latter  he  regarded,  on  the  whole,  as  a  means 
for  the  preservation  of  health  in  women,  from  its  removal  of  the  superfluous  blood, 
which,  during  pregnancy,  served  as  nutriment  for  the  fcetus. 

The  life  of  Freind  is  very  interesting.  Born  at  Croton  in  Northamptonshire,  he 
for  a  time  taught  chemistry  in  Oxford.  Next  he  was  appointed  army-physician,  and 
went  in  this  capacity  with  the  English  army  to  Spain  and  Holland.  In  1713  he 
settled  as  a  physician  in  London,  received  a  seat  in  Parliament,  and  spoke  decidedly 
against  the  imprisonment  of  a  bishop.  Accordingly  Sir  Robert  Walpole  cast  him 
into  the  Tower.  The  noble  Mead,  a  friend  of  both  Freind  and  Boerhaave,  though  a 
scientific  opponent  of  the  former,  effected  Freind's  release  by  declaring,  when  the 
omnipotent  minister  called  Mead  to  attend  him  in  sickness,  that  he  would  not  under- 
take his  case  until  Freind  was  released.  Mead  afterwards  gave  Freind  5000  guineas 
received  from  the  latter's  practice  during  his  imprisonment.  Freind  was  also  from 
1727  ordinary  physician  to  the  queen. 

[The  dearth  of  English  medical  literature  in  works  upon  the  history  of  medicine 
is  the  more  surprising,  since  English  literature  in  general  can  point  with  just  pride 
to  its  achievments  in  the  field  of  general  history.  We  need  mention  only  a  Hume, 
a  Gibbon,  a  Bancroft  and  a  Prescott,  to  show  that  the  English-speaking  peoples 
are  b}r  no  means  deficient  in  the  historic  bent.  But,  even  among  the  Americans, 
who  in  the  last  quarter  of  a  century  have  adopted  so  many  medical  fashions  from 
German}',  the  department  of  the  history  of  medicine  has  remained  almost  a  terra 
incognita. 

Besides  Freind,  the  most  important  English  medical  historian  down  to  the  pres- 
ent day,  medico-historical  subjects  were  studied  in  the  18th  century  by:  Francis 
Clifton  of  London,  who  published  in  1732  his  "State  of  physic,  ancient  and  modern"; 
William  Northcote,  an  English  naval  surgeon,  who  wrote  "A  concise  historj-  of 
anatomy  from  the  earliest  ages  of  antiquity"  (London,  1772);  John  Aikin  (1747-1822), 
an  associate  of  the  philanthropist  Howard,  who  published  in  1780  his  "  Biographical 
memoirs  of  Medicine  in  Great  Britain,  from  the  Revival  of  Literature  to  the  time  of 
Harvey".  It  is  said  that  Aikin  originally  intended  to  write  a  complete  history  of 
English  medicine,  but  was  discouraged  by  the  little  interest  and  co-operation  mani- 
fested by  his  colleagues  in  his  design,  and  according!}'  limited  his  labors  to  mere 
biographical  sketches.  William  Black  (1750-1829)  of  -London  also  published  in  1782 
"An  historical  sketch  of  medicine  and  surgery  from  their  origin  to  the  present  lime", 
a  work  translated  into  German  and  French.     H.] 

The  earliest  German  medical  historian  of  the  18th  century  was  that 
thorough  student  of  antiquity  and  conscientious  writer, 

Joh.  Heinrich  Schulze,  a  pupil  of  Hoffmann.  His  works  were  en- 
titled "  Historia  medicinse  a  rerum  initio  ad  annum  urbis  535  deducta" 
(Lipsise,  1728),  and  "Compendium  historian  medicinse  a  rerum  initio  usque 
ad  Hadriani  Augusti  excessum  "  (Hal.  17-11). 


1.  Into  Latin  by  John  Wigan  (17321),  who  also,  with  Freinds's  co-operation,  edited  an 
elegant  edition  of  Aretreus  in  1727  ;  into  French  by  Etienne  Coulet  (1727).  The 
defects  of  this  latter  translation  led  the  author  to  authorize  a  new  Frencb  trans- 
lation by  B  *  *  *  ,   and  the  latter  was  published  at  Paris  by  Senac  in  1728.     (II.) 


—  659  — 

Daniel  Wilhelm  Triller  (1695-1782;  of  Erfurt, 
professor  in  Wittenberg,  also  wrote  some  "Opuscula  mediea",  Frankfort  and  Leipzig, 
1766-1772.     Triller  was  a  poet  of  the  school  of  Gottsched. 

Joh.  Jac.  Reiske,  the  orientalist, 
wrote  on  Arabian  and  Hebrew  medicine,  a  work  in  which  he  was  aided  to  some  extent 
by  his  learned  wife. 

Joh.  Ernst  Hebenstreit, 
on  the  other  hand,  wrote  on  the  therapeutics  of  the  Ancients.  He  was  born  in  Neu- 
stadt  on  the  Orla,  and  in  the  years  1781  to  1733  travelled  in  Barbary  under  the  com- 
mission of  king  Augustus  I.  of  Poland  and  Saxonj-,  called  from  his  sexual  capacities 
""the  Strong".  Subsequently  Hebenstreit  became  a  professor  in  Leipzig,  rising  grad- 
ually from  professor  of  physiology  to  that  of  anatomy  and  surgery,  and  then  to  the 
highest  of  all  in  that  day,  the  chair  of  pathologj7. 

Far  more  important  was  the  learned  and  thorough  investigator  of 
history,  founder  of  historical  patholog}',  and  classical  writer, 

Phil.  Gabriel  Hensler  (1733-1805), 

the  friend  of  Lessing.  Lessing  himself  originally  intended  to  study  medicine,  and 
subsequentl}-  came  very  near  becoming  a  medical  historian,  as  he  proposed  to 
write  a  history  of  syphilis.  He  abandoned  the  idea,  however,  when  he  heard  that 
Hensler  had  the  subject  under  consideration.  Hensler  was  likewise  something 
■of  a  poet.  His  chief  works  are  "Geschichte  der  Lustseuche,  die  zu  Ende  des  XY. 
Jahrhunderts  ausbrach"  (1789)  and  "Vom  abendlandischen  Aussatze  im  Mittel- 
alter,  nebst  einem  Beitrage  zur  Kentniss  und  Geschichte  des  Aussatzes". — 
Hensler  recommended  gymnastic  exercises  for  health  even  earlier  than  the  Swede 
Peter  Henrik  Ling  (1776-1839).  They  were  recommended  especially  in  diseases 
of  the  internal  organs,  and  Hensler  also  recommended  deep  inspirations  in  diseases 
•of  the  lungs. 

The  son  of  a  minister,  Hensler  was  born  at  Oldesworth  in  Schleswig,  attended  the 
gymnasium  at  Husum  and  Schleswig,  completed  his  studies  in  theology,  and  then 
abandoned  this  science  and  studied  medicine,  which  he  completed  in  two  3-ears.  At 
first  he  went  as  physician  to  Preetz,  then  became  physicus  in  Segeberg  and  Altona, 
was  honored  with  the  title  of  archiater,  and  finally  made  a  professor  in  Kiel.- — Besides 
his  historical  works,  Hensler  was  equally  distinguished  as  a  practitioner.  He 
demanded  as  the  chief  requisites  of  a  practising  phj-sician  "that  he  should  be  a  good 
man,  combining  honesty,  humanity  and  artistic  sense  with  a  disposition  to  science." 
"  It  is,  however,  just  so !  There  is  no  art  in  which  one  learns  to  walk  without  making 
a  false  step.  It  is  a  misfortune  that  our  false  steps  may  so  easily  prove  fatal;  but 
this  lies  in  the  very  nature  of  our  art.  Otherwise  too  it  would  not  be  so  salutary. 
The  carpenter  breaks  his  arms  and  legs  more  readily  than  the  tailor.  Is  that  a 
ground  for  reproach  ?" 

Partially  as  the  result  of  Hensler's  activity  in  the  medico-historical  department, 
the  history  of  medicine  was  also  made  the  subject  of  study  by  the  famous 

Joh.  Christ.  Gottlieb  Ackermann  (175G-1801)  of  Zeulenroda, 
professor  in  Altdorf  near  Nuremberg  (Institutiones  historiae  medicinse  Norirub.,  1792); 
then  the  thorough  and  unprejudiced 

Joh.  Karl  Wilh.  M<">hsen  (1722-1795)  of  Berlin, 
author  of  a  "Geschichte  der  Wissenschaften  in  der  Mark  Brandenburg,  besonders  der 
Arznei'wissenschaft,  von  den  altesten  Zeiten  bis  zu  Ende  des  16.  Jahrhunderts,"  1781; 
"Verzeichniss  von  Bildnissen  grosstentheils  beriihmter  Aerzte"  etc.;  also 


—  660  — 

Joh.  Fried.  Karl  Grimm  (1737-1821)  of  Eisenach, 
ordinary  physician  in  Gotha,  who  wrote  a  translation  of  Hippocrates,  4  vols.,  Alten- 
burg,  1781-1791; 

Christ.  Fried.  Gruner  (1744-1815)  of  Sagan  in  Silesia, 
a  professor  in  Jena,  the  most  zealous  student  of  the  ancient  physicians,  also  devoted 
his  attention  to  Hippocrates. 

In  addition  to  Ackermann  the  following  physicians  distinguished 
themselves  b}*  literary  collections :  the  great 

Haller  and 

Ernst  Gottf.  Baldinger  (1738-1804). 
The  famous  savant  last  mentioned  was  born  at  Vargula  near  Erfurt,  was  originally 
an  army  physician,  then  physikus  in  Langensalza,  and  subsequently  a  professor  in 
Jena,  Gottingen,   Kassel  and   Marburg,  one  after  the  other.     He  also  distinguished 
himself  as  an  author  on  army  medicine.     His  library-  is  still  in  Darmstadt. 

The  following  physicians  must  also  be  mentioned  as  historical  writers  : 

Joh.  Fried.  Blumenbach, 
who  wrote  an  excellent  "  Introductio  in  historiam  medicinae  literariam  ",  Gottingen,. 
1786,  after  which  the  honest,  sober  and  dry 

Joh.  Daniel  Metzger  (1739-1805), 
a  professor  in  Konigsberg,  chiefly  constructed  his  own  work. 

A.  F.  Hecker  (1763-1811),  of  Kutten  near  Halle, 
a  protessor  in  the  university  of  Erfurt  (belonging  at  that  time  to  the  electorate  of 
Mayence)  and  finally  professor  in  the  Collegium  medico-chirurgicum  at  Berlin  and 
then  in  the  universityr.  He  surpassed  in  intellectual  capacity  his  more  famous  son 
Just.  Friedrich  Karl  Hecker  (1795-1850),  professor  in  Berlin,  who  was,  alas,  often 
too  verbose,  and  may  be  called  the  romancer  among  medical  historians.  — The  first 
historical  writer  upon  the  subject  of  midwifery  among  the  Germans  was 

Fr.  Benj.  Osiander. 

.  The  best  known  historical  writer  in  the  department  of  medicine, 
distinguished  for  his  profound  erudition  and  exceedingly  extensive  reading, 
yet  free  from  all  pedantry,  correct  and  candid  in  judgment,  in  diction 
simple  and  jet  forcible,  not,  indeed,  entirely  unprejudiced  (as  ma}-  be 
readily  understood,  especially  when  we  consider  the  tendencies  of  his 
time),  but  truthful  and  loving  the  truth,  in  spirit  belonging  entirely  to  the 
18th  century,  and  chronologically  to  its  latter  half  and  the  first  third  of 
the  19th,  was  the  world-famed 

Kurt  Polycarp  Joachim  Sprengel  (1766-1833)  of  Boldekow  in 
Pomerania. 

The  son  of  a  minister,  he  began  in  1784  the  study  of  theology,  but  then  trans- 
ferred his  attention  to  the  natural  sciences  and  medicine.  In  1787  he  began  to 
practise  in  Halle,  but  two  years  later  was  appointed  professor  of  medicine  there,  and 
in  1797  received  in  addition  the  professorship  of  botany.  The  latter  science  was  the 
favorite  branch  or  recreation  of  Sprengel,  as  of  many  physicians  during  the  18th 
century,  and  to  it  he  rendered  great  service,  particularly  as  regards  its  history,  while 
his  uncle  Konrad  Sprengel  of  Spandau  advanced  the  theory  of  fructification  of  plants. 
From  1792  onward  he  published  his  immortal  work,  the  first  volumes  of  which  had 
already  enjoyed  a  second  edition  before  the  last  appeared.  In  these  different  editions 
too    his    opinions   regarding   the    same    author    are    frequently    strikingly    changed. 


—  661  — 

Sprengel  developed  a  perfectly  marvellous  activity.  Besides  his  historical  work 
"Versuch  einer  Geschichte  der  Arzneikunde",  which  to  another  would  have  furnished 
sufficient  work  for  a  whole  life,  Sprengel  translated  very  much  from  the  ancient  and 
modern  languages,  and  even  wrote  among  other  things  an  "Anleitung  zur  Botanik 
fur  Frauenzimmer";  "  Beitrage  zur  Geschichte  des  Pulses";  "  Galen's  Fieberlehre"; 
"Apologie  des  Hippocrates";  "Handbuch  der  Pathologie";  "Handbuch  der  iSemiotik"; 
"  Antiquitates  botanical  etc.";  "Geschichte  der  Medicin  im  Auszuge";  "Geschichte 
der  Chirurgie"  (its  second  volume  was  written  by  his  son  Wilhelm,  born  1792.  died  a 
professor  in  Greifswald  about  1820):  "Geschichte  der  Botanik".  He  likewise  edited 
Theophrastus,  Dioscorides  etc.  and  various  journals  —  a  savant  and  a  genius  such  as 
the  ISth  century  alone  could  ripen.  Sprengel's  works  form  in  themselves  a  complete 
library. 

The  following  physicians  participated  in  a  less  degree  in  the  historical 
investigations  and  writings  of  the  18th  century. 

Mich.  Alberti  (1682-1757),  "Medic.  Theorieen  ";  Andr.  0.  Golicke,  "Hist,  medi- 
cina; universalis";  Chr.  Wilh.  Kestner,  "  Kurzer  Begriff  der  Historie  der  medicin. 
Gelahrtheit";  Gottlieb  Stolle  (was  not  a  physician),  "  Anleitung  zur  Historie  der 
medic.  Gelahrtheit";  Fried  Bonier  (172)5-1701),  "Programma  de  vera  medic,  orig." 
etc..  "  Noctes  Guelphica?"  etc.;  Georg  Matthias  (died  1773),  "  Conspect.  hist,  medico- 
rum  chronologicus";  Polycarpus  Fried.  Schacher  (1676-1737)  in  Leipzig,  "De  feminis 
ex  arte  med.  claris";  KortUm  (author  of  the  "Jobsiade"),  "  Skizze  einer  Zeit-  und 
Literaturgeschichte  der  Arzneikunde";  Phil.  Ludwig  Wittwer  (1752-1792),  "Archiv 
fur  Geschichte  der  Arzneikunde",  I  vol.;  Carl  Gottl.  Kuehn  (1754-1840),  professor  of 
physiology  and  pathology  in  Leipzig,  "  De  philosophis  ante  Hippocratem  medicina* 
cultoribus  ad  Celsi  de  medicina  praaf",  "  Medicorum  Grascorum  opera  qua?  extant", 
20  vols.,  1821-30;  F.  L.  Augustin,  "  Vollstiindige  Uebersicht  der  Geschichte  der 
Medicin  in  tabell.  Form  "  and  many-  others. 

In  Holland  Job.  de  Gorter,  among  others,  occupied  himself  with  historical 
studies. 

French, —  Ant.  Portal,  "Histoire  de  1'  anatomie  et  de  chirurgie",  1770  ;  Theophile 
de  Bordeu,  "  Recherches  sur  quelque  points  d'  historie  de  la  medecine"  etc.;  Goulin, 
"Memoires  litteraires"  etc.;  Etienne  Tourtelle,  "'  Histoire  philosophique  de  la  mede- 
cine";  Lepecq  de  la  Cloture  and  others. 

Italians. — Antonio  Cocchi  (1695-175S)  of  Mugello,  professor  of  anatomy  in 
Florence;  Giov.  L.  Bianchoni  (1717-1781)  in  Rome,  for  a  long  time  physician-in- 
ordinary  at  the  court  of  Hesse-Darmstadt,  then  at  that  of  the  Elector  of  Saxony,  and 
finally  a  count  and  embassador  at  Rome;  Leonardo  Targa  (1730-1815)  of  Verona, 
both  the  latter  well  known  for  their  labors  upon  Celsus,  and  all  three  capable 
historians. 

Danes.  —  de  Meza,  "  Tentamen  historian  medicinae". 

Among  the  physicians  who  sprung  from  the  spirit  of  the  18th  centurj-, 
and  who  occupied  themselves  with  historical  writing,  belongs  also  the 
Spanish  historian 

A.  Hernandez  Morejon  (1773-1836),  of  the  village  of  Alaejos  in  Old 
Castile,  author  of '•  Historia  bibliogiatica  de  la  Medicina  espanola'',  7  vols., 
Madrid,  1842-52. 

Sprung  from  poverty  and  tossed  about  by  the  Franco-Spanish  campaigns  and  the 
political  storms  of  the  age  of  Napoleon,  after  many  vicissitudes  of  fortune  he  was 
able  bj"  his  own  energy  and  strength  to  secure  the  appointments  of  clinical  professor 
in  the  college  of  surgery  of  San  Carlos  in  Madrid,  royal  court-physician  and  member 


—  662  — 

of  the  Supreme  Council  of  Health.  He  labored  upon  his  colossal  work  until  his 
death. 

Semeiology  too,  which,  as  we  have  seen,  had  been  revived  in  the  16th  century 
after  the  manner  of  the  Ancients,  took  in  the  18th  a  new  flight,  while  in  the  17th 
century,  as  in  our  own,  it  was  considerably  neglected.  From  the  works  en  this  sub- 
ject we  may  mention:  Ch.  Vater's  "Semiotica  medica",  1725;  Friedrich  Hoffmann's 
"Fundamenta  semiotica  medicinse",  1741);  Samuel  Schaarschmied's  "Semiotik", 
175G;  G.  E.  Hamberger's  "  Semiotische  Vorlesungen  iiber  Jodoc.  Lommius",  edited 
by  Graun,  1767;  J.  N.  Pezold  (1778);  C.  G.  Gruner  (Semiotice,  1775);  F.  A.  Weber's 
"De  signis  et  causis  morborum".  1786;  F.  G.  Danz  (Semiotik.  1793);  J.  Ch.  A.  Hein- 
roth  (Allgem.  med.  Zeichenlehre  etc  ,  1793);  Kurt  Sprengel  (Handbuch  der  Semiotik), 
whose  work  was  the  most  popular  of  its  day. 

4.    SURGERY  I OPHTHALMOLOGY,  OTOLOGY  AND  DENTISTRY). 

The  18th  centur}'  is  distinguished  as  one  of  the  most  important  in  the 
histoiy  of  surgery  also  by  the  fact  that  it  finally  conferred  upon  this  art  a 
rank  which  placed  it  in  all  respects  firmly  and  permanently  upon  an  equal 
grade  with  the  so-called  internal  medicine.  This  is  true  as  regards  both 
the  scientific  and  the  practical  side  of  this  art,  and  likewise  as  regards  the 
social  rank  of  its  higher  representatives.  The  impulse  to  all  this  advance 
again  proceeded  from  France,  the  headquarters  of  modern  surgery,  where 
even  the  curious  dispute  about  rank  between  medicine  and  surgery,  i.  e. 
between  physicians  and  surgeons,  was  first  finally  decided.  The  surgery 
of  the 

a.  French 

accordingly  exhibits  in  this  century  a  great  number  of  its  most  brilliant 
representatives.  Indisputably  the  most  influential,  though  not  the  most 
considerable  of  these  was 

Francois  Gigot  de  la  Peyronie  (1678-1747)  of  Montpellier. 

Director  of  the  Academie  de  Chirurgie,  which  he,  in  conjunction  with  Maresehal,  had 
founded  in  1731,  and  surgeon  to  the  king,  filled  with  noble  enthusiasm  for  his  own 
special  branch,  he  employed  his  considerable  wealth  almost  entirely  for  the  elevation 
of  surgery.  Thus,  in  addition  to  the  five  surgical  professorships  established  in  1724, 
he  founded  a  sixth  at  his  own  expense,  and  gave  each  professor  an  assistant.  He 
likewise  effected  the  foundation  of  four  professorships  of  surgerj'  in  Montpellier. 
Upon  the  incumbent  of  the  chair  which  he  had  founded  in  Paris  he  laid  the  obligation 
of  lecturing  on  obstetrics  to  the  surgeons  and  midwives.  In  1743  he  effected  the 
separation  of  the  surgeons  from  the  barbers,  and,  besides  all  this,  in  his  will  he 
devoted  all  his  remaining  estate  to  the  objects  to  which  he  had  also  dedicated  his 
life.  As  a  surgeon  he  rendered  special  service  in  wounds  of  the  intestine  and  in 
operations  for  hernia.  —  The  most  famous,  and  scientifically  the  most  influential 
surgeon  of  this  early  period  was,  however, 

Jean  Louis  Petit  (1674-1750)  of  Paris, 
likewise  a  director  of  the  Academie  de  Chirurgie,  and  a  professor  who  had  served 
from  the  ranks  upward  and  educated  himself  especially  in  practical  surgery  in  the 
wars.  His  fame  was  so  great  that  he  was  called  even  to  Poland  to  treat  Augustus 
the  Strong,  and  also  to  Spain,  and  some  sovereigns,  among  them  Frederick  the  Great, 
requested  some  of  his  pupils  for  field-surgeons.  His  services  extended  over  the 
whole   field  of  surgery,    including  opthalmology,    in   which    latter   science   he   was 


—  663  — 

acquainted  with  measurements  of  the  eye,  the  contraction  of  the  pupil  after  division 
of  the  sympathetic  etc.  Especially  worthy  of  mention  are  his  screw-tourniquet, 
amputation  a  deux  temps,  his  knowledge  of  the  definitive  thrombus  alter  ligation 
(Wernher  claims  that  he  was  the  first  to  observe  this),  acupressure  (an  experiment), 
and  herniotomy  without  opening  the  sack.  His  chief  works  were  entitled  "Traite 
des  maladies  des  os"  etc.,  Paris  1723,  and  "Traite  des  maladies  chirurgicales  et  des 
operations"  etc.,  published  by  M.  Lesne,  Paris  1774-88. 

Rene  Jacques  Croissant  de  Garengeot  (1688-1759), 
professor  in  the  College  de  St.  Come,  discarded  the  introduction  of  tents  of  lint  after 
herniotomy,  performed  tracheotomy  with  a  canula,  invented  a  special  turnkey  and 
restored  a  nose  which  had  been  cut  off  and  had  lain  for  a  considerable  time  upon  the 
ground.  His  method  of  curing  hernia  consisted  in  pushing  the  unopened  hernial 
sack  into  the  inguinal  canal  (Bruchpforte?)  and  fixing  it  there  until  the  two  surfaces 
united.  He  furnished  a  theory  of  hernial  formation,  though  in  this  he  was  preceded 
by  Renaulme  de  Lagaranne  (1721),  who  was  the  first  to  bring  forward  such  a  theory 
(Wernher).  Garengeot's  chief  work  was  entitled  'Traite  des  operations  de  chirurgie", 
Paris,  1720.  —  More  important  was  the  Parisian  surgeon 

Francois  Sauveur  Morand  (1697-1773), 
equally  famous  as  a  man  and  a  surgeon,  who  after 

Henri  Francois  le  Dran  (1685-1770), 
also  a  surgeon  of  Paris,  had  performed  disarticulation  of  the  upper  arm  —  le  Dran 
distinguished  himself  also  as  a  lithotomist  and  military  physician — performed  the 
first  disarticulation  of  the  thigh.  Morand  also  occupied  himself  with  paracentesis  of 
the  chest,  abdomen,  ovarian  tumors  etc.,  and  in  1753  was  the  first  to  describe  a  case 
of  osteomalacia.  He  advised  the  use  of  the  hot  iron  to  check  haemorrhage  whenever 
haste  was  required,  or  the  great,  number  of  the  vessels  rendered  ligation  difficult. — 
Le  Dran  was  one  of  Haller's  teachers.  His  chief  work  was  entitled  "Traite  des 
operations  de  chirurgie",  Paris,  1742. 

Claude  Nicolas  le  Cat  (1700-1768)  of  Blerancourt 
was  particularly  famous  as  a  lithotomist.     In  the  operation  of  lithotomy  he  recom- 
mended to  keep  the  wound  diminishing  in  size  from  without  inward,   and   is  well 
known  also  for  his  recommendation  of  a  rare  bandage,  and  for  peculiar  views  upon 
gunshot  wounds.     He  was  too  an  opponent  of  the  lithotomist 

Frere  Come  (Jean  Baseilhac,  1703-1781)  of  a  village  near  Tarbes, 
a  monk  who  by  means  of  the  lithotome  cache  operated  from  within,  and  removed 
cataract  by  an  oblique  incision  into  the  cornea. 

Jean  Astruc  (1685-1766) 

deserves  mention  as  an  eminent  historian  of  syphilis  and  a  syphilographer  of  exten- 
sive knowledge,  who  utilized  pathological  anatomjr  in  his  studies  of  the  venereal 
disease  and  thus  became  acquainted  with  visceral  syphilis.  He  was  a  famous  literary 
swordsman,  and  devoted  some  attention  to  the  theory  of  midwifery. 

Francois  Quesnay  (1694-1774)  of  Merey, 
the  undaunted  physician  of  Louis  XV.,  who,  to  the  king's  question  on  what  theory  he 
would  rule,  replied  in  the  famous  words  "On  none!  I  would  let  the  laws  rule!" 
Quesnay  was  also  an  eminent  writer  on  political  economj-  and  founder  of  the  so-called 
phvsiocratical  system  of  government.  [In  medicine  he  is  best  known  perhaps  by 
his  "  Histoire  de  1'  origine  et  des  progres  de  la  chirurgie  en  France",  Paris,  1749.] 

Brasdor  (Pierre,  1721-1776), 
well  known  for  his  method  of  ligation  in  aneurisms  (below  the  sack),  as  well  as  for  his 
treatise  on  fracture  of  the  clavicle  and  on  disarticulations. 


—  064  — 

Hugo  Ravaton  (about  1750), 
a  very  clever  military  physician,  who  discussed  gunshot  wounds  in   an   excellent 
manner,  and  recommended  amputation  with  two  flaps,  while 

George  de  la  Faye  (died  1781) 
modified  le  Dran's  incision  for  disarticulation  of  the  shoulder  and  was  also  a  capable 
oculist,  removing  the  lens  by  simple  pressure  after  making  an  incision  with  the 
cataract  knife,  which  he  first  devised. 

Loubet,  an  army-surgeon,  Delaisse,  a  surgeon  of  Montfort,  and  l'Amaury  also 
enjoyed  considerable  reputation.  The  same  was  the  case  particularly  with  Claude 
Pouteau  (1725-1775)  of  Lyons,  who  favored  the  use  of  moxas,  which  Larrey  too 
subsequently  called  his  good  friends.  Adrien  Simon  Bojr  (died  1795  at  Alzey  in 
Rheinhessen),  a  physician  of  the  Army  of  the  Rhine,  [was  also  distinguished  as  a 
surgeon  and  as  the  author  of  an  excellent  "  Traitement  des  plaies  d'  armes  a  feu",  1795.] 

Thomas  Goulard, 

at  first  a  surgeon  in  Alet,  then  a  professor  in  Montpellier,  introduced  into  surgery  the 
use  of  preparations  of  lead,  and  even  at  the  present  day  his  name  is  probably  the 
best  known  of  all  physicians  from  his  "aqua  Goulardi". 

Jean  Colombier  (1736-1789) 
wrote  the  first  handbook  of  military  hygiene. 

Antoine  Louis  (1723-1792)' of  iMetz, 
the  permanent  secretary  of  the  Academie  de  Chirurgie  and  a  protege  of  la  Peyronie, 
to  whom  he  continued  attached  by  gratitude  all  his  life,  was  a  surgeon  of  considerable 
and  well-merited  reputation.  He  served  in  numerous  wars,  and  distinguished  himself 
also  as  a  forensic  physician.  He  was  likewise  the  first  who  held  a  public  disputation 
on  the  occasion  of  his  reception  into  the  Academie  of  surgeons  In  his  quarrels  with 
the  physicians  he  proved  himself  read}'  in  blows  and  adroit  in  speech.  His  chief 
works  were  entitled  "  Cours  de  chirurgie  pratique  sur  les  plaies  d'  armes  a  feu  ",  Paris, 
1746,  "  Recueil  d'  observations  d'  anatomie  et  de  chirurgie,  pour  servir  de  base  a  la 
theorie  des  plaies  de  tete  par  contrecoup",  Paris,  1768,  etc.  Contemporary  with 
Louis  was  the  teacher 

Raphael  Bienvenu  Sabatier  (1732-1811), 
a  professor  and  member  of  the  Academie  des  Sciences.  He  devoted  himself  chiefly 
to  anatomy  and  ophthalmology,  but  also  wrote  a  famous  treatise  on  operations,  in 
which  he  recommended,  among  other  things,  the  introduction  of  a  card  in  wounds  of 
the  intestine,  and  the  resection  of  the  head  of  the  os  brachii.  Both  the  foregoing 
surgeons,  with  others,  were  teachers  of  the  most  considerable  surgeon  of  that  day, 
the  great 

Pierre  Joseph  Desault  (174-1-1795), 
a  man  remarkable  for  the  whole  course  of  his  life.  Desault  was  the  son  of  a  farmer 
of  Magny-Vernois  (near  Lure,  so  well  known  since  1870),  poor,  but  blessed  with 
children,  and  was  originally  destined  for  the  priesthood.  Without  any  disposition  for 
this  profession,  after  a  thorough  stud}-  of  mathematics,  he  took  up  surgery,  beginning 
his  studies  with  an  ignorant  master  of  his  native  town.  Thence  he  went  to  Belfort 
and  subsequently  to  Paris,  where  he  supported  himself  by  teaching  mathematics.  He 
soon  rose  step  by  step,  until  at  last,  without  any  preceding  collegiate  education,  he 
became  professor  in  the  school  of  practice  and  chief  surgeon  of  the  Hotel- Dieu. 
Here  he  established  the  first  surgical  clinic,  provided  for  its  hygienic  arrangements  etc. 
Desault  rendered  service  to  science  especially  by  the  foundation  ot  surgical 
anatomy,  a  science  of  which  Dupuytren  and  Roux  were  the  literary  coryphaei,  for 
Desault  himself  wrote  nothing.  He  was  also  of  eminent  service  in  altering  and 
improving  the  system  of  operations,  in  designing  more  appropriate  instruments,  in 


—  665  — 

the  establishment  of  a  surgical  journal  etc.,  and  particularly  in  the  education  of  many 
able  pupils.  Like  all  truly  great  surgeons  after  Wurtz,  he  was  an  opponent  of  trepan- 
ning, an  operation  still  greatlj'  abused  in  the  last  century,  and  employed  in  almost 
all  injuries  of  the  skull.  Desault  was  likewise  a  champion  of  healing  by  prima 
intentio.  Toward  the  close  of  his  life  persecuted  by  the  Revolutionists  —  his  last 
patient  was  the  unfortunate  Louis  XVII.  who,  as  now  shown,  died  of  scrofulosis  —  he 
died  suddenly  of  an  affection  of  the  brain.  His  trusty  friend  Francois  Chopart  ( 1743— 
1795),  from  whom  a  well-known  form  of  amputation  of  the  foot  has  received  its  name, 
followed  him  speedily  to  the  grave. 

The  following  surgeons  of  this  golden  age  of  French  surgery  must  also  be 
mentioned : 

Pierre  Sue  (1739-1816)  of  Paris, 
professor  of  surgery  in  1767,  and  subsequently  phj'sician  to  Joseph  Beauharnais.     In 
1812  he  was  chief  physician  in  the  campaign  against  Russia    and,  after  the  fall  of 
Napoleon,  court-physician  under  Louis  XVII I.     Sue  was  a  fertile  author  on  surgery 
•and  obstetrics. 

Jean  Juville,  to  whom  we  owe  an  improvement  in  the  construction  of  trusses; 
Pipelet,  who  rendered  service  in  the  subject  of  hernia  and  was  expelled  from  the 
Academie  for  charlatanism  ;  Jean  Pierre  David  (1737-1784)  of  Rouen,  who  described 
necrosis;  C.  A.  Lombard  (1741-1811)  and  Francois  Laur.  Marchall  of  Strassburg,  who 
performed  the  first  amputation  of  the  cervix  uteri;  Goursault,  who  performed  the 
first  cesophairotomy  in  1738;  Delacroix  in  Orleans  (amputation  at  the  hip);  Jean 
Jacques  Belloc  (171-50-1807),  inventor  of  Belloc's  canula,  who  was  first  a  surgeon,  then 
a  physician  in  Agen  and  finally  professor  of  forensic  medicine  ill  Paris;  Toussaint 
Bordenave  (died  1782);  Leblanc  in  Orleans;  Prudent  Hevin  (1715-1789);  Henri 
Louis  Duhamel  de  Monceau  (1700-1782),  who  made  investigations  upon  the  healing 
of  bones  and  their  nutrition  by  the  periosteum,  feeding  animals  with  madder  for  the 
purpose  of  staining  the  bony  tissue,  though,  according  to  Lawson  Tait,  John  Belchier 
(1706-1785)  anticipated  him  in  this  matter: 

Pierre  Francois  Percy  (1754-1825), 
a  famous  military  surgeon  under  the  Consulate  and  Empire  and  a  writer  on  subjects 
relating  to   military  surgery,  who  strongly  recommended  the  use  of  cold  water  in 
gunshot  wounds,  and,  among  other  things,   in  operations  preferred  in  many  cases  the 
scissors  to  the  knife.     The  cold  water  treatment  was  at  this  time  a  novelty. 

Not  a  few  of  the  French  surgeons  rendered  lasting  service  to  ophthal- 
mology, particular^'  the  operative  treatment  of  diseases  of  the  eye,  which 
in  the  18th  century  fell  into  the  hands  of  scientifically  educated  surgeons 
and  began  to  become  a  specialty  of  eminent  men,  instead  of  continuing  the 
field  of  charlatans  as  it  had  been  eveiywhere  heretofore.  Among  these 
French  oculists  we  mention 

Charles  de  St.  Yves  (1667-1736)  of  Paris, 
who  correctly  distinguished  capsular  and  lenticular  cataract  and  gonorrhceal  and 
syphilitic  inflammations  of  the  eyes  (Troksch),  glaucoma  (a  term  by  which  he 
designated  a  form  of  cataract  due  to  paralysis  of  the  optic  nerve  and  accompanied 
by  dilatation  of  the  pupil),  and  undertook  extraction  of  cataract  (1707).  He  was  also 
the  first  to  wash  out  the  anterior  chamber  of  the  eye  (Magnus). 

Francois  Pourfour  du  Petit  (1663-1743)  of  Paris, 
who  improved   the  technique  of  cataract  extraction  and  gave  his  name  to  the  canal 
■of  Petit.     A  pioneer,  like  Graefe  in  our  own  century,  was 


—  666  — 

Jacques  Daviel  (1696-1762), 

who  introduced  in  1750  the  extraction  of  the  lens  as  an  independent  method.  He- 
operated  by  means  of  the  inferior  flap  method,  Daviel' s  spoon  etc.  Ilis  technique 
was  still  imperfect  and  was  improved  by  de  la  Faye. 

Tenon  (1724-1 81 6) 
wrote  meritoriously  on  cataract,  and  other  diseases  of  the  eyes. 

Dominique  Ariel's  name  is  still  borne  b}*  a  syringe  and  probes.  He 
performed  the  so-called  Hunterian  operation  for  aneurism  before  Hunter, 
and  even  aspirated  fluid  from  the  chest  with  the  syringe.  The  following 
surgeons  were  also  well-known  oculists  :  Antoine  Ferrein,  who  split  open 
the  capsule  posteriorly  to  effect  depression  ;  Pierre  Guerin,  of  the  Hotel- 
Dieu  in  Lyons  ;  Jean  Janin  (1731-1799)  of  the  same  place,  who  declared 
the  capsule  removable  and  improved  iridotomia.  making  his  incision  of 
the  iris  with  scissors  ;  Baron  von  Wenzel  Sr.,  the  zealous  champion  of 
extraction,  deserves  the  greatest  credit  for  his  performance  of  iridectonry. 
He  pierced  with  the  cataract-knife  cornea  and  iris  together,  and  removed 
with  the  scissors  in  the  chamber  the  flaps  thus  formed  from  the  iris. 
Wenzel  senior  found  in  his  son,  Mich.  Jean  Bapt.  de  Wenzel,  a  worthy 
successor.  Pierre  Demours  (died  1795)  too,  the  anatomist,  and  his  son 
Antoine  Pierre  Demours  (1762-1S32),  rendered  lasting  service  to  the 
science  of  ophthalmology.  The  latter  survived  into  the  19th  century, 
as  did  also  the  famous  Delarue  (Cours  complet  des  maladies  des  3'eux, 
1820),  and  Descemet  (1732-1810),  professor  in  Paris.  Louis  Flor.  Deshaix- 
Gendron  of  Orleans,  professor  of  ophthalmology  in  Paris,  Pellier  de 
Quengsy  in  Toulouse  and  others. 

We  will  add  here  (after  Donders)  the  remarkable  fact  that  Janin  first  described, 
and  described  quite  completely,  hvpermetropia,  and  referred  it  to  too  flat  a  formation 
of  the  lens.  He  did  not,  however,  name  it  correctly.  Natural])*  he  distinguished 
merely  healthy  vision  and  shortsightedness,  while  the  hypermetropia  resulting  from 
aphacia,  as  well  as  our  hypermetropia  and  presbyopia  of  the  present  day  he  classes 
among  the  accidental  defects  of  vision  (Anomalies  of  Refraction). 

Dentistry  too  found  excellent  laborers  in  its  field.  Among  these  were 
Pierre  Fau chard  of  Paris,  who  wrote  the  first  complete  work  on  this  sub- 
ject ••  Le  chirurgien  dentiste.  ou  traite*  des  dents"  etc.,  Paris,  172S;  Pierre 
Auzebi  of  Lyons ;  Lecluse,  who  first  mentions  the  English  turnkey  ; 
Jourdain,  who  brought  forward  appropriate  instruments  and  new  artificial 
teeth  ;  P.  Moulon  (artificial  teeth)  ;  Bourdet  (artificial  palate,  lever),  dentist 
to  the  king  :  Pierre  Guissard  etc. 

The  science  of  otology,  founded  by  Duverney,  was  excited  to  practical 
advancement  by  the  attempt  at  catheterization  of  the  Eustachian  tubes 
from  the  mouth,  made  in  1721  by  the  postmaster  Guyot  of  Versailles,  an 
operation  first  performed,  however,  b}*  Archibald  Cleland  in  1741.1     Antoine 

1.  Cleland  was  an  English  army-surgeon,  and,  according  to  Lucae,  introduced  the 
Eustachian  catheter  through  the  nose,  and  practised  Valsalva's  method  of  inflating 
the  middle  ear.  His  papers  appeared  in  the  Philosophical  Transactions  for  the 
years  1740  and  1741.     (H.) 


—  667  — 

Petit  recommended  catheterization  through  the  nose  after  Julien  Busson 
had  advised  the  introduction  of  steam  into  the  tubes.  Jean  Louis  Petit 
also  practised  perforation  of  the  mastoid  process  after  the  Prussian  regi- 
mental surgeon  Jasser  had  performed  this  operation,  and  Eli  in  Paris 
practised  the  first  perforation  of  the  membrana  tympani  in  1720  for  deaf- 
ness.    Of  the  other  Romanic  peoples, 

b.  The  Italians 

were  well  represented  in  surgery,  and  although  they  had  lost  most  of  their 
earlier  reputation,  they  still  displayed  surgeons  of  importance.  Among 
these  Antonio  Benevoli  (1685-1756),  of  the  famous  surgical  headquarters 
at  Norcia,  subsequently  settled  in  Bologna  and  Florence,  was  the  first  in 
Italy  to  teach  that  the  seat  of  cataract  was  in  the  lens.  P.  Paolo  Molinelli 
(1702-1764)  and  Natal  Gius.  Palucci  (1716-1797)  of  Florence,  Paris  and 
Arienna  (who  was  the  first  to  distinguish  the  nucleus  of  the  lens  from  its 
capsule,  and  never  entirely  abandoned  depression),  distinguished  themselves 
as  oculists,  while  T.  Ambrosio  Maria  Bertrandi  (1723-1765),  a  professor  in 
Turin,  proved  himself  a  very  important  operator  and  universal  surgeon. 
Beside  him  were  ranged  the  two  Nannoni  (Angiolo,  the  father,  1715-1790, 
and  Lorenzo,  1749-1812,  the  son),  Pietro  Paolo  Tanaron,  Nic.  Capuletti, 
Malacarne  in  Turin,  Girolamo  Marini  (wrote  on  surgical  operations,  1723), 
while  Dom.  Cirillo  in  Naples,  distinguished  himself  as  a  syphilographer, 
Gius.  Flajani  (1741-1808)  and  Mich.  Troja  (1747-1827)  were  eminent  as 
operative  surgeons,  and  Flajani,  as  well  as  Carlo  Mondini  (1729-1803),  dis- 
tinguished themselves  also  as  oculists  (extraction)  ;  Guattani  (compression 
of  the  artery  above  the  aneurismal  sack)  ;  Moscati  in  Milan  ;  Gius.  Nessi 
(surgery,  1781).  Giov.  Battista  Palletta  (1747-1832)  made  himself  well- 
known  by  his  observations  relative  to  spoixbylarthrocace  and  the  so-called 
voluntary  limping. 

Antonio  Scarpa  (1752-1832)  of  Motta, 

professor  successively  in  Modena  and  Pavia,  was  one  of  the  most  important  surgeons, 
and  was  chiefly  of  service  in  the  study  of  herniologj\  diseases  of  the  eyes  (discision 
of  cataract  and  irido-dialysis,  or  tearing  the  iris  from  its  border,  an  operation  per- 
formed before  him.  however,  by  Paolo  Assalini  and  Franz.  Buzzi  in  Milan,  1788,  the 
discoverer  of  the  yellow  spot  in  1782),  the  theory  of  aneurisms,  their  treatment  by 
ligation,  the  doctrine  of  malformations  of  the  feet  etc.  Scarpa  was  likewise  an 
eminent  anatomist.     The  most  famous  surgeon  of  this  centur}-  among  the 

c.  Spaniards, 

Antonio  de  Gimbernat,  professor  in  Barcelona  from  1762-1774.  then  a 
surgeon  in  Madrid,  distinguished  himself  equally  as  an  anatomist  and 
herniologist.  Other  reputable  Spanish  surgeons  were  Pasc.  Franc.  Yirrey 
(Handbook  of  surgery,  1741)  ;  Mart.  Martinez  (New  surgery,  1722) ;  Barth. 
Serena  and  Ant.  Medina  (New  course  of  surgery,  1750) ;  Fr.  Yillaverde  and 
D.  Yelasco  (Course  of  theoretical  and  practical  operative  surgery,  1792). 


—  6(38  — 

Among  the  Germanic  races,  in  fact  among  almost  all  nations, 
d.  The  Germans 

"were  the  people  with  whom  surgery  and  surgeons  emerged  last  of  all  from 
the  mediaeval  contempt  fastened  upon  them  by  the  ;' Church  ".  Although 
•even  in  the  17th  century  we  had  possessed  not  a  few  important  surgeons, 
this  contempt  in  the  first  half  of  the  18th  century  was  still  almost  universal, 
and  was  not  entirely  lost  in  the  latter  half  of  the  century,  especially  with 
regard  to  the  ordinary  practising  surgeons,  who  were  undoubted!}',  for  the 
most  part,  only  ignorant  popular  physicians.  Hence,  doubtless,  it  resulted 
that  it  was  only  at  a  very  late  period  among  us  that  men  of  respectable 
social  and  scientific  standing  could  devote  themselves  to  surgery.  It  was 
partly  the  passion  of  the  highest  circles  to  imitate  whatever  the  French  did 
and  possessed,  that  first  led  to  a  fundamental  improvement  of  these  con- 
ditions among  us. 

This  was  the  reason  why  the  first  German  surgeon  of  complete  scien- 
tific education, 

Lorenz  Heister  (1083-1758)  of  Frankfort-on-the-Main, 
^.fter  laying  the  foundation  of  his  education  in  Giessen,  was  compelled  to  complete 
his  proper  medical  studies  in  Leyden  and  Amsterdam.  As  it  was  impossible  to 
obtain  honorable  employment  in  German  armies,  it  was  only  in  the  Dutch  military 
service  that  he  could  acquire  surgical  experience  with  a  respectable  position.  He 
remained  in  this  service  until  it  was  learned  by  experience  both  abroad  and  at  home, 
that  there  might  be  good  German  surgeons  too  besides  the  French,  who  up  to  this  time 
had  been  so  much  sought  after.  Heister  was  now  called  in  1710  to  Altdorf,  and  then  in 
1720  came  to  Helmstedt,  where  he  developed  a  great  activity  which  embraced  anatomy 
and  surgery  and  even  botany.  His  books  on  surgery  and  anatomy  in  his  time 
rendered  him  almost  an  autocrat  in  these  branches.  Surgery  he  discussed  from 
the  ordinary  dressing  of  wounds,  upon  which  he  laid  especial  weight,  and  ligation 
(acupressure),  to  the  highest  surgical  subjects.  He  also  distinguished  himself  as  a 
dentist  and  especially  as  an  oculist,  assisting  to  introduce  into  Germany  the  view  that 
cataract  depended   upon  cloudiness  of  the  lens.     In  the  latter  matter  his  pupil 

Burkhard  David  Mauchart  (1696-1751), 
born  in  Marbach  (the  native  place  of  the  regimental  physician  Schiller),  subsequently 
professor  of  anatomy  and  surgery  in  Tubingen,  followed  his  example.  He  did  away 
with  the  doctrine  of  the  laceration  of  the  peritoneum  in  the  origin  of  hernia  (P.  Koch). 
His  pupil  Boury  first  introduced  the  term  Gerontoxon  (1743)  in  a  dissertation  on 
opacities  of  the  cornea.  (  Mauchart  himself  published  no  works  under  his  own  name). 
A  contemporary  and  colleague  of  Heister's  in  Halle,  professor 

Heinrich  Bass  (1690-1754), 

rendered  good  service,  among  other  things,  in  the  practice  of  paracentesis  of  the 
chest,  which  he  performed  after  drawing  the  skin  to  one  side. 

In    Saxon}'   the    following   surgeons    of  importance    displayed    their 
activity  : 

Jon.  Zaciiarias  Platxer  (1694-1747)  of  Leipzig, 
who  wrote  in  elegant  Latin  a  long-popular  and  good  text-book  (" Institutions  chirur- 
giae   rationales  "  ) ; 


—  669  — 

Justus  Gottfr.  Gunz  (1714-1754), 
ordinary  physician  in  Dresden,  a  good  oculist  and  berniotomist; 

Karl  Friedricii  Kaltschmidt  (1706-1769), 
professor  in  Jena   a  versatile  and  bold  surgeon,  who  also  devoted  attention  to  forensic 
medicine.     Kaltschmidt  likewise  made  some  experimental  investigations  relative  to 
wounds  of  the  liver. 

Ill  Mayence  professor  Job.  Peter  Weidmann  distinguished  himself  as 
a  teacher,  surgical  investigator,  judicious  practitioner  and  bold  operator. 
He  is  well-known,  among  other  things,  for  a  treatise  on  necrosis,  translated 
into  French  by  Jourdan.  He  said  he  could  write  all  his  remedies  upon  a 
single  card,  and  of  the  many  glittering  things  in  his  case  of  instruments  he 
employed  very  few,  however  shiny  they  might  look.  In  Helmstedt  lived 
the  curious  saint  and  ingenious  charlatan,  the  ordinary  physician  Gottfr. 
Christoph  Beireis  (1730-1809)  of  Miilhausen,  who  was  at  first  professor  of 
physics  and  medicine,  and  subsequently  professor  of  surgery. 

Prussia  through  its  numerous  wars  reared  a  greater  number  of  famous 
surgeons,  for  war  has  ever  been  the  most  excellent  school  of  surger}*.  These 
men  almost  all  had  a  "destiny",  and  accordingly  perseverance  and  energy. 
Most  of  them  served  from  the  barber's  bowl  up,  and  came  often  from  very 
great  poverty  to  success  of  the  most  honorable  character,  free  from  all 
charlatanism.     The  ordinary  physician  of  Frederick  William  I., 

Joh.  Theod.  Eller  (1689-1760), 
one  of  the  founders  of  the  Charite,   was  a  good  surgeon.     The  first  surgeon  of  the 
Cbarite  and  the  first  professor  of  the  Medico-chirurgical  College,  however,  was 

Simon  Pallas  (1694-1770), 
whose  son  Aug.  Friedr.  (1781-1812)  was  likewise  a  professor  in  Berlin. 

Joach.  Friedr.  Henckel  (1712-1779), 
a  man  eminent  for  his  charity,1  rendered  special  service  to  the  subject  of  surgical 
dressings. 

Samuel  Schaarschmidt  (1709-1747), 
ordinary  physician,  was  an  extremely  fruitful  writer  on   military  medicine,   and  the 
first  surgeon  in  Berlin  to  perform  lithotomy. 

J.  Chr.  Ant.  Theden  (1714-1797), 
who   had   worked   himself  up  from   poverty    (Theden's   dressings,    Aqua  traumatica 
Thedenii,  inventor  of  the  elastic  catheter  with  a  covering  of  caoutchouc  etc.),  dis- 
tinguished himself  as  a  field-surgeon,  and  was  finally  made  surgeon-general. 

Joh.  Ulrich  Bilguer  (1720-1796)  of  Chur, 
who  studied  in  Basel,  Paris,  Strassburg  and  Halle,  and  finally  became  surgeon-general 
in  Berlin,  was  a  deserving  but  partial  opponent  of  amputation,  an  operation  which, 
like  trepanning  (and  both  Bilguer  and  Theden  advocated  the  latter  operation),  was 
undoubtedly  horribly  abused.  He  performed  the  first  resection  of  the  wrist  in  1762 
(though,  according  to  other  authorities,  a  Dr.  Beyer  anticipated  him  in  the  same  year, 
after  the  battle  of  Freiburg). 

1.  At  his  death  be  bequeathed  1,000  thaler  (a  great  sum  in  that  day)  for  the  free 
education  of  a  student  of  medicine  or  surgery.  The  latter  received  the  interest 
upon  this  sum  for  three  years. 


—  670  — 

Joh.  Leberecht  Schmicker  (1712-1786) 
occupied  the  post  of  surgeon-general  under  Frederick  IT.,  and  proved  himself  an 
eminent  surgeon  by  his  opposition  to  trepanning  and  his  introduction  of  the  treatment 
of  injuries  of  the  skull  by  cold  poultices.  He  also  recommended  millepedes  as  a 
snuff  in  amaurosis.  The  same  office  was  filled  by  J.  C.  F.  Voitus  (1745-1787)  of 
Genthin,  son  of  a  poor  rector  of  a  school. 

Another  surgeon-general  was 

Christ.  Ludwig  Mursinna  (1744-1823), 

the  son  of  a  weaver  of  Stolpe  in  Pomerania,  who  for  a  long  time  practised  his  father's 
trade  and  then  began  his  surgical  career  among  the  bath-keepers. 

Johann  Gorcke  (1750-1822), 
a  humane,  meritorious,  indefatigable  and  highly-esteemed  physician,  organizer  of  the 
Prussian  medical  department,  attained  the  position  of  surgeon-general  from  that  of 
the  son  of  a  poor  minister  of  East  Prussia. 

In  Austria  surgery  did  not  owe  its  success  to  the  daily  profit  reaped 
in  war  so  much  as  in  Prussia,  but  rather  to  the  great  and  ever  active  spirit 
of  Joseph  II.,  a  monarch  to  whom  nothing  human  was  foreign.  He,  almost 
alone  among  all  monarchs.  had  a  heart  for  the  people,  and  continued,  even 
upon  the  throne,  to  be  a  man  of  his  people  in  the  best  sense  of  that  ex- 
pression. But,  alas,  when  he  anticipated  that  death  would  grant  him  no 
time  for  quiet  action,  he  overturned  everything,  including  even  that  which 
he  had  proposed  with  regard  to  medicine  and  surgery,  branches  upon  which 
he  intended  to  bestow,  and  had  in  part  actually  bestowed,  great  advantages. 
From  the  very  outset  he  had  done  harm  by  his  undue  patronage  of  the 
surgeon  next  mentioned,  to  whom  he  entrusted  the  arrangement  of  the  so- 
called  Josephinum.     I  refer  to  Joseph's  surgeon-in-ordinary, 

Joh.  Alex,  vox  Brambilla  (1728-1800)  of  Pavia, 
who  was  also  surgeon-in-chief.  Useful  as  he  was  in  elevating  the  surgical  profession 
of  Austria,  Brambilla,  in  reliance  upon  the  favor  of  Joseph,  in  many  respects  went 
too  far,  and  particular^-  in  his  excessive  preference  of  his  so-called  medico-chirurgeons 
to  the  physicians.  He  also  wrote  a  history  of  surgery.  He  was  succeeded  in  the 
position  of  chief  of  the  Austrian  department  of  military  hygiene  by 

Matth.  3Iederer, 

from  1773  to  1796  professor  of  surgery  in  Freiburg  in  the  Brisgaw,  a  city  at  that  time 
belonging  to  Austria.  Mederer,  like  the  earlier  Paracelsus,  was  a  manly  champion 
of  the  union  of  surgery  and  medicine.  It  was  on  Mederer's  recommendation  that 
the  poor  barber, 

Joh.  Hcxczowsky  (1752-1798)  of  Czech  in  Moravia, 
was  sent  to  Paris,  London  etc.  to  obtain  his  education,  and  then  became  a  teacher  in 
the  Josephinum.      He  was  a  good  operator,  and  died  from  the   effects  of  an  injuiy 
received  in  an  operation.     Another  surgeon  who  began  his  activitj-  in  the  Josephinum 
was 

Baron  Jos.  Jac.  von  Mohrenheim  (died  1798), 
who  became  finally  ordinary  physician  of  Catherine  II.  and  obstetrician  to  the  Grand 
Duchess.     He  was  also  an  important  surgical  practitioner  as  well  as  an  oculist.     An 
army-surgeon  and  professor,  chief  of  the  city  hospital,  was 

Ferdinand  Leber  (1727-1801),  the  son  of  a  wig-maker  of  Vienna. 
He  anticipated  Guattani  in  the  practice  of  indirect  compression  of  aneurisms,  and 


—  671  — 

became  immortalized  in  the  annals  of  the  humanitarian  contests  of  the  18th  century 
bjr  his  successful  struggle  against  the  torture  —  he  was  a  "  Torturarzt".  He,  and  the 
professor  of  jurisprudence  Sonnenfels,  succeeded  in  getting  rid  of  the  torture  in 
Austria  in  1776. 

Jos.  Jac.  Plenck  (1732-1808)  and 

Jacob  yon  Reinlein  (174-1-1816), 

until  1787  professor  in  the  surgical  school,  also  belong  here. 

Carl  Caspar  von  Siebold  (1736-1807) 
(the  first  important  representative  of  a  name  often  distinguished  in  medical 
science),  as  the  founder  of  an  institution  for  surgical  instruction,  where,  for 
the  first  time  in  Germany,  surgery  was  actually  taught  clinically  or  poli- 
clinicall}-,  was  an  eminent  promoter  of  this  science,  particularly  in  South 
Germany  and  from  Wiirzburg  as  a  center. 

The  son  of  a  surgeon  of  Nidecken  in  the  duchy  of  Juliers,  he  for  some  time 
assisted  his  father,  notwithstanding  he  had  already  completed  his  higher  studies. 
Then  he  went  into  the  field-service  of  France,  during  which  he  came  to  Wiirzburg 
and  here  abandoned  military  service  in  order  to  go  to  France,  England  and  Holland 
at  the  expense  of  the  prince-bishop.  After  his  return  he  was  appointed  physician-in- 
ordinary  and  adjunct  to  a  professorial  chair,  and  subsequently  professor  of  anatomj', 
surgery  and  obstetrics.  In  this  position  he  was  one  of  the  most  famous  professors  in 
Germany,  and  even  received  tokens  of  recognition  from  France,  doubtless  because  he 
was  the  first  in  Germany  to  perform  (1778)  the  operation  of  symphyseotomy. 

Adam  Friedrich  Vogel  (1746-1785), 
a  physician  of  Liibeck,1  deserves  to  be  mentioned  here  as  an  exception  among  the 
phj'sicians  of  that  day,  since  he  did  not  scorn  surgery.  Justus  Arneman  (1763—1807), 
the  author  of  a  "System  der  Chirurgie",  and  Bernhard  Christoph  Faust  (1755-1842) 
of  Biickeburg,  the  inventor  of  the  useful  leg-swing  ( Beinschwebe),  are  also  to  be 
mentioned.  The  latter  was  a  warm-hearted  and  warm-blooded  enthusiast,  influenced 
too  by  honorable  motives,  who  pressed  forward  with  his  reform  proposals  even  to  the 
French  National  Assembl}'. 

The  greatest  German  surgeon  of  the  18th  century,  at  once  an  eminent 
surgical  writer  and  an  excellent  physician,  after  the  style  of  many  English 
surgeons,  the  man  whom  even  Dieffenbach  chose  as  his  model,  was 

August  Gottlieb  Richter  (1742-1812),  of  Zorbig  in  Meissnischen. 
where  his  father  was  a  minister.  Richter  was  the  descendant  of  a  familj-  of  ministers 
and  professors,  and  became  finally  himself  a  professor  in  Gottingen.  He  wrote, 
among  other  works,  a  famous  book  on  hernia,  which  was  translated  into  several 
languages,  published  a  surgical  "  Bibliothek",  wrote  the  surgical  text-book  "Anfangs- 
griinde  der  Wundarzneikunst "  etc.  On  the  completion  of  the  usual  studies  he  had 
visited  London,  Paris,  Lej-den  and  Amsterdam,  and  in  1771  was  made  a  professor. 
In  this  position  he  studied  all  parts  of  surgery  and  most  of  them  he  improved.  In 
the  dressing  of  wounds  his  principle  was  "geschwinde,  gelinde  und  selten."  In  his 
son  Georg  August  (1778-1832),  professor  in  Konigsberg,  Richter  found  an  editor  for 
many  of  his  writings.  Richter,  like  most  of  the  surgeons  above  mentioned,  devoted 
himself  prominently  to 

1.  Several  other  physicians  and  surgeons  of  this  name  are  known,  e.  g.  Zacharias 
(1708-1772)  and  his  son  Jac.  Christian,  likewise  in  Liibeck,  and  Benedict  Christian, 
professor  in  Altdorf. 


—  G72  — 

Ophthalmology. 

The  same  was  true  of 

Jon.  Ernst  Neubauer  (1738-1777),  a  professor  in  Jena. 

Joh.  Albert  Heinrich  Reimarus  (1729-1814), 
a  practising  physician  and  professor  in  Hamburg,  and  son  of  the  Reimarus  rendered' 
famous  by  Lessing,  was  the  first  to  employ  belladonna  as  a  mydriatic,   and   thus 
render  a  great  service  to  humanity.     The  capable  teacher  and  observer 

Joseph  Barth  (1745-1818)  of  Malta, 
professor  of  anatomy  and  oculist  of  Joseph  II.  in  Vienna,  in  1773  was  the  first  to 
give  separate  lectures  on  ophthalmology,  and  he  also  founded  an  ophthalmic  hospital. 

The  practitioner  Ant.  Karl  von  Willburg  of  Nuremberg  in  1785  was 
the  first  to  perform  reclination  of  cataract,  and  D.  G.  C.  Conradi  in  Nord- 
heim  near  Gottingen,  the  first  who  performed  discision  of  the  lens  through 
the  cornea,  with  the  object  of  securing  subsequent  spontaneous  resorption 
(1797).  We  know  from  Goethe's  autobiography  that  the  eminent,  though 
odd  and  pious,  Jung-Stilling  (1740-1817)  enjoyed  great  reputation  for  a 
loner  period  as  an  operative  oculist  or  coucher  of  cataracts. 

The  following  prominent  oculists  of  the  18th  century  continued 
eminent  in  the  19th  century  also  : 

Joh.  Ad.  Schmidt  (1759-1809)  of  Aub,  near  Wiirzburg,  a  professor  in 
Vienna,  as  competent  an  observer  —  he  first  described  e.  g.  syphilitic  iritis 
and  also  introduced  this  designation  (Proksch)  — ■  as  he  was  a  capable 
teacher  and  writer  ; 

Carl  Himly  (1772-1837)  of  Brunswick,  a  professor  in  that  city,  as 
well  as  in  Jena  and  Gottingen.  Both  of  these  oculists  were  pupils  of 
Barth  and  experimented  with  mydriatics.  Schmidt  was  the  first  to  employ 
the  latter  in  iritis,  while  Himly  used  them  extensively  in  operations. 
Both  of  them  published  an  ophthalmological  "  Bibliothek". 

Belonging  to  the  18th  century  in  spirit,  as  well  as  in  the  decisive 
period  of  his  life,  was  the  famous  oculist 

Georg  Jos.  Beer  (1763-1821),  a  professor  in  Vienna,  who  extended 
what  Barth  and  Schmidt  had  begun.  It  is  upon  his  teachings  that  the 
fame  of  the  university  of  Vienna  in  this  specialty  depends.  In  them  too 
the  ophthalmology  of  the  new  Vienna  School  took  its  origin.  Beer  made 
himself  of  essential  service  in  the  entire  department  of  ophthalmology, 
where  he  was  the  first  to  make  extensive  use  of  pathological  anatomy. 
It  was,  however,  in  the  doctrine  of  inflammations,  which  he  divided  into 
idiopathic,  those  excited  by  local  injuries,  and  sympathetic,  those  called 
forth  by  a  general  dyscrasia,  that  he  performed  the  most  eminent  service. 
He  also  promoted  greatly  the  judicious  treatment  of  cataract,  extraction, 
the  formation  of  an  artificial  pupil  (he  first  drew  forth  the  iris  and  cut  it 
off  externally)  and  the  improvement  of  instruments. 

Pupils  are  the  best  evidence  of  the  importance  of  a  teacher,  and  Beer's  pupils 
were  Ph.  von  Walther,  C.  F.  von  Graefe,  F.  Jaeger,  William  Mackenzie,  Quadri, 
Chelius,  Reisinger  etc. 


—  673  — 

Otology  was  advanced  by  Kritter  and  Lentin.  The  catheterization  of 
the  Eustachian  tubes  and  perforation  of  the  mastoid  process  were  discussed 
and  performed  in  Germany  —  the  latter  particularly  by  . 

Justus  Arneman  (1763-1807)  of  Liineberg, 
who  .was   for   a  long;  time   professor  in    Gottingen,   then    a   practising   physician   in 
Hamburg,  where  he  shot  himself. 

Orthopaedia  was  especially  cultivated  by  the  Swiss  J.  Andr.  Venel 
(1740-1791),  a  physician  of  Orbe,  who  treated  club-foot,  crooked  joints 
etc.,  though  only  by  the  aid  of  apparatus  ;  Joh.  Christian  Ehrmann  in 
Frankfort  (1749-1827),  who  died  in  Speyer.  though  born  in  Strassburg ; 
Aug.  Bruckner  (1769-1797)  in  Gotha  etc.  The  first  operative  treatment 
of  club-foot,  which  consisted  in  a  wide,  direct  incision  clear  through  the 
tendo  Achillis,  was  undertaken  by  the  Hessian  physician  Gerhardt  Thile- 
nius  (1745-1809). 

The  cosmetic  art  of  dentistry,  an  art  then,  as  to  some  extent  at  the 
present  da}',  the  favorite  field  of  charlatans,  enjoyed  much  cultivation. 

Friedrich  Hirschfeld  (also  Hirsch,  1753-1820)  of  Sensheim  in  Franconia,  court 
and  university  dentist  at  Gottingen,  was,  however,  no  charlatan.  Joh.  .Tac.  Jos.  Serre 
wrote  a  "  Geschichte  oder  Abhandlung  der  Zahnschmerzen  des  schonen  Geschlechts 
in  ihrer  Schwangerschaft  '.  Ph.  Pfaff,  ro}al  Prussian  dentist,  A.  A.  Brunner,  Carl 
A.  Blumenthal,  Joh.  Friedr.  Galette,  who  belonged  to  a  family  of  dentists  in  Mayenee, 
should  also  be  mentioned. 

e.  The  English, 

even  during  the  18th  century,  manifested  those  characteristics,  which 
distinguish  their  surgery  so  greatly  at  the  present  day  —  thorough  study 
of  anatomy  and  physiolog}',  quiet,  sober  observation,  careful,  conscientious, 
and  yet  bold,  conduct  in  operating,  and  careful  after-treatment.  In  the 
beginning  of  the  century 

William  Cheselden  (1688-1752), 
as  important  an  anatomist  as  a  surgeon -and  oculist,  was  active  in  London.  He  intro- 
duced the  formation  of  an  artificial  pupil  by  a  simple  incision  of  the  iris  (iridotomy, 
1728),  made  with  a  needle  introduced  through  the  sclera.  He  was  a  rapid  operator, 
performing  lithotomy  in  a  few  minutes.  [Cheselden  was  born  near  Somerby  in 
Leicestershire,  studied  under  a  surgeon  in  Leicester  and  subsequently  under  the 
anatomist  Cowper  and  the  surgeon  Fern  in  St  Thomas's  Hospital,  and  began  to 
deliver  lectures  at  earl}-  as  his  22d.  year.  He  was  principal  surgeon  to  Queen 
Caroline,  to  whom  he  dedicated  his  magnificent  "Osteology,  or  the  Anatomy  of  the 
Bones"  in  1733,  surgeon  to  St.  Thomas's  and  the  Chelsea  Hospitals,  and  a  member 
of  the  French  Academie  de  Chirurgie.  His  dexterity  in  the  performance  of  lithotomy 
excited  the  wonder  of  his  contemporaries,  and  stories  are  told  of  his  performance 
of  this  operation  in  fifty -four  seconds.  Originally  he  was  an  advocate  of  the  high 
operation,  but  his  experience  at  a  later  period  led  him  to  prefer  the  lateral  section. 
Like  man}'  great  surgeons,  Cheselden  is  said  to  have  been  exceedingly  nervous 
and  restless  before  commencing  an  operation,  but  as  firm  and  steady  as  a  statue 
during  its  actual  performance.  His  "Anatomy  of  the  Human  Body"  was  published 
in  1713,  and  his  "Treatise  on  the  High  Operation  of  the  Stone"  in  1723.]  His. 
pupil 

43 


—  674  — 

Samuel  Sharp  (about  1700-1778)  of  London, 
a  bold  operator,  was  equally  meritorious  in  the  operative  treatment  of  diseases  of  the 
eyes  Like  Cheselden  a  member  of  the  Academie  de  Chirurgie,  and  surgeon  of  Guy's 
Hospital,  Sharp  was  eminent  in  almost  every  department  of  surgical  art.  He  wrote 
a  "  Treatise  on  the  operations  of  surgery  "  (1739),  and  a  "  Critical  inquiry  into  the 
present  state  of  surgery"  (1750),  in  which  latter  work  he  called  the  attention  of  his 
English  colleagues  to  the  advances  made  by  the  French  in  the  science  and  art  of 
surgery. 

Alexander  Monro  Sr.  (1697-1767)  of  Edinburgh 
was  a  professor  of  anatomy  and  surgery,  and  eminent  in  both  branches.  He  probably 
contributed  more  than  any  single  individual  to  the  success  and  reputation  of  the 
medical  school  of  Edinburgh.  His  "Osteology,  or  a  Treatise  on  the  Anatomy  of  the 
Bones"  appeared  in  172l>,  and  his  "Essay  on  Comparative  Anatomy"  in  1744.  His 
sons  Alexander  (1733-1817)  and  Donald  (1729-1792)  and  grandson  Alexander 
(tertius,  1773-1859),  were  likewise  eminent  surgeons.  Other  bold  operators  were 
Benjamin  Gooch  (died  about  1780);  James  Hill,  a  surgeon  of  Dumfries  ("Cases  in 
Surgery",  Edinburgh,  1772),  and  particularly 

Charles  White, 

a  surgeon  of  Manchester,  and  the  first  representative  of  conservative  surgery,  who  in 
1768  performed  the  first  resection  of  the  humerus,  leaving  the  periosteum,  so  that  com- 
plete regeneration  of  the  bone  took  place.  He  believed  he  had  removed  the  head  of 
the  humerus,  but  as  a  matter  of  fact  this  was  first  done  in  1774  by  James  Bent  of 
Newcastle.  White  also  performed  upon  the  cadaver  resection  of  the  hip-joint,  but 
the  operation  was  first  performed  upon  the  living  subject  by  Anthony  White  in  1821. 
Charles  White  also  taught  the  reduction  of  dislocations  of  the  shoulder  with  the  heel 
in  the  axilla  (a  method  ordinarily  ascribed  to  Sir  Astley  Cooper),  and  removal  of  the 
edges  of  the  bones  in  pseudarthrosis.  ["Cases  in  Surges  with  Remarks"  London, 
1770.  As  the  excision  of  joints  is  a  peculiarly  English  operation,  it  may  be  well  to 
give  its  history  rather  more  completely.  According  to  Erichsen,  the  elbow-joint  was 
exsected  in  a  compound  dislocation  as  far  back  as  1758  by  Wainmau  of  Shripton. 
He  was  followed  by  Chas.  White  (shoulder-joint)  in  1768,  Bent  of  Newcastle  (1774), 
Orred,  Filkin  of  Northwich  (knee-joint,  1762)  and  John  O.  Justamond  of  London 
(elbow)  in  1775.  The  attention  of  surgeons,  however,  was  not  prominenth-  directed 
to  the  new  operation  until  the  publication  by  Henry  Park,  a  surgeon  of  Liverpool,  of 
his  "Account  of  a  new  method  of  treating  diseases  of  the  knee  and  elbow,  in  a  letter 
to  Mr.  Pott  "  (London,  1782).  Even  now  the  merits  of  the  operation  gained  recog- 
nition slowly,  and  in  fact  it  had  been  almost  forgotten  until  revived  in  the  present 
century  by  Liston  and  Sj-me.     H.] 

A  very  important  cultivator  and  promoter  of  surgery  (malum  Pottii)  was 
Percival  Pott  (1713-1788)  of  London, 
surgeon  to  St.  Bartholomew's  Hospital  from  1749  to  1787.  DiefFenbach  called  him 
the  model  for  surgical  writers.  [Pott's  services  were  specially  eminent  in  the  study 
of  hernia,  spinal  disease  and  chronic  diseases  of  the  joints  in  general,  fistula  lacbry- 
malis,  fistula  in  ano  and  injuries  of  the  skull.  His  complete  "Chirurgical  works" 
appeared  at  London  in  1771.]     No  less  ma}-  be  said  of 

William  Bromfield  (1712-1792)  of  London. 
surgeon  and  founder  of  the  Lock  Hospital,  and  surgeon  to  St.    George's  Hospital 
(Aneurisms;   Bromfield's  tenaculum- — tenacula  for  use  in   ligation  were  known  as 
early  as  Bruno  of  Longoburgo  !).    Disarticulation  at  the  shoulder  joint.     [Bromfield's 
''Chirurgical  observations  and  cases"  were  published  in  1773.] 


—  675  — 

Edward  Alanson  (1747-1823)  of  Liverpool 
was  the  inventor  of  the  conically  excavated  circular  amputation. 

George  Arnaud  (de  Ronsil,  died  1774), 
who  fled  from  France  to   England,  distinguished  himself  there   as  a  surgeon,  and 
particularly   as  regards  hernia  and   aneurisms.      Datiiel  Turner  wrote  "  The  Art  of 
Surgery",  1722,  with  treatises  on  skin-diseases  and  venereal  disease. 

William  Hunter  (1718-1783)  of  Long  Calderwood,  Scotland, 
originalljr  a  student  of  theology,  was  highly  famed  as  a  surgeon,  obstetrician  and 
anatomist.  A  pupil  of  Cullen,  he  went  to  London  in  1741,  began  to  lecture  on 
anatomy  and  surgery  in  174(5,  and  soon  acquired  a  wide  reputation.  After  1749  he 
devoted  himself  chiefly  to  obstetrics,  and  in  1764  was  appointed  physician  to  the 
queen.  His  success  in  practice  may  be  judged  from  the  fact  that  he  expended 
£100,000  upon  his  house,  his  library,  his  collection  of  normal  and  pathological 
anatomy  etc.  The  latter  now  forms  the  Hnnterian  Museum  of  the  University  of 
Glasgow. — In  aneurism  Hunter  tied  the  trunk  of  the  artery  above  the  sack  (Hnnterian 
method).  His  chief  works  were  the  "Medical  Commentaries",  1762-64,  and  the 
magnificent  "Anatomia  Humaui  Uteri  Gravidi  ",  which  appeared  in  1774,  and  em- 
bodied the  labor  of  twenty  years.  —  His  younger  brother 

John  Hunter  (1728-1793J  of  London, 
originally  a  ship-carpenter,  enjoyed  and  deserved,  if  possible,  still  greater  reputation. 
A  student  of  his  brother  William,  Cheselden  and  Pott,  he  began  the  practice  of 
surgery  in  London  in  1763,  became  surgeon  to  St.  George's  Hospital  in  17b8,  surgeon 
extraordinary  to  the  king  in  1776  and  surgeon-general  of  the  English  forces  in  1790. 
He  was  especially  eminent  as  a  pathological  and  comparative  anatomist  and  an 
investigator  of  the  subject  of  inflammation  and  the  blood  (experimental  pathology). 
As  a  student  of  syphilis  he  made  experiments  (on  himself?)  in  syphilitic  inoculation, 
described  the  Hnnterian  chancre  and  introduced  the  expression  "constitutional 
syphilis",  but  did  not  observe  "visceral  syphilis"  (Prokseh).  He  was  an  advocate 
of  the  unity  of  syphilis  and  the  gonorrhceal  poison.  Hunter  was  the  first  to  describe 
phlebitis,  the  muscular  layer  of  the  iris,  made  the  discovery  that  the  white  blood- 
corpuscles  precede  the  red  etc.  etc.  He  also  devoted  attention  to  botany,  mineralogy 
and  zoology  (circulation  of  insects),  and  did  not  scorn  even  the  subject  of  dentistry. 
He  attained  to  great  wealth,  and  his  anatomical  collection,  consisting  of  10,000  pre- 
parations, was  purchased  by  the  government  for  £15,000,  presented  to  the  College  of 
Surgeons,  and  forms  the  chief  part  of  the  Hunterian  Museum  in  London.  Hunter 
was  an  advocate  of  "healing  under  a  scab".  His  chief  works  were  "Natural  History 
of  the  Human  Teeth"  (1771-78);  "On  Venereal  Disease"  (1786)  and  "On  the 
Blood,  Inflammation  and  Gunshot  Wounds"  (1794). — An  equally  famous  surgeon  was 

Benjamin  Bell  (died  1806)  of  Edinburgh, 
who  rendered  eminent  service  to  the  subject  of  the  treatment  of  ulcers  and  white 
swellings  of  the  joints  and  fractures  and  dislocations,  the  favorite  field  of  English 
surgeons.  Bell  employed  tubes  of  lead  and  silver  for  purposes  of  drainage.  His 
"  System  of  Surgery",  6  vols.,  appeared  at  Edinburgh,  1783-87,  and  the  "  Treatise  on 
Gonorrhoea  Virulenta  and  Lues  Venerea"  in  1793. 

John  Bell  (1763-1820)  of  Edinburgh, 
the  elder  brother  of  Sir  Charles  Bell,  was  likewise  an  eminent  surgeon  of  the  18th 
century.  He  was  a  professor  of  anatomy,  surgery  and  obstetrics  and  a  busy  practi- 
tioner in  Edinburgh,  and  likewise  a  fertile  writer.  His  "System  of  the  Anatomy  of 
the  Human  Body"  appeared  in  London  1793-98,  and  his  "Principles  of  Surgery". 
1801-07.  John  Bell  was  an  excellent  classical  scholar,  and  one  of  the  most  skilful 
operators  of  his  day. 


_  676  — 

Thomas  Kirkland  (1721-1798)  of  Ashby  iu  Leicestershire 
studied  in  an  excellent  way  the  subject  of  fractures,  gangrene,  haemorrhages,  childbed 
fevers  etc.  Henry  Park  (1744-1831)  of  Liverpool,  a  student  of  Bromfield,  Pott  and 
Le  Cat,  performed  in  1781  the  first  resection  in  war.  A  good  syphilographer,  like 
most  of  the  English  surgeons  of  that  daj',  was  Thomas  Bayford,  who  distinguished 
the  contagium  of  gonorrhoea  from  that  of  syphilis,  and  found  simple  injections, 
without  mercury,  sufficient  to  cure  the  former  disease.  John  Abernethy  (17H4-1831) 
of  London  was  a  very  eminent  anatomist,  physiologist  and  surgeon,  who  maintained 
especially  the'propriety  of  the  internal  treatment  of  surgical  lesions.  [He  was  surgeon 
of  St.  Bartholomew's  Hospital,  and  professor  of  anatomy  and  surgery  in  the  Royal 
College  of  Surgeons,  as  well  as  a  fertile  author  on  numerous  anatomical,  surgical  and 
pathological  subjects.  His  eccentricities  of  manner,  well  known  to  the  profession, 
covered  a  kind  and  generous  heart,  though  they  have  given  him  the  reputation  of 
rudeness  and  brutality.] — Henry  Cline  1 1750-1827  i.  a  famous  surgeon  of  St.  Thomas's 
Hospital,  was  the  teacher  and  predecessor  of  Sir  Astley  Cooper.  Sir  James  Earle 
1755-1817  l,  a  relative  and  pupil  of  Pott,  [surgeon  extraordinar}-  to  the  king,  dean  of 
the  surgeons  ot  St.  Bartholomew's  and  director  of  the  College  of  Surgeons,]  was  the 
inventor  of  injections  (red  wine*  in  hydrocele  (' Treatise  of  Hydrocele",  London, 
1791).  James  Moore  of  London,  director  of  the  National  Vaccination  Institute,  was 
an  advocate  of  the  process  of  healing  under  a  scab  la  method  already  known  to 
Falloppio),  and  sought  by  compression  of  the  nervous  trunks  to  diminish  the  pain  in 
surgical  operations.  William  Hey  of  Leeds  (1736-1819),  a  pupil  of  Bromfield  and 
Donald  Monro,  discussed  resection  and  disarticulation,  and  Kerr  of  Northampton, 
amputation  at  the  hip-joint.  [The  brothers  James  (1675-1742)  and  John  (died  1759) 
Douglas  deserve  mention,  the  former  particularly  as  an  anatomist,  and  the  latter  as 
a  lithotomist  of  reputation.] 

The  American  Richard  Bay  ley  (1745-1801)  of  New  York,  a  pupil  of  John  Hunter, 
should  also  be  noticed.  [He  performed  in  1782  a  successful  disarticulation  at  the 
shoulder  joint,  and  in  1797  published  his  "Essay  on  the  Yellow  Fever".] 

[To  whom  we  may  add: 

John  Belchier  (1700-1785)  of  London, 
a  pupil  of  Cheselden.   surgeon  of  Guy's  Hospital  and  a  Director  of  St.  Thomas's 
Hospital,  and  one  of  the  first  i  1 7 M5  >  to  study  the  subject  of  the  nutrition  of  bones  by 
the  method  of  mixing  madder  with  the  food  of  the  animals  under  investigation. 

Sir  William  Blizard  (1743-1S35). 
a  pupil  of  Pott  and  the  Hunters,  surgeon  to  the  Magdalen  and  London  Hospitals  and 
the  first  surgeon  to  tie  the  superior  thyroid  artery  for  the  relief  of  goitre  and  one  of 
th-;  first  to  pass  a  ligature  about  the  subclavian.  In  connexion  with  the  anatomist 
Maclaurin  too  he  founded  in  1785  the  London  Hospital  Medical  School,  the  first 
school  united  with  a  large  hospital  in  London. 

JosephWarner  (1717-1801), 
a  native  of  Antigua,  pupil  of  Sharp  and  the  successor  of  his  master  in  Guy's  Hospital 
i  1745),  a  position  which  he  continued  to  hold  for  forty  years.     In  1775  Warner  under- 
took for  the  first  time  the  ligation  of  the  common  carotid  artery. 

Sir  Charles  Blickk  (died  1815). 
the  successor  of  Pott  in  St.  Bartholomew's  Hospital  in  1787,  master  of  Abernethy  and 
an  eminent  and  successful  surgeon. 

•  lames  Rae  (1716-1791  I,  the  first  teacher  of  clinical  surgery  in  Edinburgh;  John 
Aitken  (died  1790),  professor  of  midwifery,  anatomy,  surgery,  medicine  and  pharma- 
ceutic chemistry  in  Edinburgh,  and  the  inventor  of  the  chain-saw:  Thomas  Baynlon 


—  (J77  — 

of  Bristol  (Baynton's  dressing  for  ulcers,  1797);  Bryan  Crowther  (1765-1840)  and 
Edward  Ford,  who  studied  the  subject  of  white  swellings  of  the  joints;  Bradford 
Wilmer  of  Coventry,  who  wrote  on  the  subject  of  hernia  1 1788  i  and  Thomas  Sheldrake 
i  about  1795),  a  skilful  orthopaedic  surgeon,  also  deserve  men  I  ion.      iH.i] 

The  following  physicians  besides  Cheselden  were  distinguished  as 
oculists  : 

William  Rowley,  professor  in  Oxford  (1743-1806),  who  employed  electricity  in 
amaurosis,  but  without  success;  James  Ware  (1756-1815)  of  London,  who  des- 
cribed ophthalmia  neonatorum,  a  disease  already  recognized  as  specific  by  Joseph 
Warner  (1717-1801),  chief  surgeon  of  Guy's  Hospital;  Benedict  Duddell,  a  pupil  of 
Woolhouse  (see  page  519),  who  wrote  a  "Treatise  on  the  diseases  of  the  horny  coat 
and  the  various  kinds  of  cataracts",  London,  1729.  [Win.  Coward  (born  1656,  Oph- 
thalmiatria.  1706):  Peter  Kennedy  (Ophthalmographia.  1713);  Henry  Pemberton 
(1694-1771),  an  Iatro-mathematician  and  student  ot  physiological  optics,  who  wrote 
on  accomodation  in  1719;  James  Jurin.  who  has  been  already  mentioned,  also  dis- 
cussed the  subject  of  accommodation;  Sylvester  O'Halloran  1 1728-1807)  of  Limerick; 
Thos.  Gataker  (died  1769).  surgeon  of  St.  George's  Hospital  in  London,  who  wrote  on 
the  anatomy  of  the  eye  in  1761;  Geo.  Chandler  (cataract,  1765);  Geo.  Boithwick,  a 
surgeon  of  Kilkenny  (cataract.  1775);  Geo.  Wallis  (1740-1802,  Nosologia  methodica 
oculorum  etc  ,  1785);  Jonathan  Wathen,  a  surgeon  who  discussed  fistula  lachrymalis 
and  cataract,  and  recommended  nasal  injections  in  catarrhal  deafness  (1755);  Chas. 
Win.  Wells  (1757-1817),  a  native  of  Charleston,  S.  C,  practising,  however,  chiefly  in 
London,  wrote  "An  essay  on  single  vision  with  two  eyes,  together  with  experiments 
and  observations  on  several  other  subjects  in  optics"  (London.  1792),  and  is  said  b}' 
Sir  Benjamin  Brodie  to  have  been  a  remarkable  man.  — The  great  English  chemist 
and  physicist  John  Dalton  (1766-1844),  author  of  the  atomic  theory  etc.,  deserves 
mention  here  for  his  service  in  directing  the  attention  of  surgeons  to  the  subject  of 
■color-blindness  (Daltonism)  in  1798. — The  kindred  subjects  of  optics  and  microscopy 
were  also  studied  by  Henry  Baker  (died  1774),  the  abbe  John  Tuberville  Needham 
(1713-1781)  and  George  Adams  (1750-1795)  an  eminent  optician  of  London.  H.] 
Almost  all  the  English  surgeons  mentioned  above  also  devoted  attention  to  ophthal- 
mology, as  well  as  to  dentistry.  The  latter  subject  was  studied  especially  by  Thomas 
Berdmore. 

f.  The  Dutch 

enjoj'ed  in  this  century  eminent  surgeons,  who  officiated  also  as  obstet- 
ricians and  anatomists.     At  the  head  of  these  was 

Pieter  Camper  (1722-1789). 
who,  in  order  to  acquire  manual  dexterity  in  his  branch,  had  learned  to  use  the  lathe, 
to  make  joiner-work  and  to  paint  It  was  probabty  due  to  these  manual  occupations 
that  he  did  not  scorn  to  turn  his  attention  to  the  best  form  of  shoes1  (it  is  frequently 
advantageous  for  the  practitioner  to  know  where  the  shoe  pinches),  as  well  as  to  the 
remedies  for  corns,  to  trusses  etc.  The  Frenchman  Nic.  Leguin  was  the  first  to 
employ  elastic  springs  of  steel  in  the  manufacture  of  trusses  (1663),  and  the  double 
truss  was  brought  forward  by  Tipliarie  in  1761.  Camper  was  a  very  fruitful  author, 
and  rendered  jiood  service  in  the  doctrine  of  congenital  hernia,  the  introduction  of 

1.  Camper's  treatise  "  Ueber  die  beste  Form  der  Schuhe",  Vienna,  1782,  was  trans- 
lated and  republished  as  something  new  in  England  in  1861  and  1871,  and  I  think 
I  have  seen  it  also  published  as  an  advertisement  by  some  of  our  metropolitan 
shoe  dealers  in  this  country.    (H.) 


—  678  — 

vaccination,  the  improvement  of  the  nutrition  of  children  etc.  He  was  successively 
professor  in  Franeker,  Amsterdam  and  Groningen,  and  proposed  the  operation  of 
symphyseotomy.  —  After  him 

Andreas  Bonn  (1788-1818) 
was  professor  in  Amsterdam. 

Eduard  Sandifort  in  Leyden 
was  a  very  important  surgeon,  discussing  dislocations,  hernia?  etc..  and  famishing  the 
first  observation  of  a  dislocation  of  the  femur  downwards. 

David  von  Gesscher  (died  1810)  wrote  an  historical  work  on  the  surgery  of 
Hippocrates;  Jac.  van  der  Haar  1 1717-1799)  often  cured  tumor  albus  by  daily 
poulticing  —  literally  "Aufschlagen"  —  the  knee  with  wet  towels,  and  discovered 
echinococci  as  the  cause  of  fractures,  though  the  latter  discovery  was  also  made  by 
van  Wy  in  Amsterdam;  Gerhard  ten  Haaff  (1720-1791)  zealously  defended  the 
extraction  of  cataract  and  cured  cutoff  noses,  injected  the  Eustachian  tubes  etc.; 
Adrian  van  Pappendorp  discussed  congenital  closure  of  the  anus,  and  J.  Piet.  Rath- 
lauw1  wrote  on  cataract,  1752.  —  Among  the 

g.   Danes 
we  should  notice 

Simon  Kruger  and  his  son  ; 

Gteorg  Heuermann  (died  1768), 

an  operative  surgeon  and  oculist,  who  examined  more  closely  the  indications  for 
depression  and  extraction  of  cataract,  and  also  proposed  to  remove  the  lens  after 
incision  by  means  of  a  kind  of  corkscrew.  He  performed  iridotomy  in  1756  by  a 
puncture  through  the  cornea,  and  observed  a  hernia  of  the  foramen  ovale  in  1754. 

Heinrich  Callisen  (1740-1824). 
professor  of  surgery  in  Copenhagen,  a  learned  and  able  operative  surgeon  and  fruit- 
ful author,  recommended  too  strongly  the  perforation  of  the  mastoid  process,  and 
e.  g.  with  Alexander  Koelpin  performed  the  operation  on  the  famous  Dr.  Berger  for 
tinnitus  aurium.  Dr.  Berger  died  of  inflammation  of  the  brain,  induced  by  the  use 
of  irritating  injections  into  the  wound  in  order  to  clear  the  Eustachian  tube. 

Joh.  Clemens  Tode  (1736-1805), 
who,  like  Callisen,  had  been  a  barber,  and  after  studying  in  England  was  made  a 
professor  and  court  physician,  defended  energetically  the  distinction  between  the 
gonorrhceal  and  venereal  poisons.  However  Francis  Balfour  in  1767  had  conjectured 
that  the  two  contagia  were  different,  Charles  Hales  had  expressly  emphasized  this 
fact,  and  William  Ellis  (died  1785)  had  proved  it  (even  before  Hunter  i  by  experiments 
in  inoculation  (Proksch).     In 

h.  Sweden 

Olof  af  Acrel.-  Ibe  ;  Desault  of  the  North"  and  the  father  of 
Swedish  surgery,  distinguished  himself  as  the  most  important  surgeon  of 
the  North. 


Rathlauw  was  forbidden  to  practise  midwifery  by  the  College  of  Physicians  in 
Amsterdam  because  he  refused  to  purchase  the  so-called  secret  of  Roonhuysen. 
He  claimed,  however,  to  have  himself  discovered  the  secret  —  a  fenestrated 
instrument  with  an  imperfect  lock  which  be  described  in  1754.     (H.) 

Compare  "Olof  af  Acrel,  the  Father  of  Swedish  Surgery",  by  Prof.  Otto  E.  A. 
Hjelt  in  Helsingfors,  18*4.  Through  the  kindness  of  the  author,  the  first  pro- 
fessor of   pathological  anatomy  at  Helsingfors  (from  1859-1883^,    the    following 


—  G79  — 

He  was  educated  in  Glittingen,  Strassburg  and  the  Academie  de  Cliirurgie  of 
Paris,  and  was  familiar  with  the  literature  of  foreign  countries.  He  introduced  into 
Sweden  the  clinical  method  of  instruction  in  surgery.  His  chief  work  was  entitled 
"  Chirurgiska  handelser",  "Surgical  Cases",  and  appeared  at  Stockholm  in  1759. 
Acrel  united  physiology  and  anatomy  with  surgery,  and  the  latter  with  iorensic 
medicine,  limited  the  practice  of  amputation  and  inclined  to  conservative  surgery, 
emphasized  the  value  of  hygiene  in  the  treatment  of  wounds  etc. —  The  Swedish  royal 
physician 

Joh.  Gust.  Wahlborn 

maintained  a  constant  literary  war  with  Acrel. 

Pehr  Pierchen  (cancer)  and 

Joh.  Lorenz  Odheeius  (died  181ti). 
an   oculist   and  professor  of  medicine  in   Stockholm,  were  also  eminent  physicians. 

[Joh.  Gustay  Acrel  (1741-1801), 
the  nephew  and  pupil  of  Olof  Acrel,  was  professor  of  practical  medicine  in  the  uni- 
versity of  Upsala  and  a  skilful  practitioner.     lH.)]--  Among  the 

i.  Russians 
surgery  was  imported  by  foreigners,  and  Germans  or  Russo-(!ermans  were 
its  chief  representatives.     Among  these  we  ma}-  notice  Joh.  Mart.  Min- 
derer,  Christoph  El.  H.  Knackstedt  (1749-1799),  Mohrenheim  and  others. 

5.  MIDWIFERY. 

The  ISth  century  was  almost  more  eventful  in  midwifery  than  in 
surgery.  From  the  latter  branch  during  this  century,  and  particularly  in 
its  latter  half,  obstetrics  began  to  be  separated  too  almost  completely  and 
generally  —  less  in  practice,  however,  than  in  theory.  From  numerous 
and  careful  observations  of  the  normal  process  of  labor  made  by  men  of 
scientific  education,  it  won  perfectly  secure  ground,  and  accordingly 
founded  the  indications  for  the  choice  between  :-  Nature  "  and  instrumental 
and  manual  aids.  The  latter  undoubtedly  continued  to  be  generally  over- 
estimated in  comparison  with  the  powers  of  nature.  After  the  how  and 
when,  the  circumstances,  time,  the  object  and  possibility  of  rendering- 
assistance  were  once  established,  physicians  were  able  to  invent  suitable 
mechanical  aids  in  accordance  with  a  preconceived  plan,  or  to  alter  those 
already  invented,  often  to  improve  and  devise  the  most  appropriate  methods 
for  their  employment.     To  these  benefits  midwifery  proved  herself  specially 

works  from  his  pen  are  before  me:  "Karl  von  Linne  as  a  physician"  etc., 
Leipzig,  1882;  'Karl  von  Linne  and  his  relations  to  Albrecht  von  Haller " 
(Swedish),  Helsingfors,  1878;  "Summary  of  1000  autopsies"  (Swedish),  Helsing- 
fors, 1872:  "Medical  relations  in  Abo  about  1750",  Helsingfors,  1882;  "The 
Institute  of  Pathological  Anatomy  in  the  university  of  Finland  lsr.S-1871  " 
(Swedish),  1871;  "The  question  of  public  hygiene  in  Finland"  (Swedish),  1879; 
"The  Institute  for  Pathological  Anatomy  in  Helsingfors,  1871-1883"  (Swedish), 
1884;  "Sanitary  laws  of  Finland,  proposals  and  motives"  (Swedish),  part  I. 
1873.  part  II.  1875;  "The  diffusion  of  venereal  diseases  in  Finland"  (German), 
Berlin,  1874:  "Address  at  the  dedication  of  the  laboratory  of  pathological 
anatomy"  (s.  a.).  French. 


—  680  — 

accessible,  and  for  them  she.  like  surgery  her  mother,  showed  herself 
grateful.  For  a  Palfyn  obtained  almost  at  once  the  applause  of  all.  while 
the  derision,  scorn  and  misrepresentation  of  the  learned  physicians  befell 
e.  g.  an  Auenbrugger.  as  they  did  in  some  degree  also  the  later  Jenner. 

The  most  beneficent,  because  the  most  effective  and  bloodless  of 
inventions,  that  of  the  forceps,  required  to  be  made  again  in  the  18th 
century,  though  the  new  inventor  may  have  received  from  his  predecessors 
the  special  suggestion  thereto.     This  re-discoverer  of  the  forceps  was 

Johann  Palfyn  (1649-1730  . 
who  in  1721  exhibited  to  the  Academie  in  Paris  his  instrument  consisting  ot  two 
deeply  concave,  spoon-like,  nonfenestrated  and  separate  blades.  This  instrument 
did  not  meet  with  much  approval.  Subsequently  he  added  a  third  blade  in  order  to 
grasp  the  head  more  firmly.  The  earliest  publication  of  this  "Palfyn's  hand",  as  it 
was  called,  was  made  by  Heister  in  1724.1  This  imperfect  instrument  was  improved 
by  Duse  (who  crossed  the  arms  and  particularly  by  the  two  Gregoires,  the  elder  of 
whom  had  also  in  1720  founded  in  the  Hntel-Dieu  the  first  obstetric  clinic  for  phy- 
sicians They  added  to  their  forceps  a  kind  of  lock,  and  above  all  fenestrated  blades, 
and  under  this  form  they  were  described  in  Germany  in  1746  by  the  Leipzig  professor 
Phil.  Ad.  Bohmer  (1717-1789),  who  had  seen  them  in  the  hands  of  the  Gregoires  and 
gave  them  the  name  "Zange"  (forceps).  The  instrument  was  greatly  improved 
by  the  elder  Fried  in  Strassburg.  and  above  all  by  Levret.  who  employed  long, 
fenestrated  forceps,  with  a  revolving  pin  for  a  lock,  a  pelvic  curve  and  roughened 
handles,  and  by  Smellie,  whose  forceps  were  short,  short-handled,  with  a  marked 
cephalic  curve,  a  so-called  English  lock  and  blades  covered  with  leather.  —  The  elder 
Stein  was  especially  active  in  disseminating  the  forceps  throughout  Germany.  — 
Numerous  modifications — up  to  the  present  day  about  20u  —  were  of  course  gradu- 
ally made  by  every  important  obstetrician,  but,  on  the  whole,  the  form  of  Levret  was 
preserved  in  France,  that  of  Smellie  in  England,  and  in  Germany  that  of  Xaegele. 
with  the  so-called  German  lock. 

Midwifery  hooks  were  als>  often  improved  upon.  e.  g.  by  Smellie  and  Levret. 
During  the  18th  century. 

a.  The  French 
undoubtedly  took  the  first  place  in  obstetrics  also,  the  natural  result  of  their 
possessing  the  first   institutions  for   instruction  in  this  art.      The   oldest 
among  the   important  French  obstetricians  was  Jean  Astruc  (1684—1766) 
who.  like  most  of  the  surgeons  already  mentioned,  devoted  attention  like- 
wise to  obstetrics,  though  only  toward  the  close  of  his  life. 

How  versatile  this  physician  (who  will  also  require  notice  under  other  sections  • 
was.  may  be  judged  from  the  fact  that  he  introduced  in  \~o.\  even  into  Biblical  inves- 
tigation a  new  epoch  by  demonstrating  that  the  books  of  Genesis  must  have  been 
drawn  up  after  two  manuscripts,  of  which  the  one  always  speaks  of  Jehovah,  the 
other  of  Elohim  only.  Astruc' s  "  Train'1  des  maladies  des  fenimes"  appeared  at 
Paris  17i;i-l7K;>. 


The  French  called  the  instrument  "  Tire-tete  ",  "  Les  mains  de  Palfyn"  or  "Les 
tenettes  de  Palfyn  ".  This  instrument  was  afterwards  claimed  as  his  own  by  Le. 
Doux,  a  surgeon  of  Ypres.  Palfyn's  forceps  were  not  known  in  England  until 
1733,  when  they  were  mentioned  by  Butler  (or  Butter)  in  the  Edinburgh  Medical 
Essays  and  Observations.  At  this  time  Chapman  had  been  using  the  midwifery 
forceps  for  more  than  ten  years.     See  page  .VJ2  n.  4.      11. 


—  G81  — 

Nicolas  de  Puzos  (16SG-1753)  of  Paris 
was  the  instructor  of  midwives  in  the  Academie  de  Chirurgie  and  a  pupil  of  Clement. 
He  therefore  specially  emphasizes  podalic  version,  but  does  not  overlook  the  forceps 
also,  and  is  the  first  among  modern  obstetricians  to  recommend  perineal  support  and 
combined  external  and  internal  examination,  friction  of  the  os  uteri  as  a  preliminary 
measure  in  labor  etc.  Puzos  also  improved  the  teachings  regarding  the  pelvis, 
particularly  the  deformed  pelvis.  His  "  Traite  des  accouchements"  etc.  was  published 
posthumously  in  1759.     The  same  was  done  too  by 

Jacques  Mesnard, 
a  surgeon  of  Rouen,  who  was  the  first  of  the  French  to  direct  attention  to  the 
forceps  in  a  book.  The  obstetric  position  was  still  upon  the  back  with  the  feet  drawn 
up  against  the  buttocks.  Mesnard's  "  Le  guide  des  accouchements"  etc.  appeared  in 
1743.  Indisputably  the  most  important  French  obstetrician  of  the  18th  century, 
however,  was 

Andre  Levret  (1703-1780)  of  Paris. 
Among  other  things  he  improved  the  teachings  as  to  the  operation  of  version  and 
determined  definitely  its  indications,  warns  particularly  against  forcible  pressing 
of  the  child  upwards,  regarded  foot  presentation  as  an  indication  for  extraction,  and 
taught  a  better  method  for  the  accomplishment  of  the  latter,  converted  presentation 
of  the  buttocks  into  that  of  the  feet,  or  applied  the  forceps,  rendered  good  service  in 
his  teachings  regarding  the  Cesarean  section,  recommended  in  placenta  pra?via 
separation  of  the  edge  of  the  placenta  rather  than  penetrating  through  it  etc., 
affirmed  too  the  existence  of  the  culbufe  (recently  again  half-honored,  so  far  as  relates 
to  the  early  months  of  pregnancy;,  and  devised  Levret's  forceps,  perforator  and 
pince  a  faux  gerraes.  Levret  had  pupils  from  all  countries.  His  "  Traite  sur  1'  art 
des  accouchements  '  etc.  was  published  at  Paris  in  1753.  The  versatile  and  un- 
prejudiced 

Antoine  Petit  (1718-1794),  likewise  of  Paris, 
unprejudiced,  because,  although  a  physician,  he  did  not  despise  surgery  and  mid- 
wiferj7  (a  very  exceptional  matter  in  that  time),  and  Pean  must  be  counted  among 
the  eminent  teachers  of  midwifery  in  Paris.  Petit's  "Traite  des  maladies  des 
femmes  enceintes"  etc.  appeared  after  the  death  of  the  author  in  1800.  Pean 
flourished  about  the  middle  of  the  18th  century,  but  appears  to  have  left  no  writings. 
The  second  among  the  obstetricians  of  that  day  was 

Francois  Ange  Deleurye  (born  1737), 
a  teacher  at  Paris,  who  rendered  special  service  to  the  doctrine  of  version,  which  he 
taught  should  be  performed  immediately  after  rupture  of  the  membranes  before  the 
escape  of  the  waters.  He  likewise  divides  the  doctrine  of  extraction  from  that  of 
podalic  version,  and  remarks  that  the  former  operation  need  not  necessarily  always 
follow  the  latter.  In  Cesarean  section  he  advises  the  incision  to  be  made  in  the 
linea  alba,  because  here  no  vessels  are  injured.  Traite  des  accouchements,  Paris, 
1770. — Reliance  upon  the  aid  of  nature  in  parturition  found  an  eminent  advocate 
in  the  famous 

Fr.  L.  J.  Solayres  de  Reniiac  (died  1772) 
(a  pupil  of  the  Parisian  practitioner  Pean),  who  died  young  of  tuberculosis.  He 
discussed  excellently  the  mechanism  of  labor,  especially  in  presentations  of  the  head. 
His  "  Dissertatio  de  partu  viribus  maternis  absoluto"  appeared  in  1771,  and  marked 
an  epoch  in  the  history  of  the  obstetric  art.  In  this  work  he  reckons  presentations 
of  the  feet,  buttocks,  face  and  knees  among  those  which  need  not  necessarily  be 
terminated   artificially,   a  doctrine   which   was  contested  down  1o  the  time  of  Boer. 


—  682   — 

In  conjunction  with  the  physician  next  mentioned,  and  following  in  the  footsteps  of 
Sraellie  (1752),  he  put  the  finishing  stroke  to  the  doctrine  of  the  culbute.     His  pupil 

Jean  Louis  Baudelocque,  Sr.,  (1746-1810), 
who  rendered  eminent  service  in  his  teachings  regarding  the  pelvis,  and  invented  an 
external  pelvimeter,  based  his  own  views  upon  those  of  his  master.  Baudelocque  was 
an  opponent  of  the  artificial  induction  of  premature  labor,  and  still  more  of  symphy- 
seotomy. He  admitted  only  —  96  positions  of  the  foetus.  L'  art  des  accouchements, 
Paris,  1781. 

Jean  Francois  Sacombe  (died  1822), 
like  Sola^-res  de  Renhac  a  pupil  of  Jean  Serre  a  professor  in  Montpellier,  was  a 
mortal  enemy  of  Baudelocque  and  involved  the  latter  in  a  notorious  medical  scandal 
suit.  Sacombe  was  a  fanatic  in  his  defence  of  the  powers  of  nature  and  discarded  all 
operations.  He  desired  to  have  all  midwifery  entrusted  simply  to  physicians  and 
midwives,  and  founded  an  "Anti-Cresarean-section  School".  From  a  medical  fanatic 
he  became,  as  often  a  happens,  a  subsequent  charlatan,  and  even  went  so  far  as  to 
affirm  that  he  would  rise  upon  the  earth  again  after  his  death. — The  operation  of 
Symphyseotomy,  first  recommended  in  17(18  by 

Jean  Rene  Sigault  of  Paris, 
approved  by  Camper  and  actually  performed  upon  Madame  Souchot  by  Sigault  with 
the  assistance  of  Alphonse  Leroy  (1742-1816)  in  1 777,  excited  great  attention  and 
long  disputes  regarding  the  grounds  for  and  against  its  performance.  The  operation 
was  directed  against  Cesarean  section.  This  first  operation  terminated,  indeed,  in 
vesical  fistula  and  prolapse  of  the  vagina  and  uterus,  but  a  living  child  was  born,  and 
the  operation  then  found  a  few  imitators  in  all  countries.  Among  these  were  C.  C. 
von  Siebold,  Mursinna,  Fr.  Max  Fr.  von  Ritgen,  the  last  time  (provisionally — for 
everything  recurs  again  in  medicine!)  in  1820.  To-day,  however,  the  operation  is 
entirely  abandoned,  having  been  practised  about  57  times,  with  the  preservation  of 
38  mothers  and  Ml  children.  The  defense  of  (Cesarean  section  in  opposition  to 
Symphyseotomy  was  undertaken  among  others  by 

Theodore  Etienne  Lauverjat  (died  1800). 
who  also  brought  forward  a  new  incision  for  the  former  operation,  an  oblique  incision 
on  the  side  toward  which  the  uterus  most  inclined.     Pierre  Victor  Coutouly  in  1788 
introduced  a  kind  of  cephalotribe. 

Jacques  Andre  Millot  (1738-1811) 
was  an  independent  observer.  Jean  Bruhier  d'Ablaincourt  (i.  e.  of  Ablaincourt) 
translated  Deventer's  treatise  on  obstetric  operations,  and  thus  falsely  acquired  the 
reputation  of  a  promoter  of  the  doctrine  of  the  pelvic  inclination  and  pelvic  axis. 
Pierre  Roussel  (1742-1802)  awakened  a  special  literature  by  his  book  entitled 
"  Systeme  physique  et  moral  de  la  femrae  ".     Most  of 

b.  The  ItaliaDs 

were  educated  in  the  French  doctrines  and  often  under  French  teachers 
(particularly  Levret),  and  they  accordingly,  in  most  respects,  followed  the 
footsteps  of  their  masters.  German  midwifery  also  gained  some  influence 
in  Italy.  We  should  notice  :  Gius.  Yespa,  Domenico  Ferraro,  and  especially 
Paolo  Assalini,  chief  physician  of  the  Italian  army,  who  was  with  Napoleon 
in  Egypt.  The  latter  was  a  pupil  of  Baudelocque,  and  invented  an 
instrument  for  compression  of  the  head,  a  sort  of  cephalotribe.  an  extractor 
of  the  head  and  a  trepan-perforator. 


._  683  — 

Text-books  were  written  also  by  Nannoni  in  Naples;  Nessi  in  Pavia;  Horatio 
Valota  ;  P.  Urb.  Galeotti  in  Naples,  a  pupil  of  Nannoni;  Francesco  Asdrubali  in 
Rome;  Piccolo  in  Verona;  Antonio  Galli  in  Bologna;  Cattani  and  Nerozzi  of  tlie 
same  place;  Luigi  Calza  in  Padua,  tbe  earliest  (1769)  special  professor  of  obstetrics 
in  Italy,  and  Franc.  Valle  in  Florence,  the  latter  of  whom  was  a  specially  eminent 
representative  of  the  French  school.  German  midwifery  was  created  in  Italy  by 
Galeotti's  translation  of  Roederer's  book,  and  by  Monteggia's  translation  of  the 
works  of  Stein.- — Maria  della  Donne  and  Anna  Morandi  Manzolini  (1716-1774)  distin- 
guished themselves  as  practical  and  scientific  female  obstetricians. 

c.  The  Spaniards 

obtained  obstetrical  text-books  through  V.  Vidart  and  J.  de  Navas  in 
Madrid.     Among  the 

d.  Germans. 

with  whom  in  the  beginning  of  the  century  scientific  midwifery  occupied  a 
very  low  position,1  we  may  by  anticipation  reckon  the  obstetricians  who 
displayed  their  activity  in  Strassburg",  a  city  which  at  that  time  proved 
itself  in  midwifery,  as  at  an  earlier  period  in  surgery,  one  of  the  most 
excellent  and  earliest  introducers  of  foreign  science  into  Germany.  These 
were  : 

Joh.  Jac.  Fried  (1689-1769),  the  father,  and  his  assistant  and  teacher 
of  midwives  J.  G.  Scheid,  who  translated  la  Motte's  work  into  German  in 
1732  ;  Fried's  successors  Josias  Weigen  (died  1773)  and  G.  Albr.  Fried 
(died  1773)  the  son,  as  well  as  Joh.  Friedr.  Ehrmann  (1739-1794),  son  of 
the  Strassburg  clinician  rendered  famous  by  Goethe,  Joh.  Christ  Ehrmann 
(1710-1790).  These  taught  in  the  cit}T  (not  university)  lying-in  hospital, 
which  furnished  80-120  births  per  year,  and  to  which  men  were  admitted. 
At  all  events  the  influence  of  their  educational  activity  extended  chiefly 
over  Germany.     So  too 

Joh.  Ehrenfrikb  Thebesius  (1717-1758). 
a  pupil  of  the  elder  Fried  and  a  native  of  Hirsehberg  in  Silesia,  wrote  an  obstetrical 
text-book.      He  was  the  son  of  Adam  Christ.  Thebesius,  the  discoverer  in  1708  of  the 
so-called   foramina  Thehesii   of  the  heart.     Another  pupil  of  Fried,   far  surpassing 
Thebesius  in  importance  and  influence,  was  the  ingenious 

Joh.  Georg  Roderer  (1726-1763)  of  Strassburg, 
who  was  called,  at  the  instance  of  Haller,  to  Gottingen  (1".">1)  as  the  first  German 
professor  of  midwifery,  and  erected  there  the  first  nursery  of  scientific  obstetricians 
in  Germany.  He  founded  the  science  of  obstetrics  upon  the  basis  of  anatomy  and 
physiology,  banished  the  medical  and  exaggerated  instrumental  midwifery  of  his  day, 
and  aided  manual  midwifery  to  assume  its  proper  position  (Rohlf's).  The  doctrine  of 
the  pelvic  axis  in  elucidation  of  the  inclination  of  the  pelvis,  and  the  determination 

1.  Job.  Andreas  Deiscb  of  Augsburg,  a  pupil  of  Fried,  e.  g.  employed  sharp  instru- 
ments 29  times  in  (51  births  during  a  single  year.  Joh.  Dan.  Mittelhaeuser  in 
Weissenfels,  however,  "began  to  cut  and  slash  "  as  soon  as  everything  was  not 
precisely  normal.  In  this  way  he  had  a  death-rate  of  only  (!)  20  per  cent.  It 
was  still  the  custom,  both  during  pregnancy  and  after  labor,  to  perform  venesec- 
tion, and  this  was  particularly  tbe  case  in  puerperal  fever. 


—  684  — 

■of  the  latter,  depends  upon  Joh.  Jac  Miiller  —  Basel,  1745  —  who  was  the  first  to 
determine  the  inclination  of  the  superior  opening.  —  From  the  school  of  Roderer 
proceeded  the  anatomist  and  skilful  obstetrician  H.  A.  Wrisberg,  Roderer' s  suc- 
cessor; J.  S.  Chr.  Sommer  (1740-1802)  in  Brunswick  (pelvic  axis,  a  doctrine  which, 
however,  he  did  not  advance;  pregnancy  without  preceding  menstruation),  and  the 
Marburg  professor 

Geor<;  Wilhelm  Stein,  Sr..  (1737-1803)  of  Cassel, 
who  marks  an  epoch  in  the  field  of  German  midwifery,  though,  on  the  whole,  he 
remained  true  to  the  French  school.  He  had  been  educated  under  Levret  and 
diffused  the  teachings  of  his  master  in  his  home.  Stein  was  particularly  active  in 
determining  carefully  the  dimensions  of  the  pelvis  in  the  living  female,  in  order  to 
base  thereupon  the  indications  for  operative  interference.  He  invented  in  1772  the 
first  German  pelvimeter,  an  instrument  for  measuring  the  inclination  of  the  pelvis, 
and  gave  the  first  thorough  description  of  the  malacosteon  pelvis.  He  improved  the 
■teachings  regarding  version  and  particularly  the  employment  of  the  forceps  and 
Cassarean  section,  and  brought  forward  instruments  for  rupturing  the  membranes  (a 
finger-ring),  a  perforator,  baby-scale  etc.  Many  of  his  teachings  are  still  held  in 
honor. 

Besides  Heister,  Schaarschmidt,  Kaltschmidt  and  Bohmer  in  Gottingen, 
the  surgeons  and  obstetricians  of  Berlin  promoted  the  advancement  of 
midwifen"  in  Germany,  though  in  a  less  degree  than  those  already  mentioned, 
who  began  their  activity  contemporaneously  with  Roderer.  Among  these 
Berlin  surgeons  we  may  mention 

Joh.  Friedr.  Meckel  (1714-177  1  . 
who.  at   the   instance   of  Filer,  was  nominated  (17.31)  teacher  to  the  school  for  mid- 
wives  in  the  Charite.     He  was  followed  by  Joach.  Fried.  Henckel,  a  pupil  of  Gregoire 
and  Roderer  in  midwifery,  who  was  the  first  in  Germany  to  advocate  incision  of  the 
linea  alba  in  Caesarean  section.     Henckel  was  followed  by 

Joh.  Phil.  Hagen  (1734-1795;  of  Tuntzenhausen  near  Weissensee. 
a  self-educated  man  who  had  worked   his  way  up  from  the  deepest  poverty.     Origin- 
al^  a   company   surgeon,  he   came  to  be  surgeon-councillor  and  professor.     To  the 
very  end  of  his  life  his  Berlin  colleagues  omitted  no  opportunity  of  twitting  him  upon 
his  humble  origin.     He  recommended  the  forceps  of  Levret,  as  did  also 

Heixrich  Xepomuk  von  Crantz  (1722—1 7i»7)  of  Luxemburg, 
a  pupil  of  van  Swieten  and  the  inaugurator  (1754)  of  a  new  school  of  midwifery  in 
Vienna.  Von  Crantz  had  been  educated  as  an  obstetrician  in  England  and  France, 
and  was  a  very  popular  teacher,  chiefly  of  midwives,  but  also  of  medical  students, 
who  were  permitted  to  share  in  his  instruction.  He  was  an  advocate  of  natural  mid- 
wifery and  the  forceps,  and  discarded  all  manipulations,  cutting  instruments  etc. 
His  successor  was 

Val.  Ferd.  Lebmacher  (died  1797). 
who.  took  Crantz' s  position  after  the  latter  in   1 760  (?)   had  been  chosen  professor  of 
the  theory  of  medicine  in  place  of  Melchior  Stoerck.     Besides  these 

Raphael  Steidele  (1737-1821)  of  Innsbruck, 
tin   predecessor  of  Boer,  professor  of  theoretical  midwifery  from  1797,  and 

Ant.   Joh.  Rechberger,   teacher  of  the  actual   royal   and   imperial 
surgeon-in-ordinarv 

Simox  Zeller.  a  noble  of  Zellerberg, 
were  likewise  teachers  in  this  department.    The  latter,  like  all  the  Vienna  obstetricians 


—  685  — 

mentioned,  rendered  good  service  in  the  determination  of  the  natural  termination  or 
labor  —  especially  in  face  presentations.  He  also  endeavored  to  prove  bj-  experi- 
ments upon  rabbits  that  sj'philis  took  its  origin  from  polyandria  (Proksch). 

Joh.  Melitsch    (died  1811), 
a  pupil  of  Stark,  taught  from  1793  in  the  lying-in  hospital  founded  in  Prague  in  1789. 
The  earlier 

Stbphan  Weszpremi  (born  1723). 
a  versatile  and  famous  physician  of  Debreczin  in  Hungary,  should  also  be  mentioned 
here  as  an  obstetrician,  in  connexion  with  the  Austrians  already  noticed.     In  Jena 

Joh.  Christ.  Stark.  Sr.,  (1753-1811) 
was  an  important  obstetrician,  well  known  for  his  invention  of  instruments  (placental 
spoon,  a  ring-knife  for  dismemberment  of  the  foetus,  special  forceps,  pelvimeter  etc.),. 
the  practice  of  Ca?sarean  section,  and  for  his  publication  of  an  "Archiv  fur  Geburts- 
hilfe,  Frauenzimmer-  und  neugeborener  Kinderkrankheiten."  An  eminent  obstet- 
rician of  Marburg  was 

Joh.  Day.  Busch  (born  1755). 
who  survived  into  the  19th  century. 

J.  C.  Gehler  (1732-1796)  of  Leipzig,  Joh.  Melchior  Aepli  in  Diessenhofen  on  the 
Rhine,  Jodocus  Ehrhart  (1766-1827)  and  Ludw.  Ad.  Appun,  rendered  good  service 
in  the  discussion  of  the  removal  of  the  placenta,  that  is  its  expulsion  by  the  natural 
forces.  Up  to  this  period  the  placenta  had  been  removed  immediately,  without  even 
waiting  to  tie  the  cord.  Chr.  Jac.  Sevier  (under  the  presidency  of  G.  P.  Schaeber) 
refuted  the  doctrine  which  had  remained  in  vogue  from  the  time  of  the  Ancients 
down  to  that  day,  viz.  that  in  placenta  prsevia  the  placenta  fell  down  before  the  com- 
mencement of  labor  (De  placentie  uterina?  morbis'',  1709),  and  Paul  Scheel  in  1799 
first  brought  forward  puncture  of  the  membranes  as  a  means  for  the  artificial  induc- 
tion of  premature  labor  in  contractions  of  the  pelvis  etc.  To-day  this  operation  is  a 
popular  means  of  procuring  abortion  ! 

• 

e.  The  English 

did,  indeed,  likewise  receive  an  impulse  from  France,  yet  they  built  up 
their  midwifety,  free  from  the  actual  tutelage  of  French  doctrines,  much 
more  independently  than  was  the  case  with  the  Germans  in  the  18th 
century.  They  exercised  too.  particularly  towards  the  close  of  the  centur}', 
a  great  influence  upon  Germany. 

Indisputably  the  most  important  English  obstetrician  of  this  epoch  was 

William  Smellie  (1680-1763)  of  London. 
He  advanced  our  knowledge  of  the  position  of  the  head  during  labor  and  that  of  the 
contracted  pelvis  (besides  the  rachitic  pelvis  already  known,  he  was  acquainted  with 
the  malacosteon  pelvis  and  the  generally  contracted  pelvis),  was  the  first  to  estimate 
the  conjugata  vera  from  the  conjugata  diagonalis,  pointed  out  successful!}-  once  more 
the  operation  of  cephalic  version  as  well  as  version  by  the  breech,  although  he 
ordinarily  converted  breech  presentations  into  footling  and  then  extracted,  or  in 
breech  presentations  extracted  with  blunt  hooks.  Smellie  invented  numerous 
instruments,  including  a  forceps  with  a  so-called  English  lock,  which  is  used  almost 
exclusively  in  England  down  to  the  present  day,  and  is  covered  with  leather.1  He 
also  invented  a  special  perforator,  blunt  hooks  etc.     [His  "  Treatise  on  the  Theory 

1.   This  is  no  longer  true.     (H.) 


—  686  -- 

and  Practice  of  Midwifery"  appeared  at  London  1752.]  —  It  Smellie  gloried  in 
instruments, 

William  Hunter  (1718-1783). 
on  the  other  hand,  was  an  enemy  of  instrumental  midwifery,  and  a  special  opponent 
of  the  forceps.  Indeed,  he  was  in  the  habit  of  exhibiting  his  own  forceps  to  his 
hearers  all  covered  with  rust.  Hunter  recommended  version  by  the  breech,  described 
the  membrana  decidua  Hunterii,  and  published  in  1774  an  elegant  "Anatomia  uteri 
humani  gravidi  tabulis  illustrata"  in  Latin  and  English.  —  A  rival  of  these  obstetrical 
worthies  was  the  eminent  observer 

Thomas  Denman  (1733-1815). 
who  rendered  excellent  service  by  his  teachings  relative  to  natural  labor,  lecom- 
mended  artificial  induction  of  premature  labor  in  cases  of  great  contraction  of  the 
pelvis  instead  of  Cesarean  section  (the  former  operation  was  first  performed  by  the 
obstetrician  Macaulay  in  1756),  and  spontaneous  version  in  arm  presentations 
(Denman  s  version),  observed  the  portability  of  puerperal  fever  by  physicians  and 
nurses  etc.  He  too  was  no  great  admirer  of  the  forceps  and  of  instruments  gener- 
ally.    "  His  "  Introduction  to  the  Practice  of  Midwifery"  appeared  in  London,  1787. 

John  Aitken. 
a  professor  in  Edinburgh,  who  committed  suicide  in  1790  while  laboring  under 
delirium  tremens,  invented  the  operation  of  sawing  out  a  piece  of  the  pelvic  bones 
(pelviotomy)  to  replace  Csesarean  section,  and  a  thimble  for  puncture  of  the  mem- 
branes etc.  [His  "Principles  of  Midwifery  or  Puerperal  Medicine"  appeared  at 
Edinburgh  in  1784.] 

Sir  Fielding  Ould  (1710-1789), 

a  famous  Dublin  obstetrician  and  a  pupil  of  Gregoire,  advanced  our  knowledge  of  the 
progress  of  the  head  during  labor,  invented  a  drill-shaped  perforator  etc.  [A  treatise 
on  midwifery,  Dublin,  1742.] 

Sir  Richard  Manningham  (died  1749)  of  London 
looked  upon  podalic  version  as  the  chief  means  for  terminating  difficult  labors, 
though  he  also  mentions  the  forceps.  [In  173(i  he  established  in  his  own  house  the 
first  private  lying-in  asylum  in  London.  His  '  Artis  obstetricaria-  Compendium  tarn 
Theoriam  quam  Praxin  spectans",  a  collection  of  obstetric  aphorisms,  appeared  at 
London  in  1739.] 

Robert  Wallace  Johnson  (about  1769) 
observed  the  normal  course  of  labor,  was  the  first  to  teach  the  oblique  position  of  the 
head  at  the  pelvic  outlet,  measured  the  pelvis  with  the  simple  hand  and  brought  for- 
ward a  forceps  with  a  strong  pelvic  and  perineal  cnrve.     [New  System  of  midwifery, 
London,  1769.] 

John  Burton  (1697-1771)  of  York 
supplied  some  observations  on  living  children  delivered  by  Cagsarean  section  after  the 
death  of  the  mother,  and  devised  the    "lateral  position"   for  parturient  women.      His 
"  Essay  towards  a  complete  new  System  of  Midwifery"  appeared  at  London,  1751. 

William  Osborne  (1732-1808)  of  London 
was  an  opponent  of  Cesarean  section,  in  place  of  which  he  recommended  perforation, 
even  in  the  case  of  living  children.  He  developed  the  doctrine,  since  his  day  in 
vogue  in  England,  that  the  child  may  be  sacrificed  to  the  safety  of  the  mother.  His 
"Essays  on  the  practice  of  midwifery  in  natural  and  difficult  labors"  appeared  at 
London  in  1*792. 

John  Leake  (died  1792)  of  London, 
whose  name  will  be  again  mentioned  in  connection  with  the  subject  of  instruction  in 


—  687  — 

midwifer}7,  recommended  in  profuse  haemorrhages  to  wrap  the  legs  in  cold  wet  towels, 
invented  a  forceps  etc.  [He  wrote  a  text-book  entitled  "  Lecture  introductory  to  the 
theory  and  practice  of  midwifery  ",  London,  177;!.] 

[To  whom  we  may  add  : 

William  Giffard, 
"Surgeon   and  man-midwife"   of  London,   whose   "Cases  of  midwifery",  published 
posthumously  by  Edward  Hody  in  1734,  was  the  first  English  work  to  describe  and 
depict   the   English   forceps.     Giffard  describes  a  case   in  which   he  employed  his 
''extractors"  in  1726. 

Edmund  Chapman  of  London, 
whose  "Treatise  on  the  improvement  of  midwifery"  etc.  (London  1733)  contributed 
largely  to  the  diffusion  of  a  knowledge  of  the  midwifery  forceps,  though  he  gave  no 
plate  of  his  forceps  until  his  second  edition  in  1735.  Chapman  was  very  conservative 
in  his  teachings,  believing  that  almost  all  cases  could  be  terminated  by  the  hand  or 
the  forceps.     He  had  employed  the  forceps  at  least  as  early  as  1723. 

Alexander  Hamilton  (died  1802), 
professor  of  midwifery   in   Edinburgh  and  author   of  "  Elements  of  the  practice  of 
midwifery"  (1775),  with  treatises  on  the  diseases  of  women  and  children. 

George  Counsell, 

a  surgeon  and  obstetrician  of  London,  who  in  his  "Art  of  midwifery"  etc.  (London 
1752)    recommends    emetics   and   sternutatories   to   facilitate    labor,    together   with 
manual  dilatation  of  the  os  uteri  in  rigidit3r  of  that  organ.     He  thinks  that  footling 
presentations  alwaj-s  demand  artificial  aid,  and  that  face  presentations,  incapable  of 
conversion  into  that  of  the  occiput,  require  version  or  the  forceps. 

Bartholomew  Mosse  (1712-1749)  of  Dublin, 
who  in  1745  founded   at  his  own  expense  the  Dublin  Lying-in   Hospital,  the  first 
institution  of  its  kind  in  Great  Britain. 

Treatises  on  midwifery  were  also  published  by  Benj.  Pugh  of  Chelmsford  (1748); 
William  Rowley  of  London  (about  1789);  James  Sims  (1741-1820),  who  edited  in 
1787  "The  principles  and  practice  of  midwifery  by  Edward  Foster";  and  Charles 
White  of  Manchester  (1772),  who  has  been  already  mentioned  for  his  introduction  of 
resection. 

Edward  Rigby  (1747-1821)  of  Norwich  wrote  a  famous  treatise  on  ante  partum 
haemorrhage  (1775). 

Caesarean  section  was  discussed  by  William  Simmons  of  Manchester  (1798), 
James  Vaughan  of  Leicester  (1778),  the  father  of  Sir  Henry  Halford,  and  Wm.  Dease 
of  Dublin  (1785).  Nathaniel  Hulme  of  London  (1772)  and  Philip  Pitt  Walsh  (1787) 
studied  the  subject  of  puerperal  fever.  Thos.  Dawkes  of  Huntington  wrote  a  manual 
for  midwives  (1736);  Thomas  Thompson  (1752),  a  vindication  of  man-midwifery, 
while  Elizabeth  Nihell,  a  midwife  of  London  (1760),  opposed  male  midwifery  and 
instrumental  delivery.  —  Chas.  Nich.  Jenty,  professor  of  anatomy  and  surgery  in 
London,  supplied  in  1758  some  plates  of  the  pregnant  uterus:  James  Parsons,  an 
"Elenchus  gynsecopathologicus  et  obstetricarius"  (London,  1741),  and  Dan.  Peter 
Layard  of  London,  a  "Pharmacopoeia  in  usum  gravidarum,  puerperarum "  etc. 
(1776). 

Drinkwater  of  Brentford,  who  left  among  his  effects  a  pair  of  forceps  (he  died 
1728);  John  Mawbray,  whose  "Female  physician  "  appeared  in  1724,  and  who  is 
said  to  have  been  the  earliest  teacher  of  midwifery  in  Great  Britain;  Maxwell  Gart- 
shore  (1732-1812)  of  London  and  Joseph  Clarke  (1758-1834),  master  of  the  Dublin 
Lying-in  Hospital,  also  merit  mention.     H.] 


—  088  — 

f.  The  Dutch. 

besides  the  obstetricians  more  or  'less  connected  with  the  forceps-question, 
viz.  : 

Cornelius  Bokelman,  Jan  de  Bruin,  Plaatmann,  Abr.  Titsingh,  Jac.  de  Visscher, 
Hugo  van  de  Poll,  Rathlauw,  Joh.  Dan.  Schlichting  (born  1705),  van  der  Swam, 
Corn.  Plevier, 

can  point  to  the  versatile  Pieter  Camper  alone  as  an  obstetrician  of  greater 
importance.  He  was  the  author  of  the  proposal  of  sj-mphyseotomy. 
After  Joh.  Huwe  (died  1725)  of  Haarlem  had  first  undertaken  obstetrical 
measurements  and  Deventer  had  first  'pointed  out  the  inclination  of  the 
pelvis  (Levret  wrote  on  the  subject  without  auy  measurements),  Camper 
also  determined  more  carefully  the  pelvic  axis  and  gave  the  inclination  of 
the  pelvis  at  75°  etc. — In  Holland,  whose  medical  schools  the  Northmen  of 
that  day  preferredto  attend,  was  educated  the 

g.  Dane 

Balth.  Joh.  von  Buchwald  (1697  to  after  1760).  professor  in  Copenhagen, 
whose  pupil,  the  famous 

Chr.  Joh.  Berger  (1724-1787) 
was  the  teacher  of  the  Danish  obstetrician 

Matth.  Saxtorph  (1740-1800). 
Saxtorph  rendered  good  service  in  his  teachings  relative  to  natural  delivery  of  the 
head,  and  in  the  introduction  of  the  forceps  into  Denmark.     He  even  brought  forward 
a  forceps  of  his  own. 

The  forceps  were  first  introduced  into  Denmark  by  Janus  Bing  (1681-1751),  who 
must  not  be  confounded  with  the  versatile  Janus  Bang  (1737-1808),  a  pupil  of  Sax- 
torph. Bang  in  1774  fixed  the  angle  of  inclination  of  the  pelvis  very  nearly  correctly 
at  55°,  and  also  taught  the  mode  of  entrance  of  the  shoulders  into  the  pelvis.  —  In 

h.  Sweden 

Herm.  Schuetzerkranz  (1713-1802)  and  Joh.  Kraak  (1745-1810)  were 
teachers  of  midwifery,  and  Olof  af  Acre!  also  devoted  his  attention  to  this 
branch.     Among  the 

i.  Russians 

Baron  Jos.  Jac.  von  Mohrenheim  was  active,  though  he  did  not  specially 
advance  the  art. 

6.    ANATOMY  AND  PHYSIOLOGY.    PATHOLOGICAL  AND  GENERAL 'ANATOMY. 

Anatomy,  after  the  cultivation  which  it  had  received  in  the  preceding 
century,  could  point  in  the  18th  century  not  so  much  to  numerous  and 
brilliant  discoveries,  as  to  a  more  thorough  study  of  individual  branches 
and  of  departments  as  yet  little  investigated.  The  harvest  to  be  reaped 
by  eas}"  labor  had  diminished.  Hence,  anatomy"  at  this  period  (as  still 
more  in  our  own  age,  which  devotes  itself  especial!}-  to  its  varieties  and 
topographical   relations)  was  directed  to  the  more   minute,   less  striking 


—  689  — 

and  more  difficult  parts.  In  addition,  the  task  of  attaining  the  utmost 
possible  thoroughness  in  description  and  exposition  was  assigned  to  it 
more  and  more,  and  together  with  this,  the  elaboration  of  anatomical  facts 
with  an  eye  to  physiology,  and  yet  without  neglecting  the  search  for 
novel ty.  On  the  whole,  there  prevailed  in  anatomy,  which  now  had  more 
material  at  its  disposal,  a  tolerably  active  life.  This  may  be  judged  from 
the  considerable  number  of  capable  investigators  who  dedicated  their 
powers  to  this  subject,  as  well  as  from  the  not  inconsiderable  number  of 
new  ideas  and  facts  which  the}'  acquired. 

Microscopic  anatomy,  which  had  been  created  and  at  once  extensively 
studied  in  the  17th  centuiy,  suffered,  like  normal  anatomy,  a  relative 
quiescence.  It  ma}-  be  remarked  that  Brisseau-Mirbel  held  that  the  tissues 
—  he  applied  his  theory  chiefly  to  plants,  but  it  was  subsequently  trans- 
ferred to  the  animal  tissues  —  originated  from  cellular  and  tubular  struct-  . 
ures  ;  Medicus  looked  upon  them  as  originating  from  fibres  ;  Sprengel, 
from  vesicles,  whose  growth  was  accomplished  by  the  reception  of  water, 
and  Wolff,  from  drops  of  the  succus  nutritius  (subsequently  named  by 
Hugo  von  Mohl  "  protoplasma"),  which  transformed  themselves  into  cell- 
cavities. 

Pathological  and  general  anatomy,  both  of  which  were  destined  to 
control  the  medicine  of  the  19th  century,  were  newly  created,  not  indeed 
as  sciences  per  se,  but  yet  as  special  branches  of  science. 

A  still  more- important  acquisition  of  the  18th  century  in  the  sphere 
of  the  fundamental  sciences  of  medicine  was  unquestionably  the  revival 
and  more  active  study  of  experimental  physiology,  a  field  which,  from  the 
works  of  Galen  on  this  matter  down  to  the  time  of  Harvey  (who  certainly 
made  a  most  brilliant  beginning),  had  lain  almost  entirely  fallow,  and  even 
after  Harvey's  discovery  had  once  more  remained  rather  quiet. 

a.  The  Germans. 

This  revival,  which  marks  a  genuine  epoch  in  the  history  of  medicine, 
was  effected  by  the  German-Swiss 

Albert  von  Haller  (1708-1777)  of  Berne,  a  man  generally  called  in 
the  last  century  (like  Hippocrates  in  his  own  age)  "the  Great".  Haller 
was  a  universal  and  indefatigab'e  savant,  of  ingenious  natural  endowments, 
marvellous,  almost  unique,  capacity  for  work  and  conscientiousness,  a  man 
of  inextinguishable  love  for  art  and  science  and  one  of  the  greatest  medical 
thinkers  of  all  time,  one  who  distinguished  himself  too  as  a  notable  poet, 
botanist  and  statesman. 

In  art,  science  and  life  Haller  was  an  almost  typical  representative  of  the  Swiss. 
He  possessed  in  the  highest  degree  the  assiduity,  industry  and  tenacious  endurance 
of  his  nation.  As  a  poet  too,  he,  like  all  Swiss  poets  down  to  the  present  day,  never 
passed  beyond  the  didactic  and  the  home-spun.  His  life  was  one  of  the  graetest 
modesty.  Yet  he  also  possessed  disputatiousness,  love  for  his  country  and  his 
countrymen,  and  the  lordliness,  the  self-esteem  and  the  aristocratic  devoutness  (the 
44 


—  690  — 

Litter  in  Haller's  old  age  degenerated  into  actual  pietism.1')  peculiar  to  republican 
patricians,  from  one  of  whose  most  respected  families  he  sprung.  His  father  was  a 
jurist.  He  died,  however,  when  the  young  and  sickly  Haller  was  only  twelve  years 
old,  though  no  trilling  scholar.  For  since  his  eighth  year  Haller,  yielding  to  a  pre- 
mature passion  for  literary  compilation,  besides  his  ordinary  school  tasks  had  pre- 
pared compendiums  on  the  signification  of  German  and  foreign  words,  and  2000 
biographical  extracts  from  the  dictionary  of  Bayle  and  Moreri.  The  latter  he 
subsequently  utilized  in  his  "  Bibliothecas " .  From  his  tenth  year  he  wrote  poems  in 
Latin  and  German.  At  fifteen  he  went  to  the  university  of  Tubingen,  where  Duvernoy 
and  the  botanist  Rud.  Jac.  Camerarius  (1665-1721),  the  first  accurate  describer  of 
the  sexual  organs  of  plants  (Thomas  Millington  as  early  as  1676  had  pointed  them 
out),  were  his  teachers.  In  the  second  year  of  his  sojourn  at  Tubingen  he  wrote  an 
anatomical  article  in  opposition  to  Coschwitz.  In  1725  Haller  went  to  Leyden, 
where  Boerhaave  and  Albinus  gained  in  him  their  most  industrious  pupil.  At  the 
age  of  19  he  received  his  degree  of  doctor,  after  which  he  began  his  long  dispute  with 
the  iatro-mathematician  Hamberger  and  made  a  trip  to  England,  where  he  enjoyed 
the  anatomical  instruction  of  James  Douglas  (1675-1742),  who  desired  to  retain 
Haller  with  him.  The  latter,  however,  preferred  to  go  to  Paris  in  order  to  hear 
le  Dran  and  Winslow.  In  the  excess  of  his  zeal  for  anatomy  —  in  Tubingen  he  had 
dissected  dogs  and  in  Leyden  purchased  for  a  considerable  sum  from  Albinus  the 
half  of  a  corpse  —  he  here  engaged  in  grave-robbing,  and  betrayed  by  the  foul  odor, 
was  compelled  to  save  himself  by  flight.  Accordinglj'  in  1728  he  went  to  Basel, 
studied  here  botany  especially  and  mathematics  under  Jean  Bernoulli  (1667-1748), 
and  lectured  upon  the  former  subject  during  the  sickness  of  professor  Mieg.  Next 
Haller  undertook  a  botanical  journey  through  Switzerland  in  company  with  Job. 
Gesner,  and  then  settled  as  a  practising  physician  in  his  native  city.  He  did  not, 
however,  neglect  to  continue  his  botanical  studies  and  to  write  poetry,  so  that  in  1732 
he  published  anonymously  his  first  collection  of  poems.  Most  of  his  poems  originated 
during  this  his  first  residence  in  Berne.  At  the  age  of  26  he  was  appointed  director 
of  the  hospital  in  Berne  and  professor  of  anatomy,  in  which  latter  position  he 
occasioned  the  erection  of  an  anatomical  theater.  In  1735  he  received,  in  addition, 
the  position  of  city  librarian,  but  a  year  later  accepted  a  call  to  Gottingen  as  professor 
of  anatomy,  surgery,  chemistry  and  botany.  As  he  was  entering  upon  the  unpaved 
streets  of  Gottingen  the  wagon  overturned,  and  as  the  result  of  this  fall  Haller's  first 
wife  Marianne,  so  deeply  lamented  in  his  poems,  met  her  death.  His  second  wife  he 
lost  in  childbed,  together  with  the  infant,  but  his  third,  a  daughter  of  professor  Teich- 
meyer,  bore  him  four  sons  and  four  daughters.  In  1739  Haller  was  appointed  English 
physician-in-ordinary,  ten  years  later  an  English  state-counsellor,  while  he  was  also 
made  one  of  the  nobility  of  the  empire  by  Maria  Theresa  and  her  uxorious  spouse, 
the  emperor  Francis  I.  He  was  the  founder  of  the  botanical  garden,  anatomical 
theater  and  hall  of  anatomical  drawings  in  Gottingen,  and  of  the  "  Konigliche  Gesell- 
sehaft  der  Wissenschaften".  Of  the  latter  society  he  was  the  first  and  permanent 
president  as  long  as  he  lived.  In  1752  he  published  his  famous  researches  upon  the 
subject  of  irritability.  As  early  as  1745  Haller  had  been  received  into  the  great 
council  of  his  native  city,  and  he  continued  to  be  a  member  of  the  great  council, 
when  he  returned  there  forever,  until  chosen  Landammann  of  his  native  canton.  In 
spite  of  the  severe  labors  which  the  public  business  of  the  largest  of  all  the  Swiss 
cantons  occasioned  him,  he  was  enormously  active  in  literary  matters,  as  is  shown 
by  his  physiology,  his  numerous  critical  writings  and  his  famous  "  Bibliothecae",  in 


1.  Still  worse  he  is  reported  by  one  biographer  to  have  said  upon  his  deathbed  that 
lie  believed  nothing  at  all. 


—  691  — 

the  compilation  of  which  he  was  assisted  by  his  pupils,  his  wife  and  children.  He 
himself,  however,  was  so  busy  that  for  a  long  time  he  slept  and  lived  in  the  library. 
Yet.  in  spite  of  his  quite  unique  and  enormous  correspondence  with  the  savants  of 
the  whole  world.  Haller  never  left  a  letter  unanswered. — Haller's  permanent  influence 
upon  practical  medicine  was  only  an  indirect  one.  His  chief  importance  is  to  be 
found  more  upon  the  theoretical  side  of  the  healing  art,  though  he  introduced  into 
Germany  the  use  of  the  watch  for  the  purpose  of  counting  the  pulse.  Although  he 
was  a  professor  of  surgery  and  performed  many  vivisections,  he  was  never  able  to 
persuade  himself  to  perform  a  single  surgical  operation. 

From  what  has  just  been  said,  to  merely  indicate  here  the  services  of 
Haller  is  impossible.  Haller,  like  Aristotle,  demands  a  special  historian  of 
his  own,  and  only  an  equal  mind  can  estimate  him  completely  and  correctry. 
We  point  out  only  a  few  of  his  services : 

Haller's  anatomical  discoveries  were  almost  all  made  during  his  investigations 
on  his  chief  doctrines  and  with  reference  to  them,  and  thus  concern  such  structures 
as  come  into  consideration  in  those  doctrines.  Thus  e.  g.  he  enriched  the  anatomy 
of  the  heart,  an  organ  upon  which  he  had  made  numerous  studies  with  reference  to 
his  doctrine  of  irritability:  then  that  of  the  brain,  the  dura  mater,  to  which  he  denied 
nerves  ;  he  pointed  out  the  venous  nature  of  the  sinuses,  described  the  pes  hippocampi, 
studied  more  carefully  the  anatomy  of  the  organs  of  generation,  including  the  uterus 
(which  he  taught  should  be  regarded  as  a  muscle),  the  testicles  etc.  Besides  he 
advanced  our  knowledge  of  the  lymphatic  system  by  proving,  in  opposition  to 

Georg  Daniel  Coschavitz  (1679-1729), 
the  famous  professor  of  anatomy  in  Halle,  that  the  lingual  veins  were  no  salivary  duct. 

In  the  history  of  development  he  made  more  complete  researches  into  the  devel- 
opment of  the  fowl  (proving  e.  2.  that  in  the  H8th  hour  the  first  trace  of  the  heart 
-bowed  itself,  in  the  41st  the  first  trace  of  red  blood  etc.),  and  refuted  many  errors  of 
the  investigators  of  the  17th  century.  A  follower  of  the  theory  of  preformation  or 
evolution,1  he  also  threw  light  upon  the  history  of  development  of  the  mammalia  by 
his  investigations  upon  sheep,  goats  and  cows,  defended  the  formation  of  the  corpora 
lutea  in  the  place  of  the  expelled  ovule,  taught  the  origin  of  the  decidua  in  the  first 
13-17  days  etc.  In  his  theory  of  development  he  followed  the  assumption  that,  since 
the  creation  of  the  genus,  every  individual  is  descended  or  derived  from  a  preceding 
individual. 

In  the  physiology  of  the  circulation  Haller  studied  the  mechanism  of  the  motion 
of  the  heart.  The  internal  cause  of  this  motion  he  regarded  as  irritability,  which  was 
maintained  by  the  blood  as  a  merely  accidental  and  external  cause. —  He  pointed  out 
the  filling  of  the  coronary  arteries  during  the  systole  of  the  heart,  but  denied  to  the 
arteries  all  motive  power,  assigning  the  latter  to  the  heart  alone,  since  the  pulsations 
of  the  heart  and  those  of  the  smallest  arteries  were  felt  at  the  same  time.  —  The  pul- 
monary veins,  according  to  Haller,  are  smaller  than  the  pulmonary  arteries  because 
the  route  of  the  blood  in  them  is  shorter,  and  accordingly  more  quickly  accomplished. 

1.  That  in  the  year  1756  a  notary,  Martin  Frobenius  Ledermuller,  was  compelled  to 
defend  the  existence  of  the  spermatozoa  against  the  theologians  is  not  so  remark- 
able as  that  a  notary  should  be  willing  to  undertake  such  knightly  service. 
Again,  as  early  as  1728,  Emmanuel  Sinttema,  far  in  advance  of  his  time,  taught 
in  a  popular  treatise  that  in  women  and  maidens  an  ovule  wandered  from  the 
ovarium  each  month  into  the  uterus,  that  menstruation  was  in  this  sense  a 
purification,  that  by  it  the  uterus  was  enabled  to  receive  an  ovule  (See  Geyl, 
Arch,  fur  Gynacologie,  1887). 


—  692  — 

The  reflux  in  the  veins  is  stronger  and  easier  daring  expiration,  while  the  arterial! 
afflux  is  favored  by  inspiration  etc.  In  the  physiology  of  digestion  he  was  acquainted 
with  the  usefulness  of  bile  (regarded  by  Aristotle  as  a  useless  excrementitious  product  I 
in  the  digestion  of  fat. 

As  regards  the  mechanism  of  respiration  he  refuted  Bamberger,  who  taught,  like 
the  Ancients,  that  the  lungs  contract  independently,  a  doctrine  which  involved 
necessarily  the  assumption  that  air  existed  in  the  pleural  sack  to  restore  the  equi- 
librium of  the  pressure  of  the  air  within  and  without,  tlaller's  success  was  such  that 
the  learned  Hamberger,  while  obstinately  defending  his  own  opinion  during  life, 
declared  upon  his  deathbed  that  he  was  conquered. 

The  most  brilliant  contribution  of  Haller  to  the  physiology  of  the 
nervous  system,  however,  was  his  refutation  of  the  doctrine  of  the 
oscillatory  motion  of  the  nerves  which  had  heretofore  generally  prevailed, 
and  his  administration  of  the  death-blow  to  the  doctrine  of  the  vital  spirits. 
In  this  he  was,  so  to  speak,  the  Harvey  of  nervous  activity.  As  Harve}" 
was  the  father  of  the  modern  physiology  of  the  blood  and  of  the  changes 
of  matter,  so  was  Haller  the  father  of  our  modern  nervous  physiology. 

Haller  proved  convincingly  that  sensation  takes  place  in  the  nerves, 
or  occurs  011I3-  in  organs  endowed  with  nerves. 

If  in  the  preceding  points  Haller  had  acquired  many  opponents  and  numerous- 
followers,  the  same  was  true  in  the  widest  degree  of  the  world-famous 

Doctrine  of  irritability, 

—  proof  enough  of  its  importance  and  its  scope.  It  moved  all  the  minds 
of  the  century  —  and  not  in  the  department  of  medicine  alone  — in  a  way 
of  which  we  of  the  present  da}*  have  no  satisfactory  conception,  unless  we 
compare  it  with  our  modern  Darwinism. 

Glisson,  as  we  have  already  seen,  established  deductivel}*  the  principle 
of  a  general  irritability.  Haller  proceeded  to  follow  up  this  principle  by 
the  inductive  method,  proving  its  existence  by  experiment.  But,  in  con- 
trast to  the  generalization  of  Glisson,  he  demonstrated  that  this  irritability 
was  something  entirely  special,  a  simple  peculiarit}'  of  the  muscular  sub- 
stance, opposed  to  sensation  as  the  second  vital  phenomenon. 

As  early  as  the  year  1739  and  again  in  1 743  Haller  wrote  that  "irritability"  was 
the  cause  of  muscular  movement,  and  in  his  physiology,  published  in  1747,  he  gave 
"dead  nervous  force"  (elasticity),  "innate  nervous  force"  (irritability)  and  "nervous 
force  in  itself"  as  the  three  forces  which  produce  muscular  movements.  The  first 
investigations  relative  to  this  subject,  however,  were  published  by  Zimmermann, 
under  the  direction  of  Haller,  in  a  dissertation  "  De  irritabilitate  "  presented  for  the 
attainment,  of  the  Doctorate  in  1751.  Of  this  dissertation  Haller  said  "that  his 
learned  and  industrious  pupil  here  imparts  the  thoughts  and  observations  of  his 
master,  and  that  he  himself  (Haller)  intends  to  write  upon  this  subject  as  soon  as  he 
has  obtained  more  light".  In  the  following  year  Haller  himself  gave  an  account  of 
190  experiments  (he  described  altogether  ;">67)  undertaken  for  the  purpose  of  determin- 
ing those  parts  of  the  body  which  possess  "irritability".  He  found  that  this  irri- 
tability existed  in  the  muscular  substance  alone,  entirely  independent  of  the  nerves 
proceeding  to  it,  and  although  a  long  dispute  was  waged  over  the  question  whether 
nerve  or  muscular  substance  involved  the  contraction  —  a  dispute  not  decided  until 


—  693  — 

our  own  day  —  Haller's  original  idea  remained  established.  For  it  has  been  shown 
that  curarized  animals,  or  their  muscles,  still  react  to  salts,  high  grades  of  heat,  cold, 
acids,  alkalis  and  the  electric  current,  and  that  the  same  thing  occurs  in  muscles 
without  nerves,  as  in  the  extremities  of  the  sartorius  in  the  frog.  Moreover  the  con- 
traction is  different  when  the  nerve  is  transversed  by  a  constant  current  and  when 
this  current  flows  through  the  muscle  itself.  In  the  former  case  there  are  merely 
contractions  upon  opening  and  closing  the  current;  in  the  latter  the  contraction  con- 
tinues as  long  as  the  current  in  passing. 

According  to  Haller  there  are: 

"Sensible  parts:  brain  and  nerves.  Through  the  latter:  the  skin,  muscles, 
stomach,  intestines,  ureters,  uterus,  vagina,  penis,  tongue,  retina  and  heart.  Intestines 
and  glands  have  little  sensibility. 

Insensible  parts:  epidermis,  cellular  tissue,  fat,  tendons,  coats  of  the  intestines 
and  joints,  the  dura  and  pia  mater,  ligaments,  periosteum  and  pericranium,  bones, 
marrow,  cornea  and  iris.     Arteries  and  veins  are  generally  insensible. 

Irritable  parts:  heart,  muscles,  diaphragm,  stomach  and  intestine,  lymphatics, 
thoracic  duct,  bladder,  bursa?  mucosa?,  uterus  and  genitalia,  which  possess  a  peculiar 
irritability. 

Non-irritable  parts :  nerves,  epidermis,  skin,  membranes,  arteries,  veins,  cellular 
tissue,  viscera,  excretory  ducts  of  excreting  organs. 

All  parts  in  which  are  found  both  nerves  and  muscular  fibres  are  at  once  sensible 
and  irritable.  Such  are  muscles,  the  heart,  alimentary  canal,  diaphragm,  bladder, 
uterus,  vagina,  and  genitalia. 

All  these  researches  of  Haller  deserve  increased  recognition  from  the  fact  that  he 
lacked  the  aids  of  our  modern  physiologists.  The  earliest  German  physiological 
institute  was  founded  by  Purkinje  in  Breslau  somewhere  in  the  forties  of  the  present 
century.  Joh.  Midler,  the  great  successor  of  Haller,  possessed  no  such  advantages. 
Doubtless  the  physiologists  of  that  day  did  not  believe  in  Schiff's  famous  dictum,  that 
for  every  dog  rescued  from  vivisection  a  human  life  must  perish. 

(Investigations  relative  to  the  "Glissonian  irritability  "  ran  parellel  to  those  on 
the  Hallerian.  With  the  former  (common  to  all  fibres)  were  occupied  after  1746 : 
Friedrich  Winter  (1712-1760),  professor  in  Franecker  and  Leyden  and  his  pupil  Joh. 
Lups  of  Moscow,  who  allotted  irritability  to  plants;  Lambert,  Bicker,  Joh.  Wolfg. 
Manitius,  who  classified  irritability  in  accordance  with  the  temperament  and  period 
of  life;  Iman  Jac.  van  den  Bosch,  Walther  van  Doeveren  (1730-1783),  who  agreed  in 
many  things  with  Haller;  Jan  de  Gorter  (1689-1762)  professor  in  Harderwyk  etc.) 
Haller  is  also  the  founder  of  experimental  pathology,  since  he  was  the  first  to 
inject  putrid  matters  into  the  veins  of  animals,  by  which  the  victims  speedily  perished. 
He  ascribed  the  plague  to  the  presence  of  putrefying  matters  in  the  air. 

The  profound  impression  made  by  the  doctrine  of  Haller  upon  his 
contemporaries  ma}'  be  measured  by  the  number  of  his  supporters  and 
opponents.  Still  the  former  defended,  as  the  latter  opposed,  for  the  most 
part,  only  one  feature  or  another  of  Haller's  doctrine,  and  it  is  therefore 
difficult  to  definitely  distinguish  the  two.  Among  the  followers  of  Haller 
who  departed  but  little  from  the  ideas  of  their  master,  we  may  reckon  : 

Joh.  Gottfr.  Zinn  (1727-175!)),  professor  in  Gottingen  and  one  of  Haller's  favor- 
ite pupils,  who  published  a  work  on  the  anatomy  of  the  eye,  adorned  with  very 
perfect  plates,  and  whose  name  has  been  preserved  in  the  zonula  of  Zinn  ;  Tissot; 
Felice  Fontana  (1730-1805).  of  the  Italian  Tyrol,  professor  in  Pisa,  an  anatomist 
who,  like  Zinn,  gave  his  special  attention  to  the  eye  (canalis  Fontana?),  and  is  well 
known   as  an   artist  in  anatomical  preparations  in    wax;    Georg   Heuermann  (died 


—  b'94  — 

1767);  Georg  Christ.  Oeder  (1728-1791),  professor  in  Copenhagen;  Joh.  Gg.  Rode- 
rer;  Karl  Abraham  Gerhardt  (173S-1821) ;  Heinrich  Nepomuk  Cranz  ;  Peter  Castell ; 
William  Battie  (1704-1776),  a  physician  of  London  ;  Richard  Brocklesby  (1724-1797) ; 
Toussaint  Bordenave  (1698-1782) ;  E.  J.  P.  Housset,  professor  in  Montpellier:  Urban 
Tosetti ;  Marc.  Ant.  Caldani  (1725-1813),  professor  in  Padua;  Pietro  Moscati  (1736- 
1824),  professor  in  Pavia;  Giov.  Franc.  Cigna,  professor  in  Turin;  Giov.  Batt. 
Verna,  a  surgeon  of  the  same  place,  and  many  others. 

Irritability  was  extended  to  the  smallest  vessels  or  arteries  by:  Walther  Ver- 
schuir;  Pierre  Ant.  Fabre,  professor  in  Paris,  a  pupil  of  Petit  and  an  eminent 
syphilographer,  who  established  the  total  difference  between  the  symptoms  of  syphilis 
and  gonorrhoea;  Christ.  Ludw.  Hoffmann;  Christ.  Cramp;  Heidenreich  van  den 
Bosch;  Guil.  de  Magny ;  G.  M.  Gattenhof,  professor  in  Heidelberg  and  a  teacher  of 
Joh.  Peter  Frank  ;  Borsievi ;  Daniel  Magenise  (Maginnis?)  and  others,  some  of  whom, 
like  Gaub  and  Unzer,  applied  the  doctrine  of  irritability  to  pathology. 

Finally  the  fundamental  force  of  the  body,  of  which  irritability  and  sensibility 
were  mere  modifications,  was  allotted  to  the  cellular  tissue  by  : 

Matth.  van  Geuns  (died  1816),  Georg  Wilh.  Benefeld.  Joh.  David  Gran,  A.  G. 
Weber  in  Halle  (1783),  Joh.  Ludwig  Gauthier  in  Breslau  (1793)  and  others. 

Unconditional,  or  more  or  less  conditional,  opponents  of  the  doctrine 
of  Haller  were  : 

Robert  Whytt.  the  partisan  of  Stahl,  who  gave  vogue  to  the  idea  that  the  exces- 
sive pain  of  the  incision  through  the  skin,  always  occasioned  in  vivisections,  altered 
and  increased  the  sensibility  of  the  parts;  Karl  Christ.  Krause  (1716-1793),  professor 
in  Leipzig:  Georg  Heinrich  Delius  (1720-1791),  professor  in  Erlangen,  who  opposed 
Haller  on  a  priori  grounds  ;  Ant.  de  Haen,  who  subsequent!}-  became  a  c*overt  to  the 
doctrine;  Andr.  Midler,  professor  in  Giessen ;  Batt.  Bianchi  (1681-1761),  professor 
in  Turin,  his  birthplace;  Domen.  Sanseverini.  professor  in  Naples;  P.  Petrini  : 
Dom.  Vandelli  and  Car.  Mich.  Lotteri,  professor  in  Turin  ;  Thorn.  Laghi,  professor 
in  Bologna,  and  many  other  Italians,  who  were,  of  all  nations,  the  greatest  students 
of  the  doctrine  of  Haller.  Among  the  French  were  Lorry,  CI.  Nic.  le  Cat,  Jean 
Pierre  Jausseraud,  Louis  Girard  de  Villars,  Ch.  Geille  de  St.  Leger  etc. 

Among  the  medical  systems  which  we  have  heretofore  considered,  the  nervous 
pathology  of  Cullen,  the  doctrines  of  Gaub  and  Unzer,  Vitalism,  Brunonianism  and 
its  offshoots,  with  some  others,  were  closely  related  to  the  doctrine  of  Haller.  —  But  la 
Mettrie  too,  who  has  been  recently  rehabilitated  by  the  Berlin  physiologist  Dubois- 
Reymond,  built  up  his  denial  of  the  spirit  upon  Haller' s  "  irritability  ". 

The  theory  of  development,  through  Haller's  investigations,  gained  a 
new  impulse.  He  embraced,  as  above  intimated,  the  views  of  Harvey,  i.  e. 
the  theory  of  the  preformation  of  all  parts  in  the  germ,  and  that  these 
parts  then  mereh-  grow  (theory  of  evolution).  On  the  other  hand  the  St. 
Petersburg  professor 

Caspar  Friedrich  Wolff  (1735-1794)  revived  the  theory  of  epigene- 
sis  or  post-formation,  which  Hippocrates  and  Aristotle  had  already  adopted, 
and  which  regards  generation  as  an  actual  new  creation. 

Wolff,  the  first  meritorious  investigator  in  Russia  and  the  pioneer  in  the  history 
of  development,  was  followed  at  a  later  period  in  that  country  by  Pander  and  Baer. 
He  taught  that  in  the  incubated  hen's-egg  the  blood-corpuscles  move  before  the  heart 
and  the  blood-vessels,  and  described  the  Wolffian  bodies  which  bear  his  name.  The 
latter,  however,  he  did  not  recognize  as  envelopes  of  the  egg.  The  mammalian  ovum 
was  first  discovered  by   Baer.     Wolff,  however,  was  the  first  to  teach  the  doctrine  of 


—  695  — 

the  blastodermic  membrane,  according  to  which  all  organs  first  assume  the  form  of 
membranes,  a  doctrine  which  Pander  subsequently  perfected.  Wolff  was  also  the 
first  to  call  attention  to  the  fact  that  in  the  cellular  tissue  no  proper  cell-cavities 
exist. 

The  famous  Joh.  Friedricii  Blumenbach  (1752-1840)  of  Gotha,  and 
after  1776  a  professor  in  Guttingen,  was  the  author  of  the  doctrine  of  the 
nisus  formativus  (Biklungstrieb), 

i.  e.  of  a  peculiar  impulse,  in  addition  to  irritability  and  sensibility,  belonging  to 
every  animal  body  as  a  part  of  its  vital  force,  an  impulse  to  maintain  itself  and  to 
reproduce  itself  fin  the  sexes)  within  itself  and  the  species.  This  impulse,  in  its 
regular  operation,  manifests  itself  in  generation,  nutrition  and  reproduction;  when 
disturbed  it  produces  arrest  of  development. — Blumenbach  rendered  much  greater 
service  by  his  anthropological  investigations  than  by  this  theory,  so  famous  in  its 
day.  He  may  in  fact  be  called  the  founder  of  anthropology,  and  his  researches 
regarding  the  formation  of  the  skull  in  different  races  (he  possessed  an  almost 
unique  collection  of  skulls,  his  "  Golgotha")  and  his  activity  in  the  study  of  com- 
parative anatomy,  physiology  and  the  history  of  development,  have  tendered  him 
justly  famous.  He  was  one  of  the  busiest  and  most  popular  of  university  profesfors, 
and  endowed  with  such  attractiveness  that  Guttingen  gained  greatly  in  its  patronage 
through  Ids  influence.  His  text-books  of  physiology,  comparative  anatomy,  natural 
history  etc.  survived  numerous  editions. 

Besides  the  physicians  already  mentioned,  the  following  also  distin- 
guished themselves  as  anatomists  and  physiologists  : 

Joh.  Juncker  (1679-1759),  author  of  "  Grundriss  der  Physiologic"; 
Christian  Jac.  Trew  (1695-1769).  ordinary-physician  of  Ansbach  and 
president  of  the  "Academie  der  Naturforscher "  (osteology  and  investi- 
gations on  the  fcvtiis  and  the  new  born);  E.  J.  von  Wachendorf  (discovered 
the  pupillary  membrane  in  1737);  Carl  Sam.  Andersch  (died  at  Kimigs- 
berg  in  1777;  discovered  the  ganglion  petrosum  and  distinguished  the  9th, 
10th  and  11th  cerebral  nerves  as  distinct  nerves);  Johann  Friedrich 
Schreiber  (1704-1760),  to  whom  Morgagni  dedicated  one  book  of  his  work: 
Christ.  Gottl.  Ludwig  (1709-1773).  -Physiologic ";  Johann  Friedrich 
Cassebohm  (died  in  1743),  professor  in  Halle  (investigations  on  the  ear). 
More  important  was  Josias  Weitbrecht  (1702-1747).  professor  in  St. 
Petersburg,  and  author  of  a  famous  treatise  on  syndesmologv;  highly 
famous  was  Joh.  Nath.  Lieberkiihn  (1711-1765).  a  practitioner  of  Berlin 
who  distinguished  himself  as  an  artistic  injector,  microscopist  (he  invented 
the  solar  microscope  in  1738)  mechanician  etc.,  and  whose  name  has  been 
preserved  in  the  glands  of  Lieberkiihn. 

Heister,  Joh.  Ad.  Kulmus.  (1689-1745).  professor  in  Danzig;  Joh. 
Fried.  Meckel,  the  grandfather  (1724  1774),  who  described  the  nerves, 
bloodvessels  and  lymphatics,  glands  and  their  excretoiy  ducts  etc.;  Phil. 
Ad.  Bohmer,  were  all  good  anatomists,  and  even  the  poet  and  professor 
of  anatomy  in  Frankfort-on-the-Oder,  Joh.  Phil.  Lorenz  Withof  (1725-1789) 
who  wrote  on  lepros}',  the  hair  etc.,  deserves  to  be  mentioned. 

Better  known  anatomists  were  the  scions  of  the  distinguished  school 
of  Strassburg :    Joh.   Jac.   Salzmann    (1679-1738),   who  injected  the  lym- 


—  696  — 

phatics  with  milk,  quicksilver  etc.;  Goethe's  teacher  in  anatomy  Joh. 
Friedrich  Lobstein  (1736-1784).  professor  in  Strassburg;  Joh.  Fried. 
Lobstein  Jr.  (1777-1835),  founder  of  the  Strassburg  museum  of  patholog- 
ical anatomy;  and  the  more  important  Thomas  Lauth  (1758-1836). 
Besides  these  we  must  notice  Joh.  Ernst  Neubauer  (1738-1777),  professor 
in  Jena ;  Otto  Justus  of  Wreden  in  Hanover  (topographical  anatomy, 
1736);  Joh.  Gottlob  Haase  (1739-1803),  professor  in  Leipzig;  Lorenz 
Gasser  of  the  old  Vienna  school  (ganglion  Gasseri);  Ehrenritter,  prosector 
for  Barth,  who  wrote  a  treatise  on  the  muscles  and  described  the  tympanic 
nerve  and  jugular  ganglion  of  the  glossopharyngeal  nerve;  Phil.  Fr. 
Theodor  Meckel,  the  son  (1756-1803).  professor  in  Halle,  and  Georg  Fried. 
Hildebrand  (1764-1816),  professor  in  Erlangen,  author  of  a  famous  text- 
book on  anatomy  and  physiology,  distinguished  themselves  as  anatomists, 
and  the  same  may  be  said  of  H.  A.  Wrisberg  (1739-1808),  professor  in 
Gottingen,  who  described  the  larynx,  diaphragm,  and  sympathetic  nerve 
etc.  Less  eminent  was  Joh.  Jac.  Huber  (1707-1778)  of  Basel,  professor 
in  Gottingen  and  Cassel,  who  described  the  spinal  cord. 

Jou.  Gottlieb  Walter  (1739-1816), 
professor  of  anatomy  and  midwifery  in  Berlin,  was  a  deserving  osteologist,  founder 
of  the  anatomical  museum  of  Berlin  and  the  owner  of  a  famous  anatomical  collection, 
which  his  son 

Friedrich  August  Walter  (1764-1826), 
likewise  professor  of  anatomy  in  Berlin,  has  described. 

Justus  Christ,  von  Loder  (1753-1832;  of  Biga, 
professor  in  Jena,  Halle  and  subsequently  in  Moscow,  likewise  enjoyed  a  high  reput- 
ation.    In  Russia  he  performed  good  service  in  the  elevation  of  anatomical  instruc- 
tion.    He  also  possessed  a  considerable  anatomical  collection. 

One  of  the  most  famous  and  meritorious  anatomists  of  the  18th  century  was 
indisputably 

Samuel  Thom.  von  S5mmerring  (1755-1830), 

who  enlarged  and  improved  anatomy  by  numerous  works,  securing  for  almost  all 
parts  of  the  body,  particularly  the  organs  of  sense,  the  results  of  .his  careful  labors  by 
excellent  plates  (in  copper),  furnished  him  by  the  artist  Christian  Koek. 

Sommerring  was  born  in  Thorn.  The  son  of  a  phjsician,  he  had  studied  in  Leyden 
under  Albinus  and  Boerhaave,  and  subsequently  in  Gottingen.  At  the  ajie  of  29  he 
was  appointed  a  professor  in  Mayence,  then  in  Cassel,  and  afterwards  practised  in 
Frankfort-on-the-Main  until  he  became  physician-in-ordinary  and  a  fellow  of  the 
Academie  in  Munich  in  1804.  In  1820,  however,  he  returned  as  a  practising 
physician  to  Frankfort,  and  upon  his  death  left  to  this  city  his  noble  collection. 
He  wrote  numerous  works,  including  a  widely  famous  "  Vom  Baue  des  menschlichen 
Kbrpers",  Frankf,  1791-96.  His  work  on  the  eye,  however,  is  regarded  as  his  best. 
In  this  he  described,  among  other  things,  the  foramen  centrale  of  the  macula  flava 
and  the  macula  itself  (independently  of  Buzzi).  He  also  distinguished  the  facial  and 
auditor}'  nerves  from  each  other.  —  The  most  important  anatomist  among 


—  697  — 

b.  The  Dutch, 

indeed,  one  of  the  greatest  of  all  anatomists,  was 

B.ernhard  Siegfr.  Albinus  (Weiss,  1697-1770)  of  Frankfort-on-the- 
Oder,  who  from  his  24th  year  until  his  death  was  professor  of  anatomy  in 
Leyden. 

With  the  aid  of  the  artist  Jan  Wandelaar  ( 1092-1 759)  of  Amsterdam  he  furnished 
artistically  perfect  plates,  especially  of  the  skeleton  and  muscles.  Jan  Ladmiral 
prepared  colored  impressions  for  the  arteries  and  veins.  Albinus,  among  man}-  other 
things,  was  the  first  to  demonstrate  by  injections  the  connexion  of  the  vascular 
systems  of  the  mother  and  the  foetus  etc.     His  brother 

Friedrich  Bernhard  Albinus  (died  1778)  never  attained  the  same 
importance.  Ed.  Sandifort  (1742-1819),  from  1770  professor  of  anatomy 
in  Leyden,  must  also  be  mentioned  as  an  anatomist  of  great  reputation 
(osteology,  splanchnology,  myology  etc.).  Cornel,  de  Courcelles  (muscles 
of  the  head  and  foot)  and  Pieter  Camper  (Camper's  facial  angle)  were  also 
distinguished  as  anatomists.  —  The  Dutch  anatomists  first  mentioned  were 
likewise  the  teachers  of  the  most  important  German  physicians  and  anato- 
mists of  the  last  century.  -  -  Among  the 

c.  English 

anatomists  were  the  physicians  alreadj'  adduced  as  important  surgeons  : 
William  Cheselden  ("The  anatomy  of  the  human  body",  1713;  "  Osteo- 
graphia,  or  the  anatomy  of  the  bones",  1733);  Alexander  Monro,  father 
and  son  ;  William  Hunter  ("Anatomia  uteri  humani  gravidi  "),  the  first 
professor  of  anatom}'  to  the  Royal  Academy  in  London,  in  which  position 
he  was  succeeded  bjT  John  Sheldon  (died  1808),  and  Sheldon  by  Sir 
Anthoiry  Carlisle ;  John  Hunter ;  William  Porterfield.  who  has  been 
already  mentioned  among  the  Iatro-mechanics  of  the  17th  century,  and 
who,  together  with  Henry  Pemberton  and  Thomas  Young,  devoted  his 
attention  prominently  to  the  anatomy  of  the  eye  ;  Stephen  Hales,  who 
has  likewise  been  alread}'  mentioned,  and  who  was  eminent  for  his  investi- 
gations relative  to  the  movement  of  the  blood  ;  he  also,  in  conjunction 
with  the  physician  next  mentioned,  demonstrated  the  necessity  of  the 
spinal  cord  for  the  reflex  movements  first  indicated  b}-  Descartes  ;  Robert 
Whytt,  and  finally  the  eminent  investigator  William  Hewson  (1739-1774), 
who  wrote  upon  the  blood  and  the  lymphatic  system,  all  of  whom  were 
anatomists  of  weight. 

The  famous,  peripatetic  plrysician  John  Tuberville  Needham  (1713- 
1781)  of  London  rendered  himself  eminent  as  a  microscopist  and  investi- 
gator of  the  history  of  development,  while  William  Cruikshank  (1745-1800). 
the  assistant  and  friend  of  William  Hunter  and  the  discoverer  of  urea, 
was  a  distinguished  anatomist.  The  world-famed  John  Bell  (1763-1820), 
not  to  be  confounded  with  an  elder  John  Bell  (who  lived  1691-1780), 
wrote  a  treatise  on  anatomy,  often  reprinted.  He  was  the  elder  brother  of 
Sir  Charles  Bell,  the  eminent  surgeon  and  physiologist  of  London. 


—  608  — 

[The  Scotchman  James  Douglas  (1675-1742),  a  famous  teacher  of 
anatomy  and  surgery  in  London,  also  deserves  mention  here.  Haller  was- 
one  of  his  pupils.  Douglas's  "  Myographiae  comparator  specimen "  ap- 
peared at  London  in  1707.  He  also  published  a  very  careful  description 
of  the  peritoneum  in  1730. 

Among  the  less  important  anatomical  writers  of  England  in  the  18th  century 
were:  James  Drake  (1667-1707:  A  new  system  of  anatomy,  1707)  of  London;  Frank 
Nicholls  (1699-1778),  ordinary  physician  of  George  II.  (Compendium  anatomicum, 
1732);  the  Jesuit  missionary  in  South  America,  Thomas  Falkner  (1710-1780;  De- 
anatome  corporis  humani,  1754);  Charles  Nich.  Jenty  (1757);  William  Northcote 
(1772);  Sam.  F.  Simmons  (Anatomy  of  the  human  body,  1778);  John  Brisbane  (The 
anatomy  of  painting  etc.,  1769);  Robert  Hooper  of  London,  author  ot  "The  anato- 
mist's vade  mecum  "  (1797)  and  numerous  other  medical  text-books.      H.] 

d.  The  Italians. 

Anatomy,  the  national  department  of  the  Italians  in  medicine,  was- 
studied  by  them  excellently  in  the  18th  century. 

Antonio  Maria  Valsalva1  (1666-1723)  of  Imola 
must  be  mentioned  as  the  earliest  important  Italian  anatomist  of  this  epoch.  He 
had  the  good  fortune  to  be  a  pupil  of  the  great  Malpighi  and  the  teacher  of  the  still1 
greater  Morgagni.  He  followed  Malpighi  in  the  professor's  chair  at  Bologna  and 
rendered  good  service  to  anatomy,  particularly  by  a  work  upon  the  ear.  in  which  he 
described  and  depicted  its  most  minute  muscles  and  nerves.  Valsalva's  method  of 
inflating  the  middle  ear  is  well  known. 

Giov.  Domkn.  Santorini  (1681-1737)  of  Venice, 
a  professor  in  that  city,  was  an  excellent  anatomist  who  described  the  emissaria 
Santorini,  the  corpuscula  Santorini  of  the  larynx,  the  cartilage  of  Santorini  in  the 
nose,  the  musculus  risorius  Santorini  of  the  face,  the  muscles  of  the  anus,  penis  etc. 
He  also  described  the  corpora  lutea,  but  assigned  semen  to  the  female  as  well  as  the 
male.  Some  excellent  plates,  which  originated  with  Santorini,  were  published  28 
years  after  his  death  by 

Mich.  Girardi  (1731-1797). 
the  successor  of  Morgagni  as  professor  at  Padua. 

Giov.  Batt.  Bianchi  (1681-1761)  of  Turin, 

professor  in  Bologna  and  then  in  his  native  city,  made  himself  well-known  b)  his 
investigations  relative  to  the  liver  iHistoria  hepaticn,  1725).  A  more  skilful  and 
earnest  anatomist,  also  active  in  Turin,  was 

Giov.  Batt.  Fantoni  (1675-1758), 
son  of  the  professor  of  the  same  name  who  died  in  Turin  in  1692. 

Dom.  Cotugno  (1736-1822)  of  Buvo  in  Naples, 
a  man   who   rose   from    the  deepest    poverty,   is  well-known   from   his  wry  profound' 
investigations  concerning  the    internal    ear  (aqmeductus  and  aqua  Cotunnii).      He 
was  also  in  1770  the  first  to  demonstrate  by  boiling  the  existence  of  albumen  in   the 


1.  He  was  a  believer  in  the  generatio  requivoca  because  in  liquids  which  he  had 
heated  and  then  enclosed  in  vessels  be  still  found  microscopic  animals.  Spallan- 
zani,  mi  the  other  hand,  heated  his  liquids  in  the  vessels  themselves,  then  closed 
them,  and  finding  no  organisms  present,  concluded  that  the  exclusion  of  air,  not 
that  of  germs,  was  the  reason  of  their  absence. 


—  em  — 

urine. —  The  brain,  particularly  the  cerebellum   (even   in   cretins),  the  sinuses  of  the 
nose  etc.  were  investigated  by 

Vincenzo  Malacarne  (1744-1816)  of  Saluzzi, 
professor  in  Pavia,  Padua  and  Turin.     In  addition  he  produced  a  systematic  treatise- 
upon  the  tissues  of  the  body  and  some  chirurgieo-anatomical  works.      On  the  other 
hand 

Michele  Troja  (1747-1827),  professor  in  Naples,. 
a  native  of  Andria,  who  has  been  already  mentioned,  rendered  himself  eminent  by 
works  on  the  bones.  —  A  teacher  of  the  physician  next  mentioned  was 

Pietro  Tabarrani  (Tabarini,  1702-1780), 
who,  in  addition  to  works  on   normal  anatomy,  wrote  something  also  on  chirurgico- 
pathological  anatomj'. 

Paolo  Mascagni  (1752-1815)  of  Casteletto  near  Siena, 
professor  in   Siena.  Pisa  and   Florence,  studied  the  lymphatics,   and   undertook  the 
preparation  of  an  atlas  with  plates  of  life  size,  and  colored  after  nature.     This  was 
afterwards  published  in  lithographic  copies  of  life  size  by 

Francesco  Antommarchi  (died  1838). 
a  pupil  of  Morgagni  and  ordinary  physician  of  the  emperor  Napoleon  I. 

Leop.  Marco  Antonio  Caldani  (1725-1813), 
a  professor  in  Bologna,  Venice  and  Padua,  is  well-known  by  a   magnificent  anatomi- 
cal work  (Icones  anatomies',  181.'5)  adorned  with   copper-plates,  which  he  published 
in  conjunction  with  his  nephew  Floriano  Caldani   (died  1836),  professor  in  Bologna, 
Venice  and  Padua. 

The  physicist  and  pli3*siologist  "Lazzaro  Spallanzani  (1729-1799)  of 
Scandiano  near  Reggio,  a  professor  in  Reggio,  Modena  and  Pavia,  and 
Antonio  Scarpa  (1747-1832)  of  Motta,  a  pupil  and  subsequently  an 
assistant  of  Morgagni.  were  very  eminent  anatomists.  Spallanzani  specially 
distinguished  himself  by  his  investigations  relative  to  the  organ  of  smelL 
the  ear,  ganglia  and  nerves,  minute  structure  of  the  bones  etc.  He  was 
likewise  the  first  who  demonstrated  experimentally  the  necessity  of  the 
conjunction  of  the  semen  and  the  ovum,  by  the  artificial  fecundation  of 
the  eggs  of  frogs  and  toads,  and  by  the  injection  of  warm  semen  into  the 
vagina  of  a  bitch  he  impregnated  the  latter.  By  these  experiments 
Spallanzani  became  one  of  the  reformers  of  the  theory  of  generation  and 
development,  and  lent  his  aid  to  the  overthrow  of  the  generatio  aequivoca. 

e.  The  French. 

The  French  were  never  as  independent  and  fertile  in  normal  anatomy 
as  in  its  surgical,  topographical  and  pathological  application.  This  was- 
again  shown  in  the  18th  century.  The  ablest  anatomist  of  France  during 
this  century, 

Jacob  Benignlts  Winslow  (1669-1760),  of  Odensee  on  the  Danish 
island  of  Fiihnen.  was  "an  honorably  born  Dane,  who,  like  Stenson  (he 
wrote  his  name  Stenonis),  became  a  zealous  Catholic,  and  —  in  1732  at  the 
Jardin  des  Plantes  —  an  Academicus.'* 

Winslow,  besides  numerous  "Memoires"  (foramen  Wi-nslOwii),  wrote  a  textbook 
of  anatomy  often  printed  and'translated  into  several  languages.       Louis  .lean  Marie 


—  700  — 

Daubenton  (1716-1799),  Francois  Chaussier  (1746-1828)  and  Senac  (by  his  work 
upon  the  heart)  should  be  classed  among  the  more  famous  French  anatomists.  The 
same  ma}'  be  said  of  the  cultivator  of  the  history  of  anatomy, 

Antoine  Portal  (1742-1832),  of  Gaillac  in  the  department  of  Tarn, 
subseqtienlly  ordinary  physician  of  Louis  XVIII.,  who  devoted  his  attention  more  to 
physiology  and  surgical  and  pathological  anatomy  than  to  ordinary  anatomy.  His 
'  Hi.-toire  de  1'  anatomie  et  de  la  chirurgie"  was  published  at  Paris  in  1770. 

Joseph  Lieutaud  (1703-1780)  of  Aix, 

and  a  professor  in  that  city  until  he  became  in  1749  physician  of  the  royal  children 
and  in  1774  ordinary  physician  of  Louis  XVI.,  was  author  of  "Essais  anatomiques" 
etc.,  "  Historia  anatomico-medica"  etc.,  and  "  Elementa  phvsiologiae".  His  name 
has  been  preserved  in  the  trigonum  Lieutaudii  seu  vesica*. 

Exupere  Jos.  Bertin  (1712-1781),  of  Tremblay  near  Rennes, 
wrote  on  osteology  (ossicula  Bertini,  sphenoidal  cornua)  and  the  organs  of  voice. 

Almost  all  the  more  considerable  French  surgeons  of  the  18th  century 
(and  the  same  is  true  of  other  nations,  for  lectures  on  anatomy  and  surgery 
were  usually  delivered  by  the  same  professor)  were  more  or  less  important 
anatomists.  Besides  Ferrein,  who  has  been  alread}'  mentioned  among  the 
physicians  of  the  17th  century,  we  may  notice: 

Garengeot ;  Cesar  Verdier  (1085-1759),  professor  in  the  Academie  de  Chirurgie; 
Pierre  Tarin,  1750  professor  in  Paris;  Franc.  Pourfour  du  Petit;  Disdier  (died  1781); 
Jean  Jos.  Sue  (1710-1792),  the  grandfather,  professor  of  anatomy  and  surgery  in 
Paris;  Jean  Joseph  Sue,  his  son  (father  of  Eugene  Sue,  1804-1857,  the  novelist), 
likewise  professor  of  anatomy  and  surgery  in  Paris;  Tenon  (capsula  Tenonis) ; 
Barbaut  (died  1784);  Antoine  Petit;  Sabatier;  Pierre  Demours  (1702-1795;  mem- 
brane of  Demours,  whose  discovery  was  also  claimed  by  Descemet — died  1810)  and 
others.     Finally  separate  mention  must  be  made  of 

Felix  Vicq  d'Azyr  (1748-1794)  of  Valogne, 
less,  however,  for  his  labors  in  the  department  of  anatomy   (origin  of  the  brain  and 
nerves)  and  physiology,  than  for  his  services  in  comparative  anatomy   (especial!}' 
with  reference  to  the  vocal  organs).     Among 

f.  The  Spanish, 

besides  Martino  Martinez  (about  1716),  the  surgeon  Antonio  de  Gimbernat, 
who  has  been  already  mentioned,  distinguished  himself  as  an  anatomist. 

Pathological  Anatomy 

originated  as  a  special  branch  in  that  country  whose  national  branch  was 
anatomy  in  general,  and  which  too  in  the  14th  century  had  revived  normal 
human  anatom}-,  after  it  had  lain  fallow  from  the  time  of  the  Alexandrians 
and  Galen.  This  countrj'  was  Italy.  The  great  founder  of  pathological 
anatomy  as  a  science  was 

Giov.  Batt.  Morgagni  (1682-1772)  of  Forli. 

Morgagni  was  a  pupil  of  Valsalva,  and  at  the  age  of  19  became  his  assistant,  a 
position  which  he  continued  to  hold  until  in  1715  he  became  Vallisnieri'6  successor 
as  professor  in  Padua.  It  was  not  until  his  79th  year,  and  after  he  had  published 
several    works   on    normal    anatom}'    ("Adversaria   anatomica",    1706;     "  Epistolae 


—  701   — 

anatomicae  etc.";  liquor  Morgagni)  —  a  great  part  of  his  works  owe  their  origin  to 
his  disputes  with  Bianchi  —  that  he  allowed  his  famous  book  on  pathological  anatomy 
to  appear.  This  work  bore  the  title  "De  sedibus  et  causis  morborum  per  anatomen 
indagatis  libri  quinque",  Venice,  1761.  It  consisted  of  five  books,  the  first  dedicated 
to  Trew,  the  second  to  Bromfield,  the  third  to  Senac,  the  fourth  to  Schreiber,  the  fifth 
to  Meckel,  and  contained  70  letters.  Morgagni  did  not  cease  his  work  even  when  he 
became  blind.  To  him  we  owe  the  maxim  that  observations  should  be  weigl  ed  not 
counted  He  was  as  great  a  savant  as  an  anatomist,  and  possessed  a  wonderful 
power  of  remembrance. 

Morgagni,  who  regarded  his  great  work  as  a  continuation  of  that  of 
Bonnet,  was  the  first  to  devote  attention  extensively  and  thoroughly  to 
the  anatomical  products  of  common  diseases,  while  before  him  (since  the 
15th  century)  little  but  the  rare  discoveries  in  the  bod)-  had  been  recorded. 
He  also  directed  his  attention  to  the  preceding  diseases  and  their  history, 
taking  up  this  subject  himself  or  having  the  history  related,  and  not  con- 
fining his  search  to  the  seat  of  the  present  disease  only.  He,  however, 
erroneouslj-  regarded  the  products  of  diseases  as  their  cause,  thus  neglecting 
the  remote  causes.  Even  when  the  discoveries  of  pathological  investigations 
were  unable  to  promote  the  cure  of  disease,  Morgagni  found  them  of 
advantage,  because  the}'  might  throw  light  upon  physiology  and  normal 
anatomy  and  the  relations  between  the  symptoms  and  results  of  disease, 
and  prevent  incurable  patients  from  being  continually  tormented  with 
drugs  by  the  physicians.  On  the  other  hand,  resort  will  be  had  more 
frequently  to  measures  of  palliation.  Finally  pathological  investigations 
ma}r  settle  the  diagnosis,  a  matter  of  honor  in  itself  so  far  as  the  phy- 
sician is  concerned,  and  a  view  which,  as  we  know,  in  later  times  attained 
excessive  popularity,  so  that  for  some  time  the  curative  function  of  the 
physician  seemed  to  have  been  forgotten  in  the  interests  of  diagnostic 
precision. 

Besides  Morgagni,  other  students  of  pathological  anatomy,  or  portions 
of  this  science,  were  : 

Lieutaud,  Ed.  Sandifort,  Senac,  William  Hewson,  Ant.  Portal,  de  Hiien,  Stoll 
and  others.  The  most  prominent  of  these  pathological  anatomists,  however,  was 
John  Hunter,  though  he  promoted  the  science  more  by  lecturing  and  after  his  death 
by  his  noble  pathologico-anatomieal  collection  (purchased  by  the  go\ernment  and 
still  regarded  as  a  model  of  its  kind),  than  by  his  writings. 

Matthew  Baillie  (1761-1823), 
a  son  of  Hunter's  sister,  professor  of  anatomy  and  ordinary  physician  of  the  princess 
of  Wales  and  one  of  the  most  eminent  of  pathological  anatomists,  described  the 
preparations  of  Hunter's  collection,  though  he  was  not  always  able  to  determine  the 
preceding  disease.  He  occupied  himself  chiefly  with  the  pathological  anatomy  of 
the  brain,  the  heart  and  lungs,1  larynx,  thyroid  gland,  abdomen,  stomach  and  intesti- 
nal canal  with  their  appendages,  and  the  urinary  and  sexual  organs.  He  also  believed 
that  the  chief  benefits  of  pathological  anatomy  were  to  be  found  in  the  fact  that  it 
opposed  theories  and  taught  one  to  perfect  diagnosis,  and  to  hold  separate  the  indi- 

1.  In  1793  lie  was  the  first  to  point  out  the  gray  miliary  tubercles  of  consumption. 


—  702  — 

vidual  phenomena.  Baillie,  however,  admitted  t li-o  co-operation  in  diseases  of  a 
•certain  something,  unfathomable  b.y  our  senses  even  when  assisted  by  the  knife.  He 
understood  the  changes  of  form  and  structure  of  organs  after  diseases  merely  as  their 
results  and  products.  "Such  changes  themselves  may  then  become  again  the  cause 
of  many  symptoms."  Baillie  kept  constantly  in  view  the  practical  aims  of  medicine. 
His  treatise  entitled  "  The  morbid  human  anatomy  of  some  of  the  most  important 
parts  of  the  human  body"  appeared  in  1793,  and  was  translated  into  French,  Italian 
and  German.  The  copper-plates  by  Clift,  designed  to  illustrate  this  work,  appeared 
1799-1802.  —  Besides  Baillie,  Hunter's  brother-in-law 

Sir  Everard  Home  (1763-1832), 
professor  in  the  Royal  College  of  Surgeons,  was  entrusted  by  Hunter  himself  with  the 
duty  of  describing  his  collection.  Home,  however,  burned  ten  (!)  volumes  of  Hunter's 
own  description  of  his  collection,  in  order  to  appropriate  to  himself  the  sole  credit 
for  this  work.  Baer  judges  that  Home  must  have  been  scientifically  imbecile.  ■ — 
Hunter's  pupil, 

Wiiliam  Stark  (died  about  1770,  aged  29  years) 
distinguished  himself  by  his  investigations  relative  to  tubercle,  and  was  the  earliest 
writer  to  distinguish  between  tuberculosis  and  scrophulosis.  His  ''Works,  consisting 
of  clinical  and  anatomical  observations  with  experiments,  dietetical  and  statical" 
were  published  by  J.  Carmichael  Smyth,  London,  1788.  [Stark's  treatise  on  miliary 
tuberculosis,  however,  appeared  in  the  "Medical  Communications"  for  the  year  1785.] 
— James  Wilson  (17C>5-1821)  [wrote  some  "Lectures  on  the  blood  and  on  the  anatomy, 
physiology  and  surgical  pathology  of  the  vascular  system  of  the  human  body", 
London,  1819;]  Joseph  Adams  (1756-1818)  of  London  described  cancer  and  other 
neoplasms,  regarding  them  as  perfect  animals  (parasites),  and  John  Abernethy  like- 
wise occupied  himself  with  the  pathological  anatomy  of  tumors  in  his  "Surgical 
Observations"  etc.,  1N04  and  180G.  John  Richard  Farre,  who  wrote  on  "The  morbid 
anatomy  of  the  liver"  etc.,  London  1812-1S15,  and  William  Cooke,  one  of  the  founders 
of  the  Hunterian  Society,  who  translated  Morgagni's  "  De  sedibus  et  causis  morbo- 
rum  "  into  English  (1822),  were  of  later  date. 

In  Germany  the  new  branch  of  medicine  was  cultivated  by  onhr  a  few. 
Among  these  were  Beil,  Sommerring,  who  translated  Baillie's  work  ;  F.  G. 
Voigtel  (died  1813),  Physicus  and  "  Bergarzt "  in  Eisleben,  and  author  of 
the  first  German  "  Handbuch  der  pathol.  Anatomie ",  with  additions  by 
Ph.  Fr.  Meckel,  Halle,  1804-1815;  Blumenbach  ;  Conradi  (Handbuch  der 
pathologischen  Anatomie,  Hanover,  1796);  Christian  Friedr.  Ludwig 
(1751-1823),  professor  in  Leipzig  (Grundriss  der  pathologischen  Anatomie); 
the  later  A.  W.  Otto  (1786-1845),  professor  in  Breslau  (Handbuch  der 
path.  Anatomie,  1814)  and  others, 

(iKNERAi,  Anatomy 
was  founded  by 

Marie  Francois  Xavier  Bichat  (1771-1802). 
a  native  of  Thoirette  in  the  Department  of  Ain,  and  the  son  of  a  physician.  He 
began  his  studies  in  Nantes,  and  then  applied  himself  to  surgery  and  anatomy  in 
Lyons,  and  to  further  studies  in  the  department  of  surgery  at  Montpellier,  especially 
under  Antoine  Petit.  Subsequently  he  went  to  Paris  and  became  there  a  member  of 
Desault's  family,  his  favorite  pupil,  friend  and  assistant.  He  clung  to  bis  master 
with  the  greatest  affection  and  gratitude,  and  published  Desault's  works  after  his 
death.     On  the  latter  event  he  delivered  lectures  on  surgery,  and  from  1797  forward 


—  703  — 

gave  private  courses  in  anatomy.  Bichat  now  developed  a  feverish  and  enormous 
.scientific  activity,  and,  besides  his  other  labors,  became  the  founder  of  the  Societe  d' 
Emulation.  In  1801  he  was  appointed  to  the  Hotel-Dieu,  but  as  early  as  1802  —  like 
•the  later  Laennec,  both  creators  of  a  new  department  of  science  —  succumbed  to  the 
results  of  consumption  and  the  effects  of  a  fall,  although  in  years  the  youngest  of  the 
memorable  physicians  of  France.  Through  his  wonderful  mental  fertility  and  power, 
and  in  spite  of  his  early  death,  he  had  written  in  the  few  years  of  his  life  a  great 
number  of  important  works  —  they  include  nine  volumes.  In  1845  his  remains  were 
Temoved  to  Pere  Lachaise,  and  in  1857  he  received  a  monument  in  the  Ecole  de 
Medecine.  As  an  evidence  of  Bichat's  enormous  activity  it  may  be  stated  that  in 
a  single  winter  he  examined  700  bodies.  His  chief  works  were  the  "  Traite  des 
membranes"  (1800),  Anatomic  generate "  (1801)  and  anatomie  pathologique " 
(published  pothumously  by  Boisseau    1826  . 

From  Bichat's  general  and  pathological  anatomy  a  new  tendency  in 
medicine  —  that  tendency  which  it  manifests  to-day  —  took  its  origin. 
Bichat's  genius,  masterly  mental  power  and  charming  gracefulness  of  expo- 
sition, founded  chiefly  the  realistic  and  pathologico-anatomical  epoch. 
He  uttered  the  famous  apothegm  "  Take  away  some  fevers  and  nervous 
troubles ';  —  certainly  important  and  in  many  respects  decisive  exceptions 
—  '•  and  all  else  belongs  in  the  kingdom  of  pathological  anatomy".  He 
introduced  the  discrimination  in  detail  of  the  processes  of  disease,  or 
rather  its  products,  and  its  definite  localization  not  only  in  the  organs,  but 
also  in  their  individual  parts  and  tissues.  Out  of  this  there  grew  great 
advantages,  indeed,  so  far  as  regards  our  knowledge  of  the  morbid  alter- 
ations, but.  on  the  other  hand,  little  benefit  to  our  knowledge  of  the  essence 
of  the  causative  processes.  To  adduce  but  a  single  example  :  instead  of 
the  previous  collective  idea  of  peripneumonia  appeared  the  division  into 
pleuritis.  pneumonia  and  bronchitis.  —  ::  You  ma}'  observe  diseases  of  the 
heart,  lungs,  abdominal  viscera  etc.  night  and  morning  by  the  sick-bed  for 
twenty  years,  j'et  the  whole  furnishes  merely  a  jumble  of  phenomena, 
which  unite  into  nothing  complete.  But  if  you  open  only  a  few  bodies, 
you  will  see  the  obseurit}'  speedily  give  way.  a  result  never  accomplished 
by  simple  observation,  if  we  do  not  know  the  seat  of  the  disease  ".  Next 
Bichat  set  forth  and  established  the  tendency  of  similar  tissues  to  similar 
anatomical  forms  of  disease  : 

"As  ever}-  tissue  has  everywhere  a  similar  disposition,  since,  wherever  it  ma}'  be, 
it  possesses  the  same  structure,  the  same  properties  etc.,  so  it  is  clear  that  its  diseases 
must  be  everywhere  the  same.  Whether  the  serous  tissue  belongs  to  the  brain  as  the 
arachnoid,  to  the  lungs  as  the  pleura,  to  the  heart  as  the  pericardium,  to  the  abdominal 
viscera  as  the  peritoneum  etc.,  it  takes  on  inflammation  everywhere  in  the  same  way, 
everywhere  dropsies  occur  in  the  same  way"  etc. 

This  last  division  is  connected  with  Bichat's  creation  of  general 
anatomy.  He  distinguished  general  tissue-systems,  found  everywhere  in 
the  body,  as  e.  g.  cellular  tissue,  the  nervous  system  of  animal  and  organic 
life,  the  arterial  system,  the  venous  system,  the  system  of  exhalant  vessels 
and  lymphatics ;  and  special  tissue-systems,  peculiar  to  certain  parts 
exclusive!}',   as   e.   g.  the  osseous,   medullary,    cartilaginous,   fibrous    and 


—  704  — 

fibrocartilaginous  systems,  the  animal  and  vegetative  muscular  system, 
system  of  serous  and  mucous  membranes,  system  of  synovial  membranes, 
glandular  system,  dermoid  system,  epidermoid  system  and  the  hair}'  system. 
These  21  tissues,  selected  without  the  aid  of  the  microscope  (which  Bichat 
did  not  employ),  were  distinguished  as  simple  and  similar  elements  of  the 
body,  like  the  elements  of  chemistry,  and  like  the  cells  which  Virchow 
chose  for  his  elements.  The}'  were  assigned  to  general  anatomy,  wnile,  on 
the  other  hand,  descriptive  anatomy  had  to  do  with  their  different  com- 
binations. Thus  e.  g.  according  to  Bichat,  the  stomach,  as  the  subject  of 
descriptive  anatomy,  is  composed  of  a  serous,  mucous  and  organic  muscular 
coat.  The  simple  membranes  are  the  mucous,  serous  and  fibrous  ;  the 
compound  membranes  are  formed  by  juxtaposition  of  these,  and  are  called 
tibro-serous,  sero-mucous  and  fibro-mucous,  uniting  in  themselves  one  or 
more  of  the  properties  of  the  simple  membranes. 

Bichat  overthrew  the  ontological  and  speculative  tendency  of  medicine, 
placed  "facts"  in  the  front  rank  and  banished  ideas  and  "  ideologists ,r 
(whom,  like  Napoleon,  he  sorel}'  dreaded)  from  the  science.  Both  these 
men  furnish  many  general  points  of  comparison  ;  indeed,  we  might  call 
Bichat,  especially  in  view  of  his  reputation  and  the  wonder  which  his 
brilliant  talents  aroused,  the  Napoleon  of  medicine.  "  If  I  have  gone 
forward  so  rapidly,  the  result  has  been  that  I  have  read  little.  Books  are 
merely  the  memoranda  of  facts.  But  are  such  memoranda  necessar}'  in  a 
science  whose  material  is  ever  near  us,  where  we  have,  so  to  speak,  living 
books  in  the  sick  and  the  dead  ?"  "  Let  us  halt  when  we  have  arrived  at 
the  limits  of  the  most  careful  and  thorough  observation,  and  let  us  not 
strive  to  press  forward  where  experience  cannot  show  us  the  way  "  —  a 
sentiment  which  certainl}-  does  not  accord  with  his  earlier  vitalistic  views. 
Bichat  was  the  first  who  claimed  for  medicine  the  rank  of  an  "exact" 
science.  "Medicine  was  long  thrust  forth  from  the  bosom  of  the  exact 
sciences.  It  will  have  the  right  to  be  associated  with  them,  at  least  as 
regards  the  diagnosis  of  diseases,  as  soon  as  we  shall  everywhere  have 
united  with  the  most  thorough  and  rigorous  observation,  the  investigation 
of  those  changes  which  our  organs  suffer." 

In  the  course  of  the  further  development  of  such  views,  and  in  con- 
sequence of  the  great  sympathy  extended  to  them  everywhere,  a  new  one- 
sidedness  seized  upon  the  medicine  of  our  own  century — a  one-sidedness 
quite  as  great  as  the  b}'-gone  and  partial  idealism  of  the  18th  century, 
This  was  the  thoroughly  realistic  method,  which  gives  to  medicine  the 
rank  of  one  of  the  natural  sciences,  and  finalty  goes  so  far  as  to  desire  to 
interpret  and  explain  by  pure  realism  even  the  mental  characteristics. 


—  705  — 

7.    STATE-MEDICINE  <F0RENSIC  MEDICINE.    MEDICAL  POLICE.) 
PSYCHIATRY.    HYGIENE, 

State-medicine,  particularly  in  Germany,  gained  considerably  in  the 
18th  century  in  cultivation  and  advancement. 

Upon  some  subjects  of  this  branch  great  light  was  thrown  as  early  as 
the  beginning  of  the  century.  Thus  e.  g.  the  fatal  effects  ascribed  by  Fr. 
Hoffmann  to  the  fumes  of  charcoal  (a  case  occurred  to  him  in  1715)  gave 
rise  to  an  instructive  discussion,  into  which  was  interwoven  even  a  ^religi- 
ous element",  the  belief  in  the  devil  ;  for  the  partisans  of  the  latter  person- 
age, much  more  numerous  at  that  time  than  to-day,  desired  to  claim  or 
maintain  for  the  swarthy  master  of  hell's  fumes  the  effects  of  even  charcoal 
vapor. 

On  the  other  hand.  J.  II.  Sohulze  and  Ph.  Ad.  Bohmer  studied  into  the 
necessity  or  superfluousness  of  ligation  of  the  umbilical  cord,  and  the 
former  discussed  the  possible  injuries  to  the  health  which  might  ensue  from 
the  use  of  metallic  kitchen-utensils  :  Exupere  Bertin.  Heister,  R.  A.  A'ogel 
and  others  discussed  the  subject  of  prolonged  gestation  ;  finally  Winslow 
and  .lac.  Joh.  Bruhier  studied  the  signs  of  death. 

Phil.  Conr.  Fabrichts  (1714-1774)  of  Butzbach  in  the  Wetterau, 
professor  in    Helmstadt,   occupied   himself  with   the  docimasia  pulmonum,   ami   the 
same  subject  engaged  the  attention  of  the  surgeon  David  Mauchart, 

Christoph  Gottlieb  Buttnkk. 
professor  in  Konigsberg,  and  above  all  of 

W.  (fOTTFRIED   PLOUCQUET    .1744-1814) 

professor  in  Tubingen  ("  Nova  docimasia  pulmonum  ",  1782,   Ploucquet's  lung-test). 
Other  cultivators  of  the  subjects  of  forensic  medicine  were  : 
Mich.  Bernhard  Valentin  (1 057-1729), 

who.  like  the  legislators  and  almost  all  the  savants  of  his  day,  still  believed  in  witches 
and  magic  ("  Legal-medic.  Pandekten")  ; 

Christ.  Gottl.  Ludwig  (1709-1778), 
who  wrote  some  "  Institutiones  medieime  forensis"  ; 

Christian  Gottl.  Tropanneger, 
author  of  "  Deeisiones  medico-forenses",  1733; 

Wilhelm  TTktn'r.  Seb.  Buchholz  1734-1798), 

court-physician  in  Weimar; 

Joh.  Christian  Traugott  Schlegel  (1746-1824), 

ordinary   physician  of   the   prince  of  Waldenburg,    a   very   fruitful    writer    i  Collectio 
opusculorum  selectorum  ad  medicinam  forensem  spectautium,  Leipzig,  1  7 - :  1  - 1 7 9 1  i .  a n d 
Chr.  Fr.  Pa mk i.  (1753-1798  . 

The  following  physicians  were  eminent  as  cultivators  of  the  general 
department  of  state-medicine  : 

Joh.  Zach.  Platner  (1694-1747), 

who  did  not  wish  judges  to  decide  alone  in  penal  matters,  but  desired  physicians  also 
to  be  called  in  for  the  settlement  of  questions  of  sanity,  a  demand,  which,  when  com- 
pared with  the  views  of  that  day,  must  he  regarded  as  reformative,  and  indeed 
revolutionary ; 

45 


—  7<h;  — 

Herm.  Fried.  Teichmeyer  (1685-1746), 
a  famous  teacher  ("  Institutiones  medicinae  legalis  vel  forensis"  I  : 
Michael  Albert]  (1682-1757). 

professor  in  Halle  ("  Systema  jurisprudentise  medicae"); 

Cur.  Ehrenfried  EschenBach  (1712-1788), 
professor  in  Rostock: 

Joh.  Dan.  Metzger  (1739-1805). 

Kurzgefasstes  System  der  gerichtlichen  Arzneiwissenschaft")  a  famous  teacher  of 
state-medicine  in  Konigsberg,  who,  in  conjunction  with  the  already  mentioned 
Platner,  Uuzer,  Peter  Frank  and  Osiander,  bravely  combated  the  superstition  of 
demoniacal  diseases  and  partially  overthrew  the  belief  in  their  existence: 

Ernst  Platner  (1744-1818). 
professor  of  medicine  and  philosophy  in  Leipzig; 

Jon.  Theod.  Pyl  (1749-1794). 
professor  in  Berlin  f"  Magazin  fiir  die  gerichtliche  Arzneikunde"  etc.  i : 

K.  Fr.  Uden  (died  1798), 
who  published  some  of  the  works  of  the  physician  last  mentioned  ; 

Hermann  Delius  (died  17'.»1  i, 
author  of  "  Forensische  Chemie". 

In  France  the  Held  of  forensic  medicine  was  eminently  cultivated,  among  others, 
by  Jean  Jacques  Bellocque;  Claude  .los.  Prevost  (1672-175;!),  who  wrote  a  treatise  on 
forensic  medicine  for  physicians,  surgeons  and  midwives;  Verdier  (Jean),  who  wrote 
on  medical  and  surgical  jurisprudence.  In  Spain  J.  F.  del  Valle  wrote  on  forensic 
surgery,  and  in  England  Samuel  Farr  (1741-1795)  [of  Taunton,  author1  of  "The 
elements  of  medical  jurisprudence  ",  London.  1788,]  discussed  the  subject  of  forensic 
medicine. 

The  earliest  German  text-book  on  medical  police  was  written  in  Latin  by 

Joh.  Wilh.  Baumer  (1719-1788). 
professor  in  Erfurt  and  Giessen,  under  the  title   '  Fundamenta  politia?  medicae",  1777. 
The  subject  of  medical  police  was  not,  however,  recognized  as  a  "specialty"  until  the 
famous  and  highly-gifted 

J.  Peter  Frank. 
in  his  noble  "  System  der  mediciuischen  Policey",  1779-1819)  had  introduced  the 
official  distinction  of  medical  police  and  forensic  medicine.  This  work  of  Frank's 
musl  likewise  be  considered  the  cornerstone  of  our  modern  public  and  private  hygiene. 
Frank  calls  upon  "the  authorities"  for  aid  in  all  matters,  and  thus  became  the 
champion  of  medical  officialism.  This  was  quite  in  accord  with  the  spirit  of  the 
time,  which  strove  to  improve  everything  from  top  to  bottom  by  the  methods  of  an 
enlightened  despotism,  since  the  masses  were  still  too  illiberal  and  uneducated  to  be 
prepared  for  the  proclamation  of  the  gospel  of  self-help.  Frank's  book  was  written 
in  German  and  in  very  good  style  for  a  medical  work.  It  was  designed  for  popular 
use  in  the  best  sense,  and  in  this  idea  Frank  anticipated  the  similar  designs  of  Petten- 
kofer  at  the  present  day.  Even  in  the  commencement  of  his  career  Frank  devoted 
his  attention  to  the  subject  of  medical  police,  and  had  one  volume  of  his  work  ready 
for  publication  as  early  as  1777  Unable,  however,  to  find  a  publisher,  he  threw  the 
volume  into  the  fire,  but  soon  wrote  it  over  again,  and  two  years  later  the  first  volume 
of  his    work    was   published    in    Mannheim   by    Schwan,   the   publisher  of  Schiller's 


1.  A.  translation  of  Job.  Fried.  Fasel's  "  Elementa  inedicin.se  forensis "  (1767),  with 
numerous  additions  by  Farr.     ill. 


—  707  — 

"Robbers".  The  complete  work  embraced  the  science  of  health  from  generation  to 
sepulture.  The  first  volume  was  placed  upon  the  Index  because  it  spoke  against 
celibacy,  and  accordingly  in  the  second  edition  of  this  volume  (1784)  Frank  remarked 
in  the  preface  that  he  had  not  intended  to  attack  the  Church,  and  regretted  having 
given  offence  ;  for  he  knew  the  power  of  the  clergy.  He,  however,  made  no  change 
in  the  contents,  of  the  work.  He  labored  upon  this  work  for  his  whole  life,  and  it  will 
remain  a  monument  of  his  burning  enthusiasm  in  the  cause  of  the  welfare  of  mankind. 
The  book  embraced  the  subject  of  school-hygiene  (even  the  question  of  suitable 
benches l,  upon  which  he  advanced  very  just  principles.  His  efforts  to  increase  the 
number  of  men  are  characteristic  of  the  a<ie,  for  as  the  result  of  the  Thirty  Years' 
War,  after  which  many  localities  were  deserted  for  miles,  the  destruction  of  men  had 
been  so  great  that  in  Nuremberg  in  1(550  bigamy  was  allowed  in  order  to  render 
assistance  to  the  women.  Frank  wasa  practising  physician  when  he  began  this  work, 
which  owes  its  origin  to  practice  and  its  impotence  —  another  proof  that  it  is  practical 
life,  not  mere  book-learning,  which  gives  birth  to  memorable  works. 

Among  the  emulators   of  Frank    in    the  department   of  medical  police  must  be 
mentioned  the  famous 

E.  Ben.i.  Gottl.  Hkkkxstrkit  (1758-1803)  in  Leipzig; 
ZaCH.  GrOTTL.   \"<>N   Hl'SZTV.  Edler  von  Xassynya. 
author  of  a  "  Discurs  Tiber  die  medicinische  Polizei"    1786; 

•Inn.  Chr.  Frikdr.  Scherf  (1750-1818), 

physician-iu  ordinary  in  Detmold. 

Among  the  new  subjects  of  medical  police  since  the  18th  century  are  : 
regular  inquests,  which  were  first  established  in  Austria ;  their  result, 
morgues,  instituted  in  France  through  the  influence  of  Jos.  Jac.  de  Gar- 
danne  (1781),  and  in  Germany  through  that  of  Hufeland  ;  institutions  for 
the  rescue  of  the  drowned,  established  in  France  and  Holland  (1767),  and 
in  England  in  177-1  at  the  suggestion  of  the  Humane  Society1  in  London  ; 
the  removal  of  cemeteries  from  the  vicinity  of  churches,  adopted  in  Prussia 
since  1708  :  and  finally 

I  NOCULATION. 

The  communication  of  natural  small-pox  to  the  health}",  in  order 
to  protect  them  from  the  natural  disease,  reaches  back  into  hoary  an- 
tiquity. 

1.  The  foundation  of  the  Humane  Society  in  1774  through  the  exertions  of  Heberden, 
William  Llawes  (1736-1808)  and  Cogan,  was  the  occasion  of  a  lively  discussion  in 
England  of  the  subjects  of  asphyxia,  drowning,  apparent  death  etc.,  and  of  the 
immediate  cause  of  death  in  such  accidents.  John  Hunter  proved  that  death  in 
asphyxia  was  not  due  to  apoplexy  but  simply  to  the  want  of  air,  and  advised 
insufflation  of  the  lungs  and  rectal  injection  of  tobacco-smoke.  In  these  views 
Cullen  concurred.  Prize  essays  on  these  subjects  were  presented  to  the  Humane 
Society  by  Charles  Kite  (1788),  Edmund  Goodwyn  (1789)  and  Anthony  Fotbergill 
(179.">).  Edward  Coleman  of  London  ascribed  death  in  asphyxia  to  collapse  of  the 
lung  and  mechanical  obstruction  of  the  pulmonary  vessels,  for  which  he  advised 
venesection  (1791).  llawes  in  1777  also  wrote  "An  address  to  the  public  on 
premature  death  and  premature  interment",  and  Alex.  Johnston  (1716-1799) 
discussed  (1773)  the  practicabilitj  of  recovering  person-  apparently  dead  by 
drowning,  suffocation  etc.    (H.) 


—  70S  _ 

The  custom  is  mentioned  among  the  Indians  in  the  Atbarva  Veda.  The  oper- 
ation was  always  performed  by  the  Brahmins,  who  employed  pus  produced  by  those 
who  had  Keen  inoculated  with  natural  small-pox  one  year  before,  and  also  the  pus  of 
these  secondary  inoculations.  They  rubbed  the  place  selected  for  operation  —  in 
girls  the  outside  of  the  arm.  in  boys  the  outside  of  the  forearm  —  with  wool  until  red 
scratched  these  places  several  times  with  knives  for  a  space  about  an  inch  long,  and 
laid  upon  them  cotton  soaked  in  variolous  pus  and  moistened  with  water  from  the 
Ganges.  Before  inoculation  a  preparatory  course  of  diet  lasting  for  four  weeks  was 
considered  necessary.  The  inoculation  was  performed  in  the  open  air,  and  the 
inoculated  were  required  to  remain  out  of  bed  and  to  sprinkle  themselves  morning 
ami  evening  with  cold  water.  If  fever  made  its  appearance  the  sprinkling  was  dis- 
continued and  the  inoculated  might  at  most  stretch  themselves  before  the  threshold, 
and  must  eat  sparingly.  The  Brahmins  travelled  about  the  country  to  perform 
inoculation,  and  the  operation  was  practised  in  the  beginning  of  Spring.  Under  th< 
influence  of  such  excellent  hygienic  regulations  the  results  were  for  the  most  part 
favorable. 

Among  the  Chinese  the  so-called  "  pock-sowing"  was  practised  as  early  as  B.  C. 
1000  by  introducing  into  the  nasal  cavities  of  children,  aned  3  to  6  years,  a  pledgi 
cotton  saturated  with  variolous  pus. 

The  Arabians  had  a  "pox-sale".  Pus  from  a  patient  suffering  with  small- pox 
was  purchased  for  raisins  and  inoculated  with  needles. 

The  Circassians  too,  by  means  of -needles,  inoculated  handsome  girls  upon  th( 
cheek,  rijjht  wrist,  left  ankle,  over  the  heart  and  navel,  in  order  to  preserve  their  beauty. 

In  the  states  of  North  Africa  incisions  were  made  between  the  thumb  and  iiniex- 
finger;  among  the  negros  inoculation  was  performed  in  the  nose,  and  in  Denmark. 
Scotland,  the  Auvernne  and  other  places,  this  operation  was  performed  at  an  early 
period. 

The  employment  of  the  inoculation  of  natural  small-pox  by  the  Greeks  of  Con- 
stantinople, where  the  custom  had  been  long  naturalized  and  practised  by  old  women 
instructed  in  the  art,  exercised  a  most  important  influence  upon  the  West.  That  the 
old  women  regarded  the  operation  as  a  revelation  of  St.  Mary  did  not  impair  its 
efficacy. 

One  of  flic  first  accounts  of  the  inoculation  of  natural  small-pox  was, 
given  to  the  Royal  Society  in  London  in  1714  by  Emanuel  Timoni.  a 
physician  settled  in  Constantinople,  and  contemporaneously  by  Pilarini, 
the  Venetian  consul  in  Smyrna.  The  actual  introduction  of  the  practice 
into  the  West,  however,  was  due  chiefly  to  Marie  Pierrepont  Somerset. 
whose  married  title  was  Lady  -Maty  Wortley  .Montagu  (1600-1762),  wife 
of  the  English  embassador  to  the  Porte,  a  lady  of  somewhat  ambiguous 
conduct  but  of  indisputable  merit.  In  1717  she  had  her  son  inoculated  in 
Constantinople  by  her  surgeon  Maitland;  and  after  her  return  to  London  in 
1721  the  operation  was  also  performed  upon  her  daughter,  both  children 
at  the  period  of  operation  being  six  years  old.  These  eases  were  followed 
by  that  of  a  sou  of  Dr.  Keith.  In  1721  experiments  were  undertaken  by 
Maitland  upon  criminals,  and  as  these  turned  out  favorably,  the  Prince  of 
Wales  and  the  royal  princesses  were  inoculated  by  -Mead.  The  practice 
was  speedily  adopted  in  America,  France  and  German}",  and  the  enthusiasm 
was  so  great  that  numerous  medals  were  struck  and  given  to  physicians 
for  successful  inoculation. 


—  70!)  — 

As  inoculation  became  more  general,  of  course  some  unfortunate  cases  could  not 
be  avoided,  and  a  reaction  thus  took  place.  The  clergy  especially,  with  Bible  in 
hand  (like  the  late  Dr.  Nittinger1  who  died  in  Stuttgart  in  1876,  a  warm  opponent 
of  vaccination),  inveighed  against  this  atrocious  invasion  of  God's  prerogative  of 
punishment.  When,  however,  in  1746  bishop  Isaac  Maddux  of  Worcester  had 
recommended  inoculation  from  the  pulpit  and  established  houses  for  inoculation,  the 
operation  became  once  more  popular,  and  the  famous  Dr.  T.  Kirkpatrick  in  1734 
■■ailed  it  an  evidence  of  God's  goodness.  , 

In  Germany  the  first  inoculations  were  performed  by  Maitland  in 
Hanover,  and  the  operation  was  especially  favored  by  the  physician-in- 
ordinary  Hugo  and  by  Werlhof,  Hensler.  Koderer,  Tissot,  Lentin,  Hufeland 
and  many  others,  while  de  Haen.  who  even  raised  the  question  "  Is  inocu- 
lation allowable  in  the  sight  of  God  ?",  of  course  opposed  the  operation 
zealously,  and  Triller  wrote  a  poem  against  it. 

In  Paris  some  disputes  arose  over  the  inoculations  undertaken  there  in  17(10  by 
Angelo  Gatti,  professor  in  Pisa,  an  acute  and  accurate  observer  and  a  man  experi- 
enced in  experimental  pathology.  These  were  ultimately  terminated  in  1769  by  the 
grant  of  permission  to  inoculate.  Heretofore  a  medicus  purus  had  first  instituted  a 
preparatory  treatment  of  several  weeks;  a  surgeon  then  performed  inoculation,  and 
the  medicus  again  undertook  the  aftertreatment.  Gatti  combated  this  folly,  and 
undertook  the  entire  treatment  alone.  In  Holland  Theod.  Tronchin  (1709-1781)  of 
Geneva  had  been  active  in  the  cause  of  inoculation  at  Amsterdam  in  1748,  and  in 
Sweden  David  Sehulz  adopted  the  same  course.  In  Austria  the  Belgian  Job.  Jngen- 
housz  i  I7;i0-1799)  inoculated  the  archduke  in  1768. 

The  practice  of  inoculation  was  most  promoted  by  the  two  Suttons  near  London 
Robert  and  Daniel),  father  and  son,  who  in  1757  undertook  it  in  genuine  mercantile 
style.  The  former  professed  to  have  made  15,000  inoculations  without  a  single  fatal 
case.  He  kept  the  patient  on  strict  diet  for  nine  days,  avoiding  alcoholic  drinks. 
Then  he  gave  for  three  dajs  nine  grains  of  calomel,  a  single  dose  of  one  grain  of 
cinnabar  with  one  ounce  of  Glauber's  salt,  performed  the  inoculation  with  the  smallest 
possible  quantity  of  virus  and  very  little  scratching  of  the  skin,  administered  five  days 
thereafter  four  doses  of  Kernies  mineral  9  gt\,  aloes  20  gr.  and  camphor  9  gr.,  and 
left  the  patients  in  the  open  air.  [In  1784  the  Suttons  established  a  private  hospital 
containing  24  beds  solely  for  inoculated  patients.]  Besides  the  Suttons,  Baron  Thomas 
Dimsdale  (1712-1800),  of  Thoydon  Garnon  in  Essex,  was  a  special  promoter  of 
inoculation  and  acquired  through  this  operation  great  reputation  and  millions  of 
money.  In  1768  he  inoculated  for  a  large  sum  the  heir-apparent  to  the  throne  of 
Russia.  The  operation  was  not  prohibited  in  England  until  1840,  though  it  involved 
much  greater  dangers  than 

Inoculation  with  Cow-pox. 

an  operation  which  since  1874  has  realized  for  German  physicians  only  about  20 
^•ents  for  each  case,  though  in  unfortunate  cases — not  so  very  rare,  as  thorough 
registration  has  proven  —  it  involves  some  years  imprisonment.  In  the  grand-duchy 
of  Hesse  the  physicians  are  permitted  to  demand  about  five  cents  in  addition  for  a 
certificate  of  vaccination.     This  kind  of  inoculation   was   performed   in   1774   by  the 


1.  Heinrich  Friedr.  Germann  (1820-1878),  professor  in  Leipzig,  ra  1876  followed  in 
his  footsteps  with  a  work  in  three  volumes  entitled  "Historisch-kritische  Studien 
iiber  den  Stand  der  Impfrage".  Other  modern  opponents  in  great  numbers 
formed  an  "Antiimpfverein".     The  question  is  still  under  discussion. 


—   710  — 

tanner  Benjamin  Jesty  of  Gloucester,  and  next  upon  the  children  of  the  farmer  Jensen 
by  the  schoolmaster  Plett,  at  Starkendorf  in  Holstein,  in  17'.)2.  But  the  pioneer  in 
tin1  extensive  introduction  of  this  method  was 

Edward  Jenner  (1749-1823)  of  Berkeley  in  Gloucestershire,  who  is 
accordingly  called  justly  the  father  of  vaccination. 

Jenner  was  the  son  of  a  clergyman  and  devoted  himself  to  the  study  of  surgery 
under  the  guidance  of  Mr.  Ludlow  in  Sudbury  near  Bristol.  During  his  term  of 
apprenticeship  he  received  from  a  milkmaid,  who  hud  had  the  cow-pox,  information 
of  the  protective  power  of  this  disease  against  small-pox  as  established  by  popular 
observation.1  The  thought  of  the  immense  importance  of  such  protection  lor  tl  e 
whole  human  race  never  after  this  time  left  his  mind.  In  1770  he  went  to  Londc  n 
and  became  a  pupil  of  John  Hunter.  To  the  latter  he  communicated  his  idea,  and 
the  great  surgeon  said  to  him  'Don't  think,  investigate!"  This  he  desired  to  do, 
and  accordingly  he  went  to  Berkeley  as  a  physician  and  surgeon,  since  material  for 
his  researches  could  be  found  in  the  farms  of  that  vicinity.  The  observations  n  ade 
by  him  from  L778  forward  he  communicated  in  1788  to  Sir  Everard  Home, 
but  his  first  vaccination  was  performed  in  1706  upon  a  boy  named  James  Phipps 
with  matter  from  the  hand  of  Sarah  Nehnes,  who  had  contracted  cow-pox  in 
milking.  In  1 7! >S  he  published  his  results  in  his  work  "An  inquiry  into  the  causes 
and  effects  of  the  Variola'  vaccina?"  etc.  The  vaccine  virus  he  preserved  in  the 
form  of  silk  threads  saturated  therewith,  and  in  this  way  he  also  sent  it  to  others. 
Jenner  lived  for  a  long  time  in  Cheltenham  and  afterwards  in  London,  hut  died  full 
of  fame  and  honor  in  his  native  place,  after  having  received  in  1802  and  1807  rewards 
from  the  government  amounting  in  all  to  £30.000,  and  havingbeen  made  an  honorary 
citizen  of  London.  His  attachment  to  J.  Pliipps  induced  him  to  build  a  house  for 
the  latter  and  to  plant  roses  in  his  garden  with  his  own  hands.  Jenner's  life  was 
written  by  his  friend  Dr.  John  Baron  in  1827,  ami  in  1857  a  monument  to  his  memory 
was  erected  in  Trafalgar  Square. 

In  Germany  the  first  vaccination  was  performed  by  Hugo  von  Wreden 
in  Hanover,  which  was  then  under  English  rule.  In  1709  the  surgeon 
Christian  Friedrich  Stromeyer  (1701  1824),  who  had  been  educated  in 
England,  began  to  vaccinate  on  a  larger  scale,  and  he  induced  Dr.  Georg 
Fr.  Ballhorn  (born  1701).  the  court  physician,  to  translate  Jenner's  work 
into  German.  In  1800  both  these  physicians  were  able  to  report  upon 
1000  cases  of  vaccination. 

At  the  same  time  with  Stromeyer.  Ferro  was  in  1700  the  first  to 
vaccinate  in  Austria,  performing  the  operation  upon  his  own  children, 
and  Dr.  Jean  de. Carron  (1770-1840)  of  Geneva,  then  in  Vienna  and  sub- 
sequently in  Carlsbad,  operated  in  the  same  year. 

Meanwhile  societies  for  the  promotion  of  vaccination.  "  Jenner i an 
Societies",  had  been  formed  in  England  in  1700.  and  upon  their  model 
Heiin  established  a  similar  society  in  Berlin  in  1800.  In  the  latter  city 
Job.  Emm.  Brenner  (1745-1810).  a  simple  practitioner,  was  very  active  in 
the  diffusion  of  vaccination,  while  in  Saxony  Friedrich  Wilh.  Ludwig  Hirt 
(born  1761)  followed   his  example.     In  France  vaccination  was  promoted 


t.     \<  early  as  1765  Sutton  and  Fewster  had  determined  that  inoculation  of  persons 
infected  with  sheep-pox  was  ineffective.     11.  V.  von  Becker. 


—  711  — 

by  Pinel  and  Thouret  in  Paris  ;  in  Holland  by  Dr.  Ludwig  Heinr.  Jos. 
Vrancken  (1773-1S53)  of  Antwerp  ;  in  Belgium  by  M.  J.  Demanet  (1747- 
1831)  of  Ghent:  in  Italy  by  Aloysio  Sacco,  professor  of  medicine  and 
surgery  in  Milan,  and  in  Denmark  by  Heinrich  Callisen  (1740-1824).  In 
Spain  vaccination  was  diffused  by  Amar.  Gil  and  Salva. 

[The  earliest  vaccinations  in  the  United  States  were  performed  by  Dr. 
Benjamin  Waterhouse  (1754-1846),  professor  of  the  practice  of  medicine 
in  Harvard  College,  upon  four  of  his  own  children  in  July  1800.  He  pro- 
cured his  virus  from  Dr.  Haygarth  of  Bath.  England.  During  the  same 
summer  Dr.  John  Crawford  of  Baltimore  also  practised  the  operation  with 
virus  procured  from  Dr.  John  Ring  of  London  (Quinan).  Other  early  and 
eminent  advocates  and  promoters  of  the  practice  were  Dr.  James  Smith  of 
Baltimore,  Dr.  James  Jackson  of  Boston.  Jefferson.  Dr.  Gantt  of  Wash- 
ington, Dr.  John  Redman  Coxe  of  Philadelphia,  Dr.  Seaman  of  New  York. 
Dr.  Ramsey  of  South  Carolina  etc.  In  1802  Dr.  James  Smith  organized  in 
Baltimore  the  first  Vaccine  Institute  in  the  1'nited  States,  and  in  1813  a 
United  States  Vaccine  Agency  was  established  by  Congress  under  the 
direction  of  the  same  physician.  This  Agency  was.  however,  discontinued 
in  1822. 

■•Animal  vaccination".  "Bovine  vaccination  ".  ••Retro-vaccination  ". 
i.  e.  the  transmission  of  humanized  virus  through  the  system  of  the  cow 
and  its  subsequent  employment  in  the  inoculation  of  human  beings,  was 
first  practised  by  Michele  Troja  ( 1747-1 827)  of  Naples  shortly  after  the 
introduction  of  human  vaccination.  In  1810.  however,  this  practice  was 
prohibited.  "True  animal  vaccination',  •true  bovine  vaccination" 
(Martin),  i.  e.  the  inoculation  of  human  beings  with  the  lymph  derived 
mediately  from  a  spontaneous  case  of  cow-pox.  is  due  to  M.  Negri,  also  of 
Naples,  who  practised  it  for  several  years  prior  to  1864.  The  practice  was 
introduced  into  France  by  Depaul  in  1866,  into  Belgium  by  Dr.  Warlomont 
in  186")  and  into  the  United  States  by  Dr.  Henry  A.  Martin  of  Boston  in 
September  1870.      H.j 

Compulsory  vaccination  was  first  introduced  extensively  in  German}"' 
(Bavaria  and  the  grand-duchy  of  Hesse  1807,  Baden  1815,  Wiirtemberg 
1818;  in  the  latter  state  revaccination  of  recruits  was  first  introduced  in 
1829),  and  then  in  other  countries.  In  England,  however,  compulsory 
vaccination  was  averted  until  the  times  of  Albert,  the  Prince  Consort,  and 
it  was  first  legalized  in  1857  on  the  proposal  of  Dr.  John  Simon,  medical 
officer  of  the  Privy  Council.  In  Germany,  as  we  know,  the  strictness  of 
the  enforcement  of  vaccination  has  recently  increased,  and  since  1873 
revaccination  (of  recruits  and  scholars  in  their  12th  year  |  has  been  also 
included.  The  rigidity  of  the  law  has.  however,  justly  aroused  strong- 
opposition. 

1.  The  temporary  character  of  the  protection  of  vaccination  was  first  taught  by 
Elsasser  (r814)  and  von  Stosch  (1825).  Schoenlein  was  the  earliest  to  call  atten- 
tion to  the  distinction  between  variola  and  varioloid. 


—  712  — 

In  the  discussion  <>(  vaccination  use  was  already  made  of 
The  Numerical  Method. 

The  pioneer  in  the  emploj'ment  of  this  method  was 

Joh.  Peter  Siissmilch  1707  1777  .  member  of  the  supreme  consistorial  court  and 
a  Fellow  of  the  Academy  of  Sciences,  who  likewise  procured  the  reception  of  Lessing 
into  the  latter  society  —  an  honorable  monument  of  liis  own  liberality  of  spirit. 
Siissmilch  cultivated  the  numerical  method  in  his  work  entitled  "Nachweiss  der 
gottlichen  Ordnung  in  den  Veranderungen  des  menschlichen  Geschlechts  unler  Zu- 
ziehumz  der  Geburts- und  Sterbelisren  ",  Berlin,  17(1,  while  the  famous 

Gottfried  Achenwall  1719  1772),  professor  of  law  and  philosophy,  must  be 
regarded  as  the  man  who  conferred  the  rank  of  a  science  upon  Statistics.  The  latter 
are  considered  infallible  in  our  medicine  of  the  present  day.  although  the  investiga- 
tions upon  which  thej  are  based  frequently  manifest  the  faults  of  great  inequality  in 
themselves  and  lack  of  uniformity  in  their  conditions. 

The  Treatment  of  the  Insane, 

during  almost  the  whole  of  the  18th  century,  continued  in  a  very  bad  con- 
dition, and  it  was  not  until  toward  the  (dose  of  this  period  that  a  movement 
for  its  improvement  made  its  appearance.  At  this  time  the  lunatics  began 
to  be  removed  from  the  corners  of  hospitals  and  liberated  from  the  prisons, 
letters  and  the  hands  of  brutal  keepers,  and  to  be  looked  upon  by  the 
profession  as  actual  sick  persons,  belonging  to  the  department  of  medical 
science   and   art.      So-called  "Schools"  of  psychiatry — French.  German, 

English  etc.  —  were  founded. 

In  France  the  first  impulse  to  this  improvement  was  given  by  Anne 
Charles  Lorry  (1726-1783)  in  his  work  ■■  De  melancholia  et  tnorbis  nielan- 
cholicis  '.  which  appeared  in  176.").  lie  was  followed  by  the  true  Reformer 
of  the  Treatment  of  the  Insane. 

Philippe  Pinel  i  1  T.~>r>   1826). 
whose    work    •  Trait e    tnedico-philosophique   sur    I'alienation    mehtale,  ou 
la    Manic",    Paris.    1801,    marked    an    epoch    in    the  department  of  psy- 
chiatry. 

Pinel  removed  from  the  in.-ane  their  fetters, did  away  with  corporeal  punishments 
and  abuse,  limited  the  employment  of  drugs  and  especially  of  venesection,  separated 
the  insane  from  convicts,  taught  that  mental  diseases  should  be  looked  upon  as 
corporeal  lesions,  placed  the  insane  in  hospitals  under  the  charge  of  physicians,  and 
in  these  hospitals  classified  the  patients  according  to  the  character  of  their  diseases 

and  inculcated  the  necessity  of  their  treatment  by  gentle  means  and  by  physical 
labor.  Vet  in  spite  of  Pinel's  humane  teachings  lunatics  were  found  in  cages  in 
some  of  the  French  provincial  cities  as  late  as  1833  and  1834.     Pinel's  footsteps  were 

followed  1>\ 

Jean  Etienne  Dominiqi  k  Esquirol  (1772-1840  . 

v'.  1 1  <  •  in   IS]  7  established  a  clinic  for  mental  disease-. 
Among  the  Italians 

Vincenzio  Chiarugi  (1759  L822)  of  Florence,  was  chiefly  active  in  exciting  new 
efforts  in  this  department.  He  regarded  the  mind  as  something  immaterial  and 
therefore  incapable  of  disease  in  the  ordinary  sense  of  that  term. 


The  English  displayed  special  activity  in  this  department.     Thus 

Culleri  and  his  pupil  Thomas  Arnold  (died  1816)  of  Leicester,  as  well  as  William 
Perfect  (born  1740),  studied  the  subject  of  mental  diseases.  The  latter  believed  them 
to  be  disturbances  of  the  bodily  functions,  and  based  his  indications  upon  this  idea, 
a  system  in  which  lie  was  followed  b\  almost  all  English  alienists.  Sir  Alexander 
Crichton  (1763-1836)  distinguished  mental  disturbances  arising  from  the  passions 
from  those  depending  upon  corporeal  causes,  and  also  brought  forward  heredity  as 
one  of  the  causes  of  insanity.  William  Pargeter  of  Reading  ("Observations  on 
maniacal  disorders '".  London.  1792)  laid  the  chief  importance  in  practice  upon  the 
•character  of  the  physician  and  his  ascendency  over  the  insane.  John  Haslara 
(1764—1844)  of  London  devoted  his  attention  to  pathological  anatomy  as  related  to 
■mental  diseases,  and  William  Take  (1732  1822)  of  York,  founder  in  1793  of  the  York 
Retreat  for  the  Insane,  introduced  into  England  the  psychical  treatment  of  lunatics. 
[The  grandson  of  the  latter.  Samuel  Tuke,  though  not  a  physician,  wrote  a  description 
■of  the  York  institution  in  1813,  and  bis  great  grandson  Daniel  Hack  Tuke  (born 
1820),  likewise  medical  officer  to  the  York  Retreat,  is  one  of  the  most  eminent  of 
English  authors  on  the  subject  of  mental  diseases.  The  Tuke  family  were  all 
Quakers. 

Andrew  Marshall  (1742-1813),  an  army  surgeon  and  anatomical  lecturer  in 
London,  discussed  the  morbid  anatomy  of  mania  and  hydrophobia,  and  referred  both 
■diseases  to  lesions  of  the  brain,  particularly  of  its  vascular  apparatus :  and  Joseph 
Mason  Vox  (1762-1822)  ascribed  mental  diseases  chiefly  to  cerebral  hyperemia, 
recommending  in  their  treatment  cathartics,  cold  lotions  and  baths  and  the  use  of 
the  swing. 

James  Monro  (died  17o2i  and  his  son  John  (1715-1791),  both  physicians  to  the 
Bridewell  and  Bethlehem  Hospital:  Win.  Battie  (1704-1770),  physician  to  St.  Luke's 
Hospital  and  proprietor  of  a  private  asylum  in  London;  John  Ferriar  (1763-18151  of 
Manchester  and  John  Johnstone  (1768-1836)  of  Birmingham,  were  likewise  eminent 
-alienists.      II.] 

Among  the  Germans 

Job.  Ernst  Greding  (1718-1775),  physician  to  the  poor  house  in  Waldheim,  was 
•the  earliest  to  investigate  the  seal,  cause  and  diagnosis  of  insanity.  After  him 
Weikard  divided  mental  disturbances  into  those  of  the  intellectual  and  those  of  the 
emotional  sphere,  while  Job.  Benj.  Ehrhard  (1766-1827),  whose  memory  is  preserved 
in  the  biography  of  the  physician  Varnhagen  of  Ense,  distinguished  insanity  from 
melancholia,  hypochondria,  folly,  delirium  etc.,  and  studied  the  doctrine  of  fixed 
ideas      The  noble 

Joh.  Gottfrted  Langermann  (1768-1832) 

must,  however,  be  regarded  as  the  reformer  of  psychiatry  in  Germany.  He  was  the 
first  who  placed  the  curable  and  incurable  in  distinct  institutions,  and  "tie  divided 
•diseases  of  the  mind  into  idiopathic  and  symptomatic.  Langermann  was  the  son  of 
a  peasant  in  Ma.xen.  near  Dresden,  and  owed  his  opportunities  for  study  to  the  favor 
of  patrons  of  rank.  He  first  graduated  in  law  before  devoting  himself  to  the  study  of 
medicine  in  Jena  1794-97.  Even  bis  thesis  for  graduation  was  devoted  to  the  subject 
•of  mental  disorders,  and  bore  the  title  "  I  >e  methodo  eognoscendi  eurandique  animi 
morbos  stabilienda",  emphasizing  the  importance  of  the  improvement  of  lunatic 
asylums.  He  was  appointed  physician  to  the  St.  George  asylum  near  Beyreuth,  and 
raised  this  institution  to  the  position  of  a  model  asylum.  Finally  he  was  appointed 
state-counsellor  and  supreme  medical-counsellor  in  Berlin. 

Besides  Langermann,   Reil  and   Job.   Chr.  Hoffbauer  (1766-1827)   in 
Halle,  about  the  close  of  the  lsth  century,  made  special  efforts  to  bring 


—  714  — 

psychology  into  accord  with  physiology  in   the  department  of  alienistic 

science. 

Private  Hygiene 

in    the    18th    century    found   abundant    cultivation,    partly    in    works    of 
thoroughly  scientific  character,  partly  in  popular  writings. 

What  we  at  the  present  day  understand  by  the  term  "privsite  hygiene"  in 
earlier  times  passed  under  the  name  of  dietetics.  Hence  this  brand)  is  as  old  as 
medicine  itself.  The  Indian  physicians,  like  the  Greek  gymnasts  and  philosopheis 
and  the  physicians  from  Hippocrates  to  Galen,  were  distinguished  for  their  attention 
to  this  department  of  medicine,  and  it  was  cultivated  at  a  very  early  period  too  by 
the  laity.  Among  the  latter  we  may  mention  Plutarch  (born  A.  1).  70.  "  De  tuenda 
sanitate").  Athenaais  (born  A.  D.  220)  in  Alexandria,  who  in  his  "  Deipnosophistae", 
and  ('alius  Apicius  in  his  "De  re  culinaria  ''.  discusses  especially  the  preparation  of 
articles  of  food.  The  Arabians  too,  and  particularly  the  Salernian  physicians,  whose 
popular  poem  excited  much  attention  and  awakened  numerous  imitations,  cultivated 
this  branch  of  medicine.  Physicians  of  the  later  Middle  Ages,  like  Despars,  Hugo 
Bentius  (died  1448),  Ficinus  and  many  others  composed  numerous  writings  on 
hygienic  subjects:  indeed  as  early  as  1483  Mich.  Schrick  discussed  "'die  uszgepranten 
Wasser"  from  a  sanitary  stand-point.  At  this  period  the  drinking  of  distilled  liquor 
began.  With  the  commencement  of  the  modern  era  the  number  of  writers'on  hygienic 
subjects  increased  in  all  lands.  Of  this  large  number  we  mention  only:  Sir  Thomas 
Elyot,  author  of  "The  Castell  of  Health".  1534;  Luis  Lobera  d'Avila,  1542;  Ai.dr. 
Lacuna  i  1499-1560),  victus  ratio;  Thom.  Philologus  (born  1493),  author  of  "  De  vita 
hominis  ultra  centum  viginti  annos  producenda",  Venice,  1550;  Luigi  Cornaro  (died 
1566),  "Discorsi  della  vita  sobria":  Rud.  Goclenius  (1572-1621)  and  Mart.  Pausa 
(born  l.")H0»,  "  De  proroganda  vita  liber  aureus".  After  Sanctorius  the  following 
writers  distinguished  themselves  as  authors  on  the  subject  of  hygiene:  Bacon  and 
Thomas  Venner  (died  1660;  "Guide  to  lonii  life")  in  England;  Melch.  Sebiz  Jr. 
(1578-1674),  "  De  alimentorum  facilitations";  Phil.  .lac.  Sachs  von  Lewenheimb 
(1627-1671),  author  of  a  treatise  on  grapes;  Sim.  Paulli  (1603-1689)  in  Copenhagen, 
who  wrote  on  the  abuse  of  tobacco  in  Germany.  Joh.  Domin.  Sala  i  1579-1644),  who 
wrote  on  food:  Dom.  Panaroli  (died!657),  on  various  fruits;  Valentin  Heinr.  Vogler 
(1622-1677),  on  dietetics  in  general;  J.  Sigismund  Elsholz  (1623-1688),  author  of  a 
"  Tischbuch  ":  Ehrenfried  Walther  Tschirnhausen  (1651-J708),  mathematician, 
physicist  and  logician,  author  of  a  medicine  of  the  mind;  J.  (iottfr.  von  Berger 
(1659-1736),  "  De  tuenda  valetudine  ex  cognitione  sui  ipsius".  17o7:  John  Sinclair, 
"Handbook  of  health  and  loni:  life",  edited  by  Sprcngel.  A  book  bparing  the  now 
usual  title  of  "Hygiene-"  or  "Idea  hygieines  recensita"  (1661)  had  for  its  author 
John  Johnston,  a  Scotch  savant  and  physician. 

During  the  18th  century  the  most  distinguished  physicians  promoted 
prominently  the  subject  of  hygiene.  The  earliest  to  make  their  appearance 
were  the  famous  Hoffmann,  with  an  "Anweisung  wie  ein  Mensch  etc.  sich 
verwahren  konne"  (1715),  and  the  follower  of  Stalil.  •).  Samuel  Carl,  with 
a  "Diatordnung  fiir  Gesunde  und  Kranke",  while  Chejne  wrote  "An  essay 
of  health  and  long  life",  1724.  J.  Arbuthnol  i  1658  1735)  an  "Essay  con- 
cerning the  nature  and  choice  of  aliments  ",  1731,  and  the  famous  Neumann 
on  tea,  coffee  and  beer.  William  Cadogau  composed  a  work  "On  the 
nursing  and  management  of  children  from  their  birth  to  three  years  of 
age  ".  17  is.  and  C.  Gr.  Lober  an  "Anleitung  zu  einer  heilsamen  Lebensart 


—  715  — 

und  Gebrauch  der  Speisen";  comprehensive  works  weie  supplied  b}'  the 
Berlin  physician  J.  F.  Zuekert,  who  wrote  a  general  treatise  on  foods,  in 
1775  ;  X.  Boerner  (inedicus  sui  ipsius,  1774);  William  Falconer  of  Bath 
(•  Kemarks  on  the  influence  of  climate  "  etc.,  1781);  Bassiano  Carminati 
(Giac.  Sacchi;  -Hygiene,  terapeutice  et  materia  medica  "  Pavia  1791-95), 
and  Ludwig  Vogel  (lexicon  of  dietetics).  Wilhelm  Josephi  expatiated 
upon  marriage  and  physical  training  (1788).  The  most  famous  works 
upon  the  subject  of  hygiene,  however,  written  in  popular  style  were  the 
"  medicinischen  Fastenpredigten  "  of  Fr.  Ant.  May  (1743-1814)  of  Heidel- 
berg, who  also  delivered  lectures  for  1)0}S  and  girls  above  ten  years  of  age. 
with  the  object  of  promoting  hygiene.  It  should  be  also  remarked,  by 
the  way,  that  May  possessed  that  rare  love  of  the  truth  which  led  him  to 
discuss  with  the  students  his  own  mistakes  at  the  bedside.  Other  famous 
hygienic  writings  were  the  journal  "der  Arzt "  of  Unzer,  the  -Avis  au 
peuple  "  of  Tissot  and  the  "Makrobiotik,  oder  die  Kunst,  das  menschliche 
Leben  zu  verliingern  "  of  Hufeland.  new  editions  of  which  appear  even  at 
the  present  day. 

[To  the  catalogue  of  English  writers  upon  the  subject  of  private  hygiene  we  may 
add:  Francis  Fuller,  author  of  a  very  popular  "  Medicina  gymnastica"  (1704)! 
Edward  Baynard  of  Bath,  whoso  poem  "  Health  "  I  171!.')  survived  numerous  editions: 
James  Mackehsie,  who  wrote  in  his  old  age  a  history  of  hygiene  (1759);  Andrew 
Harper  (1789);  George  Wallis  (1793):  the  famous  Thos.  Beddoes  of  Bristol  (Hygiea 
etc.,  1802),  and  James  Parkinson  (1799),  best  known  as  the  earliest  describer  ot 
paralysis  agitans  in  1817.      II  ] 

What  we  to-da}-  call 

Public  Hygiene, 

was  created  by  Joh.  Peter  Frank  under  the  title  of  '■  Medical  Police'". 

[We  may  add  here  that  the  subject  of  military  hygiene  was  discussed,  among 
others  in  England,  by:  Richard  Brocklesby  (1724-1797),  whose  experience  in  the 
Seven  ^  ears'  War  led  him  to  recommend  light,  wooden  shelters  for  the  protection 
of  the  sick  and  wounded  in  the  field  ;  Donald  Monro  f  ]  7so  i  nnd  William  Blair  i  1798  i. 
—  Hospital  hygiene  was  also  studied  by  James  Carmichael  Smyth  i  1741-1821  I,  whose 
experiments  in  the  disinfecting  power  of  nitrous  acid  fumes  proved  so  successful 
that  Parliament  rewarded  him  with  a  present  of  £5,000,  and  he  was  soon  after 
appointed  physician  extraordinary  to  the  kimc.  Sir  William  Blizard  also  wrote 
in  1796  "Suggestions  for  the  improvement  of  hospitals  and  other  charitable  insti- 
tutions".     II.] 

From  all  that  has  been  said  it  is  clear  that  in  the  last  century  hygienic 
questions  were  treated  with  considerably  greater  predilection  than  has  been 
until  recently  the  case  in  our  own  age.  Hygiene,  however,  at  that  period 
was  devoted  more  to  the  claims  of  general  and  everyday  life,  and  less  to 
the  hygienic  regulations  against  epidemic  diseases,  than  is  the  case  to-dav: 

8.    VETERINARY  MEDICINE.    PHARMACOLOGY  AND  PHARMACY. 

Veterinary  medicine  during  the  18th  century  began  to  assuirte  the 
rank  of  a  science.  Several  circumstances  conspired  to  produce  this  result. 
Chief  among  these  was  the  necessity  of  supplying  the  armies  with  better 


—  716  — 

educated  veterinarians.  Then  too  the  great  animal  epidemics  of  the  18th 
centun*.  so  injurious  to  the  common  weal — in  Holland  alone  60,000  cattle 
are  said  to  have  perished  — ■  startled  the  states  out  of  the  indifference  with 
regard  to  veterinary  medicine  of  which  they  had  heretofore  been  guilty. 
Finally  the  extensive  investigations  in  the  department  of  zoology,  under- 
taken by  such  men  as  Button.  Daubenton,  Cuvier,  Vicq  d'Azyr  and  others. 
excited  a  lively  interest  in  veterinary  medicine  also.  Even  eminent  phy- 
sicians devoted  attention  to  the  subjects  of  this  science,  among  them  e.  g. 
Ramazzini.  Camper.  Haller.  Sauvages.  Job.  Gottlieb  Wolstein  (1738-1820) 
ete.  Special  veterinary  schools  were  now  founded,  the  first  in  17<>2  at 
Lyons,  the  second  at  Alfort  near  Charenton,  in  1703.  Thus  it  came  about 
at  last  that  better  care  was  taken  of  horses  than  of  lunatics. 

In  France  during  this  century  also  equerries  (if  noble  birth  and  ex-farriers  chiefly 
devoted  attention  to  the  department  of  hippology.     Among  these  we  may  mention  : 

Gasp,  de  Saulnier 

( "  Parfaite  connaissance  des  chevaux  '.  1  7M4  i.  who  collected  old  recipes  and  invented. 
among  others,  four  recipes,  each  containing  a  score  or  more  of  ingredients  ; 

1)E  LA  CHAYNAIE, 
("Parfait  cocher",  1744  >,    who   studied   the  diseases  of  horses  and  gave  remedies  of 
easy  preparation : 

F.  R.   DE   LA  GUERIXIKRK. 

I  "  Ecole  de  cavalerie",  etc..  1754  .  who  strove  after  simpler  prescriptions  than  his 
predecessors ; 

De  Garsailt 
Xouveau  parfait  marechal",  1755,  often  reprinted1,  who.  besides  the  pathology  of 
horses,  furnished  a  hippo-pharmaeognosy  with  plates,  and  a  hippo-pharmacodynaniio. 
We  should  also  notice 

Louis  Vitet  (1736-1800). 
a  veterinarian  of  Lyons,  who  wrote  a  "  Medecine  veterinaire"  (  17SH),  and  introduced 
the  experimental  method  into  veterinary  medicine. 

A  lawyer,  who  began  to  study  the  veterinary  art  because  his  conscience  revolted 
against  the  practice  of  law,  as  that  of  Thaer  did  against  the  practice  of  medicine, 
became  of  the  greatest  importance  in  the  development  of  veterinary  medicine.  This 
was 

Claude  Bourgelat  (1712-1779)  of  Lyons. 
whose  name  "will  ever  remain  a  subject  of  admiration  and  respect  to  all  veterinary 
physicians  [sensee).  Under  the  auspices  of  the  minister  P>ertin  he  occasioned  the 
foundation  of  both  the  veterinary  schools  mentioned  above,  and  he  was  also  a  teacher 
in  them.  Bourgelat  was  a  follower  of  Boerhaave.  He  wrote  some  comprehensive 
works:  "Elemens  de  1'  art  veterinaire ":  "Elemens  d'  hippiatrique"  etc..  ">  vols.; 
Matiere  medicale  raisonnee  "  etc. 

Contemporary  with,  and  alter,  him  the  two 

De  Lafosse 

distinguished  themselves.  The  father  Eiienne  Guillaume,  was  first  a  farrier,  but 
became  finally  royal  veterinary  physician.  His  son  and  successor  in  the  latter 
position,  Philippe  Etienne  (1739-1820),  first  studied  medicine  and  surgery  and 
became  finally  general  inspector  of  all  the  veterinary  schools.  He  continued  his 
father's  "Cours  d'  hippiatrique''  and  himself  published  a  "Dictionnaire  d'  hippologie". 


—  717  — 

Bourgelat's  successor  in  1779  in  the  school  at  Alfort  was  the  earlier  farrier 

Chabert  (Oleum  Chaberti), 
who  furnished  rare  evidence  of  his  insight  by  inviting  to  the  school  scientific  phy- 
sicians like  Gilbert  (died  1799),  Girsml,  Huzard  and  Flandrin,  to  be  his  subordinates. 
The  respect  for  veterinary  physicians  during  the  present  century  has  become  so 
high  that  Henri  Bouley  (1814-1885),  who  wrote  on  the  epidemic  diseases  of  animals, 
particularly  the  cattle-plague,  died  a  director  of  the  Academie. 
[In  England  the  eminent  animal  painter 

George  Stubbs  (1724-180G)  of  Liverpool 
wrote  "On  the  Anatomy  of  the  Horse"  (17<in),  and  about  the  same  period 

.Mi:.  Gibson, 
a  surgeon  of  cavalry,  published  a  "Farriers  guide": 

Dan.  P.  Layard  (died  1802)  of  London 
wrote  "An  essay  on  the  nature  causes  and   cure  of  the  contagious  distemper  among 
the  horned  cattle"  (1757),  and 

Mr.  Bartlet. 
a  "  Pharmacopoeia  hippiatrica"  and  "  Gentleman's  Farriery  ",  (1759).     The  eminent 
A  nglo-French  microscopist 

John  Tcberville  Needham 
also  published  in   1770  a  "  Memoire  sur  la  maladie  contagieuse  des  betes  a  comes". 

—  The  earliest  veterinary  school  founded  in  England,  however,  was  the  London 
Veterinary  College,  established  in  1791  through  the  exertions  of  Chas  Vial  de  St.  Bel, 
an  alumnus  of  the  school  of  Lyons,  who  had  as  his  assistant  Delabere  Blaine.  St  Bel 
died  in  179!!  and  was  succeeded  in  the  presidency  of  the  school  by  Mr.  Coleman,  who 
conducted  the  institution  with  eminent  success.  Lectures  on  veterinary  medicine 
were  delivered  by  Mr.  Dick  in  Edinburgh  as  early  as  1819,  but  a  regular  college  was 
not  established  until  1823,  when  Mr.  Dick  organized  and  conducted  the  Edinburgh 
Veterinary  College.  Mr.  Dick  died  in  1866,  leaving  the  college,  his  museum  and  his 
private  fortune  to  the  city  of  Edinburgh.  He  had  associated  with  himself  in  the 
administration  of  the  institution  Mr.  John  Barlow  and  Dr.  George  Wilson.  A  Xew 
Veterinary  College  was  organized  in  Edinburgh  in  1857  by  Mr.  John  Gamgee,  who 
continued  to  conduct  it  until  his  removal  to  London  in  1865.  A  veterinary  school 
was  also  founded  in  Glasgow  in  1861  under  the  auspices  of  Mr.  James  Macall.  The 
"Royal  College  of  Veterinary  Surgeons",  composed  of  alumni  of  the  Colleges  of 
London  and  Edinburgh,  was  chartered  in  1844. — In  the  United  States  charters  for 
veterinary  colleges  were  granted  in  Pennsylvania  in  1853  and  again  in  1866,  but  in 
neither  case  did  the  efforts  at  organization  prove  successful.  In  1855  George  H. 
Dadd  secured  a  charter  also  for  the  Boston  Veterinary  Institute  from  the  state  of 
Massachusetts,  hut  again  t lie  effort  resulted  in  failure.  Dr.  John  Busteed,  however, 
procured  a  charter  from  the  Legislature  of  Xew  York  in  1857  and  succeeded  in 
organizing  the  X.  Y.  College  of  Veterinary  Surgeons,  which  continued  to  impart 
veterinary  instruction  witli  considerable  success  for  about  ten  years,  when,  owing  to 
internal  dissensions,  it  was  compelled  to  suspend.  In  1875,  however,  it  was  reorgan- 
ized as  the  American  Veterinary  College,  which  now  enjoys  a  successful  career. 
Veterinary  instruction  is  also  imparted  in  the  Massachusetts  Agricultural  College 
and  in  Cornell  University. 

Among  the  earlier  English  veterinarians  and  veterinary  authors  were  Boardman 
(1805),  J.  Clark  (1785),  Peale  (1814),  White  (1815),  B.  Clark  (1815)  and  William 
Youatt  (1777-1847).     H.] 


—  71S  — 

In  Sweden 
Friedrich  Hastfer  (175ti) 

took  the  lanigerous  animals,  tlieir  perfection  and  improvement,  for  the  subject  of  au 
essay. 

In  Denmark  a  noble  veterinary  school  was  founded  in  1773  by  the  famous 
Peter  Christ.  Abildgaard  (1740-1801) 
in  Copenhagen,  and  his  successor. 

Erich  Nil  sen  Viborg  (1759-1822) 

rendered  good  service   to   the   subject  of  medicine  by  his  investigations  relative  to 
cow-pox. 

In  Germany  among  the  earliest  cultivators  of  veterinary  medicine  belonged 

Johanx  Christ.  Poltc.  Erxleben1  (1744-1777;, 

professor  in  Gottingen  ("Einleitung  in  die  Vieharzneikunde";  "  Praktischer  Inter- 
richt  in  de  Vieharzneikunde  ",  and  a  translation  of  Vitet )  : 

Joh.  Jos.  Katjsch  (1771-1825), 
government  and  medical  counsellor  in  Liegnitz,  and 

J.  Paul  Adami  in  Vienna. 
royal  "  Contagionsphysikus  ". 

A  new  era  for  veterinary  medicine  in  German  lands  began  when  Joseph  II.  in 
1777  founded  in  Vienna  the  institute  for  the  education  of  military  veterinarians  and 
farriers,  after 

Scotti  in  the  year  1760  had  made  a  beginning  of  this  work. 

J.  <!.  WOLLSTEIN 
specially  combated  the  abuse  of  bleeding  in   veterinary  medicine.     He  was  followed 

by 

Dr.  J.  J.  Pessina  (died  1808). 

Subsequently  (1817  i, 

Dr.  Joh.  Emanuel  Veith  (1787-1876;  "Handbuch  der  Veterinar- 
kunde  "), 
originally  a  Jew,  but  from    1821   honorary   canon  and   preacher   of  the   cathedral  at 

Vienna,  a  famous  pulpit  orator,  homiletic  writer  and  poet,  was  an  active  veterinarian. 
The  same  is  true  of  his  brother 

Dr.  Joh.  Elias  Veith  (1789-1885). 

The  latter  in  1823  was  appointed  professor  of  surgery  in  the  veterinary  institute, 
and  was  pensioned  in  1855,  becoming  a  very  popular  practitioner.  He  republished 
the  book  of  his  brother,  and  wrote  himself  on  forensic  veterinary  medicine. 

Veterinary  schools  were  established  in  Hanover  in  1778,  Munich  in  Bavaria 
1790,  and  Wurzburg  in  1791. 


1.  He  was  the  son  of  Dorothea  Christine  Erxleben,  daughter  of  the  physician  Poly- 
carp  Leporin,  and  a  regularly  graduated  "doctress"  (Halle  l7.">4i  who  practised 
with  good  fortune  and  skill  in  Quedlinburg  until  her  death  in  17ti2.  Besides  her, 
Laura  Bassi  is  said  to  have  graduated  in  Bologna  in  17ol.  Doctresses  of  medicine, 
at  that  period  quite  rare,  are  become  so  common  at  the  close  of  the  19th  century 
that  many  a  professor  is  able  to  select  a  consort  of  his  own  rank.  In  Bologna  in 
1885  Dr.  Giuseppina  Cattani  was  even  the  female  professor  of  anatomy,  and  Dr. 
Margherita  Fame,  female  pliysieian-in-ordinary  to  the  queen  of  Italy.  Anton ia 
Elizabetha  von  Held  (horn  l7-".n,  whose 'second)  husband  was  Muller  of  Frankfort, 
was  an  ungraduated  "Specialist"  in  syphilis. 


—  710  — 

Model  institutions  of  this  kind  were  founded  at  Berlin  in  1790  for  the  state  of 
Prussia,  at  the  instance  of 

Christian  Andreas  Cothenius  (1708-1789). 

ordinary  physician  of  Frederick  the  Great.  The  professors  to  be  appointed  to  these 
schools  were  required  to  pursue  a  course  of  study  at  one  of  the  institations  already 
existing.  J.  G.  Naumann  studied  in  Paris,  G.  F.  Sick  in  Vienna  and  the  later 
veterinar}-  apothecary,  Ratzeburg,  in  Leipzig.  The  institution  possessed  a  clinic  for 
animals,  arrangements  for  keeping  them  in  the  open  air,  cold  and  warm  baths, 
isolated  stalls  for  cases  of  glanders,  its  own  house  for  dissection,  a  smithy  etc.  Free 
foundations  for  students  from  civil  life  were  established,  in  order  to  open  the  way  for 
improvement  in  private  veterinary  medicine. 

J.  G.  Langer.mann 

too,  the  alienist  already  mentioned,  did  not  scorn  to  occupy  himself  with  the  improve- 
ment of  veterinary  art. 

Jon.  Nic.  Rohlwes  (1755-182:5:  ':Das  Gauze  tier  Thierheilkunde  ") 
and 

Chr.  Eiirenfried  Seiffert  of  Teiinecker  (1770-18o0). 
also  belonged  to  the  18th  century. 

Journals  likewise  provided  for  the  extension  of  lietter  knowledge  in  this  branch. 
In 

Pharmacology 

Ludovici's  method  of  discarding  the  antiquated  and  useless  was  not  imi- 
tated, and  it  thus  resulted  that  throughout  the  whole  18th  century  an 
incredible  number  of  strange  remedies  like  mummy,  millepeds,  wood-lice, 
various  sorts  of  dung  and  the  like,  were  regarded  as  efficacious.  Indeed 
amulets  were  still  found  in  the  shops.  Instead  of  simplifying  the  materia 
medica,  not  a  few  new  drugs  were  added  to  the  already  superabundant 
store,  and  numerous  erudite  battles  were  fought  over  the  old  and  new 
remedies,  just  as  at  the  present  day.  This  unwearied  search  after  remedies 
and  methods  for  the  cure  of  disease  is  ever  the  portion  of  physicians  ; 
while  the  full  possession  of  absolute  power  to  cure  even  the  most  trifling 
diseases  will  —  and  must  —  ever  remain  denied  them.  Special  services 
were  rendered  to  pharmacology  by  Francesco  Torti  (1658-1741  I.  Joh. 
Reinhold  Spielmann  (1722-1783).  professor  in  Strassburg,  whose  successor 
in  1784.  Joh.  Hermann  of  Barr,  was  the  founder  of  the  cabinet  of  natural 
curiosities  in  that  city,  and  by  Johann  Andr.  von  Murray  (1740-1701  I  of 
Stockholm,  professor  in  GOttingen,  author  of  an  "Apparatus  medicaminum" 
in  six  volumes. 

Torti  and  YVerlhof.  with  John  Fothergill,  Ludwig  Chr.  Althof  (1758-1832  .  a 
professor  in  Gottiugen  and  a  friend  of  Burger,  Johann  Heinrich  Rahn  (1749-1812) 
in  Zurich  ("  Pfalzgraf "),  and  many  others,  were  forced  to  struggle  continually  to 
establish  the  advantages  of  the  cinchona  bark.  Their  most  weighty  opponents  were 
Filer,  .ordinary-physician  in  Berlin,  and  Senac.  Opium  suffered  the  same  experience. 
There  was  also  much  dispute  regarding  the  advantages  of  ipecacuanha.  The  com- 
bination of  these  latter  drugs,  under  the  form  of  the  so-called  Dover's  powder,  was 
introduced  about  1760  by  Richard  Brocklesby.  A  number  of  narcotic  drugs  like 
conium,   stramonium.   Pulsatilla,   clematis,   hyoscyamus,   colchicum   and  others  were 


—  720  — 

investigated  by  Stoerck  (1760)  and  recommended  for  use,  while  the  aqua  laurocerasi 
was  investigated  by  William  Baylies  (died  17(17),  and  the  oleum  amygdalae  am  arse  by 
Martin  Poli  (died  1714)  in  Rome.  Digitalis  was  administered  in  dropsj'  by  Charles 
Darwin  (died  1778;  son  of  Erasmus  Darwin),  though  the  attention  of  t lie  pro- 
fession was  first  prominently  directed  to  the  duretie  and  cardiac  activity  of  this 
drug  bj-  Win.  Withering  (1741-1799)  of  Birmingham  (1785).  Catechu  and  kino 
(Fothergill),  colombo  (Gaub),  quassia  (Daniel  Rolander),  viola  tricolor  (Karl 
Strack).  and  senega  (Dr.  John  Tennent  of  Virginia,  17:56)  appeared  as  new  remedies. 
Acorns  were  recommended  by  Friedr.  Willi.  Jos.  Schroder,  professor  in  Marburg 
(  1771 1,  and  by  Marcus  Joseph  Marx  (  177(1).  The  internal  use  of  tar  in  diseases  of 
the  skin  and  in  gout  was  extolled  by  bishop  George  Berkeley  I  1684—1753),  and  the 
oil  of  turpentine  with  sulphuric  ether  for  gall-stones  by  .lean  Fr.  Durande  (died  1791) 
in  1770.  Arsenic  in  solution  —  the  aqua  Toffana,  so  named  after  Toffa,  a  female 
poisoner  executed  at  Naples  in  170!',  was  such  a  solution  —  was  prepared  by  Thomas 
Fowler  (1736-1801)  and  employed  (after  the  example  of  Dioscorides,  Cselius  Aure- 
lianus  and  the  Arabians  —  Marx)  by  Slevogt  (1700),  Fowler  (1786),  Adair  (1784)  and 
others.  Sulphuric  ether  with  alcohol  was  introduced  by  Hoffmann,  the  opodeldoc1 
of  the  English  by  Dr.  Steer,  the  employment  of  cooking  salt  in  haemoptysis  (common 
among  the  Ancients)  was  revived  by  Chr.  Fr.  Michaelis,  acetate  of  lead  was  intro- 
duced by  Goulard  (1760),  corrosive  sublimate  by  van  Swieten  and  Sanchez  and 
mercurius  solubilis  by  Hahnemann.  Nitrate  of  silver  was  recommended  in  epilep.-y. 
phosphorus  (Mentz  in  Langensalza)  and  phosphoric  acid  (Lentin)  inorganic  acids 
(especially  muriatic  and  nitric,  even  for  syphilis1.  Alkalis  and  alkaline  earths  were 
better  tested,  oxygen  and  carbonic  acid  were  likewise  employed  as  remedies  by 
inhalation.      Gastric  juice  was  employed  externally  for  ulcers  etc.  etc. 

Three  remedies,  or  rather  three  therapeutic  methods,  require  to  be 
more  carefully  considered,  since  two  of  them  during  the  18th  century 
began  to  be  methodically  and  generally  employed  and  scientifically  studied, 
and  the  third  was  revived  in  a  new  form. 

We  have  already  stated  that  the  Ancients,  from  the  day.-  of  the  Asclepiadse, 
employed  the  waters  of  healing  springs,  i.  e.  mineral  waters,  though  not  frequently — 
Archigenes  had  the  patient  drink  as  much  as  fifteen  pints  for  the  relief  of  stone. 
Indeed  waters  were  even  classified  according  to  their  constituents  as  alum-waters. 
sulphur-waters,  chalybeate  waters,  bituminous  water.-  etc.  We  have  also  seen  that 
the  Italian  physicians  of  the  last  half  of  the  Middle  Ages  prescribed  these  waters,  and 
Giac.  de  Dondi  e.  g.  did  a  notable  business  in  the  salts  obtained  by  evaporation  from 
the  waters  of  Abano.  At  a  later  period  mineral  waters  were  drunk  still  more  fre- 
quently, indeed  in  considerable  quantities,  for  at  that,  time,  even  more  than  to-day.  the 
excellence  and  efficacy  of  the  water  was  judged  by  its  strength,  particularly  its 
cathartic  effects.  Paracelsus  exercised  a  great  influence  upon  the  theory  and  employ- 
ment, of  mineral  springs  (particularly  those  of  Pfeffers,  Gastein  etc.),  and  it  is  one  of 
his  chief  services  that  he  subjected  the  learned  medicine  of  his  day  (which  thought 
itself  safe  only  in  guilds  and  study-rooms'  to  the  test  of  living  observation  and  actual 
life,  and  employed  chemistry  in  medicine,  particularly  also  as  it  related  to  the 
question  of  mineral  springs  As  the  science  of  chemistry  itself  was  improved,  the 
subject   of  mineral   waters   likewise   enjoyed   increasing  attention.      Thus   in   the  Kith 


1.  "  Oppodeltoch  "  is  the  original  orthography  of  Paracelsus,  from  whom  we  have 
inherited  the  term.  He  employed  it  to  represent  a  plaster,  and  the  "Opodeldoc" 
of  the  B.  P.  was  of  a  soft,  semi-solid  consistence,  the  Linimentum  Saponis  Cam- 
phoratum  of  the  IT.  S.  Pharm.  (1850).    (H.) 


—  721   — 

century  Joh.  Bauhin  (1543-1613),  professor  in  Basel,  and  Aridr.  Baccius  in  France, 
occupied  themselves,  among  others,  with  this  subject.  I n  the  17th  century,  so  devoted 
to  the  natural  sciences  and  so  extraordinarily  inquisitive,  many  persons  devoted 
themselves  to  investigations  relative  to  mineral  waters,  as  e.  g.  van  Helmont,  Liba- 
vius,  Boyle,  Lister,  Robert  Pierce  (11)90).  Urban  Hjarne  (1641-1724)  of  Stockholm, 
Duclos  and  Bourdelin,  who  in  1G70  investigated  the  French  mineral  waters  etc.  The 
states  too  began  to  meet  the  abuses  which  had  crept  into  the  baths  by  ordinances  for 
their  regulation,  for  governments  generally,  during  the  Kith  and  17th  centuries,  began 
to  interfere,  in  a  manner  which  to  us  of  the  present  day  seems  too  severe  and  stiict, 
against  the  immorality  and  insubordination,  the  debauchery,  dissipation  etc.  which 
originated  in  the  Middle  Ages  and  the  Thirty  Years'  War. 

The  pioneer  and  chief*  promoter  of  the  study  of  the  mineral  waters, 
and  the  physician  whose  intiuence  was  longest  felt  in  this  subject,  was 
Friedrich  Hoffmann,  who  from  the  outset  of  his  career,  at  the  instigation 
of  Boyle,  turned  his  attention  to  their  anatysis  and  uses.  At  least  as  early 
as  1684  he  wrote  on  the  healing  springs  of  Herrnhausen  in  the  principality 
of  Halberstadt. 

Hoffmann  gave  prescriptions  for  the  use  of  mineral  waters,  even  taught  how 
they  could  be  imitated  artificially,  and  analyzed  many  German  springs,  coming 
finally  to  the  conclusion  that  solid  constituents,  such  as  lime,  magnesia  etc.,  in  the 
form  of  an  alkali  and  carbonic  acid,  existed  in  almost  all  mineral  springs.  He  him- 
self examined  the  waters  of  Aix-la-Chapelle.  Bibra,  Carlsbad.  Lauchs.tadt,  Pynnont, 
Seydlitz  (its  salt  he  highly  recommended),  Selters.  Schwalbach,  Spaa,  Teplitz  and 
Wiesbaden.  —  The  fabulous  "  Brunnengeister  ",  however,  still  played  a  part  during 
the  whole  century,  although  by  the  aid  of  chemistry  a  more  tangible  form  for  these 
imponderable  agents  was  facilitated. 

Stahl  opposed  the  general  employment  of  mineral  waters  recommended  by 
Hoffmann,  though  he  did  not  question  their  utility  in  certain  cases.  ("Untersuchung 
der  iibel  kurirten  and  verderbten  Krankheiten  ",  Leipzig.  1726.) 

Torbern  Bergmann.  (1735-1784), 
who  was  the  first  to  lay  down  the  doctrine  of  double  elective  affinity  in  1775,  devoted 
his   attention  to  the   mineral   waters  of  Sweden  and  Denmark,    and  also  taught   the 
artificial  preparation  of  warm  and  cold  mineral  waters. 

Cranz  made  numerous  examinations  of  the  mineral  waters  of  Austria,  while  the 
Berlin  physician  Joh.  Friedr.  Ziickert  (1768)  wrote  on  those  of  Germany.  The 
springs  of  England  were  studied  by  John  Elliot  (1747-1787),  author  of  "An  account 
of  the  nature  and  medicinal  virtues  of  the  principal  mineral  waters  in  Great  Britain 
and  Ireland"  etc..  London,  1781,  and  Donald  Monro  i  1729-1792)  in  his  "  Treatise 
on  mineral  waters",  1770.  [Benjamin  Allen  (1700),  Ed.  Baynard  (Bath,  1702),  Win. 
Oliver  (Bath,  1707),  Thos.  Short  (Scarborough,  1734),  Wm.  Hillary  (Lincomb,  1743), 
Peter  Shaw  (Scarborough,  1756),  Chas.  Lucas  (Bath  etc.,  1704),  Dale  Ingram  (Epsom, 
1768),  Jas.  Johnstone  (Welton,  1787),  John  Ash  (Spaa  etc.,  1788).  John  Nott  (1793) 
Robert  Graves  (1792),  John  Rutty  (1757)  and  numerous  others  also  discussed  the 
various  mineral  waters  of  England  and  the  Continent.]  The  mineral  springs  of 
France  were  investigated  by  Jos.  Barth.  Franc,  Carrere,  Bern,  Peyrilhe  and  others. 
Sea-baths  were  recommended  in  Germany  by  S.  (1.  Yogel  (1794),  [and 
in  England  treatises  on  sea  bathing  were  written  by  Thomas  Reid  (179")). 
a  physician  of  Bath,  and  Alex.  Peter  Buchan  of  London  (1801).] 

The  first  resort  for  sea-bathing  established  in  Germany  was  that  of  Doberan  in 
1791.     This  was  followed  by  Norderney  in  1797  and  Travemiinde  in  1800. 
4IJ 


The  use  of  ordinary  water  as  a  remedial  drink  and  in  the  form  of 
(cold  and  tepid)  lavations  and  baths  for  the  cure  of  diseases,  especially 
those  of  a  febrile  character,  first  made  its  way  into  German  practice  in  the 
18th  century,  though  it  had  been  in  use  among  other  nations  at  an  earlier 
period. 

Even  Hippocrates  permitted  baths  in  febrile  diseases,  though  rather  tepid  baths 
than  cold.  He  was  particularly  fond  of  these  in  pneumonia,  to  mitigate  the  pain  and 
facilitate  expectoration  and  respiration.  We  know  too  that  Musa  cured  the  emperor 
Augustus  by  means  of  cold  baths,  after  warm  baths  had  failed  to  produce  any  benefit. 
Asclepiades,  Charmis  of  Marseilles,  Agathinus,  Herodotus,  Celsus,  Aretaus,  /Etius 
and  others,  likewise  employed  cold  water,  most  frequently  in  the  form  of  affusions  in 
the  case  of  epileptics  and  lethargic  patients,  and  as  lavations  and  cold  dressings  upon 
the  head  in  typhus.  Galen,  like  Hippocrates,  was  no  great  friend  of  cold  lavations 
and  baths,  though  he  employed  the  former  in  the  fevers  of  young  people,  excluding 
hectic  fever. — Among  the  Arabians  Rhazes  recommended  cold  lavation  and  dipping 
in  cold  water  in  cases  of  small-pox  and  measles.  Avicenna  followed  Galen,  and 
regulated  his  employment  of  cold  in  accordance  with  the  age,  constitution  and  s-eason 
of  the  year.1 

Michael  Savonarala  (1424),  who  was  likewise  a  writer  on  balneology,  was  the 
first  to  recommend  the  douche.  He  was  followed  by  Mengo  Bianchelli,  Christoforo 
Barzizi  (1450),  Cardanus  and  others  Paracelsus  had  his  lrydrophobic  patients 
dipped  in  cold  water,  in  order  to  rid  them  of  their  aversion  to  it!  Lud.  Settala 
introduced  cold  affusions.  After  him  the  drinking  of  cold  water  was  recommended 
by  Agostino  Magliari  and  Rovida  in  Naples,  while  Fra  Bernardo  Maria  de  Castro- 
giane  (Fra  Bernardo)  gave  cold  enemata.  Cold  water  baths  were  adopted  in  treat- 
ment by  Giac.  Todaro  (the  medicus  per  aquam),  Nic.  Crescendo  (1727)  in  Naples  at 
the  beginning  of  the  18th  century,  and  subsequently  by  Mich.  Sarcone  and  Nic 
Cirillo,  professor  in  Naples  in  1732,  and  others.  —  In  England  Sir  John  Floyer 
recommended  the  use  of  cold  baths  in  his  "  Psychrolusia  ",  1702,  a  work  which  refers 
the  origin  of  the  watercure  S37stem  to  baptism,  and  finds  the  cause  of  rachitis  in  the 
fact  that  children  in  baptism  were  no  longer  plunged  into  the  water  in  pious  England, 
but  simply  had  their  heads  wet,'  This  book  survived  numerous  editions.  After 
Floyer,  George  Cheyne  (1671-1748)  and  Mead  praised  cold  water,  the  latter  employ- 
ing plunge-baths  in  the  treatment  of  the  insane.  Smith  (1721)  employed  cold  water 
to  strengthen  the  constitution  of  even  small  children,  while  John  Hancock,  a  clergy- 
mau,  in  his  "Febrifugum  magnum,  or  common  water  the  best  cure  for  fevers", 
London,  1723,  recommended  it  in  measles  and  all  febrile  diseases.  Subsequently  the 
subject  of  the  water-cure  was  discussed  by  William  Buchan  (1729-1805),  William 
Wright  (1735-1819)  in  Barbadoes  (at  the  instance  of  Currie),  Robert  Jackson  (1798), 
Joseph  Brandreth  (1791)  and  ('has.  MacLean  (1797). 

In  Germany  the  drinking  of  cold  water  and  the  use  of  cold  baths  was 
recommended  by  Friedrich  Hoffmann  in  1712, 

"  in  order  to  restore  to  the  solid  parts,  both  external  and  internal,  e.  g.  the  stomach, 
their  fresh  and  elastic  motility". 


1.  Even  the  American  Indians  dip  patients  suffering  from  yellow  fever  into  cold 
water. 

?.  Floyer's  work  was  originally  entitled  "An  inquiry  into  the  right  use  of  the  hot, 
cold  and  temperate  baths  in  England",  and  appeared  at  London  in  1097.  It  was 
republished  in  1702  under  the  title  "Ancient  Psychrolusy  revived".     (H.) 


The  proper  cold-water  epoch  of  the  18th  century  began,  however,  with 
the  £(  Unterricht  von  der  wunderbaren  Heilkraft  des  frischen  Wassers" 
(]770)  of  the  Silesian  physician  Joh.  Siegismund  Hahn  (1696-1773),  son 
of  the  Dr.  Siegismund  Hahn  (1664-1742)  in  Schweidnitz,  who  already 
employed  cold  water. 

Dr.  J.  S.  Hahn  recommended  cold  lavations  in  febrile  diseases,  scarlet  fever, 
erysipelas,  small-pox  etc.  Cold  lavations  he  called  the  "  kleine  Gerathschaft  ";  sitz- 
baths  in  tabs  of  cold  water,  the  ''<;ros.se  Gerathschaft",  and  the  complete  cold 
bath,  the  "grosste  Gerathschaft  ".  — Gottfried  Hahn.  the  brother  of  J.  S.  Hahn,  was 
likewise  a  representative  of  cold-water  therapeutics  in  febrile  diseases,  a  system 
recently  revived  by  Ernst  Brand  in  Stettin  (Die  Hydrotherapic  des  Typhus,   1861). 

The  modern  method  of  employing  cold  water,  i.  e.  that  method  which 
takes  into  consideration  the  amount  of  heat  abstracted,  was  first  employed 
in  England  (1797)  by 

James  Currie  (1750-1805). 
a  physician  of  Liverpool,  who  had  been  originally  a  merchant  in  America.  He 
employed  cold  affusions  in  all  acute  diseases,  but  particularly  in  typhus,  in  which 
disease  he  regarded  them  as  the  most  efficacious  remedy,  as  we  do  again  at  the 
present  day.  He  preferred  sea-water  or  water  mixed  with  vinegar,  and  proceeded  as 
follows:  a  stream  of  water  from  a  large  vessel  was  poured  over  the  naked  patient; 
the  higher  the  temperature  of  the  patient  as  determined  by  the  thermometer,  the 
colder  was  the  water  and  the  more  frequent  the  affusions.  Even  in  acute  diseases 
like  scarlet  fever  with  diphtheria,  measles,  in  inoculations  etc.  he  employed  his 
method.  [Curries  observations  were  contained  in  his  work  "  Medical  reports  on  the 
effects  of  water,  cold  and  warm,  as  a  remedy  in  febrile  diseases"  etc.,  Liverpool,  1797.] 
influenced  by  his  experience  James  Gregory,  Win.  Falconer,  Baron  Thos.  Dims 
dale.  James  Home,  John  Clark'.  Thos.  Bateman  and  others  employed  Carrie's  treat- 
ment in  acute  diseases. 

In  France  the  cold-water  system  found  little  sympathy,  though  the 
drinking  of  cold  water  was  employed  ( 1721)  by  Etienne  Franc.  Geoffroy 
in  the  oriental  plague  at  Marseilles.  "  Cold  water  may  be  considered  a  universal 
remedy,  good  for  all  diseases  in  general,  and  for  the  plague  in  particular,  easy  to  find 
and  to  apply.  It  has  no  other  fault  than  that  of  being  too  common  and  too  well 
known,  and  therefore  too  little  used"  —  a  remark  which  indicates  a  cold  water 
enthusiasm  appropriate  only  to  our  own  century. 

Pierre  Noguez  (1725)  recommended  cold  baths  in  acute  rheumatic  and  catarrhal 
diseases,  in  pleurisy  and  pneumonia,  and  likewise  in  chronic  troubles,  where  they 
were  also  commended  by  Dr.  Pomme.  Finally  Tissot  praised  them  in  nervous 
debility  and  defective  transpiration,  in  case  the  air  was  dreaded. 

The  enthusiasm  over  the  cold-water  treatment  made  its  way  even  to  Spain,  where 
the  Dr,  Sangrado,  famous  in  his  own  way  and  well-known  from  Gil  Bias,  lapsed  into 
the  new  method. 

Electricity  (particularly  that  of  amber)  was  known  at  an  early  period, 
and  lightning-rods  were  employed  b}'  the  Egyptians  as  early  as  B.  C.  1500. 
These,  as  stated  by  Dummichen,  consisted  of  high  poles  tipped  with  copper 
and  gilded.  That  electricity  was  also  employed  at  an  early  period  in  the 
treatment  of  disease  is  shown  hy  the  fact  that  Scribonius  Largus  (A.  I).  43) 
had  the  torpedo  applied  to  patients  suffering  from  protracted  headaches. 


—  724  — 

But  it  was  not  until  the  discover}'  of  the  electric  spark  by  Guericke,  his 
invention  of  the  electric  machine,  and  particularly  the  studies  upon  elec- 
tricity made  Iry  Francis  Ilawksbee  (died  17 13),  that  the  effort  to  employ 
electricity  upon  man  was  renewed  (172!))  by  Stephen  Gray.  After  the 
invention  of  the  Leyden  jar  in  the  year  174.").  Musschenbroek  (1692-1761  ) 
experimented  with  the  same,  and  Andr.  Gordon,  a  professor  and  Benedic- 
tine monk  in  Erfurt,  electrised  animals  (1745).  All  these  were,  however, 
merely  preliminary  researches,  and 

Christ.  GrOTTL.  Kratzenstein  (1723-17!»5)  of  Wernigerode,  pro- 
fessor in  Copenhagen,  was  the  first  who  employed  electricity  to  cure 
weakness  and  paralyses,  though  J.  A.  Xollet  (1700-1744)  and  professor 
Jallabert  of  Montpellier  had  already  used  it  in  such  cases,  without  finding 
its  curative  effect  specially  reliable.  A  fashionable  mode  of  treatment  was 
speedily  made  out  of  electricity,  and  its  use  was  at  once  extended  to  all 
nervous  troubles,  (just  as  we  see  again  to-day).  A  perfect  flood  of  writings 
in  favor  of,  and  also  against,  its  use  made  its  appearance,  while  we  of 
the  present  day  can  as  yet  record  only  those  which  favor  its  employment. 

Among  the  votaries  of  the  fashionable  remedy  were  Sauvages,  de  Haen,  Johann 
Gottl.  Schaeffer  (1720-1795;  father  of  Joh.  Ulrich  Gottl.  Schaeffer:  "Die  electrisehe 
Medicin  "  etc.,  1752)  in  Regensburg.  to  whom  it  seemed  that  he  was  living  in  an 
electric  age  (what  would  he  have  said  had  he  survived  to  see  our  present  electrical 
epoch?);  William  Watson  (1715-1788),  Floyer  and  others.  Haller,  William  Rowley, 
professor  in  Oxford,  and  many  of  the  sober  English  were  active  opponents. 

The  electric  bath  was  introduced  as  a  remedial  agent  by  Gottl.  Friedr. 
Rosslev  (17G8),  and  the  electrometer  by  J.  Friedr.  Hartmann  (1770). 

Mauduyt  in  1777  employed  electricity  in  the  treatment  of  amblyopia.  The 
same  agent  was  also  used  even  by  Charles  Darwin  in  the  treatment  of  jaundice,  and 
again  by  C.  Gerhardt,  professor  in  Wur/.burg  and  subsequently  in  Rerlin.  Whether, 
however,  Darwin  was  as  successful  in  his  results  as  Gerhardt  was  in  four  cases  only, 
is  not  stated.  Hnfeland  subsequently  recommended  electricity  for  the  relief  of 
asphyxia  in  the  new-born  and  in  children,  advising  that  one  pole  should  be  placed 
upon  the  nape  of  the  neck,  the  other  upon  the  pit  of  the  stomach,  i.  e.  over  the 
diaphragm. 

The  electric  treatment  found  in  that  day  more  severe  critics  than  our 
iatro-physical  treatment.     Tims  Wichmann,  as  early  as  1765,  wrote  : 

"  There  are  fashions  in  medicine,  and  every  physician  must  be  their  slave.  .  .  . 
X<\v  remedies  seldom  work  as  well  for  another  as  for  their  discoverer.  .  .  .  Eighteen 
years  ago  it  was  the  fashion  in  all  Europe  to  electrise  paralytic  patients,  but  the 
fashion  only  lasted  nine  years.  Medical  fashions  generally  agree  with  other  fashions 
in  going  out  of  use  ordinarily  after  nine  or  ten  years.  The  fashions  too  which  pre- 
vailed .")0-40  years  ago  are  returning,  e.  g.  the  high  coiffures  (which  seem  at  that 
period  to  have  been  classed  with  the  use  of  electricity).  The  same  is  the  case  with 
electricity.  The  most  modern  and  popular  fashion  among  the  doctors  is  the  treat- 
ment bjr  the  magnet."     (Rohlfs.) 

Friedrich  Willi.  Klarieh.  the  physikus  in  Guttingen,  was  the  first  who  had 
'' extremely  favorable  "  results  with  this  latter  instrument  in  130  cases.  Unzer  and 
J.  A.  Heinsius,  however,  did  not  permit  themselves  to  be  carried  away  by  the  new 
enthusiasm.     Mesmer  originally   trod    the   stage  of  the  mountebank  with   the   same 


—  7^0  — 

agent,  and  then  went  over  to  the  absolute  humbug  of  animal  magnetism,  an  absurdity 
by  which,  as  we  have  seen,  even  men  of  importance  allowed  themselves  to  be  taken  in. 

Climatic  Treatment 

began  to  become  popular.  This  was  in  vogue  even  among  the  Ancients,  and  partic- 
ularly for  consumption.  Galen  e.  g.  recommended  mountain  air  in  consequence  of 
its  greater  dryness,  while  Antyllus  and  ^Etius  advised  lofty  localities,  i.  e.  rarified  air, 
in  this  disease  (Thomas).  In  like  manner  Tissot  and  Peter  Frank  recommended 
residence  in  the  Apennines,  and  Mayer  in  Arbon,  as  early  as  1741,  used  to  send 
patients  to  Appenzell  for  the  purpose  of  drinking  milk,  a  method  of  treatment  also 
practised  among  the  Ancients  and  during  the  Middle  Ages. 

Pharmacy 

•during  the  18th  century  did  not  make  those  great  advances  which  the 
development  of  its  subsidiary  sciences  —  chemistry,  botany  etc. — might 
have  enabled  it  to  attain.  On  the  whole,  botli  the  ancient  remedies  and 
the  methods  of  preparation  of  preceding  centuries  remained  in  vogue, 
together  with  their  innumerable  compound  preparations,  so  that  the 
pharmacies  still  resembled  considerably  a  witches'  kitchen.  Yet  a  new  era 
was  preparing  and  a  new  road  was  being  laid  out,  since  men  of  importance 
dedicated  their  powers  to  the  reorganization  of  this  branch.  The  fact  that 
academic  instruction  was  now  imparted  to  the  apothecaries  (though  at 
first  in  Prussia  and  France  only)  was  one  of  great  importance. 

The  Hollander 

Joh.  Conr.  Barchusen  (1  t!6G-1723), 
professor  in  Utrecht,  who  has  been  already  mentioned  as  an  historian,  and  who  was  a 
famous  authority  in  pharmacognosy  and  pharmaceutic  chemistry,  as  well  as  "the 
founder  of  chemical  pharmacognosy",  rendered  important  services  to  pharmacy. 

Caspar  Neumann  (1683-1737).  the  first  scientific  apothecary  in 
Germany,  wrote  also  in  German  and  was  the  founder  of  a  German 
pharmacy. 

Neumann  was  the  son  of  a  merchant  in  Zullichau,  and  was  originally  designed 
for  the  ministry,  but  at  the  age  of  twelve  years  entered  an  apothecary's  shop  as  an 
apprentice.  Subsequently  he  came  to  Berlin  and  attained  the  position  of  "  Reise- 
apotheker"  of  Frederick  I.  (1657-171;!  i,  to  whom  he  had  recommended  himself  by 
his  musical  talents.  In  1711  the  king  sent  him  upon  scientific  travels  through 
Germany,  Holland  and  England.  After  the  death  of  his  patron,  through  the  influence 
of  the  notorious  body-physician  Gundelsheimer,  Neumann  had  his  discharge  handed 
to  him  in  London.  Left  thus  without,  means,  he  was  maintained  by  a  painter  until 
he  secured  his  own  support  by  an  engagement  in  the  laboratory  of  a  physician.  Five 
years  later  he  went  with  Georire  I.  (1669-1727)  to  Hanover,  and  from  that  place 
•visited  Berlin  and  Stahl,  the  physician-in-ordinary  of  Frederick  William  I.  (1688-1740  I. 
The  latter  physician  secured  for  him  again  a  salarj-  to  travel,  and  with  the  aid  of  this 
Neumann  once  more  visited  England,  France  and  Italy.  In  1723  he  was  appointed 
professor  of  practical  chemistry  in  the  medico-chirurgical  college,  and  a  year  later  a 
member  of  the  Obercollegium  medicum.  He  likewise  received  the  oversight  of  the 
entire  Prussian  apothecary-department,  and  was  provided  with  other  civil  and 
academic  honors.  Neumann  was  a  fruitful  writer,  and  amonj.'  his  works  was  a  treatise 
entitled  "  Griindliche*und]mit  Experimenten  erwiesene  medicinische  Chemie". 


—  720  — 

After  the  death  of  Neumann  his  place  as  professor  in  the  Obereollegium  medicum 
was  filled  by 

Jon.  Heinrich  Pott  (1 692-1 777)  of  Halberstadt. 

Among  Neumann's  teachers  in  France  were  the  famous  apothecaries  and  chemists 
Ktienne  (1672-1731)  and  Claude  Jos.  Geoffroy  (1686-1752)  in  Paris,  who  brought 
forward  the  doctrine  of  elective  affinity  —  a  doctrine  so  important  that  it  was  em- 
ployed metaphorically  e.  g.  by  Gothe  —  and  in  171s  drew  up  the  first  table  of 
affinities. 

The  services  of  .Murray  we  have  already  mentioned.     Quite  level  with  him   stood 

Andr.  Sigisai.  Marggraf  (1709-1782)  of  Berlin, 
the  pharmaceutical  chemist,  discoverer  of  phosphoric  acid,  the  identity  of  cane  ami 
beet  sugar,1  and  numerous  other  bodies.     He  was  likewise  a  member,  and  director  of 
the  physical  class,  of  the  Academic. 

Joh.  Christian  Wiegleb  (1732-1800), 
an  apothecary  in   Langensalza,  is  important  as  an  historian   of   chemistry  and   the 
author  of  a  "deutschen  Apothekerbuchs  nach  neueren  und  riehtigeren  Kenntnissen  in 
der  Pharmakologie  ". 

Joh.  Georg  Model  (1711-1775), 
was  chief  apothecary  in  St.  Petersburg.     The  Swede 

Carl  Wilhelm  Scheele  (1742-1786), 
born  in  Stralsund  (at  that  time  still  belonging  to  Sweden  I,  died  in  Koping  in  Sweden, 
attained  a  world-wide  fame.     He  was  the  discoverer  of  oxygen  and  nitrogen,  tartaric 
acid,  baryta,  chlorine,  arsenious  acid,  oxalic  acid,   uric  acid,   lactic  acid   (according 
to  others  discovered  by  Berzelius)  etc.     His  countryman,  already  mentioned, 

Torbern  Bergmann  (1735-1784)  of  Catharinenborg  in  Westgothland, 
teacher  of  chemistry  iti  Upsala,  enjoyed  no  less  fame.  His  chief  services  were 
rendered  in  the  study  of  inorganic  bodies  and  preparations. 

Among  the  French  chemists  and  pharmaceutists  —  almost  all  famous  chemists 
in  the  18th  century  had  been  apothecaries,  as  in  the  17th  and  16th  centuries  they 
were  physicians — we  may  mention: 

Jean  Franc.  Demacht  (1728-1803), 

director  of  the  apothecaries  of  the  civil  hospitals  in  Paris; 

Antoine  Baume  (1728-1804)  in  Paris, 
teacher  in  the  College  de  Pharmacie; 

Pierre  Jos.  Macqder  (1718-1784), 

professor  of  chemistry  in  the  Jardin  des  Plantes  and  a  member  of  the  medical  faculty  : 

Lavoisier  : 

GlJYTON  DE  MORVEAU  (1737-1816), 
who  first  recommended  chlorine  fumigations  as  a  disinfectant. 
In  England  the  world  famed 
Priestley  and 
Henry  Cavendish  (1731-1810), 

the  discoverer  of  the  composition  of  water,  distinguished  themselves. 

Among  the  Germans  who  rendered  service  to  pharmacy  we  should  add  ; 

Martin  Heinrich  Klaproth  (1743-1817) 

professor  in  Berlin  ; 

1.  His  pupil  C.  A chard  (1753-1821)  introduced  the  fabrication  of  this  sugar,  which  at 
the  present  day  has  become  dietetically  so  important. 


Joh.  Friedr.  Aug.  Gottling  (1755-1809), 

professor  in  Jena; 

Joh.  Friedr.  Gmelin  (1748-1804)  in  Tubingen  ; 
Carl  Gottfr.  Hagen  (1749-1829)  in  Kbnigsberg  ; 

the  "  Nestor  of  German  pharmacy" 

Joh.  Barthol.  Tromsdorpf  (1770-1837), 

professor  in  Erfurt,  where  in  17'J5  he  opened  the  first  "  Pharmaceutical  Institute"  in 
Germany. 

Many  other  eminent  apothecaries,  chemists  and  physicians,  who,  like  Staid, 
Hoffmann  and  others,  occupied  their  attention  with  pharmaceutical  matters,  might 
he  named  as  promoters  of  the  apothecary's  art.  But  a  more  detailed  enumeration  of 
them  would  not  correspond  with  the  plan  of  this  sketch,  and  for  a  more  intimate 
study  of  this  subject  the  reader  is  referred  to  the  works  of  the  historians  of  chemistry 
and  pharmacy,  Wiegleb  and  Gmelin,  who  belong  to  the  18th  century,  and  to  the  work 
of  Ferd.  Jac.  Baier  (1707-1798)  in  Altdorf,  on  the  subject  of  famous  apothecaries. 

9,    EPIDEMIC  DISEASES. 

Great  epidemics  have  ever  had,  on  "the  whole,  the"  same  significance  in 
the  development  of  medical  science  and  art.  as  great  wars  in  the  devel- 
opment of  the  science  of  war.  Indeed  their  importance  is  sometimes  still 
more  profound,  since  epidemics  often  serve  to  demonstrate  the  power- 
lessness  of  prevailing  methods  of  treatment,  and  the  falsity  and  error  of 
highly  prized  theories,  indeed  of  the  foundations  of  accepted  science.  They 
aid  not  rarely  in  overthrowing  entire  phases  of  past  development.  Such 
was  the  case  e.  g.  with  the  appearance  of  syphilis,  and  subsequently  with 
that  of  the  cholera,  which  set  aside  the  preceding  tendencies  of  medicine 
and  brought  about  the  supremacy  of  the  French  pathologi co-anatomical 
school.  And  although  the  epidemics  prevailing  during  the  18th  century 
did  not  result  in  a  complete  revolution  in  the  medical  world,  they  vet 
stirred  it  up  to  productiveness  and  created  new  problems  for  investigation 
and  for  treatment. 

The  bubo-plague,  "  the  disease  of  barbarism  "  and  especially  of  declining  nations, 
in  the  18th  century  still  often  reached  the  north  of  Europe,  though  it  maintained  its 
chief  focus  and  headquarters  in  the  south-west.  Thus  from  17(K!  forward,  as  the 
result  of  the  Russo-Swedish  war,  it  spread  from  Turkey  to  Sweden.  Denmark,  Poland 
and  Prussia,  so  that  in  1709  the  coldest  year  of  the  18th  century,  more  than  300,000 
human  beings  died  in  East  Prussia  in  spite  of  the  intense  cold,  and  in  Dantzic  alone- 
more  than  !i0,000.  Obliquing  to  the  west  the  plague  reached  Styria  and  Bohemia, 
and  was  carried  by  a  ship  to  Regensburg  in  1714,  but  by  means  of  strict  quarantine 
regulations  was  prevented  from  spreading  to  the  rest  of  Germany.  A  hurricane 
swept  the  disease,  as  it  were,  out  of  all  Europe.  Yet  six  years  later  it  appeared 
anew  with  devastating  force  in  southern  France.  The  epidemics  of  lTilT  in  the 
Ukraine.  174:5  in  Messina,  1753-57  in  Transylvania.  1783  in  Cherson  'observed  by 
Howard,  to  whom  it  also  proved  fatal ),  and  those  in  Volhynia  and  Slavonia  in  the 
last  decennium  of  the  century,  were  less  severe.  The  plague  raged  with  almost  its 
worst  severity  in  Moscow  in  the  years  1770-71,  and  this  epidemic  found  its  Thucyd- 
ides  in  Gustav  Orraus  (1789-1811),  a  Finlander  and  the  first  doctor  who  graduated 
in    Russia.     He    was    compelled   by   Catharine   II.  to  answer  with   his  head   for  the 


—  728  — 

correctness  of  his  diagnosis  of  the  disease.  Of  230,000  inhabitants  there  died  more 
than  52,000,  and  in  September  alone  600-1000  per  day.  In  this  month  stupidity  and 
fanaticism  instigated  a  murderous  sedition  —  even  a  priest  was  murdered,  a  thing 
quite  unheard  of  in  Russia  —  and  the  physicians  were  threatened  until  the}"  were 
forced  to  save  themselves  by  Might.  Grape-shot  put  an  end  to  the  revolution,  but  not 
to  the  plague,  which  did  not  die  out  until  1774.  After  its  departure  nearly  1,000 
putrid  corpses,  which  the  rude  and  fanatical  populace  had  concealed,  were  discovered. 

Epidemics  of  typhus  fever  (called  "  Kriegs-,  Fleck-  or  Faulfieber",  and  by-  the 
masses  at  a  later  period  "  russisch-polnisches  Fieber")  showed  themselves  at  the 
beginning  of  the  century  in  small  numbers,  but  disappeared  before  the  plague.  From 
1733  forward,  however,  the  disease  appeared  again  in  the  train  of  the  wars,  as  e.  g.  in 
Prague  in  1742,  where  30,000  French  fell  victims  to  its  ravages.  It  appeared  also 
with  other  diseases  in  the  Seven  Years'  War.  In  1700  the  typhus  raged  with  murder- 
ous violence  in  the  vicinity  of  Mayence.  During  the  sixth  decennium  of  the  century 
it  visited  Spain.  France  and  Upper  Italy.  In  177m,  ils  the  so-called  "famine-typhus", 
it  ravaged  Saxony,  in  1783  Italy,  and  in  the  last  decennium  of  the  century  (an  epoch 
specially  distinguished  for  its  epidemics)  it  desolated  France,  the  borders  of  the 
Rhine,  the  Black  Forest,  Bavaria  and  Upper  Italy. 

Epidemics  of  "putrid  fever',  "gastric  fever",  "lingering  nervous  fever"  — the 
term  "nervous  fever"  originated  with  Willis  —  were  described,  and  they  were 
regarded  as  due  to  the  transition  of  the  "  asthenic-inflammatory"  into  the  'asthenic- 
putrid"  constitution,  of  the  "bilious"  into  the  "putrid  character",  or  to  the  "pre- 
dominance of  the  gastro-bilious,  atrabilious  or  catarrhal  element  ". 

Worm  fever",  of  which  there  were  subordinate  varieties,  as  e.  g.  febris  hyster- 
ico-verminosa,  was  observed  by   van  den  Bosch  in  1761-64. 

The  first  description  of  typhoid  fever  —  under  the  designation  of  "  Schleimfieber  " 
(morbus  mucosus)  —  appeared  in  the  18th  century,  and  was  due  substantially  to 
Roederer,  though  its  publication  was  made  by  his  pupil  Karl  Gottlob  Wagler  (1732- 
1778),  subsequently  a  professor  in  Braunschweig.1  They  described  the  disease  in 
17ti2,  and  were  the  first  (  Rohlfs)  to  utilize  the  pathological  anatomy  in  the  study  of 
an  entire  epidemic.  As  regards  its  etiology,  these  first  two  observers  already 
mention  the  contamination  of  the  springs  with  filthy  water.'-'  The  disease  was  sub- 
sequently described  by  Mich.  Sarcone  in  Naples,  John  Armstrong,  Campbell.  William 
Grant  and  Stoll. 

Malaria  in  the  last  century  still  gave  rise  to  great  epidemics.  Of  course  all  the 
conditions  of  life  favored  its  prevalence.  Thus  e.  g.  there  were  no  highroads,  and 
Gothe,  Haller,  Zimmermann  and  others  came  near  losing  their  lives  while  traveling, 
in  consequence  of  the  bad  roads.  Even  the  streets  of  most  cities  were  un paved  and 
saturated  with  the  droppings  of  animals  etc.,  while  drainage  and  the  regulation  of 
the  flow  of  streams  were  nowhere  thought  of.  Epidemics  of  malaria  were  diffused 
over  almost  all  Europe  in  1718-22,  1720-2*.  1748-49  etc.     They  prevailed  in  Germany. 


Of  course  it  is  very  difficult,  if  not  impossible,  to  indentify  precisely  many  of  the 
diseases  and  pathological  conditions  described  by  early  writers,  but  Hutchinson 
believes  that  observations  of  cases  of  typhoid  fever  are  to  be  found  in  the  writ- 
ings of  Van  den  Spieghel  (1624),  Dom.  Panaroli  (1652),  Willis,  Baglivi,  Sydenham, 
Lancisi,  Huxhani  (slow,  nervous  fever),  Sir  Rich.  Manningham  ifebricula  or  little 
fever.  1746),  Morgagni  and  Joh.  Christ-  Riedel  (1748),  all  of  which  anticipated 
those  of  Roederer.  The  latter,  however,  furnished  the  most  complete  and 
accurate  description  of  the  disease  which  had  yet  appeared.     (H.) 

11.  11.  Helcher,  a  practising  physician  in  Schweidnitz  and  the  precursor  of  the 
modern  ground-water  theory  of  Pettenkofer,  as  early  as  1714  associated  tlie  con- 
dition of  the  water  with  epidemics,  particularly  epidemics  of  the  plague. 


—  729  — 

France  and  Hungary  in  1  770-1772,  in  Holland  1779-81.     They  were  always  combined 
with  other  forms  of  fever,  to  which  they  imparted  their  peculiar  character. 

Dysenten"  prevailed  in  extensive  epidemics,  particularly  in  years  marked  by  hot 
dry  summers,  followed  by  humidity.  Such  an  epidemic  prevailed  throughout  all 
Germany  in  171!).  In  1727  Switzerland  was  ravaged,  in  1743  parts  of  Sweden,  in 
1750  northern  France  and  Switzerland,  in  1757-1759  and  1761-68  Westphalia,  1779-81 
almost  the  whole  of  northern  Europe;  in  1781!  Germany  was  again  chiefly  ravaged, 
in  1794  Flanders  and  Hanover,  and  1790-97  North  America.  Individual  cities  were 
particularly  scourged,  e.  g.  Eisenach  in  1728,  Rouen  in  1743,  Plymouth  1741, 
Nymwegen  1750,  Mayence  1757-59  etc. 

Ergotism  still  prevailed  in  many  places  during  the  18th  century,  both  epidem- 
ically and  sporadically.  It  appeared  as  an  epidemic  in  France  in  1709  and  1770-71, 
in  Germany  1710-17  and  1741.  It  showed  itself  in  the  gangrenous  form  particularly 
in  France  1709,  1710.  1747.  17«4,  1770-71;  in  Italy  1710.  in  Switzerland  1716-17. 
Under  the  form  of  convulsions  it  manifested  itself  especially  in  Germany,  and  in 
1700  in  Thuringia,  1702  in  Hanover.  Liineburg  and  Freiburg;  1710-17  in  Silesia  and 
Saxony  as  well  as  Schleswig-Holstein  :  1722-23  and  1736-37  in  Silesia,  Bohemia  and 
the  Mark;   in  northern  Germany  and  Westphalia  in  1741  :   on  the  Rhine  in  1756  etc. 

The  last  century  was  also  rich  in  pandemics,  epidemics  and  endemics  of 
influenza. 

"La  Grippe"  (influenza)  appeared  as  a  pandemic  throughout  almost  all  Europe 
in  the  years  1709,  1729,  1732.  1742.  anil  1788;  in  almost  all  America  in  1732,  1737, 
1751,  1772,  1781  and  1798;  throughout  the  entire  eastern  hemisphere  in  1781,  and  in 
the  entire  western  hemisphere  in  1701  and  1789:  throughout  Europe  and  America  in 
1707.  It  prevailed  as  an  epidemic  in  France  in  the  years  1737,  1775  and  1779:  in 
England  in  1758  and  1775,  and  in  Germany  in  1800.  Finally  it  appeared  as  an 
endemic  in  1775  in  Vienna  and  Klausthal,  1757  in  Boulogne,  1758  in  Lille  and  Paris, 
1780  in  St,  Petersburg,  1781  in  Wilna  etc. 

Hooping-cough  had  become  naturalized  everywhere  in  the  18th  century.  It 
prevailed  with  special  malignity  in  northern  countries  like  Denmark  and  Sweden,  in 
which  latter  kingdom  43,000  children  died  of  the  disease  in  1749-04. 

Diphtheria,  which  in  the  17th  century  had  showed  itself  almost  exclusively  in 
Spain  and  Italy,  was  observed  during  the  l^th  in  all  parts  of  the  world.  Thus  it 
appeared  in  Spain  in  1750,  1751  and  1764;  in  Portugal  1749,  1786;  in  France  1736-37, 
1745-47,  1748-58,  1774  and  1787 ;  in  Italy  1747;  on  the  Ionian  islands  1701;  in 
Switzerland  1752;  in  Germany  1752,  1755  and  1786;  in  Holland  1715,  1754,  1769-70; 
in  England  1744-48,  1790  and  1793;  in  Sweden  1755-62;  in  North  America  1752,  1775 
and  1799,  and  in  the  West  Indies  in  17s0. 

Epidemics  of  croup  prevailed  in  France  1740-49;  in  Sweden  1755-01  ;  in  Heil- 
bionn  1758:   in  Gottingen  1758  and  in  other  places. 

Epidemic  pneumonias  (bilious  and  putrid  pleuropneumonia)  prevailed  frequently 
and  widely  distributed  over  the  whole  world,  particularly  in  spring  and  winter.  Such 
was  the  case  in  France,  Switzerland,  Italy  and  Germany.  In  other  countries  they 
occurred  more  rarely  and  with  less  severity. 

Small-pox  had  attained  general  diffusion,  so  that  only  epidemics  of  special 
fatality  are  mentioned.  Thus  there  died  in  Paris  of  this  disease  in  1719  14.000 
human  beings,  and  it  prevailed  with  special  malignity  in  Tuscany  in  1704.  In  177C- 
71  a  pandemic  arose,  which  ravaged  especially  the  East  Indies,  so  that  tin  re  millions 
of  human  beings  died  there.  In  1766  and  1770  the  small-pox  raged  in  London; 
1749-1765  in  Sweden  (of  1,391,233  children,  144,194  died):  1769-70  in  Paris;  in 
Vienna  first  in  1763  and  again  in  1767,  on  which  occasion  the  wife  of  the  emperor 
died  of  the  disease,  while  Maria  Theresa  survived  it.     In  Kamschatka  in  1708-69  one 


—  730  — 

half  of  the  inhabitants  perished.  The  Iroquois  were  also  visited  by  the  disease.  The 
last  fourteen,  and  particularly  the  last  five,  years  of  the  18th  century  were  again 
marked  by  very  severe  outbreaks  of  this  disease. 

Scarlet  fever,  first  observed  in  the  17th  century,  had  already  gained  wide 
diffusion.  It  showed  itself  for  the  second  time  in  Breslau  in  the  year  1700;  in  Paris 
1707  and  1712;  five  years  later  in  Berlin,  Thuringia  (where  it  lasted  many  years), 
Florence  etc.  The  disease  made  a  pandemic  tour  embracing  both  hemispheres  from 
1770  down  into  our  own  century,  and  at  the  outset  and  towards  its  close  manifested 
a  peculiarly  malignant  form,  so  that  in  the  period  from  17!>.">  to  1805  it  is  said  that 
in  Saxony  alone  40,000  children  perished.  Adults  were  attacked  by  it. —  The 
distinction  between  scarlet  fever  and 

Measles  in  the  18th  century  was  still  very  unsatisfactory.  Epidemics  of  tie 
latter  disease  were  observed  among  the  negro  slaves  of  Brazil  in  1749,  and  were 
accompanied  with  very  great  mortality  owing  to  intestinal  disease.  The  disease  also 
prevailed  in  Lille  in  17J7.  Rouen  1732,  Erfurt  1778-79,  Erlangen  178:!,  Upper  Italy 
1786  and  throughout  almost  all  France,  Germany  and  England  from  1790  to  1801. 

Epidemic  erysipelas  was  also  mentioned  occasionally  during  the  18th  century, 
e.  g.  in  Naples  1700,  at  Caillan  in  Fiance  1750  and  in  Padua  1786. 

Observations  of  endemics  and  epidemics  of  puerperal  fever  were  multiplied. 
This  disease  ravaged  particularly  the  great  lying-in  institutions  ot  Paris,  London,1 
Copenhagen.  Dublin,  Edinburgh.  Berlin  etc.,  but  also  made  its  appearance  in  smaller 
places,  e.  g.  in  Gladenbach  near  Giessen  (where  mention  is  made  of  it  in  1784)  and 
other  localities. 

The  "miliary  fever"  was  originally  observed  only  among  lying-in  women  and 
sporadically  in  Middle  Germany,  and  first  in  the  17th  century,  but  in  the  ISth  century 
it  appeared  among  other  women  and  even  among  men,  particularly  in  France.  In 
Germany  it  was  first  described  by  Fr.  Hoffmann  for  Frankfort  in  the  year  172H. 
From  France  accounts  of  numerous  —  about  70  —  greater  and  lesser  epidemics 
during  the  18th  century  were  given.  These  advanced  gradually  from  the  Rhine  into 
the  interior.  They  prevailed  chiefly  in  summer  and  spring  very  few  in  the  winter. 
The  disease  also  showed  itself  in  Italy. 

Yellow  fever,  first  recognized  in  the  10th  century  and  mentioned  occasionally  in 
the  17th,  appeared  with  great  frequency  in  the  18th  century,  but  was  mostly  confined, 
as  at  a  later  period,  to  America.  Thus  of  the  greater  epidemics  of  this  disease  which 
have  been  described,  227  affected  America,  4o  Europe  and  4  Africa.  In  172!)  the 
yellow  fever  reached  Lisbon,  in  17o0  Carthagena,  \~'M  Cadiz,  1741  Malaga,  and  in 
1704  and  1780  it  again  prevailed  in  Cadiz.  In  the  last  decennium  of  the  preceding 
century,  however,  a  period  during  which,  as  already  mentioned,  epidemic  diseases  in 
general  reaped  a  reach  harvest,  yellow  fever  appeared  in  very  extensive  epidemics. 

10.    PROFESSIONAL  RELATIONS. 

The  ISth  century  is  justly  regarded  as  the  golden  age  of  the  medical 
profession.  This  is  true,  indeed,  in  a  higher  sense  than  ordinary,  but  it  is 
also  eminently  true  in  the  usual  sense  of  those  terms.  The  reasons  of  this 
fact  were  numerous.  First  and  foremost  we  may  claim  the  idealistic 
undertone  of  the  whole  century,  as  the  result  of  which  the  selection  and 
practice  of  scientific   vocations,   among  physicians   as   well   as   the   laity, 


1.  Edward  Strother  —  in  a  literary  sense  the  successor  of  Willis  —  described  puer- 
peral fever  as  a  special  form  of  fever  in  1718.  [The  first  edition  of  his  "Critical 
essay  on  fevers"  appeared  at  London  in  1716.     (H.)] 


—  731  — 

enjoyed  higher  esteem  than  it  does  at  the  present  day.  Medical  practice 
was  regarded  in  all  circles  as  a  matter  of  conscientious  vocation,  and  not 
as  one  of  the  higher  classes  of  business.  Most  members  of  the  medical 
profession  —  certainly  the  better  class  at  least  —  also  possessed,  or  at  least 
strove  to  attain,  a  universal  and  humanistic  education,  quite  in  contrast 
again  with  our  own  da}',  which,  with  rare  exceptions,  finds  its  pleasure, 
and  seeks  its  highest  object,  in  the  one-sided  education  of  special  branches. 
Hence  the  physicians  of  the  18th  century  almost  universally  strove,  with  a 
consummate  love  of  science,  to  gain  for  themselves  an  acquaintance  with 
all  the  special  medical  and  medico-technical  branches  of  knowledge. 

Upon  the  facts  just  mentioned  depended  not  only  the  high  self-respect 
of  the  physicians  themselves,  but  also  the  general  esteem  which  met  them 
everywhere.  To  this  must  be  added  as  a  further  factor  the  generally 
suitable  number  and  distribution  of  the  existing  physicians.  They  were 
not  so  scarce  as  to  render  their  services  unattainable,  nor  \-et  so  numerous 
that,  as  in  many  localities  to-day,  they  were  compelled  to  seek  their  daily 
subsistence  with  anxiety  or,  like  mountebanks,  with  advertisements  in  the 
newspapers,  and  thereby  render  themselves  the  absolute  slaves  of  the 
public.  For  all  these  reasons  the  physician  of  that  day  occupied  a  high 
position  socially.  The  public  did  not  regard  him  as  a  tradesman,  permitted 
to  work  only  so  long  as  he  gives  satisfaction  and  does  not  charge  too  much. 
Hence  it  resulted  that  among  his  clientele  he  was  looked  upon  rather  in 
the  light  of  a  family  friend,  than  as  a  mere  business  friend  —  the  popular 
idea  at  the  present  day.  The  frequent  change  of  physicians  was  a  thing 
entirely  unknown.  No  one  without  very  pressing  reasons  abandoned  his 
previous  physician.  Patients  very  rarely  made  pilgrimages  to  see  pro- 
fessors—  indeed  the  means  of  intercourse  were  so  defective  that  they 
could  not — -  and  the  professors  themselves  dared  not  prejudice  their  posi- 
tion as  teachers,  which  was  their  chief  reliance.  Moreover  the  practising 
physicians  did  not  regard  themselves  as  subordinate  to  the  professors  in 
practical  matters,  but,  on  the  contrary,  knew  that  they  were  in  these  their 
superiors.  Accordingly  we  can  readily  understand  that  the  position  of  the 
practising  physician  was  the  more  respected  and  trusted.  Most  physicians 
were  so-called  family  physicians  (Hausarzte).  who,  however,  did  not  secure 
their  clientele  for  one  or  more  years  for  a  stipulated  annual  payment  in 
gross,  or  rather  did  not  hire  themselves  out  for  such  a  sum.  but  the  families 
concerned,  of  their  own  free  will,  relieved  the  physician  of  the  disagreeable 
and  painful  task  of  demanding  money  for  professional  services.  By  this 
arrangement  the  acquisition  of  medical  practice  was,  it  is  true,  more  difficult 
than  it  is  at  the  present  day.  Practice,  as  a  rule,  was  only  to  be  obtained 
by  a  kind  of  inheritance,  so  to  speak,  on  the  death  of  some  physician  ;  or 
through  the  recommendation  of  some  older  physician,  and  the  possession 
of  eminent  general  and  special  medical  ability.  Such  was  the  case  in  the 
cities  and  the  better  classes  of  society,  and  the  rest  of  the  country  followed 
their  example.    In  the  country  there  were  still  comparatively  few  physicians 


proper,  so  that  here  they  were  rather  difficult  to  procure,  and  accordingly 

they  continued  to  be  held  in  permanent  esteem  among  the  masses,  who,  as 
we  know,  prize  only  the  more  highly  that  which  is  difficult  to  obtain.  The 
higher  practitioners,  in  contrast  to  the  physicians  of  the  lower  class,  who 
stiJl  existed,  formed  a  kind  of  superior  tribunal,  and  thus  again  the  repu- 
tation of  the  former  was  increased.  The  great  majority  of  physicians 
descended  from,  or  at  least  moved  in.  circles  of  genuine  education,  and  thus 
the  half-educated  and  ignorant  were  preserved  from  arrogating  equality 
with  them,  and  from  the  insolent  behavior  toward  the  physician  which 
might  ensue  from  such  association.  Physicians  who  had  received  the 
doctorate  were  counted  among  the  "gentry",  and  not.  as  at  the  present 
day.  among  the  artisans  and  traders.  Indeed  in  many  states  they  enjoyed 
a  certain  -'rank",  like  military  officials,  and  they  were  generally  allowed 
to  wear  a  sword.  As  the  physician  himself  did  not  estimate  cultivation 
according  to  the  purse,  so  he  preserved  in  presence  of  the  wealthy  the 
self-respect  and  the  behavior  of  a  man  of  genuine  education,  which 
manifested  themselves  externally  in  a  dignified  deportment  and.  not  very 
infrequently,  in  the  affectation  so  characteristic  of  the  age  of  perrukes. 
However,  even  the  last  was  at  all  events  better  than  its  opposite,  which 
we  so  often  see.  People  in  those  days  generally  took  off  their  hat  to  the 
physician,  for  they  recognized  him  by  his  demeanor  as  the  representative 
of  a  noble  profession,  and  a  man  who  saw  in  his  patient  a  thorough,  and 
indeed  a  suffering,  human  being,  to  whose  aid  he  was  called,  not  a  subject 
submitted  to  the  so-called  objective  and  exact  investigation  of  the  disease 
of  some  particular  organ.  The  physician  based  his  plan  of  treatment  upon 
the  entire  man  before  him.  not  upon  the  pathological  changes  demonstrable 
within  him.  He  was.  in  accordance  with  the  requirements  of  Hippocrates, 
likewise  a  psychologist  or  philosopher,  not  a  mere  technical  practitioner 
of  the  healing  art.  Moreover,  physicians  generally  were  full  of  genuine 
devoutness — undoubtedly  often  too  full  of  superstition  —  however  far 
the  most  of  them  might  be  from  all  sacerdotal  and  dogmatic  religion. 
Not  a  few.  and  particularly  not  a  few  of  the  more  considerable  physicians. 
came  from  the  parsonage,  whence  there  may  have  clung  to  them  a  certain 
profundity  and  a  greater  earnestness  in  their  conception  of  life.  Indeed, 
they  often  considered  themselves,  as  it  were,  priests  of  humanity,  and  as 
such  occupied  in  most  relations  within  their  circle  of  activity  the  place  of 
religious  pastors  and  domestic  clergy. 

Most  physicians  too  made  a  choice  of  the  medical  profession  in  a  feel- 
ing of  deep  earnestness,  as  was.  indeed,  the  case  in  the  choice  of  all  call- 
ings at  that  time,  and  thus  there  was  a  greater  number  of  physicians  at 
once  actually  and  genuinely  called  into  the  profession  by  a  love  of  their 
calling  and  by  their  natural  gifts.  Finally,  the  state  took  care  everywhere 
to  afford  physicians,  in  the  true  sense  of  the  term,  greater  protection  than 
had  been  ever  before  the  case.  Accordingly  it  strove  energetically  by  legal 
ordinances  to  separate  them  from  the  numerous  dabblers  and  quacks,  and 


—  733  — 

the  medicasters,  who  in  past  times  had  been  their  open  rivals.  Although 
this  was  accomplished  quietly  and  gradually,  yet  the  strolling  medical 
vagabonds  were  no  longer  able,  as  heretofore,  to  prejudice  with  impunity 
the  profession  of  the  higher  physicians,  a  thing  which  our  present  trade- 
law  has,  alas,  once  more  rendered  possible.  The  better  classes  of  the  pub- 
lic acted  unconsciously  in  accordance  with  the  utterance  of  Seneca:  ;'  Thou 
dost  deceive  thyself  when  thou  thinkest  a  small  fee  only  to  be  due  to  thy 
physician  ;  for  thou  dost  purchase  from  thy  physician  an  inestimable  thing 
—  life  and  good  health.  Therefore  he  is  paid  not  the  price  of  ordinary 
wares,  but  the  value  of  an  internal  effort.  As  he  serves  us,  and  when  called 
neglects  his  own  affairs  for  our  good,  so  there  is  due  to  him  not  the  wages 
of  ordinary  service,  but  the  honorarium  of  a  profession." 

In  a  social  point  of  view  the  18th  century  was  of  the  greatest  im- 
portance to  pli3*sicians  from  the  fact  that  it  finally  bore  to  its  grave  that 
division  of  the  higher  medical  faculty  into  plrysicians  and  slightly  educated 
and  despised  surgeons,  which  the  mediaeval  Church  and  the  Arabians  had 
called  into  existence.  In  how  many  other  ways  did  the  century  of  the 
Revolution  put  an  end  to  the  Middle  Ages  ! 

Of  course  the  sharp  shadows  of  the  century,  as  well  as  of  the  pro- 
fession itself — ■  including  the  famous  "colleagueship".  directed  at  that 
period  particularly  against  the  surgeons — and  the  usual  charges  of  mis- 
conduct, were  not  lacking  to  the  picture  of  the  medical  profession.  Should 
we  speak  of  these,  strong  shadows  would,  indeed,  show  themselves  ;  but 
from  an  historical  point  of  view  we  should  be  guilty  of  injustice  if  we  laid 
too  much  stress  upon  such  matters,  for  they  can  never  determine  our  esti- 
mation of  a  profession,  but  only  our  judgment  of  its  individual  members. 
Vulgarity  is  at  all  times  the  same  ;  only  at  certain  times  the  better  mem- 
bers of  the  profession  distinguish  themselves  lyy  a  greater  preponderance 
over  the  vulgar  masses,  and  this  preponderance  was  particularly  manifest 
in  the  last  century. 

Plrysicians  received  their  general  preparatory  education  at  the  gym- 
nasia or  the  so-called  academic  gymnasia  —  institutions  intermediate  be- 
tween the  gymnasium  and  university,  and  in  which  special  branches  were 
taught  modo  academico  —  and  partly  too  at  the  universities  themselves. 
To  the  latter  the  students  were  often  accompanied  by  private  tutors. 
Originally  attendance  upon  philosophical  lectures  also  was  required.  Such 
was  the  case  until  1848.  In  Austria  attendance  for  two  years  upon  lec- 
tures on  'philosophy",  i.  e.  logic,  psychology,  natural  history  and  general 
history  —  the  latter  two  for  free  students  at  least  —  was  required  before 
proceeding  to  medicine  proper,  jurisprudence  or  theolog}'.  Our  present 
••Maturitatsexamen"  (examination  for  matriculation)  was  generally  un- 
known during  the  whole  18th  century,  as  it  is  to-day  in  England  and  (with 
some  exceptions)  in  America,  though  in  Prussia  (at  the  instance  of  Gericke) 
a  beginning  was  made  in  1788.  The  testimony  of  the  director  of  the  gym- 
nasium as  to  the  maturity  of  the  student  was  sufficient;    indeed  even  a 


—  734  — 

short  so-called  •deposition"  before  the  philosophical  faculty,  i.  e.  the  simple 
answering  in  bud  Latin  of  a  few  Latin  questions,  which  the  dean  of  the 
faculty  in  question  proposed  in  the  presence  of  the  -Depositar",  who  had 
the  duty  of  supervising  this  examination,  sufficed  for  matriculation. 
Young  noblemen  who  had  been  educated  by  private  tutors  were  not  re- 
quired to  pass  any  examination  at  all.  The  supervision  by  the  state  of 
the  educational  course  of  the  students  had  not  as  yet  reached  the  point 
attained  at  the  present  day.  Perhaps  the  result  of  this  was  that  many 
students,  because  they  were  free  from  all  compulsion,  educated  themselves 
more  profoundly  in  certain  branches  than  would  ever  have  been  the  case 
in  pursuing  a  prescribed  and  rigid  course  of  study.  The  18th  century  too 
first  introduced  mathematics  and  geometry  as  new  subjects  of  gymnasial 
instruction,  indispensable  henceforth  for  medical  students.  It  was  also  in 
the  beginning  of  this  century  that  •llealschulen" '  took  their  origin,  and 
this  name  made  its  first  appearance  in  Halle  in  170G  (Paulsen).  In  spite 
of  the  complaints  of  overtasking  the  students,  which  were  not  wanting  even 
in  that  day  and  resulted  from  the  introduction  of  realistic  subjects  of 
instruction  into  the  gymnasia,  more  effort  was  made  in  instruction  to  attain 
the  multum  than  the  mulla.  More  was  left  to  private  study  and  individual 
disposition,  though  much  that  was  ••unnecessary"'  was  thus  learned.  Even 
the  study  within  the  universities  was  in  many  respects  more  free  than  it  is 
at  the  present  day.  Above  all.  a  definite  term  of  study,  examination  ordi- 
nances etc..  prescribed  by  the  state,  were  exceptional,  and  first  appeared  in 
Prussia  in  the  later  decennia  of  the  century.  At  first  all  these  matters 
were  arranged  by  the  individual  universities  or  faculties  for  themselves. 
Hence  students  of  extraordinary  ability  were  not  forced  to  pursue  the  same 
course  for  the  same  period  as  might  be  requisite  for  the  less  capable.  No 
universal  and  obligatory  directions  regarding  academic  record-books  (Beleg- 
biicherj  were  yet  known,  although  the  professors  furnished  testimonials 
of  the  course  of  study  pursued  by  the  students.  There  were  too  no  com- 
pulsoiy  lectures,  particularly  in  the  natural  sciences,  and  yet  individual 
physicians  attained  considerable  knowledge  in  certain  of  these,  and  espe- 
cially often  in  botany.  Indeed  the  latter  study,  like  chemistry  in  the  17th 
century,  was  the  recreation  of  very  many  physicians.  The  students  en- 
joyed substantially  the  liberty  of  studying  what  they  pleased,9  as  the  pro- 
fessors did  that  of  teaching  as  they  pleased. 

Among  the  fundamental  branches  of  medicine  the  study  of  anatomy 
was  that  which  was  now  chiefly  promoted  in  Germany.  Even  at  the  begin- 
ning of  the  ISth  century,  however,  mam*  students  were  compelled  to  visit 
foreign  universities,  because  the  arrangements  of  those  in  German}'  were 
so  defective.  The  French  universities  and  those  of  the  Netherlands,  par- 
ticularly Leyden,  Strassburg  and  Paris,  were  chiefly  patronized  by  German 


l.  The  German  "Realscluile"  is  a  school  in  which  the  modern  languages  and  sciences 

are  taught,     i  H.  | 
_'.  In  the  Portuguese  university  of  Uoimbra  such  was  — and  is  still  —  the  case. 


students.  In  Strassburg,  Salzmann  from  the  year  1708  had  the  students 
dissect  daily  from  10  to  12  o'clock,  and  ever}*  other  day  demonstrate  in 
the  auditorium  the  dissections  made  the  day  before  (Wieger).  In  the 
early  years  of  the  century  suitable  dissecting-rooms,  and  above  all  a  suffi- 
cient number  of  bodies,  were  wanting,  so  that  Haller  e.  g..  in  the  year  1723 
while  studying  under  Duvernoy  in  Tubingen,  was  still  compelled  to  dissect 
chiefly  dogs.  In  Leyden  too  anatomical  material  was  deficient,  and 
Albinus  received  only  one  body  for  dissection  annually.  Under  such  cir- 
cumstances the  great  Haller  looked  upon  it  as  a  special  favor  that  this 
famous  teacher  permitted  him,  for  a  considerable  compensation,  to  dissect 
on  the  second  half  of  the  body  that  which  Albinus  himself  had  dissected 
upon  the  first.  Indeed  in  Paris  Haller  was  compelled  to  steal  bodies  — 
and  to  fly  for  his  life  when  the  theft  was  discovered.  Hoffmann  in  24 
years  was  able  to  dissect  only  20  bodies,  and  even  in  the  middle  of  the 
century  only  one  dissection  was  made  in  Halle  annually  in  the  existing 
•Anatomiekammer".  Even  the  latter  room  was  a  subject  of  dispute 
between  the  university  and  the  magistracy,  so  that  the  magistrates  claimed 
and  even  took  possession  of  it,  although  the  university  had  paid  an  annual 
rental  of  30  marks  and  expended  330  marks  upon  it  for  repairs.  Werlhof 
relates  that  in  Helmstadt  he  and  five  other  students  formed  a  fund  from 
which  they  contributed  to  the  burial  expenses  of  poor  people  in  the  city 
and  country,  in  order  to  obtain  permission  to  make  dissections.  He  even 
proposed  this  plan  to  the  professors  for  their  imitation.  In  Prague  during 
a  period  of  twenty  years  (1692-1712)  only  three  dissections  were  made 
(more  are  made  now  in  a  single  day  !).  and  in  Gottingen,  the  "progressive" 
university  of  the  last  century,  matters  were  no  better  until  Haller  was 
called  there.  The  ■•theatrum  anatomicunV  (as  the  German  dissecting-room 
was  called)  founded  in  1713  in  Berlin  was  the  pride  of  the  city,  and  has 
been  the  hobby  of  all  ordinances  relating  to  the  study  of  medicine  and 
surgery,  which  have  been  issued  since  1725.  Attendance  upon  it  was  con- 
tinually enjoined  upon  physicians,  and  it  was  relatively  well  supplied  with 
bodies.  Indeed  as  early  as  1786  the  supply  of  suicides  and  persons  who 
died  in  the  work-houses  and  hospitals  was  so  great  that  about  200  bodies 
were  at  the  disposal  of  this  institution.  A  Berlin  professor  affirms  that 
many  foreigners  ( i.  e.  in  the  conception  of  that  time  non-residents  of 
Prussia)  came  to  Berlin  on  account  of  this  anatomical  theatre,  just  as  they 
do  to-day  for  its  institute  of  pathological  anatomy.  In  Vienna  such  a 
theatrum  anatomicum  was  opened  in  1718.  but  it  was  not  until  1735  that 
J.  H.  Mannagetta  the  scion  of  a  Viennese  family  of  physicians,  was  ap. 
pointed  the  first  official  and  special  professor  of  anatomy.  Bodies,  how- 
ever, were  so  scarce  that  in  1741  scarcely  a  single  dissection  could  be 
made,  while  in  Strassburg,  on  the  contrary.  Joh.  Jac.  Salzmann  in  1725  was 
able  to  dissect  thirty,  and  in  1760  even  sixty  bodies  in  a  single  winter,  and 
besides  this  to  practise  surgical  operations  upon  the  cadaver.  Regular 
exercises  in  dissection  were  rare,  although,  as  we  have  said,  they  took  place 


—  736  — 

in  Strassburg  and  were  paid  for  extra,  e.  g.  in  1790,  20  marks  for  a  dissec- 
tion of  the  muscles  and  nerves.  Anatomical  demonstrations  in  the  public 
lecture-room  were  still  an  important  question,  and  in  Strassburg  10  marks 
were  to  be  paid  to  the  fiscus  for  these.  The  prosector  was  a  surgeon,  or 
even  a  barber.  Wurzburg  received  its  first  theatrum  anatomicum  at  the 
hands  of  the  prince-bishops  Ph.  Fr.  von  Schoenborn  (1719-1724)  and  Chr. 
Fr.  von  Hutten  (1724-1729).  It  was  formed  out  of  a  summer-house  of  the 
u  Juliushospital"  and  reorganized  in  1788,  but  a  new  and  worthy  building 
was  not  inaugurated  until  1883.  In  Italy  Fontana  made  his  wax  prepara- 
tions in  order  to  use  them  for  purposes  of  instruction  instead  of  bodies, 
which  were  very  scarce.  In  Spain,  on  the  other  hand,  where  in  its  prime  a 
Vesalius  had  labored,  no  dissections  were  made,  and  even  a  special  teacher 
of  anatomy  did  not  exist  as  late  as  the  middle  of  the  century. 

In  Braunschweig  in  the  year  1780  three  thalers  were  paid  each  semes- 
ter for  exercises  in  dissection. 

[The  English  statute  of  1540,  as  already  mentioned,  permitted  the 
Company  of  Surgeons  to  take  annually  the  bodies  of  four  executed  male- 
factors "for  anatomies",  and  a  similar  privilege  was  extended  to  the  College 
of  Physicians  by  Elizabeth  in  1565.  The  number  of  bodies  thus  legally 
allotted  to  the  study  of  anatomy  was  increased  to  six  under  Charles  II. 
(1660-1685).  The  colleges  of  surgeons  and  physicians  were  thus  the  sole 
places  where  the  study  of  anatomy  could  be  lawfully  pursued,  and  accord- 
ingly we  find  many  of  the  English  anatomists  of  the  16th  and  17th  cen- 
turies holding  the  position  of  lecturers  on  anatomy  in  these  colleges.  Yet 
that  the  stud}T  of  anatoni}-  was  not  exclusively  confined  to  these  institu- 
tions is  manifest  from  the  fact  that  e.  g.  Wharton  and  Thos.  Winston,  both 
professors  of  medicine  in  (Iresham  College,  London,  delivered  lectures  on 
anatomy  in  the  17th  century.  Neither  Oxford  nor  Cambridge,  however, 
received  a  professor  of  anatomy  until  the  18th  centunr.  —  The  earliest 
universit3*  in  Creat  Britain  to  create  a  chair  of  anatomy  was  Edinburgh, 
where  Robert  Elliot,  who  had  lectured  upon  anatomy  before  the  College 
of  Surgeons  of  Edinburgh  (organized  in  1094).  was  appointed  professor 
of  anatomy  in  1705  with  an  annual  salary  of  £15.  The  College  of  Sur- 
geons had  opened  an  anatomical  theater  in  1097,  and  this  was  now  turned 
over  to  the  university.  In  1708  Elliot  was  allowed  an  assistant,  Adam 
Drummond,  who  continued  to  hold  his  position  until  in  1720  he  resigned 
to  make  way  for  Alexander  Monro  (Primus),  whose  anatomical  instruction 
soon  became  famous  throughout  Europe  and  America.  A  chair  of  anatomy 
was  also  established  in  Cambridge  in  1707,  in  the  University  of  Glasgow 
1718,  and  a  "lecturer  on  anatomy"  was  appointed  at  Oxford  in  1750.  The 
Cniversity  of  Dublin  also  provided  a  chair  of  anatomy  in  1785.  Some 
idea  of  the  scope  of  the  anatomical  instruction  of  the  18th  century  may 
be  gleaned  from  the  information  that  the  syllabus  of  the  anatomical  lec- 
tures of  Mr.  Nourse,  published  in  1748,  and  "totam  rem  anatomicam  com- 
pleetens"  comprised   only   23   lectures,  and  at  one  of  the  most  reputable 


—  737  — 

courses  of  anatomy  in  Europe,  where  Hunter  himself  was  a  student,  the 
professor  was  compelled  to  demonstrate  everything  except  the  nerves, 
vessels  and  bones  upon  a  single  cadaver.  The  vessels  and  nerves  were 
shown  in  a  fcetus,  and  the  operations  of  surgery  were  demonstrated  upon  a 
dog.     (H.)] 

Until  the  middle  of  the  century  the  clinical  method  of  instruction  in 
pathology  and  therapeutics  was  adopted  in  Le}'den  alone.  With  the  ex- 
ception of  this  university,  eveiy  where  in  Germany  theoretical  lectures  upon 
these  two  subjects  were  read  from  the  manuscript  in  the  ancient  style,  and 
it  was  not  until  a  later  period  that  a  few  professors  ventured  to  lecture 
extempore.  Everywhere  the  lectures  were  dictated  to  the  students,  and 
hence  arose  the  expression  perpetui  dictatores  to  designate  professors. 
The  physicians  were  so-called  medici  ex  commentariis,  that  is  doctors  who 
had  acquired  their  knowledge  of  diseases  from  their  books  onby.  Hence 
arose  the  saying  that  a  new  plrysician  must  always  fill  a  graveyard  before 
he  could  actually  know  diseases.  Rarely,  and  only  as  the  result  of  special 
favors,  did  the  student  see  ambulant  or  private  patients  under  the  direction 
of  his  teacher,  unless  he  practised  himself,  a  thing  which,  in  spite  of  all 
prohibitions,  happened  frequently  enough. 

The  earliest  ambulator}-  clinic1  was  ordered  at  Prague  in  1745. 
"  The  students  should  learn  to  examine,  investigate,  inspect  and  treat 
the  sick  in  the  Leyden  style  (praxis  exercitiva  sive  clinica  viva)." 
In  these  clinics  the  poor  received  advice  and  medicine  gratis.  Everything 
was  arranged  just  as  in  our  modern  policlinics.  This  institution,  however, 
survived  only  one  year.  Anton  Wenzel  Rings  (graduated  1735)  was  its 
president. 

The  first  clinical  institution  in  Germany  was  organized  at  Vienna  by 
van  Swieten  in  the  year  1754,  and  placed  under  the  charge  of  de  Haen, 
who  was  also  obliged  to  publish  clinical  reports.  This  clinic  was  estab- 
lished in  the  "Biirgerspital",  with  only  six  beds  for  men  and  the  same 
number  for  women.  All  of  these  beds  were  to  be  filled  from  the  "  Drei- 
faltigkeitshospital"  and  other  similar  institutions.  After  the  example  of 
Vienna  clinics  were  also  established  in  the  other  Austrian  universities,  and 
likewise  in  Pavia  1770  under  Borsieri,  in  Prague  1781  under  Joseph  von 
Plenciz  (1752-1785),  who  also  taught  gynaecolog)',  and  another  with  eight 
beds  under  Krzowitz  in  Ofen  1777.  In  Gottingen,  Peter  Frank,  when  he 
became  professor  there  in  1784,  and  in  Jena,  Hufeland,  rendered  good  ser- 
vice in  the  introduction  of  the  clinical  method.     Towards  the  close  of  the 

1.  The  German  system  of  clinical  instruction  is  divided  into  1.  the  ordinary  hospital 
clinic  ;  2.  the  policlinic,  where  the  sick  are  visited  by  the  students  at  their  homes 
under  the  supervision  of  the  professor;  3.  the  "ambulatory  clinic",  where  the 
patients,  or  the  reporters  of  certain  cases,  meet  at  some  determined  place,  in  which 
the  cases  are  discussed  and  suitable  prescriptions  given  by  the  clinician.  The 
latter,  therefore,  correspond  pretty  closely  to  our  ordinary  college  or  dispensary 
clinics.  (H.) 
47 


—  738  — 

century  Tubingen  received  a  clinic  with  —  four  beds.  Strassburg  did  the 
same.  It  may  also  be  remarked  that  the  great  Joh.  Peter  Frank  desired 
animal  clinics  to  be  established  for  physicians  (besides  those  devoted  to 
human  beings),  for  the  purpose  of  studying  comparative  pathologj'. 

In  France  the  clinical  method  of  instruction  for  internal  diseases  was 
first  introduced  in  1780  b}-  Desbois  de  Rochefort.  [The  first  chair  of 
clinical  medicine  in  Great  Britain  was  established  in  Edinburgh  in  17-41, 
with  John  Rutherford  as  its  incumbent.  A  similar  chair  was  founded  at 
Oxford  in  17S0.     (H.)] 

Hospitals,  during  the  whole  18th  century,  were  in  a  very  bad  condi- 
tion everywhere,  so  that  ''hospital  fever''  never  left  them.  In  the  Hotel 
I)ieu  at  Paris  several  patients  were  still  allowed  but  a  single  bed.  The 
system  of  centralization  was  also  still  in  bloom,  so  that  it  was  even  re- 
tained b}-  Joseph  II.  in  the  "Allgemeines  Krankenhaus",  which  was  sup- 
plied b}-,  and  composed  of,  the  17  Vienna  hospitals  existing  up  to  this 
time,  and  was  opened  Aug.  16,  1784.  Yet  Stoll  and  a  physician  named 
Fauken  pleaded  for  the  better  s\"stem,  and  the  latter  proposed  a  hospital  in 
the  northwestern  portion  of  Vienna,  placed  upon  an  eminence,  surrounded 
bj*  gardens,  the  buildings  to  be  011I3*  one  story  high  and  provided  with  wide 
corridors  and  doors.  Patients  suffering  from  infectious  diseases  were  to  be 
sheltered  in  separate  cottages  (Pusehmann).  As  regards  the  expense  of  a 
hospital,  it  may  be  stated  that  the  "Allgemeines  Krankenhaus"  claimed  an 
annual  budget  of  285,500  marks  (9000  marks  for  installations,  6280  marks 
for  the  clinical  institution  etc.).  The  first  director  until  1794  was  Quarin, 
who  was  succeeded  by  Melly.  [Of  the  great  general  hospitals  of  London 
the  following  were  established  in  the  18th  century  :  the  Westminster  (1719), 
Guy's  (1723),  St.  George's  (1733),  the  London  (1740)  and  Middlesex  (1745). 
The  Edinburgh  Hospital  was  founded  in  1736,  and  in  Dublin  the  Jervis 
Street  Hospital  (1726),  Stevens's  Hospital  (1733),  Mercer's  Hospital  (1734) 
and  the  Meath  Hospital  (1756).  These  institutions  became,  naturally,  the 
schools  of  England's  great  practitioners.  Eminent  physicians  and  sur- 
geons connected  with  these  hospitals  attracted  numerous  pupils,  who  were 
at  first  instructed  in  the  hospitals  themselves.  But  as  their  numbers  in- 
creased it  became  necessary  to  relieve  the  hospital  wards,  and  accordingly 
private  institutions  for  medical  instruction  were  established  by  the  most 
popular  teachers.  Such  was  the  origin  e.  g.  of  the  famous  Windmill  Street 
school  of  anatomy,  founded  by  William  Hunter  about  1770,  and  of  the 
private  medical  school  of  Sir  William  Blizard  and  the  anatomist  Maclaurin 
established  a  few  years  later.  The  latter  school  developed  in  1785  into  the 
London  Hospital  Medical  School,  the  earliest  of  the  great  hospital  medical 
schools  of  London.  In  the  same  way  the  medical  school  of  St.  Bar- 
tholomew's Hospital  was  developed  in  1790  through  the  activity,  good 
sense  and  popularity  of  the  great  Abernethy.  —  These  hospital  medical 
schools,  as  we  know,  in  the  present  century  have  quite  monopolized  the 
department  of  medical  instruction  in  England,  the  universities  of  Oxford 


—  739  — 

and  Cambridge    confining  their  medical   teaching  almost  entirely  to   the 
purely  theoretical  branches  of  medicine.     (H.)] 

More  and  more  attention  was  paid  to  instruction  in  the  sciences 
accessor}'  to  medicine  b}'  the  establishment  of  botanical  gardens  and 
chemical  laboratories.  This  instruction  was  given  by  the  professors  of 
medicine,  who  at  the  beginning  of  the  centur}'  were  still  often  eminent 
•chemists,  physicists  &c.  In  Vienna  e.  g.  a  chemical  laboratory  and  botan- 
ical garden  were  opened  in  1749.  The  same  was  the  case  in  all  civilized 
lands  except  Spain,  where  naturally  the  natural  sciences  found  no  admis- 
sion, and  even  as  late  as  1770  no  instruction  in  these  branches  was  given 
in  the  famous  university  of  Salamanca.  At  most,  these  sciences  were 
■taught  in  accordance  with  the  views  of  Aristotle,  who  was  likewise  the 
only  philosopher  tolerated,  and  thus  pure  medievalism  lasted  in  Spain 
almost  down  to  the  present  centuiy.  Lectures  on  ph}-sics,  botany  etc., 
were  regarded  as  dangerous  to  the  purit}-  of  the  faith.  Mineralogy  for 
mining  purposes  —  even  the  most  faithful  Christians  need  money  —  was 
alone  tolerated,  and  this  science  was  cultivated  in  Spain  by  the  Irishman 
Bowles.  (Buckle.)  [In  Great  Britain  botanical  gardens  were  established 
very  early,  e  g.  at  Hampton  Court  under  queen  Elizabeth,  at  Oxford  in 
1632,  at  Chelsea  1673,  at  Edinburgh  1676  and  the  Kew  Gardens  in  1760. 
Private  gardens  established  by  wealthy  amateurs  in  botany  were  also 
numerous,  e.  g.  those  of  Wm.  Sherard  at  Eltham,  of  Fothergill  at  Upton  in 
Essex  (1762)  etc.  -7-  Professors  of  botany  were  appointed  at  Edinburgh 
(1676),  Cambridge  (1721),  Dublin  (1785)  and  Glasgow  (1818).  —  Chairs 
of  chemistry  were  founded  at  Cambridge  (1702),  Edinburgh  (1713),  Dublin 
<1785),  Oxford  (1803)  and  Glasgow  (1817).     (H.)] 

Matriculation  was  of  course  the  condition  for  the  attainment  of 
academic  citizenship,  as  it  is  to-day.  It  cost  for  the  nobility  a  greater  or 
less  sum,  according  to  their  rank.  For  civilians  the  price  was  the  lowest, 
an  arrangement  which  would  have  been  a  good  one,  were  it  not  that  they 
were  thereby  stamped  as  an  inferior  class  of  academic  citizens. 

[The  ceremony  of  matriculation  in  the  17th  century  may  be  seen  in  the  experi- 
ence of  John  Evelyn  at  Leyden  in  1641.  He  writes:  "  I  went  to  see  their  Colledge 
and  Schooles,  which  are  nothing  extraordinary,  and  was  matriculated  by  the  then 
Magnificus  Professor,  who  first  in  Latin e  demanded  of  me  where  my  lodging  in  the 
towne  was,  my  name,  age,  birth,  and  to  what  faculty  I  addicted  myself;  then  record- 
ing my  answers  in  a  booke,  he  administered  an  oath  to  me  that  I  should  observe  the 
statutes  and  orders  of  the  University  whiles  I  stay'd,  and  then  deliver'd  me  a  ticket 
by  virtue  whereof  I  was  made  excise-free,  for  all  which  worthy  privileges  and  tbe 
paines  of  writing  he  accepted  of  a  rix-dollar."     (H.)] 

After  the  conclusion  of  the  course  of  study,  which  commonly  lasted 
four  years,  the  examination  was  made  by  the  professors.  The  youngest 
professors  asked  questions  first  for  an  hour,  and  the  Dean  closed  the  ex- 
amination. After  this  oral  examination,  two  questions,  the  one  on  theory, 
the  other  on  practice,  were  given  to  the  candidate,  who  was  allowed  24 
hours  to  prepare  himself  for*  their  discussion.     If  the  candidate  passed 


—  740  — 

his  examination,  lie  was  congratulated  by  the  Dean  just  as  at  the  present 
da}'.  Next  he  was  required  to  write  a  "dissertation",  which  was  criticised 
by  the  President,  after  which  a  "disputation"  and  "  Doctorpromotion " 
(graduation)  closed  the  scene  — just  as  now.  In  addition,  many  physicians 
undertook  travels  through  Germany  for  purposes  of  study  — ■  these  were 
already  recommended  by  Susruta  to  physicians,  in  order  to  learn  foreign 
diseases  and  remedies  —  visiting  various  mineral  springs  and  savants  to 
acquire  further  information.  The  wealthy  also  went  to  foreign  univer- 
sities, particularly  those  of  Holland,  France  and  England.  The  North- 
Germans  were  specially  fond  of  going  to  England,  the  South-Germans  to 
.France.  [The  same  custom  prevailed  in  England,  the  English  students  very 
frequently  visiting  for  further  instruction  the  universities  of  Paris,  Holland 
and  Italy.] 

The  expense  of  a  university  course,  even  when  compared  with  our 
present  standard,  was  not  always  trifling,  particularly  when  we  take  into 
consideration  the  increased  value  of  money  at  that  time.  Heim,  indeed, 
for  a  six  years'  course  of  stud}',  required  only  1500  marks  ($375).  His 
dinner,  however,  cost  him  about  two  cents,  for  supper  he  ate  about  one 
cent's  worth  of  bread,  and  he  occupied  a  room  with  another  student.  He 
was  poor  to  be  sure.  But,  on  the  other  hand,  when,  on  one  occasion,  he 
smuggled  a  pound  of  tobacco,  he  was  compelled  to  pay  a  fine  of  90  marks 
($22.50).  At  Strassburg,  which  was  regarded  as  an  expensive  university, 
Wieger  estimates  the  expense  of  a  four  years'  course  at  1750-1760  to 
3250-3500  marks  ($438-875).  The  Doctorate  alone  cost,  all  in  all,  about 
700  marks  ($175).  In  Vienna  and  other  places  the  expenses  of  the 
academic  course  were  lightened  by  the  rector,  who  gave  to  certain  students 
"  Bettelzeugnisse  "  (begging-certificates),  which  authorized  them  to  begin 
public. 

Medical  students  at  the  universities  were  not  permitted  to  go  out  without  their 
scholastic  cloaks,  just  as  the  pupils  in  the  gymnasia  are  required  to  wear  their  student- 
cloaks,  while  to-daj'  the  student-uniform  is  worn  in  Russia  alone,  and  the  ancient 
cloak  still  exists  in  Spain.  A  basis  for  estimating  the  number  of  medical  students  is 
given  by  the  attendance  at  Halle  in  the  days  of  Stahl  and  Hofmann.  In  the  first 
half  of  the  18th  century  this  university  was  the  most  popular  of  any  in  Germany. 
During  the  period  of  Stahl's  activity  here  there  were  altogether  538  medical  students 
educated,  or  25  per  year.  This  number  had  been  doubled  in  the  time  of  Hofmann, 
and  yet  it  was  very  moderate  when  compared  with  the  inundation  of  the  present  day. 
The  little  university  of  Giessen  has  always  now  more  students  of  medicine  than  Halle 
had  in  the  days  of  the  famous  Hofmann ;  Vienna  in  the  year  1880  had  more  than  800 
students,  Freiburg  121;  Wiirzburg  in  the  middle  of  the  last  century  could  show  at 
one  time  only  three  medical  students,  though  to-day',  as  a  rule,  their  number  is  150 
times  as  many;  so  that  from  the  very  number  of  our  students  of  medicine  in  the 
present  day  it  may  be  inferred  that  an  internal  call  to  the  practice  of  medicine  lias 
very  little  to  do  with  the  adoption  of  this  branch  of  science.  In  1879-1880  there  were 
in  Germany  3670  students  of  medicine;  1880-81,  4405;  1884-85,  7131;  1882-83,  in 
Vienna  alone  1750!!  In  spite  of  the  trifling  number  of  students  in  the  last  century  as 
compared   with   the  present  day,  complaints  were  still  made  of  too  much  of  a  good 


—  741  — 

thing,  "  bjr  which  an  educated  proletariat  was  arising".  Accordingly  in  1791  the 
Court  Commission  on  Education  (Studienhofcommission)  in  Vienna  proposed  that 
the  rush  for  study  should  be  repressed.  The  same  thing  occurred  too  in  1099,  and 
particular!}'  as  regards  medicine,  "  for  the  number  of  medici  especially  is  very  great". 
(G.  Wolf.)  This  effort  to  dissuade  3-oung  men  from  study  was  an  emanation  of  the 
increasing  tendency  to  state  oversight  of  educational  matters,  which  at  an  earlier 
period  would  not  have  been  even  thought  of. 

"  The  greatest  portion  of  the  students  belonged  too  to  the  privileged  classes". 
In  1761  a  decree  was  published  in  Austria,  providing  that  the  sons  of  citizens  and 
peasants  should  be  admitted  to  the  universities  only  when  they  had  manifested  a 
special  talent  therefor.  Even  late  in  the  19th  century  (as  quite  generally  in  the  18th) 
"  in  the  electorate  of  Hesse,  permission  for  the  so-called  lower  classes  to  pursue 
courses  of  study  was  very  limited.  Noblemen,  on  the  other  hand,  could  study  without 
any  ceremony.  Yet  the  larger  part  of  the  nobility  in  Germany  could  searcelj-  write". 
—  In  Gottingen  even  so-called  "  Prinzencollegien "  (lectures  for  princes)  were  de- 
livered. "Princes  and  counts  are  here  separated  from  the  other  listeners"  etc.  sajs 
Xenion  (Schiller).  The  "  Privatissima",  customary  even  at  the  present  day  for  the 
highest  lords,  whose  capacity  is  defective  and  who  do  not  wish  to  compromise  them- 
selves, are  a  reminiscence  of  these  "  Prinzencollegien  ". 

That  drinking  and  duelling,  emigrations  of  students,  street  rows  etc.  played  a 
great  role  in  student  life,  and  that,  particularly  in  the  small  universities  like  Jena 
and  Giessen,  the  utmost  rudeness  prevailed,  were  remains  of  mediaeval  customs,  of 
which,  indeed,  we  still  find  examples  enough  at  the  present  day.  The  students,  at 
the  beginning  of  the  century,  still  wore  a  sword  by  their  side,  and  accordingly  duels 
without  seconds  occurred  frequently  in  the  marketplaces  of  the  cities,  e.  g.  in  -lena. 
The  beadle  interfered  characteristically  with  the  Latin  cry  "  Pax  !  Pax!  subpoena 
relegationis  !  ",  and  "  Turnvater  "  Jahn  relates:  "A  special  custom  prevailed  in  the 
fighting  of  duels  in  that  day.  First  a  student  was  "  aufgebrummt "  (i.  e.  called  a 
^'dummer  Junge",  blockhead),  then  his  ears  were  boxed,  then  he  was  sprinkled  with 
a  fluid  of  dubious  character,  next  he  had  his  face  spit  into,  and  the  hunting-whip 
applied  —  of  course  with  certain  intervals — before  the  duel  proper  began.  The 
hunting-whip  particularly  played  a  weighty  part,  and  unpopular  students  were 
heartily  blessed 'therewith.  They  were  assaulted  before  they  got  out  of  bed,  and  the 
proposed  beating  was  soundly  administered".  Fights  with  journeymen,  policemen 
etc.  were  not  lacking  —  when  our  great-grandfathers  studied  medicine.  "The  greater 
part  of  those  who  attended  the  universities  devoted  the  first  part  of  their  academic 
course  to  learning  the  brutalities  of  their  elder  comrades,  to  educating  themselves  in 
their  immoral  conduct  and  to  making  themselves  at  home  in  the  technical  language 
fabricated  by  barbarians.  The  first  half  of  the  middle  period  of  his  academic  course 
was  occupied  by  the  youth  in  practising  the  follies  and  mischief  which  he  had  thus 
learned,  and  in  its  latter  half  the  former  pupil  became  the  instructor  in  vice.  The 
dregs  of  academic  life  were  devoted  to  the  learned  professions.  With  infirm  body, 
enfeebled  mind  and  exhausted  purse,  the  debauchee  now  sought  with  all  haste  to 
recall  to  his  recollection  enough  of  his  instruction  to  enable  him  to  answer  the  neces- 
sary questions  at  his  impending  examination"  —  an  idea  conceived  in  stupidity! 
General  duels  and  fracases  were  an  everyday  matter  (Jahn's  life  of  Euleri — all  of 
•which,  though  considerably  toned  down,  still  exists  in  our  own  century.  —  Besides  the 
ancient  "  Landsmannschaften  "  (at  an  earlier  period  called  "Nations'',  now  "Corps"), 
governed  oligarchically  and  despotically  by  the  "Chargirten",  there  originated  in  tin- 
last  century  so-called  "Orders"  (in  the  style  of  the  Freemasons),  e.  g.  the  "Mopsorden" 
in  Helmstedt  and  Gottingen  (1748),  the  "Pro  patria  et  fraternitatis  amove  "  in  Erfurt 
and  Helmstedt,  the  "Josephinenorden"  in  Marburg,  the  "Concordia  et  sinceritas  "  in 


—  742  — 

Halle  etc.  The  members  of  these  orders  wore  special  colors  (colored  caps  aiul 
ribbons)  like  the  "  Landsmannschaften  ",  but  were  strict!}-  interdicted  by  the  officials- 
of  the  states  and  universities. 

The  journey  to  the  university,  or  from  one  university  to  another,  was  of  course 
made  usually  on  foot.  The  wealth}-  only  made  use  of  the  post  and  extrapost,  both 
of  which  from  the  bad  condition  of  the  roads  were  not  free  from  danger  to  life.  That 
in  these  wanderings,  and  during  residence  at  the  inns,  numerous  vices  were  con- 
tracted is  easily  understood.  On  the  other  hand,  however,  greater  knowledge  of 
mankind  and  independence  of  character  were  gained.  The  student  with  his  knapsack 
and  heavy  blackthorn  for  protection  and  weapons  was  one  of  the  notable  figures  to  be 
seen  on  the  highroads. 

Many  students  regarded  it  as  no  serious  offence  to  cheat  the  professors  out  of 
their  lecture  fees,  or  to  beg  for  a  reduction  in  the  same  without  any  real  necessity. 
Indeed,  it  was  regarded  even  as  a  permissible  piece  of  imposition  on  the  part  of  a 
student. 

The  students'  doggerels  of  some  of  the  universities  have  preserved  to  us  character- 
istic views  of  student-life  in  that  day.     Thus 

"  Wer  von  Tubingen  kommt  ohne  Weib, 
Von  Jena  mit  gesundem  Leib, 
Von  Helmstitdt  ohne  Wunden, 
Von  Jena  ohne  Schrunden, 
Von  Marburg  ungefallen, 
Hat  nicht  studirt  anf  .alien." 

"In  Leipzig  ist  man  Tag  und  Nacht 
Auf  Madchens  Putz  und  Pracht  bedacht ; 
In  Halle  gibt  es  viele  Mucker, 
In  Wittenberg  Kaldaunenschlucker,  (tripe-eaters) 
Nur  Jena  ist  von  diesen  frei, 
Und  setzt  es  gleich  oft  Schlagerei." 

"Schlagerei"  (fighting),  however,  might  be  predicated  of  any  of  the  universities. 

"In  Jena  weiss  man  burschikos  zu  leben  "  etc.,. 

in  fact  so  "burschikos"  (student-like),  that  dismissed  students,  after  hearing  the 
sentence  of  the  Rector,  sometimes  boxed  his  ears  and  then  fled,  in  a  wagon  already 
waiting  for  them,  to  some  neighboring  territory,  where  they  escaped  punishment. 
Or  a  "Philistine"  (i.  e.  citizen)  was  dragged  by  the  ear  to  the  marketplace,  there 
compelled  to  kneel  down,  beg  pardon  and  shout  "Long  life  to  academic  privileges!" 

That  "  Pennalism"  had  not  died  out  needs  no  special  mention,  for  even  at  the 
present  day  portions  of  this  system  still  exist  in  the  "Corps"  and  associations.  The 
hair  of  the  "Brandfuchs"  was  singed  off  in  spots  with  a  lighted  paper,  after  which 
the  latter  was  extinguished  upon  his  cheek.  Drinking  matches  for  the  position  of 
"Bierpabst"  ("boss-drinker",  perhaps  we  might  call  it),  and  throwing  the  beasth-, 
drunken  idiots  "  into  the  chamber  of  death "  on  straw  etc.  still  continued.  The 
students  were  in  general  still  governed  by  the  special  university  laws,  which  were  not 
abrogated  until  1870. 

An  abuse  which  has  now  disappeared  was  that  of  the  "Hutschen".  This  con- 
sisted in  the  following  custom.  An  elder,  ragged  student,  with  empty  purse,  invited 
a  young  student,  whose  outfit  was  new,  to  exchange  clothing  and  purse  with  him,  and 
the  request  could  not  be  refused  without  bringing  the  new  student  into  discredit  (in 
student  slang  "in  Verschiss").  There  was  also  a  higher  kind  of  "Schmollistrinken" 
(fraternal  drinking).  —  The   despised  and   persecuted  "Deutsche   Burschenschaft  '\ 


—  743  — 

founded  at  Jena  on  June  12th,  1815,  began  first  to  oppose  these  outgrowths  of  a 
barbarous  age,  and  to  reduce  life  in  the  universities  to  a  more  polished  form.  By 
degrees  it  has  accomplished  its  aim,  so  that  the  German  medical  students  of  the~ 
present  day  would  certainly  be  called  gentle  Philistines  by  their  scholastic  pre- 
decessors. 

The  professors  of  medicine  still  represented  in  the  person  of  a  single 
individual  a  whole  row  of  branches  now  provided  with  special  chairs.  At 
least  this  was  still  common  at  the  beginning  of  the  18th  century,  so  that 
e.  g.  in  Vienna  there  were  three,  and  in  Halle  only  two,  medical  professors. 
Stahl,  the  incumbent  of  the  chair  of  theoretical  medicine,  was  the 
teacher  of  botany,  materia  medica,  dietetics,  physiology  and  the  institutes 
of  medicine,  while  Hoffmann,  who  represented  the  practical  branches,  was 
professor  of  physics,  chemistry,  anatomy,  surgery  and  the  practice  of 
medicine.  Anatomy,  surgery  and  midwifery  were  regarded  as  belonging 
together,  and  these  branches  were  usually  allotted  to  the  professor  of  sur- 
gery. The  latter  too  lectured  chief!}'  upon  the  theory  of  surgery  alone, 
and  Haller  himself  e.  g.  never  carried  a  surgical  knife,  and  never  performed 
the  smallest  surgical  operation.  In  the  later  decennia  of  the  century 
there  were,  indeed,  in  many  faculties  more  than  the  two  professors,  who 
original!}"  existed  in  all  universities.  Yet  there  were  still  no  more  than 
the  three  professors  of  medicine,  who  were  generally  created  for  the  first 
time  in  the  17th  century,  to  wit:  one  professor  of  the  theory  of  medicine, 
one  of  the  practical  branches  and  one  of  the  institutes.  With  these  was 
associated  a  fourth,  who  had  charge  of  anatomy  and  botany,  but  enjoyed 
no  salary.1  The  professors  often  did  not  lecture.  When  the}*  were  indis- 
posed a  notice  was  simply  posted  up  upon  the  "blackboard",  "Hodie  non 
legitur",  and  this  was  the  end  of  the  matter,  for  the  professors,  outside 
of  Prussia,  were  still  independent  of  the  state  (Leo).  They  were  neither 
under  such  bureaucratic  tutelage  as  in  the  stricter  oversight  exercised  at 
the  present  day,  nor  were  they  so  powerful,  and  so  conscious  of  their  power 
over  the  students,  as  they  have  become  by  means  of  the  modern  system  of 
examinations. 

"And  when  in  the  course  of  the  ISth  century  the  voice  of  the  age  imperatively 
demanded  an  increase  of  the  number  of  teachers  and  a  division  of  the  subjects  upon 
which  instruction  was  given,  the  existing  professors  boasted  of  their  jura  et  privilegia 

1.  How  matters  have  changed  in  this  respect  the  following  statistics  will  show.  In 
1877  Vienna  had  in  all  146  medical  teachers,  including  22  ordinary  professors  — 
the  result  of  specialism.  In  Germany  in  1877  there  was  one  teacher  to  every  9}4 
students !  In  1880  there  were  in  the  21  German  universities  528  medical  teachers 
(38  per  cent,  ordinary  professors,  26  per  cent,  extraordinary  professors  and  36  per 
cent.  "Privatdocenten  ").  Berlin  had  36  professors  of  medicine,  Leipzig  26, 
Munich  24,  Heidelberg  (with  about  121  students  of  medicine)  21,  Breslau  20. 
The  medical  faculties  are  the  best  supplied  with  teachers.  That  one  man,  under 
certain  circumstances,  accomplishes  more  than  a  great  number  of  average 
teachers  ■-  and  what  land  can  have  at  the  same  time  only  (or  very  many) 
eminent  teachers?  —  is  demonstrated  by  the  example  of  Boerhaave,  Haller  and 
others. 


—  744  — 

quanta  and  shoved  aside  from  their  livings  and  their  sinecures  the  professores  honor- 
arios  or  non  decanibiles,  newly  appointed  as  teachers  of  a  new  departure.  This  state 
of  affairs  existed  in  Germany  down  to  the  beginning  of  the  19th  century,  and  in  some 
•antiquated  universities  even  longer."  In  addition  to  medicine,  the  three  professors 
mentioned  above  lectured  upon  botany,  and  often  on  physics,  chemistry  and  natural 
history.  "In  general  it  may  be  taken  for  granted  that  the  number  of  professors 
established  b}~  the  statutes  down  to  the  18th  century  was  amply  sufficient  to  deliver 
the  required  lectures,  since  independent  investigation  was  rare,  belief  in  the  authori- 
ties demanded  in  all  things,  and  the  real  sciences  limited  in  extent.  But  towards 
the  close  of  the  18th  century  appeared  the  curious  situation  that  the  three  nominal 
professors  in  the  faculty,  i.  e.  those  of  chemistry,  botany  and  anatomy,  neither  of  them 
knew  anything  of  these  branches.  They  also  looked  upon  instruction  in  these 
sciences  as  beneath  their  dignity,  and  gladly  abandoned  it  to  younger  teachers  without 
any  salary ;  and  as  the  latter  increased  in  mettle,  the}-  also  shoved  it  off  upon 
uneducated  bath-keepers  and  apothecaries,  with  the  idea  that  the  latter  would  make 
less  pretensions.  .  .  .  When  new  positions  became  vacant,  the  existing  chemists, 
botanists,  anatomists,  and  ver}-  frequently  the  bath-keepers  etc.,  stepped  into  them. 
If  the  faculty  heretofore  had  often  consisted  of  Greco-German  physicians,  who 
knew  (?)  nothing  of  nature,  now  it  consisted  not  rarelj-  of  experts  in  the  natural 
sciences,  who  knew  nothing  of  medicine  (and  the  same  thing  has  occurred  here  and 
there  in  recent  times).  The  original  object  of  the  faculty,  to  be  a  board  of  examin- 
ation, which  it  had  up  to  this  time  fulfilled  and  was  able  to  fulfill,  was  accordingly 
completely  undermined  and  rendered  impossible.  The  students  saw  well  enough  that 
thejT  did  not  require  to  know  those  subjects  upon  which  they  were  examined  by  the 
members  of  the  faculty,  and  the' examiners  knew  nothing  of  what  the  students  had 
learned  from  other  teachers  ....  the  most  important  branches  which  the  time 
imperatively  demanded,  e.  g.  the  natural  sciences,  remained  utterly  (?)  neglected. 
Moreover  the  scholastic  form  of  the  examinations  of  the  16th  century  was  no  longer 
well  adapted  to  the  object  desired.  Hence  after  the  middle  of  the  18th  century  com- 
plaints were  heard  on  all  sides,  and  we  may  read  those  of  the  one  party  in  the  lamen- 
tations of  Gruner's  almanac,  those  of  the  other  in  the  grumblings  of  the  Brunonians 
and  natural  philosophers.  .  .  .  But,  even  after  the  intrusion  of  new  teachers,  the 
chief  privileges  were  still  possessed  only  by  the  old  ones,  as  a  rule  now  the  members 
of  the  faculty  so  dead  to  the  demands  of  the  time.  .  .  .  The  medical  men 
opposed  the  desired  reforms,  chiefly  on  grounds  of  self-interest:  if  the  effort  at 
imitation  and  self-preservation  necessitated  the  appointment  of  a  few  teachers  of  the 
real  sciences,  the  latter  found  suitable  quarters  in  the  ever  open  doors  of  tie 
philosophical  faculty,  already  so  heterogeneous  in  its  composition.  Thus  none  of  the 
changes  demanded  by  the  time  were  able  to  secure  a  place ;  .  .  .  the  tottering  head 
could  no  longer  hold  the  students,  who  had  become  by  degrees  more  numerous,  more 
self-reliant,  better  prepared  and  enlightened  by  the  quarrels  of  the  professors,  and 
more  independent  through  the  advances  of  the  state.  .     Thus  these   mediaeval 

institutions  estranged  themselves  more  and  more  from  the  state,  and  looked  into  the 
present  like  the  megalosaurus  upon  the  creation  of  to-day." 

To  this  sad  picture  of  the  faculties  of  the  last  century,  sketched  by 
K.  F.  Heusinger  (1792-1883),  professor  in  Marburg,  corresponded  here  and 
there  the  position  and  management  of  the  German  professors.  Frederick 
William  I.,  as  Joh.  Jac.  Moser  relates,  on  the  occasion  of  a  visit  to  the 
university  of  Frankfort-on-the-Oder,  had  a  public  disputation  on  the  sub- 
ject "  Vernttnftige  Gedanken  von  der  Narrheit",  prevented,  in  accordance 
with  the  advice  of  Morgenstern.     According  to  a  Prussian   ordinance  of 


—  745  — 

1733  too,  the  professors  were  not  permitted  to  accept  a  call  to  another 
place  under  penalty  of  severe  punishment.  The  same  rule  prevailed  in 
Saxony  as  regards  Leipzig  and  Wittenberg.  "  When  the  university  of 
Gftttingen  was  founded,  and  the  famous  professors  Hamberger  and  Wedel 
in  Jena  had  accepted  the  call  extended  to  them  and  were  preparing  for 
their  departure,  an  attachment  was  issued  upon  their  property."  (Rohlfs.) 
In  Prague  the  magistrates  let  the  college  buildings  go  to  ruin,  so  that  the 
professors  could  only  lecture  in  their  own  residences.  This  was  as  early  as 
1715,  and  it  was  not  until  1751  that  the  buildings  were  restored.  Could 
any  other  treatment,  however,  be  expected  from  the  omnipotent  state,  when 
even  members  of  the  Berlin  Board  of  Health  (1709)  required  that  those 
who  died,  even  of  the  plague,  without  taking  any  medicine,  should  be 
hanged  therefor  after  death  in  their  coffin  ? 

In  order  to  look  at  such  things  in  their  right  light,  we  must  remember  that  in  the 
18th  century,  during  the  mania  for  the  universal  introduction  of  better  conditions, 
during  the  omnipotence  of  the  state  which  prevailed  before  the  French  revolution 
and  the  universal  assumption  of  the  most  limited  intelligence  on  the  part  of  subjects, 
the  greatest  enormities  were  committed,  even  with  the  best  intentions.  This  was 
done  b}r  even  distinguished  rulers.  Let  us  think  only  of  Joseph  II.,  who,  in  the 
ordinary  sense  of  the  term,  was  none  too  virtuous,  and  who  desired  to  reform  ihe 
world  almost  entirely  bjr  laws  and  ordinances;  just  as  the  German  empire  to-day 
wishes  to  reform  church  matters,  though  they  can  be  fundamentally  reformed  by  the 
school  alone. 

The  external  situation  of  the  professors,  at  least  in  the  more  im- 
portant universities,  was  generally  not  very  bad,  nor  were  their  salaries  so 
veiy  small.  We  may  assume  as  the  average  for  the  North-German  univer- 
sities 3000-7500  marks  ($750-1875),  to  which  are  to  be  added  the  pro- 
fessorial fees.  In  Austria  the  salaries  of  professors  were  specially  im- 
proved by  van-Swieten.  De  Hiien  received  10,000  marks,  and  Frank,  at  a 
later  period,  0000  marks.  In  the  smaller  universities  the  salaries  were 
undoubtedly  bad  enough,  frequently  not  170  marks  per  annum,  and  ex- 
amples of  such  salaries  were  to  be  found  even  during  our  own  century. 
These  amounts  must,  however,  be  estimated  3-5  times  higher  than  at  the 
present  day,  in  accordance  with  the  value  of  money  at  that  period.  The 
university  professors  were  reckoned  among  the  so-called  state  officials? 
though  not  in  the  highest  class  of  these,  even  if  they  were  also  physicians- 
in-ordinaty,  a  thing  which  was  more  frequentl}'  the  case  in  the  last  century 
than  at  the  present  day.  It  makes  a  patriarchal  impression  upon  us,  how- 
ever,  when  we  read  the  domestic  calculation  of  the  first  German  professor 
of  surgeiy  given  below,  and  see  from  it  that  he  was  compelled  at  the  close 
to  boast  of  his  knowledge,  probably  to  obtain  more  readily  the  fulfillment 
of  his  modest  wishes.  Living  too,  at  least  in  North-Germany,  was  rela- 
tive^' dear.  Thus  Zimmermann  e.  g.  computed  that  he  would  require  6000 
marks  annually  in  Hanover,  and  Werlhof  reminded  Haller,  when  the  latter 
was  called  to  Berlin,  that  with  the  demands  made  in  that  cit}'  for  domestic 
arrangements  etc.,  7500  marks  would  not  go  very  far.     The  average  Ger- 


—  746  — 

man  professor  of  that  day  was  generally  compelled  to  be  satisfied  if  he 
was  able  to  procure  a  simple  living  for  his  family,  to  beget  and  bring  up 
his  children  and  pay  for  his  books.  The  scanty  lecture-fees  resulting  from 
the  small  number  of  the  students  did  not  much  improve  the  matter  (we 
read  a  good  deal  of  the  sale  of  degrees,  the  fabrication  of  dissertations  and 
corruption  in  the  examinations),  although  the  fee  for  a  course  of  lectures 
was  sometimes  half  as  much,  sometimes  quite  as  much,  as  it  is  to-day,  and 
the  value  of  mouey  (at  least  three  times  as  much  then  as  now)  must  also 
be  taken  into  consideration.  Accordingly'  the  German  professor  of  medi- 
cine in  that  day,  quite  in  contrast  with  many  medical  and  other  professors 
of  the  present  time,  made  very  little  out  of  his  scientific  knowledge,  while 
in  foreign  lands  genuine  mountains  of  gold  were  at  the  beck  of  the  pro- 
fessors, who  died,  or  might  have  died,  very  wealthy.  When  e.  g.  Morgagni 
received  5000  marks ;  when  van  Swieten  was  offered  a  salary  of  20,000 
marks  in  England ;  when  Boerhaave,  who  received  at  first  a  salary  of 
850  and  then  of  1700  marks,  by  his  private  practice  made  millions,  and 
when  the  more  considerable  French  and  English  physicians  acquired  very 
respectable  fortunes  in  the  same  way,  we  hear  nothing  of  this  sort  regard- 
ing German  professors  ;  but  we  read,  on  the  other  hand,  that  they  took 
students  to  board,  wrote  books  which  paid  them  very  badly,  made  trans- 
lations or,  like  even  Stahl  and  Hoffmann,  drove  a  trade  in  proprietary 
remedies.  Kurt  Sprengel,  as  ordinary  professor  in  1795.  received  174 
marks,  and  subsequently,  when  he  taught  several  branches,  450  and  1200 
marks.  All  other  countries,  however,  were  richer  than  poor  Gei'many, 
ravaged  during  the  17th  century  by  the  dreadful  Thirty  Years'  War  and  the 
wars  of  Louis  XIV.  waged  by  his  incendiary  generals  Louvois,  Turenne, 
Me4ac  and  others,  and  in  addition  defrauded  on  the  Rhine  in  particular  of 
her  prosperity  and  her  free  development.  And  it  was  not  until  towards 
the  end  of  the  18th  century  that  the  traces  of  this  suffering  (not,  however, 
the  unpractical  nature  of  the  Germans)  became  somewhat  obliterated. 

When  Heister  was  about  to  be  called  to  Gottingen  he  wrote  as  follows: 
c-  In  Gottingen  everything  is  more  expensive  than  in  Helmstiidt.  There  a 
cord  of  wood  costs  4  thaler,  in  Helmstiidt  only  one  thaler  and  12  good 
groschen  ;  I  consume  50  cords  of  wood  annually,  so  that  wood  alone  would 
come  100  thaler  dearer.  Again  most  kinds  of  meat  cost  there  18  pfennige 
to  2  good  groschen,  while  in  Helmstiidt  they  cost  only  1 2  pfennige,  which 
stands  to  me  for  an  increased  expense  of  50  thaler.  Moreover  beer  as- 
well  as  rye  is  more  expensive  there  than  here,  and  thus  I  should  be  as  well 
off  with  my  salary  here,  as  with  one  of  1000  thaler  there.  I  beg  leave  to 
commend  these  reasons  to  the  consideration  of  his  Excellency  Herr 
Munchausen,  in  order  to  determine  whether,  by  reason  of  these  circum- 
stances, the  salary  cannot  be  increased  a  few  hundred  thaler.  Doubtless 
another  professor  can  be  procured  in  my  stead,  but  I  will  wager  that  one 
cannot  be  easily  obtained  equal  to  me  in  anatomy,  surgery  and  botany, 
besides  the  chief  branches  of  medicine ;  still  less  one  superior  to  me"  — 


—  747  — 

and  Heister  remained  at  Helrastiidt !  [It  may  be  inferred  too  that  in 
England,  at  least  during  the  early  portion  of  the  18th  century,  the  salaries 
of  medical  teachers  were  by  no  means  magnificent.  Thus  when  in  1G77 
the  lecturers  of  the  botanical  garden  in  Edinburgh  were  organized  into  a 
College,  James  Sutherland  as  president  of  the  new  college  received  a 
salary  of  £20,  and  in  1705  Robert  Elliot,  the  first  professor  of  anatomy  of 
the  college,  was  paid  by  the  cit}-  authorities  the  noble  sum  of  £  15  an- 
nually !  This  too  almost  at  the  period  when  Mead  was  making  a  magnifi- 
cent fortune  by  his  private  practice  !     (H.)] 

That  unanimity  was  often  wanting  among  the  professors,  and  that,  on 
the  contrary,  vanity,  envy  and  strife,  abuses  regarding  degrees,  the  accept- 
ance of  gifts  etc.,  prevailed  in  many  places,  should  not  be  surprising,  since 
similar  things  have  been  mentioned  (often  unjustly)  even  in  our  own  day. 
But  it  is  surprising  that  it  was  considered  wise  to  insert  a  special  para- 
graph on  this  subject  in  the  statutes  of  the  faculty.  (See  paragraph  8 
below.) 

Statutes  of  the  Medical  Faculty  op  Frankfort-on-the-Oder 
from  the  year  1769. 

1.  Each  ordinary  professor,  when  newty  appointed,  shall  on  his  admission  paj' 
12  thaler  and  take  an  oath  not  to  deviate  from  the  statutes. 

2.  After  reception  into  the  Faculty  he  shall  not  share  in  its  emoluments,  until 
he  has  himself  held  lectures  and  demonstrations  in  his  official  capacity. 

3.  For  the  examinations  and  annual  graduation1  the  candidates  shall  pay  48 
Hungarian  or  Dutch  ducats  (about  $2  00  each),  and  one  thaler  for  the  stamped  parch- 
ment. Of  this  sum  15  ducats  and  18  groschen,  or  42  thaler,  shall  be  divided  equally 
among  the  members  of  the  Faculty,  who  are  not  Deans.  The  remainder  of  the  money 
shall  be  retained  by  the  Dean;  wherefore,  however,  he  alone  shall  pa}-  all  expenses 
except  the  printing  of  the  dissertation,  e.  g.  those  for  the  royal  confirmation,  for  the 
library,  for  the  secretary,  for  the  servants  of  the  university  etc. 

4.  When  the  Faculty  shall  voluntarily  remit  some  of  the  expense  to  a  candidate, 
it  shall  be  done  in  accordance  with  the  unanimous  views  of  the  two  professors,  and 

1.  That  the  Doctors'  Oath  was  administered  with  ancient  solemnity,  that  banquets 
etc.  followed,  need  only  be  mentioned.  Graduation  took  place,  on  the  whole, 
with  the  same  ceremonies  as  at  the  present  day  ;  the  solemn  march  of  the  can- 
didates headed  by  the  mace-bearers,  with  the  "  Paranymphen "  (boys  with 
lighted  candles)  at  the  side  'the  latter  now  omitted)  carrying  the  insignia  of  the 
doctor  (hat  etc.) ;  behind,  the  professors  according  to  rank  in  the  "goose-march", 
with  the  Dean  at  their  head.  The  Dean  then  took  the  upper  seat  in  the  double 
pulpit,  the  candidate  the  lower,  while  servants  bearing  maces  stood  on  either 
side.  After  the  reading  of  the  "Oath"  the  maces  were  crossed  and  the  oath 
administered  to  the  candidate,  who  held  his  forefinger  upon  the  mace.  First 
came  a  disputation  in  the  presence  of  all  the  medical  (and  other)  professors,  and 
in  which  the  students  raised  objections.  The  diploma  with  its  seal  etc.  followed. 
In  certain  universities  the  oath  contained  the  obligation  that  the  physician  should 
take  care  that  the  patient  should  receive  the  sacrament,  a  clause  reintroduced  in 
the  Roman  Catholic  university  of  Louvain  in  1880  ("eos  qui  quarto  die  morbo- 
acuto  decumbunt,  monituruin  est,  ut  rebus  suis  spiritualibus  et  temporalibus 
provident.") 


—  748  — 

shall  not  exceed  the  sum  of  24  thaler,  of  which  two  thirds  shall  be  deducted  from  the 
Dean  and  one  third  from  the  other  professor. 

5.  Of  all  other  emoluments,  except  those  resulting  from  legacies  (which  accrne 
to  the  Dean  only),  two  thirds  shall  go  to  the  Dean  and  one  third  to  the  other  col- 
leagues, e.  g.  the  honorarium  for  medical  decisions,  public  certificates. 

G.     The  candidates  for  the  summi  honores  are  received  into  our  Faculty. 

7.  When  an  opinion  is  requested,  the  Dean  shall  present  the  question  to  the 
meeting  of  the  Facultj',  give  his  own  vote,  demand  that  of  his  colleagues,  and  draw 
up  the  opinion.     If  a  difference  of  opinion  prevails,  the  Dean  gives  the  casting  vote. 

8.  All  disputes  should  be  avoided,  and  not  referred  either  to  the  king,  the  min- 
ister or  the  Curator,  in  order  that  our  Faculty  may  escape  disgrace. 

9.  In  witness  whereof  follow  the  signatures  of  us  two,  who  constitute  the  afore- 
said Faculty. 

Done  at  the  meeting  of  the  Faculty  held  June  15,  1769. 

C  A  RTH  A  US  ER.  H  A  RIM  A  X  X . 

(1704-1769),  professor  of  anatomy, 
botany  and  chemistry,  and  an 

important  pharmacologist. 

The  Faculties,  all  whose  actual  power  slipped  away  during  the  18th 
century,  formed,  as  at  an  earlier  period,  a  supreme  tribunal  for  the  settle- 
ment of  disputes  between  the  judicial  authorities  and  the  physici.  From 
them  "Superarbitrien"  or  supreme  judgments  were  sought,  and  in  the  follow- 
ing extract  we  find  a  very  notable  example  of  one  of  these  judgments. 

Attestatum  Medici  et  Ciiiriroorum  and  Superarbitrium 
op  the  Faculty 

concerning  a  maid-servant  who  died  suddenly  after  having  flown  into  a  passion  with 
her  fellow-servant,  and  having  on  the  same  day  received  from  the  latter  some  sharp 
blows  upon  the  ear. 

The  Physicus  tned.  Dr.  Christoph  Siegmund  Astmatm  and  the  surgeons  Andreas 
Slutius  and  Joh.  Willi.  Winckelmann  had  testified  from  the  results  of  the  post  mortem 
examination  —  musculus  crotaphites  uninjured  by  the  blows  upon  the  ear,  hence  the 
cranium  was  not  removed  ;  on  the  other  hand,  the  pylorus  stomachi  all  stained  yellow; 
the  intestinum  ileon  and  jejunum,  one  lobe  of  the  liver,  the  mesenterium,  together 
with  the  intestinum  rectum,  all  brown  and  black;  within  the  intestine  were  hardened 
faeces,  which  in  consequence  of  the  great  inflammation  could  not  be  discharged  and 
there  was  also  great  obstruction  in  the  (urinary)  bladder;  in  the  cavity  infimi  ventri 
was  a  bloody,  partly  watery  and  slimy  matter;  the  stomach  was  entirely  empty  from 
vomiting,  and  the  tunica  infima  quite  filled  with  black  spots  and  grains  —  that  it 
should  be  concluded  "  that  the  abdomen  had  been  injured  by  kicks  and  blows,  if  not 
with  sharp  or  poisonous  things,  and  that  gangrene  as  well  as  sphacelus  had  ensued"  etc. 
The  juristic  faculty  now  demanded  a  superarbit.rium  of  the  faculty  of  medicine  in 
Frankfort,  and  the  latter  decided  "  that  in  consequence  of  the  wordy  dispute  and 
passion  an  effusion  of  bile  and  severe  colic  had  ensued  (especially  as  the  deceased, 
the  day  after  the  wrangle,  had  complained  of  a  tearing  and  cutting  sensation  and  had 
vomited,  had  become  obstructed  thereby,  and  on  the  very  day  of  the  quarrel  had 
complained  of  chilliness,  had  been  also  before  this  a  sickly  person,  had  used  ginger 
and  brandjr,  had  consulted  no  physician,  drunk  cold  "  Dumper"  or  small-beer,  eaten 
cabbage,  taken  cold  etc.),  that  then  the  affectum  colicum  had  been  irritated  and 
undergone  an  exacerbation,  and  that  finally  ab  acrimonia  bilis  caustica  not  only  the 
interna  ventriculi  tunica  had  become  eroded,  but  together  with  the  pylorus  etc.  had 


—  749  — 

taken  on  gangrene,  as  the  only  result  of  which  speedy  death  must  follow.  This  our 
opinion,  fixed  and  grounded  in  arte  medica,  we  confirm  with  our  signature  and  the 
seal  of  the  Faculty.  Frankfort-on-the-Oder,  Ma}'  29,  1723."  In  this  decision  the 
clinical  view  defended  by  the  Faculty  against  the  collegium  medicum  completely 
proved  its  superiority  over  the  purely  anatomical  explanation,  as  has  been  the  case 
too  since  this  period.  Thus  this  decision  has  a  certain  value  for  the  present  day,, 
which  in  many  respects  defends  views  similar  to  those  of  the  physicus  Astmann. 

In  France  the  18  Faculties  —  the  medical  faculty  at  Paris  up  to  this 
time  consisted  of  only  four  professors  who  were  chosen  by  lot  every  two 
years,  and  accordingly,  under  certain  circumstances,  exchanged  positions, 
while  the  medical  faculty  of  Strassburg  had  only  three  professors  —  were 
abolished  by  vote  in  1792  (as  a  matter  of  fact,  however,  not  until  1794),  and 
in  their  place  was  established  the  Ecole-svstem. 

The  "democratic"  institution  of  the  "  Concours  public''  was  introduced  as 
follows:  1.  Concours  for  the  "Externat"  in  the  hospitals;  '1.  Concours  for  the 
"Internat";  3.  Concours  for  the  position  of  hospital-physician  ;  4.  for  the  position 
of  professor  agrege  (assistant  or  extraordinary  professor) ;  5.  The  position  of  ordinary 
professor,  now  assigned  by  the  Minister  of  Instruction  with  the  aid  of  the  Faculty, 
was  also  given  by  concours  at  that  time,  and  again  after  the  revolution  of  Jul}-  until 
the  restoration  of  the  Second  Empire.  The  title  of  "Doctor"  was  abolished  and 
that  of  "officier  de  sante"  alone  employed.  The  former  title  was,  however,  re- 
introduced in  1808,  though  the  latter  has  also  been  retained  until  the  present  day  to 
designate  an  inferior  class  of  physicians.  Evidence  of  preliminary  education  was 
omitted.  Practice  was  to  be  entirely  free  without  the  necessity  of  any  preceding 
examination  or  diploma.  The  latter  was  restored  in  1803.  Of  course  the  Bourbons, 
after  the  banishment  of  Napoleon  I.,  or  after  1821,  abolished  the  concours  etc. 

The  earlier  arrangement  by  which  the  students  also  gave  instruction 
no  longer  existed.  In  fact  this  had  gradually  outlived  its  usefulness  even 
in  the  17th  century.  Accordingly  the  preliminary  grades  of  Baccalaureus 
and  Licentiate'  were  gradually  combined  with  the  final  grade  of  Doctor. 
In  the  place  of  the  former  appeared  the  peculiarty  German  institution  of 
"  Privatdocenten".  Still  neither  the  number  nor  the  longevity  of  the  latter 
was  nearly  so  great  as  at  the  present  da}',  as  may  be  readily  inferred  from 
the  limited  number  of  professorial  positions.  Thus  e.  g.  Reil  was  a  private 
teacher  for  only  a  short  time  before  he  became  ordinary  professor.  Hence 
the  "  Privatdocenten"  of  weak  mind  or  character  were  not  yet  placed  in  a 
false  position  requiring  them  to  proclaim  the  fame  of  their  superior  pro- 
fessor in  order  to  finally  secure  his  place,  nor  as  "candidates"  to  fawn  upon 
their  superiors  and  seek  recruits  among  their  inferiors,  or  to  marry  spinster 
daughters  in  order  to  secure  their  future  career.  Many  teachers,  immedi- 
ately after  the  conclusion  of  their  studies,  stepped  into  the  position  of  an 
active  professor,  or  practised  either  in  a  university  city  or  elsewhere  until 
called  from  this  position  to  a  professorship.  In  this  method  hospital  prac- 
tice could  not  become  the  predominant  style,  and  the  teachers  needed  to 
be  well-schooled  practitioners,  not  simple  savants  or  experimental  thera- 
peutists. What  we  now  call  the  venia  legendi  was  still  included  in  the 
attainment  of  the  srrade  of  "  Doctor  ". 


—  750  — 

The  Latin  language  was  still  generally  employed  for  purposes- af  in- 
struction, at  least  by  the  professors  of  medicine,  while  most  of  the  surgeons 
lectured  in  German.  [As  alread}*  mentioned.  Cullen  was  the  first  professor 
in  Great  Britain  to  deliver  his  lectures  in  the  English  language.  This  was 
about  1770.     (H.)] 

It  was  in  this  century  too  that  the  profession  of  the  physician  became 
for  the  first  time  substantially  a  secular  one,  inasmuch  as  the  priests  now 
gradually  withdrew  entirely  from  it,  and  only  a  few  isolated  individuals 
devoted  attention  publickly  to  lithotomy  at  most. 

In  the  place  of  clerical  physicians,  now  entirely  excluded  from  ordi- 
nary medical  practice,  the  18th  century  introduced  Jewish  physicians  as 
fully  authorized  and  active  members  of  the  class  of  medical  practitioners. 

This  movement  began  in  France  in  the  jrear  1791,  when  the  principle  of  the 
equality  of  all  men  before  the  law,  whatever  their  position  or  religious  belief,  was 
decreed,  and  spread  thence  in  the  course  of  the  19th  century  over  the  whole  civilized 
world,  though  even  to-day  it  is  not  carried  out  thoroughly  to  its  final  and  logical 
results.  Heretofore  the  Jews  had  enjoyed  only  such  rights  as  were  granted  them  by 
favor  or  as  a  privilege.  In  Berlin  e.  g.  they  were  allowed  to  enter  and  leave  the  city 
by  one  gate  only,  and  they  might  be  expelled  at  any  hour.  In  most  cities  they  lived 
in  Ghettos,  were  permitted  to  transact  only  monetary  and  other  usurious  branches  of 
business,  and  of  studies  that  of  medicine  alone  was  allowed  them  on  the  receipt  of 
special  permission.  They  spoke  a  Hebrew-German  jargon,  could  not  write  German, 
and,  indeed,  were  forbidden  to  learn  how  to  write  it  by  the  rabbis  under  penalty  of 
excommunication.  In  Germany  Moses  Mendelssohn  (1729-1780)  was  the  pioneer  in 
the  introduction  of  an  actual  German  Judaism.  Even  under  Frederick  the  Great  the 
Jews  on  marrying  were  still  compelled  to  purchase  porcelain  from  the  royal  manu- 
factory ;  nor  were  they  permitted  to  select  for  themselves,  but  the}7  must  let  some  one 
allot  it  to  them.  Thus  Moses  Mendelssohn  e.  g.  was  compelled  to  buy  20  life-sized 
porcelain  monkeys,  which  are  preserved  as  memorials  in  the  family  down  to  the 
present  day.  Jewish  physicians  were  now  also  permitted  to  treat  Christians  (as, 
indeed,  they  were  in  many  places  during  the  Middle  Ages),  while  in  the  first  three 
centuries  of  the  modern  era  the  practice  of  medicine  was,  as  a  rule,  allowed  them 
only  araon^  their  fellow-believers.  Among  the  latter  there  was  always  one  physician 
in  each  city.  Educated  Jewish  physicians  were  few  in  number  and  exceptional  in 
the  so-called  modern  era,  since  attendance  upon  the  universities  was  ordinarily  for- 
bidden them,  though  as  we  know  it  was  permitted  in  Salerno,  Montpellier  etc.  In 
Austria  the  prohibition  of  universit}'  education  to  Jews  was  not  removed  until  the 
time  of  Joseph  II.,  and  Beer  in  17S9  was  the  first  Jew  who  graduated  in  that  kingdom. 
— During  the  Middle  Ages  the  Jewish  physicians  very  frequently  attained  considerable 
wealth,  as  e.  g.  the  Jewish  physician  Jacob  of  Strassburg,  at  Frankfort-on-the-Main  in 
the  14th  century,  who  paid  a  tax  of  53  marks  annually,  a  sum  equal  to  at  least  530 
mirks  at  the  present  day.  He  was  accordingly  reckoned  in  that  day  among  those 
who  paid  the  highest  taxes  in  Frankfort,  and  in  this  same  list  were  fourteen  of  the 
sixteen  Jewish  families  who  resided  in  Frankfort  in  that  century.  The  Jews  enjoyed 
the  sole  right,  however,  of  letting  money  upon  interest,  a  business  regarded  in  the 
Middle  Affes  as  unchristian,  though  no  longer  so  considered.  The  rate  of  interest  at 
that  period  was  often  very  high,  even  as  much  as  200  per  cent.  In  1657  even  the 
most  skilful  Jewish  physicians  were  prohibited  from  practice,  and  it  is  said  when  a 
certiin  Herr  Hirsch,  a  regularly  graduated  Jewish  physician,  in  consequence  of  his 
rare  experience  and  skill  sought  to  pass  toll-free  throughout  the  whole  land  of  W'urtem- 


—  751  — 

berg —  a  region,  which,  as  the  result  of  historic  propagation,  has  remained  down  to 
the  present  day  the  home  of  numerous  "  Zionswachter  "  (guards  of  Zion)  —  "  all  the 
clergy  protested  with  the  greatest  vehemence  against  this  privilege,  declaring  it  would 
be  better  to  die  with  Christ,  than  to  be  cured  by  a  Jewish  doctor  with  the  aid  of  the 
devil"   (Lammert). 

Throughout  the  whole  centuiy  too  physicians  were  everywhere  care- 
fulty  divided  into  the  two  classes  of  physicians  proper  (medici  puri),  who 
studied  for  four  years,  and  surgeons,  who  were  instructed  for  two  or  three 
years.  Both  classes  possessed  very  distinct  privileges,  and  it  was  not 
until  quite  the  close  of  the  century  that  this  distinction  was  somewhat 
relaxed. 

The  so-called  higher  and  highest  classes  did,  indeed,  look  upon  the 
physician  as  a  kind  of  servant  —  they  and  the  rich  financiers,  merchants, 
and  such  like,  do  the  same  thing  to-day  —  and  of  this  even  the  famous 
physicians  Zimmermann  and  Heim  complained.  The  former  said  '•  The 
ladies  who  have  sipped  coffee  with  George  II.  are  of  the  opinion  that  I 
should  be  at  their  command  as  I  am  required  to  be  at  that  of  the  king 
himself",  and  Heim  left  his  position  with  the  princess  Amalie  (well  known 
through  Trenck's  fate),  who  in  return  for  an  annual  salary  as  her  physician- 
in-ordinary  of  600  marks,  felt  at  liberty  to  treat  him  like  a  rascal,  a  piece 
of  impertinence  which  his  energetic  and  democratic  nature  would  not  en- 
dure. The  better  class  of  physicians  accordingly  respected  themselves  in 
their  profession,  and  thus  extorted  finally  a  more  complete  respect  on  the 
part  of  the  laity  than  has  ever  been  the  case  either  before  or  since. 

Professors  were  often  the  physicians-in-ordinary  of  princes,  as  e.  g 
Stahl,  Hoffmann,  Hufeland,  de  Haen  and  others. 

In  imitation  of  the  French  court,  whose  king  possessed  a  faculty  of 
physicians  —  48  physicians,  surgeons,  apothecaries  etc.,  of  whom  the  first 
two  ordinary  physicians  were  required  to  be  present  when  the  king  arose 
in  the  morning  —  almost  every  prince  of  any  importance  had  a  little  squad 
of  physicians-in-ordinaiy.  For  the  supply  of  this  class  the  court-physicians 
(Hofmedici)  were  held  in  reserve,  and  the  office  of  the  latter  was  frequently 
merel}*  titular  and  honorary,  something  like  our  court-confectioner  and 
court-tailor.  Wichmann  e.  g.  was  a  court-physician  without  salary  for  23 
years.  The  salary  of  the  physicians-in-ordinary  was  usuallj7  not  very  high. 
Peter  Frank,  as  ordinary  physician  of  the  bishop  of  Speyer,  received  1370 
marks,  a  house  and  board  free,  2000  litres  of  wine  and  2200  kilos,  of  corn. 
At  an  earlier  period  he  received  as  court  physician  of  Baden  a  salary  of 
342  marks  and  the  title  of  "Hofrath".  On  the  other  hand,  he  received  from 
Russia,  where  he  was  for  a  long  time  imperial  physician-in-ordinaiy,  a 
pension  of  9600  marks.  Famous  physicians  served  to  increase  the  glory 
of  their  lords,  and  thus  the  latter  vied  with  each  other  in  securing  the 
services  of  such  physicians  by  the  offer  of  fixed  salaries.  The  brilliant 
empress  Catharine  II.  of  Russia  was  of  course  able  to  outbid  all  other 
potentates,  even  in  the  pa}'  of  her  phj-sicians.     For  instance  she  had  Zim- 


—  752  — 

rnerruann  offered  a  salary  of  30,000  marks,  and  on  one  occasion  paid  Dims- 
dale  for  some  successful  inoculations  40,000  marks  for  travelling  expenses, 
200,000  marks  as  an  honorarium,  a  pension  of  10,000  marks  for  life,  and 
conferred  upon  him  the  title  of  physician-in-ordinary  and  a  barony  to  boot. 
The  frugal  Joseph  II.  too  gave  doctor  Guerin,  who  three  days  before  his 
death  had  come  to  a  consultation  from  Paris  to  Vienna,  an  honorarium  of 
171,000  marks  and  also  conferred  upon  him  a  barony.  Of  course  these 
were  exceptional  cases,  but  they  prove  how  medical  services  were  estimated 
in  comparison  with  preceding  times.  Ordinary  physicians  too  during  the 
last  century  not  rarely  attained  very  great  influence  upon  the  course  of 
medical,  and  indeed  of  general,  culture,  and  they  generally  employed  this 
influence  in  a  laudable  way.  We  may  refer  for  examples  to  Werlhof,  van 
Swieten,  E.  Conr.  Holtzendorff  (1688-1751),  Gorcke,  and,  with  some  limita- 
tions, to  Brambilla  and  others,  who  must,  therefore,  be  classed  among  the 
reformers  of  the  medical  profession  in  Germany. 

Some  of  them  had  great  influence  upon  the  formation  of  medical 
colleges  and  medical  ordinances.  The  latter,  although  they  laid  the  basis 
for  an  excessive  tutelage  over  physicians,  were  generall}'  wholesome,  and, 
indeed,  at  that  period  even  a  necessit}',  in  order  to  eradicate  quickly  and 
thoroughly  the  disorders  descended  from  earlier  times  and  the  mischiefs 
of  medievalism.  It  was  these  ordinances  chiefly  which  helped  to  free  the 
medical  profession  from  excrescences  and  practitioners  without  an}"  voca- 
tion for  their  business,  and  they  were  directed  in  the  most  outspoken  way 
against  these  particularly,  and  in  a  less  degree  to  the  tutelage  of  ph}'sicians 
proper.  It  was  undoubtedly  a  bad  feature  of  these  ordinances  that  the}r 
did  not  follow  quickly  enough  the  development  of  new  relations,  and  did 
not  conform  quickly  enough  to  varying  conditions  and  the  changing  spirit 
of  the  age.  Accordingly  they  resulted  in  preserving  the  existence  of 
antiquated  conditions,  and  thus  became  a  drag  upon  the  development  of 
the  relations  of  the  medical  profession.  More  especiall}'  they  occasioned 
physicians  to  remain  in  a  material  point  of  view  behind  the  other  pro- 
fessions, and  were  an  actual  detriment  to  them. 

The  following  medical  ordinances  made  their  appearance  :  a  renewal 
of  the  medical  edict  of  the  electorate  of  Brandenburg,  which  appeared  in 
Prussia  in  1725  with  the  old  rate  of  fees  ;  the  "Generale  wegen  Reme- 
dirung  der  Gebrechen  im  Medicinalwesen"  of  the  electorate  of  Saxonj^ 
1768;  a  renewed  medical  ordinance  for  Hesse- Darmstadt,  1767;  "Instruc- 
tion fiir  Physiker  in  Preussen",  1776  ;  an  ordinance  for  Westphalia,  1784r 
Hanau  and  Switzerland,  1785,  Baden  1793,  Hesse-Kassel  1778,  Lippe- 
Detmold  1789,  Denmark  1798,  Hungary  1786,  Sweden  1756  etc.  etc.;  in 
fact  there  were  as  many  ordinances  as  there  were  petty  states,  and  by  them 
the  coup  de  grace  was  finally  administered  to  that  liberty  of  emigration 
which  had  heretofore  prevailed  among  physicians.  Prussia,  which  took  the 
lead  in  all  bureaucracy  and  in  1725  was  the  first  to  introduce  examinations 
by  the  state,  made  the  beginning.     The  laity  were  presidents  of  the  colleges- 


In  order  to  give  the  reader  an  insight  into  the  style  and  spirit  of  these  ordinances 
and  the  divisions  of  the  profession  at  this  period,  we  introduce  the  Prussian  medical 
edict  of  1725. 

General  Medical  Edict  and  Ordinance,  revived  Sept.  27,  1725. 

The  College  shall  consist  of,  and  be  supplied  by,  our  acting  Hof-Rathen,  Leib- 
and  Hof-Medici  here  in  Berlin  with  the  Physicus  ordinarius  and  the  oldest  practi- 
tioners of  our  residences.  .  .  .  Our  Leib-  and  General-Chirurgus  also,  as  well  as 
our  court-apothecary  and  two  of  the  most  skilful  surgeons  of  the  guild  in  this  place 
and  two  experienced  apothecaries  shall  be  received  as  assessors. 

In  every  province  there  shall  be  a  Collegium  medicum,  consisting  of  a  Kriegs- 
and  Domanenrath  as  a  directorium,  two  medici,  two  chirurgi  and  two  apothecaries, 
who  shall  examine  conjunctim  all  surgeons,  apothecaries,  bath-keepers  and  mid- 
wives  in  that  province.  No  medicus  shall  be  admitted  who  has  not  taken  his  cursum 
anatomicum  in  the  t  heat  rum  anatomicum  at  Berlin,  and  no  apothecary  who  has  not 
made  his  processus  pharmaeeutico-chimieos  at  the  same  place.  1  State  instead  of  a 
facultyr  examination).  These  colleges  shall  maintain  communication  with  the  superior 
collegium  in  Berlin. 

The  Medici 
are  exhorted  to  concord  among  themselves,  and  are  sworn  to  treat  the  poor  gratis. 
They  are  expected  to  live  honorably  and  temperately,  in  accordance  with  the  noble 
creature  entrusted  to  their  care,  should  not  be  envious  of  each  other,  and  least  of  all 
defame  and  depreciate  each  other,  and  in  consultations  they  must  come  to  an 
agreement. 

The  Physici  in  the  country  and  cities  must  present  themselves  in  Berlin  and 
complete  a  cursum  medico-practicum,  take  the  cursum  anatomicum.  and  may  not  be 
sworn  until  they  have  passed  their  examination  (Physicatsexamen). 

The  treatment  of  internal  diseases  belongs  to  the  approved  medicinae  doctores 
alone;  on  the  other  hand  they7  are  not  allowed  to  dispense  medicines.  Private  arcana 
or  remedia  specifica  of  a  physician  must  be  first  tested,  and  may  then  be  sold  in  the 
pharmacies  for  a  reasonable  price  or  prescribed  for  his  patients  by  the  physician. 

In  remote  or  s;nall  places  where  no  medicus  can  subsist,  the  surgeons  or  apothe- 
caries may  treat  cases  of  internal  disease  which  occur,  but  must  not  administer 
powerful  drugs.  They  must  avoid  purgation,  the  administration  of  emetics,  emmen- 
agogues,  opiates,  narcotics  and  severe  salivation. 

The  medici  must  not  recommend  one  surgeon  or  apothecary  before  another. 

Physicians  must  not,  desert  their  residences  during  the  prevalence  of  the  plague 
or  epidemics,  but  need  not  go  into  infected  houses  unless  ordered  as  Pest-Medici. 

Whereas  experience  abundantly7  teaches  that  the  medici,  chirurgi  and  apothe- 
caries are  not  always  rewarded  for  their  trouble,  their  bills  take  precedence  of 
all  others. 

The  tariff  of  fees  does  not  tie  the  hands  of  gentlefolk  and  the  wealthy. 

Of  the  Chirurgi. 

They  stand  subordinate  to  the  Collegium.  The}-  are  required  to  have  served  an 
apprenticeship  of  seven  years,  to  exhibit  a  proper  indenture,  to  have  served  also  in 
the  army  during  this  period  and  to  have  passed  an  examination  before  the  Physicus. 
Then  they  must  present  themselves  before  the  Collegium  and  perform  a  cursum 
operationum  in  the  theatro  anatomico.  Finally  they  must  take  the  juramentum 
chirurgicum.  Only  those  who  have  taken  the  cursum  operationum  can  call  them- 
selves Chirurgi  and  Operatores. 

In  Berlin  only7  20  German  and  6  French  chirurgi   are   allowed   in  addition  to  the- 
Hof-  and  Leibchirurgi. 
48 


—  754  — 

All  unnecessary  banqueting  and  preparations  of  plasters  and  salves,  with  the 
punishments  therefor,  are  abolished  in  all  associations  and  guilds  of  the  surgeons. 
On  the  other  hand,  a  surgeon  who  is  to  be  newly  admitted  shall  pa}'  20  thaler,  and 
an  incorporated  surgeon  10  rixthaler,  to  the  Instrumentum  chirurgicum,  and  these in- 
strumenta  shall  be  arranged  by  the  guild  of  surgeons. — The  discipuli  shall  be  required 
to  attend  diligently  the  leetiones  publicas  in  the  theatro  anatomico.  Before  they  are 
dismissed  the  apprentices  shall  be  examined  upon  these  lectures. — External  treatment 
may  be  practised  only  by  the  surgeons  approved  by  the  collegium  medicum.  They 
shall  live  soberly  etc.,  and  in  times  of  the  plague  or  other  epidemics,  which  God 
avert,  let  them  go  into  the  lazarettos  when  ordered  to  do  so. — The  guild-surgeons  must 
give  information  concerning  dangerous  and  severe  wounds.  —  In  case  they  are  called 
in  for  examination  by  the  physicus  or  a  medicus,  they  must  give  true  evidence.— The 
treatment  of  internal  diseases  is  forbidden  to  them  ;  even  in  severe  accidents  a 
medicus  shall  be  called  in  to  external  wounds.  —  Mercurial  treatment  without  the 
knowledge  of  a  physician  is  forbidden  to  the  surgeons,  and  in  like  manner  untimely 
venesection  is  prohibited  under  severe  penalties 

Of  the  Apothecaries. 

Apothecaries  before  settling  down  must  submit  themselves  to  the  collegium,  must 
bring  with  them  indentures  and  other  attestata,  must  have  served  at  least  seven  years, 
must  submit  to  an  examination  by  our  professor  ehymiae  practicus  and  court  apothe- 
cary, and  must  then  complete  publickly  the  processus  pharmaceutico-ehymicos. 
After  the  completion  of  their  examination  they  are  to  be  sworn. — In  Berlin  there 
may  be  nine  German  and  three  French  apothecaries. — They  shall  strive  to  fear  God, 
lead  a  sober  and  temperate  life  and  behave  uprightly,  peaceably  and  obligingly  to 
everyone;  particularly  must  they  avoid  fostering  jealousy  and  discord  among  them- 
selves, and  they  must  carefully  collect,  preserve  and  dispense  their  drugs. — The 
venena  must  be  kept  locked  up  and  separate  from  other  medicines.  No  poison  shall 
be  sold  to  the  laity  without  a  certificate.  —  Internal  medicines,  not  prescribed  by  tin 
medicus,  must  not  be  prepared.  Where,  however,  recipes  are  marked  statim.  cito, 
citissimo,  the}7  must  be  prepared  before  all  others.  —  They  must  not  recommend  any 
one  medicus  in  preference  to  another.  — The  apothecaries  must  not  prescribe,  treat 
patients  or  dispense  medicines  without  prescriptions  from  the  medici.  They  may. 
however,  supply  off-hand  "Edel-,  Hertz-,  Kinder-  und  Pracipitantz-Pulver",  as  well  as 
gentle  laxantia  and  lenitiva,  like  manna,  cassia,  tamarinds,  senna,  rhubarb  and  its 
syrup  in  moderate  doses.  On  the  other  hand  vomitoria  and  other  purgantia,  as  well 
as  menses  moventia  ex  Mercurio  and  Antimonis  prasparata  and  opiata,  especially 
philonium  romanuin.  requies  Nicolai  and  particularly  Bezoardica  and  Sudorifera, 
must  not  be  sold  under  severe  penalties.  —  Inspections  must  be  made  at  least  every 
three  years,  half  the  expense  of  the  same  to  be  borne  by  the  apothecaries  and  half  by 
the  city  treasury.  All  questions  regarding  the  remedies  prescribed  must  be  answered 
at  the  request  of  the  physicians. 

The  Grocers 

must  sell  nothing  but  esculenta.  The}"  are  to  be  sworn  like  the  chemists,  distillers 
and  book-keepers,  who  sell  medicines.  The  shops  of  the  grocers  are  to  be  inspected 
with  the  aid  of  the  apothecaries  twice  a  year.  The  grocers  must  receive  no  apothe- 
caries' apprentices  into  their  business  or  guild  under  penalty  of  a  fine  of  100  thaler. 
Booksellers,  printers,  confectioners,  merchants,  traders  etc.  must  not  deal  in  medicines. 
The  same  holds  with  respect  to  many  male  and  female  characters,  who  understand 
nothing  about  medicines.  Grocers'  shops  etc.  must  not  set  up  the  signs  of  apothe- 
caries. 


—  755  — 

Of  the  Bathers. 
Bathers  and   bath-keepers,  shall   not  establish  a  bathing-house,  or  purchase  one 
already  licensed,    until  they  are  examined.     They  may  treat  neither  external   nor 
internal  diseases. 

Of  the   Midwives. 

They  must  be  examined  by  the  Collegium  medicum  or  the  provincial  colleges. 
They  must  learn  from  the  professor  anatomise  at  the  t  heat  rum  anatomicum  (the  hobby  !) 
to  know  upon  the  dead  the  nature  and  strueturam  part iu in  getiitalium.  They  must 
be  Christians  and  temperate,  not  envious  of  each  other  etc.  Jn  difficult  cases  they 
must  call  in  a  mediciis  or  chirnrgus.  They  must  not  treat  either  internal  or  external 
diseases,  in  either  married  or  single  women.  They  must  not  specially  recommend 
any  mediciis  or  chirurgus  or  apothecary. 

Mountebanks  and   Dentists. 
Moreover  the  itinerant  herniotomists,  dentists  and  root-sellers  who  travel  about 
to  the  annual  fairs,   shall  not  be  allowed  in  our  cities  to  expose  their  goods  for  public 
sale  unless  provided  with  a  license.      Even    in  the  latter  case  they  must  procure  their 
medicaments  from  tue  pharmacies. 

Studiosi   medicinae  etc. 
Studiosi  medicinu'.  preachers,  chemists  and  their  assistants,  distillers,  rummagers 
of  all  varieties.  Jews,  shepherds,  doctores  bullati,3  old  women  and  exorcists  are  not 
permitted  to  practice  medicine. 

Executioners. 
The  internal  and  external  treatment  of  diseases  is  prohibited  to  these. 

Water-sellers. 
The  sieve-makers  who  travel  through  the  country,  Thuringian  water-sellers  and 
Olitaeten-peddlers,3   shall    be  deprived   of  their  medicines,  punished  corporeally  and 
banished. 

Berlin.  September  27,  172").  Fr.  YVilhelni. 

Against  this  medical  edict  the  faculty  of  Frankfurt  remonstrated  upon  the 
following  grounds : 

1.  According  to  the  edict  of  16S5,  both  professors  were  members  of  the  college. 

2.  The  Collegium  medicum  prejudiced  the  privileges  which  had  existed  prior  to 
those  of  the  Collegium  medicum  at  Berlin,  and  according  to  which  the  professors 
had  to  examine  the  physicians,  apothecaries,  barbers  and  midwives,  to  visit  the 
officinas  of  the  first-mentioned,  and  to  approve  the  appointment  of  physici. 

3.  It  had  been  earlier  settled  that  he  who  had  studied  and  graduated  at  Frankfort 
should  be  appointed  to  the  physicate  for  other  places  in  this  country,  and  the  Faculty 
was  authorized  to  fill  such  vacancies  as  might  occur.  Now,  however,  this  arrange- 
ment was  set  aside.  The  king  should  therefore  command  the  Collegium  medicum 
not  to  prejudice  further  these  privileges;  for  by  the  decision  that  every  one  who 
wished  to  practice  in  these  lands  and  who  had  been  graduated  as  a  Doctor  medicinae 
at  Frankfort  must  have  an  Attestatum  from  the  Collegium  medicum  that  he  had  been 
examined  by  this  and  had  completed  his  cursum  anatomicum,  such  an  injury  was 
inflicted.  For  the  professors  would  be  deprived  of  their  graduation  fees,  although 
they  devoted  some  years,  and  mostly  gratis,  to  the  instruction  of  their  studiosi 
medicinae.     The  fides  of  the  Faculty  was  suspected.     The   professors  became   mere 


1.  See  page  566,  note  2. 

2.  Olitaete'n  were  all  kinds  of  oils,  essences,  perfumed  waters  etc.     One  of  the  most 

popular  of  these  was  the  "Krummholziil  ".  oil  of  the  mountain  pine,  which  was 
regarded  as  a  specific  for  tooth-ache.     (11.  i 


—    <oG  — 

officials  of  the  Collegium  medicuui.  Moreover  they  dared  affirm  that  the  most  skilful 
anatomist  might  be  nevertheless  the  most  miserable  of  practitioners  and  scarcely  able 
to  cure  a  tertian  fever  or  other  still  more  trifling  disease,  while  one  well  informed  in 
the  true  theoria  medica.  which  is  derived  from  praxis  clinica,  and  a  candidate  from 
the  university  well  instructed  in  the  correct  historia  morborum,  would  be  far  more 
capable  than  another  who  might  have  received  complete  approval  from  the  Collegium 
medicum,  because  he  had  completed  his  cursus  at  the  theatrum  anatomicum  in 
Berlin.  ':  Indeed,  as  regards  this  point,  we  may  add  that  the  anatomy  of  the  present 
day  deals  chiefly  in  subtilties,  unprofitable  and  highly  injurious  and  prejudicial  to 
true  praxis  clinica,  and  that  if  a  candidatus  medicinae  knows  it.  it  is  about  as  profitable 
to  him  as  regards  his  scientific  praxis  clinica  as  the  ars  poetica  or  pictoria,  since  it 
merely  gives  him  occasion  for  delusive  indicationibus."  The  Faculty  also  teaches 
anatomy  and  allows  no  opportunity  to  escape  of  getting  subjecta  humana,  "  though 
we  can  get  none  for  less  than  10  to  12  rix-thaler.  But  in  the  lack  of  these  our 
auditores  practice  diligently  in  sectionibus  brutorum." — Double  expenses  accrue  to 
the  candidates  at  Frankfort  and  Berlin.  All  this  is  in  violation  of  the  effectun. 
promotionis  publicae,  since  by  the  actu  promotionis,  in  accordance  with  the  impeiial 
and  electoral  privileges,  authority  is  imparted  to  the  graduated  Doctoribus  to  exercise 
Praxin  throughout  the  whole  Roman  Empire.  This  authority  now  come6  to  nought. 
-The  Collegium  medicum  receives  general  sovereignty,  and  yet  practitioners  licensed 
by  it  have  been  extremely  ignorant,  including  among  them  even  some  Stadt-Physici. 
though  the  examination  of  the  latter  the  Faculty  is  willing  to  concede  as  useful  to 
the  state.  —  The  Faculty  is  losing  money  etc. 
Frankfort-on-the-Oder,  March  '21.  IT-.'."). 

Your  Majesty's  most  obedient  and  dutiful  Servants  etc. 
To  this  protest  the  Faculty  received  the  following  cutting  reply: 
"  The  arrangement  was  not  made,  according  to  the  imputation  of  the  Faculty, 
for  the  purpose  of  injuring  them.  They  are  still  at  liberty  to  correspond  with 
the  Collegium  etc.,  but  his  royal  Majesty,  as  the  highest  Collator,  holds  himself 
bound  by  no  privileges,  when  he  knows  it  to  be  salutary  for  the  common  weal  to  alter 
or  abridge  them.  The  reasoning  which  the  petitioners  undertake  to  introduce  in 
their  memorial  regarding  the  royal  anatomical  and  surgical  institutions  heie,  and 
their  most  gracious  and  established  arrangements,  is  partly  impertinent  and  partly 
so  constituted  as  to  awaken  no  special  opinion  of  the  science  and  experience  attained 
b}T  the  petitioners  in  arte  medica,  seeing  that  almost  innumerable  diseases  are  of 
such  form  as  to  be  recognized  only  by  an  exquisite  knowledge  of  anatomy,  and  still 
less  to  be  cured  without  such  knowledge,  and  the  principium  that  .-uch  an  exquisite 
notitia  anatomhe  is  not  absolutely  necessary  to  medicis  is  the  more  dangerous, 
because  if  the  Studiosi  Medici  me  are  led  by  it  to  neglect  the  studium  anatomicum. 
they  not  only  remain  mere  bunglers  in  arte  medica  and  may  be  at  most  looked  upon 
as  Empirici  etc.  The  petition  moreover  merits  not  the  least  reflection  in  consequence 
of  its  trifling  objections.  The  Faculty  must  live  in  accordance  with  the  ordinance 
and  likewise  in  the  future  refrain  from  offensive  epistles  and  from  the  partially  false 
and  baseless  allegations  employed  in  different  places  of  their  memorial,  or  certainly 
expect  the  punishment  due  to  their  obstinacy. 

Sign.   Berlin,  Sept.  30,  \1'1">.  .  .         , 

By  his  Royal  Majesty  s  special  command. 

We  observe  that  politeness  was  not  precisely  the  reigning  characteristic  of  this 
correspondence  on  either  side- — on  the  contrary  quite  the  reverse.  At  the  present 
day  such  "renitent"  professors  would  be  dismissed  in  short  order.  It  should  be 
emphasized  to  the  credit  of  the  Faculty  that  they  entered  the  lists  so  vigorously  in 
behalf  of  the  ancient  freedom  ( Freiziigigkeit  •  of  physicians. 


In  the  18th  century  the  "Physici"  first  made  their  appearance  as 
state  physicians,  regularly  distributed  and  in  limited  numbers,  represent- 
ing state  officials  with  permanent  duties,  while  heretofore  they  had  been 
rather  city  appointees,  or  at  least  had  not  been  distributed  in  accordance 
with  a  definite  system  over  an  entire  province.  The  latter  arrangement 
began  in  Prussia  as  early  as  the  end  of  the  17th  century,  when  the  great 
Elector  in  1685  published  his  medical  edict,  which  united  to  his  marvellous, 
strict  and  bureaucratic  machine  of  state  a  public  health  department  con- 
trolled by  the  police.  This  system  was  subsequently  imitated  b}r  other 
states.  The  salary  of  a  "Puysicus"  generally  ranged  between  685  and  1025 
marks  ($171-250).  In  Prussia  one's  capacity  for  the  office  was  decided  by 
a  state  examination  ;  in  other  states  chiefly  by  the  connexions  of  the  can- 
didate, then  his  character  and  behavior. 

This  imitation  of  Prussia  was  particularly  marked  in  Russia,  which  occupied 
relations  of  old  and  hereditary  friendship  with  that  country.  Even  in  the  charter  of 
the  Berlin  "Societat  der  Wissenschaften".  founded  in  1700  on  the  pattern  of  the 
English  society,  it  is  said:  "It  is  well-known  in  what  a  good  understanding  we  are 
•with  the  Muscovite  Czar.  Since  now  the  same  .  .  etc.,  we  will  be  mindful  how, 
therefore,  as  occasion  offers  commerce  is  cultivated  and  convenient  arrangements 
made  with  this  monarch,  so  that  from  the  boundaries  of  our  land  as  far  as  China 
useful  observations  etc.  are  made." 

The  following  report  was  also  made  out  in  17sii  tor  the  Russian  officials,  and 
may  be  of  service  in  giving  us  an  insight  into  the  further  development  of  state- 
medicine  in  Prussia.1 

Medical  Arrangements  in   Prussia  in  the  Year  1786. 
I.     The  Superior  Collegium  medicum  (founded  1685), 
II.     The  Collegium  medico-ehirurgicum  (founded  1719), 

III.     The  Superior  Collegium  Sanitatis  (founded  171!)). 

I.     The  Superior  Collegium   Medicum. 
This    in    17:J-f    received   a  special    Director,    beneath   whom    were    five    medical 
-Associates,  including  the   Berlin  "  Staatsphysicus".  a  syndic  and  a  medicus  from  the 
French  colony,  2  assessors  of  pharmacy,  '_'  of  surgery.  2  medical  fiscals,  one  secretary, 
a  registrar,  one  chancery  clerk  and  one  messenger. 

The   Medicus  who  desires  to  practice  in    Prussia, 
must  hand  in  12  copies  of  his  Disputation,  as  well  as  his  diploma,  and  mention  what 
universities  he  has  attended.      He  can  then  take  his  cursum  anatomieum  (6  demonstra- 
tions upon  arranged  preparations).     Next   he  receives  a  casus  medico-practicus  to 


1.  It  is  interesting  to  observe  the  German  proclivity  of  Prussia,  which  Frederick  II. 
subsequently  set  entirely  aside.  It  is  said  (1700) :  Care  must  be.  taken  "  that  the 
ancient  and  original  German  language  may  be  preserved  in  its  natural  and 
fitting  purity  and  independence,  and  that  an  absurd  "Mischmasch"  and  non- 
sense does  not  finally  arise  therefrom  "  etc.  Faith  likewise  played  its  part.  The 
Society,  through  the  investigations  to  which  it  gave  occasion,  was  by  means  of 
the  amber  "to  light  the  light  of  Christianity  and  the  pure  Evangelium  for  those 
barbarous  people  .  .  .  in  which  we  have  the  advantage  over  other  Christian 
potentates  that  we  alone  possess  the  amber  and  also  those  wares,  which,  among 
all  those  of  Europe,  are  ordinarily  desired  and  highly  prized  in  China."  I'rose- 
lytisin  by  means  of  amber  was  at  all  events  milder  Ihan  the  favorite  means  of 
Charlemagne  1000  years  earlier —  the  sword  ! 


—    <o8  — 

discuss  in  Latin,  which  task  must  be  accomplished  in  four  week*,  and  he  must  swear 
that  it  is  his  own  independent  work.  If  successful  in  these  requirements  he  is  ther. 
permitted  to  practice.  « 

A  Chirurgus  i  surgeons  and  bath-keepers  were  united  in  1799) 
must  prove  that  he  has  studied  surgery  for  three  years  and  has  served  seven  years,  01 
been  a  "  Feldscheer"  in  a  regiment.  He  must  perform  in  public  two  anatomical 
demonstrations  and  six  surgical  operations  for  the  city,  and  if  successful  in  these  he 
must  still  pass  an  examination.  Surgeons  who  pass  a  mediocre  examination  receive 
licenses  to  shave,  cup  and  bleed  in  very  small  cities. 

An  Apothecary 
must  bring  evidence  of  having   received   instruction  and  of  seven  years'  service.     In 
case  of  his  death  or  disability,  a  sworn  and  approved  dispensing-clerk  must  be  taken. 

The   Midwives 
receive  instruction  in  the  provincial  schools  for  midwives.     Their  examination  takes 
place  before  the  superior  Collegium. 

All  persons  engaged  in  medicine  pay  the  approbation  fees  to  the  superior 
Collegium  :  medicus,  chirurgus  and  apothecary  receive  the  medical  books,  to  wit. 
the  medical  ordinance  at  the  rate  of  one  thaler,  the  dispensatofium  at  two  thaler, 
the  medical  tariff  at  16  groschen,  and  the  book  of  instruction  for  midwives  at  8 
groschen.  From  these  payments  the  subordinate  officials  receive  their  salary,  the 
balance  being  divided  among  the  unsalaried  members  of  the  superior  Collegium.  ■ — 
The  chief  receives  no  salary. — The  superior  Collegium  meets  weekly  on  Ft  Hay  at  11 
o'clock.     About  1500  cases  come  before  it  annually. 

II.     The   Superior  Collegium   Medico-chirurgicum. 

The  beginning  of  this  was  the  Theatrum  anatomicum,  founded  in  1713,  and 
provided  with  definite  regulations  in  171!».  Jn  winter  anatomical  lectures,  and  in 
summer  lectures  on  surgery,  are  to  be  held.  It  was  designed  particularly  for  army- 
surgeons.  It  was  instituted  in  1724  with  the  following  professors:  professor  of  thera- 
peutics, Dr.  Henrici  :  professor  of  anatomy  and  physiology,  Dr.  Buddeus  ;  professor 
of  botany,  Dr.  Ludolf;  professors  of  chemistry,  Drs.  Pott  and  Neumann  ;  professor 
of  mathesis  (judicial  astrology),  Schiitz;  demonstrator  of  surgical  operations,  Senft. 
In  178G  the  institution,  in  addition  to  the  Director,  had  eight  professors  :  two  pro- 
fessors of  anatomy,  one  of  botany,  one  of  physiology,  therapeutics  and  pathology,  one 
of  chemistry,  one  of  surgery.  The  professor  of  surgery  teaches  surgical  operations. 
medical  surgery  and  accouchement.  The  lectures  are  free,  the  salary  of  thepio- 
fessors  being  paid  by  the  state.  Matriculation  costs  two  thaler.  The  professors  are 
permitted  to  give  private  instruction  also,  and  the  honorarium  for  this  is  settled  by 
agreement.  In  anatomical  instruction  200  bodies  are  consumed  annually.  —  In  ti  i 
examinations  royal  pensionary  chirnrgi  and  ex-superior-  .and  staff ciiirurgi  are 
required  to  make  six  anatomical  demonstrations,  and  to  perform  six  surgical  oper- 
ations. A  surgeon  for  a  large  city  must  make  two  anatomical  demonstrations  and 
perforin  six  surgical  operations.  The  Collegium  is  independent  and  has  its  own 
chief. 

Sixteen  young  surgeons  are  instructed  gratis,  and  of  these  the  fifteen  older 
receive  an  annual  pension  of  100  thaler.  The  oldest  is  in  Potsdam  in  charge  of  the 
royal  court;  two  others  are  in  the  Charite,  and  one  in  the  "  Invalidenhaus  "  to  learn 
practice.  On  the  decease  of  a  regimental  surgeon  the  most  capable  of  the  pensionary 
surgeons  is  appointed  to  the  vacancy.  "  In  order  that  there  may  be  no  lack  of  young 
and  capable  surgeons  for  nomination  to  the  vacancies  in  the  preparatorj*  school,  the 
regimental  surgeons  must  take  as  company  surgeons  only  those  who  have  already 
acquired  surgical  knowledge,  and  who  in  the  garrisons  of  this  country  are  special I3 


—  759  — 

required  to  attend  the  public  lectures  of  the  medico-chirurgical  colleges  aDtl  the 
anatomical  dissections.  -Accordingly  four  young  surgeons,  who  have  already  some 
knowledge  of  anatomy,  physiology  and  pathology,  are  maintained  free  of  expense  in 
the  Charite  hospital,  while  two  pay  S  trifling  sum  for  board,  in  order  for  the  teim  of 
one  year  to  study  practice  in  external  and  internal  diseases  under  the  oversight  of 
the  physicians  and  surgeons  appointed  to  the  hospital,  and  to  be  subsequently 
appointed  company-surgeons.'' 

Provincial  colleges  existed:  1.  for  East  Prussia  in  Konigsberg;  2.  for  West 
Prussia  in  Marienwerder ;  3.  for  Neumark  in  Custrin  ;  I.  for  Pomerania  in  Stettin; 
5.  for  Magdeburg  in  Magdeburg;  (!.  for  Halberstadt  in  Halberstadt  ;  7.  for  the  county 
of  Hohenstein  in  Ellrich;  8.  for  Cleves  in  Cleves;  !).  for  Minden  in  Minden;  10.  for 
the  county  Mark  in  Harara;  11.  for  the  principality  Mors  in  Mors;  12.  for  East 
Frieslantl  in  Aurich.     The  members  receive  no  salary  except  their  fees. 

Physici  existed  in  most  of  the  large  cities.  They  received  a  salary  from  the 
city  exchequer,  and  in  the  Circles  from  the  treasury  of  the  Circle.  They  were 
required  to  have  made  a  specially  good  cursum  anatomicum  and  to  have  discussed 
themata  medico-Iegalia.  Such  officials  were  found  e.  g  1.  in  the  Chnrmark  :  a.  in  the 
AltmarkT;  b.  in  the  Priegnitz  4  ;  c.  in  the  Havelland  Circle  6  ;  d.  in  the  Rnppin 
Circle  2;   etc.,  etc.     Their  total  number  amounted  to  131. 

Instructors  of  midwives,  provided  with  an  annual,  fixed  .-alary,  existed  e.  g.  in 
Berlin  one;  in  Prussia  two:  in  Magdeburg  one:  in  Halberstadt  one;  in  Minden, 
Ravensburg,  Tecklenburg  and  Lingen  five:  in  Cleves  one:  in  the  county  Mark  one: 
in  Mors  one;   in  the  county  Hohenstein  one.     Total  14. 

In  the  numerous  free  cities  which  then  existed  (in  contrast  with  the 
present  da}')  the  "Stadt-Physici" '  continued  to  be  official  physicians. 
Of  these  there  were  in  the  larger  cities  several,  who  together  formed  the 
"Physieat",  a  hod}'  in  which  each  individual  had  an  equal  voice  though 
one  of  its  members  bore  the  title  of  -Physicus  primarius".  The  "Stadt- 
physici"  ranked  above  the  "Landphysici".  The  "Landdoctor"  (country 
doctor)  too  still  existed  everywhere,  and  was  held  in  less  esteem  than  the 
Stadtdoctor  (city  physician)  even  by  the  state,  just  as  he  is  at  the  present 
day  by  the  "educated".  Yet  the  inferior  medical  faculty  was  considered 
quite  good  enough  for  the  poor,  dependent  peasants,  though  Wurtz  said  : 
'Medicine  consists  not  alone  in  regard  for  the  person,  whether  he  may  be  a 
physician  of  lords  or  peasants,  whether  he  may  be  well-known  and  a  resi- 
dent of  the  city,  or  a  dweller  in  some  hamlet ;  for  the  whole  matter  depends 
upon  whether  a  man  understands  his  business  and  is  able,  and  knows  how, 
to  aid  nature,  or  not."  —  The  Landphysici  subsequently  stepped  into  the 
places  of  the  Stadtphysici,  as  indeed  the}-  do  at  the  present  day. 

For  the  practising  physicians,  who,  with  few  exceptions,  would  on  no 
account  perform  surgical  or  obstetrical  operations,  and  who.  at  least  in  the 
country,  were  still  comparatively  few  in  number,  the  right,  after  passing  an 
examination  in  some  one  of  the  German  universities,  to  settle  in  any  other 
territory  of  the  empire  without  a  new  examination  no  longer  obtained 
everywhere,  as  had  been  the  case  in  the  17th  century.     In  Prussia  at  least, 

1.  Frankfort-on-tlie-Main  has  restored  the  oltice  of  Stadtarzt,  and  appointed  to  this 
oflice  the  hygienist  Dr.  Alex.  Spiess. 


—  7til)  — 

the  model  among  German  countries  of  bureaucratic  tutelage  of  its  subjects, 
every  doctor  medicinae,  as  appears  from  tbe  medical  edict  quoted  above, 
besides  his  examination  before  the  faculty  of  his  university,  was  compelled 
to  undergo  an  examination  before  the  Collegium  in  Berlin  before  he  could 
practice  in  the  state  of  Prussia,  and  this  ordinance  applied  even  to  Prussian 
subjects.  However,  physicians  preserved  at  least  the  right  of  free  settle- 
ment even  in  Prussia,  In  the  other  German  lands,  however,  the  earlier 
right  of  migration  maintained  its  existence  for  a  longer  period  than  in  the 
model  bureaucratic  state  of  that  time,  and  if  a  medical  man  had  received 
the  title  of  Doctor  from  any  Faculty  whatever,  or  even  at  the  hands  of  a 
Pfalzgraf  (doctor  bullatus).  he  could  practice  in  most  states  of  the  empire. 
The  "diplomirten.  Wundaerzte"  (graduated  surgeons)  of  the  Josephinum 
were  employed  as  general  physicians,  but  were  denied  the  right  of  free 
migration.  Doctors  and  magistri  of  surgery  and  midwifery  who  had 
studied  with  any  of  the  faculties,  were,  on  the  other  hand,  free  to  migrate, 
and  employed  as  surgeons  to  the  Circles,  chief  physicians  in  hospitals  and, 
indeed,  as  professors.  They  were  the  operative  surgeons  (F.  Strohmeyer). 
The  Doctores  medicinae  were  practising  physicians,  physicians  of  the 
Circles  and  professors  and  were  free  to  migrate.  —  In  the  country  only  a 
few  physicians  (medici  puri).  besides  the  Physici  appointed  to  these  neigh- 
borhoods, ever  settled.  The  practice  here  belonged  in  the  main  to  the  sur- 
geons, barbers  etc.  Maria  Theresa  endeavored  to  protect  these  country- 
doctors  from  want  by  having  a  special  district  assigned  to  each  one  of 
them.  In  rare  cases  only  was  a  higher  medicus  called  into  the  country, 
quite  a  contrast  to  the  present  day.  when  in  all  parts  of  Germany  (far  more 
than  in  France,  England  etc.)  higher  physicians  are  distributed  over  the 
surface  of  the  land  in  such  numbers  that  in  1873  there  was  one  physician 
to  every  2616  inhabitants.' 

In  France,  on  the  creation  of  the  Ecoles  de  sante  in  1794,  practice 
was  made  entirely  free.  The  same  is  the  case  at  present  in  the  new  Ger- 
man Empire.  Any  one  could  practise  if  he  had  only  paid  for  a  license  as 
a  physician,  a  regulation  not  yet  introduced  into  the  new  German  Empire. 
Great  evils  arose  from  this  arrangement,  and  individual  prefects  therefore 
entrusted  medical  "Jurys"  with  a  sort  of  examination,  while  the  School  of 
Montpellier  in  1797  proposed  mere  provisory  licenses.  In  1799  an  effort 
was  made  to  go  back  to  the  old  Faculties  and  surgical  institutions  of  in- 
struction, but  it  proved  a  failure.  The  Faculties  were  not  restored  until 
the  establishment  of  the  Empire,  which  likewise  retained  Ecoles  de  medecine. 


On  the  other  hand  Wurtemberg,  considered  by  itself,  had  one  physician  for  each 
3971  inhabitants,  and  each  of  these  practitioners  had,  on  the  average,  an  income 
of  493  marks  ($123).  In  Ellwangen  the  physician  received,  indeed,  only  30 
marks,  60  pfennige.  The  poorest  paid  widwives  were  in  Tubingen  (2  marks,  40 
pfennige  per  year)  and  Ohringen  (1  mark,  70  pfennige  per  year).  —  In  1S76  a  phy- 
sician had  only  3120  persons  to  treat  (average  of  the  whole  empire).  In  Berlin 
each  of  the  lOOl  physicians  had  but  1156  persons  under  his  care. 


—  701  — 

A  numerous  class  of  physicians  which  arose  in  the  18th  century  were 
the  bath-physicians.  In  Germany  these  were  the  result  of  the  increased 
popularity  of  bathing-resorts,  occasioned  especially  by  the  influence  of 
Friedrich  Hoffmann.  In  France,  on  the  other  hand,  which  as  earl}'  as  the 
17th  century  had  inspectors  of  baths  appointed  by  the  state,  these  officials 
appear  as  a  class  of  physicians  called  into  existence  by  the  government. 
Thus  e.  g.  S6nae  was  appointed  b}'  the  state  the  chief  officer  for  the  bath- 
ing resorts.  The  baths  provided  at  the  bathing  resorts  for  the  poor  and 
for  soldiers  especially  were  placed  in  his  charge,  institutions  which,  as  we 
know,  existed  also  among  the  Romans.  In  Germany,  too.  special  "Quelleu- 
iirzte"  were  to  be  found  —  in  Gastein  the  first  permanent  bath-physician 
appeared  as  early  as  1671  —  who  in  certain  bathing  resorts  enjoyed  a 
salary  from  the  state.  Thus  Joh.  Dan.  Gohl  (died  1733)  was  "Brnnnen- 
arzt"  in  Freyenwalde,  and  Chr.  Fr.  Stromeyer,  when  appointed  to  such  a 
position,  received  in  179G  a  salary  of  750  marks.  This  arrangement,  how- 
ever, was  rare,  and,  on  the  whole,  applied  to  only  a  few  of  the  smaller 
bathing  resorts.  At  the  larger  ones  was  located  the  residence  of  the 
"Physici",  where  such  a  course  was  convenient.  Besides  these,  however, 
ordinar}-  practitioners  also  settled  in  these  resorts  —  e.  g.  at  Karlsbad  —  as 
bath  physicians.  Patients  as  a  rule  before  visiting  the  baths  obtained  the 
required  directions  as  to  their  nse  from  their  own  physicians  and  managed 
accordingly  ;  or  they  entrusted  themselves  to  the  bath-masters,  as  was  the 
usual  custom  in  earlier  times.  In  order  to  be  able  to  give  the  proper 
directions  at  home,  and  to  become  acquainted  with  the  arrangements  of  the 
bathing  resorts  and  the  effects  of  the  waters,  many  German  physicians  — 
and  man}'  English  ph}sicians  at  the  present  day  —  before  entering  upon 
practice  undertook  travels  to  various  baths,  as  e.  g.  Heim.  This  was  at  all 
events  better  than  the  system  of  the  present  day.  in  which  we  merely  con- 
sult the  prospectuses  (published  too  often  merely  as  advertisements)  and 
the  anabysis  of  the  required  waters,  without  troubling  ourselves  generally 
to  inquire  whether  the  bathing  arrangements,  the  attendance  and  the 
individual  physicians  who  present  their  own  recommendations,  are  really 
good.  An  eje  was  also  kept  at  that  time  on  the  question  whether  the 
entire  business  was  not  designed  to  basely  impoverish  sick,  frequently  poor 
and  doubi}'  unfortunate  men.  lest  the  visit  to  the  baths  might  occasion  for 
these,  instead  of  the  cure  of  their  diseases,  only  new  cares  and  subsequent 
deprivation,  added  to  the  other  unavoidable  necessities  of  the  suffering, 
particularly  if  the  visitation  of  the  baths  remained  absolutely  fruitless,  as 
was  so  frequently  the  ease.  The  number  of  the  bath  physicians  was 
trifling  in  comparison  with  the  present  day.  and  we  therefore  read  nothing 
of  the  frightful  rivalry  which  blooms  forth  here  and  there  in  our  resorts 
for  bathing,  and  of  which  the  patients  when  they  return  home  are  not  in- 
frequently able  to  tell  wonderful  stories  :  nor  do  we  hear  of  the  private 
letters  of  recommendation  which  buzz  about  our  ears  everywhere  now.  and 
often  degrade  intolerably  the  standing  of  the  profession. 


—  T62  — 

Another  innovation  which  the  last  century  introduced  into  practice 
were  the  so-called  "Hausarzte"  (family  physicians)  in  the  best  sense  of  the 
term,  an  arrangement  which,  as  already  mentioned,  impressed  upon  the 
profession  of  the  physician  a  peculiarly  beneficial  stamp. 

The  physicians  of  the  18th  century,  in  contrast  to  those  of  bygone 
ages,  did  not  look  upon  their  professional  business  as  merely  a  sort  of' 
productive  milch-cow,  to  be  drained  for  their  profit,  nor.  as  in  the  pre- 
ceding century  did  they  devote  their  attention  to  quixotic  matters,  like 
alchemy,  astrology,  uroscopy  and  the  like.  At  least  this  was  true  of  the 
better  class,  who,  as  we  have  already  remarked,  must  determine  our 
opinion  regarding  the  entire  profession,  for  in  all  centuries  the  mass  is 
pretty  nearly  the  same.  Alchemists  and  producers  of  the  philosophers 
stone  died  out  in  this  century,  and  one  of  the  last  of  ^these  was  the  Eng- 
lishman John  Price.  Physicians  too.  though  often  possessed  of  the  re- 
quired knowledge,  were  not  so  frequently  chemists,  physicists  or  mathe- 
maticians ex  professo,  i.  e.  teachers  of  these  branches,  as  was  the  case  par- 
ticularly in  the  17th  century,  but  they  practised  for  the  most  part  medicine 
only.  Then  too  they  no  longer  contracted  to  fill  positions  for  a  limited 
period,  and  still  less  did  they  travel  about  from  place  to  place,  but  rather 
as  a  rule  remained  in  the  place  once  chosen  for  a  residence  and  changed 
their  homes  very  rarely.  Thus  the  profession  acquired  a  character  of 
steadiness  and  solidity,  and  found  opportunity  to  establish  and  preserve 
the  esteem  and  affection  of  its  clientele,  which  was  not  the  rule  with  the 
mass  of  physicians  during  the  17th  century.  Of  course  with  the  improved 
social  position  of  physicians  many  mediaeval  blemishes  disappeared.  Even 
in  the  universities,  although  there  were  still  many  disorders,  the  mediaeval 
custom  of  swilling  beer  was  abandoned  somewhat  among  the  better 
students.  Hence  greater  efforts  after  improvement  and  education  appealed 
more  frequently  at  least  than  heretofore,  and  particularly  a  devotion  to 
belles-lettres  and  philosophy.  Certain  universities,  especially  Gottingen. 
became  seats,  nurseries  and  centers  of  good  taste  and  aesthetic  associations. 
in  which  not  a  few  future  physicians  took  part.  (In  our  sober  century, 
so  devoted  to  the  cultivation  of  special  branches,  such  an  interest  in 
aesthetics  would  very  likely  be  regarded  by  most  teachers,  as  well  as  by 
the  public,  not  only  as  no  recommendation  for  a  student  of  medicine  and  a 
future  physician,  but  as  an  actual  ground  for  unfavorable  criticism.) 
Accordingly  in  the  18th  century  not  a  few  members  of  the  German  medical 
profession  —  and  thereby  they  became  no  worse  physicians,  but  rather  the 
reverse  —  took  a  great  share  mediately  and  immediately  in  the  perfection 
of  our  polite  literature.  Among  these  we  may  mention  Withoff,  (Jiinther. 
Werlhof,  Haller,  Hensler,  Zimmermanu,  the  Thuringian  Neubert,  Althott', 
the  trusty  friend  of  the  great  but  unfortunate  lyric  poet  Burger,  Schiller, 
the    famous   English    poet   Mark    Akenside1   (1721-1770)    and    numerous 

1.  To  whom  we  might  add  Oliver  Goldsmith,  George  Crabbe,  John  Armstrong,  Sir 
Richard  Blackmore,  Sir  Samuel  Garth,  John  Wolcot  (Peter  Pindar)  etc.     (H.) 


—  763  — 

others.  Lessing  was,  at  least  for  a  time,  a  student  of  medicine.  Some 
physicians,  however,  were  encyclopaedists,  like  Pierer,  who  is  best  known 
by  his  "Conversationslexicon",  and  Joh.  G.  Kriinitz  (1728-1790),  the 
author  of  a  most  comprehensive  encyclopaedia  in  70  volumes  ;  others  were 
important  philosophers  like  Cabanis,  Schelling  etc.;  others,  mathematicians- 
like  Olbers  etc. 

Of  course  the  relations  between  colleagues  were  not  exempt  from  the 
hereditary  infirmity  of  the  profession  —  -T<oy<):  -noy/v  (pOovist,  /.w.  larpdq 
ia-fiut  is  a  very  old  saying  —  and  to  its  preservation  the  division  of  the 
latter  contributed  no  little  share.  Certain  Berlin  physicians  distinguished 
themselves  in  this  sphere,  so  that  a  <  iundelsheimer  may  be  regarded  as  the 
type  of  a  bad  colleague.  Professional  relations  in  general,  however,  and 
in  comparison  with  earlier  and  later  times,  were  so  good,  that  they  may  be 
looked  upon  as  models  in  their  way.  Professional  pride  was  very  active, 
and  the  great  number  of  superior  physicians,  most  of  whom  enjoyed  an 
excellent  general  education,  threw  into  the  back-ground  the  small  number 
of  unworthy  representatives  of  the  profession,  who  of  course  lacked  such 
education.  Existence,  inasmuch  as  the  profession  was  not  yet  over- 
crowded, was  not  so  difficult  as  at  the  present  day,  and  thus  the  faults  and 
infirmities  of  physicians  did  not  appear  in  so  glaring  a  light.  Many  phy- 
sicians enjoyed  so  large  a  practice  that  they  were  compelled  to  have 

Assistants,  as  was.  indeed,  the  case  with  many  of  the  old  Greek  phy- 
sicians. Even  men  of  considerable  eminence  began  their  career  as  assis- 
tants. Thus  Heim  in  1770  occupied  such  a  position  in  Spandau,  receiving 
his  board  and  lodging  free,  in  return  for  which  he  was  expected  to  treat 
the  patients  and  corporations  with  whom  his  emplo}-er  had  contracts  free 
of -expense,  though  lie  was  allowed  to  accept  voluntaiT  fees  and  presents. 
This  practitioner,  afterwards  so  famous,  served,  like  the  French  generals, 
from  the  ranks  up.  and  yet  became  the  ordinary  physician  of  a  princess, 
and,  indeed,  when  she  treated  him  improperly,  was  able  to  discard  her  as 
she  deserved.  In  the  year  1782 — we  mention  it  as  an  example  of  the 
career  of  an  eminent  physician  of  the  last  century  — he  had  in  Berlin  784 
patients,  and  from  this  practice  derived  an  income  of -1200  marks  ($1050); 
two  years  later,  however,  with  only  393  patients  his  income  increased  to 
0000  marks,  and  six  years  later  still,  with  1000  patients,  he  received  24000 
marks  ($6000)  in  money  and  2400  marks  in  presents.  In  1795  for  a  con- 
siderable period  he  made  83  visits  per  diem.  In  1805  Heim's  income  went 
up  to  36000  marks  ($9000),  in  spite  of  the  fact  that,  in  contrast  with  many 
celebrities  of  our  day,  he  had  treated  4000  poor  persons  gratis.  During 
the  years  of  the  war.  indeed,  he  suffered  some  loss  ;  but  subsequently  his 
income  again  rose  to  its  former  height,  and  even  extreme  old  age  failed  to 
teach  him  the  ingratitude  of  which  the  medical  profession  has  often  to 
complain  —  that  of  falling  an  undeserved  victim  to  younger  rivals  —  and 
which  this  modern  novelty-seeking  and  irreverent  age  brings  so  often 
before  our  eyes.     How  modestly  Heim  began  may  be  inferred  from  the  fact 


—  7IU  — 

that  he  was  able  to  give   for  his  first  "Faible"  or  writing-desk  only  180 
pfennige,  while  his  last  one  cost  750  marks. 

Taking  into  account  our  experience  of  the  present  day,  we  ma}'  esti- 
mate the  income  of  a  mediocre  practitioner  of  the  18th  century,  in  a  city 
of  some  size,  at  an  average  of  3000-4000  marks,  which  sum  expressed  in 
money  of  the  present  day  would  need   to  be   multiplied  as  much  as  three 

times. 

The  English  physicians,  in  consequence  of  the  medical  arrangements 
prevailing  in  that  country,  were  generally  better  situated  than  the  Ger- 
mans, and  accordingly  the  famous  practitioners  far  surpassed  the  German 
physicians  in  their  acquisition  of  money.  Thus  Fothergill  was  able  to 
bequeath  in  his  will  £200.000  to  the  poor.  [Fothergill's  highest  income 
in  an}-  single  year  was  £5000,  while  Dr.  John  Coakley  Lettsom  in  some 
years  took  in  not  less  than  £12.000.  and  the  largest  income  of  the  famous 
Mead  in  any  single  year  was  £7000.  Sir  Astley  Cooper  in  the  early  part 
of  the  present  century  had  for  mam*  years  an  income  from  his  practice  of 
more  than  £15,000.  and  the  highest  sum  received  by  him  in  any  single 
year  was  £21.000.  It  may  however  console  the  struggling  young  practi- 
tioner of  the  present  day  to  read  that  the  first  }-ear  of  Sir  Astley  s  practice 
netted  him  five  guineas,  and  it  was  five  years  before  his  ineome  amounted 
to  £100.  In  the  ninth  year  of  his  practice  he  took  in  £1100.  Of  course 
all  these  incomes  were  exceptional,  but  they  serve  for  comparison  with 
that  of  Heim  as  quoted  by  the  author.]  Russia  too,  then  as  at  the  present 
day,  promised  large  incomes  to  physicians.  Thus  Orriius  in  Moscow  ac- 
quired in  a  short  time  about  90,000  marks  ($22,500).  While  these  instances 
are  only  exceptional,  they  give  us  a  bas;s  for  judging  of  the  external  situa- 
tion of  popular  physicians  at  least. 

If  ptiysicians  were,  on  the  whole,  very  much  respected,  well  situated 
socially  and  generally  well  informed,  medical  practice  proper,  again  lagging 
far  behind  the  age,  was  in  many  respects  very  bad.  Many  practitioners 
were  devoted  to  the  therapeutics  of  a  certain  school,  or  imitators  of  the 
prevailing  tendency  of  the  period.  Indeed  they  were  not  all  exempt  from 
charlatanism,  an  hereditary  infirmity  founded  in  the  imperfections,  un- 
certainty and  vacillation  of  professional  treatment  and  the  weakness  of 
character  of  the  individual.  Of  this  infirmity  the  better  physicians  made 
loud  complaints.  Thus  e.  g.  Heim.  with  his  frankness  and  love  of  the 
truth,  in  the  beginning  of  his  career  expressed  himself  in  terms  of  bitter 
reproach  on  this  subject,  until  his  wife  with  much  worldly  wisdom  dis- 
suaded him  from  such  a  course  as  productive  only  of  disagreeable  relations 
and  malicious  calumny. 

Physicians,  as  a  rule,  had  still  the  most  profound  faith  in  drugs.  The 
public  too  followed  their  example  so  closely,  that  an  ordinary,  i.  e.  exceed- 
ingly large,  medicine-spoon  was  in  many  places  a  regular  portion  of  the 
dowry  of  a  bride,  (like  a  cradle  etc.).  Accordingly  prescriptions  a  yard 
long  still  fi  mrished  in   daily    practice   even   far   into   the  present  centur}'. 


—  765  — 

mixta-composita  of  ten  or  more  ingredients,  as  the  author  himself  has 
seen.  All  abracadabras  of  course  required  to  be  written  in  a  foreign 
tongue,  but  the  great  emperor  Joseph  thought  that  prescriptions  might  as 
well  be  written  in  good  German  as  in  Latin.  Uroscopy,  in  accordance 
with  the  "Urinbiichlein",  e.  g.  those  of  Th.  Majus,  Brian  (Hamburg,  1738) 
and  others,  was  still  practised.  The  prescriptions  still  contained  all  the 
trash  of  bygone  centuries,  such  as  precious  stones,  the  dung  of  various 
sorts  of  tame  and  wild  animals,  mummy,  so-called  liquid  and  potable  gold 
and  silver,  bezoary,  so-called  elephant-lice,  wood-lice  (recommended  by  the 
famous  surgeon  Schmucker  as  a  snuff  in  amaurosis)  and  a  host  of  other 
similar  things.  Theriaca  was  still  under  official  supervision,  and  its 
preparation  was  regarded  as  so  important  that  the  occasion  was  made  a 
sort  of  gala-day  in  Wiirzburg  as  late  as  1736,  in  Nuremberg  in  1754  and 
in  Paris  as  late  as  1787.  Fussiness  and  over-medication  also  prevailed  — 
e.  g.  in  cases  of  poisoning,  theriaca  internally  with  milk,  an  emollient 
clyster  and  a  cordial  plaster  —  while  even  the  better  class  of  physicians 
sold  proprietaiy  remedies  and  indulged  in  mysticism.  Not  a  few  physi- 
cians, like  e.  g.  Hoffmann,  Stahl,  Theden  and  Schmucker,  had  their  own 
arcana  and  specitica.'  in  which  they  did  a  thriving  business,  and  Heim's 
patron,  the  famous  privy-counsellor  and  physician-in-ordinary  Fr.  Herm. 
Ludw.  Muzell  (1716-1784)  of  Berlin,  who  though  a  medicus  purus  still 
practised  surgery  (he  was  the  first  to  perform  ligation  of  the  ischiatic 
artery),  even  as  late  as  the  last  half  of  the  century  advised  his  son  -'to 
confide  his  methodus  medendi  to  no  one,  not  even  to  his  most  intimate 
friend."  Under  what  regulations  the  physicians  were  permitted  to  sell 
such  proprietary  compounds  throughout  the  whole  century  is  shown  by  the 
medical  edict  quoted  above. 

Here  and  there  even  the  authorities  themselves  practiced  medicine. 
Their  prescriptions  took  the  shape  of  stringent  edicts.  Thus  e.  g.  the 
pompous  Karl  Theodore  (1724-1799)  in  the  year  1784  charged  his  subjects 
that  in  cases  of  hydrophobia  no  one  should  take  an}*  medicine,  but  simply 
make  intercession  to  St.  Hubert,  a  piece  of  advice  which  (barring  the  super- 
stition involved  in  it),  considering  the  uselessness  of  all  therapeutics  in 
such  cases,  might  not  seem  entirely  inappropriate,  particularly  if  the 
decree  had  emanated  from  some  medical  college  or  another,  and  the  inter- 
cession to  St.  Hubert  had  been  left  out.  Some  noble  and  gentle  families 
had.  and  dealt  in,  certain  inherited  family  arcana.  Indeed  as  late  as  1877 
the  ruling  family  of  Mecklenburg  supplied  such  a  secret  preparation  on 
petition  therefor,  and  it  was  not  until  1878  that  they  placed  it  in  the  hands 
of  an  apothecary  for  sale.  In  England  in  1714  the  day  and  hours  in  which 
the  king  would  cure  the  -King's  evil '  (scrofula)  b\' the  imposition  of  his 
hands  were  announced  in  posters.  —  Authoritative  decrees,  like  that  men- 


1.  In  England  Sir  Hans  Sloane  sold  a  secret  eye-salve,  and  the  famous  Mead  had  a 
secret  nostrum  for  the  bite  of  a  mad  dog.    (H.) 


—  7t>6  — 

bioded  above,  against  medication  in  disease,  might  have  produced  still 
greater  benefits  in  opposition  to  the  blooming  school-therapeutics  of  that 
day.  Yet  We  read  that  one  physician  who  practised  in  accordance  with  the 
s3"Stern  of  Brown,  of  600  fever  patients  lost  in  three  weeks  200,  and  most 
of  them  too  died  through,  and  in  a  state  of.  drunkenness  !  Marcus  too  in 
179S,  practising  the  Brunonian  system,  administered  to  each  of  480  such 
patients  whom  he  treated  in  that  year,  on  the  average  one  drachm  of  opium, 
195  grains  of  camphor,  one  ounce  of  Hoffmann's  Anodyne.  132  grains  of 
serpentaria.  528  grains  <>f  cinchona  fto-day  we  give  as  many  grains  of 
quinine,  even  in  pneumonia,  a  disease  which,  as  we  know,  gets  well  of 
itself!),  more  than  a  pound  of  rectified  spirit,  with  considerable  doses  of 
musk,  sulphuric  aether  etc.  etc.  Another  physician,  opposing  this  method 
of  Marcus,  as  dangerous  as  it  was  expensive,  estimated  that  the  complete 
cure  of  intermittent  fever,  a  disease  of  which  fortunately  men  rarely  die 
before  the  disease  disappears  of  itself,  cost  only  —  six  cents'  worth  of 
opium  and  24  cents'  worth  of  brandy.  Readily,  indeed,  might  Wedekind 
be  led  to  say  -The  value  of  medicine,  expressed  in  two  words,  consists 
chiefly  in  this,  that  civilized  nations  have  to  suffer  far  more  from  their 
physicians  than  from  their  diseases."'  This  was  especially  true  at  that 
period  —  and  indeed  far  down  into  the  present  centurj* —  of  Spain  ;  for 
the  Spanish  physicians  were  distinguished,  before  all  others,  for  their 
ignorance.  Bleeding  and  cathartics  were  their  chief  remedies  To  be  sick 
and  to  call  in  a  physician  was  in  Spain  about  the  same  thing  as  to  die. 
Think  of  it  !  When  the  authorities  once  asked  the  physicians  whether  it 
would  be  beneficial  to  the  residents  of  Madrid  to  have  the  streets  cleaned, 
these  iEsculapii  decided  that,  on  the  contrary,  it  would  be  injurious,  that 
no  variation  should  be  made  from  the  customs  of  their  forefathers,  and 
that  the  tilth  and  foul  smells  should  be  left  in  the  streets  ;  that  the  sharp 
and  stinking  air  was  even  exceptionally  good,  as  it  destroyed  the  material 
of  infection  !  (Newton's  discovery  was  also  regarded  as  dangerous,  since 
it  did  not  support  the  faith).  —  Foreign  physicians,  particularly  those  from 
the  faculty  of  Montpellier,  were  accordingly  much  sought  after  in  Spain. 
The  domestic  physicians,  as  a  rule,  when  they  had  bled  a  patient  on  one 
arm  on  one  day.  bled  him  on  the  other  arm  on  the  following  day,  so  that 
the  blood  might  be  again  equally  distributed  throughout  the  body.  (In 
Spain,  as  elsewhere,  venesection  was  looked  upon  as  a  preventive  measure, 
though  here  the  '-equilibrium"  was  established  in  the  way  described  with- 
out any  knowledge  of  the  circulation  of  the  blood.)  Some  few  physicians, 
however,  studied  the  works  of  the  heretic  Cullen  and  Hoffmann. — That 
the  sciences  accessory  to  medicine  were  in  a  very  depressed  condition  we 
have  already  stated.  Even  surgical  instruments  were  very  roughly  manu- 
factured, and  medicines  were  badly  prepared.  In  the  larger  cities  the 
drugs  were  imported  from  abroad,  and  in  the  smaller  cities  and  those  re- 
mote from  the  capital  they  were  so 'bad  that  one  had  reason  for  joy  if  they 
did  no  harm.     In  the   middle  of  the  18th  century  there  was  no  chemist  in 


—  767  — 

all  Spain,  and  indeed  the  Spaniard  Carapomanes  assures  ns  that  even  in 
1776  there  was  no  one  in  the  whole  country  who  knew  how  to  prepare  the 
commonest  drugs  like  Glauber's  salt,  magnesia,  mercur}'  and  antimony. 
The  statesman  above  named  set  to  work  to  establish  a  chemical  laboratory 
in  Madrid,  though  he  believed  that  it  would  be  regarded  as  dangerous 
(Buckle).  A  foreigner,  Cervi,  founded  the  medical  societies  at  Madrid 
and  Seville  (1732);  Servili,  the  college  of  surgery  in  Cadiz  (1741).  "In 
order  to  make  physiology  and  botany  accessible  to  the  students,  applica- 
tion was  made  to  Linnaeus  to  send  some  one  as  a  teacher.''  In  the  end, 
however,  Spain  had  its  1G  medical  schools,  with  a  curriculum  arranged  by 
the  state.  In  Spain  too  the  surgeons  were  .subordinate  to  the  physicians. 
The  number  of  the  latter  was  so  great  that  in  the  capital  there  was  one 
physician  to  every  1200  inhabitants.  Of  course  not  a  few  of  them  were 
incarnate  beggars.1  Permission  to  practice  was  easih-  obtained,  without 
requiring  much  of  an  examination  ;  it  was  also  cheap,  costing  $45  until 
towards  the  close  of  the  century  (1795).  when  in  Madrid  it  could  only  be 
obtained  for  $325. 

The  management  of  the  insane  was  everywhere  as  bad  as  possible.. 
There  were  no  physicians  for  these  poor  creatures  :  at  most  mere  atten- 
dants who  conducted  the  maltreatment  of  their  wards.  The  poorest  were 
confined  in  dark  rooms,  chained  or  put  into  cages  and  exhibited  at  a 
penny  a  head.2  Such  was  the  condition  which  the  elder  Stromeyer  found 
in  England,  in  England  whose  physicians  might  have  learned  from  their 
great  poet  Shakespeare  (1564-1616),  almost  two  hundred  years  before,  the 
best  and  most  humane  principles  for  the  treatment  of  the  insane  !     At  this 

1.  Even  down  to  the  forties  of  the  present  century  it  was  the  custom  for  Spanisli 

students  during  their  vacation  to  ■'terminiren",  i.  e.  go  begging  like  the  mediaeval 
••travelling  scholars".  Up  to  this  time  too  no  college  fees  were  paid,  and  the 
students  wore  a  peculiar  black  dress  with  a  sword.  In  the  colony  of  Manila 
Jesuits  still  taught  medicine  in  the  medical  school  of  that  place,  and  the  leper- 
houses  were  under  the  oversight  of  clergy  of  the  religious  orders.  The  assign- 
ment of  patients  to  these  houses  was  made  by  the  bath-keepers  (medicillo),  as  in 
the  Middle  Ages.  Most  of  the  apothecaries  ibotanico)  are  Germans.  (Kiirbel  ; 
••  Wiener  Wochenschrift  *',  1878  . 

2.  John  Aubrey  writing  towards  the  close  of  the  17th  century  says  :    "  Till  the  break- 

ing out  of  the  Civil  Wars  Tom  o'  Bedlams  did  travel  about  the"  country.  They 
had  been  poor  distracted  men.  but  had  been  put  into  Bedlam,  where,  recovering 
some  soberness,  they  were  licentiated  to  go  a-begging,  i.  e.  they  had  on  their  left 
arm  an  armilla  of  tin  about  four  inches  long;  they  could  not  get  it  off.  They 
wore  about  their  necks  a  great  horn  of  an  ox  in  a  string  or  baudry,  which, 
when  they  came  to  an  house  for  alms,  they  did  wind,  and  they  did  put  the  drink 
given  them  into  this  horn,  whereto  they  did  put  the  stopple.  Since  the  wars  I  do 
not  remember  to  have  seen  any  one  of  them."  Perhaps  Edgar  in  "  King  Lear  " 
refers  to  the  latter  custom  when  he  says  "  Poor  Tom,  thy  horn  is  dry  ".  During 
the  last  century  the  Bethlehem  Hospital  for  the  insane  was  a  favorite  resort  of 
the  belles  and  beaux  of  London  for  amusement.  Sam.  Johnson  and  Boswell 
wandered  through  the  institution,  and  Steele  took  three  schoolboys  to  see  "the 
lions,  the  tombs,  Bedlam  and  the  other  places  which  are  entertainments  to  raw 
minds,  because  they  strike  forcibly  on  the  fancy"   <  Jeaffreson).    (H.'i 


—  768  — 

time  the  harmless  insane  in  London  wore  upon  their  left  arm  a  ring,  and 
about  their  neck  a  large  ox-horn,  and  were  permitted  to  go  about  the 
streets  begging  ! 

The  following  account  is  given  of  the  German  institutions  for  the 
insane : 

•  In  these  dens,  exposed  to  all  the  storms  of  the  elements,  there  was 
a  lack  of  fresh  air,  sunlight,  exercise,  amusement,  in  short  of  all  the 
physical  and  moral  means  which  are  required  for  the  cure  of  the  sick. 
The  attendants  of  the  goalers  are  for  the  most  part  rough  men,  with  whom 

barbarity  is  an  everyday  matter The  bellowing  of  the  maniacs  and 

the  rattling  of  the  chains  resound  day  and  night  in  the  streets  (of  the 
dens),  in  which  cage  strikes  against  cage,  and  deprive  each  new  comer 
speedily  of  what  little  reason  may  have  been  left  him."  Thus  wrote  Red 
as  late  as  1803  ! 

The  first  insane  asylum,  according  to  our  present  system,  in  the  civilized  states 
of  the  north  was  that  of  St.  Luke's  in  London,  which  was  opened  in  1751.  This  was 
followed  in  1"!I2  by  one  erected  for  the  Quakers  near  York.  The  first  institution  in 
Germany  was  established  at  Sonnenstein  in  Saxony.  Still  such  asylums  continued 
too  few  to  be  at  first  anything  more  than  models  for  the  treatment  of  the  insane:  in 
most  places  the  old  style  was  still  followed  for  a  long  time.  Thus  in  the  twenties  of 
the  present  century  the  insane  in  Italy  were  chained,  without  clothing  and  without 
means  for  preserving  cleanliness.  In  the  provincial  cities  of  France  matters  were 
managed  in  about  the  same  way,  even  as  late  as  among  the  thirties  of  the  present 
century.  The  infamous  "  Narrenthurm "  continued  in  use  in  Vienna  still  longer 
— until  l85o !  In  Germany  too  the  old  rooms  for  the  insane  were  only  gradually 
done  away  with  during  the  first  half  of  the  present,  century. 

The  management  of  the  syphilitic  was  as  bad  as  that  of  the  insane. 
In  ordinary  practice  the  treatment  of  the  former  was  conducted  at  home  by 
surgeons  or  itinerant  empirics.  Indeed,  even  in  Vienna  until  the  time  of 
van  Swieten.  the  syphilitic  were  treated  in  the  hospital  of  St.  Marcus  twice 
a  year  b}"  such  an  empiric,  who  knew  nothing  whatever  of  medicine.  They 
were  dosed  with  the  secret  remedy  of  the  hospital  until  salivation,  haemop- 
tysis not  rarely,  vomiting  etc.  set  in,  or  mercurial  poisoning  for  life,  at  all 
events,  was  induced.  It  was  not  until  the  death  of  this  quack  that  in  1754, 
through  the  powerful  influence  of  van  Swieten.  a  genuine  physician  was 
appointed  to  the  hospital  for  the  syphilitic. 

Most  of  the  hospitals  were  still  in  a  lamentable,  indeed,  a  dreadful 
condition,  rather  nests  of  disease  than  institutions  for  the  cure  of  the  sick  : 
for  hospital  hygiene,  with  which  even  Theophrastus  von  Hohenheim  was 
acquainted,  was  utterly  lost  sight  of  or  neglected.  In  the  Hotel-Pieu  at 
Paris  (said  to  have  been  founded  by  bishop  Landri,  A.  I>.  651)  single  large 
halls  contained  more  than  800  patients.  The  entire  institution  contained 
1  220  beds,  of  which  734  were  large,  i.  e.  occupied  by  four  to  six  patients, 
and  486  small  (3  feet  wide,  while  the  large  beds  were  5  feet  in  width)  for 
single  patients.  The  mortality  amounted  to  20  per  cent.  !  Almost  all 
those   who  underwent  operations,  particularly   amputations,    died.  —  Max 


—  769  — 

Nordau  with  the  shrewdness  of  a  newspaper  reporter  describes  the  earlier 
condition  of  the  greatest  hospital  in  Paris  :  "  In  the  lower  hulls,  which 
lacked  light  and  air.  there  were  no  beds.  On  the  tiled  floor  lay  heaps  of 
straw,  and  upon  these  pallets  the  sick  crowded  each  other,  packed  together 
like  herrings  in  a  cade.  On  one  occasion  when  Louis  the  Saint  visited  the 
hospital,  the  straw  upon  which  the  miserable  creatures  were  rolling  was  so 
frightfully  filthy,  stinking  and  rotten  that  the  king  in  affright  ordered 
fresh  straw  to  be  brought  at  once  from  the  Louvre  ami  spread  out  in  the 
halls.  About  the  middle  of  the  last  century  beds  were  furnished,  but  the 
situation  of  the  sick  was  in  no  way  improved  thereby.  In  one  bed  of 
moderate  width  lay  4,  5  or  G  sick  persons  beside  each  other,  the  feet  of  one 
to  the  head  of  another,  children  beside  gray-headed  old  men,  indeed,  in- 
credible but  true,  men  and  women  intermingled  together.  In  the  same  bed 
lay  individuals  affected  with  infectious  diseases  beside  others  only  slightly 
unwell  ;  on  the  same  couch,  body  against  body,  a  woman  groaned  in  the 
pangs  of  labor,  a  nursing  infant  writhed  in  convulsions,  a  typhus  patient 
burned  in  the  delirium  of  fever,  a  consumptive  coughed  his  hollow  cough 
and  a  victim  of  some  disease  of  the  skin  tore  with  furious  nails  his  infer- 
nally itching  integument.  Medical  service  was  deficient,  the  medical 
directions  scarcely  followed  and  the  choice  of  remedies  very  limited.  The 
patients  often  lacked  the  greatest  necessaries.  The  most  miserable  food 
was  doled  out  to  them  in  insufficient  quantity  and  at  irregular  intervals. 
The  nuns  were  in  the  habit  of  feeding  with  confectionery  those  patients 
who  seemed  to  them  pious  enough,  or  at  least  those  who  reeled  off  their 
rosaries  with  sufficient  zeal,  but  the  body  exhausted  by  disease  required 
not  sweets,  but  cried  out  for  meat  and  wine.  Such  food,  however,  the  sick 
never  received  in  profusion,  save  when  it  was  brought  to  them  by  the 
wealthy  citizens  from  the  city.  For  this  purpose  the  doors  of  the  hospital 
stood  open  day  and  night.  Any  one  could  enter  ;  an}-  one  bring  whatever 
he  wished  ;  and  while  the  sick  on  one  day  might  be  half-starved,  on 
another  day  they  might  very  likely  get  immoderately  drunk  and  kill  them- 
selves by  overloading  their  stomachs.  The  whole  building  fairly  swarmed 
with  the  most  horrible  vermin,  and  the  air,  of  a  morning,  was  so  pesti- 
ferous in  the  sick-wards,  that  nurses  and  inspectors  did  not  venture  to 
enter  them  without  a  sponge  saturated  with  vinegar  before  their  mouths. 
The  bodies  of  the  dead  ordinarily  lay  24  hours,  and  often  longer,  upon  the 
deathbed  before  thev  were  removed,  and  the  other  sick  during  this  time 
were  compelled  to  share  the  bed  with  the  rigid  corpse,  which  in  this  in- 
ternal  atmosphere  soon  began  to  stink,  the   green  carrion-flies   swarmed 

about Whoever  has  not  had  enough  of  these  revolting  details  will 

find  them  still  more  highly  colored  in  the  monograph  regarding  the  Hotel- 
Dieu  published  in  1SG7  by  Dr.  Pietra-Santa."  Under  Louis  XVI.  each 
patient  was  first  furnished  with  his  own  bed.  the  sexes  w-ere  separated, 
children  placed  by  themselves,  attention  given  to  better  nourishment  and 
the  feeding  of  the  sick  by  the  donations  of  the  charitable  done  away  with. 
49 


—  770  — 

"Accordingly  in  a  few  months  the  mortality  sunk  from  25  to  13  per  cent. 
The  mediaeval  condition  of  affairs,  however,  was  perceptible  down  to  our 
own  times,  and  until  towards  the  close  of  the  seventies,  when  the  old 
hospital  was  torn  down  and  a  new  building  erected  on  the  same  site. 
Even  the  latter  does  not  correspond  with  German  ideas  of  hygiene."  Such 
was  the  condition  of  affairs  almost  everywhere,  and  it  was  not  until  the 
introduction  of  clinical  instruction  that  the  situation  was  somewhat  im- 
proved. A  new  chapter  in  this  department  of  the  healing  art  was  opened 
particularly  by  the  pioneer  Joseph  II.  in  Vienna,  though  it  was  not  until 
the  middle  of  our  own  century  that  hospitals  generall}'  were  thoroughly  re- 
formed. How  horrible  the  sanitary  conditions  of  the  hospitals  were  at  the 
close  of  the  18th  and  the  beginning  of  the  present  century,  may  be  judged 
from  the  fact  that  in  some  places,  e.  g.  Frankfort-on-the-Main,  even  physi- 
cians declined  hospital  service  as  equivalent  to  sentence  of  death. 

The  physician  of  the  last  century,  like  the  ancient  periwig,  was  even 
in  externals  a  very  different  kind  of  man,  at  least  on  festive  occasions, 
from  other  men,  and  was  then  recognized  as  certainly  by  his  dress  as  are 
many  of  our  modern  '-precise  followers"  of  iEsculapius,  or  charlatans 
d'exaetitude, —  a  kind  peculiar  to  our  century  —  by  the  fashionable  cut 
of  their  clothing,  their  universal  greetings  and  rapid  gait,  their  imperturb- 
able amiability  and  the  thermometer,  stethoscope,  percussion-hammer  etc. 
etc.  peeping  out  of  their  coat-pocket.  As  at  that  time  a  cap  was  placed 
upon  the  doctor's  head  in  graduation,  in  recognition  of  the  fact  that  phy- 
sicians at  an  earlier  period  belonged  to  the  clerical  profession,  so  in  later 
life,  when  called  upon  to  represent  a  physician,  he  wore  a  flesh-colored  or 
scarlet  coat  ( scarlet  was  the  color  of  the  medical  guild,  black  that  of 
theologians,  yellow  that  of  lawyers),  the  procuring  of  which  would  have 
cost  old  Heim  150  marks  before  his  entrance  upon  practice  in  Berlin,  if  he 
had  not  received  a  present  of  one.  The  coat  even  belonged  to  medical 
politics.  [The  regulation  full-dress  costume  of  the  English  physician  of 
the  last  century  consisted  of  a  well-powdered  wig.  silk  coat  and  breeches 
(short)  with  stockings,  buckled  shoes,  lace  ruffles,  cap,  and  last,  though  by 
no  means  least,  a  gold-headed  cane.  In  cold  weather  there  was  added  to 
this  costume  a  muff  for  preserving  the  delicay  of  touch  in  feeling  the  pulse 
of  his  patients.  According  to  Jeaffreson,  the  last  of  the  silk-coated  physi- 
cians in  England  was  Dr.  Henry  Revell  Reynolds,  one  of  the  attendants 
upon  George  III  ,  and  in  his  day  the  Brummel  of  the  Faculty.     H.] 

Werlhof,  however,  at  his  second  marriage  —  some  variations  from  the  guild- 
costume  were  permitted  even  at  this  day  —  wore,  instead  of  the  ordinary  scarlet  coat, 
one  of  violet-colored  velvet.  This  wedding  of  Werlhof 's,  who  by  the  way  was  wealthy 
from  the.  beginning,  furnishes  us  with  some  interesting  information  as  to  the  domestic 
arrangements  and  customs  of  well-to-do  physicians  of  the  18th  century.  He  had  a 
parlor  decorated  with  elaborate  tapestry  (we  find,  however,  no  mention  of  a  waiting- 
room  with  its  table  covered  with  literature,  such  as  is  seen  with  some  famous  doctors 
and  professors  at  the  present  day),  with  high  armchairs  of  walnut  upholstered  in 
Utrecht   red  velvet,   a   Venetian   mirror  and  a  chandelier  of  rock-crystal.     Adjoining 


—  771  — 

this  room  was  a  hall  decorated  in  plaster,  whose  tables  were  adorned  with  brilliant 
damask  and  glittering  silver.  On  the  ground-floor  were  set  out  two  tables,  25  covers 
for  the  house-servants  and  their  friends,  and  25  for  the  poor  pensioners  of  the  family. 
Each  poor  person  received  from  the  bridegroom  two  gulden,  and  Fran  Sarah,  the 
bride  (a  widow),  gave  each  of  the  servants  a  "  Lammesdukaten"  provided  with  a 
ring.1 — The  coachman's  father  had  to  be  carried  home  he  got  so  drunk.  Haller 
was  present,  and  his  valet,  an  Italian,  made  vain  efforts  to  kiss  Sarahs  waiting-maid. 
Rhinewine  was  sent  by  the  elector  of  Cologne.  Finally  sweet  Constantia  wine  was 
handed  about  in  small  cut  Venetian  glasses.  Haller  delivered  an  epithalamium. 
The  choristers  sung  a  hymn  before  the  door  etc.  (Rohlfs).  Compare  these  arrange- 
ments and  this  wedding  with  that  of  Felix  Plater!  And  a  great  many  of  the  weddings 
of  physicians  during  the  18th  century  must  have  passed  off  like  that  of  Plater. 

The  "  Corps  of  medical  savages  "  and  the  superstition  which  served 
their  purposes,  although  the  former  were  subjected  to  legal  proceedings 
and  the  latter  was  opposed  by  the  so-called  "enlightenment"  of  that  time 
(of  which,  however,  we  observe  no  traces  among  the  masses  even  to-day), 
were  in  the  18th  century  very  great  and  almost  as  motley  and  manifold  in 
form  as  in  the  depth  of  the  [Middle  Ages.  In  no  department  of  human 
activity  has  licensed  and  unlicensed  charlatanry  been  ever  better  rewarded 
than  in  medicine  ;  and  naturally,  for  "primitive  medicine"  everywhere  was 
based  almost  entirely  upon  it.  Besides  apothecaries  and  their  apprentices, 
who  still  dabbled  in  medicine  to  the  very  limits  of  propriety,  there  were 
among  the  so-called  "  Yolksarzte":  grocers,  book -sellers,  printers,  confec- 
tioners, merchants  and  traders,  mountebanks,  tooth-doctors,  midwives, 
medical  students.2  preachers,  chemists  and  their  assistants,  distillers, 
rummagers  of  all  kinds,  Jews,  shepherds,  doctores  bullati,  old  women, 
conjurors,  executioners3  and  their  following,  sieve-makers,  Thuringian 
peddlers  of  water  and  olitaten,4  uroseopists,  herniotomists  (who  also  cut 
awaj-  the  testicles),  root  peddlers,  bath-keepers,  dealers  in  nostrums  etc,  etc. 
And  this  rabble  was  conspicuous  in  the  county  far  down  into  the  present 
century  ;  indeed,  even  to  day  it  has  not  entirel}-  died  out,  and  our  laws 
permitting  freedom  of  occupation  are  fast  filling  its  ranks  again.5  That 
among  the  common  people  it  was   directed  to  touch  the   hand  of  an  exe- 

1.  Probably  something  like  our  modern  "bangles".     (H.) 

2.  In  the  year  1716  the  studiosus  medicine  Ephraim  Gerichius  was  fined  25  imperials 

for  practising  medicine,  and  again  50  imperials  for  a  second  offence,  so  that  his 
practice  must  certainly  have  been  profitable.  A  predecessor  of  this  fellow,  like- 
wise named  Ephraim,  in  the  year  1(585  forged  a  diploma  and  practised  on  the 
strength  of  it. 

3.  An  executioner  was  appointed  Prussian    'llofarzt"  (court-physician)  as  late  as 

the  beginning  of  the  18th  century. 

4.  See  note  page  

5.  In  the  year  1877  the  "Doctorbauerinn  "  Hoheniiester  in  the  Bavarian  highlands 

had  more  than  1000  patients  from  the  higher  and  highest  classes.  The  peasants 
must  not  be  blamed  too  much  if  they  do  not  escape  from  medical  superstition. 
Free  trade  helps  the  quacks  so  much  that  in  Bavaria  in  1874  there  were  altogether 
1156  (911  men  and  245  women) ;  in  1875  there  were  1262;  in  1876,  1396.  We  see 
the  matter  improves  each  year!  In  1880  there  were  in  Bavaria  and  Saxony  more 
quacks  than  physicians  ! 


—  772  — 

cuted  felon  for  the  cure  of  epilepsy,  and  that  many  other  superstitious 
procedures  were  practised,  can  excite  no  wonder,  for  they  are  still  in  vogue 
in  the  present  day.  and  they  seem  the  less  remarkable  in  the  ISth  century 
because  a  regular  system  of  popular  schools  nowhere  existed.  But  it  is 
rather  remarkable  to  observe  complete  pagan  medical  superstition  in  full 
bloom  in  the  enlightened  18th  century,  even  among  the  wearers  of  the 
highest  clerical  honors.  Yet  a  regular  pagan  amulet  was  found  in  1740  on 
the  breast  of  the  prince  bishop  Anselm  Franz  of  Wttrzburg,  count  of  Ingel- 
heim.  after  his  death.  —  The  author  of  the  "Artzney-TeufFel"1  remarks  on 
this  subject  as  follows  : 

"  Very  easily  can  the  overgrown  Empirici  plaster  over  the  eye  of  the  common 
man,  who  holds  entirely  to  the  opinion  that  it  makes  no  difference  whether  the 
Medicus  be  learned  or  unlearned,  providing  only  he  has  many  experimenta  and  some 
wagondoads  of  written  prescriptions  and  tricks,  as  if  the  whole  art  of  medicine 
consisted  in  this.  Thus  he  can  readily  give  him  advice.  Therefore  they  have  no 
scruples  in  going  for  counsel  in  their  bodily  necessities  to  all  sorts  of  evil  and 
mischievous  fellows,  such  as  Jews,  gipsies,  tooth-pullers,  hangman's  apprentices,  old 
women,  witches,2  soothsayers,  magicians,  cut-purses,  vagabond  Salt  in  banco  and 
mountebanks  and  such  contemptible  riff-raft."  ....  That  such  fellows  are 
endured  is  due  to  the  fact  "that  the  authorities  are  blinded  by  Satan,  and  the  apothe- 
caries are  permitted  to  sell  poison  to  cursed  Jews,  alchemists,  bath-servants  and 
ignorant  quacks,  while  dabsters,  calf-doctors  and  rag-pickers,  magicians,  witches, 
crystallomancers,  soothsayers,  conjurors  and  other  mancipia  of  the  devil  are  allowed 
to  practise  medicine."  .     Examples  of  cures:   "  One  devil' s-head  gave  to  all 

the  sick  who  consulted  him  a  little  rasped  or  pulverized  rogue's-bone,  so  that  in  one 
year  almost  all  the  bones  of  thieves  and  murderers  which  he  could  collect  from  the 
(numerous)  gallows  and  wheels,  were  swallowed  down.  With  such  unicorn-  and 
heart-powders  the  devil-doctor",  whom  the  author  accuses  rather  of  being  a  suborner 
of  such  cases  than  a  blockhead,  "  knows  how  to  comfort  his  patients,  although  in 
Jure  Canonico  and  sub  poena  excommunicationis  and  exauctorationis  it  is  very 
strictly-  forbidden  to  Christians  to  seek  counsel  and  aid  from  Jews  in  their  sickness." 
Even  a  blind  Jew  was  an  uroscopist;  another  sent  from  a  distance  a  purgative, 
which  "  not  only  brought  awa}'  from  the  woman  concerned  the  fruit  of  her  body, 
to  wit  2  twins,  but  also  put  an  end  to  her  own  life."  (!!)  Then  "the  Alcumistic 
Society,  after  losing  all  its  possessions  and  goods  in  searching  after  the  philosophers' 
stone,  and  blowing  them  up  the  chimney"  also  dabbles  in  medicine.  "When  such 
an  Alt-Kuhtuistic  medicaster  had  given  to  a  sick  peasant,  who  was  prostrated  by 
fever,  some  of  his  murderous  mercurius  vitae,  the  patient  at  once  became  sick  even 
unto  death,  and  the  next  day  proceeded  ad  patres".  Similar  things  were  done  also 
by  "certain,  covetous,  inexperienced,  careless,  bibulous,  perjured,  fool-hardy  and 
deceitful  apothecaries  ",  as  well  as  by  the  "  Uromantes  or  uroscopists.''  But,  and  this 
is  the  worst  of  all,  "we  find  even  excellent  Practicos,  who  permit  the  sick  to  bring 
their  urine  to  the  house,  and  from  its  appearance  diagnosticate  the  disease.3    It  is  true 

1.  'Artzney  Teuffel  oder  kurzer  Discurs  darinn  diesem  Ertz-Morder  seine  Larve  abge- 
zogen,  und  wie  tuckisclij  boshaftund  arglistig"  etc.,  by  Ananias  Ilorer,  1721.   (H.) 

•_'.  In  1749  a  nun  of  To  years  was  burned  as  a  witch;  in  1756  a  magician  was  con- 
demned to  death  ;  in  1752  a  maiden  of  13  years,  and  in  1 7 ">4  one  of  14  years,  was 
executed  as  a  witch,  and  in  1750  and  1782  (in  Glarus)  the  last  witches  were  burned  r 

:;.  Zininiennann  said  that,  from  ltussia  to  Switzerland,  lie  was  regarded  as  a  great 
practitioner,  who  had,  instead  of  books,  a  large  number  of  urine  glasses,  in 
which  the  doctor  ordinarily  urinated  himself. 


—  773  — 

we  find  more  of  these  physicians  than  is  good,  and  many  a  commencing  practicus, 
against  his  will  and  with  the  highest  chagrin,  is  forced  to  allow  such  quackery,  lest 
otherwise  he  lose  his  patients  and  acquire  a  bad  reputation  with  the  common  people. 
For  many  miserly  people  avoid  calling  in  a  physician  in  order  to  save  a  florin  or  so. 
For  a  batzen  (coin)  they  call  in  a  urinist  and  piss-prophet."  "Of  all  external  diseases, 
however,  we  can  see  nothing  in  the  urine,  nor  can  we  tell  whether  the  patient  has 
taken  shortly  before  some  rhabarbara  (the  favorite  remedy  of  Frederick  the  Great), 
"senna-leaves,  saffron  or  the  like,  whether  he  exercises  vigorously  or  has  drunk  much, 
by  all  of  which  the  urine  is  very  frequently  altered."  In  veterinary  practice  much 
dependence  was  placed  on  exorcisms  and  witches.  "What  then  is  the  good  of  such 
piss-quackery  and  open  deceit,  which  ought .  justly  to  shame  the  very  lungs  (vitals)  of 
an  honorable  man  and  a  graduated  person."1  "When  now,  through  the  transmission 
of  other  liquorum,  perchance  the  urine  of  a  horse,  cow,  ass  or  other  beast,  or  indeed 
of  his  own  urine  (there  is  an  example  of  such  a  case),  a  ridiculous  judicium  has  been 
wormed  out  of  these  Euclionibus,  whereby  they  prostitute  themselves  individually 
and  collectively  and  fall  into  undying  disgrace  and  contempt,  who  can  have  any 
sympathy7  with  them?" — Such  an  uroscopist  advised  a  clergyman  who  had  the 
dropsy  to  be  bled  (the  same  thing  is  done  by  regular  graduates  to-day!),  and  the 
patient  died  under  the  operation.  —  Moreover  medical  practice  was  undertaken 
by  "  over-curious,  impertinent  women,  old  weather-prophetesses,  midwives,  procu- 
resses, female  nurses  or  other  trumpery,  who  have  spent  in  revelry  or  evaporated  with 
the  aid  of  their  husbands  their  own  means."  "  The}-  hackle  the  medicum  (tout 
comme  chez  nous!),  give  behind  the  doctor's  back  a  powder  of  pearls,  emerald, 
unicorn,  bezoar2  and  gold"  etc.  A  hag  of  this  sort  gave  "  a  few  years  ago  to  a  pious, 
noble  woman  who  lay  in  the  severe  pangs  of  labor,  a  spoonful  of  aqua  fortis,  with  the 
comforting  assurance  that  as  this  water  had  the  power  to  separate  from  each  other 
gold  and  silver,  so  by  its  influence  the  child  would  speedily  be  separated  from  its 
mother.  But  they  found  after  the  severest  anguish  and  suffering  that  this  water 
could  separate,  not  the  child  from  the  mother,  but  the  soul  from  the  body,  for  in  a 
few  hours  mother  and  child  expired.'  —  That  in  Italy  charlatanism  was  even  worse 
than  in  Germany  may  be  inferred  from  a  passage  in  Goethe's  "  Italienische  Reise": 
"At  Malo  (in  Naples)  I  saw  a  punchinello,  who  was  quarreling  with  a  little  monkey 
on  a  platform  of  boards,  above  which  was  a  balconj-  where  a  very  pretty'  maiden  sold 
her  favors.  Beside  the  monkey's  platform  a  quack  sold  to  the  faithful  his  arcana 
against  all  evils".  —  [Even  in  sober-minded  England  charlatanism  of  all  grades  and 
varieties  reaped  a  rich  harvest.  We  need  onty  mention  the  names  of  Joanna  Stevens, 
whose  specifics  for  stone  were  purchased  by  the  government  for  £5000,  after  having 
received  a  certificate  as  to  their  efficacy,  which  bears  not  only  the  names  of  many 
noble  lords,  but  even  those  of  Cheselden,  Hawkins  and  Sharp;  Mrs.  Mapp,  or 
"Crazy  Sally  of  Epsom",  whose  reputation  as  a  bone-setter  was  rather  enhanced 
than  impaired  03'  habits  of  drunkenness ;  James  Graham,  whose  "  Templum  yEscu- 
lapio  Sacrum  "  in  London,  with  its  "  celestial  bed"  guaranteeing  to  the  occupants 
thereof  the  blessing  of  abundant  and  beautiful  progeny  at  the  moderate  rate  of  £100 
per  night,  was  a  fitting  monument  of  its  founder,  half  fool,  half  knave;  Mr.  and  Mrs. 
Loutherbourg,  whose  marvelous  cures  by  the  imposition  of  their  hands  excited  the 


1.  A  short  time  ago  a  circle-physician  was  buried  in  the  country  who  had  acquired 

great  reputation  by  the  practice  of  uroscopy,  while  a  regularly  graduated  phy- 
sician in  the  city  has  obtained  a  fortune  by  the  same  means.  And  we  write  no 
in  1709,  but  1875! 

2.  A  stone  of  musk-like  odor  from  the  stomach  of  a  kind  of  goat  in  the  Caucasus. 

Miraculous  powers  were  ascrilied  to  it. 


—  774  — 

admiration  of  the  metropolis  about  1789;  Dr.  Mj'ersbach,  the  purchaser  of  a  medical 
degree  at  Erfurt  on  what  in  more  recent  times  is  known  as  the  "  Philadelphia 
system",  and  whom  Lettsom  strove  to  drive  into  his  merited  obscurity;  and  finally 
that  prince  of  charlatans,  St.  John  Long,  the  beau  ideal  of  a  handsome,  witty  and 
acute  Irish  impostor,  for  whose  love  a  host  of  noble  and  gentle  ladies  languished  in 
vain.  The  latter,  however,  belongs  to  the  present  century.  The  victims  of  these 
high-toned  charlatans  of  the  English  metropolis  were  of  course  chiefly  of  the  belter 
classes.  But  what  must  have  been  the  condition  of  affairs  among  the  more  ignorant 
and  illiterate  population  of  the  provincial  cities  and  in  country  districts?    H.] 

During  the  whole  18th  century  the  surgeons  were  still  strictly  sepa- 
rated from  the  physicians,  even  in  education.  Nor  were  they  esteemed  as 
equal  in  rank  with  the  latter,  particularly  in  Germany,  where  the  guild 
organization  was  likewise  preserved.  It  was  the  French  Revolution  and 
its  influence  upon  other  nations  which  finally  brought  about  the  equality 
of  surgeons  and  physicians,  and  the  guild-surgeons,  like  the  guilds  them- 
selves, received  their  coup  de  grace.  This  change  was  inaugurated  by  the 
abolition  of  the  18  Universities  or  Faculties  and  the  15  Colleges  de 
Medicine  of  France  in  1702,  together  with  that  of  the  Societe  Royale  de 
Medicine  (founded  177(1)  and  the  Academic  de  Chirurgie  (founded  in 
1731).  *  Their  place  was  taken  b}r  the  Societes  libres  de  Medicine.  The 
two  distinct  branches  of  medicine  and  surgery  were  now  united  into  one 
department  of  general  medicine. 

The  18th  century  not  only  introduced  a  class  of  surgeons  possessed, 
on  the  whole,  of  a  scientific  education  and  devoted  to  general  surgery,  but 
also  specialists  in  individual  branches,  particularly  scientific  oculists.  Yet 
even  some  of  these  (as  here  and  there  at  the  present  day)  by  travelling 
about  acquired  a  mediaeval  and  anomalous  sort  of  practice,  which  compelled 
them  to  compete  with  the  kindred  'travelling  eye-destroyers  ",  still  widely 
diffused  throughout  the  country. 

Surgical  instruction,  at  least  in  the  larger  states,  was  given  in  special 
institutions  or  in  the  universities,  and  in  Germany  the  German  language 
was  employed  in  the  instruction  of  surgeons,  though  not  in  that  of  phy- 
sicians. The  required  knowledge  was  no  longer  obtained  exclusively  from 
members  of  the  guild.  Yet  for  the  lower  class  of  surgeons  the  old  method 
was  still  followed  in  many  places.  In  Strassburg  the  Chirurgi  and  Tonsures 
at  the  university  were  so-called  '-Students  of  the  minor  roll  ".  and  their 
number  frequently  equalled  or  even  exceeded  that  of  the  medical  students 
proper.  Their  examination  was  not  made  before  the  faculty,  but  before  a 
colleague  of  the  guilds,  associated  with  the  professor  of  anatora}-.  Before 
examination  they  were  required  to  exhibit  an  indenture  and  evidence  of 
five  years'  service  in  the  city,  though  in  different  universities  the  require- 
ments were  different. 

The  conditions  of  instruction  in  the  branches  of  surgery  and  midwifery 

1.  By  this  abolition  charlatanism  acquired  such  a  control  over  medical  education  that 
the  arrangement  was  soon  abandonel.  In  Germany  the  decree  of  1S68  authorizing; 
freedom  for  medical  botchery,  has  not  yet  brought  us  quite  to  this  point. 


—    <  <  o — 

(which  were  always  looked  upon  as  belonging  together)  had  first  improved 
in  France,  or  rather  they  had  developed  here  further  and  higher,  in  im- 
mediate connection  with  the  preparations  and  acquisitions  of  the  17th 
century.  This  was  occasioned  especially  by  the  fact  that,  at  the  instance 
of  la  Peyronie  and  parti}-  too  at  his  expense,  chairs  of  instruction  in 
surgery  had  been  erected  in  Paris  and  Montpellier  (1724).  The  -Charite  " 
(founded  1727)  was  from  its  foundation  an  institution  for  the  instruction 
of  military  physicians.  The  foundation  of  the  Societe"  de  Chirurgie  in  1731, 
however,  was  of  the  greatest  influence  upon  the  elevation  of  surgery  in 
France.  This  institution,  on  the  abolition  of  the  College  de  St.  Come  in 
1753,  was  raised  into  the  Academic  de  Chirurgie.  which  latter,  on  the 
foundation  in  1795  of  the  Academie  Francaise.  was  merged  into  the  medical 
department  of  this  institution.  The  so-called  "Eeole  pratique",  established 
in  1750,  in  which  a  Desault  and  a  Chopart  (1743—1795)  subsequently 
taught,  was  designed  for  the  practical  education  of  surgeons.  Desault 
particularly  marks  an  epoch  in  the  history  of  surgical  instruction,  since  in 
1785,  as  president  of  the  Hotel-Dieu,  he  opened  the  first  surgical  clinic  in 
France,  and  taught  and  operated  here  three  hours  ever}'  morning.  By  his 
lectures  on  surgical  anatomy  he  thus  gave  to  surgical  instruction  that 
deeper  and  more  secure  foundation,  which  up  to  this  period  it  had  generally 
lacked.  [In  England  the  barbers  and  surgeons  continued  to  form  a  single 
corporation  until  1745.  and  the  Royal  College  of  Surgeons  was  not  incor- 
porated until  1800.  Surgical  instruction  was  imparted  by  members  of  the 
company  of  surgeons,  by  the  hospital  surgeons  and  by  such  professors  of 
anatomy  as  existed  in  the  universities.  James  Rae,  lecturer  on  surgery  to 
the  College  of  Surgeons  in  Edinburgh,  gave  "practical  discourses  on  cases 
of  importance  in  the  Royal  Infirmary"  for  some  years  prior  to  1772.  and 
may  thus  be  called  the  first  teacher  of  clinical  surgery  in  Edinburgh.  The 
Monros  also  lectured  on  surgery  as  well  as  anatomy,  but  it  was  not  until 
1803  that  a  distinct  chair  of  clinical  surgery  was  established  in  the  Univer- 
sity of  Edinburgh,  in  direct  opposition  to  the  remonstrances  of  Alex. 
Monro  (Secundus).  In  180(i  a  Royal  Professor  of  Military  Surgery  was 
also  appointed  after  similar  opposition,  but  a  chair  of  systematic  surgery 
was  not  created  until  as  late  as  1831.  The  first  incumbent  of  the  latter 
chair  was  John  William  Turner,  who  was  succeeded  on  his  death  in  1835 
by  Sir  Chas.  Bell.  The  University  of  Glasgow  received  a  professor  of  sur- 
gery in  1815,  and  the  University  of  Dublin  not  until  1849.  Generally  the 
subjects  of  anatomy  and  surgery  were  taught  during  the  18th  century  by 
the  same  professor.     (H.)| 

Practical  (private)  instruction  in  midwifery  was  first  imparted  to  men 
by  the  elder  Grt'goire  from  the  year  1720  onward.  The  midwives,  how- 
ever, still  had  their  own  public  institution  for  instruction  in  the  Hotel- 
Dieu,  as  the}'  had  in  the  preceding  century.  The  participation  of  men  in 
this  instruction  was  strictly  prohibited,  even  when  in  1797  the  school  for 
midwives   was  removed    to    the   Maternite.   where   theoretical    instruction. 


—  770  — 

which  had  always  been  given  by  men,  was  imparted  by  Baudelocque. 
Public  theoretical  lectures  at  least  on  midwifery  were  already  given  to  sur- 
geons at  the  instance  of  la  Peyronie  in  1743  ;  practical  midwifery  they 
learned  in  small  private  institutions,  or  in  their  own  practical  duties.  In 
Vienna  obstetrical  instruction  was  first  given  in  1748. 

In  Germany  the  first  impulse  to  the  improvement  of  surgical  instruc- 
tion was  given  by  Heister.  This  was  greatly  increased  by  Prussia  when 
the  preceding  Theatrum  anatomicum  was  converted  into  a  Collegium 
medico-chirurgicum  in  Berlin,  that  is  into  an  institution  for  the  education 
of  military  physicians  and  medico-chirurgeons  for  the  low  country,  a 
change  effected  in  172+  by  Dr.  Holtzendorf,  Surgeon-General  of  Frederick 
William  I.  Frederick  II.  then  enlarged  the  institution.  It  was  remodeled 
into  the  "Pepiniere"  in  1705.  and  re-christened  the  "Friedrich-Wilhelms- 
Institut"  in  1817,  and  has  continued  united  with  the  "Medicinisch-chirur- 
gischen  Academic"  since  1811. 

A  "Collegium-medico  chirurgicum"  for  Saxony,  similar  to  the  Prussian, 
was  opened  in  Dresden  in  1748  by  Augustus  II.,  and  three  years  later  the 
first  surgical  clinic  was  added  to  it.  All  barbers'  and  bath-keepers' 
apprentices  were  permitted  to  participate  in  the  instruction  and  the  prac- 
tical exercises,  on  the  payment  of  an  honorarium  of  31!  marks  and  some 
slight  fees.  Such  pupils  as  had  passed  the  examination  in  this  school  were 
required  to  be  admitted  into  the  guilds  of  barbers  and  bathers  with  the 
rank  of  '-Masters"  without  any  further  ceremony,  and  enjoyed  the  privilege 
of  being  preferred  before  others  in  the  assignment  of  places  of  business. 
The  institution  was  enlarged  in  1777.  a  teacher  of  dentistry  was  added,  and 
the  salaries  of  all  the  teachers  increased.  The  same  king  in  1753  granted  a 
Collegium  medico-chirurgicum  for  the  Poles,  and  in  1768  a  medical 
Academy  was  likewise  authorized,  but  not  erected.  The  clinic  was  sup- 
plied with  a  hospital  accomodating  1 200  patients,  and  received  an  annual 
endowment  of  1200  marks.  A  school  for  midwives  was  erected  in  1781, 
together  with  an  institution  for  the  education  of  male  obstetricians. 

The  improvement  of  surgical  instruction  extended  far  beyond  the 
boundaries  of  Austria  when  Joseph  II.  in  1785,  through  Brambilla,  opened 
the  'Medicinisch-chirurgischc  Akademie"  or  '-Josephinum",  and  also 
erected  permanent  military  hospitals  in  Prague,  Briinn,  Milan.  Mantua, 
Pesth.  Olmiitz  etc.  Before  this  the  guilds,  as  well  as  the  business  of 
shaving  (still  united  with  that  of  surgery),  had  been  done  away  with, 
since  the  latter  occupation  was  not  consistent  with  the  title  of  Doctor  or 
Magister  of  surgery  and  medicine,  now  bestowed  upon  the  so-called  Medico- 
chirurgeons. 

The  medico-chirurgical  -Josephs-Akademie"  was  next  created,  in 
order  to  do  away  with  the  defects  regarding  surgical  matters  in  the  army. 
Here  two  classes  of  army-surgeons  were  educated  :  the  first  class  became 
onby  surgeons,  and  were  required,  after  the  completion  of  their  instruction, 
to  serve  10  vears  in  the  army  ;    the  second  class   attained  the  degree  of 


Doctor,  but  were  required  to  bind  themselves  to  15  years'  service.  Instruc- 
tion in  medicine  was  imparted,  in  a  limited  degree,  to  the  latter  alone.1 
The  pupils  of  the  Josephinum  were  chiefly  ordinary  barbers,  or  the  sons 
of  poor  officials  (these  came  with  special  frequency  from  southern 
Germany),  who  were  able  to  educate  themselves  in  Vienna  because  instruc- 
tion here  was  free  of  expense.  Many  of  these  pupils  subsequently  attained 
great  skill,  and  obtained  important  positions  in  the  military  service  of 
other  German  states,  since  in  the  latter  there  was  still  a  scarcity  of  good 
surgeons  even  down  into  the  19th  century.  As  an  example  of  one  of  these 
surgeons,  and  a  memorial  of  one  who  died  without  fame,  though  a  practi- 
tioner of  the  best  kind,'-  embalmed  in  the  hearts  of  his  patients,  we  mention 
here  Ludwig  Rauch  (1764-1836)  of  Arheilgen  near  Darmstadt,  educated 
in  the  Josephinum  and  at  one  time  military  'Chef  of  the  Grand  Duke  of 
Hesse  and  ':  Stabsmedicus  ". 

Since  the  life  and  education  of  Ranch  may  be  regarded  as  typical  of  the  career 
■of  surgeons  in  the  last  centur}-,  and  have  therefore  a  certain  value  in  the  history  of 
culture,  we  introduce  the  following  detail?. 

Rauch,  the  son  of  an  official  who  lost  his  property  through  mining  speculations, 
entered  upon  his  surgical  apprenticeship  in  Butzbach.  After  completing  his  term  of 
apprenticeship,  he  passed  his  guild-examination  in  Giessen  and  received  the  following 
certificate: 

"  We,  the  senior  sworn  and  examined  Chirurgi  in  the  city  and  fortress  of 
Giessen,  testify  that  the  honorable  Ludwig  Rauch,  legitimate  son  of  the  sometime 
princely  March-Commissioner  Rauch  of  Echzel,  at  the  date  underneath  written  did 
appear  before  us  and  gave  us  due  notice  that  he  had  been  for  three  years  a  pupil  of 
the  most  honorable  and  experienced  Conrad  Daub,  chirurgus  juratus  and  citizen  of 
Butzbach,  and  with  his  colleagues  of  that  place,  at  the  end  of  which  period,  however, 
he  has  resolved,  in  God's  name,  to  enter  upon  the  years  of  travel  fixed  b_y  the  guild 
of  that  place  for  better  qualification  in  the  aforesaid  surgery.  According^-  he  prays 
us  to  this  end  to  furnish  him  a  certificate  of  the  completion  of  his  instruction  and  of 
his  behavior  sub  sigillo  of  this  princely  Collegium  chirurgicum  of  Hesse,  and  to  enter 
his  discharge  in  the  official  records  of  the  guild.  As  now  we,  in  complicance  with 
the  truth,  are  both  disposed  and  obliged  to  sajT,  of  our  own  knowledge,  that  the 
aforesaid  Ludwig  Rauch  has  gone  through  his  three  years  term  of  study  in  three 
successive  j'ears  down  to  the  annum  currentem  et  datum,  and  in  the  same  has  not  only 
devoted  himself  to  the  learning  of  laudable  surgerj-,  but  has  also  during  this  time 
been  trusty,  obedient,  modest,  diligent,  discreet,  honorable  and  generally  praise- 
worth}-  in  his  behavior,  as  becomes  an  upright  Studiosus  chirurgia?,  so  we  must 
declare  that  his  patron  has  not  only  been  pleased  with  him  in  all  respects,  gives  him 
this  public  testimony  and  would  gladly  have  retained  him  for  a  longer  period  were 
it  not.  to  his  disadvantage,  but  we  must  also  state  that  we  can  say  of  him  nothing  but 
that  his  mode  of  life  up  to  this  time  has  been  such  as  to  give  evidence  of  good  train- 
ing and  an  exceptionally  praiseworthy  zeal.     Accordingly  we  have  not  been  able  to 


1.  According  to  Fr.  Stroll m eye r,  the  pupils  of  the  Josephinum  and  other  medico- 

chirurgical  institutions  were  so-called  "diplomirte  Wundaerzte,",  and  as  such 
were  general  physicians,  though  not  granted  liberty  to  change  residence  at  pleas- 
ure.    (Medico-chir.  Centralblatt,  1884,  33.) 

2.  He  died  in  Worms.    Napoleon  I.  invested  him  with  the  cross  of  the  Legion  of  Honor 

with  his  own  hands  upon  the  battle-field,  because  he  treated  friend  and  foe  alike. 


—  778  — 

refuse  this  his  just  petition,  but  have  assented  to  the  same,  and  bv-  virtue  of  this  open 
letter  before  the  guild  in  corpore  assembled,  and  wishing  the  candidate  God's  blessing, 
we  have  declared  him  free  and  discharged  from  his  instruction  so  laudably  completed. 
Therefore  our  friendly  request  is  addressed  to  everyone,  and  particularly  to  our 
masters  and  employees,  that  thejT  will  give  full  credence  to  this  open  letter,  willingly 
receive  the  before-mentioned  Ludwig  Rauch,  by  reason  of  his  completed  instruction 
and  the  qualities  already-  noticed,  into  all  fraternities,  offices,  guilds  and  other  laud- 
able associations  and  societies,  and  will  extend  to  him  corporate  qualifications,  ad- 
vancement and  their  best  assistance  and  good-will  in  all  proper  demands.  Such 
conduct  not  only  will  he  recognize  with  due  thanks  and  true  service,  but  we  also  are 
ready  and  prepared  to  reciprocate  on  all  similar  occasions.  In  witness  whereof  we 
have  not  only  subscribed  this  certificate  with  our  own  hands,  but  have  also  affixed 
the  official  seal  of  our  guild." 

Done  at  Giessen,  January  2.  1780. 
Joh.  Gottfr.  Christ.  Keller,  D.  'Daniel,  with  a  squint  toward  the 

chirurgus  juratus  ordinarius.  contraction  of  Dr.)  Bergner,  Chirurgus. 

At  the  top  is  the  seal  of  Hesse.  At  the  bottom  the  seal  of  the  guild,  with  the 
inscription  "  Hasso-Giessenses  chirurgi".  This  seal  contains  above  a  sun  and  hover- 
ing angel,  beneath  a  patient  upon  whose  left  arm  a  surgeon  in  his  surgeon's  gown  is 
performing  venesection. 

In  the  month  of  June  Rauch  went  into  the  service  of  the  landgrave  of  Hesse  as 
supernumerary  assistant  surgeon  (in  the  landgrave's  own  regiment),  where  he  remained 
until,  on  the  first  of  September,  1788,  he  went  into  the  Austrian  service  in  the  regiment 
Preiss  in  Vienna.     On  October  2  he  received  the  following  diploma: 

"  His  Roman  Imperial  Royal  Apostolic  Majesty's  Counsellor,  Knight  of  the 
Roman  Empire,  Lord  of  Carpiano  in  Austrian  Lombardy,  acting  Chiriater  and 
Protochirurgus  of  the  Imperial  Royal  armies,  Doctor  of  Surgery,  Director  of  the 
Imperial  Royal  Josephine  medico-chirurgical  Academy  and  of  its  educational  matters, 
Inspector  of  all  military  hospitals,  first  surgeon  of  the  noble  German  Bodyguard, 
Fellow  of  the  Royal  Academy  of  Surgery  at  Paris,  of  the  College  of  Surgery  at 
Montpellier,  and  of  the  Academy  of  Sciences  in  Bologna,  Mantua  and  Florence, 
Honorary  Member  of  the  Imperial  Royal  Academy  of  the  Liberal  Arts  in  Vienna 
— testifies  hereby  that  Rauch,  Ludwig,  a  native  of  Echzel  near  Darmstadt,  in  religion 
evangelical,  24  years  old,  having  practised  in  the  military  hospital  in  Darmstadt,  lias 
attended  the  medical  and  surgical  lectures  in  the  Royal  Imperial  Josephine  medico- 
chirurgical  Academy,  and  has  displayed  both  in  his  studies  especial  assiduity  and  in 
the  treatment  of  internal  and  external  diseases  the  requisite  zeal:  that  he  has  been 
duly  examined  and  found  qualified  to  serve,  and  to  be  appointed,  assistant  surgeon, 
under  the  oversight  of  his  superiors,  in  His  Royal  Imperial  Majesty's  army. 

Signed  at  Vienna  Oct.  2,  1788.  J.  Brambilla." 

In  1788  followed  a  campaign  in  Syrmia.  1789  in  Croatia,  Bosnia,  Servia,  1790  in 
Slavonia  and  Servia.  Survived  the  plague.1  Jan.  1,  179o  he  was  appointed  superior 
surgeon  of  the  travelling  hospital  at  Heidelberg,  Weissenburg  and  Hagenau,  and  in 
the  stationary  hospital  at  Baden-Baden,  in  the  army-corps  of  the  upper  Rhine  under 
the  command  of  Ordnance-Master  von  YVurmser.  Campaign,  olockade  of  Landau, 
on  the  line  of  Weissenburg  and  in  Alsace.  —  1794  he  became  a  regimental  surgeon  in 
the  Hessian  service,  having  received  his  discharge  from   the  Austrian  government. 

1.  The  "Pest-medici"  and  "Pest-chirurgi"  of  earlier  date  died  out  in  the  18th  century. 
Franz  von  Schraud  was  the  last  "CJeneralpestdirector"  in  Austria.  The  'Torture- 
doctors"  also  died  out. 


—  779  — 

Here  he  shared  in  the  campaign  near  Rastadt,  in  the  Palatinate,  near  Mayence,  on 
the.  Sieg  and  near  Neuwied,  from  Rheingau  to  Bavaria.  In  1806  was  appointed 
staff-sursreon  :  campaign  in  Prussia,  1809  in  Austria.  There  as  major  surgeon  he 
was  made  a  member  of  the  Legion  of  Honor,  and  in  1810  received  the  title  of  "Stabs- 
medicus";  1811  campaign  to  Magdeburg,  Stettin  and  Damm,  passes  through  typhus 
fever;  1811  becomes  actual  "  Stabsmedicus  "  with  the  direction  of  the  entire  medical 
corps  of  the  field  hospitals  and  their  attendants.  Campaigns:  1811  Dantzic,  1813 
Silesia,  1814  to  France.  1819  his  diploma  as  a  knight  of  the  Legion  of  Honor  was 
renewed.  Signature  :  Macdonald. —  21  years  of  campaigning.  —  Subsequently  Doctor 
emeritus  of  the  facultj'  at  Giessen.  Rauch's  therapeutic  principles  were  those  of 
Brown,  which  were,  indeed,  for  a  long  time  almost  obligatory  in  the  Austrian  army. 
Such  a  career  was  certainly  adapted  to  form  capable,  surgeons  and  humane 
physicians,  and  accordingly  many  of  the  Medico-surgeons  were  men  of  this 
character. 

The  Josephinum.  which  was  unquestionably  of  very  great  importance 
in  the  improvement  of  military  medicine  and  the  elevation  of  the  position 
of  arnry-physicians  during"  the  last  century,  has  likewise  attained  historical 
significance  from  the  fact  that  Branibilla.  in  opposition  to  the  old-fashioned 
Faculty,  extorted  the  recognition  of  surgeons  as  social  equals  of  other 
members  of  the  medical  profession  in  Austria.  When,  however,  no  distinc- 
tion was  made  between  physicians  and  surgeons,  the  Josephinum  occupied 
a  difficult  position,  and  so  in  1820  it  was  closed  for  the  first  time.  In  1822 
it  was,  however,  reopened,  and  from  1S24.  through  the  efforts  of  "Oberfeld- 
arzt"  Job.  Nepom.  Jsfordik.  it  was  provided  with  a  complete  curriculum  of 
instruction  like  a  university.  In  184S  it  was  once  more  closed  —  in  1852 
a  so-called  "  felddienstliches  Institut"  was  created  by  way  of  a  change  — 
then  again  opened  in  the  reactionary  period  of  1854,  but  in  1870  it  was 
done  away  with  as  a  distinct  institution  with  its  own  teachers  for  11  years, 
though  revived  once  more  in  1884. 

The  first  school  of  instruction  in  midwifery  on  German  soil  existed  in 
Strassburg  under  the  elder  Fried  as  early  as  1728.  Tn  1737  a  genuine 
school  for  midwives  was  erected  here,  in  which  (until  1870)  instruction  in 
the  German  language  was  obligatory,  because  the  students  did  not  under- 
stand French.  Only  rarely  was  a  parallel  course  in  French  delivered  for 
the  benefit  of  pupils  from  Lothringia  and  upper  Alsace. 

The  first  institution  for  the  education  of  obstetricians  in  Germany  was 
erected  at  Gottingen  in  Hanover  in  1751.  and  was  under  the  direction  of 
the  ingenious  Roderer.  The  latter  (so  little  knowledge  and  fear  was  there 
of  infection)  was  also  the  teacher  of  practical  anatomy,  like  almost  all 
professors  of  surgery  before,  and  of  midwifery  long  after  this  epoch. 
During  the  period  of  Roderer's  activity  here  20-21  births  were  under 
observation  annually.  In  Berlin  a  school  for  midwives  was  organized, 
where  obstetrical  lectures  for  surgeons  were  also  delivered.  In  the  year 
1788  the  same  arrangement  was  made  in  Jena,  in  1782,  through  the  in- 
fluence of  Venel,  in  Bern,  and  in  1790  for  the  first  time  in  Marburg,  while 
such  an  institution  had  been  founded  in  Kassel  as  much  as  30  years  before. 

In  Wnrzburg  C.  C.  von  Siebold  founded  a  famous  school  for  surgeons 


—  78(1  — 

and  obstetricians,  and  provided  further  that  only  such  surgeons  of  the 
city  and  country  as  had  been  examined  by  a  commission  should  be  received 
for  instruction  therein.  The  requisites  for  admission  into  this  school  were 
that 

••  The  subject  must  possess  good  morals,  sufficient  mental  capacity 
and  corporeal  strength,  a  sensitive  heart,  knowledge  of  the  German  and 
Latin  languages,  of  course  perfection  in  arithmetic  and  writing,  sufficient 
means  for  the  purchase  of  books  and  instruments"  etc.,  from  which  we  ma}* 
infer  that,  even  as  late  as  the  close  of  the  18th  century,  persons  of  no  great 
education  devoted  themselves  to  surgery,  and  that  a  high  preparatory  edu- 
cation was  out  of  the  question. 

In  Brunswick  the  pupils  of  the  school  of  surgeons  in  that  place  were 
required  in  1780  to  assist  their  teachers  and  hosts  in  practice,  i.  e.  in 
shaving.  Not  until  they  had  taken  out  their  matricula  were  the}'  freed 
from  the  business  of  shaving  and  permitted  to  wear  a  sword  and  carry  a 
cane  (!),  privileges  otherwise  prohibited.  The  lectures  in  Brunswick  also 
were  free,  but  were  delivered  very  irregularly  and  were  plastered  all  over 
with  learned  citations. 

Board  and  lodging  with  the  prosector  of  the  institution  cost  the  elder  Stromeyer 
here  only  225  marks  annually,  though  he  had  no  room  or  light  of  his  own,  but  was 
compelled  to  share  the  light  of  the  servantmaid  until  he  had  extorted  one  from  his  host. 
Some  old  surgical  instruments  of  his  teacher  were  offered  to  him  for  purchase,  and 
the  wife  of  the  prosector  spoke  of  him  contemptuously  as  "  He".  Yet  Stromejer, 
for  a  surgeon  of  the  last  century,  sprung  from  a  comparatively  "good  family",  and 
had  enjoj'ed  a  tolerably  liberal  preparatory  education. 

In  Wurtemberg,  the  land  of  the  "thick-headed"  Suabians,  the  ordinance 
for  the  examination  of  barbers  and  bath-keepers  was  very  rigorous.  It 
required  of  the  '-subject"  to  be  examined  not  only  a  suitable  bodily  con- 
stitution but  also  satisfactory  volubility  —  he  must  be  '-respondendo 
battant",  ready  of  reply  (observe  the  mixture  of  Latin  and  French  scraps  !) 
—  and  well-versed  in  manipulation.  If  such  was  not  the  case,  the  ''subject, 
be  he  old,  or  be  he  travelled  as  much  as  he  please,  has  he  a  wife  (which 
any  person  in  the  world  may  get)  and  few  or  many  children",  he  shall  not 
be  admitted  a  "Master",  but  shall  be  dismissed. 

Separate  lectures  on  widwifery  were  still  exceptional  at  the  univer- 
sities. Almost  the  earliest  were  delivered  by  Heister  at  Helmstiidt  in  1754, 
and  the  latest  at  Tubingen  in  1795. 

At  by  far  the  most  of  the  universities  lectures  on  surgerj-  and  midwifery  were 
combined  throughout  the  whole  18th  century,  and  this  was  the  case  at  Giessen  even 
at  the  beginning  of  the  present  century.  —  The  instruction  of  midwives  too,  in  spite 
of  the  schools  erected  for  them  in  some  states,  was  still  in  the  hands  of  the  "Physici' 
throughout  almost  the  entire  century,  though,  as  we  know,  the  physici  themselves 
never  practised  midwifery.  The  German  midwives,  accordingly,  received  their 
practical  schooling  from  older  midwives,  or  on  mechanical  subjects  or  "phantoms". 
Indeed,  the  latter,  even  at  the  present  day,  serve  exclusivel}*  to  exercise  students  in 
the  practice  of  the  operations  of  midwifery,  instead  of  the  actual  performance  of 
oparations   upon  the   parturient  woman   under   the  oversight  and   guidance  of  the 


—  781  — 

teacher.  Were  the  latter  system  pursued  it  would  never  again  hapj  en  that  a  young 
physician,  after  pulling  off  the  limb  of  a  child,  could  go  away  (as  occurred  as  late 
as  1874)  and  leave  the  poor  woman  to  be  delivered  bjr  another  physician. 

In  Denmark,  in  spite  of  the  constant  intrigues  of  the  physicians 
against  the  surgeons,  surgical  instruction  was  finally  given  in  173G  (after 
the  French  S3"stem  and  in  place  of  the  private  surgical  lectures  heretofore 
delivered)  in  an  ••Anatomico-chirurgical  School"  under  the  direction  of 
Simon  Criiger,  and  independent  of  the  quarrelsome  Faculty.  At  the  insti- 
gation of  the  latter  it  was,  indeed,  kept  closed  in  the  years  1772-1784,  but 
only  to  be  revived  in  1785  as  the  "Royal  Academy  of  Surgeiy",  in  which 
instruction  in  surgery  was  again  undertaken  after  the  French  method.  — 
Balth.  Joh.  Buchwald,  as  early  as  1720,  instructed  midwives  in  midwifery 
upon  an  improved  system,  but  a  lying-in  asylum  was  first  erected  in  176(1 
by  the  famous  Christ.  Joh.  Berger,  and  the  education  of  midwives  was 
connected  with  this  institution.  Physicians  and  surgeons  were  also  ad- 
mitted to  this  school. 

In  Sweden  Samuel  Ainirillius  first  delivered  lectures  on  surgeiy  in 
Upsala,  but  01  of  Acrel  was  the  first  to  raise  this  branch  to  the  scientific 
grade  of  his  day,  and  to  procure  for  it  the  respect  of  the  physicians.  In- 
deed from  1752  forward  physicians  were  required  to  practise  surgical 
operations,  though  up  to  this  Lime  surgery  had  been  regarded  an  occupa- 
tion unworthy  of  them  (Hjelt). 

Even  Russia,  in  the  interest  of  military  hygiene,  turned  her  attention 
to  surgical  schools.  While  in  the  17th  century  physicians  existed  at  the 
Imperial  Court  only,  in  1789  a  school  for  150  inferior  surgeons  and  100 
apprentices  was  erected  in  St.  Petersburg,  another  for  50  under-surgeons 
and  100  apprentices  in  Moscow,  and  a  third  for  40  under-surgeons  and  50 
apprentices  in  Kronstadt.  The  salary  of  the  professors  amounted  to  about 
3000  marks  ($750)  per  annum,  that  of  the  under-surgeons  to  450  marks 
and  that  of  the  apprentices  to  150  marks.1 

In  England,  where  the  barbers  were  not  separated  from  the  higher 
surgeons  until  1800.  instruction  in  surgery  was  given  by  individual  private 
surgeons,  and  the  only  obligation  laid  upon  the  college  or  guild  of  sur- 
geons was  to  deliver  free  lectures  on  anatomy.  For  this  latter  purpose 
the}-  had  a  house  of  their  own  with  an  anatomical  theatre,  dissecting  and 
operating  room.     Any  other  instruction  must  be  paid  for,  as  the  teachers 

1.  In  the  year  1880  there  were  in  Russia  14,458  Doctors  of  Medicine,  1077  veterinary 
physicians  and  312  licensed  oculists  and  dentists.  Of  this  army  of  doctors, 
rivalling  that  of  Germany,  914  were  found  in  St.  Petersburg.  In  Charkow  in 
1881  officiated  the  "first  female  professor"  since  the  days  of  Salerno,  Madame 
Iwanitzka.  —  The  American  physician  Dr.  J.  S.  Billings  estimated  the  total 
number  of  physicians  of  the  world  in  1881  at  180,000,  of  whom  the  largest  share 
belonged  to  America  (65,000)  and  the  smallest  (5000)  to  Spain.  England  was 
allowed  35,000,  Germany  and  Austria  32,000,  France  26,000  etc.  The  Medical 
Faculty  of  Paris  in  1882  assumed  the  number  of  physicians  in  all  civilized  lands 
at  182.000. 


—  7S2  — 

had  no  salary.  Stromeyer  e.  g..  when  he  visited  England  to  complete  his 
education,  was  compelled  to  pay  a  fee  of  £18  for  a  single  term,  while  for 
his  dinner  and  lodging  —  he  shared  his  bed,  however,  with  a  companion  — 
he  had  to  pay  only  10s  per  week.  —  Obstetrical  instruction  was  given  from 
lTtio  in  the  Lying  in  Asylum  of  Westminster  by  Edward  Ford.  Brickender 
and  John  Leake,  and  in  their  private  houses  or  lying-in  asylums  by  the 
German  Krohn.  Thos.  Penman  and  Win.  Osborne.  [The  separation  of  the 
surgeons  and  barbers  in  England  was  effected  by  an  act  of  Parliament  in 
174.").  The  Royal  College  of  Surgeons,  however,  was  not  incorporated 
until  1800.  John  Maubray  is  said  to  have  given  private  instruction  in 
midwifery  in  England  as  early  ms  1724.  and  Richard  Manniugham  had  a 
private  lying-in  establishment  in  his  own  house  as  early  as  1736.  At  the 
instance  of  the  Colleges  of  physicians  and  surgeons  in  Edinburgh,  the  city 
authorities  appointed  Mr.  Joseph  Gibson  to  deliver  instruction  to  midwives 
in  that  city  as  early  as  1726.  but  no  chair  of  midwifery  was  established 
in  the  University  until  1739.  The  College  of  Physicians  in  Dublin  also 
established  a  professorship  of  midwifery  in  1743.  while  the  University  of 
Glasgow  postponed  such  an  appointment  as  late  as  1815.  John  Mosse  of 
Dublin  founded  a  private  lying-in  establishment  as  early  as  1746,  and  in 
1759,  after  the  enlargement  of  this  institution,  he  was  succeeded  by  Sir 
Fielding  Quid,  who  was  probably  a  pupil  of  Gregoire.  This  institution  is 
now  the  famous  Rotunda  Lying-in  Hospital  of  Dublin.  The  British  Lying- 
in  Hospital  was  founded  in  174'.*.  the  City  of  London  Lying-in  Hospital  in 
1750  and  the  Queen  Charlotte  Hospital  in  1752.  Fleury,  physician  to  the 
Meath  Hospital  in  Dublin,  is  said  to  have  opened  an  obstetric  policlinic  in 
1763.     (H.)] 

In  Italy  male  midwifery  elevated  itself  in  a  similar  way.  and  the  edu- 
cation of  midwives  was  also  improved.  A  school  for  midwives  was  erected 
in  Piedmont  in  172S.  a  similar  institution  with  a  two  years'  course  at  Padua 
in  1769,  one  in  Rome  1786  etc. 

In  Holland  surgery  was  taught  in  the  universities  as  in  Italy,  for  in 
both  states  surgeons  were  never  so  despised  as  in  other  countries.  The 
instruction  of  midwives  was  placed  in  the  hands  of  educated  surgeons  in 
their  capacity  as  •■Vroedmeesters*'.  and  even  the  most  considerable  sar- 
LM'oiis  did  not  scorn  to  impart  instruction   in  this  department. 

How  active  was  the  zeal  for  the  elevation  of  surgical  instruction 
during  the  18th  century,  and  how  general  was  the  imitation  of  the  example 
furnished  by  Prance,  may  be  judged  most  decidedly  from  the  fact  that  a 
surgical  clinic  was  opened  in  Lisbon  in  1762.  Even  twenty  years  earlier 
a  "College"  had  been  founded  in  Spain,  and  this  was  followed  by  two 
others  to  serve  as  schools  of  surgery.  The  equality  of  physicians  and  sur- 
geons was  effected  too  lure,  as  in  other  countries,  towards  the  close  of  the 
18th  century. 

The  only  result,  however,  of  the  great  improvement  in  surgical  in- 
struction in  all  places  was  that  the  armies  of  the  different  potentates  were 


—  783  — 

generally  furnished  with  better  surgeons,  while  private  or  civil  surgery, 
even  to  the  end  of  the  century,  continued  almost  in  its  mediaeval  condition. 
In  like  manner  obstetrical  private  practice,  particularly  in  German}-,  still 
remained  in  a  most  wretched  state.  At  most  a  tendency  to  improvement 
began  to  show  itself  in  both  branches  in  the  larger  cities. 

Here  and  there  "  Stadtaccoucbeure"  were  appointed  in  the  18th  century.  In 
Prankfort-on-the-Main  e.  g.  this  was  done  about  1749,  in  consequence  of  the  difficult 
confinement  of  ".Frau  Rath"  with  Gothe,  who,  as  we  know,  was  born  "blue"  as  the 
result  of  a  protracted  labor. 

The  barbers  or  lower  surgeons  educated  in  the  guilds  were  still  almost 
ever}' where  and  exclusively  the  practitioners  of  surgery,  and  even  the 
itinerant  surgeon  was  still  a  permanent  member  of  the  medical  faculty. 
Thus  in  the  year  1704  the  famous  J.  Andr.  Eysenbarth  (1661-1727),  a 
highly  privileged  medicus  and  operator  of  Magdeburg,  who  was  a  type  of 
the  itinerant  surgeon  and  whose  name  has  passed  into  a  proverb,  treated 
the  masses  in  the  style  of  his  class,  i.  e.  he  travelled  from  city  to  city 
with  the  necessary  vehicle  and  retinue  of  such  artists,  had  a  theater  and 
harlequin,  in  the  former  of  which  satirical  pranks  were  exhibited,  while 
beside  it  rope-dancing  etc.  were  performed.  Thus  he  trumpeted  the  fame 
of  his  skill  and  his  remedies,  sold  the  latter,  operated  on  everything 
that  came  in  his  way.  dragged  out  teeth  etc.  Even  at  that  time  it  was 
somewhat  customary  for  -actors,  physicians,  mountebanks  and  id  (!)  germs 
hominum"  to  act  in  this  way.  According  to  an  earlier  ordinance  they  were 
required  to  pay  stallage,  they  could  offer  their  art  and  science  for  sale  for 
four  days  only,  and  must  then  move  on  to  pursue  their  treatment  in  the 
same  way  somewhere  else  —  a  system  which  we  may  live  to  see  restored, 
though  in  a  somewhat  --more  modern"  form,  in  these  clays  of  blessed  free- 
trade  with  theif  -Doctores  Philadelphia?'"  and  reduced  practitioners.  For 
the  former  and  better  regulated  condition  of  affairs  did  not  correspond  to 
the  German  ideal  of  Manchesterism  (which  should  legitimately  play  into 
the  hands  of  Socialism)  so  entirely  as  it  must  do  if  the  great  war  is  to 
benefit  Germany  in  this  respect  also.  These  itinerant  doctors,  according 
to  all  accounts,  still  made  Germany  unsafe  in  a  medical  point  of  view  far 
down  into  the  18th  century.  Thus  vagrant  doctors  received  permission 
from  the  authorities  to  practise  in  Bavaria  in  1756,  and  for  the  last  time 
in  1772.  But  the  fellows  practised  their  tricks  without  an}-  license  for 
much  longer,  perhaps  until  swept  away  by  the  French  wars.  Old  people 
still  living  on  the  Rhine  can  recollect  such  characters.  Among  the  itin- 
erant surgeons  there  were  also  some  lithotomists,  herniotomists.  and  par- 
ticularly large  numbers  of  oculists,  who,  before  the  days  of  Daviel.  still 
operated  everywhere  in  the  old  way  and  were  genuine  vagrant  surgical 
sinners.  Even  Dudell  said  :  £i  I  operate  on  everything  ;  if  the  operation 
succeeds,  well  and  good  ;  if  it  fails,  the  patients  are  yet  no  worse  off  than 
before,  for  then  too  they  could  not  see."  In  operations  for  hernia  they 
went  not  only  at  the  hernia,  but  also  at  the  very  root  of  humanity  itself, 
since  as  a  rule  they  extirpated  the  testicles  too. 


—   7*4   — 

Among  the  physicians  proper  the  vast  majority  still  scorned  the 
practice  of  surgery,  of  which,  on  the  whole,  too  they  understood  nothing. 
Still  they  claimed  the  right  to  be  called  in  as  spectators  of  everything  done 
by  the  surgeons,  and  of  course  to  be  paid  for  their  attendance.  In  many 
quarters  this  was  still  the  case  in  the  first  half  of  the  19th  century,  for 
the  author  recalls  from  his  youthful  da\'S  a  certain  "Physicus",  who.  as  a 
medicus  purus,  in  the  case  of  even  the  simplest  wounds,  and  of  course 
much  more  in  cases  of  fracture,  always  had  eveiy  surgical  manipulation 
performed  under  his  own  oversight  (i.  e.  in  the  presence  of  his  learned 
Highness  who  knew  nothing  whatever  about  surgery)  by  a  local  surgeon 
handed  down  to  our  century. 

Throughout  the  whole  century  the  stationary  and  itinerant  surgeons 
were  almost  the  sole  male  practitioners  of  midwifery,  for  the  physicians 
only  rareh"  devoted  their  attention  to  theoretical  obstetrics,  and  any  prac- 
tical knowledge  of  this  branch  was  quite  exceptional.  Nevertheless  the 
latter  demanded  to  be  called  in  to  cases  of  midwifery  also,  and  this  course 
was  followed  the  more  readily  since  the  surgeon  still  put  himself  under 
the  control  of  the  physician,  because  he  himself,  in  a  social  point  of  view, 
was  not  very  much  respected.  Male  midwifeiT  too  was  in  general  a  rare 
matter,  in  fact  so  rare  that  in  the  Prussian  medical  tariff  of  1725  the 
quotations  for  this  service  are  entirely  wanting,  and  this  blank  continued 
in  Bremen  as  late  as  1854,  though  it  was  filled  up  in  the  Hessian  tariff  of 
1767.  On  the  whole,  with  the  exception  of  a  few  university  towns  and 
larger  cities  and  their  vicinity,  the  practice  of  midwifer}'  still  occupied 
almost  its  mediaeval  position.  Even  the  forceps  were  not  commonly  em- 
ployed before  the  close  of  the  century,  and  Deisch  and  his  companions 
tortured  their  wretched  patients  at  their  own  sweet  will,  in  fact  so  far 
that  in  Frankfort-on-the-Main  about  1700  the  heads  of  children  and  the 
uteri  of  the  mothers  were  still  frequently  torn  jiwav  (Strieker;.  But 
male  assistance,1  even  of  this  kind,  during  the  first  half  of  the  century 
was  only  resorted  to  when  everything  else  failed  —  when  the  mid- 
wives  had  exhausted  their  strength  and  skill  in  the  use  of  the  labor- 
stool,  inunctions,  manual  twistings  and  external  pressure  "of  their  hand- 
racks  "  etc.,  for  they  were  no  longer  allowed  to  operate  with  instru- 
ments. In  the  most  favorable  cases  recourse  was  then  had  to  rude  efforts 
at  version,  but  in  the  majority*  of  cases  the  surgeons  resorted  to  the 
mediaeval  operations  of  dismemberment,  cutting  in  pieces,  tearing  away 
limbs  etc.,  under  which  treatment  often  a  quarter  or  more  of  the  mothers 
died. 

••When  they  (the  surgeons)  were   called  to  do  anything,  or   really  did 

1.  The  epidemics  of  puerperal  fever,  which  at  an  earlier  day  were  so  frequent  in  the 
tmiversity  lying-in  hospitals,  have  been  often  ascribed  to  the  union  of  the  pro- 
fessorships of  anatomy,  surgery  and  midwifery.  Even  during  the  student  life  of 
the  author  in  Giessen  no  one  considered  it  necessary  after  using  his  hands  in 
anatomical  researches,  to  disinfect  them  before  practising  the  obstetrical  toucher. 


—  785  — 

anything,  the}*  came  with  hooks  and  pitiably  tore  into  many  pieces  the 
children  within  the  womb,  whom  very  frequently  they  might  have  got  hold 
of  with  their  simple  hands,  and  thus  prevented  what  so  often  happened, 
the  laceration  of  the  womb  of  the  wretched  mothers  with  their  hooks  in 
addition  to  the  children,  and  the  risk  of  the  mothers'  lives." 

From  the  second  half  of  the  century  the  midwives  were  educated  in 
schools  pretty  much  like  those  of  the  present  day.  and  enjoyed  too  the 
same  "higher"  education  which  they  possess  to-day.  In  the  Prussian  med- 
ical tariff'  even  the  quotations  for  their  services  were  wanting,  but  they  are 
to  be  found  in  the  Hessian  tariff'  which  appeared  52  years  later. 

The  first  school  for  the  instruction  of  men  in  midwifery,  outside  of 
Paris,  was  erected,  as  we  have  said,  by  the  elder  Fried  in  Strassburg.  A 
practical  school  for  midwives  was  erected  here  in  1737,  and  in  it  (until 
1870)  instruction  in  the  German  language  was  obligatory,  because  the 
pupils  did  not  understand  French.  Rarely  only  was  a  parallel  course  in 
the  French  language  given  for  pupils  from  Lothringia  and  Upper  Alsace. 
Fried  educated  many  pupils,  who  then  introduced  into  German}-  a  better 
practice  and  were  also  better  instructors  of  midwives.  Instruction  under 
Fried  cost,  with  incidental  expenses,  300  marks  ($75).  Observation  of  a 
single  case  of  labor  in  the  city  and  in  presence  of  a  midwife  cost  about  11 
marks.  Lectures  alone,  delivered  evenings  from  6-8  P.  M.,  were  120 
marks.  At  all  labors  in  the  hospital  two  pupils  were  allowed  to  take  part, 
and  to  make  examinations  under  the  direction  of  their  instructor.  The 
female  pupil  (Lehrtochter)  of  the  hospital  midwife  also  assisted.  The 
midwives  of  the  city,  together  with  their  pupils,  were  required  to  attend 
once  each  j'ear  the  dissection  of  a  female  (if  possible  a  pregnant  woman), 
.so  as  to  learn  to  know  the  parts,  and  to  attend  the  bi-weekly  lectures  under 
penalty  of  a  fine.  Of  the  six  "sworn  city  midwives"  (they  were  regular 
officials),  each  was  permitted  to  take  one  pupil  under  her  practical  instruc- 
tion for  a  year,  and  each  of  these  pupils  was  then  required  for  another 
year  to  receive  theoretical  instruction  from  the  teacher  of  midwifery. 
They  were  then  examined  b}*  the  Plrysicus,  pro-dean  and  instructor  of  mid- 
wives,  and  received  a  certificate.  They  were  also  required  to  pass  a  written 
examination  before  the  six  -'sworn  midwives",  after  which  they  were  them- 
selves sworn,  and  expected  to  take  pupils,  though  only  for  the  country  — 
each  of  them  two  (Wieger).  The  superior  midwives  had  a  sign  with  the 
arms  of  the  city  upon  their  house,  while  the  six  examined  "Lehrtochter" 
were  "Vortauferin'nen"  (i.  e.  they  held  the  infants  at  baptism),  and  enjoyed 
the  right  of  putting  out  a  sign  without  the  arms  of  the  city. 

The  barbers  were  still  looked  upon  generally  as  members  of  the  med- 
ical profession,  and  were  designated  as  surgeons.  They  furnished  the 
figurative,  and  for  the  most  part  also  the  actual,  fathers  of  surgery.  Most 
of  the  great  surgeons  of  the  last  century  proceeded  in  both  senses  from 
their  ateliers,  and  in  their  youth  had  flourished  the  barber's-bason.  In- 
deed shaving,  cutting  corns  etc.  were  looked  upon  as  necessary  prelimina- 
50 


—  786  — 

ries  to  proper  surgical  stud\-  until  towards  the  end  of  the  century  in  almost 
all  quarters,  and  in  certain  parts  of  Germany  until  a  still  later  period. 
The  cosmetic  department  of  the  business  of  the  actual  guild-masters  was, 
however,  mainly  performed  by  their  apprentices  and  pupils.  The  barbers 
were  permitted  or  expected  to  undertake  nothing  but  the  treatment  of 
external  diseases  :  the  bath-keepers,  who  are  still  mentioned  in  the  medical 
ordinance  of  1725,  were  required  to  abstain  even  from  this,  and  could  only 
shave  etc.  and  keep  bath-houses.  They  were  united  with  the  barber-sur- 
geons into  a  single  guild  in  Prussia  in  1779.  and  in  Wurzburg  the  guild 
of  bath-keepers  was  not  abolished  until  1787. 

Among  the  better  surgeons  the  apprentices  were  already  called  assist- 
ants, and  the  elder  Stromeyer  paid  one  of  these  assistants  a  salaiy  of  300 
marks. 

In  the  18th  century  actual  surgeons  for  the  first  time  attained  the 
rank  and  office  of  professors,  standing  on  a  level  with  the  professors  of 
medicine,  though  not  exactly  recognized  as  equals  by  the  latter,  while  here- 
tofore surgery  had  been  taught  by  professors  who,  during  the  whole  course 
of  their  life,  had  never  performed  even  a  venesection.  These  new  surgical 
professors  were  now  actual  surgeons,  most  of  them  men  very  well  educated 
in  their  department  and  schooled  practitioners.  Some  of  them  were  gen- 
uine models  as  writers  and  greatly  enriched  their  department  of  knowledge; 
indeed,  on  the  whole,  they  were  superior  in  this  matter  to  the  physicians, 
who  were  too  devoted  to  the  pursuit  of  theories.  Not  a  few  of  them  belong 
among  the  greatest  surgeons  of  all  time  !  Undoubtedly  they  were  favored 
by  the  time,  inasmuch  as  the  department  of  surgery  still  required,  in  many 
respects,  to  be  newly  constructed. 

Of  course  each  potentate  had  his  body-surgeons  as  well  as  his  court-* 
surgeons.  The  royal  body-surgeon  in  Hanover  at  the  close  of  the  century 
received  a  salary  of  24<m  marks  ($600),  and  the  court-surgeon  half  of  this 
sum. 

District  surgeons  had  the  duties  of  a  state  physician,  but  were  sub- 
ordinate to.  not  adjuncts  of.  the  Physicus. 

The  city  surgeons,  as  a  rule,  were  more  highly  educated  in  their 
department  and  occupied  a  higher  rank  than  the  provincial  or  country  sur- 
geons. The  most  of  the  latter  were  nothing  more  than  rather  superior  bar- 
bers, which  latter  class  now  generally  called  themselves  "Chirurgi". 

In  Germany  the  jealousy  of  the  physicians  against  the  surgeons,  even 
as  late  as  among  the  eighties  of  the  last  century,  went  so  far  that  the  medici 
puri  in  Berlin,  the  city  of  intelligence,  compelled  the  surgeon  Gilh'.  who 
had  got  him  a  horse  and  carriage  in  order  to  attend  to  his  practice,  to  dis- 
card these  and  return  to  his  practice  on  foot. 

The  burning  question  as  to  the  equality  of  medicine  and  surgery  was  also  dis- 
cussed frequently  with  the  pen.  The  scorn  for  the  latter  branch  went  so  far  that 
even  the  students  here  and  there,  e.  g.  in  Freiburg,  rebelled  against  their  teachers, 
and  even  threatened  violence  when  the  latter  argued  in  favor  of  the  union  of  the  two 


■branches.  At  the  present  da^y  the  feeling  is  reversed;  at  least  the  man  who  speaks 
•of  a  separation  of  the  two  is  regarded  with  a  shrug  of  the  shoulders- — and  yet 
operative  practice  has  become  almost  a  monopoly  of  the  professors,  since  the  general 
physician  cannot  acquire  the  special  education  necessary  therefor. 

Besides  the  native  surgeons,  there  were  in  the  first  half  of  the  18th 
■century  very  many  French  surgeons  practising  in  the  chief  cities  of  Ger- 
many. These  were  regarded  as  better  surgeons  than  the  Germans,  and 
originally  enjoyed  special  legislation  of  their  own  in  the  French  colonies 
within  the  German  cities,  and  particularly  in  cities  which  were  occupied  as 
royal  residences.  This  arrangement  was  changed  in  Prussia  in  1725. 
Subsequently  there  was  considerable  difficulty  in  getting  rid  of  these 
arrogant  guests. 

In  neighboring  Denmark  the  condition  was.  on  the  whole,  the  same  as 
in  Germany.  Physicians  and  surgeons  occupied  a  position  of  hostility 
towards  each  other  ;  indeed,  in  accordance  with  the  national  character,  this 
hatred  was  still  more  biting  and  unextinguishable  than  with  us.  In  like 
manner  the  male  obstetricians  and  the  raidwives  maintained  an  active  feud 
with  each  other. 

In  France,  at  least  in  the  capital  and  the  larger  cities,  surgery  enjoyed 
better  representatives  than  in  other  countries,  in  accordance  with  the  better 
■educational  arrangements  introduced  into  this  country  at  an  ear  y  date. 
In  like  manner  male  midwifery,  the  foundation  of  which  had  been  laid 
during  the  17th  eentury,  was  generally  naturalized  there  in  the  cities  and 
among  the  higher  classes.  In  the  provinces  well  educated  midwives  at 
least  were  to  be  found.  —  The  Faculty  and  the  surgeons,  however,  still 
■quarreled  in  the  mediaeval  style,  as  they  had  done  ever  since  the  founding 
of  the  College  de  St.  Come  by  Pitard.  and  their  strife  was  really  never  con- 
cluded until  the  abolition  of  the  universities. 

In  Holland,  as  in  Italy,  surgeons  and  male  obstetricians  were  held  in 
greater  esteem.  ' 

The  same  may  be  said  of  England,  where,  as  in  Holland,  the  public 
speedil}"  decided  in  favor  of  male  midwifery,  although  here  instrumental 
methods,  particular!}'  the  forceps,  were  too  frequently  employed. 

England  has  been  always  distinguished  by  peculiar  medical  arrangements, 
which,  since  their  first  regulation  in  the  year  14(11,  have  remained  almost  entirely 
unchanged. 

The  English  universities  are  much  les.-  the  exclusive  and  proper  educational 
centres  for  physicians  than  is  the  case  with  us.  Thej-  consist  of  a  nuvnbei — 12-24 — of 
so-called  "  Colleges  ',  in  which  the  pupils,  who  subsequently  become  "physicians" 
only  (medici  puri),  are  brought  tip  quite  monastically  as  in  our  "  Convicten".  They 
study  chiefly  the  litera?  humaniores,  while  professional  studies  are  vety  defectively 
cultivated,  so  that  students  of  medicine,  having  obtained  the  degree  of  doctor  from 
the  universities,  now  begin  their  special  studies  in  foreign  universities,  or  in  the  so- 
called  hospital-schools  of  their  own  country,  in  order  to  complete  their  defective 
professional  education.  [This  description  applies  chiefly  to  Oxford  and  Cambridge, 
which  have  no  medical  faculties  proper,  though  instruction  in  anatomy  and  phy- 
siology is  given.     The  universities  of  Scotland  and  Ireland  have  generally  complete 


—  788  — 

medical  faculties,  and  that  of  the  university  of  Edinburgh  is  deservedly  famous.  The 
degrees  of  Baccalaureus  and  Doctor  Medicinae  and  of  Bachelor  and  Master  of  Surgery 
can  be  conferred  only  by  the  universities,  though  the  license  to  practise  may  be 
obtained,  as  we  shall  see,  from  various  other  examining  bodies.     H.] 

At  the  head  of  the  universities,  which  depend  upon  foundations  and  are  entirely 
independent  in  their  management,  while  they  retain  and  anxious!}'  and  energetically 
defend  their  ancient  privileges,  stands  a  chancellor  and  with  him  a  vice-chancellor. 
The  supreme  judicial  authoritj-  and  defender  of  the  rights  of  the  university  is  the 
high  steward,  and  his  assistants,  so  to  speak,  are  the  proctors.  The  latter  maintain 
discipline  among  the  students  in  the  colleges  as  well  as  among  those  outside  of  these 
institutions  but  residing  in  the  university  cities.  The  students  bear  various  titles 
such  as  scholar,  exhibitioner,  sizar,  nobleman,  fellow-commoners,  pensioners  etc. 
The  teachers  are  called  tutors,  and  are  assisted  by  the  fellows.  All  the  officials  thus 
mentioned  receive  their  salaries  from  the  universities  alone.  A  number  of  students 
too  are  educated  at  the  expense  of  the  university,  while  others  defray  themselves  the 
entire  expense  of  their  education,  or  at  least  a  part  of  it.  Those  scholars  who  do  not 
reside  in  the  college  buildings  are  domiciled  in  so-called  "Halls",  i.  e.  private  insti- 
tutions, where  they  are  supplied  with  board  and  lodging  and  receive  instruction.  The 
method  of  instruction  is  still  quite  scholastic,  and  the  attainment  of  the  degree  of 
"  Doctor"  still  confers  great  respect. 

Besides  the  universities  there  are.  in  connection  with  the  great  hospitals, 
hospital-schools,  the  arrangement  of  which  corresponds  in  the  main  with  that  of  our 
medical  faculties'.  The  teachers  in  these  schools  are  the  physicians  to  the  hospitals, 
and  others  chosen  to  the  honorary  office  of  teacher  from  among  the  more  eminent 
practitioners.  The  latter  have  no  salary  or  a  very  trifling  one,  and  are  also  con- 
sulting physicians  or  surgeons  and  operators  in  the  hospitals.  The  hospitals  have 
their  auditoria,  dissecting-rooms,  laboratories,  libraries  etc. 

In  London  e.  g.  such  schools,  supported  by  private  foundations  and  the  proceeds 
of  the  places  obtained  by  annual  purchase,  exist  in  connection  with  the  famous 
hospitals  of  St.  Thomas,  St.  Bartholomew,  St.  George,  The  London  Hospital,  Guy's 
(founded  in  1724  by  Thomas  Guy,  a  London  bookseller),  Charing  Cross  Hospital, 
Middlesex  Hospital,  St.  Mary's  Hospital,  Westminster  Hospital  etc.  [Medical 
schools  are  also  associated  with  the  hospitals  of  King's  College  and  University 
College  in  London,  though  here  the  medical  faculties  are  united  with  other  faculties 
into  universities.]  The  course  at  these  hospital  schools  lasts  three  years.  Of  the 
hundreds  of  students  who  attend  these  schools  a  small  number  are  assigned  to  each 
house-physician  for  practical  or  clinical  instruction.  The  fees  for  instruction,  the 
use  of  apparatus,  library  etc.  are  either  paid  in  a  single  payment  at  the  beginning  of 
the  course,  or  in  annual  payments  until  the  fixed  sum  is  completed.  These  fees  too 
are  quite  moderate,  amounting  to  about  £90.  —  The  pupils  of  the  universities  proper 
also  frequently  enjoy  practical  instruction  in  these  schools. 

A  final  examination  determines  the  question  of  capacity  for  practice.  This 
examination  is  not  conducted  by  the  state  —  though  an  effort  was  made  in  1874  to 
introduce  a  state  examination' —  but  by  the  teachers  themselves,  as  a  matter  outside 
of  state  control. 

Authorization  to  practise  likewise  is  not  given  by  the  government,  but  by  the 
elective  presidents  of  the  societies  of  the  various  classes  of  educated  physicians  who 
exist  in  England.  These  societies  are  entirely  independent  of  the  government  and 
are  known  as  the  Ro3*al  College  of  Physicians,  Royal  College  of  Surgeons  and  the 
Society  of  Apothecaries.  [There  are  some  nineteen  of  these  examining  boards, 
including  the  faculties  of  the  various  universities,  the  Royal  Colleges  of  physicians 
and   surgeons   in   London.    Edinburgh   and   Dublin,  the   Faculty  of  Phj'sicians   and 


—  789  — 

Surgeons  in  Glasgow,  the  Society  of  Apothecaries  in  London,  Apothecaries  Hall  in 
Ireland  etc.,  all  of  which  are  by  the  Medical  Act  of  1858  responsible  for  their  actions 
to  the  General  Council  of  Medical  Education.  By  the  same  Act  it  is  made  the  duty 
of  the  General  Council  to  see  that  the  various  examining  boards  exercise  their 
functions  in  a  discreet  and  impartial  manner,  and  if  necessary  to  punish  any  im- 
proprieties on  their  part  by  reprimand,  or  in  aggravated  cases  by  the  withdrawal 
from  the  offending  board  of  its  right  to  give  diplomas.]  Each  of  these  societies  has 
a  list  of  its  members  (medical  directory)  and  those  only  whose  names  are  borne  upon 
this  list  are  regarded  as  physicians,  while  all  others  —  practice  is  absolutely'  free  — 
are  looked  upon  as  quacks.  These  colleges  also  control  the  discipline  of  the  medical 
profession,  and  maintain  its  honor  in  a  strict  and  efficient  manner.  A  physician 
who  advertises  himself  frequently  or  conspicuously  is  regarded  as  a  quack;  the  same 
is  the  case  with  homoopaths  etc.  Whoever  offends  against  medical  decorum  may 
be  struck  off  from  the  list  of  the  colleges  —  the  supreme  penalty. 

The  three  classes  of  physicians  existing  in  England  are  accordinglj-  the  following: 

1.  Physicians  proper,  pure  internal  physicians,  corresponding  to  the  earlier 
medici  puri.  They  are  recruited  from  the  students  of  Cambridge,  Oxford  etc.  They 
are  prohibited  from  performing  any,  even  the  most  trifling,  surgical  operation,  so 
that  e.  g.  in  1885  Dr.  Little,  who  had  performed  subcutaneous  tenotomy,  was  com- 
pelled to  vindicate  himself  by  arguing  that  tenotomy  was  not  of  the  nature  of  a 
surgical  or  external  procedure  —because  it  was  performed  beneath  the  skin  and  was 
bloodless.  The  physicians,  of  course,  attain  a  considerable  practice  only  slowly,  yet, 
in  spite  of  this  fact,  they  all  claim  the  same  fees  as  the  most  popular  and  famous 
practitioners.  Thus  for  each  visit  and  consultation  they  receive  a  guinea,  and  who- 
ever takes  a  less  fee  degrades  himself  in  the  eyes  of  his  colleagues.  The  system  of 
making  visits  too  is  not  the  same  as  with  us.  English  physicians  visit  their  patients 
but  seldom — everyday,  or  ever3' other  day ;  it  is  only  in  cases'of  extreme  danger 
that  more  frequent  visits  are  made,  and  this  is  true  for  all  their  clientele  without 
exception,  whether  they  are  more  or  less  wealthy.  However  they  also  make  friendly' 
calls,  which  are  not  charged,  and  have  certain  limited  hours  for  office  consultations. 
It  is  only  in  extremely  pressing  cases  that  they  accept  for  the  same  day  patients  who 
have  not  been  announced  before  their  hours  of  visitation.  Most  such  patients  are 
•compelled  to  wait  until  the  next  day.  Many  physicians  of  London  and  other  cities 
go  into  the  country  from  Saturday  afternoon  until  Monda}-,  in  order  to  secure  rest 
and  refreshment.  Those  patients  who  cannot  wait  until  the  return  of  their  own 
physicians  are  forced  to  select  another  for  temporary  emplojment. 

2.  Surgeons,  i.  e.  pure  surgeons.  These  attend  none  of  the  universities,  but  most 
of  them  become  pupils  of  an  old  practitioner  or  surgeon  before  visiting  the  hospital 
schools  at  the  conclusion  of  their  studies,  in  order  to  obtain  complete  theoretical 
knowledge.  They  receive  the  same  fees  and  take  the  same  rank  as  the  physicians. 
Nor  are  they  prohibited  from  prescribing  internal  medicines.  Oculists  are  counted 
also  among  the  surgeons.  — The  same  course  of  instruction  and  study  is  also  followed 
by  the 

3.  Apothecaries.  These  are  likewise  called  General  Practitioners,  inasmuch  as, 
like  the  German  physicians,  they  practise  in  all  branches.  They  form  the  class  of 
family  physicians.  Their  fee  is  usually  half  a  guinea  for  each  visit  or  consultation. 
The  apothecaries  also  form  the  ordinary  obstetricians  and  dispense  their  own 
medicines,  which  they  procure  from  the  Apothecaries'  Hall. 

The  last  two  classes  of  physicians  do  not  decide  upon  the  practice  of  one  or  the 
•other  branch  of  the  profession  until  the  close  of  their  education  in  the  hospital 
schools,  but,  this  selection  once  made,  they  are  distinguished  from  each  other,  though 
both  departments   may  be  united   in   the  same  person.     While  the  future  surgeon 


—  790  — 

obtains  his  license  to  practise  from  the  College  of  Surgeons  alone,  and  the  apothecary 
from  the  Society  of  Apothecaries  alone,  he  who  desires  to  obtain  authority  to  pursue 
both  kinds  of  practice  must  obtain  a  license  from  both  colleges.  The  physicians  in 
1805  formed  the  "  Medico-chirurgical  Society",  which  publishes  the  famous  "Medico- 
chirurgical  Transactions."     This  society  also  possesses  foreign  members. 

The  English  physicians  enjoy  complete  independence  and  self-government. 
That,  since  the  state  has  made  practice  completely  free,  there  is  much  quackery  is  a 
matter  of  course:  still  quackery  does  not  preponderate  over  the  practice  of  the 
regular  physicians,  since  tiie  latter  are  very  careful  of  their  professional  honor  before 
the  public,  and  avoid  in  every  possible  way  the  slightest  contact  with  quacks,  and  far 
more  anything  like  community  with  them.  This  feeling  is  carried  so  far  that  one  of 
the  most  famous  English  physicians  who  accidentally  met  a  homoeopath  at  the  bed- 
side was  compelled  to  publickly  vindicate  his  conduct. 

The  English  "chemist"  is  represented  by  our  apothecary.  lie  merely  offers 
drugs  for  sale  and  puts  up  the  prescriptions  of  the  physicians  and  surgeons,  [but  is 
entirely  unauthorized  to  practise.     The  same  may  be  said  of  the  druggist. 

Perhaps  a  more  definite  idea  of  the  divisions  of  the  English  medical  profession 
will  be  given  the  American  reader  if  we  say  that  the  functions  of  the  English 
"physician"  proper  (the  possessor  of  the  university  degree  of  M.  B.  or  M.  D.)  corre- 
spond in  some  degree  to  what  we  understand  by  a  "  consulting  physician  ",  while  the- 
English  "  apothecary "  (enjoying  the  diploma  of  the  Apothecaries'  Society)  corre- 
sponds to  our  ordinary  family  and  general  practitioner,  and  the  "chemist"  or  "drug- 
gist" to  our  apothecary.  The  English  apothecaries  were  legalized  by  an  act  of 
Parliament  in  1543,  and  formed  into  one  of  the  city  companies  together  with  the 
grocers  by  James  I.  in  1606.  In  1617  they  were  separated  from  the  grocers  and  set 
up  for  themselves  under  the  title  of  the  "Apothecaries  of  the  city  of  London".  Their 
claim  to  the  right  o'f  prescribing  for  patients  as  well  as  of  dispensing  medicines  was  a 
chronic  subject  of  dispute  between  the  apothecaries  and  physicians,  and  led  to  the 
famous  "  Dispensarian  Campaign"  between  the  College  of  Physicians  and  ihe  Com- 
pany of  Apothecaries  toward  the  close  of  the  17th  century,  in  which  the  physicians 
appeared  to  no  great  advantage.  The  quarrel  was  finally  settled  in  favor  of  the 
apothecaries  by  the  House  of  Lords  in  1703,  and  gradually  the  victors  have  largely 
withdrawn  from  the  business  of  dispensing  medicines,  preferring  the  more  honorable 
duty  of  prescribing,  and  abandoning  the  dispensing  of  drugs  to  the  "chemist  and 
druggist".  Jeaffreson  says  "Prior  to  1788,  it  is  stated  on  authority,  there  were  not 
in  all  London  more  than  half-a-dozen  druggists  who  dispensed  medicines  from  physi- 
cians' prescriptions.  Before  that  time,  the  apothecaries  —  the  members  of  the 
Apothecaries'  Company  —  were  almost  the  sole  compounders  and  preparers  of  drugs. 
At  the  present  time  it  is  exceptional  for  an  apothecary  to  put  up  prescriptions,  unless 
he  is  acting  as  the  family  or  ordinary  medical  attendant  to  the  patient  prescribed  for.' 
The  Apothecaries'  Company  was  authorized  in  1722  to  visit  all  shops  in  London  and 
destroy  drugs  unfit  for  use.  In  17-18  they  were  authorized  to  appoint  ten  examiners 
without  whose  license  no  person  might  compound  or  sell  medicines  in  London  or  for 
seven  miles  around  that  city,  and  in  1815  aboard  of  12  members  of  the  Apothecaries' 
Society  was  empowered  to  examine  and  license  all  apothecaries  in  England  and 
Wales.  In  1858  the  licentiates  of  this  society  were  authorized  to  act  in  Ireland  and 
Scotland  also. 

The  separation  of  the  surgeons  and  barbers  in  1745  has  been  already  mentioned, 
as  well  as  the  incorporation  of  the  Royal  College  of  Surgeons  of  London  in  1800. 
Either  physician  or  apothecary  may  acquire  the  additional  diplomas  of  the  Royal 
College  of  Physicians  or  the  Royal  College  of  Surgeons,  in  which  event  he  is  entitled 
to  the  title  of  M.  R.  C.  P.   or  M.  R.  C.  S.  —  Finally,  as  the  possession  of  the  diploma 


—  791  — 

of  the  latter  great  corporations  in  itself  authorizes  medical  or  surgical  practice,  a 
large  number  of  practitioners  in  England  have  neither  the  university  M.  D.  nor  the 
diploma  of  Apothecaries'  Hall,  but  simply  that  of  the  Royal  Colleges  of  physicians 
or  surgeons.     H.] 

Medical  arrangements  in  America  have  been  from  the  outset  similar  to  those  of 
England,  but  continued  until  a  short  time  since  entirely  unregulated,  practice  free  etc., 
and  without  the  English  self-government.  The  latter  is  now  just  beginning  to  show 
itself,  so  that  quackery  in  the  United  States  has  overgrown  reputable  practice.1 

[The  earliest  medical  school  founded  within  the  United  States  was  the  institution 
now  known  as  the  Medical  Department  of  the  University  of  Pennsylvania,  founded 
by  Drs.  John  Morgan  and  William  Shippen  at  Philadelphia  in  17(13.  This  was 
speedily  followed  by  the  school  now  known  as  the  College  of  Physicians  and  Surgeons 
of  New  York,  established  in  1767  under  the  charter  of  King's  College.  The  Medical 
Department  of  Harvard  University  was  founded  in  1782;  the  College  of  Philadelphia, 
in  1790,  and  the  Medical  School  of  Dartmouth  College  in  1798.     H.] 

B3-  decrees  all  the  states  of  the  Union  have  established  colleges  and  universities, 
many  of  them  several  institutions  of  this  kind,  so  that  in  18;>6  there  were  in  the 
United  States  no  less  than  79  universities  and  colleges,  though  of  course  of  quite  a 
different  kind  from  those  of  our  own  land.  Of  these  institutions  88  enjoyed  the  right 
"to  make  doctors" — a  manufacture  in  which,  as  we  know,  Philadelphia  has  recently 
greatly  distinguished  herself.  [According  to  Dr.  John  S.  Billinjrs,  there  had  been 
established  in  the  United  States  down  to  1876  no  less  than  84  medical  schools  author- 
ized to  confer  degrees  in  medicine,  and  of  these  7)9  were  still  existing  at  that  date. 
Five  of  these  colleges  were  founded  in  the  18th  century,  and  the  number  of  their 
graduates  down  to  the  close  of  that  century  is  estimated  at  221. J  Most  of  these 
institutions  are  private  foundations.  —  The  first  physicians  in  America  were  the 
missionaries  and  priests,  a  phenomenon  renewed  also  in  the  beginning  of  American 
medical  culture.-  Subsequently  physicians  wandered  to  the  new  colonies,  many  of 
them  the  refuse  of  the  profession  among  other  nations.  This  is  no  longer  the  case, 
but  America  ma}7  be  looked  upon  as  the  model  of  a  state  in  which  physicians,  who 
make  a  complete  business  of  their  profession,  dwell  under  regulations  of  absolute 
free-trade.  Yet  recently  the  medical  profession  in  America  has  elevated  itself  both 
scientifically  and  practically  by  the  inauguration  of  a  strict  professional  code,  though 
even  now,  in  consequence  of  the  complete  liberty  of  practice,  an  excessive  number  of 
male  and  female  quacks  continue  to  ply  their  trade.  This  is  done  to  even  a  criminal 
extent  in  numerous  cases,  so  that  recently  strict  laws  against  such  practices  have ' 
been  passed,  white  similar  laws  to  restrict  the  sale  of  quack  remedies  have  likewise 
appeared,  though  certainly  they  do  not  seem  to  have  been  executed.  "Any  person 
who  prepares,  has  prepared,  has  in  his  possession,  or  conceals,  obscene  medicines,  or 
induces  another  to  prepare  or  to  sell  such  remedies,  or  who  only  advertises  tin  in. 
shall,  if  over  21  years  of  age,  be  punished  by  imprisonment  at  hard  labor  for  two 
years  and  a  fine  of  $100-$5000,  or,  if  under  21  years  of  age,  with  three  months' 
imprisonment  and  a  fine  not  to  exceed  $500.'"  Since  the  establishment  of  medical 
free-trade  in  Germany  even  the  American  code  has  been  taken  as  a  model  for  our 
country,  an  appearance  of  retrograding  civilization  which  excites  much  reflection 
upon  the  conditions  with  us.  In  recent  times  American  medicine,  however,  has 
become  in  many  respects  the  teacher  of  the  European,  a  phenomenon  historieally 
explicable  from  the  younger  civilization  of  the  New  World,  and  even  pointed  out  by 
old  Gothe : 

1.    Unless  the  definition  of    'quackery  "  is  made  very  comprehensive,  this  is  a  rather 
exaggerated  description  of  a  state  of  medical  affairs  by  no  means  satisfactory.    (H.) 


—  792  — 

"America,  du  hast  es  besser, 
Als  unser  Continent,  der  alte!"  etc. 

[It  should  be  borne  in  mind  that  the  above  rather  pessimistic  account  of  medical 
affairs  in  the  United  States  was  written  prior  to  1876,  since  which  date  man}-  medical 
reforms  have  been  introduced  in  various  states.  Still  it  cannot  be  denied  that  there 
is  yet  abundant  room  for  improvement  in  our  medical  relations.  The  subject,  how- 
ever, is  far  too  extensive  to  warrant  discussion  in  this  place.     H.] 

According  to  the  medical  tariff  of  the  Royal  Prussian  Collegium  Medicum, 
published  in  1725,  the  first  visit  to  the  house  of  the  patient  in  a  case  of  ordinary 
disease  was  charged  at  one  thaler;'  in  case  of  an  infectious  disease  (except  the 
plague)  two  thaler.  Each  visit  without  writing  a  prescription,  in  a  case  of  ordinary 
disease,  8  groschen,  and  if  a  prescription  was  written,  12  groschen  :  for  the  same  in 
cases  of  infectious  disease,  1 5  groschen  and  one  thaler.  The  first  consultation,  to 
each  physician,  one  thaler;  for  each  subsequent  consultation,  12  groschen.  A  night- 
visit,  one  thaler.  Visits  requiring  the  physician  to  travel  some  distance  were 
charged  at  two  thaler  for  each  (German)  mile,  and  two  thaler  for  each  day  the  phy- 
sician was  absent  from  his  home.  The  cure  of  venereal  disease  was  a  matter  of 
private  arrangement  between  physician  and  patient.  The  poor  were  to  be  treated 
gratuitously.  Surgeons  were  allowed  for  dressing  an  ordinary  wound  six  groschen 
14  cents) ;  for  elevation  of  the  bone  in  depressed  fracture  of  the  skull  10-15  thaler; 
-and,  if  the  use  of  the  trepan  was  required.  2-3  thaler  fur  each  application  of  this 
instrument.  Fractures  in  old  persons  were  treated  for  10-16  thaler,  and  in  young 
persons  for  G-lO  thaler.  Travel  was  charged  at  12  groschen  (29  cents)  for  each 
(German)  mile,  and  one  thaler  for  each  day's  absence  from  home. 

This  tariff-ordinance  was  not  substantially  different  from  that  of  1G85.  It  pre- 
vailed during  the  18th  century  and  (inasmuch  as  it  was  for  the  most  part  simply 
renewed  in  1815)  also  holds  good  down  to  the  present  day. 

According  to  the  medical  ordinance  adopted  for  Hesse  in  1707,  the  first  visit  to 
a  case  of  ordinary  disease  cost  10  albus,2  8  heller;  in  a  case  of  infectious  disease,  21 
albus,  4  heller;  night  calls  10  albus,  8  heller;  visits  to  the  country,  without  travelling 
•expanses,  1  rixthaler,  10  albus,  8  heller;  the  cure  of  venereal  disease  10  rixthaler  or 
more,  according  to  circumstances;   post  mortem  with  report,  2  rixthaler. 

Surgeons  were  allowed  for  trepanning  3-6-10  rixthaler;  for  catheterization  1-2 
rixthaler;  herniotomy,  8-10-15  rixthaler;  Cesarean  section  5-8  rixthaler;  lithot- 
omy 10-12-20  rixthaler;  treatment  of  a  fracture  5-10  rixthaler;  gun-shot  wounds 
5  H>-12  thaler;  venesection  4-5'  albus ;  enemata  10-16  albus;  extraction  of  a  tooth 
2H -5;'  albus;  a  surgical  (!)  night-watch,  10-16  albus;  the  treatment  "luis  venerea?  per 
salivationem"  (never  to  be  undertaken  without  calling  in  a  physician)  without  board 
and  lodging  (!),  8-12-16  rixthaler;   etc.,  etc. 

The  tariff  for  medici  and  accoucheurs  allowed  for  an  examination  before  birth, 
or  for  personal  assistance  and  counsel  during  labor,  1-4  rixthaler;  for  a  natural 
accouchement,  accomplished  without  aid,  3-5-6  thaler;  for  version  before  the  escape 
of  the  waters,  5-G-8  thaler;  after  the  escape  of  the  waters,  6-8-10  thaler;  for  an 
instrumental  operation,  8-10-12  thaler;  Cesarean  section,  10-15-20  thaler;  the  same 
operation  after  the  death  of  the  mother,  S-10-12  thaler;  reposition  of  a  prolapsed 
uterus,  2-3-4  thaler;  operation  for  the  removal  of  a  polypus  uteri,  4-6-8  thaler. 

Midwives  received  for  a  visit   at   request  before  accouchement  3-6-8  albus;  for 


1.  The  thaler  consisted  of  30  groschen,  and  was  worth  it!  our  present  money  about 

70  cents.     (II.) 

2.  An  albus  was  equal   to  'J  heller  and  was  worth  in  our  present  money  about  1"/ 

cents.     The  rixthaler  may  be  computed  at  about  70  cents.    (11.) 


—  793  — 

attendance  during  labor,  according  to  time  required,  circumstances  and  people, 
1-2-3  rixthaler;  for  each  visit  after  confinement,  1-2  albus ;  for  enemata,  4-6-8 
albus;  reposition  of  an  incomplete  prolapsus  uteri,  with  the  application  of  a  pessary, 
10— 12— 1G  albus;  where  the  prolapse  was  complete,  16-20  albus. 

We  have  quoted  the  above  tariff  ordinances  quite  freely  because  they  furnish  us 
a  safe  guide  as  to  the  valuation  of  medical  professional  services  in  the  18th  century, 
and  give  us  a  basis  for  a  comparison  with  the  19th.  This  will  establish  the  fact  that 
in  the  18th  century,  as  generally  at  an  earlier  period,  physicians  were  socially  much 
better  situated  than  in  our  own  day,  although  in  the  second  half  of  that  century  the 
view  of  the  authorities  had  found  expression  that  the  services  of  the  physician  could 
be  cut  down  to  half  groschen  or  even  to  heller,  and  that  their  performance  need  not 
be  looked  upon  as  an  art  but  as  mere  mechanical  labor.  At  an  earlier  period,  con- 
sidering the  small  number  of  physicians  and  the  high  (triple)  value  of  money,  the 
proverb  "  Galenus  dat  opes",  still  held  good  to  some  extent;  now,  however,  when  the 
proverb  should  read  "Galenus  dat  nickel",  the  following  comparisons  are  significant. 

In  the  year  1224  according  to  the  medical  tariff  of  Frederick  II.  the 
physician,  for  a  visit  at  the  residence  of  the  patient,  received  a  fee  of  60 
pfennige,  that  is  to  say.  in  the  present  value  of  money,  at  least  6  marks. 
For  visits  outside  of  the  city  his  fee  was  3  marks.  60  pfennige.  or  in  our 
money  about  36  marks  !  At  least  Kriegk  estimates  the  relative  value  of 
money  at  this  period,  compared  with  that  of  the  present  time,  in  this  ratio. 
In  the  beginning  of  the  16th  century  the  ph}-sician  was  paid  85  pfennige 
per  diem,  equal  to  about  5  marks  at  the  present  da}".  In  the  18th  centuiy, 
as  we  have  just  seen,  the  tariff  was  still  tolerabh'  high.1  At  a  later  period, 
however,  matters  got  worse  !  In  spite  of  the  enormous  depreciation  in  the' 
value  of  money,  the  first  visit  at  the  residence  of  the  patient,  according  to 
the  Hessian  tariff  of  1865,  costs  85i  pfennige  to  1.71  marks  ;  in  the  next 
four  weeks  45J  to  85^  pfennige ;  from  the  fifth  week  forward,  only  35  to 
70  pfennige  !  Vaccination  costs  25  pfennige !  In  England  and  Sweden'2  only 
has  the  pay  of  physicians  at  the  present  day  remained  at  its  mediaeval 
standard.  We  see  that  German  physicians  have  every  reason  to  wish  for 
the  return  of  the  Middle  Ages  in  order  to  better  their  condition  ! 

Apothecaries  during  the  18th  century  attained  a  better  scientific  edu- 
cation in  German^*,  and  were  more  respected  socially  and  better  protected 
by  the  state  than  heretofore,  since  the  authority  to  dispense  medicines  was 
withdrawn  from  the  druggists,  grocers  etc. 

A  passage  in  the  medical  ordinance  of  Hesse  in  1727  reads:   "The  sale  of  the 

following,  and  other  articles  which  belong  to  the  pharmacies,  such  as  etc 

is  forbidden  without  special  license  to  all  dealers  and  traders,  under  penalty  of  a  fine 
of  17   marks  and  confiscation  of  the  goods,  since  not  only  the  pharmacies  are  injured 

1.  The  necessaries  of  life  at  this  period  were  about  four  times  cheaper  than  at  present. 

In  Darmstadt  a  pound  of  meat  cost  only  16  pfennige;  100  kilos  (220  pounds)  of 
bailey,  5  marks;  of  wheat,  7  marks,  20  pfennige;  2  litres  of  lagerbier  cost  12 
pfennige;  8  eggs,  the  same  etc.     [1  mark  =  100  pfennige  =  24  cents.] 

2.  In  Sweden  there  in  one  physician  to  every  8.")00  of  the  population:  in  Denmark  1: 

3000;  in  Norway  1:  4784.  In  the  last  country  the  mortality  amounts  (therefore?) 
to  only  1.7  per  cent.  In  Vienna,  on  the  other  hand,  there  was  in  1887  one  phy- 
sician to  858  inhabitants. 


—  794  — 

thereb}',  but  the  common  people  too  are  often  endangered  in  life  and  limb 

Peddlers  of  theriaca,  itinerant  dealers  and  other  mountebanks  and  old  women  are 
forbidden  to  either  sell  medicines  or  to  practise  secretly."  For  each  violation  of  this 
ordinance  the  offender  was  to  be  punished  by  a  fine  of  about  9  marks,  and  beaten 
according  to  the  decision  of  the  authorities  —  the  latter  a  punishment  still  very 
common  and  certainly  very  effective  also. 

The  same  action  was  taken  in  France  with  regard  to  the  grocers,  into 
whose  hands  the  entire  wholesale  dealing  in  drugs  now  passed.  Per- 
mission to  carry  on  the  business  of  an  apothecary  in  Prussia  was  made 
dependent  upon  an  examination  before  the  Collegium  medico-chirurgicum 
and  a  certain  definite  term  of  practical  experience  in  a  pharmacy.  Pupils 
and  assistants  or  dispensing-clerks,  on  the  other  hand,  pursued  their 
studies  with  masters,  as  at  an  earlier  period  ;  for  a  special  school  for 
pharmaceutists  was  not  established  in  France  until  the  year  1777  under 
the  form  of  the  College  de  Pharmacie,  while  at  the  same  time  masterships 
and  sworn  members  of  guilds  were  abolished.  The  College  was  a  private 
association,  which,  by  permission  of  the  state,  controlled  the  relations  of 
the  pharmaceutical  profession. 

It  was  composed  of  actual  or  titular  master-apothecaries,  and  had  for  its  board 
of  directors:  the  four  apothecaries-in-ordinary  as  honorary  directors;  four  active 
directors  and  twelve  deputies.  The  active  directors,  together  with  the  medical  faculty, 
had  charge  of  all  inspections;  the}-  were  elected  to  their  position.  Twice  a  }-ear 
there  were  general  meetings.  With  the  exception  of  the  pupils  in  (he  Hotel-Dieu 
and  in  the  Hospital  for  Incurables,  all  apothecaries  were  required  to  pass  an  ex- 
amination before  this  college.  All  pupils  were  entered  in  its  register,  and  even 
changes  of  situation  were  to  be  announced  and  recorded. 

The  instruction  consisted  in  free  courses  of  lectures  on  natural  history,  botany, 
chemistry,  and  pharmacy.  These  lectures  were  public,  and  were  delivered  by  three 
demonstrators  nominated  for  six  years  at  the  general  meetings,  each  of  whom  had  an 
assistant. 

After  the  College  a  so-called  free  Societe  de  Pharmacie  was  formed,  and  this  in 
179G  erected  a  free  Ecole  de  Pharmacie.  The  College  existed  still  for  a  long  time 
with  the  Ecole. 

In  Germany  there  were  nothing  but  private  schools  for  the  education  of  apothe- 
caries. Most  of  the  latter  were  instructed  by  other  apothecaries,  and,  on  the  ex- 
piration   of  their  apprenticeship,  received  a  certificate  of  instruction. 

To  the  earlier  apothecaries- in-ordinary  were  now  added  court-  and 
travelling  apothecaries,  i.  e.  apothecaries  who  accompanied  the  high  lords- 
upon  their  travels,  in  place  of  the  simple  medicine-chests  of  earlier  days 
and  which  even  the  Egyptians  possessed. 

The  practice  of  medicine  was  prohibited  to  the  apothecaries,  and  their 
pharmacies  were  subjected  to  a  still  stricter  inspection.  In  Prussia.  Neu- 
mann was  the  first  general  inspector  of  the  pharmacies. 

The  pharmacies  for  a  long  period  passed  into  the  hands  of  new  owners 
either  by  inheritance  or  by  marriage,  and  in  Frankfort-on-the-Main  e.  g.  it 
was  not  until  1757  that  a  pharmacy  was  sold  (Kriegk). 

Ordinal'}"  veterinaiy  practice  continued  entirely  in  its  mediaeval  state. 
Equerries,   farriers,   shepherds,  old    women    etc.  were    the    popular  practi- 


tiouers,  for  the  veterinarians  or  "Rossarzte",  educated  in  the  veterinaiy 
schools,  had  not  as  yet  attained  private  practice.  The  common  practi- 
tioners of  veterinary  medicine  at  this  period  (as  often  even  at  the  present- 
day)  directed  their  practice  against  witches,  enchantments,  the  devil  in- 
carnate etc.,  employing  charms,  pouring  down  devil's-drinks  and  the  like. 
On  the  other  hand  the  18th  century  produced  the  first  professors  of  veter- 
inary medicine.  The  earliest  of  these  appeared  in  France,  but  in  1777  a 
school  for  the  education  of  army  veterinarians  was  founded  in  Vienna,  with 
Scotti,  Mengmann  and  Heller  as  its  first  teachers.  A  similar  school  was 
opened  in  Dresden  in  1780,  and  in  Berlin  in  17!>0.  For  the  first  time  too 
since  the  days  of  the  Ancients  a  regular  veterinary  army-service  was 
essayed,  the  French  assuming  the  initiative,  while  the  Austrians  and 
Prussians  followed  their  example. 

Joseph  II.  ou  the  opening  of  the  veterinary  school  in  Vienna  decreed  that  no 
one  who  attended  this  school  and  exercised  himself  in  the  anatomy  of  dead  horses, 
whether  he  were  a  civilian  or  a  military  official,  should  be  regarded  as  having  injured 
his  reputation,  but  that  such  conduct  should  rather  be  looked  upon  as  meritorious. 
"No  one,  therefore,  under  penalty  of  my  disfavor  and  severe  punishment,  shall  cast 
any  unbecoming  reproach  upon  another  on  this  account.  In  like  manner  the 
farrier' s-apprentices  who  attend  this  useful  school  and  produce  the  certificate  of  their 
teacher  that  they  have  obtained  good  ability  in  this  branch,  shall  be  preferred  to  the 
rights  of  a  master  in  the  guilds  of  all  my  hereditary  lands  before  others,  and  even 
before  the  sons  of  masters  and  those  who  have  married  a  master's  daughter  "  (We 
see  that  certain  advantages  are  associated  not  only  with  the  daughters  of  professors, 
but  that  similar  advantages  accrued,  even  in  that  day,  to  a  marriage  with  the  daughter 
of  the  mister  of  the  guild!.  "In  the  regiments  too  no  other  persons  shall  be  accepted 
as  farriers." 

Army  medical  affairs  made  some  advance  in  the  18th  century,  though 
in  the  year  1705  in  Prussia,  which  may  be  taken  as  a  sample,  they  were 
still  so  imperfect  that  of  35  regiments  — standing  armies  were  now  intro- 
duced everywhere  —  only  six  were  sufficiently  supplied  with  regimental 
surgeons.  This  advancement  was  rapid,  and  proportioned  to  the  improve- 
ments in  surgery  and  surgeons  and  the  demands  of  an  improved  system 
of  warfare. 

While  heretofore  the  officers  alone  had  charge  of  the  surgeons,  the 
appointment  and  oversight  of  the  company  surgeons  was  in  1712  trans- 
ferred to  the  regimental  surgeons.  The  title  of  "Generalchirurgus"  was 
conferred  upon  the  regimental  surgeon  of  the  guard,  and  in  1716  this  title 
was  converted  into  an  actual  office.  The  first  actual  Generalchirurgus  and 
surgeon-in-ordinary,  and  as  such  chief  of  the  department  of  surgeons,  was 
Ernst  Conrad  Holtzendorf  ( 1G88  1751).  Even  before  his  da}-  —  as  early 
as  1713  —  the  rank  of  the  regimental  surgeons  had  been  raised;  the}-  now 
stood  just  under  the  chaplain  and  above  the  drummers,  but  were  yet  sub- 
ject to  punishment  with  the  cane.  They  now  advanced  too  towards  a 
better  education.  In  the  first  place  some  of  them  were  sent  abroad,  par- 
ticularly to  France,  and  the  Collegium   medico-chirurgicum    was  erected. 


—  Till!  — 

after  the  plan  of  the  theatrum  anatoinicum,  for  the  better  education  of 
regimental  surgeons  at  home.  The  military  physicians  educated  here  and 
in  the  practical  school  of  the  Charite  were  called  "Pensionarchirurgen". 
Before  their  appointment  in  the  army  they  were  required  to  pass  the  ex- 
amination of  city  surgeons  and  operators.  The  company  surgeon  was  re- 
quired only  to  shave,  to  visit  the  sick  and  wounded  and  to  report  to  the 
regimental  surgeon  and  the  captain.  He  was  not  permitted  to  treat 
patients  independently.  (Frederick  the  Great,  •'  in  order  to  alwajs  obtain 
better  subjects  for  the  military  service",  appointed  in  the  year  1744  twelve 
French  surgeons.)  Patients  dangerously  ill  or  personally  important  were 
brought  to  the  regimental  surgeons,  who  had  to  report  to  the  colonel 
commanding.  Cases  of  singular  or  unusual  death  required  a  post  mortem 
examination. 

Besides  the  surgical  faculty,  there  was  still  a  perfectly  distinct  medical 
faculty,  employed  chiefly  for  consultation.  This  consisted  of  the  regimental 
medici,  over  whom  a  "Generalstabsmedicus"  was  appointed  in  Filer.  In 
garrison  towns  and  fortresses  "Garnisonsmedici"  were  also  created. 

Instead  of  the  one  "Generalchirurgus"  of  an  earlier  period,  there 
appeared  after  1767  three  of  these  officials,  of  whom  the  first  acted  as  chief. 
Besides  these,  there  were  also  several  other  titular  "Generalchirurgi''.  In 
1 787  the  office  of  the  "Bataillonschirurgen"  was  created.  It  always  belonged 
to  the  first  of  the  four  regimental-surgeons. 

Salaries  of  the  Prussian  army-physicians  during  the 
18th  century. 

Year.  M.  Pf. 

1771 — Regimental  surgeon  Brandhorst         .....      monthly     45  — 

The  surgeons  also  received  "Seifegroschen"  for  soap. 

1723 — Generalchirurgus  Holtzendorf  .....    annually  1)00  — 

1725 — Regimental  surgeon  of  cavalry       .....         monthly  318  — 
Of  this  sum  each  surgeon  of  a  squadron  received  18  marks,  and  the 
regimental   surgeon  was  required   to  keep   in  order  the  medicine- 
chest  and  chest  of  instruments. 
Regimental  surgeon  of  infantry           .....      monthly 

f  as  staff-pay  ....     36  — 

i.  from  each  company  .  .  30  — 

On  the  other  hand,  he  was  required  to  give  to  each  company-surgeon 

10  marks,  and  to  keep  in  order  the  medicine-chest  etc. 

1*726 — Regimental  surgeon  of  infantry  .....      monthly     33  ■ — 

In  addition  from  each  company  .....  24-30  — 

For  medicine,  from  each  man  about  10  pfennige,  about  .  180  ■ — 

Total  monthly  237-243  — 

Company-surgeon  .......  monthly     12  30 

and  could  no  longer,  as  heretofore,  enjoy  civil  practice. 

Regimental  surgeon  of  cavalry        .....         monthly     13  40 

In  addition  for  medicine  .......  180  — 

Surgeon  of  the  squadron         ......  monthly     19  40 


M. 

l'f 

monthly  318 

30 

monthly     10 

50 

monthly   135-144 

— 

.     monthly     7V 

— 

monthly     19 

40 

.     monthly     45 

— 

monthly     15 

— 

annually  1500 

— 

—  797  — 

^Jnder  Frederick  II.  the  salary  continued  the  same  as  heretofore, 

but  the  fees  for  medicine  were  higher,  since  the  size  of  the  regiments 

was  increased.     Thus 
the  regimental  surgeon  received  altogether, 
Company-surgeon     ...... 

Battalion-surgeon  with  medicine  fees 
Regimental  surgeon  of  cavalry 

with  fees  for  medicine. 
Surgeon  of  the  squadron         ..... 

Superior  surgeon  of  artillery       .... 

Surgeon         ........ 

Generalchirurg  Theden       ..... 

Under  succeeding  rulers  the  salaries  remained  the  same. 

In  1782  the  squadron  or  company  surgeon  in  Hanover  received  pay  of  6  thaler 
per  month.  The  elder  Stromeyer,  accordingly-,  at  first  thoughlessly  ate  too  good 
dinners,  which  by  themselves  cost  him  two  and  a  half  thaler  per  month,  and  was 
speedily  forced  to  go  back  to  18  pfennige  dinners  every  day  !  Schiller,  whose  father 
Job.  Caspar  was  originally  a  regimental  surgeon,  before  becoming  a  civil  surgeon  in 
Marbach  and  subsequently  an  administrative  officer,  had,  as  we  know,  a  monthly  pay 
of  30  marks  00  pfennige,  but  as  a  —  regimental  physician.  It  may  be  remarked  here 
incidentally  that  Schiller,  as  a  physician,  was  notorious  for  his  heroic  treatment  as- 
long  as  he  practised.  In  Austria  the  "Protochirurg"  received  a  salary  of  G000  marks 
and  the  "Stabschirurg",  1200  marks  (doubled  in  war)  ;  the  regimental  surgeon,  1200- 
marks,  the  "Bataillonschirurg  ".  480  marks  and  the  "Underchirurg",  366  marks  per 
annum.. 

In  France  the  surgical  inspector  received  a  salary  of  4800  marks,  the  superior 
surgeon,  1600  marks,  and  the  subordinate  surgeon,  300  marks  with  board.  During  the 
period  of  the  Republic  these  salaries  were  sometimes  more,  sometimes  less. 

Naturally  Jews  were  nowhere  admitted  as  military  physicians  during  the  18th 
century,  not  even  after  the  French  Revolution  until  probably  a  short  time  ago, 
because  the  Conncil  of  Vienna  in  1267  had  forbidden  them  to  practise  medicine  on 
Christians.  This  decree,  however,  was  never  observed  and  executed  everywhere,  so^ 
that  e.  g.  Isaac  Friedrich  in  the  year  1388,  Salman  Pletsch  in  the  3Tear  1394  (his 
salary  was  36  gulden)  and  Isaac,  in  the  year  1398,  were  even  salaried  city-physicians 
at  Frankfort-on-the-Main,  and  were  consulted  by  Christians.  The  study  of  medicine 
was  also  forbidden  to  the  Jews  in  the  16th  century,  and,  accordingly,  after  the  Middle 
Ages,  educated  Jewish  phj'sicians  who  practised  among  Christians  were  exceptional. 
This  continued  unchanged  until  the  French  Revolution,  which  restored  to  the  Jews- 
the  citizenship  which  they  had  possessed  in  many  places  during  the  Middle  Ages. 
Yet  even  at  the  present  day  they  are  not  endowed  with  just  the  same  rights  in 
Germany  as  the  Christians,  and,  as  we  know,  professors  of  Jewish  descent,  who  i  what 
never  before  has  occurred  since  the  days  of  Salerno)  are  once  more  to  be  found,  and 
even  in  considerable  numbers,  were,  and  are  still,  required  generally  to  abandon 
their  religion.  Indeed,  until  late  in  the  19th  century  medicine  was  the  only  study 
which  was  open  to  the  Jews.  Actual  Jewish  city-physicians,  provided  with  a  .-alary, 
did  indeed  exist,  but  state-physicians  proper  (the  successors  of  the  mediaeval  city- 
physicians)  of  Jewish  descent  are  even  to-day  very  rare,  and  where  they  exist  are 
appointed  through  personal  favor  or  patronage.  Here  too  we  may  observe  a  retro- 
grade movement  contrasted  with  the  Middle  Ages!  Not  only  religious  intolerance 
and  a  prejudice  which  has  become  historical  played  their  part  from  the  beginning  in 
these  restrictions,  but  the  ethnological   aversion    towards   representatives   of  a   race- 


—  70S  — 

originally  foreign,   an   aversion   which  makes  itself  felt  everywhere,  evef^ifter  long 
association,  must  be  taken  into  consideration. 

The  S3*stem  of  field-hospitals  throughout  the  whole  century  continued 
very  bad.  and  was  not  improved  by  the  Prussian  hospital-ordinance  of 
1787,  nor  even  by  the  general  introduction  in  1703  of  movable  hospitals, 
which  had  been  inaugurated  about  the  close  of  the  Kith  century  under 
Henry  IX.  of  France.  Larry  was  particularly  active  in  promoting  this 
system.  Barrack-hospitals,  proposed  by  Leibnitz  as  early  as  1714,  also 
existed;  at  least  Pringle  erected  such  hospitals  in  1758.  But  the  whole 
system  suffered  from  the  persistence  of  the  double,  and  strictly  distinct, 
medical  and  surgical  faculties,  and  it  was  with  the  design  of  destroying 
this  distinction  that  the  Pepiniere  and  Josephinum  were  organized,  to  pro- 
duce army-physicians  educated  completely  in  both   surgery  and  medicine. 

It  should  also  be  mentioned  that  field-apothecaries  existed  in  many, 
though  not  in  all,  states. 

In  Saxony  the  physicians  and  surgeons  had  a  special  uniform,  different  from 
that  of  the  soldiers,  and  the  same  was  the  case  in  other  countries.  The  "  Feld- 
medicus"  had  a  dark  blue  uniform,  collar  embroidered  in  gold,  gold  facings,  gilt 
sword-belt  and  hat-cord.  The  "  Stabsfeldscheerer "  had  in  addition  a  red  vest  with 
gilt  trimming.  His  assistants  had  a  red  vest  without  gilt  trimmings,  a  sword  without 
a  belt,  and  a  hat  without  a  cord.  The  hospital  field-surgeons  had  a  dark  gray  coat 
with  red  collar  (H.  Frolich).  The  gaiters  formerly  worn  by  the  surgeon  uave  way 
to  jack-boots.  Shaving  in  the  18th  century  was  frequently  discarded.  In  Saxony, 
the  land  of  courtesy,  towards  the  end  of  the  centuiy  surgeons  were  required  to  be 
addressed  as  "  You",  instead  of"  He"  as  in  preceding  times. 

How  disgraceful,  in  spite  of  all  improvements,  were  the  social  position 
and  the  treatment  of  the  arnn'-physieian  even  in  the  second  half  of  the 
century  may  be  inferred  from  the  fact  that  in  the  year  1758  Dr.  Ellenberger 
of  Zinnendorf,  the  ■Teldmedicus".  was  subjected  to  corporeal  punishment 
at  the  command  of  a  colonel,  and  that  a  general  upon  his  death-bed  could, 
leave  orders  that  fifty  blows  apiece  should  be  given  to  the  "Tausend- 
Sackerments-Feldscheerer",  in  case  the  post  mortem  gave  results  different 
from  those  which  they  had  declared  to  him  regarding  his  disease. 

In  Austria  at  the  beginning  of  the  Seven  Years'  War  all  army  surgeons  of  the 
Protestant  confession  were  compelled  to  go  over  to  the  Catholic  faith  or  to  leave  the 
arm}'.  The  'Church"  did  not  scorn  utterly  and  entirely  even  the  otherwise  despised 
surgeons. 

How  deplorable,  however,  was  the  situation  of  the  wounded  generally 
after  a  battle  in  the  last  centuiy,  and  even  among  the  troops  of  the  best 
managed  military  states.  France  and  Prussia,  may  be  judged  from  the  facts 
thai  the  French  field-hospitals,  and  the  engagement  of  their  physicians, 
lay  in  17.">0  in  the  hands  of  contractors,  who  cheated  the  physicians  of 
their  stipulated  pay  and  the  wounded  of  the  necessary  care,  and  that  in 
Prussia,  after  the  battle  near  Torgau  (Nov.  3,  17G0),  the  wounded  lay  all 
night  upon  the  open  fields  exposed  to  robbery.  Yet  the  declaration  of  the 
neutrality  of  hospitals  and  the  medical  corps  had  been  frequent!}'  made  and 


—  •  799  — 

demanded,  e.  g.  before  the  battle  near  Dettingen,  an  arrangement  in  which 
the  18th  century  anticipated  the  idea  of  the  Geneva  Convention.  The  king 
considered  it  requisite  to  recommend  to  the  surgeons  "not  to  cut  on"  arms 
and  legs  by  the  dozen".  The  soldiers  wearied  by  their  march  too  were 
bled  —  to  remove  their  fatigue  (or  its  cause)  forthwith  ! 

[11.    MEDICINE  IN  THE  ENGLISH  COLONIES  OF  NORTH  AMERICA  DURING 
THE  EIGHTEENTH  CENTURY. 

As  the  17th  century  witnessed  the  foundation  of  the  American  col- 
onies, so  the  18th  century  was  the  period  of  their  development  and 
growth.  Of  the  colonial  settlements  which  subsequently  formed  the  original 
thirteen  United  States,  all  save  Georgia  were  established  during  the  17th 
century. 

The  entire  population  of  these  colonies  at  the  period  of  the  accession 
of  William  III.  and  Mary  (1689)  is  estimated  to  have  been  little  in  excess 
of  200,000  souls  —  scarcely  that  of  a  mediocre  city  in  these  modern  days 
—  and  the  settlements  were  scattered  in  a  thin  and  often  interrupted  line 
along  the  Atlantic  coast  from  Maine  to  South  Carolina.  By  1714  the  pop- 
ulation had  increased  to  376.000  whites  and  59.000  negroes  ;  in  1750  it 
was  estimated  at  1,040,000  whites  and  220,000  negroes,  and  in  1790  the 
first  census  of  the  United  States  determined  the  population  at  3.177,257 
whites  and  752,009  negroes,  or  a  total  of  nearly  four  million  souls  —  an 
increase  of  nearly  2000  per  cent  in  a  single  century  !  It  is  to  be  borne  in 
mind  too  that  this  enormous  growth  occurred  in  spite  of  the  ordinary  hard- 
ships and  perils  of  colonial  life,  and  in  the  teeth  of  a  constant  succession 
of  bloody  and  exhausting  wars.  In  the  71  years  intervening  between  1689 
and  1760  the  colonies  had  passed  through  no  less  than  four  severe  con- 
tests, whose  united  duration  amounted  to  27  years. 

The  confusion  of  social  relations  occasioned  by  the  introduction  into 
the  colonies  of  such  a  mass  of  new  vitality  gathered  from  all  the  nations 
of  western  Europe,  and  the  burdens,  dangers  and  anxieties  of  a  protracted 
warfare,  would  seem  to  offer  few  conditions  favorable  to  the  cultivation 
of  the  sciences.  Yet  amid  these  apparently  hostile  surroundings  there 
were  present  likewise  some  conditions  which  fostered  the  development 
of  medical  science  at  least.  Foremost  among  these  we  may  mention  the 
introduction  into  the  colonies  of  numerous  educated  medical  men,  who 
served  as  army-surgeons  with  the  British  forces  in  America,  and  whose 
precepts  and  example  could  not  fail  to  excite  interest  and  emulation  in 
their  colonial  colleagues.  Then  too  war  itself  proved  on  this  occasion,  as 
so  often  before  and  since,  the  best  school  of  medicine  and  surgery.  Among 
the  numerous  immigrants  who  came  to  these  shores  there  was  (besides 
many  pretenders  and  charlatans)  a  considerable  number  of  respectable 
and  well-educated  physicians  of  the  Old  World,  who  hoped  to  enjo}-  a 
more   lucrative   business,  or  increased   libertv   of  conscience   in  the  New- 


—  800  — 

These  brought  with  them  into  their  new  homes  the  latest  medical  theories 
and  the  improved  practice  of  their  day,  to  be  disseminated,  consciously  or 
unconsciously,  among  their  colonial  neighbors  and  colleagues.  The  con- 
stantly increasing  commercial  intercourse  between  the  Old  World  and  the 
New,  and  the  growing  wealth  of  the  colonists,  also  enabled  a  larger  number 
of  young  men  to  acquire  their  medical  education  in  Europe.  From  all 
these  causes  it  is  apparent  that  the  standard  of  medical  ability  would 
naturally  be  gradually  elevated  in  the  colonies,  and  such  was  the  fact 
throughout  the  entire  18th  century.  It  was  not.  however,  until  the  founda- 
tion of  the  medical  schools  of  Philadelphia  and  New  York  about  the  middle 
of  the  centuiy  that  this  improvement  became  very  manifest,  and  these 
schools  were  both  an  evidence,  and  the  cause,  of  the  improved  spirit  of  the 
medical  profession  during  the  latter  half  of  the  century. 

The  stagnant  waters  of  colonial  medical  life  were  stirred,  however, 
during  the  first  half  of  the  18th  centuiy  by  the  controversy  over  the 
subject  of  the  inoculation  of  small-pox,  a  controvers}'  which  sheds  con- 
siderable light  upon  the  medical  relations  of  that  period.  In  the  pre- 
ceding pages  we  have  had  abundant  opportunities  to  observe  the  gen- 
erally pernicious  influence  of  the  clergy  on  medicine,  and  it  is  with  a 
feeling  akin  to  refreshment  that  we  record  here  the  fact  that  the  introduc- 
tion of  the  practice  of  inoculation  for  small-pox  was  largely  due  to  the 
suggestion  and  advocacy  of  the  clerical  profession.  In  the  year  1721  the 
Rev.  Cotton  Mather  of  Boston,  whose  name  has  already  attained  an  un- 
enviable notoriety  in  this  history  in  connexion  with  the  '-Salem  witchcraft",. 
having  read  in  the  Transactions  of  the  Royal  Society  of  London  the  com- 
munications of  Dr.  Timoni  and  Pilarini  relating  to  the  practice  of  inocula- 
tion in  Turkey,  called  the  attention  of  several  of  his  medical  acquaintances 
to  this  subject.  None  of  them,  however,  paid  any  considerable  attention 
to  the  matter  except  Br.  Zabdiel  Boylston,  whose  name  accordingly 
deserves  the  most  prominent  position  among  the  physicians  of  the  first 
half  of  the  18th  century.  Dr.  Boylston,  the  son  of  Dr.  Thos.  Boylston 
of  Brookline,  Massachusetts,  was  born  in  Massachusetts  in  1680  and  edu- 
cated under  the  direction  of  his  father  (an  M.  D.  of  Oxford)  and  Dr.  John 
Cutter,  an  eminent  ph}7sician  and  (surgeon  of  Boston.  Settling  in  the 
latter  city  Dr.  Zabdiel  Boylston  soon  acquired  both  fame  and  fortune  in 
the  practice  of  his  profession,  while  his  interest  in  botany  and  natural 
history  led  him  into  correspondence  with  Sir  Hans  Sloane  and  other  mem- 
bers of  the  Royal  Society.  He  was  much  impressed  by  the  facts  related  in 
the  communications  of  Timoni  and  Pilarini,  and  determined  to  put  the 
question  of  inoculation  to  immediate  proof.  Accordingly  on  June  27th, 
1721,  he  inoculated  with  the  virus  of  natural  small-pox  his  own  son,  aged 
13  years,  and  two  negro  servants  in  his  family.  All  these  cases  proved 
entirely  successful,  and,  encouraged  by  this  success.  Dr.  Boylston  within 
the  next  twelve  months  inoculated  in  Boston  and  its  vicinity  247  persons 
of  both  sexes  and  of  all  ages.     During  the  same  period  39  persons  were 


—  801  — 

also  inoculated  by  other  physicians,  and  of  the  whole  286  patients  thus 
treated  six  (about  2  per  cent.)  died,  while  of  5759  persons  who  took 
the  disease  in  the  natural  way  844  died,  a  mortality  of  over  14  per  cent. 
In  spite  of  this  demonstration  of  the  advantages  of  inoculation  the  opera- 
tion was  violently  opposed,  not  only  by  the  populace,  but  even  more 
strongly  by  the  majority  of  the  medical  profession,  while,  singularly 
enough,  its  warmest  advocates  and  defenders  were  found  within  the  ranks 
of  the  clergy.  The  press  too  assailed  the  new  operation,  and  Benjamin 
Franklin,  then  a  youth  of  sixteen  employed  in  the  office  of  his  brother, 
opposed  it  in  the  columns  of  his  brother's  newspaper  "  The  New  England 
Courant".  It  should,  however,  be  said  to  the  honor  of  the  future  phil- 
osopher that  he  subsequently  admitted  the  incorrectness  of  his  youthful 
opinions.  Dr.  Boylston  was  threatened  with  hanging  by  the  populace,  and 
on  one  occasion  was  compelled  to  secrete  himself  for  two  weeks  in  a 
private  place  in  his  house  in  order  to  escape  the  search  of  an  infuriated 
mob,  excited  bj'  the  slanders  of  the  newspapers  and  his  medical  colleagues. 
Undisma}"ed,  however,  by  these  persecutions  Dr.  Boylston  pei'severed  in 
his  course,  and  finally  enjo}red  the  satisfaction  of  seeing  the  advantages 
of  his  system  generally  recognized.  In  1723,  on  the  invitation  of  Sir 
Hans  Sloane,  he  visited  England,  was  made  a  member  of  the  Royal  Society 
and  enjoyed  the  acquaintance  of  the  royal  family  and  the  most  distin- 
guished persons  of  the  period.  Three  years  later,  on  the  request  of  the 
Royal  Society,  he  also  published  an  account  of  his  practice  of  inoculation 
in  America,  which  he  dedicated  to  the  princess  Caroline.  Dr.  Boylston 
died  in  1766. 

At  the  head  of  the  medical  opponents  of  inoculation  in  Boston  was 
Dr.  William  Douglass,  a  Scotchman  and  an  alumnus  of  Leyden  and  Paris, 
who  had  settled  in  Boston  in  1718.  A  man  of  no  mean  ability,  but  en- 
dowed with  the  obstinac}'  and  the  conceit  of  his  nation,  Dr.  Douglass  has 
been  wittily  described  as  one  who  was  "always  positive  and  sometimes 
accurate".  He  was  well  versed  in  astronom}'  and  the  natural  sciences,  and 
in  1743-44  published  an  almanac1  entitled  "Mercurius  Novanglicanus,  by 
William  Nadir  S.X.Q."  Dr.  Douglass  opposed  the  practice  of  inoculation 
with  all  his  Scotch  energy  and  perseverance,  though  it  is  said  that  he  too 
lived  long  enough  (he  died  in  1752)  to  modify  his  views  upon  this  subject. 
His  publications  relating  to  inoculation  were  entitled  "  The  Inoculation 
of  the  Smallpox  as  practised  in  Boston,  1722"';  ''The  Abuses  and  Scandals 
of  some  late  Pamphlets  in  favor  of  Inoculation,  1722";  "A  practical  Essay 
concerning  the  Smallpox,  containing  the  History"  etc.,  1730.  He  also 
published  a  "  Practical  History  of  a  New  Eruptive  Miliary  Fever,  with 
Angina  Ulcusculosa",  which  prevailed  in  Boston  in  1735-36,  and  an 
historical  work  entitled  "The  British  Settlements  in  North  America",  in 

1.   Dr.  Nathaniel  Ames  (1708-1764),  a  practitioner  of  Dedham,  Mass.,  also  published 
an  almanac  annually  from  1735  to  1764. 
51 


—  802  — 

two  volumes.  The  latter  work  is  said  to  be  a  curious  compound  of  per- 
sonal reminiscences  and  quarrels,  together  with  a  summary  of  public  affairs 
displaying  little  judgment  and  discretion,  and  containing  many  inaccuracies 
Other  opponents  of  inoculation  in  Boston  were  Dr.  Lawrence  Dalhonde,  a 
popular  French  physician,  who  published  a  curious  deposition  in  opposi- 
tion to  the  operation,  and  Dr.  Joseph  Marion,  who  with  Dr.  Douglass 
testified  to  the  accuracy  of  the  translation  of  this  deposition.  In  spite 
of  all  opposition,  however,  the  practice  of  inoculation  soon  spread  through- 
out New  England,  and  in  a  few  years  reached  New  York,  Philadelphia, 
Baltimore  and  even  Charleston.  Public  hospitals  for  inoculation  were 
established  in  1764  at  Point  Shirly  by  Dr.  William  Barnet,  and  in  the  same 
year  at  Castle  William  in  Boston  harbor  by  Dr.  Samuel  Gelston  of  Nan- 
tucket. Dr.  Isaac  Band  Sr.  (died  1740),  Dr.  William  Aspinwall  (1743- 
1823),  who  had  a  private  hospital  for  inoculation,  Dr.  Lemuel  Hayward 
(died  1821),  Dr.  Henry  Stevenson  of  Baltimore,  Dr.  John  Ely  of  Connec- 
ticut and  Dr.  Benjamin  Gale  (1715-1790),  also  of  Connecticut,  were  emi- 
nent as  inoculators  during  the  18th  century.  The  operation  was  introduced 
into  South  Carolina  as  early  as  1738  by  Drs.  Maubray  (a  surgeon  in  the 
British  navy)  and  Kirkpatrick.  In  1750  Dr.  Adam  Thomson  (died  1768) 
of  Maryland  published  'A  Discourse  on  the  Preparation  of  the  Bod}*  for 
Smallpox",  Philadelphia,  in  which  he  advocated  the  preparative  em  ploy  - 
rment  of  mercury  and  antimony  before  the  performance  of  inoculation,  a 
method  which  he  had  made  use  of  since  1738.  Though  Dr.  Thomson's 
method  at  first  met  with  considerable  opposition,  it  was  speedily  adopted 
in  many  parts  of  the  country,  e.  g.  by  Dr.  Barnet  of  Boston,  Dr.  Gale  of 
'Connecticut  etc.,  and  was  also  highly  commended  in  England  by  Huxham, 
Woodward  and  others.  Eventually  it  came  to  be  known  as  the  "American 
method",  and  is  usually  ascribed  to  Dr.  Gale,  who  gave  a  full  description 
of  the  method  in  the  Transactions  of  the  Philosophical  Society  for  1765. 
Dr.  Gale  himself,  however,  referred  the  method  to  Dr.  Thompson  "of  Penn- 
sylvania or  Maryland"  and  Dr.  Morison  of  Long  Island.  —  Hospitals  for 
inoculation  were  usually  established  in  secluded  places  in  the  neighbor- 
hood of  cities,  and  occasionally  produced  so  much  alarm  as  to  influence 
commerce  injuriously.  This  was  so  much  the  case  in  1747  in  the  city  of 
New  York  that  Gov.  Clinton  issued  a  proclamation  "strictly  prohibiting 
and  forbidding  all  and  every  of  the  Doctors,  Physicians,  Surgeons  and 
Practitioners  of  Physick,  and  all  and  ever}'  other  person  within  this 
province,  to  inoculate  for  the  small-pox  any  person  or  persons  within  the 
City  and  Count}'  of  New  York,  on  pain  of  being  prosecuted  to  the  utmost 
rigor  of  the  law." 

Among  the  more  eminent  physicians  of  the  first  half  of  the  18th 
century  we  may  mention  Dr.  John  Mitchell,  F.  B.  S.,  an  Englishman  who 
settled  in  Virginia  about  1700  and  was  distinguished  as  a  botanist  as  well 
as  a  physician.  Besides  numerous  communications  to  the  Boyal  Society, 
Dr.  Mitchell  published  a  work  on  botany  (1769),  and   in  1743  wrote  an 


—  803  — 

11  Essay  on  the  Causes  of  the  Different  Colors  of  People  of  Different 
Climates",  published  in  the  Philosophical  Transactions.  His  most  im- 
portant production,  however,  was  a  paper  on  yellow  fever  as  it  appeared 
in  Virginia  in  1737,  1741  and  1742,  the  manuscript  of  which  fell  subse- 
quentl}'  into  the  hands  of  Dr.  Rush,  who,  as  he  himself  confesses,  derived 
from  it  many  valuable  ideas.  Another  eminent  botanist  and  physician  of 
Virginia  was  Dr.  John  Claj'ton  (1685-1773),  a  native  of  England,  who 
came  to  Virginia  in  1705.  His  "Flora  Virginica"  was  published  at  Leyden 
by  Gronovius  in  1739,  1743  and  1762.  Dr.  Cadwallader  Colden  (1688- 
1776),  a  native  of  Scotland  and  an  alumnus  of  Edinburgh,  is  perhaps 
better  known  as  a  naturalist  and  a  statesman  than  as  a  physician.  He 
-came  to  Philadelphia  in  1708  but  removed  in  1718  to  New  York,  where  he 
held  the  office  of  Lieut.  Governor  from  1761  to  1775.  His  interest  in 
medicine  was  manifested  by  a  paper  on  the  "Sore-throat  Distemper"  (1735), 
and  others  on  cancer  and  "On  the  Virtues  of  the  Great  Water  Dock".  He 
also  published  in  1743  some  "Observations  on  the  Yellow  Fever  of  New 
York,  1741-42".  Dr.  Colden  was  also  an  eminent  botanist  and  natural 
philosopher,  maintaining  a  correspondence  for  many  years  with  Linnaeus, 
Gronovius  of  Leyden,  and  the  more  eminent  ph}Tsicians  and  naturalists 
of  his  own  da}-,  both  in  Europe  and  his  adopted  country.  With  Dr. 
Franklin  particularly  he  carried  on  a  long  and  intimate  correspondence, 
and  it  is  said  in  one  of  Dr.  Franklin's  letters  that  the  idea  of  the  American 
Philosophical  Society  (established  in  1743)  was  suggested  bjT  Dr.  Colden. 
Dr.  Thomas  Cadwallader,  a  native  of  Philadelphia,  but  a  pupil  of  Chesel- 
den,  was  the  first  physician  in  Philadelphia  to  perform  dissection  (1752), 
and  an  assistant-of  Dr.  Shippen  in  his  anatomical  lectures.  He  was  also 
one  of  the  earliest  contributors  to  American  medical  literature  by  his 
"  Essay  on  the  Iliac  Passion",  published  in  1740.  In  this  essa}*  he  recom- 
mends in  the  treatment  of  the  disease  under  discussion  mild  cathartics  and 
opium,  instead  of  the  mercury  and  drastics  heretofore  commonly  employed. 
We  owe  likewise  to  his  pen  an  essay  whose  title-page  bears  the  following 
words  :  "An  Essay  on  the  West  India  Dry  Gripes,  with  the  method  of 
preventing  and  curing  that  Cruel  Distemper.  To  which  is  added  an  extra- 
ordinary case  in  Physick.  Printed  and  Sold  by  B.  Franklin,  Philadelphia, 
MDCCXLV."  Dr.  Cadwallader  was  also  one  of  the  first  physicians 
appointed  to  the  Pennsylvania  Hospital  in  1751.  He  died  Nov.  14,  1779. 
Dr.  John  Bard  (1716-1799),  a  native  of  Burlington,  N.  J.,  was  educated 
under  Mr.  Kearsly,  an  English  surgeon  of  Philadelphia.  Dr.  Bard  him- 
self began  his  practice  in  Philadelphia,  but  in  1746  removed  to  New  York, 
where  he  soon  acquired  great  popularit}"  and  eminence.  In  1749  he 
addressed  to  "a  weekly  society  of  gentlemen  in  New  York"  an  essay  on 
the  nature  and  causes  of  the  malignant  pleurisy  which  had  prevailed  on 
Long  Island.  He  likewise  published  in  the  "London  Medical  Observations 
•and  Inquiries"  a  case  of  extra-uterine  foetation  treated  b}'  gastrotomy  in 
1759    (the  first  case   recorded  in   this  country),  and  the    "  Medical    and 


—  804  — 

Philosophical  Register',  edited  by  Drs.  Hosack  and  Francis,  contains 
several  papers  from  his  pen  on  the  nature  and  character  of  yellow  fever. 
In  1750  Dr.  Bard,  in  conjunction  with  Dr.  Peter  Middleton  (died  1781), 
injected  and  dissected  before  a  class  of  students  the  body  of  a  criminal, 
which  had  been  delivered  to  them  for  educational  purposes.  Dr.  Bard  was 
also  the  first  president  of  the  Medical  Societ}'  of  New  York  on  its  organ- 
ization in  1788.  We  should  also  notice  among  the  early  American  med- 
ical writers  Rev.  Jonathan  Dickinson  of  Elizabethtown,  N.  J.,  a  clergyman 
who,  after  the  custom  of  the  early  colonial  clergy,  also  practised  medicine, 
and  who  published  in  17-10  in  pamphlet  form  some  ''Observations  on  that 
Terrible  Disease  vulgarly  called  The  Throat  Distemper";  Dr.  John  Walton, 
who  is  said  by  Thacher  to  have  published  in  Boston  in  1732  an  essay  on 
fevers  ;  Dr.  John  Lining,  a  native  of  Scotland  who  emigrated  to  South 
Carolina  in  1730,  instituted  some  physiological  experiments  after  the 
method  of  Sanctorius,  and  published  them  in  the  Transactions  of  the 
Ro3ral  Society  for  1743,  and  ten  years  later  published  "A  Description  of 
the  American  Yellow  Fever"  in  the  form  of  a  letter  to  Dr.  Robert  Whytt 
of  Edinburgh  ;  Dr.  John  Tennent  of  Virginia  published  in  1736  the  first 
account  of  the  polygala  senega  and  its  use  in  pulmonaiy  complaints. 

The  interest  of  the  colonists  in  educational  matters  had  been  already 
shown  in  the  preceding  century  by  the  establishment  of  Harvard  College 
in  Massachusetts  and  William  and  Mary  College  in  Virginia.  During  the 
18th  centur}'  numerous  colleges  and  so-called  "universities"  were  founded 
in  the  different  colonies.  The  most  important  of  these  were  Yale  College, 
founded  in  1701,  the  College  of  New  Jersey  (Princeton),  founded  in  17-16, 
the  University  of  Pennsylvania,  174!',  King's  College  (now  Columbia), 
N.  Y.,  1754,  Rhode  Island  College  (Brown  University),  1764,  Dartmouth 
College,  1769,  Queen's  College  (Rutgers),  N.  J.,  1770,  Dickinson  College, 
Penn.,  1783,  Union  College  1795,  the  University  of  North  Carolina,  1795 
etc.  In  none  of  these  institutions,  however,  was  any  medical  instruction 
imparted  during  the  first  half  of  the  18th  century.  During  this  period 
the  vast  majority  of  colonial  practitioners  of  medicine  were  compelled  to 
satisfy  themselves  with  such  education  as  could  be  acquired  in  the  offices 
of  the  more  or  less  eminent  physicians  or  surgeons  of  their  vicinity.  The 
system  of  apprenticeship  for  three  to  seven  }-ears  was  still  in  vogue  through- 
out the  entire  18th  century.     Thacher  says  of  Dr.  John  Bard  : 

"  He  received  the  rudiments  of  a  polite  and  classical  education  at 
Philadelphia,  and  at  the  age  of  14  or  15  years  was,  according  to  the  cus- 
tom of  that  day,  bound  apprentice  to  Mr.  Kearsly,  an  English  surgeon  of 
good  talents,  but  of  so  unhappy  a  temper  that  his  presence  banished 
cheerfulness  from  his  family.  He  treated  his  pupils  with  great  rigor  and 
subjected  them  to  the  most  menial  emploj'ments,  to  which  Dr.  Bard  has 
been  heard  to  say  he  would  never  have  submitted  but  from  the  appre- 
hension of  giving  pain  to  his  excellent  mother,  who  was  then  a  widow  with 
seven  children  and  a  very  moderate  income,  and  from  the  encouragement 


—  805  — 

he  received  from  the  kindness  of  her  particular  friend,  Mrs.  Rears]}-,  of 
whom  he  always  spoke  in  terms  of  the  warmest  gratitude,  affection  and 
respect."     This  was  about  17M0-87. 

An  indenture  of  the  year  1760  (quoted  by  Wickes)  contains  the  fol- 
lowing provisions,  which  shed  much  light  upon  the  relations  of  the  period  : 
"  During  all  which  term"  (four  years  and  eight  months)  "the  said  Apprentice  his 
said  Master  well  and  faithfully  shall  serve,  his  secrets  keep,  his  lawful  commands 
every  where  obey.  He  shall  do  no  damage  to  his  said  Master,  nor  see  it  to  be  done 
by  others  without  letting  or  giving  notice  to  his  said  Master.  He  shall  not  contract 
matrimony  within  the  said  term.  At  cards,  dice  or  any  other  unlawful  game  he  shall 
not  play,  whereby  his  said  Master  may  have  Damage.  He  shall  not  absent  himself 
day  or  night  from  his  said  Master's  Service  without  his  leave,  nor  liant  Ale  houses, 
Taverns  or  play  houses,  but  in  all  things  as  a  faithful  Apprentice  he  shall  behave 
himself  towards  his  said  Master  all  his  during  his  said  term.  And  the  Said  Master 
during  the  S'd  term  shall  by  the  best  of  his  Means  or  Methods  Arts  and  Mysterys  of  a 
Physician  and  Surgeon  as  lie  now  professes  Teach  or  cause  the  said  Apprentice  to  be 
Taught  to  perfection  in  consideration  of  the  sum  of  One  hundred  Pounds  Lawful 
money  of  New  York  to  him  in  hand  paid  by  the  said  James  Hubbard  (in  four 
payments);  that  is  to  say  Thirty  Pounds  in  hand  down,  and  the  remainder  in  Four 
Equal  payments.  One  each  year  till  the  whole  is  paid.  And  the  said  William  Clark 
Acknowledges  himself  therewith  contented  and  the  receipt  thereof.  And  the  said 
Master  is  to  provide  his  said  Apprentice  with  sufficient  Meat,  Drink,  Washing  and 
Lodging  and  Mending  his  said  clothes  within  the  Said  term.  And  the  said  James 
Hubbard  is  to  find  him  in  wearing  apparel  during  said  term  aforesaid.  At  the  end 
of  Said  term  the  Said  Master  shall  and  will  give  unto  the  said  Apprentice  a  new  set 
of  surgeon's  pocket  instruments — Solomans  Dispensatoty,1  Quences  Dispensatory 
and  Fuller  on  Fevers,  and  for  the  true  performance  of  all  and  every  of  the  said 
■covenants"  etc. 

At  the  expiration  of  the  period  of  apprenticeship  it  was  customary  to 
furnish  the  embiyonic  doctor  with  a  certificate,  of  which  the  following,  also 
from  Wickes.  furnishes  an  example  : 

"  Philadelphia.  This  is  to  certify  all  whom  it  may  concern  that  Mr.  Saml.  Treat 
hath  served  as  an  Apprentice  to  me  for  nearly  four  years,  during  which  time  he  was 
constantly  employed  in  the  practice  of  Physic  and  Surgery  under  my  care,  not  only 
in  my  private  business,  but  in  the  Pennsylvania  Hospital,  in  which  character  he 
always  behaved  with  great  Fidelit}'  and  Industry.  In  Testimony  of  which  I  have 
hereunto  set  my  hand  this  first  day  of  September  One  thousand  Seven  hundred  and 
Sixty-five.  Signed  John  Redman." 

During  the  first  half  of  the  18th  century  no  preliminary  education  on 
the   part  of  the  apprentice  was   demanded,   but  on   the   foundation  of  the 

1.  Probably  the  "New  London  Dispensatory"  of  William  Salmon,  London,  1678. 
Wickes  says  "  We  have  seen  a  copy  of  Salmon's  Herbal,  published  in  1696.  which 
was  the  text-book  of  a  New  Jersey  physician  of  large  practice  and,  in  his  day,  of 
much  reputation.  Being  a  man  of  property  he  paid  the  expenses  of  a  messenger 
to  England  to  obtain  the  volume.  It  is  a  folio  of  1300  pages;  cost  £50."  Quences 
Dispensatory  is  probably  the  "  Dispensatory  of  the  Royal  College  of  Physicians 
in  London",  published  by  Dr.  John  Quincy,  London,  1721-22.  Thomas  Fuller,  a 
physician  of  Kent  in  England,  published  in  1730  a  treatise  entitled  '•  Exanthe- 
matologia  ;  or  an  attempt  to  give  a  rational  account  of  eruptive  fevers,  especially 
the  measles  and  smallpox,  with  an  appendix  concerning  inoculation",  London. 


—  806  — 

New  Jersey  Medical  Society  in  1766  it  was  ordered  that:  -hereafter  no 
student  be  taken  an  apprentice  by  any  member  (of  the  Society )  unless  he 
has  a  competent  knowledge  of  Latin  and  some  initiation  in  the  Greek.'' 
Also  that  "iio  member  hereafter  take  an  apprentice  for  less  than  four  years, 
of  which  three  shall  be  with  his  master,  and  the  other  may.  with  his 
master's  consent,  be  spent  in  some  school  of  physic  in  Europe  or  America." 
The  fee  for  instruction  was  fixed  at  £100  per  annum.  Proclamation  money. 

That  even  this  imperfect  system  of  medical  education  was  capable 
of  producing  very  competent  practitioners  may  be  inferred  form  the 
example  of  Drs.  Zabdiel  Boylston.  John  Bard  and  numerous  other  colonial 
physicians,  whose  circumstances  did  not  permit  them  to  gain  their  educa- 
tion in  Europe. 

Special  courses  of  lectures  upon  certain  branches  of  medicine  seem 
to  have  been  delivered  occasionally  by  more  or  less  eminent  physicians 
before  the  establishment  of  any  medical  schools  proper.  The  anatomical 
lectures  of  Dr.  Giles  Firman  of  Boston  in  1647  have  been  already  men- 
tioned. The  dissection  and  instruction  of  Drs.  John  Bard  and  Peter 
Middleton  of  New  York  in  1750.  and  the  anatomical  lectures  of  Dr. 
Thomas  Cadwallader  of  Philadelphia  about  the  same  period  have  also 
received  notice  above.  A  course  of  instruction  in  osteology  and  myology 
by  Thomas  Wood,  a  surgeon  of  New  Brunswick,  was  also  advertised  in  the 
New  York  Weekly  Post  Boy  for  January  27.  1752.  This  advertisement 
closes  as  follows  : 

X.  B.  If  proper  Encouragement  is  given  in  this  Course,  he  i  Dr.  Wood)  proposes 
soon  after  to  go  thro'  a  Course  of  Angiology  and  Neurology;  and  conclude  with  per- 
forming all  the  Operations  in  Surgery  on  a  Dead  Body.  The  use  of  which  will 
appear  to  every  Person  who  considers  the  Necessity  of  having  (at  least)  SEEK  them 
performed  before  he  presumes  to  perform  them  himself  on  any  living  Fellow  Creature." 
The  fee  for  this  course  was  to  be  six  pounds,  Proclamation  money. 

A  course  of  lectures  on  anatomy,  the  history  of  anatomy  and  com- 
parative anatomy  was  delivered  at  Newport.  Rhode  Island,  by  Dr.  William 
Hunter  (1720-1777)  in  the  years  1754-5-6.  Dr.  Hunter  was  a  near  rel- 
ative of  the  famous  brothers  William  and  John  Hunter,  and  a  pupil  of  the 
elder  Monro  of  Edinburgh.  He  was  a  Scotchman  by  birth  and  immi- 
grated to  Bhode  Island  in  1752.  where  he  acquired  great  reputation  as  a 
surgeon  and  married  into  one  of  the  most  opulent  families  of  that  colony. 

None  of  these  essays,  however,  resulted  in  an}-  permanent  advance- 
ment of  medical  education  in  the  colonies.  A  more  prosperous  event 
awaited  the  efforts  of  Drs.  Shippen  and  Morgan  of  Philadelphia.  Dr. 
William  Shippen  Jr.  (1736-1S08),  a  native  of  Philadelphia,  was  educated 
at  the  College  of  New  Jersey  and  began  his  medical  studies  under  the 
direction  of  his  father  Dr.  Win.  Shippen  Sr.  At  the  age  of  twenty-one 
vears  he  went  to  London  and  lived  for  a  season  in  the  family  of  Mr.  John 
Hunter,  spending  much  of  his  time  also  in  the  anatomical  theater  of  Dr. 
Wm.    Hunter.     He  likewise    devoted    much    attention   to   the   subject  of 


—  807  — 

obstetrics  under  the  direction  of  Dr.  Hunter  and  Dr.  McKenzie,  a  celebrated 
obstetrician  of  London.  Graduating  in  1761  at  the  university  of  Edin- 
burgh, where  he  had  been  a  student  of  Cullen  and  the  elder  Monro,  he 
returned  in  1762  to  America,  and  began  preparations  at  once  to  intro- 
duce public  instruction  in  practical  anatomy  and  rnidwifeiy  into  this 
country.  His  first  course  of  lectures  was  delivered  in  the  same  year,  and 
was  attended  by  a  class  of  twelve  students.  Similar  private  courses  were 
delivered  by  Dr.  Shippen  in  1763  and  1761,  but  in  1765  a  medical  depart- 
ment of  the  College  of  Philadelphia  (founded  in  1749)  was  organized,  and 
in  this  department  he  received  the  appointment  of  professor  of  anatomy 
and  surgery.  Dr.  Shippen's  anatomical  lectures  were  continued  regularly 
until  the  winter  of  1775,  when  they  wrere  interrupted  by  the  war  of  the 
Revolution.  During  this  time  the  annual  number  of  students  had  increased 
to  between  thirty  and  forty.  In  Jul}-  1776  Dr.  Shippen  was  appointed 
chief  physician  to  the  flying  camp  of  the  Continental  army,  and  in  1777 
was  unanimously  elected  by  the  Provincial  Congress  Director  General  of 
all  the  army-hospitals.  In  1780  he  was  again  chosen  Director  General  of 
the  Army-Medical-Department,  but  this  position  he  resigned  in  1781  in 
order  to  devote  his  entire  attention  to  the  medical  school  in  Philadelphia. 
Even  during  the  war  Dr.  Shippen's  anatomical  lectures  had  been  suspended 
onl}'  during  the  winters  of  1776  and  1777,  as  subscquenth'  he  returned  to 
the  city  eveiy  winter  and  delivered  the  usual  course,  shortened  somewhat 
by  the  exigencies  of  the  occasion.  Dr.  Shippen  was  also  the  first  public 
teacher  of  midwifery  in  this  country,  and  contributed  probably  more  than 
any  other  single  individual  to  the  popularizing  of  male  midwifery.  The 
loss  of  a  favorite  and  onl}r  son  in  1798  so  changed  the  entire  current  of 
Dr.  Shippen's  thoughts  that,  subsequent  to  this  sad  event,  he  never  re- 
covered his  previous  interest  and  activity  in  medical  matters,  though  even 
as  late  as  1807  he  delivered  the  introductory  address  to  the  course  of 
lectures  before  the  medical  class  of  the  University  of  Pennsylvania  — 
increased  now  probabl}-  to  the  number  of  nearly  400. 

Dr.  John  Morgan,  F.  R.  S.  (1735-1789)  was  likewise  a  native  of  Phila- 
delphia, and  in  1757  received  the  first  literar}-  honors  conferred  by  the 
College  of  Philadelphia.  He  began  his  medical  studies  under  Dr.  John 
Redman,  and  having  completed  his  apprenticeship  entered  the  provincial 
army  as  a  lieutenant  and  surgeon  in  the  last  of  the  wars  against  the  French. 
In  1760  he  left  the  army  and  sailing  to  Europe  attended  the  lectures  and 
dissections  of  Dr.  William  Hunter,  and  subsequently  spent  two  years  at 
Edinburgh  under  the  teaching  of  the  Monros,  Cullen,  Rutherford,  Whytt 
and  Hope.  Graduating  at  Edinburgh  in  1762,  Dr.  Morgan  made  an  ex- 
tended tour  of  the  continent  in  the  further  prosecution  of  his  medical 
studies,  and  upon  his  return  to  London  was  elected  a  Fellow  of  the  Royal 
Societ}-  and  was  admitted  a  Licentiate  of  the  College  of  Physicians  of 
London  and  a  member  of  the  College  of  Physicians  of  Edinburgh.  In 
1765  he  returned  to  Philadelphia,  and  it  was  largely  through  his  personal 


—  808  — 

influence  that  the  medical  department  of  the  College  of  Philadelphia  was 
organized  in  the  same  year,  he  himself  receiving  the  professorship  of  theory 
and  practice.  In  1775  Dr.  Morgan  was  appointed  by  Congress  "Director 
General  and  Physieian-in-Chief  of  the  hospital  in  the  American  army ",  in 
place  of  Dr.  Church,  but  in  1777  was  unjustly  dismissed  from  the  service 
on  charges,  the  truthfulness  of  which  was  fully  disproved  by  an  investiga- 
tion subsequently  inaugurated  at  his  own  request. 

Drs.  Shippen  and  Morgan  were  originally  the  sole  professors  of  the 
medical  faculty  of  the  College  of  Philadelphia.  In  1768,  however.  Dr. 
Adam  Kuhn,  a  pupil  of  Linnaeus,  was  appointed  professor  of  materia  medica 
and  botany,  and  Dr.  Benjamin  Rush  in  1709  received  the  appointment 
of  professor  of  chemistry.  Dr.  Thomas  Bond  in  the  latter  year  was  like- 
wise appointed  to  give  clinical  lectures  in  the  Pennsylvania  Hospital.  Such 
was  the  organization  of  the  first  medical  college  founded  in  the  United 
States.  The  first  medical  commencement  of  this  institution  occurred  June 
21,  170S,  on  which  occasion  the  degree  of  M.  B.  was  conferred  upon  ten 
candidates.  The  charter  of  the  College  of  Philadelphia  was  abrogated  for 
political  reasons  in  1779,  and  the  University  of  Pennsylvania  organized. 
In  1789  the  charter  of  the  former  institution  was  restored,  though  without 
interfering  in  any  respect  with  the  privileges  of  the  University,  and  in 
1791  the  two  schools  were  united.  Since  this  period  the  medical  depart- 
ment of  the  University  of  Pennsylvania  has  been  one  of  the  most  eminent 
medical  schools  of  our  land. 

In  1767  the  medical  department  of  King's  College,  New  York,  was 
organized  with  the  following  very  complete  faculty  :  Samuel  Closse}-,  pro- 
fessor of  anatomy  ;  Peter  Middleton,  prof,  of  the  theory  of  physic  ;  John 
Jones,  prof,  of  surgery  :  James  Smith,  professor  of  chemistry  and  materia 
medica  ;  John  V.  B.  Tennent,  prof,  of  midwifery,  and  Samuel  Bard  professor 
of  the  practice  of  physic. 

Dr.  Clossey  was  an  Irish  physician  who  had  attained  some  reputation  before  his 
arrival  in  this  country  by  a  pathological  work  entitled  "  Observations  on  some  of  the 
Diseases  of  the  Human  Body,  chiefly  taken  from  Dissections  of  Morbid  Bodies " 
(London,  l76o).  On  the  outbreak  of  the  Revolution  he  returned  to  his  native  laud, 
where  he  soon  after  died. 

Peter  Middleton,  a  native  of  Scotland,  was  equally  distinguished  for  his  profound 
learning  and  his  professional  talents.  We  have  already  noticed  his  injection  and 
dissection  of  a  human  body  in  1750,  in  conjunction  with  Dr.  John  Bard.  Dr.  Mid- 
dleton also  published  in  17(J!)  a  "Medical  Discourse,  or  Historical  Inquiries  into  the 
ancient  and  present  state  of  medicine."  He  died  of  cancer  of  the  pylorus  at.  New 
York  in  the  Year  1781. 

James  Smith  (died  1812)  was  a  brother  of  the  historian  William  Smith,  an 
alumnus  of  Leyden,  and  more  eminent  as  a  theorist  than  as  a  practitioner. 

John  V.  B  Tennent  was  a  native  New  Jersey,  an  alumnus  of  Princeton  College 
and  the  University  of  Edinburgh,  and  a  Fellow  of  the  Royal  Society.  He  died  at  an 
early  age  in  the  West  Indies,  whither  he  had  gone  to  recover  his  health. 

Samuel  Bard  was  one  of  the  most  eminent  physicians  of  the  18th  century.  The 
son  of  Dr.  John  Bard,  who  has  been  already  mentioned,  he  was  born  in  Philadelphia 


—  809  — 

in  1742  and  received  his  preliminary  education  in  King's  College,  New  York.  In 
17GI  he  repaired  to  London  and  placed  himself  under  the  instruction  of  Dr.  Alexander 
Russell,  but  in  the  following  year  removed  to  Edinburgh,  where  he  enjoyed  the 
teaching  of  Cullen,  the  Monros,  Ferguson,  Rutherford,  Whytt,  Hope,  Gregory  etc. 
On  May  13,  1765,  Dr.  Bard  received  his  medical  diploma  from  the  university  of 
Edinburgh,  having  presented  a  thesis  entitled  "  De  viribus  Opii",  which  elicited 
numerous  encomiums.  In  the  following  year  Dr.  Bard  returned  to  his  native  land 
and  was  appointed  professor  in  the  medical  department  of  King's  College,  as  above 
mentioned.  The  foundation  of  the  New  York  Hospital  was  largely  due  to  his 
suggestion,  and  he  continued  one  of  its  visiting  physicians  until  his  retirement  in 
1798.  He  was  likewise  one  of  the  founders  of  the  New  York  Dispensary.  On  the 
reorganization  of  the  Medical  Faculty  of  Columbia  College  in  1791,  he  was  made  its 
Dean,  and  in  1813  became  the  president  of  the  College  of  Physicians  and  Surgeons. 
Besides  numerous  introductory  and  other  addresses,  Dr.  Bard  published  in  17  71  a 
paper  on  "Angina  Suffocativa",  another  on  uterine  haemorrhage  in  1788  and  a  work 
on  obstetrics  (Compendium  of  the  Theory  and  Practice  of  Midwifery)  in  1807.  He 
died  May  24,  1821. 

Lectures  in  the  medical  department  of  King's  College  began  on  the 
first  Monday  of  November,  1767,  and  the  degree  of  M.  B.  was  conferred 
upon  Mr  Robert  Tucker  and  Samuel  Kissam  —  the  first-fruits  of  the  now 
famous  College  of  Physicians  and  Surgeons  —  Tuesday,  Ma}'  16, 1769.  The 
first  regular1  degree  of  M.  D.  in  the  United  States  was  conferred  upon 
Samuel  Kissam  in  March  1770  by  King's  College,  which  anticipated  in  this 
matter  the  College  of  Philadelphia  b}-  a  single  year.  During  the  war  of  the 
Revolution  all  instruction  in  King's  College  was  discontinued,  and  the 
buildings  were  occupied  for  hospital  purposes.  In  1787  the  name  of  tbe 
institution  was  changed  to  Columbia  College,  but  it  was  not  until  1792  that 
the  faculty  was  complete^'  reorganized,  and  between  this  period  and  1800 
it  is  said  that  the  number  of  medical  degrees  conferred  was  only  fifteen. 
The  success  of  the  medical  department  of  Columbia  College  was,  however, 
far  from  satis  factor}",  and  in  1807  tire  Board  of  Regents  deemed  it  wise  to 
charter  the  present  College  of  Physicians  and  Surgeons  of  New  York. 
Internal  feuds  and  medical  rivalries  combined  to  cripple  the  efforts  of  both 
institutions,  and  in  1813  the  two  medical  schools  were  united  under  the 
presidency  of  the  venerable  Samuel  Bard,  the  title  of  College  of  Physicians 
and  Surgeons  being  retained,  and  the  medical  department  of  Columbia 
College  discontinued.  In  1860  the  connexion  with  Columbia  College  was 
again  restored  by  the  designation  of  the  College  of  Physicians  and  Surgeons 
as  the  Medical  Department  of  Columbia  College. 

The  medical  department  of  Harvard  University  was  founded  in  1783, 
mainl}T  through  the  efforts  of  Dr.  John  Warren,  who  became  the  first  pro- 

1.  "In  1663  Capt.  John  Cranston  was  licensed  by  the  general  court  '  to  administer 
physicke  and  practice  chirurgerie ',  and  had  conferred  upon  him  the  degree  of 
M.  D.  in  the  following  words:  'And  is  by  this  court  styled  doctor  of  physick  and 
chirurgery  by  the  authority  of  this  the  general  assembly  of  this  colony  '  (Rhode 
Island)",  and  the  honorary  degree  of  M.  D.  was  conferred  upon  Daniel  Turner 
by  Yale  College  in  1720.  As  Dr.  Turner  had  been  a  liberal  benefactor  of  the 
College  the  M.  D.  was  facetiously  said  to  signify  muliwm  donavit.     (Toner.) 


—  810  — 

fessor  of  anatom}-  and  surgery.  "With  him  were  associated  Dr.  Benjamin 
"Waterhouse  as  professor  of  Theory  and  Practice,  and  Aaron  Dexter  as 
professor  of  Chemistry.  The  lectures  were  delivered  in  Cambridge  until 
the  erection  of  the  Massachusetts  Medical  College  in  Mason  Street, 
Boston.  1815. 

Dr.  John  Warren  was  born  in  Roxbury,  Mass.,  July  27,  1753,  graduated  at 
Harvard  College  in  1771,  and  studied  medicine  with  his  brother  the  eminent  patriot 
Dr.  Joseph  Warren  (1741-1775),  who  was  slain  at  the  battle  of  Bunker  Hill.  Dr. 
John  Warren  attended  the  wounded  in  this  battle,  and  during  the  Revolutionary 
War  became  superintending  surgeon  of  the  military  hospitals  in  Boston.  In  1780  he 
delivered  lectures  on  anatomy  to  his  students  and  the  physicians  of  his  acquaintance 
in  Boston,  and  in  1783  was  appointed  professor  of  anatomy  and  surgery  in  the  newly 
established  Medical  School  at  Cambridge.  He  was  President  of  the  Massachusetts 
Medical  Society  from  1804  until  his  death,  and  one  of  the  most  eminent  surgeons  of 
New  England.      He  died  in  Boston,  April  4,  1815. 

Dr.  Waterhouse  (1754-1846)  was  a  native  of  Newport,  R.  I.,  studied  in  London 
and  Edinburgh  and  graduated  at  Leyden  in  1780.  In  addition  to  his  professorship 
in  Harvard  College,  he  was  also  professor  of  natural  history  in  Brown  University-, 
Providence,  and  the  first  lecturer  on  this  subject  in  any  American  colle<ie.  He  is 
best  known,  however,  as  the  introducer  of  the  practice  of  vaccination  into  the  United 
States  in  1800.  His  "  Lectures  on  the  Theory  and  Practice  of  Medicine"  appeared 
in  1786. 

Dr.  Dexter  (1750-1829)  was  an  alumnus  of  Harvard  and  a  pupil  in  medicine  of 
Dr.  Samuel  Danforth  of  Boston. 

In  1787  Dr.  Nicholas  Romayne  established  a  very  successful  private 
medical  school  in  New  York,  which  of  course  conferred  no  degrees.  In 
1791,  however,  having  associated  with  himself  other  teachers,  Dr.  Romayne 
applied  to  the  Regents  of  the  University  of  New  York  for  authority  to 
confer  degrees.  On  the  denial  of  this  recpjest  he  applied  to  Queen's  College 
(now  Rutgers),  New  Jersey,  for  similar  authority,  and  in  1793  received  the 
desired  power.  This  arrangement  continued  until  181G,  when  it  was 
terminated  by  an  act  of  the  Legislature  of  New  York.  Subsequently 
medical  degrees  were  conferred  upon  the  students  of  this  school  b}'  the 
Faculty  of  Geneva  College  in  Western  New  York,  but  this  arrangement 
was  likewise  soon  terminated,  and  the  school  ceased  to  exist. 

Dr.  Romayne  (1756-1817)  was  a  native  of  New  York  and  an  alumnus  of  the 
University  of  Edinburgh.  He  also  visited  the  continent  and  spent  two  years  in  Paris. 
Returning  to  his  native  country  about  1782,  in  the  following  year  he  was  appointed 
one  of  the  Trustees  of  the  reorganized  Columbia  College,  but  soon  after  resigned  this- 
position  in  dis-rust  and  opened  a  private  school  of  medicine,  in  which  he  taught 
anatomy,  practice,  chemistry  and  botany  with  eminent  success.  In  180(5  he  was 
elected  the  first  President  of  the  Medical  Society  of  the  City  and  County  of  New 
York,  and  in  the  following  year  President  also  of  the  College  of  Physicians  and 
Surgeons,  positions  which  he  filled  with  great  ability  and  acceptability.  A  man 
of  great  pride  and  possessed  of  the  utmost  confidence  in  his  own  opinions,  Dr. 
Romayne,  though  enjoying  the  reputation  of  extraordinary  ability,  was  for  a  con- 
siderable period  somewhat  under  the  ban  of  the  medical  profession  in  New  York, 
though  his  last  days  were  highly  honored. 


—  811  — 

The  Medical  School  of  Dartmouth  College  was  established  in  1798  by 
the  energy  and  enterprise  of  Dr.  Nathan  Smith,  who  for  twelve  years  con- 
stituted its  entire  Faculty,  except  that  during  two  courses  of  lectures  he 
was  assisted  by  a  lecturer  on  chemistry. 

Nathan  Smith  (17(12-1829)  was  a  native  of  Rehoboth,  Mass.  and  an  alumnus  in 
medicine  of  Harvard  College.  He  likewise  studied  in  England  and  Scotland.  Besides 
his  multitudinous  duties  at  Dartmouth  College,  he  also  lectured  in  the  University  of 
Vermont  and  Bowdoin  College,  and  in  1818  was  appointed  professor  in  the  new 
medical  school  of  Yale  College.  It  is,  accordingly,  unnecessary  to  say  that  he  was  a 
man  of  extraordinary  energy  and  versatility  of  genius,  representing  what  our  Dr. 
Holmes  would  call  a  whole  "  settee"  of  professorships. 

Most  of  these  medical  institutions  were  modelled  after  the  University 
of  Edinburgh,  of  which  many  of  the  colonial  professors  were  alumni. 
Their  general  regulations  relative  to  admission,  examination,  graduation  etc. 
may  be  inferred  from  the  following  notice  published  by  the  Medical  Depart- 
ment of  King's  College,  N.  Y.,  in  1707  : 

"  Decrees  in  Physic  will  be  conferred  upon  the  following  Terms: 

1.  Eacli  Student  shall  be  matriculated  as  in  the  Universities  of  England. 

2.  Such  Students  as  have  not  taken  a  Degree  in  Arts  shall  satisfy  the  Examiners 
before  their  admission  to  a  degree  in  Physic,  that  they  have  a  competent  knowledge 
of  at  least  the  Latin  Language,  and  of  the  necessary  Branches  of  Natural  Philosophy. 

3.  No  Student  shall  be  admitted  to  his  Examination  for  a  Bachelor's  Degree  in 
less  than  three  Years  after  his  Matriculation  ;  and  having  attended  at  least  one  com- 
plete Course  of  Lectures  under  each  Professor:  Unless  he  can  produce  proper 
Certificates  of  his  having  served  an  Apprenticeship  of  three  Years  to  some  reputable 
Practitioner;  in  which  Case  he  may  be  admitted  to  his  Examination  in  Two  Years 
from  his  Matriculation. 

4.  In  one  Year  after  having  obtained  a  Bachelor's  Degree  a  Student  may  be 
admitted  to  his  Examination  for  the  Degree  of  Doctor;  provided  he  shall  previously 
have  attended  two  Courses  of  Lectures  under  each  Professor,  be  of  Twenty-two  Years 
of  Age  and  have  published  and  publickly  defended  a  Treatise  upon  some  Medical 
Subject. 

5.  The  Mode  of  Examination,  both  public  and  private,  shall  be  conformable  to 
the  Practice  of  the  most  celebrated  Universities  of  Europe. 

6.  Students  from  anj'  reputable  University  may  be  admitted  ad  eundem,  produc- 
ing proper  Certificates,  and  Graduates  will  be  entitled  to  the  same  privilege  on 
producing  the  like  Certificate  and  satisfying  the  Professors  of  their  Medical  Abilities." 

The  Course  of  Lectures  began  usually  in  September  and  closed  in 
the  following  May  or  June.  Dr.  Shippen's  anatomical  course  consisted  of 
sixty  lectures.  In  1760  the  fee  for  the  anatomical  course  of  Dr.  Closs}' 
was  £5  ;  for  private  pupils  £10,  and  for  the  course  of  materia  medica 
£3  5s.  An  introductory  lecture  was  regularly  delivered  at  the  opening 
of  the  course  as  at  the  present  day.  The  expense  of  the  degree  of  M.  B. 
to  the  student  amounted  to  about  $60  in  our  present  currency.  Since  1812 
no  degree  except  M.  D.  has  been  conferred  by  our  American  colleges.  Dr. 
Billings  estimates  the  total  number  of  graduates  of  our  medical  colleges 
between  1760  and  1800  at  221. 

The  earliest  medical  library  established  in  this  country  was  that  of 


—  812  — 

the   Pennsylvania  Hospital,  founded   in   1762,  and  now  containing  about 
13,000  volumes.     Man}"  of  these  volumes  were  selected  specially  for  this 
library  b}-  Dr.  Lettsom  of  London  and  Louis  in  Paris.     The  library  of  the 
New  York  Hospital,  now  containing  about  10.000  volumes,  was  begun  in 
the  year  177G,  and  the  library  of  the  College  of  Physicians  of  Philadelphia 
in  1788.    According  to  Bartlett,  the  libraries  of  American  physicians  about 
1776  consisted  of  the  works  of  Boerhaave   with  the  commentaries  of  Van 
Swieten  ;    the    Physiology    of    Haller ;    the    Anatomy    of    Cowper,    Keil, 
Douglass,  Cheselden.  Monro  and  Winslow  ;  the  Surgery  of  Heister.  Sharp, 
Le  Dran   and   Pott  ;    the  Midwifery  of   Smellie  ;    the   Materia  Medica  of 
Lewis  and  the  works  of  Sydenham,  Whytt,  Mead,  Brookes  and  Huxham. 
The  works  of  Cullen  were  just  becoming  known  (Billings). 

Medical  societies  for  mutual   improvement  and    protection  seem  to 
have  been  introduced   into   the  colonies  at  an  early  period.     In  1730  Dr. 
Douglass  addresses  his  paper  on   ';The  Throat  Distemper"  to  "a  Medical 
Society  of  Boston":    Dr.  John  Bard's  essay  upon  "The  malignant  Pleurisy" 
in  1749  was  drawn  up  at  the  request  of  "a  weekly  Societ}-  of  Gentlemen 
in  New  York,  and  addressed  to  them   at  one  of  their  meetings",  and  the 
introductory  lecture  of  Dr.   Middleton  to   the  course  of  lectures  in    the 
medical  department  of  King's  College  in  1769  speaks  of  a  medical  society 
"now  subsisting".     This  latter  society  seems  to  have  dissolved  in  1794,  or 
rather  to  have  merged   itself  into   a  new    association  styling  itself   The 
Medical  Society  of  the  State  of  New  York  —  not  to  be  confounded,  how- 
ever, with  the  Societ}'  of  the  same  name  authorized  by  the  Legislature  in 
1806  and    organized   in    1807.     The    former    society  in  1806    was    again 
merged  into   the  present  Medical  Society  of   the  County  of  New  York. 
The  following  medical  societies  and  associations  were  also  organized  during 
the  18th  century  : 

New  Jerse}'  State  Medical  Society    .....         1766 

Massachusetts  Medical  Society    ......     1781 

College  of  Physicians  of  Philadelphia     ....         1787 

Medical  and  Chirurgical  Faculty  of  Maryland  (1789),  incorp.    1799 
.Medical  Society  of  Delaware  ......         17S9 

Medical  Society  of  South  Carolina      .....     1789 

New  Hampshire  Medical  Society      .....         1791 

Connecticut  State  Medical  Society 1792. 

The  earlier  State  medical  societies,  e.  g.  those  of  New  Jersey,  Mass- 
achusetts, Delaware  etc.,  were  authorized  to  license  candidates  for  the 
practice  of  medicine,  and  to  examine  the  candidates  as  a  preliminary  to 
such  license  ;  hence  they  were  important  agents  in  determining  the  stan- 
dard of  medical  education  in  the  colonies. 

Pestdiouses  were  established  in  the  vicinity  of  the  larger  cities  from 
time  to  time,  as  the  prevalence  of  epidemic  diseases  demanded. 

The  first  general  hospital  chartered  in  the  colonies  was,  however,  the 
Pennsylvania  Hospital  of  Philadelphia,  organized  in  1751  with  a  medical 


—  813  — 

staff  of  six  physicians  and  surgeons,  viz.  Drs.  Llo}d  Zachary,  Thomas 
Bond,  Phineas  Bond,  Thomas  Cadvvallader,  Samuel  Preston  Moore  and 
John  Redman.  Patients  were  received  into  a  temporary  building  in  1752, 
and  the  permanent  hospital  building  was  opened  for  their  reception  in 
December  175G.  —  It  was  within  the  walls  of  this  hospital  that  the  first 
clinical  instruction  in  America  was  given  by  Dr.  Thomas  Bond. 

The  establishment  of  the  New  York  Hospital  was  largely  due  to  the 
influence  of  Dr.  Samuel  Bard,  who  in  1769,  at  the  first  commencement  of 
the  Medical  Department  of  King's  College,  directed  attention  in  his  public 
address  to  the  necessity  of  such  an  institution.  Upon  the  same  day  Sir 
Henry  Moore,  Governor  of  the  province  of  New  York,  started  a  subscrip- 
tion for  the  establishment  of  a  suitable  hospital  in  New  York  City,  and 
the  sum  of  £800  was  soon  pledged  for  this  object.  The  corporation  of  the 
City  of  New  York  added  to  this  amount  the  sum  of  £300  and  the  corner 
stone  of  the  hospital  was  laid  July  27,  1773.  The  building  was  unfortu- 
nately destroyed  by  fire  on  Feb.  28,  1775,  before  it  was  quite  ready  for 
occupation,  and  in  consequence  of  the  war  was  not  rebuilt  and  put  into  a 
condition  to  receive  patients  until  January  3,  1791. 

The  Philadelphia  Dispensary  for  the  gratuitous  treatment  of  the  sick 
poor,  the  first  institution  of  its  kind  in  the  United  States,  was  founded  in 
1786,  and  was  soon  followed  by  the  New  York  Dispensar}-  organized  Jan. 
4,  1791  and  incorporated  in  1795. 

The  earliest  institution  for  the  special  care  of  the  insane  was  the 
Eastern  Lunatic  Asylum  at  WilHamsburgh,  Virginia,  chartered  in  1772, 
and  opened  for  the  reception  of  patients  in  1773.  Its  first  physician  was 
Dr.  John  Minson  Gait  of  WilHamsburgh.  —  It  should,  however,  be  remarked 
that  the  charter  of  the  Pennsylvania  Hospital,  granted  in  1751,  also  pro- 
vided for  the  care  of  lunatics,  though  the  institution  was  not  specially 
designed  for  their  treatment  and  protection. 

In  pathology  America  has  always  followed  the  lead  of  the  Old  World, 
and  the  medical  s}'stems  of  Europe  have  been  ever  reflected  in  American 
practice.  Accordingly  the  earliest  educated  medical  practitioners  of  this 
country  followed  in  general  the  views  of  Sydenham.  With  the  opening  of 
the  18th  century,  however,  the  influence  of  Boerhaave  and  his  teachings 
was  strongl}-  felt  in  the  colonies,  and  in  1760  Bush  declared  that  "the  sys- 
tem of  Boerhaave  governed  the  practice  of  every  physician  in  Phila- 
delphia." To  the  system  of  Boerhaave  succeeded  that  of  Cullen,  who  had 
been  the  teacher  of  man}-  of  the  early  professors  in  our  medical  schools, 
and  the  doctrines  of  Cullen  were  generally  accepted  in  this  counti*}*  until 
the  close  of  the  century  and  even  later.  In  the  last  decennium  of  the 
centur}'  the  famous  Benjamin  Bush,  who  exercised  a  more  conspicuous 
influence  upon  the  theory  and  practice  of  medicine  in  the  United  States 
than  any  of  his  predecessors  at  least,  taught  and  practised  a  modified 
Brunonianism,  to  which  he  professed  to  have  been  led  by  his  experience 
with  the  epidemic  of  yellow  fever  in  Philadelphia  in  1793. 


-  814  — 

Dr.  Rush  was  born  near  Philadelphia  Dec.  24,  17-45  and  received  his  early 
education  in  Nottingham,  Maryland.  He  entered  Princeton  College  in  1759  and 
received  his  degree  of  A.  B.  in  the  following  year.  For  the  next  six  years  he  pursued 
the  study  of  medicine  in  the  office  of  Dr.  John  Redman  of  Philadelphia',  and  formed 
one  of  the  members  of  Dr.  Shippen's  first  class  in  anatomy.  On  the  expiration  of 
his  apprenticeship,  Dr.  Rush  went  to  Edinburgh  and  received  here  the  degree  of  M.  D. 
in  17t>8,  on  which  occasion  he  presented  a  thesis  entitled  'De  Coctione  Ciborum  in 
Ventriculo".  Having  visited  the  hospitals  of  London  and  Paris,  he  returned  in  1796 
to  Philadelphia,  and  was  immediately  appointed  prolessor  of  chemistry  in  the  newly 
organized  medical  department  of  the  College  of  Philadelphia.  In  177fi  Dr.  Rush  was 
a  member  of  the  Continental  Congress  and  one  of  the  Signers  o'"  the  Declaratirn  of 
Independence.1  In  1777  he  was  appointed  by  Congress  Surgeon-General  of  the 
hospital  in  the  Middle  Department,  and  in  1787  he  was  ajiain  a  member  of  the  Con- 
vention for  the  adoption  of  the  Constitution  of  the  United  States.  He  died  in  Phila- 
delphia April  19,  1813. 

Dr.  Rush  was  a  voluminous  and  indefatigable  writer  on  a  very  great  variety  of 
subjects,  medical,  political,  educational  and  philosophical.  Selections  In  m  his 
writings  entitled  "Medical  Inquiries  and  Observations",  5  vols,  were  published 
1789-9S,  and  a  collection  made  by  himself  and  entitled  "Medical  Inquiries  and 
Observations  upon  the  diseases  of  the  Mind"  appeared  in  1812.  These  were  the 
more  important  of  Ins  medical  works. 

The  so-called  system  of  Dr.  Rush  rejected  the  complicated  nosology 
of  Cullen,  and  referred  all  diseases  to  a  morbid  excitement,  induced  b}' 
irritants  acting  upon  previous  debility.  Hence  his  therapeutics  recognized 
but  two  classes  of  remedies,  depressants  and  stimulants,  and  the  duty  of 
the  physician,  after  having  decided  upon  the  class  of  disease  from  which 
his  patient  was  suffering,  consisted  simply  in  selecting  the  most  appropriate 
depletive  or  stimulant  as  the  case  might  be.  "  Fevers  of  all  kinds  are 
preceded  by  general  debility,  natural  or  accidental.  From  this  a  sudden 
accumulation  of  excitability  takes  place,  whereby  a  predisposition  to  fever 
is  created."  .  .  .  "All  diseases  are  preceded  lrv  debility.  There  is  but 
one  exciting  cause  of  fever,  and  that  is  stimulus  ;  and  that  consists  in  a 
preternatural  and  convulsive  action  of  the  blood  vessels.  All  the  supposed 
varieties  of  fevers  have  but  one  proximate  cause,  and  that  is  morbid  excite- 
ment." The  favorite  remedies  of  Dr.  Rush  were  venesection  and  calomel, 
both  of  which  he  employed  with  a  freedom  which  to  us  of  the  present  day 
at  least  seems  like  recklessness.  Calomel  he  called  "  the  Sampson  of  the 
materia  medica",  a  statement  which  readily  called  forth  from  his  opponents  the 
witty  rejoinder  that  in  this  point  at  least  Dr.  Rush  was  correct,  for  calomel, 


There  were  no  less  than  five  physicians  in  the  Congress  which  declared  the  inde- 
pendence of  the  United  States,  viz  :  Benjamin  Rush  of  Pennsylvania,  .losiah 
Bartlett  and  Matthew  Thornton  of  New  Hampshire,  Oliver  Wolcott  of  Connecticut, 
and  Lyman  Hall  of  Georgia  In  the  Provincial  Congress  of  Massachusetts  in 
1774-75  there  were  also  no  less  than  22  medical  men.  It  was  Dr.  Samuel  Prescott 
of  Concord  who  accompanied  Paul  Revere  and  William  Dawes  in  their  hasty  ride 
to  inform  the  people  of  the  expedition  of  the  British  to  capture  the  military 
stores  at  Lexington,  and  Dr.  Joseph  Warren  sealed  his  devotion  to  liberty  with 
his  blood.  Physicians  may  well  glory  in  the  conduct  and  reputation  of  their 
Revolutionary  colleagues. 


—  815  — 

like  its  athletic  namesake  had  most  undoubtedly  "  slain  its  thousands  ". 
In  the  terrible  epidemic  of  yellow  fever  which  ravaged  Philadelphia  in 
1793  Dr.  Rush  began  his  treatment  with  a  sharp  purge  of  ten  grains  each 
of  calomel  and  jalap,  and  the  effects  of  this  powder,  "  especialhy  when 
repeated  according  to  circumstances,  not  only  answered,  but  far  exceeded 
his  expectations  "  (Thacher)  —  a  result  which,  unless  the  type  of  fever  has 
greatly  changed  since  his  day,  we  can  readily  understand,  though  not  in 
the  precise  sense  intended  b}'  his  biographer.  Rush's  purging  powders, 
of  which  it  may  be  said  to  the  doctor's  credit  that  he  at  least  made  no 
secret,  were  sold  by  the  apothecaries  almost  as  a  specific  for  }-ellow  fever. 
Their  use  was  to  be  followed  b}'  a  venesection  of  10-12  ounces,  and  this 
course  of  purgation  and  blood  letting  was  to  be  repeated  until  the  patient 
recovered  —  or  succumbed.  Dr.  Rush's  system  of  treatment  of  course 
met  with  warm  opposition,  and  violent  and  vituperative  disputes  were 
waged  in  the  newspapers  over  its  merits.  At  the  head  of  the  opposition 
to  Dr.  Rush  stood  Dr.  William  Currie  «( 1755-1829)  of  Philadelphia,  author 
of  an  "Historical  Account  of  the  Diseases  which  occur  in  the  different 
parts  of  the  United  States",  (Philadelphia,  1792),  "A  Treatise  on  the 
S}"nochus  Icteroides  or  Yellow  Fever'-  (Phila.,  1792)  and  other  works, 
while  the  afterwards  eminent  surgeon  Dr.  Philip  Syng  Pin-sick  (1768-1837) 
related  in  the  "Gazette  of  the  United  States"  (1797)  a  successful  case 
under  Rush's  treatment,  in  which  the  patient  had  been  bled  22  times  in  10 
days  and  had  thus  lost  176  ounces  of  blood,  and  Dr.  John  Redman  Coxe 
(1773-1864),  then  just  beginning  his  career  of  success  in  Philadelphia, 
reassured  the  timid  public  by  gravely  informing  the  readers  of  the  news- 
papers that  every  man  of  medium  size  possessed  400-450  ounces  of  blood 
in  his  own  right,  and  might  therefore  spare  the  trivial  loss  of  a  venesec- 
tion without  any  danger.  —  Dr.  Rush's  eminent  position  as  a  patriot  and 
a  professor  in  the  chief  school  of  medicine  in  the  United  States  un- 
doubtedly lent  to  his  precepts  and  example  a  force  which  even  their  in- 
trinsic merits  would  under  less  favorable  circumstances  have  scarcely  won 
for  them. 

Practical  anatomy  began  to  be  cultivated,  as  we  have  seen,  with  some 
regularity  from  about  the  middle  of  the  century.  The  bodies  of  executed 
criminals  were  occasionally  furnished  by  the  authorities  for  the  purpose 
of  dissection,  but  undoubtedly  the  chief  supply  of  anatomical  material 
was  obtained  surreptitiously  by  the  robbing  of  cemeteries.  Popular  preju- 
dice against  the  dissection  of  the  human  body  ran  high,  and  the  "Doctors' 
Mob"  of  1788  in  New  York,  which  for  two  da}'S  defied  the  control  of  both 
the  civil  and  military  authorities,  bears  witness  to  the  intensity  of  this 
feeling.  In  the  same  year  the  body  of  an  executed  criminal,  which  had 
been  given  to  the  doctors  for  dissection  by  the  authorities  of  Baltimore, 
was  forcibly  taken  from  them  by  the  enraged  populace.  Secret  dissections 
were  performed  in  Harvard  College  as  early  as  1771,  twelve  years  before 
the  foundation  of  its  medical  department,  but  the  practice  was  legal  felony 


—  816  — 

iu  Massachusetts  for  sixty  years  longer.  According  to  Holmes,  the  text- 
books in  anatomy  toward  the  close  of  the  century  were  "probably  Chesel- 
den  and  Monro,  perhaps  Winslow,  and  for  those  who  could  read  French, 
Sabatier.  The  Professor  himself  had  the  magnificent  illustrated  works  of 
Albinus  and  of  Haller,  the  plates  of  Cowper  (stolen  from  Bidloo)  and 
others.  The  student  may  have  seen  from  time  to  time,  if  he  did  not  own, 
the  figures  of  Eustachius  and  of  Haller." 

No  special  professor  of  physiology  existed  in  any  medical  school  in 
this  country  during  the  18th  century.  The  imperfect  state  of  pl^sio- 
logical  science,  and  particularly  of  experimental  physiolog}*,  during  this 
period  rendered  a  special  instructor  in  this  department  superfluous.  The 
ordinary  physiological  text-book  during  the  latter  half  of  the  century 
seems  to  have  been  Haller's  "Prima?  Linere  Physiologiae",  which  appeared 
in  1747  and  was  translated  into  English  in  175-1. 

Surgery,  when  we  consider  the  circumstances  of  the  time,  has  no  rea- 
son to  be  ashamed  of  its  position  in  Amer'ca  during  the  18th  centuiy. 
While  surgical  authors  were,  of  course,  almost  entirel}*  wanting,  the  names 
of  not  a  few  capable  practical  surgeons  have  been  preserved  to  us. 
Naturally  the  most  eminent  of  these  were  the  professors  in  the  various 
medical  schools,  but  numerous  equally  capable,  though  less  celebrated, 
surgical  practitioners  were  scattered  throughout  the  country.  —  Among 
the  professors  of  surgery  perhaps  the  first  place  is  due  to  Dr.  John  Jones 
(1729-1791),  of  the  medical  department  of  King's  College  in  New  York. 
A  native  of  Long  Island,  Dr.  Jones  had  enjo3'ed  the  instruction  of  Dr. 
Thomas  Cadwallader  of  Philadelphia,  Drs.  William  Hunter  and  Pott  of 
London,  and  of  Petit,  Le  Cat  and  Le  Dran  in  Paris.  Upon  his  return  to 
this  country  he  settled  in  New  York,  served  as  a  volunteer  surgeon  in  the 
campaign  against  the  French  in  1755.  and  in  17G8  was  appointed  the  first 
professor  of  surgery  in  King's  College.  In  1775  he  published  the  first 
native  surgical  work  which  appeared  in  this  country,  "Plain,  Precise,  Prac- 
tical Remarks  on  the  Treatment  of  Wounds  and  Fractures"  (New  York), 
which,  according  to  Billings,  was  a  mere  compilation  from  Ranby,  Pott 
and  others,  and  contained  only  one  original  observation,  viz.,  a  case  of 
hernia  cerebri  following  the  operation  of  trephining.  Dr.  Jones  was  the 
medical  attendant  of  Washington  and  Franklin,  and  was  particularly  emi- 
nent as  a  lithotomist.  Dr.  William  Shippen  Jr.  (173G-1808),  first  professor 
of  surgery  in  the  College  of  Philadelphia,  and  Dr.  Thomas  Bond  (1712- 
178-1),  first  professor  of  Clinical  Medicine  (17G9)  in  this  country,  were 
also  eminent  as  surgeons,  and  the  same  may  be  said  of  Dr.  John  Warren 
(1753-1815).  founder  of  the  medical  department  of  Harvard  College. 
Ocher  excellent  surgeons  of  more  local  celebrity  were  : 

Dr.  Richard  Bayley  (1745-1801)  of  Connecticut,  who,  after  a  course 
of  study  under  Hunter  in  London,  settled  in  New  York  in  1772.  Dr. 
Bayley  studied  carefully  the  pathological  anatomy  of  croup  and  "putrid 
sore  throat'*  (diphtheria),  and  was  led  by  his  investigations  to  distinguish 


—  817  — 

the  two  diseases  as  essentially  different,  to  inculcate  the  purely  inflam- 
matory character  of  croup  and  to  recommend  its  treatment  by  venesection 
from  the  jugular  vein,  blisters  to  the  throat,  antimony  and  calomel.  His 
views  were  published  in  the  form  of  a  letter  to  Dr.  Hunter  in  1781.  In 
1792  Dr.  Bay  ley  was  appointed  professor  of  anatomy  in  the  reorganized 
medical  department  of  Columbia  College,  but  was  transferred  in  1793  to 
the  chair  of  surgery,  his  son-in-law,  the  famous  Dr.  Wright  Post,  taking 
the  professorship  of  anatom}*.  Dr.  Bayley  was  a  successful  lithotomist, 
and  in  1782  performed  disarticulation  of  the  arm  at  the  shoulder  joint. 
He  was  also  distinguished  as  an  oculist,  preferring  extraction  to  depres- 
sion of  the  lens  in  cataract.  In  1795  or  96  he  was  appointed  Health 
Officer  of  the  port  of  New  York  and  was  very  active  in  securing  the 
passage  of  the  Quarantine  Act  of  1799.  In  1797  he  published  an  "Essay 
on  Yellow  Fever",  in  which  he  advocated  the  local  origin  of  the  disease 
and  its  non-contagiousness.  Dr. .Bayley  died  Aug.  17,  1801,  of  typhus 
fever  contracted  in  the  discharge  of  his  duties  as  Health  Officer  of  the 
port  of  New  York. 

Dr.  Charles  McKnight  (1750-1791),  a  pupil  of  Dr.  Shippen  of  Phila- 
delphia, entered  the  arm}*  as  a  surgeon  before  the  completion  of  his  med- 
ical studies  and  b}*  his  abilities  rose  in  1780  to  the  position  of  chief  hos- 
pital physician  of  the  Middle  Department.  At  the  close  of  the  war  he 
settled  in  New  York,  delivered  lectures  on  anatomy  and  surgery  in 
Columbia  College  and,  with  the  exception  of  Dr.  Bayley,  was  the  most 
eminent  surgeon  of  his  day.  His  only  publication,  however,  was  the  report 
of  an  operation  for  the  removal  of  an  extra-uterine  foetus,  published  in  the 
"London  Medical  Observations  and  Inquiries",  vol.  iv.  Dr.  McKnight  is 
said  to  have  been  one  of  the  earliest  practitioners  in  New  York  to  employ 
a  carriage  in  visiting  his  patients.  He  was  cut  off  prernaturel}*  by  pneu- 
monia at  the  early  age  of  41. 

William  Baynham  (1749-1814),  a  native  of  Caroline  County,  Virginia, 
after  receiving  his  preliminary  education  at  home,  was  sent  to  London  at 
the  age  of  20  years  and  entered  a  student  at  St.  Thomas's  Hospital.  Here 
he  made  the  acquaintance  of  Mr.  Else,  the  professor  of  anatom}7,  to  whom 
he  subsequently  became  assistant,  and  under  whose  guidance  he  acquired 
that  knowledge  of  anatom}*  for  which  he  was  afterwards  so  justly  celebrated. 
Mr.  Baynham's  skill  in  the  injection  of  anatomical  preparations  was  marvel- 
lous for  his  day,  and  won  for  him  the  earnest  commendation  of  William 
Hunter.  In  1781  Mr.  Baynham  became  a  member  of  the  Company  of 
Surgeons  of  London  and  took  up  his  residence  in  that  city,  but  four  years 
later  returned  to  his  native  state  and  settled  in  Essex  Co.,  where,  in  spite 
of  his  remote  and  undistinguished  residence,  he  speedily  acquired  a  widely 
extended  reputation  as  a  skilful  and  successful  surgeon.  He  was  particu- 
larly eminent  as  a  lithotomist,  but  was  also  a  skilful  oculist  and  twice 
performed  the  operation  of  gastrotomy  for  the  relief  of  extra-uterine 
foetation,  viz.,  in  1791  and  1799.  Mr.  Baynham  was  probably  at  least  the 
52 


—  818  — 

equal  of  any  surgeon  of  his  day  in  this  country,  as  he  was  unquestionably 
its  best  anatomist,  but  his  quiet  and  somewhat  eccentric  character  and 
remote  residence,  together  with  the  absence  of  any  extended  works  from 
his  pen,  have  combined  to  render  his  name  unfamiliar  to  his  countrymen. 

Dr.  Benjamin  Church  (1734-1776),  the  first  Director-General  and 
Physiciau-in-Chief  of  the  Hospital  Department  of  the  Continental  Army, 
was  also  one  of  the  most  eminent  surgeons  of  New  England.  In  1775  lie 
was  accused  of  treasonable  correspondence  with  the  enem}-,  tried  by  court- 
martial  and  imprisoned.  After  remaining  in  prison  for  eighteen  months 
he  was  allowed  to  depart  for  the  West  Indies,  but  the  vessel  in  which  he 
sailed  was  lost  at  sea. 

Thomas  Kast  (1750-1820)  of  Boston,  Samuel  Adams  (1738-1828)  of 
Westchester  Count}',  N.  Y.,  Gustavus  Brown  Horner  (1761-1815)  of 
Fauquier  County,  Virginia,  James  S}Tkes  (1761-1822)  of  Dover,  Delaware, 
Andrew  Wiesenthal  (1762-1798)  and  Lyde  Goodwin  of  Baltimore  were 
also  eminent  surgical  practitioners. 

Midwifery  during  the  first  half  of  the  18th  century  remained  almost 
exclusively  in  the  hands  of  ordinary  midwives,  whose  qualifications  con- 
sisted simply  in  a  more  or  less  extensive  personal  experience.  In  difficult 
cases  only  were  physicians  called  upon  for  aid.  Probably  the  earliest 
regular  obstetrician  of  the  colonies  was  Dr.  John  Moultrie  of  Charleston, 
a  Scotchman  who  came  to  this  country  in  1733  and  died  in  Charleston  in 
1773.  The  earliest  notice  of  any  male  obstetrician,  however,  is  found  in 
the  following  extract  from  the  "N.  Y.  Weekly  Post  Boy"  of  July  22,  1745  : 

"  Last  night  (Sunday,  July  21)  died  in  the  Prime  of  Life,  to  the  almost  universal 
Regret  and  Sorrow  of  this  City,  Mr.  John  Dupuy,  M.  D.,  Man  Midwife  ;  in  which  last 
Character,  it  may  be  truly  said  here,  as  David  did  of  Goliah's  Sword,  there  is  none 
like  him. 

Dr.  James  Lloyd  (1728-1810)  of  Long  Island,  a  pupil  of  William 
Hunter  and  Smellie  who  settled  in  Boston  in  1752,  is  said  to  have  been 
the  earliest  regular  practitioner  of  obstetrics  in  New  England,  while  a  Dr. 
Attwood  of  New  York  City  "  is  remembered  as  the  first  Dr.  who  had  the 
hardihood  to  proclaim  himself  as  a  man  midwife  :  it  was  deemed  a  scandal 
to  some  delicate  ears,  and  Mrs.  Grany  Brown,  with  her  fees  of  two  or  three 
dollars,  was  still  deemed  the  choice  of  all  who  thought  women  should  be 
modest."  This  was  in  1762.  The  earliest  public  teacher  of  obstetrics  in 
this  country,  however,  was  Dr.  William  Shippen  Jr.  of  Philadelphia,  whose 
first  course  on  this  subject  was  delivered  in  1762.  Dr.  John  V.  B.  Tennent, 
F.  R.  S..  a  native  of  New  Jersey  and  an  alumnus  of  the  University  of 
Edinburgh,  was  appointed  in  1767  the  first  regular  professor  of  midwifery 
on  the  organization  of  the  Medical  Department  of  King's  College,  N.  Y., 
in  that  year.  On  the  death  of  Dr.  Tennent  in  1770  he  was  succeeded  by 
Dr.  Samuel  Bard.  The  following  advertisement  appeared  in  the  "  Pennsyl- 
vania Gazette  ",  Jan.  1,  1765. 

"Dr.   Shippen,  Jr.,   having  been  lately  called  to  the  assistance  of  a  number  of 


_  819  — 

women  in  the  country  in  difficult  labors,  most  of  which  were  made  so  by  the  unskil- 
ful old  women  about  them:  the  poor  women  having  suffered  extremely,  and  their 
innocent  little  ones  being  entirely  destroyed,  whose  lives  might  have  been  easily 
saved  by  proper  management:  and  being  informed  of  several  desperate  cases  in  the 
different  neighborhoods  which  had  proved  fatal  to  the  mothers  as  well  as  to  their 
infants,  and  were  attended  with  the  most  painful  circumstances,  too  dismal  to  be 
related!  He  thought  it  his  duty  immediately  to  begin  his  intended  Courses  in  Mid- 
wifery, and  nas  prepared  a  proper  apparatus  for  that  purpose,  in  order  to  instruct 
those  women  who  have  virtue  enough  to  own  their  ignorance  and  apply  for  instruc- 
tion, as  well  as  those  young  gentlemen  now  engaged  in  the  study  of  that  useful  and 
necessary  branch  of  surgery,  who  are  taking  pains  to  qualify  themselves  to  practise 
in  different  parts  of  the  country  with  safety  and  advantage  to  their  fellow  citizens." 
(Wickes.) 

So  far  as  is  known  no  women  possessed  of  "  virtue  enough  to  own 
their  ignorance  and  apply  for  instruction  "  presented  themselves,  but  Dr. 
Shippen's  effort  to  inaugurate  a  school  for  midwives  deserves  all  honor. 
The  Doctor  also  supplied  "  convenient  lodgings  "  for  the  accommodation  of 
a  few  poor  women  during  their  confinement,  and  thus  established  a  sort  of 
lying-in  asylum  or  hospital.  The  chair  of  midwifery  in  the  College  of 
Philadelphia  continued  united  with  that  of  anatomy  until  1810,  when  a 
professorship  of  midwifery  was  instituted  here,  as  in  New  York  at  a  much 
earlier  period.  The  onl}r  special  legal  regulations  for  midwives  of  which 
we  have  any  record  are  contained  in  the  following  ordinance  adopted  b}-  the 
authorities  of  New  York  City,  July  16,  1716. 

"  It  is  ordained  that  no  woman  within  this  corporation  shall  exercise  the 
employment  of  midwife  until  she  have  taken  oath  before  the  mayor,  recorder  or  an 
alderman  (the  terms  of  which  are  prescribed)  to  the  following  effect:  That  she  will 
be  dilisrent  and  ready  to  help  any  woman  in  labor,  whether  poor  or  rich  ;  that  in  time 
of  necessity  she  will  not  forsake  the  poor  woman  and  go  to  the  rich  ;  that  she  will 
not  cause  or  suffer  any  woman  to  name  or  put  any  other  father  to  the  child,  but  only 
him  which  is  the  very  true  father  thereof,  indeed,  according  to  the  utmost  of  her 
power;  that  she  will  not  suffer  any  woman  to  pretend  to  be  delivered  of  a  child  who 
is  not  indeed,  neither  to  claim  any  other  woman's  child  for  her  own ;  that  she  will 
not  suffer  any  woman's  child  to  be  murdered  or  hurt;  and  as  often  as  she  shall  see 
any  peril  or  jeopardy,  either  in  the  mother  or  child,  she  will  call  in  other  midwives 
for  counsel;  that  she  will  not  administer  any  medicine  to  produce  miscarriage; 
that,  she  will  not  enforce  a  woman  to  give  more  for  her  services  than  is  right;  that 
she  will  not  collude  to  keep  secret  the  birth  of  a  child;  will  be  of  good  behavior; 
will  not  conceal  the  birth  of  bastards"  etc. 

In  the  winter  of  1789  Dr.  George  Buchanan  of  Baltimore  delivered 
a  course  of  lectures  on  the  "Diseases  of  Women  and  Children  "  to  a  class 
of  nine  students,  and  at  the  same  period  Dr.  Andrew  Wiesenthal  lectured 
at  his  own  house  on  an  atom  }T,  physiology,  pathology,  operative  surgery 
and  the  gravid  uterus.  During  the  succeeding  winter  Dr.  Buchanan  also 
delivered  a  course  of  lectures  on  midwifery,  in  conjunction  with  several 
other  lecturers  on  other  departments  of  medicine  (Quinan). 

During  the  whole  of  the  18th  century  the  majority  of  physicians 
prepared  their  own  medicines,  as  in  country  districts  at  the  present  day. 


820 


In  the  cities  the  apothecaries  also  practised  medicine  as  in  England. 
According  to  Toner,  Dr.  John  Morgan  of  Philadelphia  in  1765  was  the  first 
physician  to  publickly  advocate  the  separation  of  the  duties  of  the  phy- 
sician and  pharmacist.  Medicines  were  common])-  compounded  in  accord- 
ance with  the  pharmacopoeias  of  London  or  Edinburgh.  The  earliest 
example  of  a  special  American  pharmacopoeia  is  that  drawn  up  by  Dr. 
William  Brown  (probably  the  successor  of  Dr.  Rush  as  Physician-General 
of  the  Middle  Department;  and  published  at  Philadelphia  in  1778.  It 
was  printed  entirely  'in  Latin  upon  32  pages,  the  printed  text  occupying 
upon  each  page  a  space  4^  inches  in  length  and  2^  inches  in  width,  and 
was  designed  specially  for  the  use  of  the  Continental  Army.  This  pharma- 
copoeia bears  the  date  "  Lititz,  Mart.  12,  1778",  and  was  evidently  issued 
from  the  military  hospital  located  at  Lititz,  Lancaster  County.  Pennsyl- 
vania. As  the  first  essa}-  at  a  domestic  pharmacopoeia  in  the  Western 
World  its  title  page  is  worthy  of  preservation  : 


PHARMACOPOEIA 
Simpliciorum  &  Efficaciorurn, 

In  Usum 

X(  >SOCOMII  MILITARIS, 

Ad  Exercitum 

Fcederatarum  America?  Civitatum 

Pertinentis; 

Hodiernse  Nostra?  Inopia? 

Rerumque  Angustiis, 

Feroci  hostium  sa?vitia?,  belloque  crudeli 

ex  inopinato  patriae  nostra?  illato  debitis, 

Maxime  Accommodata. 

Auctore  GULIELMO  BROWN,  M.  D.* 
Editio  Altera. 

Philadelphia? : 

Ex  Ofticina  Caroli  Cist. 

M.  DCC.  LNXXI. 


The  little  pamphlet  contained  84  formula?  under  the  head  of  "  Medica- 
menta  Interna"  and  16  under  that  of  ••  Medicamenta  Externa  seu  Chirur- 
gica ",  though  singularly  enough  the  "  Epithema  Vesicatorium  ",  •' Fotus 
Anodynus",  "Linimentum  Comphoratum"  etc.  are  placed  among  the  medi- 

*This  is  a  fac  simile  of  the  title  page  of  the  1'nd  edition  of  Brown's  Pharmacopoeia, 
reprinted  by  "  The  American  Journal  of  Pharmacy",  Sept.  1884.  In  that  of  the 
first  edition  it  is  said  that  the  name  of  the  author  does  not  appear  and  the 
publishers  are  Styner  and  Cyst. 


£. 
1 

s. 

0 

d. 
0 

0 

15 

0 

0 

7 

0 

0 

7 

0 

0 

1 

8 

n 

7 

6 

0 

2 

0 

0 

10 

0 

0 

14 

0 

0 

12 

0 

1 

10 

0 

0 

10 

0 

0 

4 

6 

0 

1 

0" 

—  821  — 

catnenta  interna,  while  the   "  Tinctura  Myrrhae  et  Aloes"  appears  among 
the  tnedicamenta  chirurgica. 

A  general  idea  of  the  price  of  ordinary  drugs  about  the  middle  of  the  last  centurj' 
ma}-  be  fathered  from  the  following  items  extracted  from  a  price  list  published  in  the 
"New  York  Weekly  Post  Boy",  June  18,  1750- 

"  For  Ready  Money,  York  Currency. 

All  Compound  Waters,  per  Gallon         . 

Cantharides.  per  Pound        ..... 

Electuarium  Mithridat.  .... 

Theriaca  Andromachi  ..... 

Emplastrum  Diachylon  ..... 

Gum  Ammoniac,  "per  Pound  .... 

Gum  Arabic        ...... 

Gum  Assas  Fcetida?  .... 

Gum  Camphor  -...., 

Gum  Opium  ...... 

Manna  opt.  ... 

Fol.  Sennte,  Alex.  .  .  .  '   . 

Ivory  Gi3'ster  Pipes,  per  Doz. 

Phial  Corks,  per  Gross         ..... 

The  more  important  proprietary  medicines  about  the  same  period  are  enumerated 
in  the  following  advertisement: 

"  Just  imported,  and   to  be  sold  Wholesale   or  Retail,  by  Patrick  Carryl,  at  the 
sign  of  the  Unicorn' &  Mortar,  in  Hanover  Square, 

A  compleat  Assortment  of  Drugs  and  Medicines,  as  also  Perry's  and  Betton's 
British  Oil,  Cripple  curing  Oil,  Bateman's  pectoral  Drops,  Turlington's  Balsam  of 
Life,    Duffy's    Elixir,    Anodyne    Necklaces,    Stoughton's    Bitters,    Hungary    Water, 
Hooper's    Female   Pills,   Lockyer's   Pills,   Shop   Furniture  for  Apothecaries,  Vials, 
Pots"  etc.,  etc.     (The  N.  Y.  Weekly  Post  Boy,  January  28,  1751.) 

According  to  Toner,  the  earliest  regulation  of  the  fees  of  practitioners  of  medicine 
and  surgery   in  the  colonies  is   found   in  an  act  entitled  "An  act  for  regulating  the 
fees  and  accounts  of  the  practicers   in    physic ",   passed  by  the  General  Assembly  of 
Virginia   in   1736.      By   this   act  "Surgeons  and   apothecaries,   who  have  served  an 
apprenticeship  to  those  trades",  were  allowed  : 

"  For  even-  visit  and  prescription  in  town   or  within  5  miles 

For  every  mile  above  5  and  under  10 

For  every  visit  of  10  miles  ..... 

And  for  every  mile  above  10 

With  an  allowance  of  all  ferringes  in  their  journeys. 
To  surgeons  for  a  simple  fracture  and  cure  ihereof 
For  a  compound  fracture  and  cure  thereof 

But  those   persons   who  have  studied   physic  in  any  university,  and 
taken  any  degree  therein,  shall  be  allowed  for  every  visit  and  pre- 
scription in  town  or  within  five  miles  .... 

If  above  5  miles,  for  every  mile  more  under  10 

For  a  visit  if  not  above  10  miles        ..... 

And  for  every  mile  above  10 

With  an  allowance  of  ferriages  as  before." 

The  act  further  provided  that  each  prescription  must  be  accompanied  with  a  bill 
specifying  the  name,  quantity  and  price  of  each  ingredient  entering  into  the  com- 


t. 

s. 

d. 

0 

5 

0 

0 

1 

0 

0 

10 

0 

0 

0 

6 

2 

0 

0 

4 

0 

0 

0 

10 

0 

0 

1 

0 

1 

0 

0 

0 

1 

0 

0 

1 

6 

0 

2 

0 

0 

5 

0 

0 

15 

0 

0 

7 

6 

—  822  — 

position  of  the  same,  under  penalty  of  non-suit  in  case  of  any  action  founded  upon 
such  bill. 

Wickes  also  furnishes  us  a  "Table  of  Fees  and  Rates"  established  by  the  New 
Jersey  Medical  Society  in  1766.     According  to  this  table, 

Visiting  in  towns,   whereby   the  physician  and  surgeon  can  readily 

attend  the  patient  without  riding,  to  be  charged  for  according  to  the 

duration   of  the  ailment  and  degree  of  attendance,  viz.:   In  slight    £.     ?.     d. 

cases,  whereby  a  visit  or  two  may  be  wanted  .  .  .000 

In  other  cases  requiring  longer  and  daily  care  and  attendance :  for 

each  week's  attendance,  and  in  proportion  for  lesser  or  more  time, 

exclusive  of  medicines        .  .  .  .  .  .0100 

Visits  in  the  country  under  half  a  mile  to  be  charged  for  as  in  towns, 

viz.,  per  week  etc.  .  .  .  .0100 

Every  visit  above  half  a  mile,  and  not  exceeding  a  mile  and  a  half.  0       16 

Every   visit  above  one  and  a  half  miles,   and  not  exceeding  fifteen 

miles,  for  each  mile  additional  .  .  .  .010 

Ever}-  visit  above  15  miles,  and  not  exceeding  25  miles,  for  each  mile 

above  15  and  under  25 
Every  visit  above  25  miles  for  each  mile  above  25 
Every  visit  in  the  night,  exclusive  of  other  things 
Consultation  fees,  viz. :  Every  first  visit  and  opinion  by  the  consulted 

physician  or  surgeon,  exclusive  of  travelling  fees 
Every  succeeding  visit  and  advice  by  ditto 

Fees  for  surgical  operations  and  services,  exclusive  of  visits  and  traveling 
charges,  viz.  : 

Phlebotomy,  Is.  6d  ;  Extracting  a  tooth,  Is.  6d ;  Cutting  an  issue,  2s;  Cupping 
with  scarification  2s;  catheterization,  each  time,  7s.  6d  ;  Administering  a  clyster, 
3s.  9d ;  trepanning,  £3;  couching  or  extracting  cataract,  £3;  iridectomy,  £3; 
amputations  of  the  arm  or  leg,  £3,  and  each  subsequent  dressing  for  14  days  5s; 
lithotomy,  £5,  and  each  dressing  5s;  Midwifery  —  natural  delivery,  £1  10s;  in  a 
preternatural  case,  £3;  instrumental  cases,  £3. 

Fractures  —  of  nose,  £1  7s;  of  jaw,  £1;  of  clavicle,  £1  10s;  of  arm  £1  10s;  of 
leg,  £2,  etc. 

Simple  gonorrhoea,  including  medicines,  £2  5s;  when  attended  with  chancres  or 
particular  trouble  £3. 

These  rates  are  computed  in  "Proclamation  Money",  which  estimated  six 
■Shillings  to  the  dollar  and  remained  the  legal  standard  down  to  the  Revolution. 

According  to  Wickes,  wages  about  this  same  period  were  2s.  6d.  to  3e.  6d.  per 
day;  shelled  corn,  per  bushel,  3s.  6d.  to  4s;  wheat,  5s.  to  6s.  7d  ;  rye,  3s.  6d ;  buck- 
wheat, 2s.  6d.  to  3s;  flax,  9d.  per  pound;  butter,  Is.  6d  ;  sugar,  7d;  oats,  per  bushel, 
Is.  6d.  In  1760  the  salary  of  the  Governor  of  New  Jersey  was  £1000  proclamation 
money,  equivalent  to  about  $2500  in  our  present  money. 

In  1781  a  club  of  physicians  in  Boston  established  for  their  own  protection  the 
following  tariff  of  fees  : 

For  a  single  visit  in  the  city  .       $0.50 

Consultation  .....  .1.00 

Night  calls  .  -  .  .  .  .1.00 

Obstetrical  cases  .  ■  •  -  -  •  8. 00 

Capital  operations  in  surgery  .  .  £5  0s.  Od. 

Reducing  a  dislocation  or  setting  a  fractured  bone  .  £1  Is.  Od. 

Bleeding,  opening  an  abscess,  extracting  a  tooth  .  .       $0-50 

to  which  was  to  be  added  the  usual  fee  for  a  visit. 


—  823  — 

The  original  organization  of  ihe  "  Hospital"   (Medical  Department)  of  the  Con- 
tinental  army,   estimated   ibr  a  force  of  20,000  men,  was  adopted  by  the  Continental 
Congrsss  July  27,  1775,  and  provided  for 

One  Director-General  and  Chief  Physician,  his  pay,  per  day  $4.00 

Four  surgeons  with  pay  per  day  ....  1 ,33i 

One  apothecary,  with  pay  per  day  .  .  .1 .33| 

20  Surgeons  Mates  (assistant  surgeons),  with  pay  per  day  066f 

One  clerk,  .......  0  66§ 

2  Storekeepers,  with  pay  per  month  (if   .  .  .  4.00 

One  nurse  to  every  10  of  the  sick,  with  pay  per  day  of        .  .  006| 

In  1776  the  pay  of  hospital  surgeons  was  increased  to  $1.66  per  day,  that  of 
mates  to  $1.00  and  that  of  hospital  apothecary  to  $1.66,  and  in  May  1778,  in  con- 
sequence of  the  depreciation  in  Continental  money,  the  paj-  of  surgeons  was  again 
raised  to  $60,  and  that  of  mates  to  $40  per  month. 

The  first  Director-General  and  Chief  Physician  of  the  Continental  Army  was  Dr. 
Benj.  Church  of  Massachusetts.  He  was  dismissed  on  charges  of  treasonable  corres- 
pondence with  the  enemy,  and  succeeded,  Oct.  17,  1775,  by  Dr.  John  Morgan  of 
Philadelphia,  who  was  in  turn  dismissed  the  service  and  succeeded  by  Dr.  William 
Shippen,  April  11,  1777. 

Tt  has  been  usually  assumed  that  the  colonial  period  of  American 
medicine  was  a  period  peculiarly  infested  with  quacks  and  charlatans  of 
all  varieties.  I  suspect,  however,  that  this  assumption  is  scarcely  war- 
ranted b}'  the  facts  of  the  case,  and  that  the  mistake  has  arisen,  to  some 
extent  at  least, "from  confounding  the  popular  signification  of  the  term 
"quack"  with  its  genuine  meaning.  In  the  popular  sense  of  the  term,  a 
"quack"  is  a  practitioner  who  has  received  no  "regular"  (i.  e.  collegiate  or 
university)  medical  education.  According  to  our  lexicographers,  how- 
ever, a  quack  is  a  boastful  pretender  to  skill  or  knowledge  which  he  does- 
not  really  possess.  It  will  readily  be  seen,  therefore,  that  the  possession 
of  numerous  medical  diplomas  does  not  necessarily  exempt  the  holder 
from  a  just  charge  of  quackery,  in  its  true  and  legitimate  sense.  Dr. 
Douglass  of  Boston,  writing  to  Dr.  Cadwallader  Colden  of  New  York  in 
1720,  says  : 

"You  complain  of  the  practice  of  Physick  being  undervalued  in  your  parts  and 
with  reason;  we  are  not  much  better  in  that  respect  in  this  place;  we  abound  with 
Practitioners,  though  no  other  graduate  than  myself,  we  have  fourteen  Apothecary 
shops  in  Boston  ;  all  our  practitioners  dispense  their  own  medicines." 

Now  while  Dr.  Douglass  was  at  this  period  the  only  regularly  grad- 
uated physician  in  Boston,  it  would  be  manifestly  unfair  to  call  Dr.  Zab- 
diel  Boylston  and  others  of  his  contemporaries  "quacks",  though  so  much 
is  implied  in  Dr.  Douglass's  statement.  William  Smith,  in  his  "  History 
of  the  Province  of  New  York  from  its  First  Discovery  to  the  Year  1722'r 
(London,  1757),  writes  : 

"The  History  of  our  Diseases  belongs  to  a  Profession  with  which  I  am  \ery 
little  acquainted.  Few  Physicians  amongst  us  are  eminent  for  their  Skill.  Quacks 
abound  like  Locusts  in  Egypt,  and  too  many  have  recommended  themselves  to  a  full 
Practice  and  profitable  Subsistence.  This  is  the  less  to  be  wondered  at,  as  the  Pro- 
fession is  under  no  Kind  of  Regulation.     Loud   as  the  Call  is,  to  our  Shame  be  it 


—  824  — 

remembered,  we  have  no  Law  to  protect  the  Lives  of  the  King's  Subjects  from  the 
Malpractice  of  Pretenders.  Any  Man  at  his  Pleasure  sets  up  for  Physician, 
Apothecary  and  Chirurgeon.  No  candidates  are  either  examined  or  licensed,  or 
even  sworn  to  fair  practice.  In  1753  the  City  of  New  York  alone  boasted  the  Honour 
of  having  above  forty  Gentleman  of  that  Faculty." 

Here  too  the  historian  undoubtedly  employs  the  term  "quack"  as 
S3-non3Tmous  with  irregular  practitioner,  i.  e.  one  not  possessed  of  a  col- 
legiate or  university  education.  In  this  sense  undoubtedly  the  colonies 
were  overrun  with  "quacks".  Toner  says  "There  were  probably  not  3,500 
physicians,  all  told,  in  the  United  States  when  the  colonies  declared  them- 
selves independent  of  Great  Britain.  It  is  further  probable  that  there 
were  not  much,  if  any,  over  350  who  had  received  a  medical  degree."  Of 
course  then  nine  tenths  of  the  colonial  practitioners  of  medicine  were 
irregular  physicians,  or  popularl}r  "quacks".  Something  too  ma}'  reason- 
abl}T  be  allowed  for  the  "pride  of  place"  of  the  writers  quoted.  Both  were 
highly  educated  and,  in  some  respects,  learned  men,  who  doubtless  looked 
down  with  compassionate  scorn  upon  their  unfortunate  contemporaries 
whose  circumstances  had  not  permitted  them  to  enjoy  advantages  similar 
to  their  own.  It  is  no  uncommon  thing,  even  at  the  present  day,  to  read 
in  our  journals  and  newspapers  contributions  from  disappointed  youths 
and  dyspeptic  seniors,  which  might  lead  one  to  the  opinion  that  American 
medicine  was  almost  wholly  abandoned  to  charlatanism  and  deceit.  Yet, 
while  matters  are  far  from  what  we  would  wish  to  have  them,  American 
medicine  is  abundantly  able  to  care  for  itself.  —  On  the  whole  then  I  find 
no  very  reliable  evidence  that  the  American  colonies  in  the  18th  century 
greatly  surpassed  their  contemporary  states  of  the  Old  World  in  the 
possession  of  quacks  in  the  genuine  sense  of  that  term.  Certainl}'  the 
more  showy,  and  therefore  more  dangerous  charlatans  of  Europe  found 
little  to  tempt  them  in  the  rude  social  surroundings  and  relatively  im- 
pecunious condition  of  the  Western  colonists.  We  read  very  little  of  the 
itinerant  oculists,  lithotomists,  tooth-pullers  et  id  omne  genus,  whose 
vagaries  rendered  life  in  Europe  dangerous  at  this  period.  Yet  that  such 
characters  really  existed  also  in  colonial  life  is  manifest  from  the  following 
advertisements  : 

"Doctor  Graham,  Oculist  and  Aurist,  is  arrived  in  this  City  from  Philadelphia, 
and  majr  be  consulted  at  his  apartments  at  Capt.  Fenton's  opposite  Trinity  .Church, 
in  the  disorders  of  the  Eye  and  its  appendages;  and  in  every  species  of  deafness, 
hardness  of  hearing,  ulcerations,  noise  in  the  Ears  etc.  Persons  born  Deaf  and 
Dumb,  and  those  labouring  under  any  impediment  in  their  Speech,  by  applying 
personally,  will  probably  be  assisted. — The  Doctor  intends  to  sail  for  England  in  a 
few  months;  those,  therefore,  who  have  occasion  for  assistance,  must  apply  immedi- 
ately."—The  N.  Y.  Gazette;  and  the  Weekly  Mercury,  July  19,  1773. 

"Doctor  Dubuke,  Oculist  and  Dentist,  just  arrived  from  Boston,  begs  leave  to 
inform  the  Public  in  general  that  he  practices  Physick  and  Surgery,  and  undertakes 
to  cure  the  following  diseases  and  ailments  viz. : 

Any  disorders  in  the  Eyes  and  Ears,  white  swelling,  green  wounds,  ulcers,  if 
ever   so  old;    wens,  if  ever  so  big;    scald   on  the   head,   polipus,   the    cancer,  cold 


—  825  — 

humours,  rheumatism,  King's  evil,  salt-rheum,  the  yellow  and  black  jaundice,  the 
piles,  phtiscial  cough,  hair  lips,  the  bloody  flux,  immoderate  bleeding,  and  the  vene- 
real disease  in  all  its  stages,  without  salivation. 

He  also  acquaints  the  Public  that  he  has  found  some  medicines  which  cure  the 
cancer  without  cutting;  surprising  drops  which  cure  the  gravel,  so  that  the  afflicted 
with  the  same  ma}'  depend  on  being  helped  by  it. 

The  Doctor  prepares  and  sells  extraordinary  good  tooth  drops,  which  cure  the 
toothach  in  one  minute.  Teeth  powder  that  makes  them  as  white  as  snow  in  a  short 
time,  and  cures  the  scurvy  in  the  gums.  Asmatic  pills  which  remove  the  complaint 
in  a  few  minutes;  stomach  pills  in  boxes  with  proper  directions.  He  also  cleans 
teeth  in  the  neatest  manner,  and  sets  artificial  ones.  He  will  wait  on  any  Ladies  or 
Gentlemen  that  will  honor  him  with  their  commands,  at  Mrs.  Elizabeth  Andersons 
in  Broad  Street. 

P.  S. — The  Doctor  has  got  some  herbs  which  cure  the  cholic  in  a  few  minutes." — 
The  Constitutional  Gazette,  Oct.,  18,  1775. 

The  same  newspaper  of  March  9,  1776,  publishes  the  following  item  of  news: 

"  New  York,  March  9.  —  The  famous  Doctor  Dubuke,  a  Frenchman  who  was 
branded  here  last  January  term  for  stealing  indigo  etc.,  departed  last  Thursday  from 
the  city  in  the  Amboy  stage  boat  to  visit  Philadelphia  and  the  southern  colonies. 
He  professes  himself  a  dentist,  and  has  travelled  through  the  eastern  colonies  under 
various  names." 

Probably  the  most  magnificent  piece  of  (conscious  or  unconscious)  medical 
imposture  developed  in  the  western  world  during  the  18th  century  was  the  system  of 
"Metallic  Tractors"  invented  by  Dr.  Elisha  Perkins  (1740-1799)  of  Norwich, 
Connecticut.  Dr.  Perkins,  a  practising  physician  of  intelligence  and  reputed 
integrity  of  character,  professed  by  the  aid  of  two  rods  or  "tractors"  (the  one  of  steel 
the  other  of  brass)  drawn  gently  over  the  affected  part,  to  be  able  to  cure  local 
inflammations,  pains  in  the  head,  face,  teeth,  breast,  side,  stomach,  back,  rheumatism 
etc.  Whether  the  Doctor  was  a  deceiver,  or  himself  deceived,  remains  uncertain. 
At  all  events  he  patented  his  discovery  in  1796,  and,  traveling  about  the  country 
exhibiting  its  marvellous  effects,  soon  excited  great  attention  and  the  utmost  enthusi- 
asm. Thousands  of  cures  were  reported  under  the  influence  of  the  metallic  tractors, 
pamphlets  were  published  in  explanation  of  the  modus  operandi  of  the  new  thera- 
peutic agent,  and  "  Perkinism  "  (as  the  system  was  subsequently  called)  was  fully 
endorsed  by  many  learned  and  intelligent  physicians  and  philosophers.  The  fame  of 
the  new  system  soon  spread  to  Europe.  The  tractors  were  introduced  at  Copenhagen 
in  1798  and  investigated  by  a  committee  of  physicians  and  surgeons,  whose  report 
(published  in  an  octavo  volume)  was  on  the  whole  favorable  to  "  Perkinism  ".  After 
the  death  of  Dr.  Perkins  his  son  secured  a  patent  for  the  tractors  in  England,  and  in 
1804  a  "  Perkinean  Institution"  was  established  in  London  under  the  presidency  of 
the  Right  Honorable  Lord  Rivers.  In  spite  of  the  rose-colored  reports  of  this 
institution  the  imposture  soon  declined,1  and  is  now  remembered  only  as  one  of  the 
numerous  delusions  of  the  past,  recalled,  perhaps,  by  the  more  recent  developments 
of  "  metallotherapy  "  or  Burqism. 

The  first  well-cligested  attempt  to  regulate  the  practice  of  medicine 
and  surgery  in  the  colonies  is  found  in  "An  Act  to  Regulate  the  Practice 
of  Physick  and  Surgery  in  the  City  of  New  York",  adopted  by  the  General 
Assembly,  June  10,  1 7 G 0 .     It  provided 

1. — Its  downfall  in  England  was  largely  due  to  the  experiments  of  Dr.  John  Hay- 
garth  of  Bath,  who  showed  (1799)  that  all  the  phenomena  of  "  Perkinism  "  could 
be  produced  by  wooden  tractors. 


—  826  — 

"That  from  and  after  the  Publication  of  this  Act,  no  Person  whatsoever  shall 
Practice  as  a  Physician  or  Surgeon  in  the  said  City  of  New  York,  before  he  shall  first 
have  been  examined  in  Physic  and  Surgery,  and  approved  of  and  admitted  by  one  of 
his  Majesty's  Council,  the  Judges  of  the  Supreme  Court,  the  Kind's  Attorney  General, 
and  the  Mayor  of  the  City  of  New  York  for  the  Time  being,  or  by  any  three  or  more 
of  them,  taking  to  their  assistance  for  such  Examination,  such  proper  Person  or 
Persons  as  they  in  their  discretion  shall  think  fit.  And  if  any  Candidate,  after  due 
Examination  of  his  Learning  and  Skill  in  Physic  or  Surgery  as  aforesaid,  shall  be 
approved  and  admitted  to  practice  as  a  Physician  or  Surgeon,  or  both,  the  said 
Examiners,  or  any  three  or  more  of  them,  shall  give,  under  their  Hands  and  Seals, 
to  the  person  so  admitted,  as  aforesaid,  a  Testimonial"  etc.  a 

Violations  of  this  act  were  to  be  punished  by  a  fine  of  Five  Pounds  for  each 
offense,  "one  Half  thereof  to  the  Use  of  the  Person  or  Persons  who  shall  sue  for  the 
same,  and  the  other  Moiety  to  the  Church  Wardens  and  Vestrymen  of  the  said  City 
for  the  Use  of  the  Poor  thereof." 

A  similar  act  was  passed  by  the  Legislature  of  New  Jerse}',  Sept.  2Gr 
1772.  This  act,  however,  added,  among  other  things,  the  following  im- 
portant section  : 

"5.  And  be  it  further  enacted  by  the  Authority  aforesaid  :  That  ever}-  Physician, 
Surgeon  or  Mountebank  Doctor  who  shall  come  into,  and  travel  through  this  Colony, 
and  erect  any  Stage  or  Stages  for  the  sale  of  Drugs  or  Medicines  of  any  Kind,  shall 
for  every  such  Offense  forfeit  and  pay  the  sum  of  Twenty  Pounds,  Proclamation 
money;  to  be  recovered  in  any  Court  where  the  same  may  be  cognizable,  with  Costs 
of  Suit ;  one  Half  to  the  Person  who  will  prosecute  the  same  to  Effect,  the  other 
Half  to  the  use  of  the  Poor  of  any  City,  Borough,  Township  or  Precinct  where  the 
Offense  shall  be  committed"  (Wickes). 

Of  American  medical  literature  during  the  18th  century  little  remains 
to  be  said.  According  to  Dr.  John  S.  Billings,  up  to  the  commencement 
of  the  Revolutionary  War  it  consisted  of  one  medical  book  (Dr.  Jones's 
treatise  on  fractures,  already  mentioned),  three  reprints  and  about  twenty 
pamphlets.  After  the  close  of  the  war  most  of  the  literary  contributions 
of  American  physicians  were  contained  in  the  Memoirs  of  the  American 
Academy  of  Arts  and  Sciences,  (Boston,  1785)  and  the  Transactions  of  the 
American  Philosophical  Society  of  Philadelphia.  The  earliest  separate 
work  was  the  "Cases  and  Observations  by  the  Medical  Societ}"  of  New 
Haven  County,  in  the  State  of  Connecticut"  (New  Haven,  1788).  The 
voluminous  writings  of  Dr.  Benjamin  Rush  and  the  works  of  Dr.  William 
Curry  have  been  already  noticed.  Besides  these  James  Tytler's  (1747- 
1804)  "A  Treatise  on  the  Plague  and  Yellow  Fever,  with  an  Appendix-' 
(1799),  "A  Collection  of  Papers  on  the  subject  of  Bilious  Fevers,  prevalent 
in  the  United  States  for  a  few  years  past"  (New  York,  1796)  and  "A  Brief 
History  of  Epidemic  and  Pestilential  Diseases"  &c.  (Hartford.  1799),  the 
latter  two  works  by  the  lexicographer  Noah  Webster  (1758-1843),  deserve 
mention  in  this  connexion  "An  Experimental  Inquiry  into  the  Properties 
of  Opium"  by  John  Leigh  of  Virginia  received  the  Harveian  prize  in  1785, 
and  was  published  at  Edinburgh  in  the  following  year.  —  Of  reprints  and 
translations  of  foreign  works  the  most  important  were  Cullen's  "Lectures 
on  Materia  Medica  "  (Philadelphia,  1775)  and  "First  Lines  of  the  Practice 


—  827  — 

of  Physic"  (Philadelphia,  1781),  Van  Swieten  on  the  Diseases  Incident  to 
Armies,  Ranb}'  on  Gunshot  Wounds  and  Northcote  on  Naval  Surgery  (all 
three  of  which  were  published  in  one  volume,  together  with  the  second 
edition  of  Jones's  "Practical  Remarks",  at  Philadelphia  in  1776)  and  the 
writers  of  the  London  and  Edinburgh  schools,  Brown,  John  Hunter, 
Benjamin  Bell,  Denman,  Smellie,  Hamilton,  Beddoes  and  Robert  Jackson. 
Translations  of  Swediaur  on  Venereal  (New  York,  1788)  and  Blumenbach's 
"Elements  of  Physiology"  (Philadelphia,  1795)  also  appeared. 

The  earliest  medical  journal  to  appear  in  the  United  States  was  en- 
titled "A  Journal  of  the  Practice  of  Medicine  and  Surgery  and  Pharmacy 
in  the  Military  Hospitals  of  France.  Published  by  order  of  the  King. 
Reviewed  and  digested  by  M.  Be  Home,  under  the  inspection  of  the  Royal 
Society.  Annotated  from  the  French  bj'  Joseph  Brown.  No.  1.,  vol.  i, 
New  York:  J.  McLean  &  Co."  This  appeared  about  1790  and  consisted 
of  select  translations  from  the  "Journal  de  Medecine  Militaire",  which  was 
published  in  Paris  from  1782  to  1788.  The  first  original  medical  journal 
of  the  United  States,  however,  was  "The  Medical  Repository",  a  quarterly 
edited  in  New  York  by  Drs.  Elihu  H.  Smith  (1771-1798),  Samuel  L. 
Mitchill  (1764-1831)  and  Edward  Miller  (1760-1812),  which  appeared  in 
1797  and  continued  to  exist  until  1824.  For  seven  j-ears  this  journal  had 
the  field  of  medical  journalism  entirely  to  itself,  until  the  "Philadelphia 
Medical  Museum",  edited  by  Dr.  Coxe,  appeared  in  1804.     (Billings.) 

The  more  important  epidemics  which  prevailed  in  the  colonies  during 
the  18th  century  were,  according  to  Toner  : 

Small-pox,  which  appeared  in  Boston  1701,  1702,  1721,  1730,  1752, 
1764,  1776  and  1792  ;  in  New  York  1721.  1731.  and  1752  ;  Philadelphia 
1730-32,  1736  and  1756;  Charleston,  S.  C.  1700,  1717,  1732,  1738  and 
1760. 

Yellow  fever  in  Boston  1796  and  1798;  New  York  1702,  1732,  1741, 
1743,  1791,  1795,  1798  and  1799;  Philadelphia  in  1741.  1762,  1793,  1797- 
99;  Charleston,  S.  C.  in  1700,  1703,  1728,1732,  1739,  1745,1748,1749, 
1753,  1755,  1758,  1792,  1794,  1795,  1796.  1797.  1799  ;  New  Orleans  in 
1769,  1791,  1793-95,  1797,  1799,  1800. 

Scarlatina  (according  to  J.  Lewis  Smith  first  imported  into  the  United 
States  in  1735),  in  Boston  1702  (?).  1735,  1795  ;  New  York  in  1792-94. 

Measles  in  Massachusetts  1713,  1739,  1769,  1773  ;  New  Fork  17^8  and 
1795  ;  Philadelphia  1771,  1773,  1788,  179(>  ;  Charleston,  S.  C.  1747.  1759, 
1772,  1775. 

Angina  (Diphtheria)  in  Kingston,  N.  H.  1733-35  ;  Boston  1735,  1769; 
New  England  1737,  1742,  1787  etc. 

The  first  quarantine  act1   adopted  in  the  colonies  was  passed  by  the 


No  regular  system  of  quarantine  was  enforced  in  England  until  1710.  In  1720  the 
famous  Dr.  Richard  Mead  was  authorized  to  draw  up  a  system  of  quarantine 
regulations,  which,  after  the  repeal  of  the  act  of  1710,  were  adopted  by  the 
English  government. 


—  828  — 

General  Assembly  of  Pennsylvania  in  1700,  and  was  entitled  "An  act  to 
prevent  sickly  vessels  coming  into  this  government".  It  imposed  a  penalty 
of  £100  on  any  infected  vessel  which  landed  in  the  province.  Other 
quarantine  acts  of  greater  or  less  severity  were  adopted  b}'  Massachusetts 
in  1701,  Virginia  1722,  Delaware  1726,  North  Carolina  1755,  New  York 
1758,  Maryland  1766  etc. 

The  first  general  quarantine  act  adopted  bj-  Congress  was  passed 
Feb.  23,  1799,  and  was  designed  to  be  supplementary  to  the  various  state 
acts.     It  was  entitled  ''An  act  respecting  quarantine  and  health  laws." 

HI 


FOURTH   PERIOD. 


THE  NINETEENTH  CENTURY. 


MEDICINE  FROM  THE  CLOSE  OF  THE   FIRST  FRENCH 
REVOLUTION  TO  THE  PRESENT  DAY. 

HISTORY  OF  CONTEMPORARY   MEDICINE. 


MEDICINE   UNDER   THE   INFLUENCE   OF   REALISTIC 
PHILOSOPHY.     (THE   MEDICINE   OF  SCIENTIFIC 
SPECULATION   AND   OBSERVATION.) 


Tapdffffet  rone  avOpdyitooz  ou  ra 
icpaYfJLOLTa,  aXXa  rd  7cepl  roiv  KpaYfidrutv 
doy/jLara.     Euripides. 

THE  NINETEENTH  CENTURY 

has  become  politically  the  age  of  German  precedence,  a  precedence  founded, 
:as  we  know,  in  our  wars  for  independence,  and  still  requiring  for  its  main- 
tenance and  successful  completion  continued  concord  and  unit}*  of  feeling. 
On  the  other  hand,  until  recently  we  have  stood  in  an  economical  point 
of  view  under  English  influence,  and  we  still  stand  socially,  and  in  scien- 
tific matters  largely,  under  the  influence  of  French  doctrines.  The  tendency 
of  the  medical  culture  of  our  century,  and  of  our  people  especial!}',  seems  a 
■continuation,  indeed  sometimes  an  exaggeration  of  French  medicine,  a 
■science  which  manifested  itself  as  a  school  of  pathological  anatomy  and 
diagnosis,  and  was  established  by  Bichat  as  the  so-called  scientific  or 
exact  medicine.  The  golden  age  of  German  medicine  was  the  18th  cen- 
tury ;  the  19th  has  become  an  era  of  ascendancy  for  French  methods  in 
medical  science. 

The  latter  century,  with  a  nervous  restlessness  and  a  haste  peculiar 
to  our  age,  undertook  those  duties  in  the  historical  development  of  civiliza- 
tion which  had  been  delivered  to  it  by  its  predecessor.  .Accordingly,  first 
of  all,  it  rescued  from  their  former  mediaeval,  ignoble  and  all  too  sub- 
ordinate position,  a  whole  class  of  men  —  and  the  most  numerous  class 
of  all  —  the  so-called  common  people,  heretofore  excluded,  if  not  com- 
pletely, at  all  events  unduly,  from  progressive  culture  and  from  participa- 
tion in  the  enjoyment  of  its  fruits  The  emancipation  of  the  laborer  and 
the  destitute  was  for  ever  accomplished,  on  the  one  hand,  by  the  extension 
of  education  to  the  common  people  through  the  diffusion  of  common- 
schools,  which  had  never  before  existed,  and  which  owe,  indeed,  to  the 
18th  century  their  creation,  but  whose  introduction  and  perfection  is  one 
of  the  most  beautiful  and  most  humane  achievements  of  the  nineteenth  — 
an  achievement  too  which  originated  in  German  lands.  On  the  other 
hand,  this  elevation  of  the  masses  was  due  to  a  higher  recognition  of,  and 
a  greater  respect  for,  ordinary  labor,  and  to  the  better  remuneration  result- 
ing therefrom.  Hand  in  hand  with  these  influences  go  the  efforts  and  the 
achievements  of  our  age  in  the  improvement  of  the  external  life  of  the 
people  in    general,    and    of  individual    peoples.     This    improvement   first 

(831) 


—  832  — 

assumed  in  Germany  —  an  historic  deed  of  wide  prescience  !  —  the  mem- 
orable form  of  an  insurance  of  sick  laborers  by  the  state.1  But  in  the 
programme  of  our  century- — the  establishment  of  the  equalit}"  of  all  men 
before  the  law  —  the  extermination  of  serfdom  and  slavery  is  to  be  re- 
garded as  the  most  humane  part.  In  this  Denmark  made  the  beginning  in 
1803  ;  Russia  finally  followed  in  1862  ;  the  United  States,  amid  "streams 
of  blood  and  tears"  —  the  constant  requirement  of  all  deeds  of  humanity  — 
made  her  record  a  tabula  rasa  in  18b'4,  and  Brazil  completed  the  achieve- 
ments of  the  Western  Continent  in  1888.  Even  in  Africa  and  Asia  the 
abolition  of  slavery  is  in  prospect.  But  the  animal  in  man  continues  its 
activity  in  other  directions.  Pure  humanit}'  can  never  bloom  in  perfection 
on  earth  ! 

The  diffusion  of  education  —  though  undoubtedly  among  the  so-called 
lower  classes  this  was  at  first  trifling  in  amount  and  frequently  an  injurious 
and  even  dangerous  pretence  at  education  —  and  the  diffusion  of  prosperity 
are  indubitabl}*  the  chief  benefits  for  which  the  masses  have  to  thank  the 
present  century. 

Common-schools  are  one  of  the  most  characteristic  achievements  of  our  century, 
whether  regarded  in  themselves  or  in  their  results.  The  pioneers  in  their  introduc- 
tion were  .Toll.  Heinrich  Pestalozzi  (1746-1827)  of  Zurich  and  his  pupils.  Attend- 
ance upon  them  was  first  made  obligatory  in  Germanj',  and  this  custom  spread  thence 
to  other  countries.  To  these  were  added,  as  a  higher  grade,  the  "  Realschulen",  the 
Industrial  Schools  as  special  educational  institutions,  and  the  highest  grade  of  all,  the 
polytechnic  universities.  —  This  diffusion  of  education  is  in  part  also  a  result  of  the 
prodigious,  and  in  many  respects  monstrous,  growth  of  the  daily  press,  which  char- 
acterizes our  age  above  all  ages  since  the  invention  of  printing.  Through  it  all 
modern  life  receives  the  character  of  publicity,  and  is  subjected  to  discussion  in  a 
much  higher  degreee  than  was  the  case  in  any  one  of  the  ancient  republics,  so  notori- 
ous for  their  gossip.  Indeed,  the  very  existence  of  domestic  life,  the  fortress  and 
guarantee  of  a  healthy  community  as  well  as  of  good  morals,  seems  recently  every- 
where endangered  by  this  license,  and  threatens  to  cease.  In  the  production  of  the 
same  result  the  publication  of  books,  as  almost  every  volume  of  the  modern  so-called 
realistic  and  natural  (emotional)  school  proves,  takes  a  still  greater  part.  How  great 
the  activity  of  the  press  has  become  may  be  shown  by  the  single  fact  that  in  Paris 
alone,  books  to  the  value  of  48  millions  of  francs  appear  annually.  Eut  the  diffusion 
of  education  does  not  prevent  too  the  bloom  of  the  grossest  superstition.  Quackery 
under  its  different  forms  and  medical  superstitions  of  all  kinds  are,  in  the  department 
of  medicine,  signs  of  our  time,  which  with  the  utmost  self-consciousness  we  call 
"enlightened".  As  in  the  last  century  "sham-enlightenment"  was  spoken  of,  so  in 
the  present  we  must  speak  of  "  miseducation  "  and  "  overeducation  ".  It  is  likewise 
an  evil  sign  of  the  times  that  the  philosophic  Malthusianism  of  the  18th  cenluiy  has 
been  able  in  the  19th  to  develop  into  the  so-called  Neomalthusianism,  i.  e.  the  artifi- 
cial prevention  of  the  natural  increase  of  population,  and  to  be  even  preached  up  by 
English  and  German  physicians.  While  in  the  18th  century  the  increase  of  popula- 
tion was  the  cry  among  princes  and  authors,  the  former   (and  Bismarck  made  the 

1.  November  1,  1884,  the  day  of  the  introduction  of  this  system,  should  accordingly 
be  celebrated  by  coming  generations  as  a  gala-day  in  honor  of  the  talents  of  the 
Emperor  William  I.  as  a  ruler,  and  the  statesmanlike  genius  of  Bismarck,  so  far 
outstripping  its  time. 


—  833  — 

beginning)  are  now  forced  by  "overpopulation"  to  socialistic  measures  in  politics, 
and  the  latter  into  communistic  theories  and  doctrines. 

In  the  tendenc}7  and  course  of  its  intellectual  development  the  19th 
century  occupies  not  so  much  the  position  of  completing,  as  of  reacting 
realistically  against,  the  idealistic  tone  of  the  preceding  century.  Of  course,, 
beside  this  realism  the  idealistic  spirit  still  enters,  but  it  always  occupies 
the  second  rank,  and  in  no  centur}"  of  modern  times  has  the  ruling  idea 
appeared  so  prominent  as  in  the  present  age,  so  that  opposition  to  realism 
can  scarcely  be  said  to  exist. 

While  the  18th  century,  in  its  cosmopolitism,  regarded  it  as  its  chief 
task  to  rescue  from  the  relics  of  mediaeval  restrictions  and  limitations  the 
life  (and  particularly  the  spiritual  side  of  the  life)  of  the  people,  regarded 
as  an  ideal  whole  with  common  interests,  or  as  humanit}-  ;  while  too  it 
sought  to  attain  its  proposed  objects  in  accordance  with  the  requirements 
of  Idealism,  and  undertook  and  effected,  above  all,  the  legal  emancipation 
of  the  citizen,  the  third  estate,  in  accordance  with  its  formation,  yet  left 
the  material  side  of  life,  and  especiall}-  of  the  life  of  the  masses,  almost 
untouched  to  futurity  ;  so  the  nineteenth  centur}7  struggles  almost  extrav- 
agantl}-  for  the  accomplishment  of  the  economical,  or  rather  the  material, 
demands  of  existence.  The  former  century  dedicated  its  chief  care  to  the 
cultivation  of  the  intellectual,  the  latter  applies  itself  to  the  improvement 
of  the  material  life,  devoting  to  this  purpose  all  its  intellectual  power. 

Accordingly  our  century  places  in  the  foreground  the  individual,  and 
exposes  him  to  the  test  of  freedom,  while  the  18th  century  struggled  for 
both  these  objects  in  the  interests  of  the  body  politic.  The  latter  century 
desired  to  emancipate  the  people  ;  our  own  seeks  to  bring  the  individual 
up  to  the  highest  valuation  and  —  exhaustion  of  his  powers.  Hence  the 
principle  of  the  division  of  labor,  even  in  the  sciences,  where  it  has  intro- 
duced the  often  exaggerated  specialism  of  the  present  day  —  a  specialism 
which  in  practice  degenerates  into  charlatanism  (Specialisterei).  If  in  the 
investigation  and  stud}7  of  the  overgrown  sciences  specialism  is,  in  many 
respects,  useful  and,  indeed,  necessary,  so  is  its  excess,  as  so  often  wit- 
nessed, injurious  and  dangerous  especially  to  the  unity  of  science,  while  it 
forces  practice  into  the  arms  of  an  absolute,  though  concealed  charlatanism. 
It  is  always  too  (as  it  was  in  Egypt)  the  companion  of  a  far  advanced 
civilization,  which  strives  by  over-education  to  resist  decay . 

If  the  last  century  was  a  century  of  struggle  for  true  freedom,  subordinating  the 
individual  to  the  good  of  the  whole,  and  no  longer,  as  heretofore,  to  the  absolutism 
of  rulers  —  the  fruit  of  rudeness  or  of  over-education  and  blind  faith  —  the  peculiar 
tendency  of  our  own  age  is  to  an  unbounded  license,  in  which  the  individual  (or  asso- 
ciation of  individuals)  puts  his  own  claims  before  those  of  the  bod}-  politic,  regards 
the  latter  as  a  disturber  of  freedom  and  of  free  development  and  addresses  to  it  his 
own  arbitrary  demands.  In  this  category  we  include  also  the  Manchester  system 
and  the  self-government  of  individual  professions  and  classes,  inasmuch  as  by  them 
Egoism  is  elevated  into  a  doctrine.  The  18th  century  was  the  birthday  of  modern 
republicanism,  of  parliamentary  government  or  constitutionalism  ;  our  own,  however, 
53 


—  834  — 

we  must  claim  to  be  the  era  of  revolutionary  individualism,  communism  and  socialism. 
The  fruit  of  the  18th  century  was  the  constitutional  co-operation  of  the  educated 
citizen  class  in  an  enlightened  government:  the  fruit  of  our  own  rash  and  too  pre- 
cipitate century,  if,  in  spite  of  a  tendency  to  self-destruction  founded  in  the  very 
essence  of  socialism  itself,  it  should  be  able  to  attain  maturity,  will  develop  as  an 
unbridled  ochlocracy,  a  tyranny  of  the  multitude  based  simply  upon  physical  and 
numerical  superiority,  a  superiority  exerted  to  engross  the  possessions  of  the  other 
classes,  acquired  by  the  previous  labor  and  education  of  long  centuiies,  without  any 
recognition  of  the  just  claims  resulting  therefrom.  As  the  so-called  upper  classes  in 
former  times  generallj"  scorned  common  labor,  so  conversely  it  is  not  recognized  by 
the  socialists  of  the  present  day  as  it  was  in  the  last  century.  Socialism  is  a  result 
of  the  doctrine  of  materialism  popularized  and  puffed  up  into  a  crilerion  of  educa- 
tion, of  a  philosophy  which  in  the  preceding  century  the  upper  classes  alone  embraced, 
but  which  to  the  masses  seems  a  doctrine  of  political  economy.  Hence  the  aim  of 
the  doctrine,  originally  simply  philosophical  (in  a  certain  sense  even  idealistic)  and 
socialistic,  disappears,  and  it  degenerates  into  actual  revolution  and  anarchy.  These 
are  enhanced  by  the  luxury  of  the  rich,  by  stock-jobbing,  universal  and  inoidinate 
militarism,  the  dearth  of  work  resulting  from  machine-labor  etc.,  etc. 

The  over-valuation  of  the  material  is  the  natural  consequence  of  the 
elevation  of  external  life  in  the  19th  century  to  a  pitch  heretofore  unan- 
ticipated, and  of  the  excessive  gratification  of  its  demands,  an  object  for 
which  all  our  physical  and  intellectual  powers  are  set  in  motion.  And  if  a 
century  is  to  be  called  great  in  consequence  of  benefits  to  external  life 
heretofoi'e  unattained,  and  of  the  expenditure  and  development  of  great 
powers  in  the  improvement  and  facilitation  of  that  life,  then  is  our  century 
the  greatest  of  all.  To  the  same  result  contribute  the  numberless  and 
grand  (in  part  at  least)  discoveries  and  inventions  accomplished  through 
the  help  of  the  natural  sciences,  whose  astonishing  growth  has  been  the 
work  of  our  day.  To  the  multitude,  however,  they  seem,  and  serve  onty 
as,  means  for  the  enhancement  of  profit,  and  consequently  of  sensuality 
and  luxur}-,  evils  which  in  almost  all  strata  of  societ}'  have  attained  a 
diffusion  and  a  degree  scarcely  ever  before  reached,  and  which  threaten  to 
divert  man's  strength  entirely  from  his  higher  interests  to  the  sphere  of 
purely  external  enjoyment.  Such,  since  the  existence  of  states  and  people 
developed  into  over-maturit}1,  have  been  the  effects  of  Realism,  or  rather 
of  Materialism,  as  the  result  of,  and  in  union  with,  a  high  development  of 
the  practical  sciences  and  a  highly  cultivated  technics,  both  of  which  ever 
indicate  a  corresponding  decline  in  the  development  of  a  people.  For  con- 
temporaneously with  their  high  perfection  (Alexandria,  Rome  under  the 
Empire  etc.)  the  downfall  of  civilization  has  been  always  introduced,  unless 
events  opposed  some  obstacle  or  brought  forward  a  new  and  more  ideal 
tendenc}'.     When  the  summit  is  reached  all  paths  lead  downwards. 

The  realistic  tendency  of  civilization,  as  a  whole,  in  the  19th  century, 
or  rather  the  reaction  against  the  idealism  of  the  18th,  meets  us  from  the 
very  outset  in  almost  every  department  of  science,  though  the  persistence 
of  idealism  in  some  of  them  reached  down  even  into  the  second  third  of 
our  centur}*.     It  manifested  itself  first  in  France,  whose  Romanic  people 


—  835  — 

seem  capable  of  embracing  but  very  temporarily  the  philosoph}"  of 
Idealism,  which  in  modern  times  has  always  been  substantially  of  German 
origin.  And  Realism  per  se  should  not  be  called  injurious,  so  far  as  it 
supplies  the  necessary  reaction  against  and  supplements  Idealism.  But 
the  fact  that  it  has  fallen  into  one-sidedness  still  more  than  the  latter 
system,  that  it  recognizes  and  admits  the  value  of  itself  alone,  can  be  only 
harmful. 

In  statecraft,  instead  of  republican  constitutionalism,  appeared  the 
absolutism  or  practical  politics  of  Napoleon  I.,  who,  as  we  know,  bore  a 
deadly  hatred  against  all  ':  Ideologues".  This  was  continued  and  increased 
by  the  gifted  Cavour  and  Napoleon  III.,  and  by  Bismarck,  in  this  respect 
the  successor  of  both. 

In  place  of  cosmopolitism  in  politics  appeared  the  so-called  policy  of  nationalities, 
an  expression  of  the  tendency  of  our  centurj-  to  the  individual  and  the  concrete. — 
Even  the  French  during  the  18th  century,  in  opposition  to  their  real  nature,  belonged 
among  the  "furious"  champions  of  cosmopolitism,  the  child  of  humanism.  Hence 
Herder  said  mockingty:  "Manners  and  customs!  how  pitiable,  as  if  there  were  still 
nations  and  national  character;  ....  Indigenous  philosophy!  narrow  circle  of 
ideas  —  constant  barbarism  !  God  be  praised  !  all  national  characteristics  are  extin- 
guished among  us!  we  all  love  each  other,  or  rather  no  one  needs  to  love  another; 
we  associate  with  each  other,  have  the  same  customs,  are  courteous  and  happy  !  We 
have,  indeed,  no  fatherland,  no  kindred  for  whom  we  live,  but  we  are  friends  of 
humanity  and  citizens  of  the  world.  The  monarchs  of  Europe  even  now  all  speak 
French;  soon  we  shall  all  do  the  same!  —  And  then  —  0  bliss!  the  golden  age  will 
once  more  begin  —  where  are  ye,  national  characteristics!"  (See  "Auch  eine 
Phiiosophie  der  Geschichte  der  Menschheit ".)  —  But  in  our  age  it  was  a  Frenchman, 
Napoleon  III.,  who  elevated  "Nationality"  to  the  ruling  principle  in  politics,  though 
of  course  the  French  were  again  to  be  the  "Nationality7",  as  in  the  last  century  they 
were  understood  to  be  "  Humanity".  On  both  occasions  it  was  the  French  doctrine 
which  was  everywhere  extolled.  In  political,  as  well  as  in  ordinary  life  there  pre- 
vails a  deification  of  success,  even  at  the  expense  of  ethics,  and  an  often  brutal 
employment  of  power  l — both  phenomena  not  wanting,  indeed,  in  an  earlier  age,  but 
more  striking  in  our  own  century. 

The  common  people,  with  by  far  the  greater  part  of  the  educated, 
were  during  the  18th  century  (as  generally  subsequent  to  the  Reformation) 
thoroughly  devoted  to  religion,  as  an  ideal  good,  and  accordingh-  stood 
under  the  influence  of  the  only  Idealism  which  they,  as  a  rule,  recognize 
and  cultivate.  The  intellectual  characteristic  of  the  19th  century,  Realism 
and  Materialism  (and  Nihilism,  Socialism  and  Anarchy,  which  spring  from 
both),  on  the  other  hand,  impresses  its  stamp  not  onl}T  upon  theology, 
which  in  a  certain  sense  it  even  benefits,  but  also  —  and  here  comes  in 
the  actual  injury  —  upon  the  religious  side  of  the  life  of  the  people.  The 
masses  incline  to  these  doctrines,  have  an  unmistakable  tendency  to  irre- 
ligion,  or  in  other  words  their  Idealism  is  meeting  destruction  at  the  hands 
of  Materialism. 

1.  It  would  be  ludicrous  to  exemplify  tins  statement  by  Ernst  Schweninger,  as  the 
matter  is  of  too  little  importance  ;  still  he  ought  to  be  mentioned,  since  his 
activity  is  displayed  in  the  sphere  of  medicine. 


—  83b"  — 

This  is  not  contradicted  by  the  religion  of  creed  and  letter  wbich  has  recently 
become  so  prominent,  and  in  which  even  positivism  endeavors  to  replace  the  lack  ui 
an  inner  acceptance  of  the  religious  idea.  The  success  of  the  materialism  of  Feuer- 
bach  and  Strauss  is  a  loud  witness  to  the  decay  of  popular  life  in  a  religious  point  oi 
view.  —  The  Christian  religion  was  most  idealistic  and  —  most  powerful  during  the 
short  period  when  the  doctrines  of  its  founder  were  not  yet  forged  into  unbending 
creeds.  With  the  latter  began  substantially  its  destruction,  and  only  the  Chinese 
rigidity  of  the  Catholic  doctrine  and  regulations  (mistaken  by  many  for  admirable 
and  grand,  while  they  merely  assure  its  permanence),  as  well  as  the  later  subjection 
of  its  servants  to  the  despotism  of  the  unnatural,  their  internal  demoralization  and 
the  artificial  maintenance  of  stupidity  among  the  people —  a  crime  in  which  the  tem- 
poral authorities  must  share  the  blame  —  preserved  the  structure  from  falling.  Prot- 
estantism was  substantially  nothing  but  an  idealistic  reaction  against  Positivism  and 
Realism,  in  other  words  against  rigid  faith  in  dogma.  It  led  —  or  should  have  led  — 
Christianity  back  to  the  ideas  upon  which  it  is  based,  and  only  so  far  as  it  did  this 
was  it  vigorous  and  effective.  It  too  has  now  lapsed  into  Realism,  the  product  of 
Rationalism,  or  among  the  orthodox  in  a  very  large  degree  into  pure  faith  in  creeds. 
The  civilized  people  of  Antiquitj",  however,  began  to  perish  when  their  masses  brgan 
to  withdraw  from  their  adherence  to  the  prevalent  religious  Idealism  and  to  lapse 
into  a  skeptical  and  nihilistic  Materialism,  however  different  its  fashion  from  that  of 
the  present  day.     This  is  a  sign  of  waning  civilization. 

Realism,  in  the  shape  of  an  inclination  to  seize  the  actual,  while  dis- 
regarding the  speculative  in  form,  the  tendency  towards  the  real  at  the 
expense  of  the  ideal,  shows  itself  in  our  century  even  in*  the  various  depart- 
ments of  art,  in  all  of  which  a  realistic,  reproductive  and  representative 
method  prevails  to-day,  quite  in  contrast  to  the  idealistic  and  productive 
activity  of  the  last  century. 

In  art,  in  accordance  with  the  constitution  of  that  department,  this  idealistic 
tendency  continued  longest.  Yet  compare  the  ideal  forms  of  the  poesy  of  a  Schiller 
or  a  Goethe  (though  the  latter  in  many  of  his  poems  already  favored  the  transition  — 
the  "two  souls  in  his  breast'"  are  symbolic  of  the  struggle  which  prevailed  between 
the  two  tendencies  within  him)  with  the  realistic  conceptions  and  exhibitions  of  the 
modern  drama.  A  few  only  form  an  exception  to  the  rule,  though  even  these  are 
forced  to  recognize  the  realistic  tendency.  Tragedy,  the  ballad  and  similar  species 
of  composition,  to  which  ideal  creations  have  always  been  chiefly  adapted,  have  lost 
their  popularity  almost  entirely,  while  romances,  novels,  plays  founded  upon  adultery 
etc.,  as  creations  of  the  day  and  thoroughly  realistic  in  presentation,  are  quite  in 
vogue.  Indeed  this  is  so  far  the  case  that  we  now  speak  of  a  "  realistic  school "  as 
we  used  to  speak  of  a  classical  or  romantic  school.  In  sculpture  the  forms  of  a 
Canova  (1757-1822),  a  Dannecker  (1758-1841),  a  Rauch  (1777-1857)  and  others 
furnish  objects  for  comparison  with  the  realistic  (in  a  good  sense)  specimens  of 
E.  Rietschel  (1804-1861)  and  his  school.  Painting,  as  is  well  known,  likewise  culti- 
vates the  realistic  tendency,  often,  indeed,  the  open  cultivation  of  the  senses  and  of 
sensuality,  naturalism,  brutalism  and  sensationalism.  Finally  in  music  the  same 
thing  is  seen  in  Richard  Wagner  and  his  school,  to  saj'  nothing  of  Offenbach.  — 
Meritorious  as  this  realistic  reaction  against  a  one-sided  Idealism  maj'  be,  it  must' 
not  be  forgotten  that  in  its  excess  it  drags  mankind  down  to  the  triteness  of  every 
day  life,  instead  of  elevating  it,  though  such  elevation  has  ever  been,  and  must  always 
be,  the  duty  of  art,  if  it  is  to  be  art  in  reality. 

In  the  sciences  realism  has  the  upper  hand,  manifesting  itself  partly 


—  837  — 

by  a  one-sided  cultivation  of  the  inductive  method  — -  to-day  we  attempt  to 
construct  even  a  s}*stem  of  "inductive  morality"!  —  and,  on  the  other 
hand,  appearing  as  a  realistic  and  natural  conception  and  explanation  of 
their  scope,  so  far  as  the  latter  permits,  and  b}1  a  preference  for  the  prac- 
tical sciences.  The  predominant  cultivation  of  the  natural  sciences  in  our 
age  is  both  an  expression  and  a  cause  of  the  intellectual  peculiarity  of 
our  century,  and  the  characteristic  tendency  of  the  latter  to  individualism, 
instead  of  the  universalism  of  the  last  century,  expresses  itself  in  the 
general  cultivation  of  branches,  or  the  division  of  each  science  into  an 
ever  increasing  number  of  special  departments,  that  specialism  which 
originated  in  France  though  it  does  not  reach  its  acme  in  that  country. 
This  specialism,  particularly  in  medicine,  threatens  to  degenerate  into 
charlatanism  (Specialisterei)  in  science  and  practice,  and  thus  there  is 
danger  that  the  connexion  between  the  individual  and  separate  offshoots 
and  the  parent  stem  may  be  lost,  and  dexterity  and  routine  in  particulars 
may  take  the  place  of  thoughtful,  organic  comprehension  of  the  whole. 

Another  peculiarity  of  the  medicine  of  the  present  day,  the  almost  exclusive 
study  of  the  present,  whose  trifling  services  are  frequently  overestimated,  is  mani- 
festly connected  causatively  with  the  phenomenon  last  mentioned;  for  science,  thus 
subdivided,  no  longer  seeks  connection  with  science  as  a  whole,  and  has  no  faith  in 
it,  because  the  branches  newly  separated  from  the  parent  stock  are  regarded  as  so 
many  actually  new  sciences,  particularly  as  the  new  remedies  and  facts  which  our 
age  has  undoubtedly  supplied  in  magnificent  abundance,  favor  this  appearance  of 
complete  novelty.  Data  for  the  history  of  these  individual  branches,  wrested  chiefly 
from  their  historical  connexion,  render  obscure  their  historical  union  with  the  higher 
achievements  of  medicine  as  a  whole,  and  impart  to  the  early  histor_y  of  these  branches 
a  fragmentary  or  disconnected  air;  so  that  to  begin  the  connected  history  of  the 
latter  with  the  present  time  must  make  the  past  seem  of  little  importance,  or  even 
utterly  useless.  To  the  specialism  of  the  present  day,  which  obtrudes  itself  upon  us 
in  most  extensive  and  utterty  unorganized  cj'clopaedias,  produced  by  dozens  of 
co-laborers,  and  has  totally  displaced  the  universalism  of  the  earlier  writers  by  which 
the  physicians  of  the  last  century  still  distinguished  themselves,  is  doubtless  to  be 
largely  ascribed  that  want  of  interest  in  medical  history  which  is  so  plainly  manifest. 
For  when  we  depreciate  the  connexion  of  a  science,  we  begin  substantial!)'  to  deny 
its  history. 

Over  the  medicine  of  the  present  day  the  natural  sciences,  the 
daughters  of  medicine,  have  attained  a  control  still  more  absolute  than 
was  the  case  during  the  17th  centuty,  the  realistic  predecessor  of  our  own 
age.  This  is  particularly  manifest  from  the  fact  that  we  take  the  natural 
sciences  not  only  for  our  model  (which  would  certainly  be  advantageous), 
but  for  our  sole  model  in  the  treatment  of  medical  subjects.  Indeed  so  far 
is  this  the  case  that,  in  accordance  with  the  programme  of  Bichat.  we  call 
medicine  actually  a  natural,  exact  or  experimental  science.  Hence  the 
criticism  of  Buckle  regarding  the  cultivation  of  the  natural  sciences  is 
applicable,  mutatis  mutandis,  to  medicine  :  "  It  cannot  however  be  con- 
cealed that  they  manifest  an  inordinate  respect  for  experiments,  an  undue 
love  of  minute   detail  and  a  disposition  to  over-estimate  the  inventors  of 


—  838  — 

new  instruments  and  the  discoverers  of  new,  but  often  insignificant  facts. 
.  ..."  In  vain  do  we  demand  that  they  (the  details)  should  be  generalized, 
and  reduced  into  order."  ....  "  We  want  ideas,  .and  we  get  more  facts. 
We  hear  constantly  of  what  nature  is  doing,  but  we  rarely  hear  of  what 
man  is  thinking."  ....''  We  are  in  the  predicament,  that  our  facts  have 
outstripped  our  knowledge,  and  are  now  encumbering  its  march."  The 
same  author,  whose  opinion  is  of  weight  as  that  of  one  who  regards  the 
matter  from  a  stand-point  none  too  close,  thinks :  "  The  magnificent 
generalizations  of  Newton  and  Harvey  could  never  have  been  completed  in 
an  age  absorbed  in  one  unvarying  round  of  experiments  and  observations." 
The  cultivation  of  the  inductive  method,  which  in  the  natural  sciences 
leads  only  apparently  to  the  desired  object,  likewise  proves  this. 

Only  apparently,  I  say,  because  the  deductive  principles  of  the  latter  —  affinity, 
atoms  (a  well-known  philosophical  doctrine  of  Dernocritus),  molecular  forces,  gravity, 
motion  etc.  —  are  not  made  sufficiently  prominent,  or  these  very  axioms  brought  for- 
ward a  priori  are  counted  as  realistic  discoveries.  That  they,  however,  have  stood 
the  test  of  induction  was  a  result  very  much  more  easily  accomplished  in  the  natural 
sciences  than  in  medicine,  because  the  objects  of  the  former,  simple  and  permanent 
in  their  nature,  are  not  subjected  to  constant  changes  of  vital  activity,  like  the 
more  highl}"  organized  beings  endowed  with  life  and  subjected  to  continual  develop- 
ment. 

In  our  medicine  of  the  present  day  we  do,  indeed,  discard  the  great 
hypotheses  of  an  earlier  age,  which  in  the  form  of  theories  embraced  the 
whole  of  science,  but  in  their  place  we  cultivate  numerous  minor  theories, 
which  frequently  we  do  not  regard  as,  and  will  not  admit  to  be,  hypotheses. 
The  foundations  and  preliminaries  of  our  knowledge  of  the  living  organism, 
acquired  through  and  by  means  of  the  natural  sciences,  experiments  etc., 
often  pass  for  the  actual  essence  of  that  organism,  as  the  laws  of  life  and 
its  phenomena  —  laws  which  will  remain  metaphysical  so  long  as  the 
spirit,  at  once  the  creator  and  the  object  of  science,  is  metaphysical. 

As  regards  the  actual  foundations  of  science  (without  which  medicine 
would  remain  a  tottering  structure,  unreliable  enough,  had  not  much  of 
importance  been  brought  to  light),  our  knowledge  has  been  greatly 
advanced.  Such,  however,  is  not  the  case  with  our  systematic  insight  into 
the  over-luxuriant  mass  of  material  which  has  been  collected.  Facts  have 
been  "gathered  to  excess  ;  yet  the  error  of  our  profusion  has  become  the 
occasion  of  our  indigence"  (Bacon).  Such  is  the  fact  in  the  present  case. 
We  see  the  whole  before  the  individual ;  or  rather  we  no  longer  see  the 
connexion  of  the  details,  because  leading  principles  for  the  scientific 
masteiy  of  this  immense  material  in  facts  scarcely  anywhere  exist.  These 
principles,  if  henceforth  we  regard  medicine  as  a  natural  science,  will  be 
found  — at  least  this  is  the  teaching  of  the  history  of  all  sciences  —  only 
by  wa}-  of  synthesis,  a  method  certainly  the  peer  of  anabysis,  and  not  sub- 
ordinate to  it,  as  has  become  almost  an  article  of  faith.  To  create  deduct- 
ive principles  for  the  mass  of  actual  material  already  collected  will  un- 
doubtedly be  the  struggle  of  an  historically  necessary,  and  therefore  inev- 


—  839  — 

itable  reaction  against  one-sided  Realism.  We  hope  that  the  impulse  to 
this  reaction  may  proceed  from  Germany  !  Perhaps  experience,  acquired 
inductively,  and  deductive  thought  may  this  time  succeed  in  so  uniting, 
that  the  results  of  both  may  correspond,  and  the  highest  grade  of  certainty 
which  human  knowledge  can  attain  may  thus  be  imparted  to  medicine  also. 
This  would  likewise  imply  a  return  to  the  demands  of  Bacon,  "The  main 
point  continues  to  be  the  light  of  new  principles,  which  from  single  threads 
lead  with  certainty  back  to  others",  and  to  the  claims  of  the  great  phil- 
osopher and  ph3'sician  of  Cos  : 

"  To  attain  the  highest  degree  of  precision  in  the  peculiar  indeflnite- 
ness  of  the  subjects  of  our  art  is,  of  course,  difficult.  And  }ret  many 
medical  cases  require  this  grade  of  precision.  Accordingl}T,  I  am  far  from 
asserting  that  we  should  discard  the  old  (i.  e.  philosophic)  medicine,  as 
non-existent  or  useless,  because  it  is  not  always  satisfactory.  For  by 
reflection  alone,  in  1113'  opinion,  we  can  also  approximate  the  truth,  and  it 
is  wonderful,  indeed,  to  what  excellent  and  important  knowledge  we  have 
arrived  in  this  way,  and  not  by  chance."     (See  Haeser,  2d.  edition,  p.  50). 

The  shadows  of  man's  spiritual  life  too  are  as  little  lacking  in  the 
century  of  "education"  and  Realism,  as  the}'  were  in  the  age  of  Idealism 
and  "enlightenment"  in  medicine.  In  this  connexion  we  mention  only 
Mesmerism  or  animal  magnetism,  which  continued  to  haunt  us  down  in  to 
the  second  half  of  the  present  century  ;  Somnambulism,  Spiritualism,  to 
which,  singularly  enough,  men  like  Wallace,  Maximilian  Perty,  Crodkes, 
Varle}'  (the  Englishmen  among  these  were  members  of  the  Royal  Society), 
Zbllner,  Weber  and  others,  were  devoted.  We  raaj  notice  the  religious 
fraud  of  the  miraculous  cures  at  Treves.  Lourdes,  Marpingen  etc.,  to  say 
nothing  at  all  of  table-turning,  infallibility  and  all  the  superstition  which 
still  secretly  prevails  in  medical  matters  among  high  and  low.  The  most 
highly  educated  were,  as  we  know,  Irv  no  means  exempt  from  the  belief  in 
Mesmerism,  the  infallibility  of  a  man  etc.,  and  a  considerable  portion  of 
mankind,  from  that  day  to  this,  has  more  readily  followed  impostors  and 
fools  than  the  light  of  reason,  even  when  perfectl}'  able  in  other  respects 
to  make  use  of  the  latter. 


1.    INFLUENCE  UPON  MEDICINE  OF  PHILOSOPHY,  THE  NATURAL  SCIENCES, 

TECHNICS,  THE  PRESS,  LEARNED  ASSOCIATIONS 

AND  THE  UNIVERSITIES. 

That  philosoph}'  has,  from  the  outset,  exercised  a  great  influence  upon 
medicine,  originally  as  a  part  of  this  science  and  subsequently  rather  as  a 
principle  in  the  treatment  of  its  subjects,  as  a  dispenser  of  the  method  of 
investigation,  is  proven  by  the  whole  past  history  of  medical  art.  Only  in 
the  centuries  of  the  modern  period  it  has  happened  conversely  that  the 
products  of  medicine,  i.  e.  of  her  daughter  branches,  the  natural  sciences, 
have  maintained  great  influence  upon  philosophy. 


—  840  — 

In  the  18th  century  finally  the  views  of  Cabanis  and  the  Vitalists,  of 
Condillac  and  of  Bichat  showed  especially  this  mutual  influence  of  the 
two  branches  of  science  upon  each  other.  And  the  most  recent  tendency 
in  medicine  likewise  stands  under  the  influence  of  the  Frenchmen  last 
mentioned,  and  demands  obedience  to  the  pure  Baconian  principles.  Bacon, 
however,  by  no  means  regarded  the  perquisition  of  the  actual  as  the  ultimate 
object  of  science,  but  rather  called  it  the  way  toward  the  end  of  causal 
knowledge.  He  considered  observation  and  registration  of  facts  the  pre- 
liminaries and  prelude  to  this  knowledge,  but  the  chief  object,  the  con- 
clusions which  the  mind  by  the  aid  of  these  draws  with  reference  to  the 
final  causes  of  things.  Nor  would  he  finish  with  observation  of  the  senses 
as  such,  nor  remain  satisfied  with  the  products  of  such  observation. 

If  the  dualism  of  Kant,  who  accepted  the  real  and  the  ideal  side  by 
side,  had  no  direct  influence  upon  medicine,  although  J.  Jac.  Bernhardi, 
professor  in  Erfurt,  1805,  employed  his  doctrines  in  the  definition  of  health 
and  disease,  still  less  could  this  be  the  case  with  the  Idealism  of  J.  G. 
Fichte  (1762-1814),  who  brought  forward  the  "Ego"  as  the  creative  prin- 
ciple, and  the  world  as  its  image,  i.  e.  the  image  of  God.  The  influence 
which  the  philosoph}-  of  the  physician 

F.  W.  J.  von  Schelling  (1775-1854)  exercised  upon  medicine  was, 
however,  much  greater.  This  philosophy  (in  opposition  to  the  critical 
tendency  of  Kant,  which  promoted  in  Germany  the  enlightement  of  the 
18th  century),  like  that  of  Spinoza,  taught  the  equalit}-  of  the  real  and  the 
ideal.1 

This  philosoph}^,  in  its  day  regarded  almost  as  a  revelation  from  heaven,  but  in 
fact  merely  a  beatifying  "philosophy  of  identity",  takes  for  its  starting  point  the 
absolute  unity,  the  All,  identical  with  God,  the  self-willing,  self-affirming,  who  only 
reveals  himself  but  cannot  be  cognized.  "The  eternal  purity  in  eternal  plenitude  and 
the  eternal  plenitude  in  eternal  purity  is  God,  eternal  affirmation  as  well  eternally 
affirmed  by  himself,  in  a  way  absolutely  simple  and  indivisible.  God  is  therefore  the 
indifference  of  ideal  and  real,  soul  and  body,  the  identity  of  subjectivity  and  objectivity. 
.  .  This  absolute  identity  of  the  subjective  and  objective  is  not  the  peculiarity, 
the  essence  of  God,  but  is  rather  the  essence  of  all  things,  the  absolute  generality, 
without  all  dualism."  What  Schelling  regards  as  cognition  of  the  All  is  accom- 
plished by  reason.  In  it  is  everything  and  outside  of  it  is  nothing.  Reason  is  regarded 
as  a  special  force  by  which  we  effect  that  cognition,  as  an  idea  of  God,  as  general 
cognition.  The  understanding,  on  the  other  hand,  is  a  faculty  which  separates 
things,  upholds  the  unit}',  and  "has  also  no  part  in  the  idea  of  the  absolute.''  —  The 
eternal  in  matter,  as  "unity  in  totality",  is  weight,  but  the  eternal,  as  "totality  in 
unity",  is  light;  the  copula  of  both  is  the  essence  of  things,  which  begets  matter. 
The  latter  manifests  itself  in  these  three  dimensions — weight,  light  and  identity  of 
both.  A  symbol  of  weight  is  the  solid,  of  light  the  air,  of  the  copula,  water.  Like- 
wise in  the  organism  there  are  three  dimensions  ":  reproduction,  irritability  and  sen- 
sibility. The  identity  of  these  is  the  essence  of  the  organism,  the  organism  itself. 
Health,  however,  is  the   harmony  of  these  dimensions.     "Disease  is  the  alteration 

1.  Compare  "  Uimisse  zur  Kritik  der  neueren  deutschen  Medicin  "  (Munich,  1851), 
by  Dr.  H.  Rohlfs,  author  of  the  "medicinischen  Classiker  Deutschlands",  Stuttgart. 
Enke. 


._  841  — 

of  dimensions  of  the  organism,  by  which  it  ceases  to  be  a  pure,  untroubled  reflex  of 
the  All,  an  originally  perfectly  qualitative  affection." 

This  "system"  was  altered  in  accordance  with  individual  views  by  Schelling's 
pupils,  most  of  whom  where  pl^sicians,  and  particularly  the  "polarities",  with  their 
corresponding  "indifferent  points",  were  substituted  for  the  few  dimensions  of 
Schelling.  These  polarities  were  accounted;  sensibility  —  irritability  —  subjectivity 
—  objectivity,  electricity  —  magnetism,  oxygen  —  hydrogen,  acid  —  alkali  etc.,  and 
the  whole  thing  finall}'  degenerated  into  a  farce,  in  which,  as  ideas  were  lacking, 
words  the  more  easily  took  their  place. 

The  pure  Rationalism  of  G.  W.  Fr.  Hegel  (1770-1831),  whose  supreme 
principle  was  "  absolute  reason ",  of  which  religion  was  regarded  as  a 
representation  —  the  controversies  arising  over  this  question  afforded 
support  to  our  Materialism  of  the  present  day,  though,  on  the  other  hand, 
they  called  forth  an  orthodox  reaction  —  had  no  demonstrable  direct 
influence  upon  medicine,  except  perhaps  in  the  historical  writing  of  this 
department,  in  which  was  still  mingled  the  style  of  the  romancists.  Yet 
modern  Materialism  must  be  regarded  as  an  emanation  of  the  Hegelian 
philosophy,  and  has  found  its  most  spirited  and  influential  representative 
in  Ludwig  Feuerbach  (1804-1872),  and  its  medical  champions  in  the 
Dutchman  Jac.  Moleschott  (born  1822),  professor  in  Turin  and  Rome, 
Karl  Vogt  (born  1817),  professor  in  Geneva,  Louis  Riichner  (born  1824) 
professor  in  Darmstadt,  and  others. 

The  "exact"  philosophy  of  Joh.  Friedrich  Herbart  (1776-1841) 
depends  upon  subjective  experience,  which  is  supposed  to  direct  thought. 
Experience  is  the  foundation  of  philosophy,  and  the  beginning  of  philo- 
sophy- is  skepticism,  while  metaphysics  particularly  is  called  a  science  of 
experience.  This  doctrine  was  applied  to  medicine  b\-  the  medical  philo- 
sopher Rud.  Herm.  Lotze  (1817-1884),  professor  in  Gottingen. 

The  latest  philosophy.  "  Philosophy  of  the  Unconscious  ",  of  Ed.  von 
Hartmann  (born  1842),  which  depends  upon  the  results  of  the  natural 
sciences  and  embraces  Darwinism,  is  an  expansion  and  completion  of 
Arthur  Schopenhauer's  (1788-1860)  pessimism  and  doctrine  of  the  will. 
The    natural    philosophy   of   Charles  Darwin1    (1809-1882),    grandson  of 

1.  Charles  Eobert  Darwin,  son  of  the  physician  Robert  Waring  Darwin,  was  born  in 
Shrewsbury,  received  his  early  education  in  his  native  city,  and  from  the  age  of 
16  years  studied  in  Edinburgh  and  Cambridge.  In  1831  he  received  his  degree  of 
Master  of  Arts,  went  in  the  same  year  on  a  journey  around  the  world  and  on  this 
occasion  conceived  in  is:;:;  the  first  ideas  of  his  system.  This  in  1836  he  denned 
more  precisely  as  a  common  descentof  species.  His  chief  work  ("On  the  Origin  of 
Species",  1859),  was  translated  into  all  modern  languages  and  reached  in  England 
itself  six  editions  and  72,000  copies.  In  187J  appeared  "The  Descent  of  Man, 
and  Selection  in  Relation  to  Sex  ",  and  in  1872  "The  Expression  of  the  Emotions 
in  Man  and  Animals".  Darwin  married  in  1839,  had  five  sons  and  two  daugh- 
ters, and  from  1842  resided  upon  his  estate  Down,  in  Kent.  He  is  buried  in 
Westminster  Abbey,  and  his  coffin,  like  the  metallic  plate  on  Harvey's  grave, 
bears  the  inscription:  "Charles  Robert  Darwin,  born  Feb.  12,  180.9  ;  died  April 
Kith,  1882."  Besides  Darwin's  predecessors,  Goethe  and  Lamarck,  he  is  said  to 
have  had  others  among  the  Indians,  in  Aristotle,  Ovid,  and  even  among  the 
Babylonians. 


—  84l>  — 

Erasmus  Darwin,  often  regarded  as  a  pure  science  of  nature,  is  founded 
upon  scientific  investigation  and  an  ingenious  employment  of  individual 
results.  Although  based  up  to  the  present  time  upon  few  facts,  and  in 
spite  of  the  skepticism  of  our  age,  it  finds  almost  general  acceptance.  Its 
gaps  are  bridged  over  by  numerous  hypotheses,  indeed,  by  fanciful  theories 
which  have  originated  far  more  with  his  followers  than  with  Darwin  himself, 
who  was  extremeby  cautious  in  his  conclusions.  Aided  by  such  h}-potheses, 
Haeckel  formed  his  complete  natural  philosophical  system,  often  design- 
ated "  Haeckelism ",  a  system  constructed  with  dialectic  dexterit}-  and 
possessing  as  man}r  admirers  as  opponents.  In  it,  in  accordance  with  the 
programme  and  bent  of  our  age,  and  influenced  by  the  eminently  popular 
style  of  its  author,  all  the  cultivated  were  able  to  participate,  as  if  it  were  a 
"  new  faith".  Recently  a  natural  philosophical  sect  in  medicine  too  seems 
to  be  coming  forward. 

In  France  the  philosophy  of  A.  Comte  (1798-1857),  '-Positivism", 
embraced  also  by  Littre  (1801-1881),  a  pupil  of  Comte,  acquired  some 
influence  in  medicine.  It  contrasts  strongly  with  the  German  idealistic, 
utterly  materialistic  and  atheistic  natural  philosophy  of  Schelling.  Comte 
required  of  philosophy  only  that  it  should  work  out  the  general  ideas  and 
the  results  of  the  other  sciences.  To  search  after  causes  and  objects  was 
not  its  dut}T.  His  most  important  follower  was  Claude  Bernard,  though 
the  whole  "  exact "  school  of  France  is  based  upon  his  teachings. 

Comte  himself  was  a  pupil  of  Count  Claude  Henri  de  St.  Simon  (died  1825),  the 
father  of  modern  socialism  and  communism,  whose  "religion",  gathered  from  his 
letters,  was  not  known  until  1803. 

When  medicine  declares  that,  at  the  present  day,  it  stands  under  the 
influence  of  no  system,  this  statement  is  an  error,  for  it  follows  realistic 
and  materialistic  doctrines  as  strongly  as  it  ever  did  those  of  natural 
philosophy.  We  must,  therefore,  regard  the  tendency  of  "medical  thought" 
at  the  present  day  as  just  as  one-sided  as  it  ever  was  before  under  the 
control  of  any  other  system.  The  watchword  "natural  scientific  tendency" 
merely  veils,  but  does  not  take  away,  its  philosophical  principles,  and 
so,  our  ridicule  of  the  earlier  medical  systems,  is  quite  unjustifiable. 
"  Modern  "  medicine  embraces  nothing  but  a  theorem  of  investigation  by 
the  senses  ! 

That  the  influence  of  the  natural  sciences  upon  medicine,  from  which 
they  were  not  completely  separated  until  the  19th  century,  must  in  our  age 
be  extensive,  may  be  inferred  from  the  effect  of  these  sciences  upon  the 
general  culture  of  the  present  day.  It  is  demonstrable  too,  even  in  par- 
ticulars, that  in  most  directions  this  influence  has  been  favorable,  though 
it  has  not  been  always  and  in  all  directions  advantageous  to  medical  art, 
especially  as  Virchow  himself  voluntarily  declared  at  the  fifteenth  meeting  of 
"Naturalists",  that  the  natural  sciences  could  be  studied  and  comprehended 
only  imperfectly  by  physicians. 

Even  Goethe  understood  this:     "  In  all  our  academies  we  attempt  far  too  much. 


—  843  — 

.  .  .  In  earlier  times  lectures  were  delivered  upon  chemistry  and  botany  aa 
branches  of  medicine,  and  the  medical  student  learned  enough  of  them.  Now,  how- 
ever, chemistry  and  botany  are  become  sciences  of  themselves,  incapable  of  com- 
prehension by  a  hasty  survey,  and  each  demanding  the  study  of  a  whole  life,  yet  we 
expect  the  medical  student  to  understand  them.  He  who  is  prudent,  accordingly 
declines  all  distracting  claims  upon  his  time,  and  limits  himself  to  a  single  branch 
and  becomes  expert  in  one  thing." 

Thus  the  discoveries  and  doctrines  in  the  department  of  botany,  the 
eldest  daughter  of  medicine,  became  in  a  double  sense  of  controlling 
influence  in  the  department  of  medicine.  On  the  one  hand,  they  created  a 
better  knowledge  of  the  natural  history  of  existing  medicinal  plants  and 
revealed  new  plants,  which  were  required  to  first  pass  the  test  of  the 
chemical  laboratory  before  being  admitted  to  the  sick-bed.  On  the  other 
hand,  they  led  to  a  new  classification  of  plants  into  "natural  families".  Tn 
the  latter  respect  the  natural  systems  of  the  physician  Augustine  Pyrame 
de  Candolle  (1778-1841)  of  Geneva,  and  his  son  Alphonse,  and  of  the  great 
Viennese  botanist  Stephan  Ladislaus  Endlicher  (1804-1849),  like  the  arti- 
ficial system  of  Linnaeus  in  the  last  century,  manifestly  called  into  exist- 
ence the  so-called  natural  historical  school  of  medicine.  Moreover  the 
discovery  of  plant-cells  (1838)  by  Matth.  Jakob  Schleiden  (1804-1881) 
of  Hamburg,  professor  in  Jena  and  Dorpat  and  finally  in  Frankfort-on-the- 
Main,  who  (according  to  Rohlfs)  announced  the  discovery  already  fore- 
shadowed by  Oken  (1805)  and  Heinrich  Baumgartner  (1830)  in  their  cell- 
theories,  and  the  almost  contemporaneous  discovery  of  animal  cells  by 
Thomas  Schwann,  became  in  the  course  of  time  the  origin  of  our  most 
recent  cellular  Vitalism,  and  of  the  unit}'  in  our  conception  of  organic  life. 
Finally  microscopic  botany,  through  Schwann's  discovery  of  the  influence 
of  lower  fungi  in  the  production  of  fermentation  and  putrefaction,  called 
forth  in  medicine  and  surgen-  the  most  recent  theor}-  of  infectious  fungi, 
upon  which  Darwinism  likewise  exercised  some  influence. 

From  the  large  number  of  eminent  botanists  of  our  own  century,  which  matured 
the  physiology  of  plants,  we  may  mention,  beside  those  already  noticed,  the  follow- 
ing: Jean  Baptiste  Antoine  Pierre  de  Lamarck  (1744-1829),  the  predecessor  of 
Charles  Darwin  and  during  his  life  derided  as  a  fool,  and  Gothe,  who  may  also  be 
counted  among  Darwin's  predecessors;  David  Heinrich  Hoppe  (1760-1846),  first  an 
apothecary;  then  a  physician,  who  with  E.  Willi.  Martius  (1756-1849),  professor  in 
Erlangen  (father  of  the  famous  South  American  traveller  and  botanist  C.  Ph.  von 
Martius,  1794-1868,  in  Munich)  and  Stallknecht,  all  three  at  that  time  apothecary's 
assistants  in  Regensburg,  founded  in  1790  the  "  Botanische  Gesellschaft"  and  the 
journal  "Flora";  the  famous  Heinrich  Adolph  Schrader  (1756-1836)  in  Gottingen 
and  the  equally  eminent  Heinr.  Friedr.  Link  (1769-1851),  in  Berlin;  Christ.  Gottfr. 
Nees  von  Esenbeck  (born  1776)  in  Breslau,  and  his  brother  Th.  Friedr.  Ludwig 
(1787-1837),  both  from  Reichenberg  near  Erbach ;  Heinr.  Gottl.  Ludw.  Reichenbach 
(1793-1879)  in  Dresden;  Willi.  Dan.  Jos.  Koch  (1771-1849)  of  Kusel  in  the  Palat- 
inate; Phil.  Bruch  (1781-1846),  the  apothecary  of  Zweibriicken  and  professor  in 
Erlangen,  who  displayed  numerous  accomplishments,  and  the  brothers  Fr.  W.  and 
C.  H.  Schultz  (Bipontinus);  G.  Wilh.  Bischoff;  Hugo  von  Mohl ;  Unger;  Hermann 
Schacht;  G.  F.  W.  Meyer;  Alexander  Braun  (1805-1877),  professor  in  Giessen  and 


—  844  — 

Berlin;  Jauine  and  Auguste  de  St.  Hilaire;  Benj.  Delessert;  Sir  Jos.  Banks  (1743— 
1820),  famous  as  a  companion  of  Cook  and  president  of  the  Royal  Society  in  London  ; 
John  Hill  (fl.  1760);  James  Edward  Smith  (1759-1828);  Robert  Brown  (1773-1858), 
one  of  our  greatest  investigators  of  plants,  who  demonstrated  the  nucleus  of  cells  and 
the  process  of  fructification  by  the  transfer  of  pollen  to  the  ovule;  the  equally  emi- 
nent John  Lindley  (1799-1865);  Sir  William  Jackson  Hooker  (1785-1865),  regius 
professor  of  botany  in  Glasgow;  John  Claudius  Loudon  (1783-1843);  finally  Aylmer 
Bourke  Lambert  (fl.  1822),  Vice-President  of  the  Linmean  Society  of  London,  and 
the  Spaniard  Hippol.  Ruiz,  who  rendered  valuable  service  to  our  knowledge  of  the 
varieties  of  cinchona  etc. 

[To  these  we  may  add  the  following  American  botanists:  Gotthilf  Heinrich 
Ernst  Muhlenberg  (1753-1815);  Dr.  Benj.  Smith  Barton  (1766-1815),  professor  of 
botany  and  natural  history  in  the  College  of  Philadelphia,  and  his  nephew  Dr.  William 
P.  C.  Barton  (died  1855),  professor  of  botany  in  the  University  of  Pennsylvania; 
Dr.  Jacob  Bigelow  (born  1787);  Stephen  Elliott  (1771-1830);  Amos  Eaton  (1776- 
1842);  Dr.  William  Darlington  (1782-1863,  Darlingtonia  Californica) ;  Dr.  Lewis  C. 
Beck  (1798-1853);  Dr.  David  Hosack  (1769-1835),  professor  of  botany  in  Columbia 
College  and  founder  (1811)  of  the  first  botanical  garden  in  the  United  States;  Thomas 
Nuttall  (1786-1859),  an  Englishman,  curator  and  lecturer  at  the  botanical  garden  of 
Harvard  College  from  1822  to  1828;  Dr.  John  Torrey  (1798-1873),  professor  of 
botany  in  the  College  of  Phj-sicians  and  Surgeons,  N.  Y.,  and  one  of  the  founders  of 
the  New  York  Lyceum  of  Natural  History;  Dr.  Asa  Gray  (1810-1888)  etc.     H.] 

As  regards  the  modern  microscopic  investigation  of  fungi  we  must  mention: 
Bassi  and  Balasma  (silkworm  fungus,  Botrytis  Bassiana,  1835);  Schoenlein  (achorion 
•of  favus,  produced  experimental!}-  bj'  Remak)  ;  Eichstadt  in  Greifswald  (fungus  of 
herpes  tondens  and  pityriasis  versicolor);  Goodsir  (sarcina  ventriculi,  1850);  Keber 
(fungus  of  vaccine  virus,  1854);  Pollender  (saw  in  1855  the  bacilli  of  malignant 
pustule  for  the  first  time,  but  proved  by  inoculation  their  connexion  with  the  etiology 
of  the  disease  in  the  year  1863);  Davaine  (preventive  inoculation,  still  very  question- 
able) ;  Basch  (fungus  of  dysentery) ;  Klob,  Pacini,  Strahler  (supposed  cholera  fungus); 
Obermeyer  (spirochaste  of  recurrent  fever);  Koch  (bacillus  tuberculoseos,  1882, 
cholera  fungus  1885,  etc.);  Bollinger  and  Israel  (Actinomyces  hominis  et  bovis  1) ; 
Audouin  (fungus  in  area  Celsi);  Tommasi-Crudeli  and  Klebs  (intermittent  fever); 
Neisser  (gonorrhoea);  E.  Klebs  (microsporon  septicum);  L.  Letzerich  (diphtheria); 
Traube  (vesical  catarrh);  Fehleisen  (erysipelas);  Klebs  (pneumonicoccus  in  the 
corpse,  1875);  Leyden  (the  same  withdrawn  from  the  lungs  of  the  living  patient  by 
means  of  a  hypodermic  syringe) ;  Franz  Ziehl  (the  same  in  sputum) ;  Friedlaender 
(the  same  in  the  air);  Pagenstecher  and  A.  Pfeiffer  in  Wiesbaden  (inoculation  of 
lepra,  tubercle  bacillus,  1883)  etc. 

[In  this  connexion  the  excellent  dissertation  of  Dr.  J.  K.  Mitchell  (1798-1858) 
"On  the  Cryptogamous  Origin  of  Malarious  and  Epidemic  Fevers"  (1849),  and  the 
valuable  papers  of  Dr.  Geo.  M.  Sternberg,  U.  S.  A.  on  the  micrococcus  of  gonorrhoea! 
pus,  are  worthy  of  mention.  Historically  too  the  papers  of  Dr.  J.  H.  Salisbury  on 
the  contagium  of  various  infectious  diseases  are  likewise  of  interest.     H] 

In  more  recent   times   (1868)   E.   Eallier,  professor  in   Jena  (born  in 

1.  The  fungus  of  actinomycosis  seems  to  have  been  first  demonstrated  in  this  country 
by  Prof.  James  Law,  a  veterinarian  of  Ithaca,  N.  Y.,  in  1883,  and  Prof.  W.  T. 
Belfield  of  Chicago  in  the  same  year.  The  first  two  cases  of  this  disease  in  the 
human  subject  detected  in  the  IT.  S.  were  presented  to  the  Chicago  Medical  Society, 
Dec.  15,  1884,  by  Dr.  John  B.  Murphy,  who  singularly  enough  had  observed  both- 
The  accuracy  of  his  diagnosis  was  continued  by  Drs.  Belfield  and  Fenger.     (H.) 


—  845  — 

Hamburg  in  1831,  at  first  a  gardener)  excited  great  attention  in  medical 
circles  by  his  investigations  of  microscopic  fungi  and  their  development 
and  particularly  by  the  application  of  his  results  to  the  etiolog}-  of  epi- 
demic diseases.  These  fungi,  as  early  as  the  forties  of  the  present  century, 
were  raised,  as  already  mentioned,  to  etiological  importance  in  the  depart- 
ment of  diseases  of  the  skin,  and  El.  Magnus  Fries  (1794-1878)  and  Karl 
Adolph  Agardh,  both  in  Lund,  Chr.  Gr.  Ehrenberg'  (1705-1876)  of 
Delitzsch,  from  1826  professor  in  Berlin,  the  Leeuwenhoeck  of  the  19th 
century,  and  particularly  Louis  Pasteur  (born  1822), a  with  others  before 
him,  had  occupied  themselves  with  this  subject.  Henle  too,  as  early  as 
1840,  gave  a  praiseworthy  impulse  to  the  revival  of  the  idea  of  a  eontagium 
animatum.  Hallier's  doctrine,  like  eveiything  new  in  the  present  day,  at 
once  obtained  numerous  enthusiastic  followers,  including  the  surgeon 
Hiiter,  who  even  rated  the  fungi  systematically.  But  it  also  met  some 
quiet  opponents,  among  whom  was  the  famous  mycologist  Prof.  Herm. 
Hofmann  in  Giessen,  who  as  earl}'  as  the  beginning  of  the  sixties  made 
investigations  in  the  same  direction.  The  influence  which  this  fungus- 
theory  attained  temporarily  in  therapeutics,  medical,  surgical  and  obstet- 
rical, is  well  known. 

The  teachings  of  Hallier  that  the  one-celled  microscopic  forms  of  fungi  (cocci) 
were  merely  stadia  of  development  of  higher  forms,  and  that  certain  forms  of  these 

1.  Ehrenberg  held  firmly  to  the  animal  nature  of  microscopic  organisms. 

2.  His  inoculations  for  the  prevention  of  hydrophobia  are  exciting  much  attention, 

but  still  require  longer  trial  at  the  hands  of  other  experimenters.  In  April  1866, 
according  to  Pasteur's  own  statement,  he  had  inoculated  68S  persons  bitten  by 
rabid  dogs,  and  of  these  one  girl  only,  who  was  not  submitted  to  treatment  until 
the  36th  day,  suffered  from  hydrophobia.  Of  38  patients  bitten  by  wolves,  three 
had  died.  We  know,  however,  that  only  a  small  percentage  of  persons  bitten  by 
rabid  animals  ever  become  actually  hydrophobic,  and  the  attack  often  occurs  at 
a  relatively  late  period.  —  Pasteur's  inoculations  against  anthrax  seem  to  have 
proved  unsuccessful. 

[This  note  seems  to  the  translator  to  do  scant  justice  to  the  eminent  Frenchman. 
The  report  of  a  committee  appointed  by  the  Local  Government  Board  of  Great 
Britain  in  1887  to  investigate  the  subject  of  M.  Pasteur's  preventive  inoculations 
in  hydrophobia,  and  consisting  of  such  men  as  Sir  James  Paget,  T.  Lauder 
Brunton,  George  Fleming,  Sir  Joseph  Lister,  Richard  Quain,  Henry  E.  Pioscoe, 
J.  Burdon  Sanderson  and  Victor  Horsley,  endorses  the  claims  of  the  French 
savant  in  the  following  terms:  "The  committee  think  it  therefore  certain  that 
the  inoculations  practised  by  M.  Pasteur  have  prevented  the  occurence  of 
hydrophobia  in  a  large  proportion  of  those  who,  if  they  had  not  been  so  inocul- 
ated, would  have  died  of  that  disease."— The  inoculations  against  anthrax,  when 
performed  with  due  care,  would  also  seem  reasonably  successful. 

Pasteur's  first  inoculation  of  the  human  subject  for  hydrophobia  was  performed 
upon  Joseph  Meister,  July  7-16,  1885.  On  Dec.  21,  1885,  he  began  the  inoculation 
of  four  children  of  Newark,  N.  J.,  who  had  been  sent  to  him  for  treatment.  The 
inoculations  were  completed  Jan.  1,  1886,  and  the  children  reached  their  homes 
in  safety  Jan.  14,  1886-  These  were  the  first  inoculations  performed  upon 
natives  of  the  United  States.  In  October  1886  Dr.  Valentine  Mott  of  New 
York  reported  four  apparently  successful  inoculations  performed  by  himself  with 
virus  procured  from  Pasteur's  laboratory.    H.] 


—  846  — 

fungi  were  of  pathological  significance,  were  successfully  opposed  by  de  Bary,  Cohn, 
Klebs,  Karsten,  Naegeli  and  others,  who  proved  that  the  cocci  neither  originated  in, 
nor  were  developed  into,  higher  fungi.  Hallier  too  was  the  originator  of  the  culture 
of  fungi,  though  not  of  "pure  cultures",  which  were  invented  by  Cohn.  The  latter 
defended  the  doctrine  of  specific  kinds  of  bacteria  for  the  different  forms,  while 
Naegeli  denied  this  view. 

On  the  other  hand,  Alfred  Russell  Wallace  (born  1822),  a  future  rival 
of  Darwin  in  regard  to  the  priority  of  the  doctrine  known  as  ''Darwinism", 
and  an  eminent  naturalist,  and  the  persevering  German  botanist  Dr.  Carl 
Hasskarl,1  who,  though  often  disturbed  in  his  life's-work  by  misfortune, 
calumny  and  ingratitude,  was  finally  repaid  with  complete  success,  by  their 
introduction  (1851)  of  the  Peruvian  cinchona  into  English  and  Dutch 
India,  rendered  to  practical  medicine  a  service  not  even  now  sufficiently 
valued.  Without  this  humane  and  characteristically  professional  act  cin- 
chona and  its  preparations,  particularly  under  its  recent  abuse  in  medicine, 
would  have  finally  disappeared  from  our  store  of  drugs. 

If  the  influence  of  botaii}T  upon  medicine  proved  itself  in  many  ways 
a  controlling  one,  though  substantially  external,  that  of  physics,  and  the 
mathematics  associated  therewith,  has  manifestly  become  much  more  pro- 
found, and  has  given  the  key-note  to  medical  science.  This  is  far  more  the 
case  in  our  own  centur}T  than  during  the  17th,  its  predecessor  in  this 
respect,  though  the  19th  centurj-  has  not  produced  any  special  "school"' 
The  latter  fact  is  due  to  the  division  of  the  medicine  of  the  present  day 
into  numerous  distinct  branches,  and  to  its  partition  among  entirely  dis- 
connected laborers,  as  the  result  of  the  immense  mass  of  material  collected 
in  each  department.  Thus  the  connexion  of  the  individual  branches  has 
been  almost  destroyed.  The  influence  of  physics  too  has  not  been  so 
sharply  separated  from  that  of  chemistry  as  was  the  case  in  the  17th  cen- 
tury,  so  that,  were  such  an  expression  permissible,  we  ought  in  our  day  to 
speak  rather  of  a  physico-chemical  school. 

In  conformity  to  the  tendency  of  medicine  in  the  early  years  of  the 
present  century,  the  subjects  of  pb^-sies  —  those  of  botany,  as  we  have 
seen,  supplied  at  a  later  period  the  impulse  to  the  formation  of  an  actual 
school  —  gave  occasion  at  least  for  systematic  and  scientific  speculations 
on  'polarity",  for  a  priori,  instead  of  the  later  inductive,  identification  of 
physical  and  corporeal  forces  etc.  Accordingly  physics  has  become  the 
chief  prompter  and  assistant  in  the  flourishing  physico-physiological  exper- 
iments of  the  present  day,  while  Haller,  the  creator  of  modern  experimental 
physiology,  conducted  his  experiments  rather  medicall}-.  This  influence 
upon  physiology  especially,  showed  itself,  indeed,  as  we  have  seen,  in  the 
17th  century  also  ;  but  in  our  own  century,  in  accordance  with-  the  in- 
creased results  of  physical  investigation,  it  has  become  more  important. 
Thus  the  laws  of  the  lever  and  of  mechanics  in  general  have  become  the 
phjsics  or  mechanics  of  the  skeleton,  those  of  hydrodynamics,  especially 

1.  He  had  been  anticipated  by  F.  W.  Junghulm  (1858). 


—  84.7  — 

the  laws  of  undulations,  have  become  the  physics  of  the  circulation,  those 
of  filtration,  of  end-  and  ex  osmosis,  explain  the  physics  of  secretion  and 
absorption,  the  doctrines  of  the  diffusion  of  gaseous  bodies  and  their 
absorption  b}-  fluids  are  applied  in  explanation  of  respiration,  the  laws  of 
acoustics  become  the  physics  of  speech  and  hearing,  those  of  optics,  the 
physics  of  sight  etc.  The  subject  of  electricity  has  gained  the  greatest 
influence  over  nervous  physiology,  and  nervous  physics  has  become,  as  we 
know,  a  distinct  specialty  of  physiologj'.  In  fact  even  mental  activity 
nowadays  is  on  the  road  to  becoming  transformed  into  a  cerebral  physics. 
Of  course  in  all  these. investigations  the  metaphysical  forces,  whose  ac- 
ceptance at  the  present  da}'  is  still  a  logical  necessity,  continue  disre- 
garded, and  onl}'  the  homme  machine,  who  is  subject  to  these  researches,  is 
investigated,  though  modern  materialism  believes  that  it  has  already 
attained  a  contrary  result.  In  practice  too  electricity  has  gained  new 
interest.  That  our  whole  physical  diagnosis  is  founded  upon  physics,  is 
expressed  in  its  very  name.  The  role  which  the  mechanical  and  physical 
acquisitions  of  our  time  are  to  play  in  (pathology  and)  therapeutics,  is 
however,  yet  in  its  rudiments,  and  it  seems  as  though  they  would  call  into 
being  an  actual  iatro-mechanical  school.  How  far  physics  has  become  a 
branch  of  medicine  may  be  judged,  among  other  things,  from  the  fact  that 
there  are  to-day  special  text-books  on  medical  physics,  and  that  the  ther- 
mometer is  used  every  day  in  one  single  large  hospital  more  frequently 
than  in  many  of  our  meteorological  stations  taken  together. 

Among  the  numerous  physicists  of  the  present  century  we  may  mention  :  Chladni 
(1756-1827)  of  Wittenberg,  the  founder  of  acoustics  and  the  first  to  give  an  explana- 
tion of  meteorolites;  Seebeck  (1770-1831),  who  discovered  thermo-electricity  and 
entoptic  figures,  and  was  also  the  first  to  give  a  method  for  the  testing  of  color- 
blindness by  means  of  colored  wool;  Jos.  von  Fraunhofer1  (1787-1826)  in  Munich,  a 
famous  optician  and  technologist;  Reichenbach  (1772-1826),  an  optician;  Martin 
Ohm  (1792-1872),  electricity  (his  investigations  first  appeared  in  the  famous  "Anna- 
len  "  of  Christian  Poggendorf)  ;  Sommering,  the  inventor  of  the  electric  telegraph; 
Alexander  von  Humboldt;  Julius  Rob.  Mayer  (1814-1878),  the  son  of  an  apothecary, 
superior  surgeon  and  city  plrysician  in  Heilbronn,  and  a  kindred  spirit  with  Coper- 
nicus, Kepler,  Newton  etc.  He  originated  the  mechanical  theorj-  of  heat,  though  his 
priority  in  the  matter  was  contested  for  some  time  by  the  Englishman  James  Prescott 
Joule,  a  brewer  of  Manchester,  and  eclipsed  by  Helmholtz  (law  of  the  conservation  of 
force);  Rud.  Clausius  (born  1822)  in  Bonn,  mechanical  theory  of  heat;  G.  A.  Hirn 
of  Muhlhausen  in  Alsace  and  others.  Job.  Miiller  of  Kassel  (1809-1875),  professor 
in  Freiburg,  also  distinguished  himself  as  a  physicist,  and  particularly  by  his  edition 
of  the  text-book  of  Pouillet;  Kirchhoff,  immortalized  hy  his  invention  (in  conjunction 
with  Bunsen)  of  the  spectral  analysis  (1860);  Phil.  Reis  (died  1864),  an  elementary 
teacher  in  Friedrichsdorf  near  Homburg,  the  telephone  (improved  by  Graham  Bell  in 

1.  "The  German  Newton",  born  in  Straubing,  and  worked  his  way  up  to  immortality 
by  his  own  powers,  from  the  lowest  position  and  in  spite  of  the  deepest  poverty 
and  want.  "Fraunhofer  lines"  of  the  spectrum,  inventor  of  a  glass  unsurpassed 
for  optical  purposes,  inventor  and  improver  of  the  achromatic  microscope,  of  the 
astronomical  telescope  with  large  objectives,  of  the  heliometer,  the  circular 
micrometer  etc. 


—  848  — 

L875);  Thomas  Alva  Edison  (born  1847),  electric  light,  phonograph  etc.;  Graham 
Bell,  photophone,  1880;  H.  W.  Dove  (1808-1879)  of  Liegnitz,  professor  in  Berlin, 
the  founder  of  meteorology  and  climatology;  J.  B.  Listing,  professor  in  Gottingen 
(1803-1883),  physiological  optics;  Rutherford,  inventor  of  the  maximum  and 
minimum  thermometer;  Wollaston  (1766-1828),  stereoscopic  vision;  Leslie  (1766- 
1839),  differential  thermometer,  hygrometer;  Daniell  (1790-1845),  constant  current, 
condensing  hygrometer;  Michael  Faraday  (born  1794),  electricity  by  induction; 
Grove,  constant  current  through  zinc  and  platinum  plates;  Hans  Christ.  Oersted 
(1777-1851),  discoverer  of  electro-magnetism ;  Zamboni  (1775-1846),  dry  electric 
piles;  Francesconi,  falling  bodies,  velocity  of  light  etc.- — Laplace  (1752-1833); 
Urbain  J.  Jos.  Leverrier  (1811-1877),  who  foretold  the  position  of  the  planet  Neptune, 
which  Galle  in  Berlin  then  discovered;  Ampere  (1775-1847),  discovered  the  electro- 
dynamical  phenomena,  Amperian  theory;  Malus  (1775-1812),  discoverer  of  the 
polarization  of  light  (1808);  Dulong  (1785-1838)  and  Alex.  Therese  Petit  (1791- 
1820)  together  brought  forward  in  1819  the  law  of  specific  heat;  M.  H.  Dutrochet 
(1776-1847),  endosmosis  and  exosmosis  ;  Fresnel  (1788-1827),  undulatory  theorj'  of 
light;  Francois  Arago  (1786-1853)  discovered  rotatory  magnetism  and  wrote  on 
light,  sound  etc.;  Jos.  Nicephore  Niepce  (1785-1833)  discovered  (1814)  a  process  for 
preparing  the  photographic  pictures  which  bear  the  name  of  the  following  scientist  ; 
Daguerre  (1788-1851)  improved  in  1839  the  process  known  as  daguerreotyping;  W. 
H.  Fox  Talbot  (died  1877)  discovered  in  1840  the  process  of  photograph}',  which 
finds  such  various  applications  in  anatomy,  surgery  etc.,  and  is  likely  to  take  the 
place  of  other  methods  of  artistic  reproduction.1  Savart  (1791-1841),  an  eminent 
student  of  acoustics;  Horace  Bened.  de  Saussure  (1740-1799),  hygrometer, 
Theodore  de  Saussure  (1767-1845),  meteorology;  John  Tyndall  (born  1820),  a 
famous  meteorologist  and  student  of  acoustics,  mechanical  theory  of  heat;  Lambert 
Adolphe  Jacques  Quetelet  (1796-1873)  of  Brussels  exercised  a  decisive  influence 
upon  our  modern  science  of  statistics  by  his  calculation  of  probabilities,  through 
which  he  was  led  to  the  conclusion  that  medical  art  exercised  very  little  influence 
upon  mortality,  and  that  this  influence,  so  far  as  it  went,  was  bad;  Raoul  Pictet  of 
Geneva  in  1877  exhibited  oxygen  in  the  form  of  a  liquid,  thus  confirming  the 
mechanical  theory  of  heat,  while  Cailletet  in  Paris  produced  liquid  air  and  nitrogen. 
The  share  in  the  extension,  and  the  partially  new  construction  of  the 
medical  department  of  hygiene  assumed  recently  —  at  the  instance  of  the 
French  —  by  physics  or  meteorology  and  the  natural  sciences  in  generalr 
is  to  be  welcomed  as  highly  beneficial,  inasmuch  as  they  must  supply  in 
this  department  the  actual  foundations  for  medical  thought,  and  will  not 
devote  themselves  to  short-lived  theories  of  etiolog}',  and  therapeutics. 
The  champion  of  this  accessory  branch  of  medicine  to-day  is  the  worth}" 
physician,  chemist,  pharmaceutist  and  recent  hygienist,  Max  von  Petten- 
kofer  of  Munich,  who  by  his  spirited  advocacy  has  brought  into  honor  and 
zealous  exercise  this  practical  and  promising  department  of  the  treatment 
of  the  body -politic,  instead  of  that  treatment  of  individuals,  which,  from 
a  remote  antiquity,  has  been  in  many  respects,  alas,  so  deceptive,  and  in 
spite  of  constant  and  great  changes  has  always  afforded  so  little  benefit. 
This  he  accomplished  too,  although  the  earlier  impulse  given  by  the 
excellent  pharmacologist  and  medical  statistician  Fr.  Oesterlen  (died  1877) 

1.    The  first  photographic  portrait  from   life  was  taken   by  Prof.  John  W.  Draper 
(1811-1882),  of  the  University  of  New  York,  in  1835K     (H.) 


—  849  — 

had  remained  without  any  considerable  effect.     In  the  actual  support  of 
this  branch 

Chemistry  also  has  a  share.  This  science,  which  heretofore  has  gone 
to  work  almost  exclusively  by  anatysis,  has  recently  employed  also  the 
synthetic  method,  so  important  in  the  preparation  of  alkaloids  for  use  in 
medicine.  The  absolutely  astonishing  achievements  of  chemistiy,  which, 
in  union  with  those  of  physics  and  mechanics,  have  given  to  our  life  of  to- 
day, when  contrasted  with  that  of  an  earlier  period,  an  entirely  altered 
appearance,  likewise  render  its  influence  upon  the  development  of  general 
medicine  more  prominent  than  is  the  case  with  an}-  other  branch  of  the 
natural  sciences.  And  this  influence  has  been  for  the  most  part  good, 
since,  of  all  the  accessor}-  sciences,  chemistry  has  supplied  the  greatest 
abundance  of  valuable  material,  physiological,  pathological  and  thera- 
peutic, as  the  result  of  the  unexpectedly  rapid  advances  of  organic  chem- 
istry created  chiefly  by  the  Germans.  From  the  latter  science  physio- 
logical and  pathological  or  medical  chemistry  have  been  constructed  as 
special  branches. 

The  influence  of  chemical  doctrines  upon  the  theoretical  constitution 
of  medicine  showed  itself  in  the  doctrine  of  "  erases  ",  in  its  da}-  so  wide 
spread  and  evanescent,  and  above  all  in  numerous  minor  113-potheses  in 
pathology  and  pharmacodynamics  etc.,  which  for  the  most  part  appear  as 
ingenious  as  fleeting.  Most  profound,  however,  was  the  influence  of 
chemistry  upon  the  development  of  phj-siology,  and  especially  upon  the 
doctrines  of  the  changes  of  matter  and  of  nutrition  (or  dietetics). 

Tn  the  last  two  branches  chemistry  also  introduced  much  one  sidedness.  Thus, 
instead  of  the  earlier  and  natural  methods  of  nutrition,  there  often  appears  at  the 
present  da\r —  and  this  theory  in  fact  penetrates  to  the  masses  —  a  theoretic  and 
chemical  nutrition,  in  which  the  self-acting  and  self-adjusting  organism,  the  "  internal 
chemist"  of  Paracelsus,  is  often  disregarded,  and  considered  a  lifeless  retort,  though 
it  certainly  selects,  while  the  retort  simply  obeys  chemical  laws.  To  adduce  a  few 
examples:  we  mention  merely  the  theoretical  feeding  of  the  scrofulous  and  consump- 
tive with  "nitrogenous  or  carbonaceous  food",  which,  however,  in  practice  scarcely 
ever  half  attains  its  object,  for  the  diseased  organism  does  not  assimilate  this  food  at 
all;  the  famous  "potato-blood"  of  the  Irish,  i.e.  the  consideration  of  the  mental 
attainments  of  the  people  from  the  stand-point  of  their  food,  without  reflecting  that 
these  attainments  were  the  same  before  thej'  used  potatoes  as  food,  and  when,  there- 
fore, they  could  not  maintain  a  "carbonaceous  brain";  the  Liebig's  children's 
food,  which,  though  properly  constructed  chemically,  still  remains  mostly  without 
results,  because  its  correctly  selected  constituents  are  incorporated  into  the  organism 
under  a  form  different  from  that  in  which  the}'  exist  in  mother's  milk;  the  introduc- 
tion of  pepsin  into  the  supposed  retort  of  the  stomach,  which  does  not,  however,  give 
the  desired  reaction  because  the  organ  of  the  stomach  is  concerned  in  the  matter  etc. 
Pathology  too  is  frequently  ruled  by  chemico-physiological  and  chemico- 
pathological  views.  In  like  manner  diagnosis  and  therapeutics  receive 
many  acquisitions  and  much  aid  from  chemistry,  therapeutics  especially 
through  the  exhibition  of  purely  chemical  remedies,  chiefly  the  alkaloids, 
though  undoubtedly  by  means  of  the  latter  a  treatment  has  been  at  times 
54 


—  S50  — 

instituted  allied  more  nearly  to  toxicology  than  to  therapeutics  proper. 
Toxicolog}-  too,  on  its  side,  has  been  greatly  advanced  by  chemistry. 
By  the  numerous  discoveries  in  the  department  of  chemistry,1  as  well  as  in 
the  other  natural  sciences  and  in  technics,  a  large  number  of  transient 
"  fashionable  remedies  "  have  also  been  produced,  to  the  injury  of  thera- 
peutics in  the  eyes  of  both  physicians  and  laity. 

Among  the  chemists,  the  French  were  especially  prominent  in  the  beginning  of 
the  century,  but  were  speedily  compelled,  particularly  in  organic  chemistry,  to  yield 
the  precedence  to  representatives  of  the  German  people.  Among  the  numerous 
eminent  chemists  whom  our  century  has  furnished  we  bring  forward  the  following: 
Count  Claude  Louis  Berthollet  (1748-1822)  of  Talloirein  Savoy,  at  the  instance  of  the 
well-known  Dr.  Tronchin  appointed  ordinary  physician  of  the  Duke  of  Orleans, 
senator  and  peer  of  France,  especially  meritorious  for  his  demonstration  that  it  was 
not  oxygen  alone  which  could  form  acids,  as  well  as  for  the  fact  that  he  revised  the 
doctrine  of  affinity.  He  founded  in  Arcueil,  after  the  model  of  the  Italian  academies 
of  the  16th  and  17th  centuries,  a  private  academy,  to  which  belonged  Gay  Lussac 
(1778-1850;  volumetric  theory),  the  famous  Louis  Jacques  Thenard  (1777-1857),  ■ 
Alex,  von  Humboldt,  Collet-Descotils,  Laplace,  Biot,  the  great  Swedish  chemist 
Johann  Jac.  Berzelius  (1779-1848;  animal  chemistry,  doctrine  of  chemical  proportions, 
a  more  precise  determination  of  the  atomic  weights  and  of  the  atomic  theory  etc.), 
and  Dulong;  Louis  Nic.  Vauquelin  (1763-1829),  the  discoverer  of  numerous  inorganic 
and  organic  combinations  and  substances;  Chaptal  (1758-1832),  eminent  as  an 
agricultural  chemist,  like  J.  B.  Boussingault  (born  1802)  ;  Jos.  Louis  Proust  (1755- 
1826) ;  J.  Bapt.  Dumas  (1800-1884)  of  Alais  (Gard),  from  his  21st  year  a  teacher  of 
^chemistry  in  Paris,  who  investigated  especially  the  alkaloids;  Jos.  Pelletier  (died 
1812),  who  with  Caventou  (1789-1877)  discovered  quinine  in  the  year  1820;  Balard 
(1802-1878),  the  discoverer  of  bromine,  well  known  among  ns  by  Strecker's  edition 
of  his  text-book;  Victor  Regnault  (methylchloroform,  1840,  and  monochlorethyl,  1838, 
two  anaesthetics  similar  to  chloroform);  Mich.  Eug.  Chevreuil,  member  of  the  Academie 
(born  1786,  still  living  in  Angers);  Magendie;  Jos.  Matth.  Bonavent.  Orfila  (1787- 
1852),  the  toxicological  investigator  so  eminent  in  medicine,  and  others.  Among  the 
Germans:  Karl  Aug.  Hoffmann  (1760-1832),  an  analyst  of  many  mineral  waters; 
Jeremias  Benj.  Richter  (1762-1807),  founder  of  stcechiometry  ;  Adolph  Ferd.  Gehlen 
(1775-1815),  zoochemist  in  the  university  hospital  at  Halle;  Joh.  Wolfg.  Doebereiner 
(1780-1849)  in  Jena,  the  discoverer  of  platinum  black,  promoter  of  the  chemistry  of 
fermentation,  of  the  analyses  of  mineral  waters  etc. ;  Fried.  Wilh.  Adam  Sertiiner 
(1783-1841),  an  apothecary  in  Einbeck  and  then  in  Hameln,  discoverer  of  the  first 
organic  base  of  morphium  (1804,  not  published  until  1816);  Franz  von  Ittner  (1787- 
1823),  who  prepared  (1803)  anhydrous  prussic  acid;  Christ.  Gottfr.  Gmelin,  professor 
in  Tubingen  (toxicology),  and  Leopold  Gmelin  (1789-1853),  professor  in  Heidelberg, 
eminent  for  many  labors  in  physiological  chemistry;  Carl  Gnstav  Bischof  (born  1792) 
in  Bonn,  numerous  analyses  of  mineral  waters;  C.  G.  Mitscherlich  (1794-1863)  in 
Berlin,  a  famous  pharmaco-chemist  (isomorphism) ;  Heinrich  Rose  (1795-1864)  in 
Berlin,  eminent  as  a  perfecter  of  organic  analysis;  Reinhold  von  Reichenbach  (died 


In  chemistry  too  we  have  recently  begun  to  distinguish  between  "modern  "  (in  the 
sense  of  philosophical  and  speculative)  and  "classical"  (i.e.  depending  upon 
observation)  chemistry.  Representatives  of  the  former,  according  to  Albrecht 
Rau,  are :  Dumas,  Aug.  Laurent  (1807-1853)  of  la  Folie  near  Langres.  and  Gerhard  t 
(1816-1855)  of  Strassburg,  a  pupil  of  Liebig.  The  chemists  between  Boyle  and 
Berzelius-Liebig  are  representatives  of  "  classical  chemistry  ". 


—  851  — 

1887  in  Graz),  chemist;  Karl  von  Reichenbach  (1788-1869),  inventor  of  the  "Od",  a 
pretended  natural  force,  and  discoverer  of  paraffin,  creasote  etc. ;  Friedr.  Stromeyer 
( 1778— 18;>5),  a  famous  chemist  in  Gottingen;  the  greatest  of  German  chemists  Justus 
von  Liebig  (1803-1873),  who  marks  an  epoch  in  the  development  of  chemistry  by  his 
improvement  of  instruction  (he  was  the  founder  of  university  laboratories,  while  up 
to  this  time  individual  teachers  merely  gave  instruction  in  private  laboratories),  of 
organic  analysis,  agricultural  chemistry,  physiological  chemistry  etc. ;  Christian 
Friedr.  Schoenbein  (1791)-] 868)  in  Basel,  discoverer  of  ozone,  gun-cotton,  collodion 
•etc.,  a  man  as  simple  in  his  life  as  he  was  eminent  in  his  science;  Phil.  Lorenz 
Geiger  (1785-1836);  Friedr.  Ad.  Aug.  Struve  (1781-1810),  artificial  mineral  water; 
Joh.  Andr.  Buchner  (1783-1852)  in  Munich;  Tragendorf  in  Dorpat;  F.  L.  Winckler; 
Em.  Osann  (1787-1842)  in  Berlin;  Fr.  Mohr,  commentary  on  the  Prussian  pharma- 
copoeia; Friedr.  Wohler  (1800-1882)  of  Eschenheim  near  Frankfort,  a  pupil  of  Ber- 
7.elius,  professor  in  Gottingen  (the  first  synthetic  preparation  of  an  organic  body,  viz. 
urea;  investigation  of  substances  under  high  pressure  and  low  temperature ;  liquid 
and  solid  carbonic  acid  etc.),  and  Rob.  Willi.  Bunsen  (born  1811),  both  equally  im- 
portant in  inorganic  and  organic  chemistry;  the  eminent  physiological  chemists 
C.  G.  Lehmann  in  Leipzig,  E.  C.  F.  von  Gorup-Besauez  in  Erlangen,  Jos.  Scheerer  in 
Wiirzburg,  Jul.  Eug.  Schlossberger  in  Tubingen,  Carl  Schmidt  in  Dorpat,  Rochleder 
(died  1874)  in  Vienna.  Friedr.  Schodler  (meritorious  for  his  diffusion  of  scientific  and 
chemical  information  in  our  intermediate  schools,  died  1884,  ret.  71)  in  Worms  and 
then  in  Mayence,  Voit,  Pettenkofer  in  Munich;  Neubauer  in  Wiesbaden  (died  1879, 
urinary  investigation);  Dupre  and  Selmi  (1866  and  1873,  alkaloids  of  dead  bodies,, 
ptomaines);  Hermann  Kolbe  (1818-1884;  salicylic  acid),  an  opponent  of  the  type 
theory  of  Ch.  Tred.  Gerhardt  (1816-1856)  and  his  assistant  Laurent,  and  of  the  so- 
called  structural  chemistry.  A  Niemann  in  Gosler  (cocaine,  1880);  Merck  in  Darm- 
stadt (preparation  of  numerous  vegetable  poisons)  and  many  others.  One  of  our 
most  important  physiological  chemists  was  G.  J.  Mulder  (1803-1880)  in  Utrecht,  who 
rendered  eminent  service  in  the  study  of  the  chemistry  of  the  protein  bodies,  and 
•demonstrated  their  identity  in  the  animal  and  vegetable  kingdoms.  Among  the 
English  the  following  chemists  distinguished  themselves:  John  Dalton  (1766-1844), 
founder  of  the  atomic  theory,  who  also  in  1794  described  the  first  case  of  color-blind- 
ness (in  himself),  though  the  condition  was  also  known  to  Jas.  Huddart  in  1777. 
From  Dalton  this  condition  is  known  as  "Daltonism".  Sir  Humphry  Davy  (1788- 
1829),  the  founder  of  agricultural  chemistry,  of  electro-chemistry,  discoverer  of  the 
metals  of  the  alkalis,  [of  the  intoxicating  properties  of  nitrous  oxide,  inventor  of  the 
"  safety  lamp"  etc.];  Faraday,  (1791-1867);  James  Marsh  (1789-1846),  Marsh's  test 
for  arsenious  acid  (1836);  Thomas  Graham  (1805-1869),  [discoverer  of  the  law  of 
diffusion  of  gases  (1834)];  Avogadro  (molecular  theory,  1811;  a  molecule  is  the  most 
minute  part  of  a  chemical  body,  in  contradistinction  to  the  atom,  the  most  minute 
part  of  matter  in  general)  ;  James  Young  (1811-1883),  the  chemistrj'  and  industrial 
uses  of  coal,  first  illumination  of  London  with  gas,  1810,  etc.  The  various  elements 
were  discovered:  iodine  b}-  Courtois,  1812;  chromium  by  Yauquelin  ;  bromine  by 
Balard  ;  cadmium  by  Stromeyer;  boron  by  Gay  Lussac ;  lithium  by  Arfvedson; 
calcium,  potassium,  sodium,  magnesium  and  strontium  by  Sir  H.  Davy;  selenium, 
silicium,  thorium,  barium  by  Berzelius  ;  aluminium  and  beryllium  by  Wohler;  caesium 
and  rubidium  by  Bunsen  etc.  Ladenburg  in  1886-87  first  prepared  an  artificial 
coniin  synthetically,  and  this  first  production  of  a  vegetable  product  by  synthesis  is 
of  the  most  extended  significance  (in  medicine  also),  since  the  way  is  thus  opened  for 
further  advances,  and  a  monopoly  in  the  production  of  carbo-hydrates  and  albumin- 
ates is  taken  away  from  vegetables,  though  F.  Cohn  at  the  Berlin  convention  ©f 
41  Naturforscher"  had  just  declared  this  department  as  yet  closed  against  science. 


—  852  — 

Zoology  too  worked  happil}-  in  aid  of  medicine.  Comparative  anat- 
omy, founded  scientifically  by  Cuvier,  furnished  some  important  revela- 
tions. It  even  exercised  some  influence  upon  the  medical  theories  of 
natural-philosophical  physicians,  e.  g.  upon  C.  Rich.  Hoffmann's  so-called 
"Ideal  pathology",  which  was  in  fact  a  pathology  of  comparative  anatomy, 
/oology  proper,  however,  was  of  great  advantage  to  the  history  of  devel- 
opment. The  natural  history  and  history  of  development  of  human  par- 
asites rose  to  a  clearness  and  completeness  heretofore  sought  in  vain,  and 
the  pathology,  and  in  many  ways  even  the  therapeutic  procedures,  of  the 
physician  were  thereby  advanced.  The  discussion  of  parasites,  which  was 
specially  renewed  about  the  close  of  the  thirties,  and  particularly  the  dis- 
cussion relative  to  scabies,  was  undoubtedly  the  occasion  for  the  exposition 
of  a  special  theory  of  parasitism  in  diseases. 

Wichmann's  doctrine  of  the  contagion  bj-  means  of  the  itch-mite  had  fallen  into 
forgetfulness.  and  even  Schonlein  said:  ''Whether  an  itch-mite  is  present  in  human 
scabies  is  to  this  hour  problematical."  M.  Gales,  an  apothecary  in  the  Hopital  de 
St.  Louis  in  Paris,  had  made  fallacious  statements,  but  was  unmasked  and  shown  to 
bean  impostor  by  Francois  Vincent  Raspail  (1794-1878).  Renucci  in  1834  showed 
the  method  of  finding  the  itch-mite  commonly  employed  bj-  the  common  people  in 
Corsica,  but  Hebra  was  the  first  to  defend  unreservedly  the  doctrine  of  Wichmann. 
Eichstedt,  professor  in  Greifswald,  thoroughl}-  studied  the  burrows  of  the  mite  and 
Kramer  in  1847  demonstrated  the  male  animal. 

Among  others  the  following  zoologists  and  physicians  made  them- 
selves of  service  in  the  advancement  of  our  knowledge  of  the  animal  para- 
sites of  man  : 

The  famous  Oken  ;  Richard  Owen  ( born  1N04)  of  London  discovered  the  trichina, 
while  Zenker  in  Erlangen  in  1800  succeeded  in  establishing  its  pathological  anatomy, 
pathogenesis  and  diagnosis  in  man.  The  physician  Rupprecht  in  Hettstadt  was  the 
earliest  to  describe  and  give  a  name  to  the  disease  trichinosis  ;  [in  the  United  States 
the  natural  history  of  the  trichina  was  carefully  investigated  by  Pi  of.  John  C.  Dalton 
in  18G4,  and  the  first  cases  of  trichinosis,  diagnosticated  as  such,  were  observed  by 
Dr.  Joseph  Schnetter  of  New  York  in  the  same  Aear;]  Carl  Theodor  Ernst  von 
Siebold  (1804-1885)  in  Munich  studied  the  natural  history  and  history  of  develop- 
ment of  the  tapeworm,  whose  larvae  had  been  already  recognized  by  A.  Ephr.  Goze 
(1731-1793),  the  friend  of  Linnanis  and  the  most  famous  helminthologist  of  the  last 
century,  and  subsequently  von  Grafe  _proved  them  the  cause  of  certain  cases  of  blind- 
ness; Bilharz  (distomum  haematobium);  Dubini  (anchylostomum  duodenale,  1837); 
E.  Wagner  (echinococcus);  Beneden;  Seeger;  Paul  Gervais;  C.  Davaine  (1811- 
1882),  the  most  famous  of  the  French  helminthologists,  "  Traite  des  Entozoaires  et 
des  maladies  vermineuses  ",  I860;  Rud.  Wagner  (1805-1864);  above  all  the  indefati- 
gable Friedr.  Rud.  Leuckart  (born  in  Helmstadt,  1823),  at  first  professor  in  Giessen, 
now  in  Leipzig,  who  wrote  a  justly  famous  work  in  two  volumes  on  "die  Parasiten 
des  Menschen";  Kiichenmeister,  and  others. 

Mineralogy,  of  course,  exercised  the  least  influence  upon  the  develop- 
ment of  medicine  ;  at  most  the  branch  of  crystallography  in  some  points 
aided  microscopic  diagnosis. 

Of  great  importance  for  the  scientific,  as  well  as  the  practical,  portion 
of  medicine,  are  also  the  discoveries  made  during  the  present  century  in 


—  853  — 

the  department  of  the  reproductive  arts,  and  the  advances  in  mechanics 
and  technics,  which  have  been  pushed  to  a  height  heretofore  undreamed  of. 

To  point  out  only  a  few  of  these,  we  majr  mention  under  the  first  .head  the  arts 
of  lithography  (invented  by  Aloys  Senefelder,  died  1834)  and  chromolithograph}7,  of 
daguerreotyping  (1833)  and  photograph}-  (1839),  of  wood-cutting,  which  has  been  so 
highly  developed  in  our  day,  and  has  taken  the  place  of  the  expensive  steel  and 
copper  engraving  for  purposes  of  illustration.  In  the  second  category  we  may  notice 
first  of  all  the  improvement  of  the  microscope,  and  in  general  of  the  physical  and 
mechanical  apparatus  employed  in  medicine;  the  pneumatic  boot,  pneumatic  cabinet, 
pneumatic  receivers  and  apparatus,  the  more  useful  industrial  employment  of 
caoutchouc,  the  sphygmograph,  physiological,  optical,  chemical  and  surgical  apparatus 
and  instruments,  the  galvanic  cautery,  the  apparatus  and  arrangements  for  the  trans- 
port of  the  sick  and  for  the  care  of  the  wounded  and  the  diseased  (the  railroad  invented 
by-  Geo.  Stephenson  in  1829,  introduced  into  Germany  in  1835)  etc.,  and  the  results 
attained  by  their  means.  The  improvements  of  the  microscope  especially  by  the 
engineer  Selligue,  the  two  Chevaliers  (achromatism)  and  Fraunhofer  —  John  Dollond 
( 1 706—1  TGI,  originally  a  silk-weaver)  had  made  achromatic  lenses  as  early  as  1757 
—  like  its  invention  in  the  17th  century,  were  the  undoubted  cause,  and  in  part  too 
the  result,  of  the  tendency  of  the  medicine  of  our  age,  and  particularly  of  German 
medicine,  to  the  investigation  of  the  smallest  corporeal  elements,  the  most  minute 
corporeal  life,  whose  principle  it  was  believed  had  been  discovered  in  them,  without, 
however,  drawing  anj-  nearer  to  its  real  cause.  The  cellular  pathology  of  the  present 
day,  which,  like  all  theories  of  the  past,  will  remain  of  historic  value  for  the  future  as 
an  evidence  of  the  medical  spirit  of  the  age,  must  be  regarded  as  an  expression  of 
the  influence  of  the  microscope.  The  most  notable  microscopic  technicians  in  our 
day  are  Giov.  Batt.  Amici  (1784-1863)  in  Florence;  Charles  Chevalier  in  Paris 
(inventor  of  the  immersion  lens  and  compound  objective);  Kellner  in  Wetzlar, 
Oberhauser  and  Hartnack  in  Paris,  Schiek  in  Berlin,  Jos.  von  Baader  (died  1835),  an 
engineer  in  Munich,  Kuess  in  Hamburg,  Karl  Zeiss  in  Jena  etc.  Of  late  the  instru- 
ments of  Zeiss  (Jena  glass  etc.)  with  Abbe's  illuminating  apparatus  have  become 
specially  famous.  Emil  Stohrer  (1810-1883)  in  Leipzig  acquired  great  reputation  as 
a  manufacturer  of  electro-therapeutic  apparatus.  To  proceed  any  further  in  our 
enumeration  would  lead  us  too  far. 

The  development  of  the  medical  press  in  our  age  has  not.  as  it  seems, 
yet  reached  its  climax,  for  its  extent  is  daily  increasing,  so  that,  together 
with  the  not  inconsiderable  production  of  books,  it  threatens  to  attain, 
and,  indeed,  has  already  attained,  the  proportions  of  an  illimitable  flood. 
The  experimental  and  statistical  tendency  of  medicine,  for  the  satisfaction 
of  which  a  continually  extending  press,  and  an  ever  increasing  circle  of 
medical  literati,  are  compelled  to  labor,  contributes  most  largely  to  this 
condition  of  affairs. 

The  literary  productions  of  the  day  are  thus  participated  in  by  an  ever  enlarging 
circle,  so  that  to-day,  quite  in  contrast  with  the  custom  of  earlier  times,  it  is  a  great 
rarity  tor  a  physician  not  to  have  published  at  least  a  few  interesting  cases.  The 
medical  press  of  our  day  has,  doubtless,  been  of  great  advantage  in  preserving  the 
interest  of  the  mass  of  physicians  in  the  scientific  questions  of  the  time,  in  alleviating 
professional  trials,  in  utilizing  observations  heretofore,  as  a  rule,  important  merely7  to 
the  special  physicians  therein  concerned,  and  in  investigations  to  a  certain  extent 
special  in  their  nature.  On  the  other  hand,  through  this  participation  in  the  current 
questions  of  struggling  science,  the  so-called  medical  fashions,  particularly-  fashionable 


—    S54  — 

therapeutics,  to  which  the  experimenting  hospital  physicians  or  clinicians  have 
commonly  given  occasion,  have  been  promoted  in  practice.  Another  result  of  the 
wide  extent  of  the  medical  press  is  unquestionably  the  decline  of  medico-historical 
studies,  and  tBe  neglect  of  the  books  and  observations  —  to  say  nothing  of  the  methods 
of  observation — of  the  earlier  physicians,  so  that  a  retrospective  glance  into  medicine 
is  rare,  inasmuch  as  the  affairs  of  the  present  seem  to  exhaust  the  interest  and  the 
gth  of  our  physicians.  Finally  a  peculiar,  and.  if  such  an  expression  may  be 
allowed,  a      -  erudition  and  demonstration  at  the  bedside  have  come  into  vogue, 

an  erudition  based  rather  upon  the  collected  experience  of  others  than  upon  personal 
experience  and  observation,  to  the  exclusion  of  all  deductive  reasoning.  By  this 
enormous  collection  of  cases  however,  the  difficulty  of  the  practitioner  in  utilizing 
the  material  increases.  This  is  eq  ecially  true  with  regard  to  the  so-called  clinical 
material,  since  the  conditions  under  which  it  is  collected.  &-  the  method  and 

purr  its  collection,  which  scarcely  ever  pursue  chiefly  strictly  practical  aims, 

differ  very  greatly  from  the  demands  and  the  form  of  ordinary  or  normal  practice. 

An  enumeration  of  the  medical  journalistic  literature  of  our  century  would  far 
transcend  the  limits  of  the  preseut  work.  Accordingly  only  a  few  of  the  earlier  and 
still  existing  examples  of  this  literature  will  be  mentioned,  without  pretending  to  com- 
pleteness in  our  discussion  of  the  subject.  In  the  year  lv7^  we  bad  in  Germany  no 
than  78  — iical  organs,  and  in  the  meantime  this  number  has  been  increased. 
Among  these  are:  "Reil'a  Archiv  Pfaff  s  Mittheilungen  aus  der  Medicin"; 
'"Horns  Archiv":  'Meckel?  Archiv":  Hufeland's  "Journal  "  the  first  German 
weekly  journal  I  and  :"  Bihliothek  der  praktischen  Heilkunde  ":  Gilbert's  'Annalen"; 
Oken  s  "Isis  ":  Joh.  Friedr.  Pierer  s  1767-1832:  the  ancestors  of  the  author  of  the 
well-known  "'  Conversationslexicon  were  physicians,  like  himself.  Gg.  Peter.  1646- 
1685.  was  a  physician  "  Medicinische  Annalen  nnd  medicinische  Zeitung"  :  Hecker's 
"Hi  -ehe  Annalen  "  :  Holsehers  "'Annalen  der  Heilkunde        Gersdorff's  "Reper- 

torium der  medicinisehen  Journal:?  -er's  "  Repertorium  der  .Medicin  ":  Rust 

and  Kritisches  Repertorium  " ;    Kleinert's  "  Repertorium  der  mediciniseheu 

Journalist:'*  ' :  Tiedemann  s  "Zeitschrift  fur  Physioiccie  :  Rusts  "  Magazin  fur 
Heilkund-r  Qenschel's  "Janus ":  ' Jahrbucher  der  ambulatorischen  Klinik  in 
Halle  :  Sach  s  "  Jahrbucher  der  Leistungen  der  Heilkunde  :  Froriep  s  "  Notizen  ": 
Beck's  "Allgemeines  Repertorium  :  Oppenheim  s  "  Zeitschrift  :  Hitzig  s  'Annalen": 
Loder's  "  Journal  for  Chirurgi-  '  -  deiberger  Jahrbuche:  iDger  gelehrte 

Hohnbaum  and  Jahn's  '   Medicinisches  Conversationsblatt     :  "Zeit- 
schrift fur  Geburtshilfe " ;    "Berliner  medicinische   Centralzeitung     :       Archiv  des 
'aekervereins  " ;    "Jenaer   Litentturaeitane  L:*erarisches   Central- 

"  of  Zarncke    review   :  Siebenhaar  and    Mart        -       Magazin    fur   Staarsarznei- 
knnde  ' :  Wochenschrii:  "  -  he   Klinik     : 

Betz  s  "  Memorabilien  :  Wintrich's."  Medicinische  Xeuigkeiten  :  Correspnndenz- 
blatt  for  Schweizer  Aerzte"  ;  Henle  and  Pfeufer's  "  Zeitschrift  fur  rationelle  Medicin": 
J.  Miller's  "  Archiv  fur  Anatomic  Physiologie  nnd  wissensehaftliche  Medicin"  ; 
~n  fur  praktische  Aerzte  '.  edited  by  Paul  Guttmann  :  "Allgem. 
med.  Centralzeitung  "  in  Berlin,  founded  by  J.  J.  Sac:  -  332;  "  Bay- 

risches  medicinisches   Intelligenzblatt "' :     Wittels  •       Wiener   Wochenschrift ", 

the  excellent  organ   of  the   "  New  Vienna  School    ;   Schnr  :ener  medicin- 

ische roedico-ehirurgiscbe  Rundschau',   the  latter  two  the 

organs  of  the  "  Young  Vienna  School" :  "Berliner  klinische  Wochenschrift",  the 
literary  rendezvous  of  the   Berlin '"  Natural  Scientific   School        "  Prager  medicin- 

1.   The  author  seems  to  use  this  word  in  the  unusual  sense  (at  least  in  English)  of 
-  -  •     -    I      ses '        H . 


—  >5o  — 

ische  Wochenschrift ":  "  deutsehe  Zeitschrift  fur  Thiermedicin  und  vergleichende 
Pathologic":  "Archiv  fur  Psychiatrie  und  Nervenkrankbeiten"  :  ' 'deutsehe  Zeit- 
schrift fur  Chirnrgie":  Roser  and  Wunderlich's  'Archiv  fur  physiologisehe  Heil- 
kunde";  "Archiv  fiir  Geburtshilfe  und  Gynakologie "  :  "Archiv  fur  Ohrenheilkunde  "; 
Ziemssen's  "  deutsehes  Archiv  fur  klinische  Medicin  '  :  Canstatt's  '  Jahresbericht "  ; 
Schmidt's  ''  Jahrb'ucher  ".  edited  by  Prof.  A.  Winter  in  Leipzig  at  an  earlier  period 
in  conjunction  with  Herm.  Eberh.  Riehter.  1808-1876  .  founder  of  the  "deutsehe 
Aerztebund  ",  1873,  professor  in  Dresden  :  Yarrentrapp  s  "Zeitschrift  fur  Hygieine" 
(the  first  German  journal  devoted  to  hygiene.  V.  was  the  pioneer  hygienist  of 
Germany.  School  hygiene  and  particularly  the  "  vacation  colonies  "  of  poor  school 
children  were  founded  by  him! ;  Reinbardts  or  Yirchow's  "Archiv".  published  since 
1S4T  in  conjunction  with  the  lamented  B.  Reinhardt :  "Archiv  fur  experimentelle 
Pathologie  und  Pharmakologie  :  'Archiv  fiir  Staatsarzneikunde  :  '*  Prager  Yiertel- 
jahresschrift  " :  "' Jahresberichte  uber  Fortschritte  der  Anatomie  und  Physiologie"  ; 
"  deutsehe  medicinische  Wochenschrift      by  P.  Borner    182   -188s  deutsehe  Zeit- 

schrift fiir  praktische  Medicin"  by  Kunze.  continued  by  B.  Frankel :  "  deutsches 
Archiv  fiir  Geschichte  der  Medicin  nnd  medic.  Geographie  ".  edited  by  Heinricb 
Rohlfs  (and  earlier  in  conjunction  with  Gerhard  Rohlfs,  the  African  traveller)  etc. 
Among  English  journals  we  mention  "  The  Medico-chirurgical  Transactions,  by  the 
Medical  and  Chirurgical  Society  of  London  ":  "Dublin  Medical  Transactions  "  : 
"  Edinburgh  Medical  and  Surgical  Journal  :  *  The  Medico-chirurgical  Review  "  ; 
"  The  London  Medical  and  Surgical  Journal  :  '*  The  Liverpool  Medical  Gazette  "  ; 
"The  Quarterly  Medical  Review":  '"Guy's  Hospital  Reports':  "  The  Lancet "  : 
"  The  London  Medical  Gazette  "  British  and  Foreign  Medical  Review  :  "  Dublin 
Medical  Press  "  :     "  Medico  chirurgical  Review  'Edinburgh  New  Philosophical 

Journal":  ['"British  Medical  Journal  "  ;  "Dublin  Journal  of  Medical  Science": 
"Glasgow  Medical  Journal  ':  "  London  Medical  Record  ":  "Braithwaite  s  Retrospect  "; 
"  The  Practitioner  etc.  —  The  earliest  medical  journal  of  the  United  Sia:es  was  the 
'  New  York  Medical  Repository  '  (1797-1824  .  of  which  mention  has  been  already 
made.  Next  in  order  of  time  was  the  "  Philadelphia  Medical  Museum  "  1804—1811  | 
edited  by  Dr.  John  Redman  Coxe.  which  was  followed  almost  immediately  by  the 
"Philadelphia  Medical  and  Physical  Journal  "     1804      -  edited   by  Dr.  Benj.  S. 

Barton.  The  "Baltimore  Medical  and  Physical  Recorder ".  edited  by  Dr.  Tobias 
Watkins,  appeared  in  1808-9,  and  the  ''  New  England  Journal  of  Medicine  and 
Surgery"  began  its  career  as  a  quarterly  in  Boston  in  1812.  The  latter  journal  in 
1828  was  consolidated  with  the  "  Boston  Medical  Intelligencer  and  converted  into  a 
weekly  under  the  title  of  "The  Boston  Medical  and  Surgical  Journal  .  which  con- 
tinues to  be  one  of  our  ablest  medical  periodicals  at  the  present  day.  The  earliest 
medical  journal  west  of  the  Alleghany  mountains  was  the  "  Western  Quarterly 
Reporter  of  Medical.  Surgical  and  Natural  Science'",  which  appeared  at  Cincinnati 
in  1822-23  under  the  editorship  of  John  D.  Godman.  The  "  Journal  de  la  Societe 
Medieale  de  la  Nouvelle  Orleans  '  .  a  quarterly  which  appeared  in  1831,  was  the  first 
medical  journal  published  in  the  South,  and  the  "Pacific  Medical  and  Surgical  Journal", 
which  appeared  in  ISoS.  is  the  oldest  of  the  existing  medical  periodicals  of  the  Pacific 
coast  (Billings).     According  to  Dr.  John  S.  Billings  there  were  in  the  States, 

in  1876,  4ii  regular  medical  journals,  with  S  in  Mexico  and  7  in  Canada.  The  more 
important  of  the  existing  medical  periodicals  of  the  United  States  arc:  "The 
American  Journal  of  the  Medical  Sciences'  .  which  made  its  first  appearance  in  1-20 
under  the  title  of  the  "  Philadelphia  Journal  of  the  Medical  and  Physical  Sciences  ', 
edited  by  Dr.  Nathaniel  Chapman.  This,  the' facile princeps  of  American  medical 
journalism,  became  in  ls-t>  the  recognized  organ  of  Americau  and  English  medicine, 
and  with   numerous   and  able  collaborators   in   England  adopted  the  additional  title 


—  85(5  — 

of  "The  International  Journal  of  the  Medical  Sciences".  Its  present  editors  are 
Dr.  I.  Minis  Hays  of  Philadelphia  and  Malcolm  Morris,  F.  R.  C.  S.,  of  London; 
"New  York  Medical  Journal";  "  New  York  Medical  Record "  ;  "Medical  News" 
(Philadelphia);  "The  Medical  Times";  "Boston  Medical  and  Surgical  Journal"; 
"Chicago  Medical  Journal  and  Examiner";  "Cincinnati  Lancet  and  Clinic"; 
"St.  Louis  Medical  and  Surgical  Journal"  ;  'Maryland  Medical  Journal  "  ;  "New 
Orleans  Medical  and  Surgical  Journal";  "  Louisville  Medical  News"  ;  "  Gaillard's 
Medical  Journal";  "  Journal  of  the  American  Medical  Association";  "American 
Journal  of  Obstetrics";  "Virginia  Medical  Monthly";  "American  Journal  of 
Pharmacy";  "Archives  of  Ophthalmology";  "Archives  of  Otology";  "Archives  of 
Pediatrics"  etc.].  The  "  Medicinisch-Chirurgisches  Correspondenzblatt  "  (monthly), 
edited  by  Dr.  Marcell  Hartwig  of  Buffalo,  N.  Y.,  was  the  first  organ  of  the  German 
physicians  in  the  United  States.  [In  1886  the  "  New  Yorker  medizinische  Presse  ",  a 
monthly  journal  in  the  German  language,  appeared  in  New  York  under  the  editorship 
of  Dr.  G.  W.  Rachel.]1  — Among  the  French  we  may  mention  :  the  "  Memoires  de  la 
Societe  d'  Emulation"  ;  "  Bulletins  de  la  Societe  medicale  d'  Emulation  "  ;  "Aimales 
cliniques  de  la  Medecine  de  Montpellier  "  ;  "  Memoires  et  Bulletins  de  1'  Academic  de 
Medecine";  "Archives  Generales  de  Medecine";  "Revue  Medicale  Franeaise  et 
Etrangere";  "Journal  de  Medecine  et  de  Chirnrgie  Pratique";  "La  Lancette 
Fran9aise";  "Journal  Therapeutique  ";  edited  b}r  Dr.  Adolphe  Gubler  (born  inMetz 
1812,  died  1879  in  Toulon,  Member  of  the  Academie  and  at  an  earlier  period  physician 
to  the  Hopital  Beaujon),  professor  of  therapeutics  in  Paris;  "  L'  Union  Medicale", 
edited  by  Amedee  Latour  (died  1882) ;  "Gazette  des  Hopitaux  "  ;  "Gazette  Medicale  "; 
"Gazette  Hebdomadaire  de  Medecine  et  de  Chirurgie";  in  Belgium  "L'Abeille 
Medicale";  "  L'  Art  Medicale  "  (Rud.  Laussedat,  died  1878)  ;  "Journal  de  Medecine 
de  Bruxelles  "  (edited  by  Prof,  van  den  Corput)  ;  in  Russia  the  "  Petersburger  medi- 
cinische  Zeitung  "  (edited  for  a  long  time  by  Heine's  brother  Maximilian,  1811-1878)  ; 
in  Spain  "  El  Siglo  Medico  "  ;  "  El  Genio  Medico  "  (edited  by  Dr.  Tejada  y  Espana, 
died  1886),  etc.  French  journalism  especially  acquired  a  rank  growth  under  the 
influence  of  the  pathologico-anatomical  school,  so  that  since  the  thirties  a  genuine 
flood  of  medical  periodicals  has  arisen,  with  the  object  of  preserving  the  endless  facts 
and  experiments  which  have  already  been  repeatedly  published. 

A  peculiarity  of  the  medical  periodical  literature  of  the  present  cen- 
tury, and  indeed  of  scientific  literature  in  general,  is  that  in  our  age  it  is 
everywhere  written  in  the  national  language,  while  the  international  Latin 
was  far  more  commonly  emploj'ed  by  savants  and  physicians  even  in  the 
18th  century.  The  Latin  language  was  preserved  too  in  dissertations,  at 
least  in  many  universities,  even  be%yond  the  middle  of  the  present  centur}-. 

By  this  general  employment  of  the  national  language  literary  productions  have 
been  increased  and  facilitated,  while  the  survey  of  the  literature  of  other  peoples  has 
become  rarer  and  more  difficult,  and  the  independent  acquisition  and  enjoj'ment  of 
such  literature  (so  far  as  it  is  not  obtainable  by  reports)  have  been  comparatively 
diminished.  The  medical  literature  of  individual  peoples  lias  lost  its  earlier  inter- 
national and  universal  character,  and  become,  so  to  speak,  more  localized.  Another, 
not  always  beneficial  (indeed,  usually  injurious)  and  often  frivolous  result  of  the 
general  use  of  the  national  language  and  of  printing,  has  been  the  appearance  of 

1.  Most  of  the  journals  mentioned  will  compare  favorably  with  similar  periodical 
literature  of  any  other  country.  To  many  other  of  our  journals  Dr.  Billings' 
application  of  the  French  criticism,  "  II  y  a  trop  de  tintamarre  la  dedans,  trop  de 
brouillamini",  is  both  witty  and  wise.     (II.) 


—  857  — 

innumerable  so-called  popular  works  on  medical  subjects.  The  deceptive  daily 
advertisements  of  proprietary  remedies  are  likewise  to  be  looked  upon  as  an  out- 
growth of  the  press. 

As  first  during  the  lSth  century  in  France,  so  also  among  other 
nations,  and  especially  in  Germany,  there  have  reappeared  in  our  century 
of  specialism  those  literary  associations  which  find  their  expression  either 
in  great  compilations,  published  by  many  specialists,  pursuing  rather 
literary  than  practical  aims,  too  comprehensive  and  detailed  (and  from  the 
accumulation  of  material  in  the  present  day  promising  to  continue),  or  in 
journals  managed  by  the  combined  experts  of  one  and  the  same  department. 
To  this  class  belong  too  the  innumerable  city  and  provincial  societies,  and 
the  migratory  assemblies  of  savants  of  all  kinds. 

The  first  "  Wanderversammlung"  of  German  naturalists  and  physicians  was 
called  into  existence  by  Oken  in  1822,  and  served  as  a  model  for  all  such  institutions 
in  other  countries  and  on  other  occasions.  Nowadays  all  branches  of  science  (and 
even  trades  down  to  hatters  and  tailors)  hold  such  "  congresses"  ;  indeed  we  have 
now  an  "International  Congress"  in  the  department  of  medicine.  This  German 
congress  of  savants,  originally  constituted  under  the  idea  of  the  unity  of  the  practical 
sciences  as  a  whole,  has  by  degrees  lapsed  into  the  popular  principle  of  the  associa- 
tion of  specialties  and  specialists,  so  that  one  branch  after  another  has  detached 
itself  from  the  parent  stem  and  pursued  special  objects  in  distinct  "sections". 
Indeed  some  of  these  associations  degenerate  into  mere  cliques:  "  One  man  protects 
and  supports  another,  because  he  is  himself  protected  and  supported  by  him.  To 
most  of  them  science  is  merely  something  by  which  they  are  enabled  to  make  a 
living,  and  they  deify  even  error,  if  from  it  they  make  their  living"  (Gothe).  An 
association  of  the  practising  physicians  of  Germany,  to  pursue  practical  and  social 
objects,  under  the  direction  of  certain  savants  and  doctrinaires,  is  in  process  of  forma- 
tion. The  association  of  German  physicians  for  the  cultivation  of  public  hygiene  is 
already  in  possession  of  a  very  prosperous  organization,  for  here  the  element  of 
practical  physicians  proper  has  energetically  assumed  the  initiative  and  has  the  pre- 
ponderance. 

[fn  no  country  of  the  world,  probably,  has  the  principle  of  medical  "associations" 
been  developed  so  widely  and  completely  as  in  the  United  States.  Besides  the  almost 
innumerable  state  and  county  medical  societies,  and  the  associations  connected  with 
our  larger  cities,  there  were  in  1884—85  the  following  "  National  Medical  Associations": 
The  American  Medical  Association,  organized  1847;  American  Pharmaceutical 
Association,  1852;  American  Ophthalmological  Society,  1864;  American  Otological 
Society,  1868;  American  Neurological  Association,  1875;  Association  of  Medical 
Superintendents  of  American  Institutions  for  the  Insane;  American  Association  for 
the  Cure  of  Inebriates,  1870;  American  Public  Health  Association,  1872;  American 
Gynecological  Society,  1876;  Association  of  Medical  Officers  of  American  Institutions 
for  Idiotic  and  Feeble-Minded  Persons,  187(5;  Association  of  American  Medical  Editors, 
1869;  Association  of  American  Medical  Colleges,  1876;  American  Dermatological 
Association,  1876;  American  Academy  of  Medicine,  1876;  American  Laryngological 
Association,  1878;  American  Surgical  Association,  1879;  National  Association  for 
the  Protection  of  the  Insane  and  the  Prevention  of  Insanity,  1880;  American  Climato- 
logical  Association,  1883.  In  the  same  year  there  were  no  less  than  36  local  medical 
societies  in  the  city  of  New  York  alone.  Without  denying  certain  advantages  con- 
nected with  such  a  thorough  division  of  medical  labor  in  our  larger  cities,  the  ten- 
dency to  the  formation  of  petty  cliques  and  the  danger  of  running  "  specialism"  to 
seed  are  very  manifest.     (H.)] 


—  858  — 

The  German  universities  have  decreased  considerably  in  number 
during  the  present  century.  In  1800  the  university  of  Ingolstadt  was 
abolished  and  united  with  that  of  Landshut,  which  in  1827  was  in  turn 
removed  to  Munich.  The  university  of  Fulda  ceased  to  exist  in  1804,  and 
the  famous  old  universit}*  of  Helmstiidt  in  1809.  Th<:  university  of 
Frankfort-on-the-Oder  was  in  1811  united  with  that  of  Breslau,  while  a 
year  earlier  the  university  of  Berlin  was  newly  founded.  In  1816  the 
famous  university  of  Wittenburg  was  united  with  that  of  Halle.  The' 
universities  of  Ma3Tence  and  Altdorf  died  out.  On  the  other  hand  the' 
university  of  Bonn,  abolished  in  1792,  was  restored  in  1818,  the  university 
of  Dorpat  was  revived  in  1802,  and  the  university  of  Zurich  was  founded 
in  1833.  Strassburg,  after  its  restoration  to  its  native  land,  was  re- 
organized upon  the  German  system  in  1872  as  the  youngest  of  the  German 
universities  —  it  is  in  fact  one  of  the  oldest.  The  German  universities  of 
the  present  da}-,  however,  in  contrast  with  those  of  the  preceding  century, 
have  become  almost  universally  mere  places  for  the  study  of  special 
branches,  and  for  the  acquisition  of  the  knowledge  absolutely  requisite  for 
securing  a  livelihood  (Fach-  und  Brodstudiums),  and  the  reputation  of  a 
savant  frequently  casts  the  calling  of  a  teacher  into  the  shade.  They  are 
no  longer  simple  institutions  of  instruction,  but  serve  likewise  as  places- 
for  investigation — a  change  which  began  to  manifest  itself  as  early  as  the 
18th  century.  This  peculiarity  not  infrequently  works  to  the  disadvantage 
of  their  educational  aims.  In  all  our  universities  too  the  clinical  or  prac- 
tical side  of  medical  education  is  largel}-  cultivated,  though  least  in  oper- 
ative measures.  All  are  supplied  with  the  necessary  institutions  and 
laboratories,  which  are  open  to  the  students. 

Besides  the  institutions  already  mentioned,  the  university  of  Czernowitz  was 
opened  in  1875,  and  the  oldest  German  university  in  Prague  was  divided  into  a 
German  and  a  Czech  department  in  1882.  A  large  number  of  German  universities 
was  also  abolished,  chiefly  by  Napoleon  I. :  Fiinfkirchen  (a  German-speaking  univer- 
sity, though  located  in  Hungary),  Bamberg,  Olmiitz  (1853),  Culm,  Cologne,  Erfurt, 
Treves,  Dillingen,  Paderborn,  Rinteln,  Salzburg  (1810),  Dtiisburg,  Biitzow,  Herborn 
(1817,  founded  1584),  Lingen,  most  of  them,  as  we  see,  located  in  towns  forming  the 
residences  of  bishops.  The  cultivation  of  the  sciences  was  injured  thereby,  although 
by  the  enlargement  of  the  surviving  institutions  the  professors  gained  in  influence 
and  income,  a  matter  in  which  the  representatives  of  the  universities  have  taken  a 
lively  interest  in  our  century.  On  the  other  hand,  the  French  Faculties,  abolished 
during  the  Revolution,  were  restored  bjr  Napoleon  I.  and  Louis  XVIII,  but  now  five 
Faculties  were  established,  the  juristic,  medical  and  theological,  with  the  philosophical 
now  divided  into  two,  viz.,  the  Faculty  of  letters  and  philology,  poesy,  geography, 
history,  rhetoric  and  geology,  and  the  Faculty  of  Sciences,  to  which  were  assigned 
the  mathematical,  mechanical  and  natural  sciences,  together  with  philosophy.  In 
the  year  187;">  a  retrograde  movement  towards  the  mediaeval  division  of  universities 
was  made  in  France  (as  at  an  earlier  period  in  Belgium),  by  the  establishment  of 
state  and  so-called  free  universities,  the  latter  of  which  belong  to  the  clergy  and  are 
similar  in  their  influence  and  evil  effects  to  the  clerical  universities  of  an  earlier 
period.  We  see  here  again  an  exemplification  of  Buckles  remark,  that,  after  great 
wars,  the  power  of  the  priests  always  increases. 


—  859  — 

During  the  course  of  the  present  century  the  German  universities' 
have  been  all  reorganized.  The  branches  of  natural  science  have  been 
withdrawn  from  the  medical  professors  and  placed  in  the  hands  of  special 
teachers.  Gradually  instruction  in  these  branches  has  become  obligatory 
upon  physicians,  and  accordingly  they  have  usurped  the  place  of  the  ear- 
lier philosophical  subjects  of  instruction,  to  the  advantage  of  specialism 
and  the  injury  of  the  general  education  of  the  students. 

The  subjects  of  medical  instruction  too  have  been  multiplied  (a  process  not  yet 
entirely  finished),  and  thus  the  theoretical  education  of  students  is  presumed  to  be 
promoted.  But  at  the  same  time  the  defective  instruction  in  the  natural  sciences 
(physics,  chemistry,  botany,  zoology,  comparative  anatomy,  and  for  a  long  time  also 
mineralogy)  produces  simply  superficial  learning,  and  often  does  more  harm  than 
good.  In  spite  of  the  prolongation  of  the  term  of  stud}'  (to  5  years),  and  in  spite  too 
of  the  fact  that  the  clinical  system  of  instruction  is  eve^where  introduced,  practical 
education  on  leaving  our  universities  is  trifling,  for,  as  we  know,  the  students  in  a  few 
places  only,  before  entering  upon  their  practical  career,  are  enabled  to  learn  upon  the 
living  patient  how  to  perform  any  operative  procedure  whatsoever.  And  as  long  as 
the  final  examinations  are  not  assigned  in  each  country  to  boards  of  examination 
independent  of  the  universities,  the  free  choice  of  his  teacher,  so  verj'  important, 
indeed,  so  essential  to  the  practical  formation  of  the  future  physician,  and  the  actual 
liberty  of  removal,  are  lacking,  although,  from  the  degradation  of  physicians  to  the 
level  of  "  tradesmen'',  both  these  deficiencies  must  be  expected.  The  last  measure, 
however,  imperfect  and  unjust  as  it  is,  seems  in  the  light  of  all  historical  experience, 
destined  necessarily  to  exercise  the  worst  influence  upon  medical  studies  and  pro- 
fessional standing.  The  same  may  be  said  of  the  testimonium  required  by  the 
universities,  which  no  longer,  as  heretofore,  entitles  a  classical  education  only  to  the 
study  of  medicine,  since  a  practical  school  education  is  now  sufficient  for  this  purpose. 
We  say  nothing  of  the  authorization  of  female  students  of  medicine,  already  effected' 
in  other  countries  and  commented  upon  favorably  by  some  of  our  German  teachers. 

[According  to  Dr.  John  S.  Billings,  there  had  been  chartered  in  the  United  States 
up  to  the  year  1876  no  less  than  84  medical  schools,  of  which  59  were  still  in  opera- 
tion at  that  date.  The  more  important  of  these  schools  (omitting  those  founded 
during  the  18th  century,  which  have  been  already  mentioned),  with  the  year  when' 
their  first  diplomas  were  awarded,  are  as  follows:  Medical  Department  of  the 
University  of  Maryland,  1811  ;  Medical  Department  of  Yale  College,  1814;  Bowdoin 
College  and  Medical  School  of  Maine  (Brunswick),  1821  ;  Medical  School  of  the  State 
of  South  Carolina  (Charleston),  1825  ;  Jefferson  Medical  College  (Philadelphia),  1826; 
Medical  College  of  Georgia  (Augusta).  183:5;  Medical  Department  of  the  University 
of  Louisiana  (New  Orleans),  1835;  Medical  Department  of  the  University  of  Louis- 
ville, 1838;  Albany  Medical  College,  1839;  Medical  College  of  Virginia  (Richmond), 
1839;  Medical  Dept.  of  the  University  of  the  City  of  New  York,  1842;  St.  Louis 
Medical  College,  1843;  Rush  Medical  College  (Med.  Dept.  Univ.  Chicago),  Chicago, 
1844;  Medical  College  of  Ohio  (Cincinnati),  1821;  Cleveland  Medical  College,  1844; 
Med.  Dept.  of  the  University  of  Michigan  (Ann  Arbor),  1851;  Med.  Dept.  of  the 
University  of  Nashville,  1852;  Bellevue  Hospital  Medical  College  (New  York  City), 1862. 
The  average  production  of  the  medical  colleges  of  the  United  States  in  the  seven 
years  1870-1876  was  2,100  "doctors"  per  annum.  The  vast  majority  of  our  medical 
schools  are  entirely  disconnected  from  any  other  institutions  of  learning,  though  a 
few  preserve  a  nominal  connexion  with  certain  "  universities"  or  "colleges".  They 
are  merely  voluntaiy  associations,  receiving  no  aid  from  state  or  municipal  authori- 
ties, rarely  possessed  of  any  endowment,  and  depending  for  their  support  upon  the 


—  8(J0  — 

fees  of  their  students.  As  a  rule  nothing  more  than  a  fair  common-school  education 
is  required  as  a  preliminary  to  matriculation,  though  recently  the  Medical  Department 
of  Harvard  University  has  adopted  a  somewhat  more  thorough  preliminary  examin- 
ation and  a  graded  course,  with  the  anticipated  result  of  perceptibly  diminishing  the 
quantity,  and  perceptibly  improving  the  quality  of  its  medical  students.1  The  final 
examinations  are  everywhere  in  the  hands  of  the  professors,  and  the  traditional 
terrors  of  the  "  green  room  '  exist  more  in  anticipation  than  in  reality.  The  usual 
term  of  study  required  for  graduation  is  three  years.  Of  the  natural  sciences 
chemistry  (superficially)  and  more  rarely  botany  alone  are  taught.  In  many  of  our 
medical  schools  clinical  instruction  is  merely  nominal,  though  in  the  large  cities  very 
good  facilities  for  practical  education  are  afforded. 

The  practical  results  of  our  present  system  of  medical  instruction  naturally  vary 
largely  in  different  institutions.  In  all  of  them  the  theoretical  education  of  the 
student  is  inferior  to  that  imparted  by  the  European  universities.  Practically,  how- 
ever, the  conscientious  graduates  of  our  larger  metropolitan  colleges  are  probably 
quite  as  competent  to  cope  with  disease  as  any  of  their  more  highly  ( i.  e.  theoretically  i 
educated  European  colleagues.  In  many  of  the  smaller  colleges  the  results  are,  of 
course,  far  less  successful,  and  the  new-fledged  "doctor"  is  here  turned  loose  upon 
the  world  to  gain  by  experience  what  he  failed  to  acquire  from  the  somewhat  ill- 
supplied  bosom  of  his  alma  mater.  Within  the  last  few  years,  however,  the  establish- 
ment of  "  policlinical"  or  "post-graduate"  medical  schools2  in  many  of  our  large 
cities  has  done  much  to  supplement  the  deficiencies  of  our  minor  institutions  for 
medical  instruction,  and  with  the  increasing  development  of  the  country  and  the 
rapid  extension  of  facilities  of  communication,  it  may  be  reasonably  expected  that 
many  of  our  ill-supplied  and  ill-supported  medical  schools  will  gradually  disappear 
before  the  inexorable  demands  of  the  Darwinian  law.  There  is  genuine  comfort  too 
in  the  reflection  with  which  Dr.  Billings  concludes  his  admirable  sketch  of  the  history 
of  American  "  Literature  and  Institutions  "  during  the  first  century  of  our  Republic: 
"  We  have  no  reason  to  boast,  or  to  be  ashamed  of  what  we  have  thus  far  accom- 
plished .  .  .  and  we  may  begin  the  new  century  in  the  hope  and  belief  that  to 
us  applies  the  bright  side  of  the  maxim  of  Cousin:  '  It  is  better  to  have  a  future 
than  a  past'."     H.] 

2.    SYSTEMS,  THEORIES  AND  SCHOOLS  OF  THE  NINETEENTH  CENTURY. 

From  the  history  of  every  century,  and  especially  from  the  history 
of  medicine,  we  may  draw  the  experience  that  the  representatives  of  any 
epoch  always  regard  it  as  certain  that  they  have  trodden  the  veiy  best 
paths  to  attain  the  knowledge  of  the  truth  ;  the}-  even  incline  to  the 
assumption  that  the}-  alone  are  in  possession  of  the  highest  attainable 
science  and  of  the  best  methods  of  investigation,  indeed,  often  of  the  truth 
itself.  In  this  the}r  doubtless  affirm  nothing  more  than  the  principle  of 
evolution,  in  virtue  of  which  the  living  and  the  present,  in  contrast  to  the 

1.  The  example  of  Harvard  has  also  already  borne  fruit  in  several  other  schools,  and 

the  demand  for  improvement  in  medical  education  is  becoming  daily  more  and 
more  importunate.     (H.) 

2.  Of  these  the  earliest  was  the  "New  York  Polyclinic",  organized  in  1880-81  and 

opened  in  1882.  A  similar  institution  was  opened  in  Philadelphia  in  188:5,  and 
policlinical  schools  are  now  to  be  found  in  most  of  our  large  cities.  Instruction  in 
these  schools  is  imparted  only  to  possessors  of  the  diploma  of  M.  B.  or  M.  D.    (H.  I 


—  861  — 

past,  place  themselves  in  the  forefront  of  the  right.  But  even  the  present 
is,  of  course,  only  a  phase  of  the  general  development  of  culture,  upon 
which  is  imposed  always  those  limitations  and  errors  which  have  ever 
existed  for  and  in  the  development  of  the  sciences,  as  in  that  of  humanity. 
That  this  is  quite  true  for  the  present  century  also,  and  especially  for  its 
medical  culture,  its  history  has  already  demonstrated.  It  is  no  more  free 
from  error  than  the  earlier  centuries,  and,  indeed,  even  surpasses  them  in 
the  monstrosity  of  its  medical  doctrines.  In  this  connexion  we  may 
merely  mention,  by  anticipation,  homoeopath}',  Rademacherism,  ideal 
pathology,  isopathy  etc.,  all  of  them  phenomena  of  our  century,  so  boast- 
ful of  its  superiority.  The  changes  of  systems,  theories,  hypotheses  — 
Goethe  calls  the  latter  lullabies  with  which  teachers  lull  their  pupils  to 
sleep  —  and  methods  of  thought  constantly  recur  so  long  as  medicine 
exists,  and  are  the  expression  of  every  tendency  of  culture  and  of  the  bent 
of  ever}'  age  —  but  they  are  not  the  truth.  Hence  they  are  for  the  most 
part  maintained  only  during  their  period  of  florescence.  And  we  too  at 
the  present  day,  in  spite  of  the  universal  domination  of  the  analytic 
method,  are  not  exempt  from  these  expressions,  and  daily  experience  that 
the  hypotheses  of  the  time  are  regarded  almost  as  so  man}'  truths,  while 
we  have  accustomed  ourselves  to  condemn  only  the  theories  of  the  past. 

"As  regards  the  stand-point  of  theoretic  medicine  no  one  will  be  deceived.  .  .  . 
The  art  of  experimenting  produces  instruments,  but  a  collection  of  experiments  is 
never  made  a  science  by  instruments.  .  .  .  Building  material  is  there  in  abun- 
dance, so  that  we  can  scarcely  see  the  ground  upon  which  the  structure  is  to  stand, 
but  the  foremen  are  disputing  and  uncertain  about  the  plan.  .  .  .  Indeed,  we  are 
led  to  think  that,  among  the  sciences  which  have  for  their  subject  the  knowledge  of 
nature  and  her  forces,  medicine  assumes  the  lowest  place.  .  .  .  What  lies  very 
close  to  fancy  is  employed  as  a  bridge  ;  if  we  come  safely  over  it,  we  let  it  fall  into 
ruin  behind  us,  instead  of  giving  it  a  secure  and  permanent  foundation  ;  if  it  fails  to 
support  us,  we  lay  the  blame  upon  the  imperfection  of  the  science"  (Liebig).  To  us 
the  following  criticism  seems  also  of  value  :  "Our  surgei-y  in  2000  years  has  made 
brilliant  advances  ;  the  special  science  which  considers  the  internal  relations  of  the 
body,  into  which  the  human  eye  cannot  look,  has  made  none;  we  stand  face  to  face 
with  the  same  enigmas  as  did  our  forefathers  "  (Bismarck). 

The  systems  of  an  earlier  day  were  longer-lived  ;  we  need  recall  but 
those  of  the  Dogmatists  and  of  Galen.  In  modern  times  they  are  becom- 
ing more  ephemeral.  While  the  systems  of  Theophrastus,  of  the  Iatro- 
chemists  and  the  Iatro-physicists  lasted,  on  the  average,  a  century,  the 
most  highly  prized  systems  of  the  18th  century  endured  scarcely  more 
than  a  quarter  of  this  period.  Indeed,  many  of  our  own  day  scarcely  last 
more  than  a  couple  of  decennia,  and  are  outstripped  only  by  the  revolu- 
tions in  therapeutic  methods,  so  that  Gutzkow  could  say  ':  Medical  men 
devise  new  systems  every  day". 

So  long  as  the  final  cause  and  the  forces  of  life  itself,  health}-  as  well 
as  diseased,  are  unknown  —  and  in  truth  this  will  always  be  the  case,  for 
here  the  maxim  of  Marcus  Aurelius,  6n  xav  oTtok^".^.  ever  holds  good  — 


—  862  — 

so  long  will  medicine  be  compelled  to  occupy  itself,  as  it  has  done  for 
thousands  of  years,  with  the  changes  of  hypotheses  and  theories.  Much 
error  and  little  truth  is  here  again  the  lot  of  humanity.  Systems,  theories 
and  methods  of  investigation,  however,  disappear  like  the  races  from  which 
they  spring  ;  things  alone  remain  ever  the  same,  and  concerning  these, 
svstems  busy  themselves,  and  over  them  they  dispute  in  the  course  of  the 
history  of  culture,  with  methods  constantly  changing,  yet  from  time  to 
time  recurring  to  some  earlier  path.  Ideas  about  things,  and  the  methods 
of  expressing  these  ideas,  separate  and  distinguish  characteristically  the 
different  epochs  of  civilization.  What  the  struggling  present  considers 
the  highest  point  ever  attainable,  or  perhaps  onby  thus  far  attained,  this 
the  history  of  the  future  may  readil}'  disregard,  as  it  has  done  with  so 
many  similar  views  of  the  past.  The  phases  of  development  of  huraanit}- 
in  history  are  various.  Humanit}'  itself  and  its  essence  alone  remain  un- 
changed. The  latter  is  uninterrupted  development  to  an  object  and  end 
for  us  inscrutable,  but  which,  at  all  events,  excludes  the  possession  of 
complete  truth.  For.  according  to  the  profound  maxim  of  Lessing,  only 
the  struggle  for  the  truth  is  the  portion  of  humanity.  History,  however, 
is  the  only  mirror  in  which  we  can  and  must  regard  the  present,  with  its 
systems  and  methods. 

The  Systems,  Theories  and  Schools 

■of  the  19th  centuiy,  at  least  a  considerable  portion  of  them,  are  rooted  in 
the  soil  of  the  18th  century,  which  was  so  fertile  in  such  phenomena. 
Indeed  their  cradle  was  often  placed  in  the  later  years  of  the  latter  cen- 
tUFy.     Such  was  preeminently  the  case  with  the  so-called 

a.  Theory  of  Excitement, 

a  simple  modification  of,  or  if  you  will,  an  improvement  upon,  Brunonian- 
■ism.     Its  founder  was  the  highly  intellectual 

Johann  Andreas  Roeschlaub  (1768-1835). 
He  was  born  in  Lichtenfels,  near  Bamberg,  and  was  originally  a  student  of 
theology  before  devoting  himself  to  medicine  in  Bamberg  and  Wurzburg.  Graduating 
at  the  age  of  27  years,  he  was  made  in  the  same  year  extraordinary  professor,  and  in 
1798  ordinary  professor  in  Bamberg,  and  physician  to  the  hospital  in  that  place 
under  Marcus.  Thence  he  was  called  in  1802  to  Landshut,  and,  after  the  abolishment 
of  that  university,  to  Munich.  In  1824  he  was  pensioned,  and  in  1834  got  rid  of  by 
the  grant  of  the  title  of  "  Hofrath",  in  place  of  the  position  of  medical  counsellor 
which  he  had  enjoyed  since  1804.  His  chief  works  were:  "  Untersuchungen  liber 
Pathogenie,  oder  Einleitung  in  die  Heilkunde  "  1798-1800,  3  vols.  ;  "  Lehrbuch  der 
Nosologie  ",  1801 ;  "  Magazin  fur  Vervollkommnung  der  theoretischen  und  praktischen 
Heilkunde".  The  latter  journal,  published  from  1799,  had  originally  many  collabor- 
ators, but  lost  them  through  Roeschlaub's  quarrelsomeness,  so  that  he  finally  stood 
alone  and  the  journal  collapsed  in  1803;  "  Erster  Entwurf  eines  Lehrbuchs  der 
allgemeinen  Iaterie  und  ihrer  Propadeutik ",  1804;  "Lehrbuch  der  besondern 
Nosologie,  latreusiologie  und  Iaterie",  1807. 


—  863  — 

The  doctrine  of  excitement  was  a  theory  of  solidism,  a  doctrine  which 
"endeavored  to  mould  into  one  the  errors  of  Brown  and  the  fancies  of 
Schelling."  According  to  this  theory,  life  depends  upon  irritability, 
which,  however,  is  inherent  in  the  organism  as  an  independent  capacity. 
Thus  two  things,  irritability  and  organization,  are  taken  into  consideration, 
while  Brown  recognized  the  former  alone.  Life  also  is  a  condition  not 
only  enforced  from  without,  but  also  springing  from  within.  Excitabilitj-, 
on  its  part,  is  divided  into  susceptibilit}7  to  irritation  and  reaction  against 
it.  These  two  in  fact  represent  one  principle  only,  but  are  to  be  distin- 
guished in  idea.  The  grade  of  irritability  determines  the  condition  and 
behavior  of  the  bod}'.  Bodily  health  consists  in  moderate  irritation  and 
moderate  excitabilit}'.  Qualitative  alterations  of  parts,  accordingly,  are 
not  taken  into  consideration.  Disease,  on  the  contrary,  is  either  a  devia- 
tion from  that  medium  condition  upwards  =  hypersthenia  (instead  of 
Brown's  sthenia),  or  downwards  =  asthenia,  or  a  disproportion  between 
irritation  and  excitabilit}'.  Asthenia  again  is  divided  into  direct  — 
absolutely  —  or  indirect  —  relatively  —  too  slight  irritation,  and  a  condi- 
tion consisting  in  a  combination  of  both.  The  second  variety  is,  for  the 
most  part,  a  sequela  of  hypersthenia.  The  highest  grades  of  asthenia  are 
causes  of  death.  There  is  no  such  thing  as  disease  of  the  fluids  of  the 
body,  though  there  is  a  corruption  of  these.  This  Roeschlaub  endeavors 
to  prove  as  follows  : 

"  That  body  only  can  be  called  organic,  which  has  the  capacity,  of  its  own  inde- 
pendent activity,  to  administer  certain  functions.  To  administer  a  function  in  this 
way  it  is  necessary  that  such  a  substance  shall  possess  the  capacity  to  generate  active 
motions  of  its  parts.  Now  fluid  substances  are  those  whose  constituent  parts  are 
movable  upon  each  other  by  any,  never  so  slight,  motive  force,  are  simply  capable  of 
suffering  passive  motions.  Hence  rigid  bodies  alone  can  generate  active  motions, 
while  disease,  as  a  condition  of  the  organism,  must  be  determined  from  all  or  certain 
of  its  parts.  The  fluids,  however,  as  not  organic,  cannot  be  called  parts  of  the  organ- 
ism. Hence  the  name  of  disease  cannot  be  applied  to  the  changes  which  arise  in  the 
fluids  of  the  organism."     (See  Rohlfs.) 

Besides  disease,  there  is  an  "indisposition",  which  has  for  its  object  not  the 
organism,  but  the  functions. 

Roeschlaub  too  is  one  of  the  first  who  taught  in  Germany  that  "Dis- 
ease is  not  the  opposite  of  health,  and  that  the  limits  arbitrarily  drawn 
between  pathology  and  physiology  must  be  swept  away.1'  This  definition 
was  subsequently  adopted  especially  by  Henle  and  Virchow,  and  was  looked 
upon  as  new,  though  it  was  not  really  so. 

To  his  original  theory  Roeschlaub  subsequently  added  a  chemical  or 
qualitative  potenc}*,  oxygen,  so  as  not  to  avoid  entirety  the  alterations 
of  quality.  In  his  further  course  he  inclined  towards  natural  philosophy, 
then  to  mysticism  and  theosophy,  and  finally  made  the  confession  —  for 
once  an  honest  Systematist  —  that  he  had  been  mistaken  in  his  whole 
theory.  In  this  position  of  honesty  he  stands  almost  alone,  but  furnishes 
undeniable  evidence  of  great  penetration  and  moral  power. 


—  804  — 

Roeschlaub  laid  down,  as  the  quintessence  of  his  doctrine,  thirty  so-called  laws 
of  excitability : 

1.  Without  an  irritant  there  is  no  irritation. 

2.  Without  irritation  no  excitement. 

!!.   Without  irritability  no  irritation  and  likewise  no  excitement. 

4.  Without  irritability  no  vital  function. 

5.  Irritation  stands  and  falls  with  the  irritant. 

fi.   Equally  powerful  irritants  occasion  greater  irritation  the  greater  the  excita- 
bility. 

7.  The  greater  the  excitability,  so  much  the  less  may  be  the  irritant  to  produce 
considerable  excitement  and  conversely. 

8.  Every  irritation  diminishes  excitability  etc. 

— distinctions  in  which,  from  the  standpoint  of  our  present  knowledge,  we  can  recog- 
nize nothing  but  simple  ingenuity. 

The  number,  as  well  as  the  intellectual  importance,  of  the  followers 
of  the  theory  of  excitement  was  considerable.  Still  the  adhesion  of  many 
was  brief.  Among  others  the  adhesion  was  not  pure,  i.  e.  their  own  ideas, 
those  of  the  humoral  patholog}',  of  natural  philosophy,  or  the  doctrines 
of  Red  etc..  were  united  with  those  of  Roeschlaub.  The  most  memorable 
of  the  partisans  of  Roeschlaub's  system  were  :  the  prematurely  deceased 
and  talented 

Ltd.  H.  C.  Niemeyer  (1775-1800  ;  Materialien  zur  Erregungstheorie 
etc..  1800)  ; 

Kurt  Sprengel.  The  best  known  partisan  of  the  theory  of  excite- 
ment was 

Adalbert  Friedrich  Marcus  (1753-1810)  of  Arolsen, 
a  physician  in  Bamberg  after  1778  and  ordinary  physician  of  the  prince-bishop. 
Though  a  Jew  by  birth,  he  became  a  teacher  in  1795  and  finally  director  of  the 
"  Schule  fur  Leibarzte  ".  Subsequently  he  became  one  of  the  first  partisans  of  the 
natural  philosophical  school,  and  finally  a  devotee  of  the  theory  of  inflammation,  a 
forerunner  of  Bouillaud,  who  treated  and  maltreated  with  bleeding  everything  and 
everybody. 

A.  L.  Ernst  Horn  (1774-1848)  of  Brunswick, 
where  he  taught  after  180'2,  subsequently  a  teacher  in  Wittenberg  and  Erlangen,  and 
finally,  after  the  founding  of  the  university,  in   Berlin,  was  an  eminent  university 
professor.     "  Horn's  Archiv"  was  for  a  long  time  an  influential  organ. 

Friedr.  Wilh.  von  Hoven  (1760-1838)  of  Ludwigsburg, 
the  home  of  many  eminent  men,  a  friend  of  the  regimental  physician  Schiller1  of  the 
"Karlschule"  here,  for  a  long  time  professor  in  Wiirzburg,  and  subsequently  medical 
counsellor  in  Ansbach  and  Nuremberg. 

Adolph  Christ.  Heinrich  Henke  (1775-1845),  professor  of  legal 
medicine  in  Erlangen  ;  the  historian  A.  F.  Hecker,  L.  J.  K.  Mende,  the  first 
and  last  eminent  teachers  of  state-medicine  ;  J.  H.  Miiller  ("System  der 
gesammten  Heilkunde  nach  der  Erregungstheorie",  4  vols.);  Ludwig 
Christ.  Wilhelm  Cappel  (1771-1803),  professor  in  Gottingen  ;  the  learned, 
and  in  his  day   highly  esteemed.  Job.  Wilhelm  Heinrich   Conradi  (1780- 

1.  His  monthly  salary  was  30.80  marks  (£7.39). 


—  865  — 

18G1)  of  Marburg,  professor  in  that  city,  in  Heidelberg  and  after  1823  in 
Gottingen  ("Beitrage  zur  Erregungstheorie.  1802";  "Grundriss  der  Patho- 
logie   und  Therapie";    medical  encyclopaedia    and  methodology,    both   re- 
printed  several    times,   etc.);    J.  Jos.  Doemling.  professor    in   Wiirzburg.' 
Eschenmayer  and  manj'  others. 

The  practitioners  and  eclectics  especialh'  were  important  opponents 
of  the  theoiy  of  excitement.  At  their  head  we  may  place  the  Lessing  of 
medicine, 

Johann  Stieglitz  (1767-1840)  of  Arolsen,  one  of  the  clearest  and 
calmest  of  minds,  an  eminent  and  highly  esteemed  physician  and  the 
founder  of  etiological  diagnosis. 

Stieglitz  liad  studied  in  Gottingen,  afterwards  settled  in  Hanover,  where  in  1802 
he  was  appointed  court-physician,  in  1806  physician-in-ordinary,  in  1820  "  Hofrath  ", 
and  died  in  the  offices  of  medical  counsellor  and  president  of  the  medical  board. 

Besides  Brnnonianism,  including  the  theory  of  excitement,  Stieglitz 
with  great  sagacity,  calmness  and  dexterity  also  opposed  homoeopath}'  and 
animal  magnetism.  Regarding  the  former,  i.  e.  the  theory  of  excitement. 
he  said  :  ';  It  is  not  surprising  that  absolutely  nothing  is  cleared  up,  and 
that  practical  knowledge  is  neither  enriched  nor  improved  b}'  these  Bru- 
nonian  refinements.  There  is  no  such  thing  as  one  only  saving  system  ! " 
Such  was  his  judgment  on  theories  in  general  !  —  Towards  the  end  the 
politic,  ingenious  aqct, "diplomatic" 

Christ.  Wilhelm  von  Hufeland  (1762-1836)  of  Langensalza,  son 
of  a  physician  in  Weimar,  also  entered  the  lists  in  opposition  to  the  theory 
of  excitement. 

Hufeland  was  originally  a  practitioner  in  Weimar,  then  became  professor  in 
Jena  and  finally  in  Berlin.  In  the  latter  city  he  was  made  state-counsellor,  became 
a  very  popular  physician  and  was  finally  appointed  physician-in-ordinary.  He  was 
one  of  the  most  famous  physicians  of  his  time,  and  has  remained  known  to  a  wide 
circle  down  to  the  present  day,  particularly  through  his  "  Makrobiotik  ".  In  science 
he  always,  with  the  best  of  intentions,  filled  the  role  of  a  mediator,  but  was  thus 
brought  into  conflict  with  almost  all  theorists,  and  yet  by  the  aid  of  his  powerful 
"  Bibliothek  "  and  his  "  Journal  ",  his  firmness  and  consistency,  lie  was  enabled  to 
control  the  disputants.  He  was  one  of  the  busiest  of  practitioners  and  a  very  fruitful 
author. 

He  wrote:  "  To  him  who  fails  to  make  a  religion  of  the  healing  art  it  is  the  most 
cheerless,  wearisome  and  thankless  art  upon  earth  ;  indeed,  in  him  it  must  become 
the  greatest  frivolity  and  a  sin.  .  .  And  what  is  it  with  many?  Nothing  but  a 
simple  speculation,  a  means  for  making  a  fortune,  for  acquiring  wealth  and  honor, 
at  most  among  the  better  minds  a  system  of  investigating  nature!"  The  latter, 
according  to  the  programme  of  the  "  natural  scientific  school",  is  its  position  at  the 
present  day. — -"Hufeland  belonged  to  those  mediatorial  natures,  who,  without  being 
very  productive  themselves,  possess  the  gift  of  modesty,  of  recognizing  the  services 
of  others,  and  yet  have  talent  enough  of  their  own  not  to  stand  in  the  shade.  He 
had  a  noble,  warm  and  most  benevolent  heart."  (Kohlrausch,  "  Erinnerungen.") 
Hufeland  also  possessed  strong  penetration,  as  is  shown  by  his  saying:  "Successful 
treatment  requires  only  one  third  science  and  two  thirds  of  savoir  faire." 
55 


—  866  — 
Christian  Hkixrkti  Pfaff  (1773-1832)  of  Stuttgart, 

a  pupil  of  the  "Karlschule "  (like  his  countryman  G.  F.  Jaeger.  1785-1866,  the  father 
of  the  speculative  "Discoverer  of  the  soul",  which  was  supposed  to  manifest  itself  by 
evil  exhalations),  from  1797  a  professor  in  Kiel  ("J.  Brown's  System  der  Heilkunde", 
"Revision  der  Grundsatze  des  Brown'schen  Systems"  etc.). 

Phil.  Karl  Hartmann  (1773-1830)  of  Heiligenstadt, 

professor  of  general  pathology  in  Vienna  and  a  famous  teacher  ("Analyse  des 
Brown'schen  Systems',  "  Theorie  der  Krankheit"). 

Alexander  von  Humboldt.     The  eminent 
Friedrich  Ludwig  Kretsiq  (1770-1839). 

first  professor  in  Wittenberg,  where  he  founded  an  ambulatory  clinic,  then  physician- 
in-ordinary  and  professor  in  Dresden  ("System  der  prakt.  Heilkunde  ",  "Krankheiten 
des  Herzens").  Kreysig  first  demonstrated  endocarditis  (long  before  Bouillaud)  and 
was  acquainted  with  defects  of  the  cardiac  valves,  though  not  with  their  diagnosis, 
inasmuch  as  he  was  not  in  possession  of  auscultation.  The  so-called  "  purring 
tremor"  (freinissement  cataire)  was  also  known  to  him  before  Laennec,  and  he 
likewise  recognized  rheumatism  as  a  cause  of  diseases  of  the  heart  (before  Bouillaud). 
—  Also  the  ingenious,  but  eccentric 

Karl  Jos.  Windischmann  (1775-1839)  of  Mayence, 
who,  in  consonance  with  his  course  of  study,  was  sometimes  professor  of  philoi-ophy, 
sometimes  of  medicine,  and  for  a  long  time  physieian-in-ordinary  of  the  elector  of 
Mayence  in  Asehaffenburg,  belonged  among  the  opponents  of  the  theory  of  excite- 
ment. He  embraced  Mesmerism,  and  desired  to  reunite  religion  and  medicine  in 
their  original  relations,1  while  in  deep  Catholic  faith  (the  "-fashion  "  in  this  day  of 
romance,  and  adopted  even  by  many  Protestants  of  that  time)  he  regarded  mental 
diseases  as  results  of  Adam's  sin  etc.  Originally  one  of  the  Illuminati  and  a  Free- 
mason, he  became  afollower  of  Schelling  and  a  Romanci.-t2  who  discussed  the  historical 
development  of  medicine  romanticallj-  and  ingeniously,  but  not  very  profoundly. 
His  chief  title  to  fame  must  rest  upon  the  fact  that  he  was  the  teacher  and  patron  of 
Franz  Bopp,  the  son  of  the  elector's  commissary  and  the  creator  of  comparative 
grammar  and  the  science  of  language. 

Wenzel  Aloys  Stutz  (1772-1806),  a  physician  at  Gmiind  in  Swabia, 
still  known  for  his  treatment  of  tetanus  with  opium,  nitrate  of  potash  internally  and 
potash  baths,  and  the  peripatetic,  ingenious 

GrEORG  Christian  Gottlieb,  baron  Wedekind  (1761-1831).  of 
Gottingen, 

professor  in  Mayence  and  then  ordinary  physician  of  Ludwig  I.  in  Darmstadt,  also 
an  opponent  of  homoeopath}-,  as  well  as 

Christ.  Gottfried  Gruneb  in  Jena, 
and  many  other  physicians  who  still   belonged  entirely  to  the  spirit  of  the 
18th  century,  were  opponents  of  the  theory  of  excitement. 

A  far  worse  offshoot  of  the  Brunonian  theory,  absolutely  baleful  in  its 
application  to  practice,  was  the  so-called  ''New  Italian  Theory"  of 

1.  Like  Ringseis,  who  expected  remarkable  advantages  for  the  sick  from  this  source. 

2.  The  German   "  Ronmntiker  "   is  a  follower  of  medieval  taste  in  art  and  litera- 

ture.    (II. 


86; 


b.  Stimolo  and  Contrastimolo, 

which  had  for  its  author  Giovanni  Rasori  (1762-1837)  of  Milan.  This  was 
a  genuine  blot  upon  the  healing  art  beyond  an}r  other  of  the  various  sys- 
tems, however  strongly  the  same  charge  might  be  made  also  against  the 
latter.  In  this  we  see  again  that  long  centuries  of  experience  and  the 
venerable  conclusions  of  great  minds  may  at  times  be  utterly  lost  to  pos- 
terity, and  in  times  too  which  believe  they  may  boast  of  the  highest  intel- 
ligence. And  poor,  sick  humanity  must  ever  supply  the  material  of  inves- 
tigation for  such  theoretical  systems  (constructed,  we  may  admit,  with  the 
best  of  intentions)  and  for  the  therapeutics  based  thereupon  !  Far  worse 
too  than  the  theories  and  hypotheses  themselves  are  in  this  case  the 
methods  of  treatment  founded  upon  them,  though  fortunately  such  has 
been  the  fact  with  comparatively  few  systems.  Among  these  few  positively 
dangerous  systems  belonged,  however,  as  the  following  examples  will  show, 
the  theory  of  stimolo  and  contrastimolo. 

Rasori  had  studied  medicine  in  Parma,  his  native  c i  1 3r ,  and  in  the  neighboring 
Pisa.  He  then  adopted  in  England  the  Brunonian  theory,  and  after  practising  for  a 
time  in  Milan,  taught  this  theory  in  his  lectures  as  a  professor  in  Pavia,  a  position 
which  he  did  not  long  occupy.  After  the  transformation  of  Upper  Italy  into  the  so- 
called  Cisalpine  Republic  he  occupied  a  high  administrative  position  in  Milan,  from 
which  he  was  called  in  1800  to  devote  his  attention  to  an  epidemic  of  typhus,  which  had 
broken  out  in  Genoa.  On  this  occasion  he  found  such  bad  results  from  the  Bruno- 
nian treatment  that  he  abandoned  it  and  invented  his  own  theory,  which,  as  chief  of 
a  clinic  in  Milan  in  1807,  he  then  zealously  supported,  though  only  in  his  lectures 
and  minor  writings.  After  Upper  Italy  fell  into  the  possession  of  Austria,  Rasori  was 
kept  in  prison  for  four  years,  but  was  then  restored  to  his  position  at  Milan,  and 
retained  it  until  his  death.  The  chief  work  upon  his  theory  was  entitled  "Delia 
nuova  dottrina  medica  Italiana.  Prolusione  alle  lezioni  di  clinica  medica  nella  P. 
Universita  di  Bologna  per  1'  anno  1816-17  del  Professore  Giacomo  Tommasini. 
Firenze,  1817." — Rasori  himself  first  published  his  views  in  his  translation  (1803)  of 
Erasmus  Darwin's  "Zoonomia".  It  was,  however,  his  numerous  pupils  in  Italy  who 
ohiefty  diffused  his  doctrines  in  writings.  —  In  German}'  the  Rasorian  theory  was 
introduced  to  notice  by  W.  Wagner  in  his  "  Kritische  Darstellung  der  Lehre  vom 
Contrastimulus.     Berlin,  1819." 

On  the  whole,  the  doctrine  of  Rasori  too  is  merely  a  new  edition  of 
the  system  of  the  Methodists,  so  often  set  forth,  only  it  had  deteriorated  in 
practice. 

Rasori  assumes  a  diathesis  di  stimolo  (diathesis  sthenica  of  Brown, 
status  strictus  of  the  Methodists)  and  a  diathesis  di  contrastimolo 
(diathesis  asthenica  of  Brown,  status  lax  us  of  the  Methodists),  but,  in 
contrast  to  Brown,  teaches  that  the  diathesis  di  stimolo  is  the  most  fre- 
quent. To  this  he  adds  (again  differing  from  Brown)  a  local  stimulation, 
which  passes  over  into  a  general  diathesis,  a  diathesis  di  stimolo,  unless  it 
is  speedily  removed.  In  the  diathesis  di  stimolo  the  organic  fibre  is  irri- 
tated and  contracted.  The  symptoms  of  this  condition  are,  among  others, 
spasms,    contracted  and  quick    pulse,    active   delirium    etc.,  while    in  the 


—  808  — 

cadaver  are  found  a  contracted  and  bloodless  heart,  and  tense,  deep-red 
muscles.  In  the  diathesis  di  contrastimolo  on  section  we  find  the,  heart 
tilled  with  blood,  together  with  paleness  and  flaccidity  of  its  fibres,  and  as 
symptoms  during  life,  relaxation  of  the  organic  .fibres,  a  weak  pulse,  ring- 
ing in  the  ears,  quiet  delirium,  anxiety,  sopor.  Pain,  tetanus,  constipation, 
mucus-  and  worm  fever  are  to  be  considered  expressions  of  local  irritation. 

The  diagnosis  of  these  diatheses,  singularly  enough,  cannot  be  made 
from  the  s}-mptoms,  but  solely  from  tbe  remedies  which  benefit  them  or 
make  them  worse,  a  doctrine  similar  to  that  of  Rademacher,  though  the 
latter  from  the  efficacy  of  his  remedial  agents  reasoned  back  to  the  dis- 
eases named  after  them. 

There  are  external  and  internal  irritants.  Among  the  latter  belongs 
the  blood,  which  is  likewise  the  most  general  irritant,  while  among  counter- 
irritants  are  classed,  lymph,  bile,  urine,  gastric  juice  etc. 

Venesection  is  to  be  regarded  as  the  most  reliable  diagnostic  means. 
If  it  is  beneficial,  the  diathesis  di  stimolo  is  present  and  remedies  ma}T  be 
selected  accordingly.  For  the  attainment  of  the  diagnosis,  however,  vene- 
section should  not  be  practised  more  than  twice.  If  this  measure  proves 
injurious,  the  diathesis  di  contrastimolo  exists. 

All  remedies  which  act  in  accord  with  a  venesection  which  has  proved 
beneficial  are  likewise  suitable  to  oppose  the  stimolo.  Among  these  con- 
trastimulants  belong  musk,  alcohol,  camphor,  cinchona,  opium,  ethereal  oil, 
ammonia  etc.  On  the  other  hand,  among  the  stimulants  are  aconite,  nux 
vomica,  belladonna,  coffee,  tea,  digitalis,  chamomile,  iron,  jalap,  gamboge, 
ipecac,  castoreum  etc.  —  The  individual  remedies  in  both  these  classes  are 
of  equal  value,  though  a  few  among  them  have  an  eminently  specific  action 
upon  special  organs,  so  that  e.  g.  digitalis  acts  upon  the  heart,  belladonna 
upon  the  brain  and  vessels  etc.  If,  however,  a  remedy  acts  too  powerfully, 
in  other  words  if  the  irritant  acts  less  powerfully  than  the  irritation  of  the 
remedy,  this  fact  is  shown  by  the  unfavorable  action  of  the  drug.  If  e.  g. 
the  contrastimulus  of  the  drug  is  stronger  than  the  irritation,  pain  in  the 
stomach,  vomiting  etc.  occur.  —  Huge  doses  of  medicine  were  often  admin- 
istered, as  e.  g.  1.  4  grammes  of  gamboge  for  diarrhoea,  60-90  grammes  of 
saltpeter  per  diem  etc. 

Diseases  are  divided  into  : 

1.  Infectious  diseases  with  the  diathesis  e  stimolo,  e.  g.  syphilis, 
itch    etc.; 

2.  Epidemic  diseases  arising  from  miasm,  e.  g.  diarrhoea,  typhus  ; 

3.  Hereditary  diseases,  e.  g.  phthisis,  scrofula,' epilepsy  ; 

4.  Diseases  arising  from  accidental  causes. 

The  following  clinical  histories  will  serve  to  show  how  patients  were 
"treated"  in  accordance  with  this  theory  : 

Syphilis. 

"Giuseppina  Vigano  of  Bassera,  aged  27,  stoutly  built,  lias  hitherto  enjoyed  the 
best  of  health.     She  came  to  the  clinic   on  Aug.!},  fearing  that  the  syphilitic  child 


—  869  — 

which  she  was  nursing  had  infected  her.  Facies  good  and  gives  evidence  of  health, 
the  remainder  of  the  skin  somewhat  pale,  appetite,  pulse  and  all  the  functions  normal, 
the  nipples  on  both  sides  slightly  sore,  small  ulcers  upon  the  child's  lips.  Ordered 
spare  diet,  a  pound  and  a  half  of  wheaten  bread  and  two  eggs  per  diem.  Aug.' 4: 
extractum  aconiti  et  pulv.  herb,  aconiti  aa  8  grammes  (in  the  original  the  old  medical 
weights  are  employed)  in  12  pills.  —  Aug.  5:  general  condition  unchanged,  the  same 
medication.  —  Aug.  6:  general  condition  the  same.  Ordered — extract,  aconiti  et 
herb,  aconiti  aa  12  grammes. — Aug.  7  :  the  local  trouble  continues,  general  condition 
the  same:  extract,  aconiti  15  grammes. — Aug.  8:  appetite  impaired,  skin  and  eyes 
somewhat  yellow  :  ext.  aconiti  24  grammes. — Aug.  9:  jaundice  more  apparent:  ext. 
aconiti  30  grammes.  -August  10:  melanicterus,  vomiting,  pain  in  the  stomach,  loss  of 
appetite,  the  unfortunate  patient  is  forced  to  keep  her  bed:  ext.  aconiti  30  grammes. 
— August  11:  nausea  has  persisted  during  the  past  night,  vomiting  and  delirium  make 
their  appearance,  vision  is  reported  disturbed,  voice  husky  and  weak :  ext.  aconiti 
15  grammes. — August  12:  has  had  a  very  restless  night,  patient  tormented  with 
great  suffering,  left  her  bed  and  could  not  get  back  again  without  help.  The 
medicine  is  (at  last!)  suspended  and  nothing  is  administered.  Towards  evening 
voiceless,  soporose,  closed  e3res,  trismus,  convulsions,  dyspnoea,  very  rapid,  irregular 
pulse,  dry,  harsh  skin.  Ordered  —  venesection  to  one  pint  (!).  August  13:  body 
less  jaundiced,  but  the  other  symptoms  aggravated.  Belly  distended,  the  blood  drawn 
yesterday  has  a  soft,  yellow  coating.  Venesection  repeated,  barley-water  with  (once 
more  !)  0.35  grammes  of  tartar-emetic  and  two  enemata,  containing  each  1.4  grammes 
of  tartar-emetic. — Towards  evening  condition  worse:  (nevertheless)  a  venesection  of 
one  pint.  —  August  24:  soporose  condition  persists,  respiration  still  (!)  difficult. 
Touch  us.  Barley-water  and  tartar-emetic  are  prepared  but  —  the  unfortunate  patient 
died  towards  evening"  —  systematically  poisoned  (134  grammes  of  ext.  aconiti  in 
seven  days!)  to  remove  a  disease  which  would  probably  have  got  well  without  any 
medical  aid  ! 

Peripneumonia. 

"Steffano  Cananzi,  aged  20,  of  melancholic  constitution,  never  before  sick, 
except  two  months  ago  a  tertian  fever,  which  disappeared  after  the  7th  accession. 
On  May  23  towards  evening  had  a  heavy  chill,  followed  bj'  high  fever  and  headache. 
May  24 :  venesection  performed  at  the  patients  house.  A  mucilaginous  decoction 
ordered.  May  25  and  2(i:  condition  unchanged.  The  fever  manifests  remissions. 
Pains  continue.  May  27:  the  patient  taken  to  the  clinic.  Face  pale,  skin  dry  and 
harsh,  pulse  tense  and  hard,  pain  in  the  chest,  increased  by  coughing,  still  little 
expectoration.  May  28 :  restless  last  night  in  consequence  of  his  cough, the  other 
conditions  unchanged,  urine  scanty  and  full  of  sediment.  Ordered  a  venesection  of 
about  18  ounces,  tartar-emetic  1.1  grammes.  Towards  evening  another  venesection 
of  18  ounces.  May  29:  all  the  symptoms  worse,  expectoration  scanty,  diarrhoea  but 
no  vomiting,  complains  of  great  weakness,  pulse  hard  and  contracted.  Ordered 
venesection  of  18  ounces,  tartar-emetic  1.2  grammes.  Towards  evening  another 
venesection  of  18  ounces.  May  30:  Weakness  increased,  mournful  look  (quite 
credible!),  small  pulse,  persistent,  dry  cough,  obstinate  diarrhoea.  Venesection  of 
18  ounces,  tartar-emetic  1.2  grammes.  Towards  evening  another  venesection  of  18 
ounces.  May  31  :  sleepless  night,  very  great  weakness,  quiet  delirium,  subsultus 
tendinum,  groaning  respiration,  incontinence  of  urine  and  fa?ces.  Venesection  and 
tartar  emetic  repeated  as  before."  —  About  seven  o'clock  in  the  evening  the  unfortu- 
nate patient  "breathed  forth  his  soul",  for  in  four  days  he  had  lost  about  nine  pints 
of  blood  and  taken  4.4  grammes  of  tartar-emetic. 

These   two    clinical    histories,    even  were  they  only  exceptional,   condemn    the 


—  870  — 

system  mare  loudly  than  all  words.  For  this  is  no  longer  a  "  system",  but  system- 
atic murder  under  the  infatuation  of  a  theory.  While  we  read  the  sympathetic 
epitaph  "the  unhappy  patient  died",  or  "the  unfortunate  patient  breathed  forth  his 
soul  ",  a  feeling  of  oppression  comes  over  every  sensitive  nature  —  a  feeling  t<  o  not 
removed  by  the  good  results  in  the  following  case,  for  here  too  the  treatment  is 
undoubtedly  irresponsible  for  the  fortunate  termination. 

Rheumatic  Fever. 

"A  young  man,  aged  20  years,  who  five  days  before  had  been  discharged  from  a 
hospital  into  which  he  had  been  taken  for  a  slight  pneumonia,  had  not  been  free  from 
fever  since  the  day  of  his  discharge,  and  also  suffered  dragging  pains  in  the  muscles, 
especially  those  of  the  calf  of  the  legs.  He  was  accordingly  received  into  the  clinic, 
where  he  had  come,  upon  August  3d.  He  had  a  quick  and  contracted  pulse,  burning 
thirst,  and  cough  without  pain.  August.  4:  the  same  symptoms,  sputa  streaked  with 
blood.  Ordered  1.1  grammes  of  pulv.  digitalis.  Aug.  5:  pulse  116  beats  per  minute, 
palpitation  of  the  heart  Digitalis  1.7  grammes.  Aug.  6  :  pulse  less  frequent  and 
contracted,  general  heat  somewhat  diminished,  palpitation,  no  cough.  Ordered 
pulv.  digitalis  2.1  grammes.  Aug.  7:  epistaxis,  arterial  pulse  somewhat  irregular 
and  less  frequent  than  yesterda}',  pupils  dilated.  Pulv.  digitalis  0.6  grammes.  Aug. 
8:  pulse  less  frequent  than  yesterday  and  very  irregular  (5.5  grammes  of  digitalis 
had  been  given  in  four  days).  Medicine  discontinued.  Aug.  9:  pulse  scarcely  30 
per  minute  (!).  In  other  respects  the  patient  is  doing  tolerably  well.  Aug.  10-14: 
the  patient  feels  well,  but  the  irregularit}'  and  infrequency  of  the  pulse  continue. 
Aug.  15:  the  fever  has  returned  with  excessive  chilliness  and  heat;  pulse  more 
frequent  than  usual;  no  passage  from  the  bowels  for  two  days.  Ordered  cambogia- 
0.3  grammes.  Vomiting  soon  follows  its  administration.  At  evening  0.3  grammes  of 
Kermes  mineral.  Aug.  16:  sixteen  movements  of  the  bowels  in  24  hours.  Some 
fever  remains  and  the  pains,  which  had  disappeared  for  a  few  days,  have  returned. 
Simple  emulsion.  Aug.  18:  the  muscular  pains  continue;  manifest  return  of  fever; 
12  movements  of  the  bowels.  Ordered  one  pint  of  wine.  Aug.  19:  the  diarrhoea 
and  pains  have  ceased.  One  pint  of  wine.  Aug.  20:  no  fever,  no  pain.  No 
medicine  administered.     The  patient  is  soon  discharged  cured." 

This  clinical  history  too  was  taken  in  1825  in  the  "  Spedale  Maggiore  "  at  Milan. 
The  digitalis  poisoning  in  this  case,  in  contrast  to  those  before  quott  d,  terminated 
without  serious  results  (See  Schlesinger). 

Among  the  inconceivably  numerous  and  eminent  followers  of  the 
doctrine  of  Rasori,  some  of  whom,  in  spite  of  the  therapeutic  atrocities 
already  pointed  out,  were  able  by  the  help  of  statistics  to  report  favorable 
results,  we  should  mention  :  Syro  Borda,  professor  in  Pavia  ;  Vincenzio 
Lanza,  grandfather  of  the  physician  and  eminent  statesman  Giov.  Lanza 
(1815-1882);  Bondioli;  the  famous  Valer.  Luigi  Brera  (1772-1840),  suc- 
cessive!}' a  physician  in  Milan,  professor  in  Pavia,  Padua,  and  Bologna, 
and  finally  a  physician  in  Venice  ;  Enrico  Acerbi  (1785-1827),  professor 
in  Milan;  Bassiano  Carminati  of  Lodi,  professor  in  Pavia;  Giov.  Antonio 
Fossati  (1786-1852)  and  others.  —  Among  the  opponents  of  this  doctrine 
were  J.  A.  F.  Ozanam,  a  famous  epidemiologist,  who  rejected  as  absolute  folly 
the  doctrine  of  a  contagium  animatum  which  originated  in  the  17th  and 
18th  centuries  (Loeffler);  Giov.  Batt.  Spallanzani,  physicus  and  a  physician 
in  Reggio :    Federigo  Carpo    in   Venice;    Geromini ;    Giuseppe    Agostino 


—  871  — 

Amoretti,  professor  in  Turin  (1816);  Maurizio  Bufalini  (1787-1S61),  pro- 
fessor in  Florence,  and  numerous  others.  Emiliani,  Guani  and  Robini  were 
partial  adherents  of  the  theor}'  of  Rasori.  while  Francesco  Puccinotti 
(1794-1872)  in  Pisa  displaced  more  independence. 

After  the  doctrine  of  Rasori  had  run  its  course,  there  also  began  in 
Italy  a  powerful  revival,  to  which  a  part  of  the  professors  of  the  French 
school  of  pathological  anatomy,  and  a  still  larger  portion  of  the  Prague- 
Vienna  school,  united  themselves.  In  the  latter  party  belong,  above  all, 
Arnaldo  Cantani  (born  at  Hainsbach  in  Bohemia  in  1837),  since  1868  a 
professor  in  Naples,  translator  of  Niemeyer's  "Lehrbuch",  author  of  a  work 
on  diabetes  etc..  and  Salvatore  Tommasi  and  Tanturri,  both  also  professors 
in  Naples  :  Tommasi-Crudeli,  a  pupil  of  A'irchow,  in  Rome ;  Guido 
Baccelli,  in  1881  Italian  Minister  of  Instruction  ;  Achille  Bianchi  (died 
1876)  of  the  -Ospedale  San  Spirito";  Brunelli,  an  electrotherapeutist ; 
Magni  (oculist)  etc. 

Puccinotti,  Salvatore  di  Renzi  (1800-1872).  and  Alfonso  Corradi  (epi- 
demiographer)  distinguished  themselves  as  medical  historians. 

The  political  revival  of  Italy  matured  also  a  revival  of  Italian  medi- 
cine, and  as  Germany  assisted  in  paving  the  way  for  the  former,  so  also  she 
exercised  a  controlling  influence  upon  the  latter,  thus  returning  in  our  own 
century  the  impulse  which  she  had  herself  received  from  Ital}-  in  the  16th 
and  17th  centuries. 

The  relative  importance  of  the  Italian  universities  may  be  judged  from  the 
following  estimate  of  the  number  of  their  students  in  1877.  .  Naples  2435,  Turin  1234, 
Padua  974.  Pavia  652,  Rome  559,  Bologna  511,  Pisa  470,  Genoa  388,  Palermo  333, 
Modena  22:>,  Catania  152,  Siena  141,  Messina  79,  Cagliari  o4,  Mac-erata  52  —  al- 
together 8441  students  against  18,000  in  German}'. 

If,  according  to  Rasori's  theory,  the  chief  task  of  the  physician  con- 
sisted in  discovering  the  'diathesis"  upon  which  so-called  methods  of 
treatment  of  objectionable  energy  might  be  based,  in  the  Hahnemannism, 
preached  up  at  the  present  day  with  more  energy  than  for  many  years,  and 
which  as  the  so-called 

c.  Homoeopathy 

opposes  itself  to  '-Allopathy"  (a  false  catch-word  devised  by  the  uomoeop- 
athists),  there  prevails  a  system  of  therapeutics  still  more  inconceivable 
in  principle,  but  which  is,  at  all  events,  less  dangerous  in  practice  than 
that  of  Rasori.  We  might  even  call  this  system  entirely  innocent,  were 
there  not  in  the  treatment  of  the  sick  sins  of  omission  as  well  as  of  com- 
mission. Instead  of  tentative  venesection  of  the  patient,  the  action  of 
drugs  upon  the  healthy  becomes  the  guide  for  the  selection  of  remedies. 
Accordingly,  for  the  removal  of  a  given  congeries  of  symptoms  —  there 
are  no  diseases,  but  merely  their  symptoms,  which  are  to  be  regarded  as 
signs  of  an  injury  to  the  vital  force  —  that  remedy  must  be  selected, 
which,  when  administered  to  the  healthy,  has  produced  the  same,  or  at  least 


872  — 

a  similar,  group  of  symptoms.  The  artificial  form  of  disease  produced  by 
such  a  remedy  then  expels  the  natural,  but' weaker  disease.  This  system 
of  therapeutics  thus  follows  the  Old  Testament  maxim  that  like  is  to  be 
returned,  <>r  banished  by  like.  The  most  thorough  knowledge  of  the  effects 
of  drugs  upon  the  healthy  body,  and  an  extremely  careful  comparison  of 
the  phenomena  thus  produced  with  the  symptoms  of  disease  in  any  given 
case,  are  absolutely  necessary  to  the  physician.  In  this  way  the  best 
remedy  must  infallibly  be  discovered,  and.  still  better,  patients  at  a  dis- 
tance need  not  be  deprived  of  the  benefits  of  homoeopathic  treatment, 
since  the  symptoms  may  he  imparted  by  letter.  The  physician  then  com- 
bats the  disease  on  the  principle  "Similia  similibus  curantur",  instead  of 
proceeding  according  to  the  allopathic  maxim  "Contraria  contrariis",  but 
attains  the  same  result  as  the  allopathic  physician  and  far  more  certainly. 
For  the  homoeopath  acts  with  a  complete  consciousness  of  what  he  is 
doing,  while  the  allopath  at  last  can  meet  with  good  results  only  when, 
wandering  unconsciously  and  accidentally  into  homoeopathic  paths,  he 
lights  upon  the  right  course.  By  this  course  of  reasoning  "allopathic" 
and  natural  cures  are  deprived  of  their  inconvenient  powers  of  demon- 
stration against  homoeopath)'.  It  must  not.  however,  be  overlooked  that 
the  simplest  remedies  are  administered  in  the  utmost  possible  dilution. 
Only  in  their  preparation,  and  before  administration,  they  must  be  strongly 
shaken  or  triturated,  since  thereby  their  efficacy  is  infinitely  increased. 
There  is  no  such  thing  as  a  vis  medicatrix  naturee,  and  likewise  there  is  no 
disease  which  can  withstand  homoeopath)'.  All  diseases  are  curable  by  its 
means,  but  each  individual  disease  by  one  specific  remedy  alone,  which 
cannot  be  replaced  by  any  similar  one.  Hence  occasional  failures  are  due, 
not  to  homoeopathy  itself,  but  to  human  short-sightedness,  which  over- 
looked the  proper  homoeopathic  remedy.-  As  the  result  of  these  prin- 
ciples, homoeopath}',  more  than  all  other  medical  systems,  produces  the 
impression  of  reckoning  upon  the  ingenious  arrangement  of  deception  and 
the  credulity  of  the  weak-minded.  Indeed,  so  far  is  this  the  case  that  we 
must  keep  constantly  before  our  eyes  the  in  many  respects  eminent  char- 
acter of  its  founder,  in  order  to  avoid  constant  recurrence  to  this  idea.  — 
Hahnemann  too  sought  the  origin  of  his  theory  of  Similia  similibus  in 
the  writings  of  Hippocrates,  Thomas  Erastus,  von  StOrck  and  Stahl  (see 
Bakody).  As  a  specimen  of  his  pharmacodynamics  we  quote  the  follow- 
ing passage : 

"When  .  .  .  lycopodium  seed  is  treated  in  the  method  by  which  homoeopathic 
arl  develops.lhe  raw  drugs,  and  a  grain  (0.05)  of  it  i*  brought  by  means  of  a  triple 
trituration  of  one  hour,  each  time  with  100  grains  (fi.O )  of  milk  t-ugar,  to  the  millionth 
dilution  and  potency,  a  remedy  is  produced  of  such  wonderful  power,  that  one  grain 
of  the  latter  ....  dissolved  in  10(1  drops  of  dilute  alcohol  and  shaken  twice  in  the 
hand,  exhibits  a  medicinal  fluid,  which,  even  in  the  smallest  dose  (one  or  two  pellets, 
of  t he  size  of  a  poppy-seed,  moistened  with  it),  is  still  entirely  too  active  in  the 
diseases  for  which  it  is  appropriate.  Even  the  fluid  diluted  still  more  highly,  up  to 
the  billionth   (second)   potency,   cannot  yet  be  employed   for  patients,  even  in  the 


—  873  — 

minute  dose  aforesaid,  in  consequence  of  its  excessive  violence.  Not  until  the. 
potentized  sextillionth  dilution  (VI.)  does  the  drug  begin  to  be  useful,  provided, 
however,  that  for  irritable  and  feeble  patients  only  the  still  higher  potentized  dilu- 
tions, the  octillionth  (VIII.)  and  decillionth  (X.),  are  employed,  in  the  dose  of  one 
or  at  most  two  very  small  pellets  moistened  with  the  fluid.  The  lycopodium  seed 
occasions  891  different  symptoms,  which  the  homoeopathic  physician  must  simply 
record,  and  the  statements  relative  to  its  observed  effects  sometimes  read  curiously 
enough,  e.  g.  only  one  hair  on  my  head  aches  etc.,  etc.  A  suitable  dose  of  this 
remedy,  when  rightly  selected,  continues  its  effects  for  40  to  50  days,  or  perhaps  a 
little  longer."  (See  Wunderlich.  i  After  five  days  it  occasions  itching  of  the  nose, 
after  eleven  days  griping  in  tlie  hepatic  region,  after  28  days  its  effeel  extends  still 
further  downwards  and  produces  pruritus  aid.  The  first  evacuation  after  taking  this 
drug  is  still  lumpy,  but  after  sixteen  days  the  passages  become  soft  etc.  —  Bakody 
(Hahnemann  redivivus,  1883)  calls  such  examples,  indeed,  "perfidious  selections" 
on  the  part  of  bis  opponents,  but,  even  under  more  favorable  criticism,  they  ^ive 
evidence  of  weighty  errors  in  observation.  On  the  other  band,  it  must  justly  be 
granted  that  many  excellent  principles  are  to  be  found  in  Hahnemann's  views,  and 
these  his  followers,  e.  g.  Bakody  —  have  known  how  to  select. 

The  causes  of  morbid  phenomena  in  acute  conditions  are  errors  of 
diet,  in  the  widest  sense,  and  external  injurious  agencies,  including  the 
ordinary  miasmata,  contagia  etc.,  while  for  chronic  lesions  there  are  three 
chronic  miasmata,  the  psoric.  syphilitic  and  condylomatous.  In  the  latter 
class  of  causes  are  to  be  numbered  also  the  inbred  and  hereditary  troubles 
induced  by  the  drugs  of  allopathic  physicians,  which,  like  the  miasmata 
last  named,  have  existed  in  the  human  body  from  time  immemorial.  Seven 
times  out  of  eight,  however,  the  psoric  "chronic"  miasma,  i.  e.  "Psora", 
suppressed  itch,  is  the  cause  of  disease,  a  truth  in  the  investigation  of 
which  Hahnemann  spent  not  less  than  thirteen  years  of  his  life,  and  which 
then  transmitted  to  popular  knowledge  occasions  at  the  present  day  much 
silly  babble  everywhere  about  suppressed  itch. 

By  long  study  Hahnemann  had  discovered  412  symptoms  of  the  "psora",  and  he 
said  that  the  itch,  deprived  of  its  chief  symptoms  upon  the  skin  (which  still  exist*  d 
in  the  leprosy  and  were  easily  gotten  rid  of,  but  now  had  been  for  thr<  e  centuries 
driven  in),  occasioned  "  so  many  of  its  secondary  symptoms,  that  at  least  seven 
eighths  of  all  chronic  complaints  arose  from  this  single  source,  while  the  remaining 
eighth  was  due  to  syphilis  or  sycosis,  or  a  complication  of  two  of  these  three  miasmatic 
chronic  diseases,  or  (in  rare  cases) -of  all  three". 

There  are  only  general  diseases,  none  local.  The  products  of  disease 
found  on  post  mortem  section  are  the  result  of  blundering,  and  particularly 
■of  the  blunders  of  allopathic  physicians.  Such  residua  are  not  found  after 
homoeopathic  treatment.  —  Hahnemann,  however,  never  made  autopsies. 

In  order  to  correctly  comprehend  the  extremely  important  action  of 
drugs  upon  the  healthy  it  is  necessary  to  administer  simple  remedies  and 
to  record,  or  still  better  to  have  recorded,  these  effects  in  their  most  minute 
details,  without  any  influence  from  examinations  etc.  Then  the  pure  forms 
come  to  light.  In  this  way  we  find  e.  g.  that  lycopodium  seed  in  the 
homoeopathic   dose  occasions  almost  inexpressibly  wonderful    phenomena. 


—  874  — 

It  produces  falling  of  the  hair,  confusion  of  thought,  eruptions,  and  makes 
people  fall  asleep  during  coitus  without  the  occurrence  of  emission.  —  In 
these  provings  of  drugs  we  observe  both  primary  and  secondary  effects. 
By  means  of  the  former  the  vital  force  is  imperceptibly  altered  ;  b}'  means 
of  the  latter,  however,  the  organism  protects  itself  from  the  drug,  especially 
when  the  dose  has  been  too  large. 

Special  pathology  in  reality  does  not  exist,  and  the  whole  of  Diag- 
nostics is  based  upon  a  search  after  the  similarities  between  the  phenomena 
of  disease  and  those  produced  by  drugs 

In  therapeutics  there  are  specifics  011I3-,  and  their  efficac}-  (in  entire 
contradiction  to  the  'experience  of  sensible  men)  is  continually  enhanced 
by  dilution,  since  they  thereby  multiply  many  fold  their  effective  "spiritual" 
principle  by  transferring  it  to  the  material  of  solution  or  dilution,  restamp- 
ing  this  solvent  itself  with  the  drug. 

"To  smell  (!)  of  one  decillionth  of  a  grain  of  silica,  potentized  to  the  millionth 
attenuation  by  thrice  triturating  one  grain,  each  lime  for  one  hour,  and  always  in  100- 
grains  of  sugar  of  milk,  which  one  grain  dissolved  in  alcohol  in  27  diluting  vessels 
has  brought  to  the  30th,  i.  e.  the  trillionth  development  of  potency,  is  sufficient  for 
the  cure  of  baldness,  dandruff,  gray  cataract,  amaurosis,  nocturnal  incontinence  of 
mine,  excessive  sexual  passion,  fetid  sweating  of  the  feet  and  incapaeit}"  to  think." — 
Such  statements  Bakody  calls  a  "  hyperdynamical  theory  of  potency  ",  proceeding; 
from  a  "consistency  which  sacrifices  all  facts",  and  he  says  that  owing  to  this  theorjr 
opposition  was  excited  within  the  Hahnemannian  fold  itself,  and  thus  it  resulted 
that  "the  hoary  reformer  with  his  ultradynamic  followers  separated  themselves  com- 
pletely from  the  common  tendency  of  scientific  effort,  and  the  former  in  his  latter 
years  became  a  victim  of  illusions."  Among  the  "soap-bubbles  of  morbid  consist- 
ency of  this  old  man  in  his  second  childhood  "  belong  undoubtedly  the  statements- 
mentioned  with  entire  credence  by  Hegewald  in  1884  :  "  Digitalis  is  indicated  in 
double  vision,  cannabis,  alternating  with  magnesia,  in  capsular  cataract,  euphrasiar 
in  coughs  which  make  their  appearance  by  day  only,  hyoscyamus,  in  nocturnal 
coughs  "  etc. 

A  single  dose  of  a  properly  chosen  specific  frequently  cures  imme- 
diately, but  often  also  it  seems  at  first  to  produce  an  aggravation  of  the 
symptoms.  This,  however,  finally  passes  away  of  itself,  or  must  be  re- 
moved by  new  drugs.  Not  infrequently  the  proper  disease  is  first  revealed 
by  means  of  the  remedy.  The  effect  of  homoeopathic  remedies  is  extended 
through  long  periods,  and  ma}'  persist  for  weeks  and  months.  Hence  the 
same  dose  of  the  drug  should  not  be  administered  anew  until  an  improve- 
ment is  no  longer  observed.  Jn  the  administration  of  homoeopathic  remedies 
the  strictest  diet  is  always  to  be  observed.  Accordingly  it  seemed  to  G?3the 
that  "he  who  in  his  own  person  carefully  adheres  to  an  appropriate  diet, 
already  unconsciously  approximates  to  the  '  method '  of  Hahnemann.'^ 
Allopathic  treatment  is  only  admissible  in  poisoning,  syncope,  choking 
etc.  — The  inventor  of  this  hyperdynamic  system,  which,  a  few  points  of 
agreement  excepted  —  Erasistratus  too  e.  g.  considered  the  most  minute 
doses  specially  efficacious  —  stands  in  contradiction  to  all  the  earlier 
views,  as  well  as  to  all  experience  and  the  results  of  what  is  regarded  as, 


—  875  — 

reasonable  observation  and  thought,  but  which  certainly  did  not,  like  the 
system  of  Rasori,  facilitate  direct  murder,  was 

Samuel  Christian  Friedricii  Hahnemann  (1755-1843)  of  Meisseiu 
son  of  a  poor  but  skilful  porcelain  painter  of  that  town. 

From  1775  Hahnemann  pursued  his  studies  in  Leipsic,  and  after  1777  in  Vienna, 
chiefly  under  the  direction  of  Quarin.  Struggling  continuallj'  with  poverty,  which 
led  him  to  take  the  position  of  a  family  physician  in  Hermannstadt,  in  the  family  of 
the  governor  of  that  city,  he  thus  obtained  the  means  to  take  his  medical  degree  in 
Erlangen  about  1779.  He  then  practised  in  Hettstadt  (now  famous  in  the  history  of 
the  trichina')-  and  Dessau,  was  next  physicus  in  Gommern,  near  Magdeburg,  then  a 
physician  in  Dresden  and  Leipzig,  where  he  also  devoted  his  attention  to  clumistry 
(mercurius  solubilis  Hahnemannii,  Hahnemann's  wine-test)  and  to  translating.  He 
was  induced  by  Cullen  to  test  upon  himself  the  effects  of  cinchona,  and  is  said  to 
have  thus  been  attacked  by  the  symptoms  of  intermittent  fever,  a  fact  which  ulti- 
mately led  him  to  his  maxim  "  Similia  similibus",  already  formulated  bjr  Paracelsus. 
This  principle  once  discovered,  Hahnemann  felt  it  necessary  to  test  it  in  piactice, 
but,  in  consequence  of  his  habit  of  dispensing  his  own  drugs,  he  fell  into  a  conflict 
with  physicians  and  apothecaries,  which  assumed  wide  dimensions.  From  17'.)0 
forward,  hunted  from  place  to  place  by  both  these  opponents,  he  became  in  1792 
superintendent  of  the  insane  asylum  at  Georgenthal  in  Thuringia,  and  in  1794 
physician  in  Pyrmont  and  Brunswick.  Here,  as  his  enemies  relate,  he  from  neces- 
sity occasionally  feed  the  relatives  of  his  epileptic  and  insane  patients,  at  the  rate  of 
many  professors,  and  cheated  whenever  an  opportunity  offered  itself.  In  1795  he 
practised  in  Konigsl  utter,  where  he  proved  belladonna,  "the  remedy  for  scarlet 
fever";  then  in  1*00  he  was  in  Altona,  Eilenburg,  in  a  village  near  Leipzig,  and 
(repeating  the  fate  of  earlier  adepts)  in  1802  in  AVittenberg  and  Torgan.  From  the 
latter  town  Hahnemann  first  addressed  his  writings  to  the  right  quarter — tie  laity. 
In  1805  he  first  introduced  the  word  ''homoeopathy"  (in  contradistinction  to  "allo- 
pathy", a  term  which  he  also  invented),  and  thus  gained  an  effective  war-cry,  and  of 
course  only  increased  still  more  the  bitterness  against  his  doctrine  and  himself.  His 
theory  gained  in  influence  through  the  publication  in  1810  of  his  chief  work  the 
"Organon  der  rationellen  Heilkunde".  In  1811  Hahnemann  settled  in  Leipzig, 
where  he  gave  lectures.  His  early  followers,  some  of  whom  were  young  men  with- 
out an}-  education,  proved  drugs  upon  themselves  (Stapf  Gross,  Hornburg,  Wislicenus 
etc.)  and  practised  homoeopath}-  at  once.  Hahnemann  became  an  extremely  popular 
physician,  patronized  now  by  persons  of  rank,  who,  indeed,  ha\e  almost  always  con- 
sidered it  their  privilege  to  set  the  fashion  of  running  after  nonsense  and  ehailatanry 
in  medicine.  Of  course  their  example  is  then  followed  by  those  of  lesser  rank  and 
by  the  lowly.  In  1818  homoeopathy  was  interdicted,  though  an  interdict  in  matters 
of  opinion,  and  above  all  of  faith,  always  produces  only  an  effect  opposite  to  that 
intended.  In  1821  the  Saxon  authorities  forbade  physicians  to  di.«-pense  their  own 
drugs.  Hahnemann  now  went  to  Kbthen  as  physician-in-ordinary  and  counsellor  of ' 
the  then  lord  of  Anhalt-Kothen,  where  his  popularity  increased  still  more  rapidly 
than  before.  Five  years  after  the  death  of  his  first  wife  (18H0)  Hahnemann  married 
a  young  Frenchwoman,  Melanie  d'Hervilly,  who  enticed  him  to  Paris,  where  the  old 
man  died  in  1843  —  a  millionaire.  His  practice  was  continued  by  his  widow.  — In 
the  year  of  Hahnemann's  death  a  kind  of  state  examination  for  homoeopathy  was 
introduced  into  the  Prussian  regulations,  and  in  1851  and  1855  monuments  to  his 
fame  were  erected  in  Leipsic  and  Dessau.  —  In  addition  to  his  chief  work  mentioned 
above,  Hahnemann  wrote  numerous  articles  for  medical  journals  and  many  books. 
Among  the  latter  we  may  mention  his  "  De  helleborismo  veterum",  1811;   "Reine- 


—  870  — 

Arzneimittellelire  ",  1811;  "  Die  chronisclien  Krankheiten  ":    "Die  Heilung  der  asia^ 
tischen  Cholera";   "Die  antipsorischen  Arzneien"  etc. 

From  the  outset  the  lait3*,  and  particularly  the  nobility,  were  the  most 
eminent  adherents  of  the  doctrines  of  Hahnemann,1  though  the  latter  were 
also  favored  by  Hufeland.  Among  these  lay  homoeopaths  we  may  mention 
E.  G.  von  Brunnow  (1796-1843),  the  poet,  and  Hahnemann's  son-in-law 
von  Boninghausen.  From  the  list  of  physicians  who  followed  Hahne- 
mann's doctrines,  though  characteristically  enough  they  were  not  recog- 
nized by  Hahnemann  himself  as  full  homoeopaths,  we  ma}-  notice  among 
many  others  :  Moriz  Midler  and  Carl  Hanbold  at  Leipsic.  Wilhelm  Gross 
(died  1847)  in  Jiiterbogk  and  J.  Eduard  Stapf  (born  1783)  in  Naumberg. 
who  founded  in  1818  the  "Archiv  fur  die  homoopathische  Heilkunst". 
Midler  was  also  the  director  of  the  first  homu'opathic  clinic  in  Leipsic 
(1822),  and  like  Ludwig  Schrun  in  Hof,  Gottlieb  Ludwig  Rau  (1799-1841, 
"Organon  der  specifischen  Heilkunst")  of  Erlangen,  P.  Wolf  in  Dresden, 
Karl  Friedr.  Gottfr.  Trinks  (1800-1868)  in  Dresden  and  A.  Noack  and  L. 
Griesselich,  founder  of  the  homoeopathic  union  in  Baden  and  editor  of  the 
journal  ''Hygeia",  speedily  wandered  awaj'  from  the  "pure  doctrine".  The 
same  may  be  said  of  J.  Th.  Biickert  in  Herrnhut  (1800-1885),  Hausmann 
(died  1876),  professor  of  homoeopathy  in  Pesth,  Jos.  Buchner  (1813-1879), 
professor  in  Munich  and  a  famous  homoeopath  ;  Goullon  (died  1883)  in 
Weimar  etc.  George  Rapp  (1818-1885)  of  Annweiler  in  the  Palatinate, 
was  professor  of  the  clinic  for  internal  diseases  in  Tubingen,  In  this 
position  he  undertook  investigations  regarding  the  therapeutics  of  Hahne- 
mann, Rademacher  and  the  so-called  allopathic  system,  and  finally  decided 
in  favor  of  the  first.  According!}'  in  1854  he  was  removed  from  his  pro- 
fessorship and  became  ph}-sicus  in  Rottweil.  Finally  he  was  appointed 
physician-in-ordinary  to  the  queen  of  Wurtemberg.     Joh.  Heinrich  Kopp 

l.  How  far  the  enthusiasm  for  Hahnemann's  doctrines  went  is  shown  by  a  hymn  to 
the  air  "  Lasst  uns,  ihr  Briider"  etc.,  communicated  by  Strieker  in  Frankfort, 

and  which   we  quote  for  the  edification   of  the  partisans  and   opponents  of 
homoeopathy  : 

"Homceopatljik,  himmliseher  Strahl,  Dauernd  und  mild, 

Dein  Preis  erschalle  Kiirpers  und  Geistes 

Froh  beini  Fokal.  Leidensgebild. 

Wesen  zu  retten  Und  der  Erkrankten 

Voin  friihen  Grab,  Genesen  jetzt  viel, 

Sandte  ein  Gott  dich  Ohne  Beschwerden 

Vom  Himniel  lierab.  Wandelnd  zum  Ziel. 

Dummheit  und  Diinkel  FreutEuch  dess,  Freunde  ! 

Mordeten  liier  Jubelt  entziickt, 

Blindlings  und  klugelnd  Dass  unsre  Lehre 

Menschen  und  Thier.  Sicher  begliickt. 

Einfach  und  ewig,  Weihet  drum  dankbar 

Wie  die  Natur,  Leben  und  Kraft, 

Folgt  deine  Lehre  Ihr,  die  seit  Jahreir 

Dieser  audi  nur.  Gutes  nur  schafft." 
Schnell  drum  verschwindet, 


—  877  — 

(1777-1858)  in  Hanau,  Joh.  Mich.  Leupoldt  (born  1794,  died  a  few  years 
ago)  in  Erlangen,  Fleisdhmann  in  Vienna  and  W.  J.  A.  Werber  were  also 
favorers  of  homoeopathy  with  very  important  modifications.  In  surgery 
homoeopathic  principles  were  employed  by  J.  A.  Schubert.  F.  A.  Giinther, 
Joh.  Wilh.  Lux  (1773-1850)  in  Leipsic,  W.  Starke,  J.  C.  Schafer  (HomOo- 
pathische  Thierheilkunst,  2d.  ed.  1856)  and  others  were  partisans  of  homoe- 
opathic principles  in  veterinary  medicine.  —  Among  modern  homoeopaths 
we  may  mention  0.  Buchmann  in  Alvensleben  (microscopic  and  other 
observations  and  investigations  regarding  the  solubility  of  the  metals  etc., 
1881);  Dr.  Hegenwald  (Hahnemann's  atomic  doctrine)  etc. 

For  ever}'  precept  laid  down  by  Hahnemann  there  gradually  developed 
distinct  shades  and  parties,  and  by  these  continual  changes,  new  explana- 
tions and  'principles"  there  arose  finally  a  "new"  homoeopathy,  the  scien- 
tific system,  an  expression  implying  that  the  old  system  was  not  scientific 
The  most  important  representatives  of  this  modern  homoeopathy  are  : 
Altschul  (Lehrbuch  der  Homoopathie);  von  Grauvogl  (Grundgesetze  der 
Physiologie,  Pathologie  &c;  das  homoopathische  Aehnlichkeitsgesetz  ; 
offenes  Send  sen  re  i  ben  an  Liebig,  1861)  and  Bernhard  Hirschel  (died  1878) 
in  Dresden,  the  '-most  scientific"  of  homoeopaths  and  an  historian,  particu- 
larly of  the  "Vienna  school",  equipped  with  both  medical  and  general  edu- 
cation. (Grundriss  der  Homoopathie  nach  ihrem  neuesten  Standpunkte, 
2d.  ed.,  1854  etc.).  The  Wurtemberg  "Obermedicinalrath"  Paul  Sick  (Die 
HomOopathie  im  Diaconissenhause  zu  Stuttgart,  1879),  and  Prof.  Bakody 
in  Pesth,  who,  by  the  way,  is  frequently  very  sober  in  his  criticisms,  should 
also  be  mentioned  in  this  connection. 

"The  more  modern  school,  like  the  older  allopathic  system,  recognizes  the 
necessity  of  an  anatoniico-physiological  basis,  respects  the  vis  medicatrix  natvrce, 
acknowledges  the  benefit  of  crises  etc.,  and  holds  to  the  necessit}'  of  diagnosis  in 
disease  and  the  investigation  of  the  character  of  the  disease  in  addition  to  the  com- 
plex of  symptoms.''  "  Homoeopathy  demands  even  a  diagnosis  of  the  remedy,  which 
must  agree,  i.  e.  must  manifest  a  similarit}-,  as  far  as  possible,  with  the  disease." 
"Homoeopathy  discards  all  generalization  and  desires  the  most  individual  special- 
ization." ''It  is  not  a  question  of  the  dose,  but  of  the  selection  of  the  remedy,  which 
js  the  substance  of  homoeopathy.  Whether  larger  or  smaller  doses,  powders,  tinctures 
or  infusions  are  administered,  is  all  one,  provided  only  that  the  simile,  i.  e.  the 
specific  relation  of  the  remedy  to  the  locality  and  variety  of  the  disease  is  preserved." 
(This  homoeopath}',  accordingly,  does  not  compel  the  wife  of  a  homoeopathic  phy- 
sician to  say:  "Why  don't  you  prescribe  for  us  such  and  such  pills?  Then  we  would 
not  need  to  consume  every  year  so  many  hundredweight  of  prunes!",  nor  could 
Stromeyer  say  of  it,  "What  sort  of  a  medical  art  is  that  which  cannot  even  open  the 
bowels?",  for'it  can  no  longer  discard  purgatives  and  emetics  as  Hahnemann  did.) 
"The  principle  similia  similibus  therefore  continues  to  be  the  most  important 
characteristic  of  the  modern  school,  a  principle,  however,  to  be  so  explained  that  it 
does  not  suggest  merely  an  external  similarity  of  symptoms,  but  an  agreement 
between  the  disease  and  the  remedy  founded  upon  the  seat,  character,  course  etc. 
of  the  former;  for  mere  physiological  similarity,  without  taking  into  account 
the  pathological  character  of  the  disease,  is  not  sufficient"  (Hirschel).  Bakody 
admits   only  the  following    principles    of  Hahnemann:    "Experimental  proving  of 


—  878  — 

drugs,  one  by  one,  upon  the  healthy  human  organism,  observing  carefully  all  their 
toxicologieal  effects."  "A  universal  and  strict  comparison  and  differentiation  of  the 
pathologico-physiological  and  pathologico-anatomical  changes  produced  experiment- 
ally in  the  health}-  by  each  single  drug,  comparing  them  with  those  of  the  morbid 
processes  which  theA*  resemble."  Also  for  therapeutic  purposes  the  employment  of  a 
single  remedy  only,  and,  indeed,  one  selected  in  accordance  with  the  law  "Similia 
similibus"  derived  from  experiment  upon  the  healthy.  The  fourth  principle  re- 
quires the  employment  for  therapeutic  purposes  of  a  single  drug  only,  and  in 
relatively  small  doses. 

We  see  that  of  the  original  homa>opathy  not  much  more  than  the  name  (defined 
as  something  substantial,  but  really  an  empty  word)  survives.  Independent  of  this 
there  remains  no  substantial  characteristic  of  the  old  homoeopathy,  except  that  the 
remedy  must  be  "  diagnosticated  ". 

That  a  doctrine  like  Hahnemann's,  which  in  so  many  ways  broke  with 
all  the  past  and  with  all  previous  reasonable  observation,  must  work  a 
revolution  in  the  lay  circles,  to  whose  "better"  judgment  it  appealed  and 
whose  medical  velleities  it  flattered,  was  a  matter  of  course.  It  put,  in- 
deed, to  the  proof  the  famed,  sound  and  simple  common-sense  of  the 
masses,  and  the  latter  —  succumbed,  as  it  has  ever  done  before  the  mys- 
tical doctrines  of  medicine.  For  in  the  idea  of  the  majority  of  the  laity 
medicine  still  appears  to  be  a  n^stical  knowledge  or  a  blind  matter  of 
experiment.  In  this  the  19th  century  is  precisely  like  the  Middle  Ages  — 
and  upon  the  thoughtless  assumptions  and  superstition  of  both  the  edu- 
cated and  uneducated  depends  the  success  of  homoeopathy,  though  the 
rage  for  fashions  in  medicine  smooths  the  wa}\  How  long  before  the 
appearance  of  homoeopathy  was  it  that  many  physicians  still  practised 
magnetism  and  visceral  clysterization  ?  Manj'  of  Hahnemann's  disciples 
too  knew  that,  as  Fr.  A.  Lange  says.  "Charlatanry  in  medicine  is  better 
paid  than  rational  treatment," 

The  following  physicians,  among  others,  were  important  opponents  of 
the  doctrines  of  Hahnemann  :  Stieglitz,  who  ever  stood  upon  the  wall 
when  false  ideas  threatened  a  breach  in  the  defences  of  Hippocratic  art ; 
Kurt  Sprengel  ;  L.  Wilh.  Sachs  (1787-1848),  professor  in  Konigsberg; 
Bogislaus  Conrad  Kriiger-Hansen  (1776-1850),  a  practitioner  in  Giistrow; 
■Jon.  Christian  Aug.  Heinroth  (1773-1843),  professor  of  mental  diseases  in 
Leipsic,  and  a  pupil  of  Pinel  ;  Ferd.  Gottlieb  von  Grinelin  (1782-1848),  a 
professor  in  Tubingen  ;  G.  von  Wedekind  :  Friedi".  Alex.  Simon  (born  1793), 
a  physician  in  Hamburg  (Samuel  Hahnemann,  Pseudomessias  medicus  ; 
Die  unsterbliche  Narrheit  S.  Hahnemanni,  andrer  Theil ;  author  also  of 
"Der  Vampyrismus  des  19.  Jahrhunderts"):  Karl  Friedr.  Heinrich  Marx 
(1796-1877)  of  Karlsruhe,  professor  in  Gottingen,  eminent  as  an  author  for 
his  literaiy  style,  his  profound  erudition  and  thought,  and  as  an  apostle  of 
humane  and  Hippocratic  art ;  Ignaz  Rud.  Bischoff,  Edler  von  Altenstern 
(1784-1850),  professor  in  Vienna;  Karl  Ernst  Bock  (1809-1873),  'Unset- 
Bock"  of  the  "Gartenlaube",  and  others.  —  Moreover  the  "scientific" 
homoeopaths  themselves  must  be  regarded  as  opponents  of  Hahnemann, 


—  87!)  — 

for  they  have  called  many  of  his  doctrines  whims  and  senile  weaknesses 
(see  Bakody),  or  sacrificed  them  as  utenable.  Hence  some  of  them  intro- 
duce him  in  the  third  person  and  in  large  capitals,  like  a  deit}T,  in  order 
by  such  external  and  ridiculous  homage  to  make  amends  for  their  internal 
scorn  for  the  man.  It  is  characteristic,  at  all  events,  that  Hahnemann 
found  no  pure  and  absolute  followers  among  the  homoeopathic  phj'sicians 
of  reputation.  "For  the  thoughtful  among  his  disciples the  doc- 
trine of  Hahnemann  remains  a  scientific  method  for  the  erection  of  a 
science  of  healing"  (Bakody)  —  the  thoughtless,  however,  are  merely 
simple  dupes.  —  An  offshoot  of  homoeopathy,  which  by  its  foulness 
brought  much  harsh  criticism  upon  its  parent  system,  was  the  doctrine 
called 

Isopathv, 

the  filthiest  theory,  at  all  events,  ever  invented.  According  to  this  system,  like  was 
to  be  cured  by  like,  i.  e.  small-pox  by  variolous  pus,  diarrhoea  b}-  faecal  matter, 
gonorrhea  by  gonorrheal  pus  —  taken  internally  be  it  understood! — tapeworm  by 
the  ingestion  of  joints  of  the  tapeworm,  and  a  lot  of  such  remedies.  Among  the 
Isopathists  were  Lux  and  G.  Fr.  Midler.  It  would  thus  seem  that  no  pure  or  impure 
possibility,  and  no  conceivable  absurdity,  can  be  adduced,  from  which  it  is  impossible 
to  form  a  medical  theory.  And  so  it  is  certainly  not  the  most  gratifying  advantage 
of  the  study  of  the  history  of  medicine  that  we  observe  how  every  absurdity,  if  it  is 
only  preached  up  with  the  necessary  confidence  and  perseverance,  finds  its  dupes 
and  followers,  and  that  history  is  often,  in  the  most  unheard  of  ways,  metamorpl  osed 
into  a  record,  mildly  speaking,  of  human  follies.  And  the  fact  that  this  statement 
holds  quite  as  good  for  our  own  centurj-  as  for  any  period  of  the  Middle  Ages  or  of 
Antiquity,  furnishes  us  a  thoroughly  humiliating  historical  doctrine  and  tiuth,  to 
wit,  that  as  long  as  men  live  and  labor,  folly  and  reason  dispute  ihe  balance,  and 
that  reason  by  no  means  always  depresses  its  side  of  the  scale.  One  of  the  most 
fraudulent  outgrowths  of  homoeopathy  is  the  "  Electro-homoeopathic  System  "  of 
count  Cesare  Mattei  (Neue  Methode  etc.,  Stuttgart,  Edwin  Hahn,  1880),  the  substance 
of  which  may  be  judged  from  the  following  passage:  "But  what  do  we  know  of 
vegetable  (sic!)  electricity?  So  sa3*  the  doctors,  and  rightly,  for  even  I  who  dis- 
covered it  know  nothing  of  this  agent.  I  know  that  I  investigated  it  and  found  only 
a  little  magnesia.  I  noticed  that  this  vegetable  fluid  manifested  a  quick  and  often 
momentary  activity,  and  I  said:  'This  activity  is  electrical;  it  is  electricity.'  I 
have  seen  this  electricity  cure  troubles  tegarded  as  incurable,  and  I  said  to  myself: 
'  This  is  a  remedial  agent.'  That  is  all  I  know  of  vegetable  electricity,  and  far  be  it 
from  me  to  make  a  secret  of  it.  On  the  contrar}-  I  tell  it  to  all,  even  to  those  who  do 
not  wish  to  know  of  it ! !  "  —  Such  nonsense  and  fraud  is  preached  up  by  many  in  this 
19th  century,  the  century  of  education,  invention  and  advancement,  and  numbers 
swear  by  it,  to  the  pecuniary  profit  of  these  bold  representatives  of  humbug! 

The  doctrine  of  Hahnemann  too  undermined  the  very  foundations  of 
medical  tradition  as  the}'  had  been  held  for  centuries,  so  that  even  to-daj- 
the}r  are  tottering  from  the  shock,  and  it  especially  summoned  medicine 
to  a  new  proof  and  simplification,  as  well  as  to  a  rarer  employment  of  its 
apparatus  of  healing.  This  must  be  regarded  as  a  ripe  and  cultured  ser- 
vice to  medicine.  But,  on  the  other  hand,  in  a  social  direction  its  influence 
was  undoubtedly  injurious,  inasmuch  as  by  its  popularization  of  medical 


—  880  — 

practice  it  was  partially  responsible  for  the  fact  that  the  social  standing  ot 
the  physician  was  lowered  in  comparison  with  earlier  ages. 

While  homoeopathy  in  German}',  in  spite  of  individual  examples  to  the  contrary 
among  the  laity,  seemed  among  physicians  at  least  to  he  verging  towards  extinction, 
after  the  erection  of  the  new  German  Empire,  which  offered  to  physicians  unbridled 
quackery  as  its  earliest  gift,  while  its  first  statesman  for  a  long  time  encouraged 
charlatanism,  the  system  of  Hahnemann  began  again  to  flourish  almost  as  luxuriantly 
as  among  the  humbug  loving  portion  of  the  inhabitants  of  the  United  States.  In 
Wurtemberg  in  1883  the  state  even  licensed  a  homoeopathic  pharmacy.  In  1886 
there  were  four  exclusively  homoeopathic  central  pharmacies,  together  with  numerous 
others  which  kept  homoeopathic  remedies.  In  the  United  States  there  are  32 
homoeopathic  pharmacies,  and  even  in  England  homoeopathy  flourishes.  The  same 
may  be  said  of  France  where  many  works  upon  the  subject  of  homoeopathy  have 
recently  appeared.  Among  these  we  may  notice:  Hirschel's  "Guide  du  medecin 
homoeopathique  an  lit  du  malade  ",  1874;  Alexis  Espanet's  "Pratique  del'  homce- 
opathie  ",  1875;  Hoffmann's  "  L'  homceopathie  expose  aux  yeux  du  monde  "  1870; 
Constantin  Hering  (born  in  Oschatz,  Saxony,  in  1800,  died  in  Philadelphia  in  1880), 
who  (1834)  introduced  homoeopathy  into  the  United  States,  wrote  "  The  Domestic 
Phj'sician'',  1858,  with  numerous  medical  essays;  Jahr's  "  Nouveau  manuel  de 
medecine  homo?opathique  ",  1872:  Prost-Lacuzon  and  Berger's  "  Dictionnaire 
veterinaire  homoeopathique",  1865;  Gunthers  "Nouveau  manuel  de  medecine 
homoeopathique  "  1871,  etc.  etc.  Most  of  these  works,  it  is  true,  are  translations 
from  the  German.  But  it  is  precisely  these  excrescences  of  German  medicine  that 
have  contributed  to  the  discredit  of  that  science  among  the  French!  Thus  Bouchut, 
in  his  history  of  medicine  which  appeared  in  1873,  calls  homoeopathy  in  its  entirety 
—  and,  alas,  with  justice  !  —  une  folie  allemande. 

[In  England  the  system  of  Hahnemann  is  said  to  have  been  introduced  in  1827 
by  a  Dr.  Quin,  physician  to  the  king  of  the  Belgians.  It  has  never,  however,  become 
very  popular  in  the  "  land  of  common  sense",  and  even  at  the  present  day  is  said  to^ 
comprise  not  more  than  300  registered  ph}'sicians  in  the  whole  British  Isles.  Liver- 
pool e.  g.  enjoys  the  luxury  of  but  10  homceopathists,  Glasgow  but  five  etc.  In 
London  there  is  a  single  homoeopathic  hospital  with  100  beds,  and  connected  with 
this  institution  the  only  college  of  instruction  in  the  United  Kingdom.  In  a  country 
like  the  United  States,  where  every  "  free  and  enlightened  "  citizen,  male  or  female, 
feels  abundantly  competent  to  criticise  not  only  medical  opinions  but  also  religious 
beliefs,  it  is  by  no  means  surprising  that  homeopathy  has  met  with  considerable 
popularity.  Incomprehensible,  of  course,  to  the  majority  of  its  adherents,  its  very 
transcendentalism  renders  the  doctrine  popular  —  omne  ignotum  pro  magnifico  — 
and  in  certain  circles  faith  in  the  illusions  of  homtjeopathy  is  natural!}"  regarded  as 
an  evidence  of  precocity  (!)  of  intellect.  The  fact  too  that  this  system  dispenses  with 
all  the  disagreeable  elements  of  medication  has  contributed  large!}7  to  its  adoption 
among  the  more  fastidious,  or  as  they  would  doubtless  call  themselves  the  more 
"intelligent".  The  earliest  practitioner  of  homoeopathy  in  the  United  States  is  said 
to  have  been  Dr.  Hans  B.  Gram  (again  a  German),  a  native  of  Boston,  but  educated 
in  Copenhagen.  On  his  return  to  the  United  States  in  1825  he  settled  in  New  York, 
where  he  died  in  1840.  In  1844  the  American  Institute  of  Homoeopathy  was  founded 
with  about  50  members.  The  earliest  homoeopathic  journal  established  in  this 
country  appeared  in  New  York  about  1834.  It  was  entitled  "The  American  Journal 
of  Homoeopathia  "  and  was  edited  by  Drs.  J.  F.  Gray  and  A.  Gerald  Hull.  In  1886 
the  homoeopathic  fraternity  claimed  11,000  practitioners  in  the  United  States,  with 
5  national  and  28  state  societies,  51  hospitals,  48  dispensaries  and  22  journals.    The 


—  881  — 

homoeopathic  colleges  were  also  credited  with  a  production  of  500  physicians  am  u- 
ally.  It  should,  however,  be  stated,  that  while  the  shibboleth  of  homoeopathy  is 
preserved,  the  system  of  Hahnemann  has  become  almost  extinct  in  the  United  States, 
as  well  as  abroad.  Barring  some  few  simpletons,  for  whom  the  potencies  of  Hahne- 
mann conceal  the  impotence  of  their  own  intellectual  capacities,  the  majority  of 
so-called  homoeopathic  practitioners  of  the  present  day  pride  themselves  upon  an 
eclecticism  which  stands  ready  to  appropriate  what  experience  proves  useful  in  any 
system.  In  a  word  they  are  "regular"  physicians  without  knowing  it,  merely 
employing  the  term  "  homreopathic  "  as  a  bait  to  attract  the  unwary,  or,  like  the 
sugar-coating  of  a 'pill,  to  disguise  the  disagreeable  facts  wilhin. 

While  as  a  system  of  medicine  homoeopath}'  can  claim  no  considerable  import- 
ance, as  a  protest  against  the  hypermedication  of  Rasori  and  his  school  it  has 
doubtless  accomplished  no  little  good.  The  apparent  successes  of  its  followers  have 
led  thoughtful  physicians  to  a  more  careful  sludy  of  the  natural  history  of  disease 
and  to  greater  caution  in  the  differentiation  of  the  post  hoc  and  propter  hoc  in 
therapeutics.  While  too  the  regular  profession,  under  the  guidance  of  the  French 
and  Germans,  has  devoted  a  too  exclusive  attention  to  pathology  and  the  perfection 
of  diagnosis,  and  in  therapeutics  has  adopted  a  practical  nihilism,  the  homoeopaths, 
proceeding  to  the  opposite  extreme,  have  over-elaborated  their  so-called  system  of 
therapeutics,  to  the  practical  exclusion  of  diagnosis  and  pathology.  Here  too  the 
middle  course  is  the  only  safe  one,  and  the  protest  of  the  homoeopaths  against  the 
super-scientific  but  inhuman  tendency  of  the  regular  profession  has  awakened  in  the 
latter  an  increased  activity  in  the  study  of  the  therapeutic  action  of  drugs,  which 
if  properly  directed  and  controlled,  will,  we  trust,  in  the  near  future  produce  beneficent 
results.  —  Of  the  homoeopathic  system  itself  the  old  criticism  that  "  What  is  true  is 
not  new,  and  what  is  new  is  not  true"  seems  fair  enough  even  at  the  present  da}'.  H.] 
Intimately  connected  with  the  natural-philosophical  tendency  in  med- 
icine, a  tendency  which  ultimately  enveloped  that  science  in  a  fog  of 
philosophical  phraseology,  and  especially  by  its  long  continued  supremacy 
worked  to  its  injury,  stands  a  S3rstem  or  theor}*  comparable,  at  least  in  its 
influence  upon  life,  to  Mesmerism  and  Hahnemannism.  As  the  latter  sys- 
tems introduced  among  the  masses  supernatural  and  simple  therapeutical 
notions  and  habits,  so  by  means  of  the  doctrine  of 

d.  Cranioscopy 

(called  by  Gall  Organology,  by  Spurzheim  Phrenology  and  by  others 
"  Craniology  "),  they  now  began  to  occupy  themselves  with  physiologico- 
psychological  problems.  Thus  the  doctrine  of  Gall,  which  in  itself  supplied 
some  fruitful  ideas,  was  distorted  into  a  grotesque  affair  of  fashion,  a  result 
particularly  favored  by  the  fact  that  it  still  preserved  some  mystery,  inas- 
much as  its  author  did  not  publish  his  theory  until  1810.  In  this  wa}'  the 
otherwise  deserving  founder  of  this  s}7stem  occupied  an  ambiguous  light 
with  the  better  class  of  physicians  through  the  impression  produced  by  his 
doctrine,  went  astray  himself,  and  was  flnall}',  by  his  own  fault,  but  under- 
servedly,  degraded  into  the  Mesmer  of  physiology. 

Franz  Joseph  Gall  (1757-1828),  of  Tiefenbronn,  near  Pforzheim  in 
Baden, 

expounded  his  doctrine  in  Vienna  as  earl}*  as  1796.     It  was,  however,  interdicted  by 
the  authorities  in  the  following  year,  because  danger  to  the  faith  and  lovalty  of  sub- 
56 


-  882  — 

jecta  was  smelted  in  the  new  system.  Gall  now  wenl  to  Germany,  lectured  upon  his 
doctrine  in  different  cities  and  testified  to  it  practically,  e.  g.  in  the  prisons  of 
Spandau  and  Purlin.  In  the  latter  city  of  intelligence  (a  quality  now  assumed 
to  he  established  too  in  its  physical  basis)  two  medals  with  his  likeness  were  struck! 
Still  this  enthusiasm  did  not  last  long,  and  Gall,  with  Spurzheim,  a  pupil  whom  he 
hail  obtained  in  Vienna,  went  to  Paris,  where  the  new  theory  was  at  once  received 
with  sympathy.  Gall  continued  to  practise  in  Paris  and  became  very  rich,  dying  at 
M(introu<_re.  near  that  city,  in  18*28. 

Dr.  Joh.  Caspab  Spurzheim,  his  pupil,  and,  like  Gall  himself,  a  gifted 
and  deserving  anatomist,  was  born  at  Longvvieh,  near  Treves  in  1776. 
Originally  ;i  theologian,  having  accepted  with  enthusiasm  the  doctrine  of 
Gall,  he  was  instrumental  in  introducing  it  into  England,  where  he  resided 
from  1813-1817  and  1821-1828.  In  1832  he  came  to  the  United  States 
and  was  attracting  great  attention  to  his  theory  when  he  died  at  Boston 
Nov.  10th  of  the  same  year. 

Secret  phrenological  societies  (like  those  of  Mesmer)  were  quietly  established, 
the  first  being  organized  at  Edinburgh  in  1820.  The  agitation  of  Spurzheim  (whose 
teachings,  like  those  of  Gall  himself,  were  not  without  a  beneficial  influence  upon 
psychiatry'  led  to  the  formation  of  other  societies  in  London  and  Paris,  and  even  in 
India.  In  the  year  1832  the  number  of  these  societies  in  Great  Britain  alone  amounted 
to  29.  Spurzheim  also  established  a  special  journal  devoted  to  phrenology,  the  editors 
of  which  were  George  Combe  of  Edinburgh  and  H.  C.  Watson,  [while  among  its 
prominent  contributors  were  Sir  George  Mackenzie,  Macnisb  and  others.  This 
journal  reached  the  20th  volume,  having  survived  from  1823  to  1847.  Among  the 
prominent  supporters  of  phrenology  in  England  were  also  Andrew  Combe,  John* 
Elliotson  (also  devoted,  as  we  have  seen  to  Mesmerism)  and  archbishop  Whately. — 
In  the  United  States  the  teachings  of  Gall  and  Spurzheim  were  introduced  by  Dr. 
Charles  Caldwell  (1772-1853)  of  North  Carolina,  who  had  been  a  pupil  of  Gall  and 
devoted  himself  between  1821  and  1832  to  the  dissemination  of  his  master's  doctrines 
from  the  rostrum  and  by  the  formation  of  phrenological  societies.  George  Combe 
also  delivered  several  courses  of  lectures  in  the  United  States  on  the  subject  of 
phrenology  between  1880  and  1840.  Among  the  most  active  apostles  of  the  new 
doctrine  in  the  United  States,  however,  were  0.  S.  Fowler,  his  brother  L.  N.  Fowler, 
their  sister  Charlotte  (Fowler)  Wells  and  her  husband  Samuel  R.  Wells  (died  1875). 
The  "  Phrenological  Journal"  was  established  by  them  in  1863,  Other  important 
representatives  of  phrenology  in  the  United  States  -were  J.  S.  Grimes,  Nelson  Sizer, 
.1.  It.  Buchanan  of  Cincinnati,  W.  B.  Powell  of  Kentucky,  John  S.  Hittell  of  New  York, 
D.  P.  Butler,  Dr.  Levi  Reuben  etc.      H.] 

Gall,  who  undoubtedly  deserves  great  credit  for  his  labors  upon  the 
anatomy  of  the  brain,  considered  the  latter  a  series  of  independent 
"organs",  located  beside  each  other,  and  held  that  protuberances  npon  the 
external  surface  of  the  skull  showed  with  precision  the  degree  of  develop- 
ment of  these  organs.  The  dispositions  were,  indeed,  preformed,  but  by 
education  they  might  be  developed  in  a  good  direction,  i.  e.  the  disposition 
to  evil  might  be  restrained  and  made  inactive,  so  that  e.  g.  a  man  with  a 
disposition  towards  murder  ueed  not  necessarily  be  an  actual  murderer. — 
This  assumption  of  special  districts  in  the  brain  for  special  mental  facul- 
ties bus.  indeed,  many  grounds  in  its  favor,  and  has,  even  in  more  recent 
times,  received  some  confirmation  from  experiment  and  observation.     Gall, 


—  883 


however,  converted  his  theory  into  a  "s}-stem"  too  speedily,  and  after  mere 
observations  upon  the  skull. 

He  assumed  27  "organs":  the  reproductive  sense;  sense  of  love  of  children;  of 
friendship;  sense  of  self-defence,  courage  and  quarrelsomeness  ;  of  murder:  of  cun- 
ning; of  association  (in  animals);  of  theft:  sense  of  elevation,  pride;  sense  of  vanity, 
sense  of  glory;  sense  of  caution;  sense  of  things,  memory  of  things;  sense  of  locality : 
sense  of  persons;  sense  of  names;  sense  of  words  ;  sense  of  language  ;  of  colors  ;  of 
tones;  of  numbers;  sense  of  art,  of  construction  ;  comparative  sagacity  ;  the  meta- 
physical sense,  profundity  of  mind;  sense  of  wit;  the  poetic  sense;  sense  of  good- 
nature; sense  of  imitation,  mimicry  ;  the  theosophic  sense;  sense  of  stability,  fii  m- 
ness. 

Spurzheim  divided  the  organs  still  more  minutely:  ' 


First  Class 

Feeliogs, 

Second  Class:    Intellectual  Faculties. 

Fikst  Order. 

Second  Order. 

Third  Order. 

Fourth  Order. 

Propensities. 

Sentiments. 

Perceptive  Faculties. 

Reflective  Faculties. 

Amativeness, 

Self-esteem, 

Individuality, 

Comparison, 

Pliiloprogenitiveness, 

Line  of  approbation, 

Sense  of  form, 

Causality. 

Concent  rat  tveness, 

Cautiousness, 

"    size, 

( Inliabitiveness), 

Benevolence. 

"    weight, 

Adhesiveness, 

Veneration, 

"       "    color, 

Combativeness, 

Firmness. 

'    locality. 

Destructiveness, 

Conscientiousness. 

"    numbers, 

( Alimentiveness  i. 

Hope, 

order, 

Secretiveness, 

Wonder, 

"   eventuality, 

Acquisitiveness, 

Ideulitv, 

'    time, 

Constructiveness. 

Wit. 

"    tone. 

Imitation. 

:'    language. 

Of  course  the  pros  and  rons  of  this  system  brought  forth  an  entire  literature  of 
their  own. 

Among  its  partisans  were  T.  Forster,  G.  Comte,  G.  S.  Mackenzie,  Cloquet, 
Broussais,  Bouillaud,  Andral,  Fossati.  Karl  Otto  in  Copenhagen  and  others.  Con- 
ditional followers  were  J.  A.  Walther,  J.  D.  Metzger,  Hufeland,  Loder,  Reil,  Himly  &c. 

Among  the  opponents  of  the  system  were  J.  Th.  Walther,  A.  Moreschi,  J.  F. 
Ackermann  particularly,  professor  in  Heidelberg  and  Jena;  C.  A.  Rudolphi  (1771- 
1832),  a  famous  physiologist  in  Berlin  and  author  of  a  natural  history  of  intestinal 
worms  etc  ;   Serres,  Flourens,  Magendie  and  others. 

The  subject  was  studied  at  a  later  period  by  K.  K.  Noel,  K.  G.  Cams  and,  latest 
of  all,  by  Gustav  Scheve,  who  died  in  Frankfort-on-the-Main  in  1880. 

Gothe,  who,  both  during  his  university  course  and  subsequently,  "was  much 
interested  in  medicine  and  accordingly  studied  cranioscopy,  took  a  very  profound 
view  of  the  doctrine  of  Gall.  "The  brain  remains  the  foundation  and  chief  object, 
since  it  is  not  required  to  adapt  itself  to  the  skull,  but  the  skull  must  conform  to  it. 
So  far  is  this  the  case  that  the  internal  diploe  of  the  skull  is  arrested  by  the  brain  and 
confined  b}-  its  organic  boundaries.  On  the  other  hand,  in  case  of  a  sufficient  supply 
of  bony  material,  the  external  lamina  asserts  the  right  of  enlarging  itself  even  to  a 
monstrous  degree,  and  of  forming  internally  so  many  chambers  and  departments. 
In  every  way  Gall's  demonstration  of  the  brain  was  superior  to  that  of  the  schools, 
where   the  organ   was   cut  into  horizontal   or   vertical  sections  and  a  view  given  of 

1.  Fowler  and  Wells  increased  the  number  of  faculties  to  43,  and  likewise  changed 
some  of  their  names.     (H.) 


—  884  — 

certain  parts  following  one  after  another,  to  which  names  were  assigned,  as  if  this 
were  all  that  was  necessary.  Even  the  base  of  the  brain,  the  origins  of  the  nerves, 
remained  known  as  mere  localities,  from  which  I,  interested  as  I  was,  could  gain 
•  nothing  further."  Gothe  desired  to  draw  some  general  conclusions,  and  even  Gall 
went  too  far  into  the  specific  to  suit  him.  "Whoever  bases  his  position  upon  the 
general  will  probably  be  unable  to  rejoice  in  a  number  of  desirable  pupils.  On  the 
other  hand,  the  particular  attracts  mankind,  and  justly  so:  for  life  is  assigned  to  the 
particular,  and  very  many  men  can  prosecute  their  life  in  the  particular,  without 
necessarily  advancing  further  than  the  point  were  human  reason  comes  to  the  aid  of 
their  five  senses." 

Some  previous  views  of  a  similar  nature  are  to  be  found  too  among  the  Ancients 
and  the  Arabians.  The  latter  assumed  in  the  four  ventricles  of  the  brain  the  seat  of 
common  sensation,  of  imagination,  judgment,  and  recollection.  Similar  hints  are  to 
be  found  in  Albertus  Magnus,  Mondino,  Petrus  Montagnanus,  Ludovico  Dolci, 
Willis,  and  Charles  Bonnet,  who  styled  the  brain  the  "rendezvous  of  very  different 
organs ". 

The   theory  of  Francois  Joseph   Victor  Broussais  (1772-1838), 
designated 

e.   Physiological  Medicine  (better  Broussaismj, 

exhibited  a  mixture  of  the  views  of  Brown,  Pinel  and  Biehat,  combined 
with  Friedrich  Hoffmann's  doctrine  of  the  sympathy  of  the  various  organs 
with  the  stomach,  Stoll's  concealed  inflammation  and  gastricism,  and  the 
theory  of  inflammation  of  Marcus. 

Broussais,  the  son  of  a  physician  at  St.  Malo  in  Bretagne,  manifested  even  in 
his  youth  unusual  mental  as  well  as  corporeal  strength,  and,  as  the  result  of  both,  a 
disposition  to  brawling  and  fighting  in  both  departments.  Jn  1792  he  volunteered 
in  the  army  of  the  Republic,  but  rose  only  to  the  grade  of  a  sergeant.  Returning 
home  sick,  his  father  succeeded  in  inducing  him  to  become  a  physician.  However, 
when  his  parents  were  murdered  and  his  house  burned  down,  he  tried  his  foitune 
upon  a  privateering  vessel  until  1798.  when  he  betook  himself  to  Paris,  at  the  age  of 
26,  in  order  to  prosecute  his  studies.  Biehat  particularly  gave  him  assistance. 
Graduating  in  1803,  he  practised  two  years  in  Paris  and  then  served  for  three  years 
with  the  armies  of  Napoleon  in  Holland,  Germany,  Austria  and  Italy.  On  his 
return  to  Paris  he  published  his  "  Histoire  des  phlegmasies  ou  inflammations 
chroniques"  (1808),  and  then  again  went  as  an  army  surgeon  to  Spain  until  1814. 
In  the  latter  year  he  was  appointed  second  physician  to  the  hospital  Val  de  Grace, 
and  in  this  position  began  his  private  lectures  upon  his  new  doctrine.  The  attend- 
ance upon  these  lectures  was  immense,  but  his  success,  combined  with  his  reckless 
antagonism  of  the  ancient  doctrine,  brought  him  enemies  and  quarrels.  This  was 
particularly  the  case  after  1816,  when  he  published  his  "  Examen  de»la  doctrine 
inedicale  generalement  adoptee"  etc,  a  work,  which  did  not,  however,  require  a 
second  edition  until  the  lapse  of  five  3*ears.  One  year  later  his  "Annales  de  la 
medecine  physiologique  "  began  to  appear  and  were  continued  until  I8M4,  in  which 
year  his  "  Traite  de  physiologie  applique  a  la  pathologie"  was  published.  In  the 
year  1828,  iu  a  work  entitled  "  Sur  1'  irritation  et  la  folie  ",  he  applied  his  principles 
to  mental  diseases.  Finally  in  1831  Broussais  was  appointed  ordinary  professor. 
According  to  L.  Stromeyer,  Broussais  was  not  an  extraordinary  teacher,  but  was 
extremely  self-conceited  and  passionately  wrangled  with,  and  indeed,  even  abused, 
all  who  declined  to  accept  his  doctrines  unconditional^-.  As  a  therapeutist  he  was 
simply  a  man   of  routine.     His  star,   however,   declined,  to  rise  only  once  again  in 


I8o6,  when  he  delivered  his  lectures  on  phrenology.     Two  years  later  Broussais  died 
at  Vitry,  where  a  monument  was  subsequently  erected  to  his  memory. 

Life,  according  to  Broussais  (as  with  Brown  at  an  earlier  date),  depends 
upon  external  irritation,  especially  that  of  heat.  The  latter  excites  in  the 
body  peculiar  chemical  processes,  which  in  turn  maintain  regeneration  and 
assimilation  as  well  as  contractility  and  sensibility.  When  these  functions 
supported  by  heat  cease,  death  at  once  ensues.  Health  depends  upon  the 
moderate  action  of  the  external  irritants  ;  disease,  upon  their  weakness,  or 
more  frequently  upon  their  extraordinary  strength.  Disease  is  nothing- 
whatever  ontological. 

For  Broussais,  in  contrast  to  Brown  who  held  almost  all  diseases  to  be 
general  (and  asthenic),  general  diseases  or  essential  fevers  do  not  exist  at 
all,  at  least  not  immediately  upon  the  action  of  abnormally  strong  irrita- 
tions. They  always  originate  from  local  irritations  proceeding  from  a 
certain  diseased  organ  or  part  of  an  organ,  particularly  from  the  heart, 
and  most  of  all  from  the  mucous  membrane  of  the  stomach  and  intestines, 
and  diffuse  themselves  throughout  the  rest  of  the  body  through  sympathy 
and  by  way  of  the  nervous  system.  The  ganglionic  system  is  a  system  of 
nervous  centers  related  to  the  general  nervous  system,  transmitting  irrita- 
tions sympathetically  like  the  latter,  and  independent  of  the  will.  Too 
strong  irritants  produce  an  "irritation",  which  manifests  itself  as  congestion 
(active  congestion).  General  debility*,  which  we  observe  in  disease,  depends 
upon  the  fact  that  if  the  excitement  in  one  part  is  too  strong,  it  becomes 
abnormally*  weak  in  the  other  parts,  and  is  thus  generalized.  In  this  way 
too  congestion  (passive  congestion)  may  occur.  s Every  irritation,  which 
through  sympathetic  irritation  of  the  heart  produces  fever,  has  become  an 
inflammation,  and  the  main  criterion  of  the  latter  is  bypersemia.  If  the 
sympathetic  irritation  is  stronger  than  the  original  and  local  irritation,  we 
have  the  so-called  metastases.  If  these  appear  in  the  secreting  organs 
and  are  also  beneficial,  the}'  are  to  be  understood  as  crises.  All  strong 
"irritations"  have  the  common  property,  on  the  one  hand,  of  exciting  the 
brain  sympathetically  (hence  headache,  vertigo;,  and  on  the  other,  of  pro- 
ducing congestion  or  inflammation  of  the  stomach  (hence  the  coated 
tongue,  lack  of  appetite).  The  affection  of  the  stomach  always  excites  the 
small  intestine,  and  both  always  suffer  together.  Since,  however,  the  sym- 
pathetic irritations  of  the  brain  are  almost  always  the  effect  of  irritation 
of  the  stomach  and  small  intestine,  we  have  almost  always  to  deal  exclu- 
sively with  the  famous  'gastroenteritis",  which  likewise  is  the  source  of 
the  essential  fevers.  ("All  the  essential  fevers  of  the  authors  are  referable 
to  a  simple  or  complicated  gastroenteritis.  This  they  have  misinterpreted 
when  it  is  unaccompanied  by  pain,  and  even  when  pain  has  been  found 
to  exist,  they  have  always  regarded  it  as  a  symptom.  A  knowledge  of  the 
morbid  conditions  of  the  stomach  is  the  key  to  pathology.")  Through 
complications  it  occasions  typhus  and  all  other  so-called  infectious  dis- 
eases, including  the  epidemic  diseases  of  the  skin  and  even  the  ordinary 


—  886  — 

skin  eruptions,  which  are  to  be  regarded  as  arising  sympathetically  from 
the  stomach.  Specific  morbid  poisons,  even  that  of  syphilis,  Broussais 
absolutely  denied. 

Chronic  constitutional  diseases  depend  very  frequently  upon  an  exist- 
ing chronic  inflammation  or  chronic  gastroenteritis.  The  same  is  true  of 
hypochondria  and  mental  diseases. 

"Gastroenteritis",  "the  basis  of  pathology",  is  divisible  into  two 
varieties.  If  the  gastroenteritis  predominates,  it  is  ordinarily  accompanied 
with  pains  in  the  gastric  region  and  sudden  vomiting  of  food  and  drink. 
If,  however,  the  enteritis  is  the  chief  lesion,  great  thirst,  a  sensation  of 
internal  heat,  an  abdomen  sensitive  and  hot  to  the  touch,  a  quick  and  hard 
pulse  and  a  tongue  coated  in  the  middle  and  red  at  the  edges,  are  the 
characteristic  phenomena. 

The  tissue  and  organ  systems,  employing  these  terms  in  the  sense  of 
Bichat,  are  the  usual  routes  for  the  propagation  of  diseases.  In  this  idea 
Broussais  afforded  great  support  to  the  tendency  towards  pathological 
anatomy.  He  was  a  solidist  of  the  tissues  and  organs.  Tn  opposition  to 
the  nervous  solidists  (Cullen  etc.),  who  accepted  functional  diseases  with- 
out local  lesions,  Broussais  admitted  only  local  organic  changes  with  sub- 
sequent disturbances  of  function. 

In  therapeutics  Broussais,  like  Asclepiades  and  his  imitators  in  many 
respects,  Brown  and  Hahnemann,  admitted  no  vis  medicairix  natures. 
Accordingly  the  physician  is  not  the  minister,  but  the  lord  of  nature.  He 
must  anticipate  diseases  —  "couper",  "faire  avorter"  —  particularly  the 
gastroenteritis,  against  which  all  his  treatment  must  be  primarily  directed, 
since  it  exists  almost  everywhere  as  a  primary  or  S3"mpathetic  lesion. 
For  this  purpose  the  antiphlogistic  or  weakening  method  is  chiefly  service- 
able ;  derivative,  irritant  or  corroborant  measures  are  incomparably  less 
useful.  Febrile  and  inflammatory  diseases  he  treated  by  the  withdrawal 
of  nourishment,  carried,  like  everything  else,  to  the  extreme.  The  most 
powerful  antiphlogistic  treatment,  however,  consists  not  in  venesection 
(which  should  be  employed  at  most  only  in  plethoric  patients  and  espe- 
cially in  recent  inflammations  of  an  organ  particularly  well  supplied  with 
arterial  blood),  but  in  the  application  of  numerous  leeches  to  the  abdominal 
or  gastric  region.  In  robust  individuals  at  least  30-50  should  be  applied 
at  once,  and  it  was  only  in  very  great  debility  that  5-8  might  be  sufficient. 
In  this  system  of  therapeutics  often  a  hundred,  or  indeed  several  hundred 
leeches  were  applied  to  a  single  patient,  or,  what  amounts  to  the  same 
thing,  to  a  single  belly,  and  it  is  not  to  be  wondered  at  when  we  learn 
that  in  consequence  of  Broussais's  "hirudinomania"  leeches  became  scarce, 
a  scarcity  from  which  we  probably  have  to  suffer  even  now.  In  the  year 
1833  alone  41,500,000  leeches  were  imported  into  France,  and  onl}-  nine  or 
ten  millions  exported.  Yet  in  1824  2-300,000  were  sufficient  to  supply  all 
demands  ! 

In  order  to  guard  against   sympathetic   gastroenteritis,  leeches  should 


—  S87  — 

be  applied  not  only  to  the  gastric  region,  but  likewise  to  the  organ  pri- 
marily attacked.  Thus  in  rheumatism  and  gout  they  should  be  applied  to 
the  joints  and  the  pit  of  the  stomach,  in  croup  to  the  neck  and  the 
stomach,  in  phthisis  to  the  chest  and  stomach  &c.  Wet  cups  rarely  ac- 
complish anything.  Even  in  cases  of  worms  the  abdominal  integument 
was  compelled  to  pa}*  its  bloody  tribute,  particularly  if  "enteritis"  pre- 
vailed. The  hypochondriac  region  and  finallv  even  -'the  contracted  neigh- 
borhood of  the  anus"  were  likewise  favorite  fields  for  this  "hirudino- 
therapy",  and  the  matter  went  so  far  that  in  France  ■-every  belly  is  either 
garnished  with  leeches  or  displays  numerous  scars  due  to  past  bites"  — 
and  this  without  regard  to  the  question  whether  man  or  woman.  3'outh, 
maiden  or  child  was  to  furnish  the  blood.  The  anal  region  was  selected 
e.  g.  in  recent  diarrhoea  arising  from  colitis,  in  colic,  dysenteiy  etc. 
Besides  leeches,  only  a  spare  diet,  mucilaginous  and  acid  drinks,  and 
"  antiphlogistico-einollient"  poultices  to  the  umbilical  region,  were  favored. 
If,  however,  all  food  was  immediatel}-  rejected,  the  physician  was  to  let  the 
patient  fast  absolutely  for  several  da}-s,  and  administer  tepid  foot-baths  or 
complete  baths.  —  Chronic  inflammations  also,  in  the  majority  of  cases,  of 
course  demand  leeches,  but  applied  to  the  affected  parts,  e.  g.  the  external 
scrofulous  glands.  Even  syphilis  was  treated  by  direct  abstraction  of 
blood  from  the  specially  affected  locality,  and  by  cooling  drinks.  —  The 
derivative  method  by  the  employment  of  diuretic  remedies,  blisters, 
emetics  and  cathartics  etc.,  was  mostly  injurious,  since  it  did  little  but  add 
a  new  irritation  to  that  already  existing,  or  increase  or  render  chronic  the 
"concealed"  gastroenteritis.  This  was  especially  true  of  cathartic  doses 
of  calomel,  which  were  liable  to  occasion  chronic  diarrhoea,  consumption 
and  dropsy  —  In  rare  cases  tonics  are  useful,  e.  g.  in  intermittent  fever 
after  the  failure  of  antecedent  employment  of  the  antiphlogistic  method. 
Cinchona  must,  however,  be  administered  in  such  cases  with  the  greatest 
prudence,  lest  the  "concealed"  gastroenteritis  return  with  so  much  the  more 
violence.  Irritant  remedies,  particularly  in  the  nervous  stadium  of  disease, 
are  to  be  discarded. 

While  Broussais  rendered  good  service  to  medicine  by  his  war  auainst 
the  ontology  of  diseases  which  had  hitherto  prevailed,  on  the  other  hand, 
by  his  doctrine  of  the  invariably  local  nature  and  expression  of  these  he 
favored  the  one-sidedness  of  the  anatomical  school.  His  "gastroenteritis" 
must  be  looked  upon  as  a  sj-stematic  phantasy,  of  which  we  see.  and  have 
seen,  so  man}-.  Yet  it  is  manifest  from  what  has  been  said  that  the 
sanguinary  therapeutics  —  the  touchstone  of  the  doctrine  of  a  physician  — 
of  Broussais  may  be  called  something  of  an  improvement  upon  the  system 
of  Rasori  ! 

In  France  and  Italy,  the  land  of  bloodletting,  the  doctrine  of  Broussais 
gained  numerous  followers  ;  in  Germany  and  England,  however,  it  had 
scarcely  any.  Among  the  partisans  of  this  doctrine  there  were  in  partic- 
ular many  military  physicians  of  eminence. 


—  888  — 

Besides  Dupuytren,  to  be  mentioned  hereafter  as  one  of  the  most  eminent  of 
surgeons,  the  old  Francois  Chaussier,  who,  as  already  noticed,  had  introduced 
Vitalism  into  Paris,  was  also  a  follower  of  Broussais.  The  same  is  true  of  Claude 
Francois  Lallemand  (1790-1854)  of  Metz,  first  professor  in  Montpellier,  tlien  in 
Paris,  ordinary  physician  of  Ibrahim  Pacha  and  Mehemtt  Ali  and  founder  of  the 
'Prix  Lallemand"  ("Recherches  anatomico-pathologiques  sur  1'  encephale  et  ses 
dependances";  'Clinique  medico-chirurgicale  ") ;  J.  L.  Begin  (1793-1859),  "Traite 
de  physiologic  pathologique,  redige  suivant  les  principes  de  la  nouvelle  doctrine 
medicale";  "  Traite  de  therapeutique  redige"  etc.:  the  Vitalist  H.  ChaufTard  (1823- 
1879J,  a  famous  clinical  teacher  of  the  Paris  faculty  at  the  Hopital  Beaujon.  and 
after  1870  the  successor  of  Andral  in  the  chair  of  general  pathology;  Jacques  M.  A. 
Goupil  (1800-1837),  "Exposition  des  principes  de  la  nouvelle  doctrine  medicale" 
etc.  Louis  Charles  G.  Roche  (born  1790)  of  Nevers,  one  of  Broussais's  most  zealous 
followers  ("  De  la  nouvelle  doctrine  medicale"  etc.);  Francois  Gabriel  Boisseau 
(1791-1836  ,  professor  in  the  military  hospital  at  Metz  ("  Nosographie  organique" 
etc.;  "  Pyretologie  physiologique,  e.xposee  suivant  la  doctrine  de  Broussais"); 
Antoine  Laurent  Jesse  Bayle  (born  1799),  who  applied  the  doctrine  of  gastritis  to 
diseases  of  the  mind:  H.  M.  T.  Desruelles,  who  treated  syphilis  without  mercury  and 
with  leeches:  A.  T.  L.  Jourdan ;  M  Devergie  Sr.,  both  of  whom  were  antimercuri- 
lists ;  P.  J.  Montgellaz,  who  wrote  on  intermittent  irritation;  Casimir  Broussais 
(  1803-1847),  adjunct  professor  at  the  Val  de  Grace  and  the  discoverer  of  "duodenite", 
who  gave  a  report  of  his  father's  clinic  ;  Pierre  Francois  Olive  Rarer  (1793-1867)  in 
Paris,  originally  a  follower  of  Broussais  and  an  eminent  pathological  anatomist; 
Cruveilhier,  and  finally 

Jean  Baptiste  Bouillald  (1707-1881),  professor,  and  from  1831 
chief  physician  to  the  Charite,  who  adopted  particularly  the  symptomatic 
nature  of  fever  and  the  sanguinary  therapeutics  of  Broussais,  but,  for  a 
change  and  to  originate  a  "new  method",  maltreated  the  poor  sick  ''objects 
of  experiment'  by  "bleeding  coup  sur  coup",  though  in  this  matter  he 
found  models  in  England  and  Germany.  As  the  homoeopaths  looked  upon 
Hahnemann  (the  most  sensible  man  and  the  most  perfect  dialectician  of 
all  medical  heretics),  so  Bouillaud  regarded  Dr.  Broussais  as  the  '-Messiah 
of  Medicine"  —  a  science,  alas,  overstocked  with  Messiahs:  Bouillaud 
rendered  eminent  service  to  our  knowledge  of  diseases  of  the  heart  and 
their  connection  with  rheumatism  (though  in  this  he  was  anticipated  by 
Kreysig).  as  well  as  to  the  subject  of  the  obliteration  of  bloodvessels. 
His  chief  works  were  entitled  "Clinique  medicale  de  l'hopital  de  la  Charite 
etc.",  "Traite  clinique  du  rhumatisme  articulaire"  etc.,  "  Traite*  clinique  des 
maladies  du  coeur"  etc.,  "  Traite*  clinique  et  experimental  des  fievres  dites 
essentielles".  In  these  he  shows  himself  an  eminent  physical  diagnostician 
and  the  god-father  of  the  so-called  "Medecine  exacte". 

The  numb'']-  of  Broussais's  opponents  was  at  fust  not  very  considerable,  but  it 
gradually  increased.  Many  physicians  of  the  "  School"  to  be  next  mentioned  in 
particular  were  included  in  this  number.  Among  these  Auguste  Francois  Chomel. 
professor  of  pathology  in  the  Ecole  de  Medecine  at  Paris  and  chief  physician  to  the 
IlAtt-1  Dieu,  who  will  be  again  mentioned,  was  prominent  from  the  outset.  '1  he  same 
may  be  said  of  the  famous  Halle,  who  has  been  already  mentioned,  and  who  declared 
that  one  could  smell  the  pride  of  the  sectary  in  the  very  style  of  Broussais.  We 
should  also  mention   Fouquier,   Francois  Emmanuel   Fodere  ( 1764-183.")),  from  1814 


—  889  — 

"professor  of  forensic  medicine  and  hygiene  in  Strassburg,  and  author  of  the  first 
French  work  on  these  subjects,  who  rendered  good  service  to  the  doctrine  of  epidemic 
diseases,  and  has  been  already  noticed  in  our  account  of  the  medicine  of  the  18th 
■century;  A.  Coste,  Fr.  Dubois  and  others.  In  Denmark  the  doctrine  of  Broussais 
was  opposed  particularly  by  Karl  Otto  (1795-1879),  professor  of  forensic  medicine 
and  pharmacology  in  Copenhagen.  He  was  a  native  of  the  island  of  St.  Thomas 
and  made  his  debut  in  the  role  of  a  writer  of  travels,  but  devoted  himself  to  phrenol- 
•o?3T,  the  temperance  question,  and  finally,  after  resigning  his  professorship,  to  free- 
masonry.  In  Germany  the  earliest  opponent  of  Broussais  was  Heinrich  Spitta  (born 
1799),  professor  in  Rostock;  he  was  followed  by  the  famous  Franz  Paula  von 
Gruithu'isen  (1774-1852),  professor  successively  of  medicine,  the  natural  sciences  and 
•  astronomy  in  Munich;  W.  H.  Conradi  and  others.  On  the  other  hand  C.  M.  Hailly 
and  the  Italian  Campagnano  endeavored  to  combine  the  doctrines  of  Rasori  and 
Broussais  —  theoretically  to  improve  the  treatment  of  suffering  humanity,  but  really 
in  the  interest  of  therapeutic  maltreatment.  Alas,  in  the  history  of  medicine  how 
many  doctrines  have  been  welded  together,  to  occasion  in  practice  only  the  utmost 
"misery  of  the  poor  patients! 

Contemporaneous  with  the  foregoing  school  of  medicine,  and  its  an- 
tagonist in  all  respects  so  long  as  it  survived,  was  the 

f.  French  (Paris )  School  of  Pathological  Anatomy  and  Diagnosis, 

•which  has  given  tone  to  the  whole  medicine  of  the  19th  century.  Hence 
its  consideration  among  the  schools  of  medical  thought  is  necessary,  inas- 
much as  it  manifested  itself  far  move  as  a  prolonged  and  wide-spread 
tendenc}'  in  pathology,  than  in  pure  and  macroscopic  pathological  anatomy. 
In  other  words,  since  it  taught  us  for  a  long  time  to  look  upon  pathology 
as  pathological  anatomy,  while  aiming  to  elevate  the  latter  science  into 
"a  clinical  anatomy"  and  making  it  the  dut}- of  the  pln*sician  as  regards 
his  patient  to  search  for  changes  in  the  pathological  anatom}-  and  to  inves- 
tigate the  local  products  of  disease.  To  medicine,  however,  it  assigned 
the  duty  of  removing  these  products,  instead  of  the  causative  morbid  pro- 
cesses, which  latter  were  utterly  neglected.  The  living  patient  became  a 
subject  for  pathologico-anatomical  and  local  diagnosis  and  for  local  thera- 
peutic investigational"  for  simple  expectant  and  general  treatment.  Man}' 
diseases,  therefore,  were  regarded  as  incurable,  since  the  products  of  pro- 
cesses which  had  run  their  fatal  course  were  observed  and  studied  more 
than  the  process  of  healing.  No  indications  were  laid  down.  The  ability, 
indeed  almost  the  desire,  to  cure  diseases  was  weakened.  If. in  the  purely 
expectant  treatment  the  vital  activity,  designated  the  vis  medicatrix 
naturae,  was  at  first  left  to  work  undisturbed,  in  later  times  the  newl}' 
discovered  alkaloids  were  administered  with  great  freedom  ;  indeed  their 
employment  was  pushed  to  abuse,  since  it  is  undecided  whether  such 
powerful  remedies  permit  nature  to  work  undisturbed.  —  Functional  or 
dynamic  disturbances  were  disregarded,  and  even  the  diseases  of  the  fluids 
•of  the  body  were  at  first  almost  utterly  forgotten,  both  errors  resulting 
from  the  fact  that  these  diseases  could  not  be  found  in  the  cadaver  by  the 
knife  etc.     The  patient,  on  the  whole,  was  treated  rather  as  a  living  cadaver 


—  890  — 

or  a  living  anatomical  preparation,  not  as  a  sentient  being,  endowed  with 
vital  forces.  To  this  statement  a  few  physicians  only  of  this  school  — 
e.  g.  Andral  —  form  an  exception.  Thus  the  study  of  the  dead  (on  the 
living)  was  pursued,  and  the  charge  which  Asclepiades  once  made  falsely 
against  Hippocrates  was  revived,  this  time  indeed  upon  new  grounds.  As 
the  proper  processes  of  disease  were  neglected,  so  etiolog}',  and,  for  a  long 
time  at  least,  prophylaxis  or  hygiene,  shared  their  fate. 

In  France  everyone  experiments  with  the  sick,  less  to  attain  the  best  method 
of  cure,  than  to  enrich  science  with  an  interesting  discovery  and  to  advance  a  step 
the  accuracy  of  diagnosis  by  some  new  physical  sign.  Foreigners  are  not  wrong 
when  they  say  '  In  France  the  physician  treats  rather  the  disease  than  the  patient'  " 
lEmil  Kratzmann,  died  1876). 

If  practice  in  this  way  lost  in  efficiency  and  value,  on  the  other  hand 
our  knowledge  of  tlie  changes  produced  in  the  bod}7  by  disease  was  un- 
deniably promoted,  both  b}T  post  mortem  examinations  and  the  so-called 
physical  aids  invented  for  the  investigation  of  the  products  of  disease  in 
the  living.  The  pure  diagnosis  by  means  of  the  senses  was  cultivated 
incomparably  more  carefully  and  certainly  than  in  earlier  days,  but  it  was 
accomplished  less  by  means  of  the  ordinary  senses  than  by  the  aid  of 
percussion,  urometry,  mensuration,  microscopy  (only  slightly),  chemical 
investigation  etc. 

In  both  ways  the  seat  of  many  products  of  disease  was  discovered 
with  an  acuteness  and  accurac}'  heretofore  not  dreamed  of.  Accordingly 
a  great  number  of  localizations  of  disease  were  looked  upon  as  new  dis- 
eases and  assigned  new  names,  and  the  latter  henceforth  appear  instead  of 
the  earlier  vague  and  general  designations,  which  had  regarded  disease 
as  a  totality  with  local  results.  (Thus  e.  g.  the  collective  term  "asthma", 
which  is  now  divided  into  local  classes.)  Conversely,  from  this  time 
forward  the  new  school  recognized  local  diseases  alone,  and  derived  the 
changes  in  the  general  condition  from  these.  Indeed  "the  local  diseases 
were  looked  upon  as  more  or  less  sanative  efforts  of  nature  to  resolve  in 
some  way  or  another  some  sort  of  general  difficult}-  (dyscrasia),  and  not  as 
limited  and  local  inflammatory  processes."  The  latter  idea  was  first  devel- 
oped when  a  "  new  humoral  pathology  "  was  called  into  life  by  the  school. 

This  separation  into  concrete  individual  diseases  according  to  the 
recognized  localization  was  especiall}T  promoted  by  the  specialism  which 
arose  almost  necessarily  when  the  mass  of  ''exact"  facts  and  discoveries, 
simply  registered,  became  so  large  that  one  individual  was  no  longer  able 
to  master  all  of  them  in  the  department  of  every  organ.  T  ndoubtedl}-  this 
was,  in  many  respects,  a  beneficial  division  of  labor  for  scientific  study. 
But  to  medical  practice,  which  has  always  to  deal  with  the  whole  man,  and 
which  cannot  and  should  not  consider  single  and  separate  departments,  the 
transmission  of  specialism  (save  some  few  branches)  was  manifestl}'  in- 
jurious. 

Moreover  the  school  promoted  the  overgrowth  of  the  study  of  cases 


—  891  — 

(Casuistik),  as  well  as  the  scientific  specialism  which  results  therefrom, 
while  specialism  in  practice  took  root  in  the  Paris  school  far  less  than  in 
its  German  successor.  The  so-called  "interesting  cases"  were  specially 
studied,  while,  on  the  other  hand,  the  everyday  matters,  with  which  ordi- 
nary practice  (in  contrast  to  hospital  practice)  has  most  frequently  to  deal, 
remained  neglected.  Hospital  practice  now  became  predominant,  and 
separate  departments  arose  for  diseases  of  the  chest,  the  skin  etc.  At 
these  clinics,  however,  brilliant  diagnoses  were  the  chief  aim,  the  best 
marked  and  the  rare  cases  were  cultivated  for  this  very  reason,  while  those 
in  which  an  anatomical  localization  could  not  be  established  with  the 
stethoscope,  pleximeter  etc.  were  pushed  aside,  almost  like  fables  of  an 
earlier  and  unscientific  period. 

The  seductiveness  of  the  anatomico-diagnostic  and  pathologico- 
anatomical  knowledge  so  greatly  advanced,  promoted  still  further  a  one- 
sidedness,  which  finally  culminated  in  the  arrogant  belief  that  medicine 
really  originated  in  the  anatomical  school  of  Paris.  Before  it  there  was 
supposed  to  have  been  no  medicine,  or  at  least  no  science  of  medicine. 
This  for  a  long  time  passed  for  an  axiom,  and  produced  the  same  effects  as 
the  theoretical  dogmas  of  earlier  systems,  and  it  was  only  at  a  later  period 
that  the  conviction  began  to  be  expressed  that  this  school  too,  as  had  so 
often  happened  in  the  history  of  medicine,  had  taken  a  part  for  the  whole. 
The  past  was  utterly  ignored,  and  eveiy thing  not  acquired  b}-  the  newest 
aids  of  knowledge  and  not  of  to-day,  was  regarded  as  superannuated. 
Thus  this  school  isolated  itself  entirely  from  the  earlier  medicine,  to  which 
it  was  inclined  to  deny  even  the  capacity  for  correct  observation. 

In  order,  however,  to  gain  general  conclusions  from  the  immense  col- 
lection of  observations,  in  which  general  principles  were  supposed  to  take 
no  part  (observation  alone,  and  not  thought  per  se,  might  claim  recognition 
and  value),  Louis  and  others  subsequently  called  in  the  aid  of  statistics. 
In  this  way  many  valuable  results  were,  indeed,  obtained,  but  very  often 
too,  in  consequence  of  too  small  a  number  of  cases,  or  from  combining 
those  taken  under  the  most  different  relations  and  in  the  most  varied 
localities,  without  the  certainty  of  an  always  accurate  diagnosis  etc., 
results  and  consequences  ensued,  which  were  frequently  again  overthrown 
by  subsequent  statistics.  Hence  arose  much  uncertainty,  particularly  in 
therapeutics,  whose  results  were  also  submitted  to  the  numerical  method, 
though  in  this  branch  certainly  very  little  equality  in  the  basis  of  classi- 
fication was  to  be  obtained,  and  the  statistics  often  bore  upon  their  face, 
(and  still  bear)  the  evidence  of  unconscious  or  conscious  deception.  — 
Moreover  the  school  rendered  good  service  in  doing  away  with  over-medi- 
cation, a  practice  which  of  late  seems  disposed  to  reappear. 

Physiology  and  microscopic  anatomy  were  not  cultivated  by  the 
French  anatomical  school  until  a  later  period,  and  deductive  thought  was 
of  course  utterly  excluded  as  inadmissible  in  "exact"  medicine,  or  the  so- 
called  Positivism. 


—  892  — 

A  short  but  pregnant  characterization  of  the  tendency  of  the  French  school  is 
furnished  us  03-  Isensee  (1844),  one  of  its  great  admirers:  "Let  us  consider  now 
briefly  the  French  medicine  of  the  present  day  and  its  therapeutics.  The  French 
physician  who  stands  at  the  bedside  of  a  patient  behaves  as  follows:  he  looks  upon 
him,  and,  with  a  thorough  knowledge  of  anatomy,  divides  his  body  into  the  systems 
of  Bichat.  Reasoning  then  more  or  less  after  the  manner  of  Broussais,  he  assumes 
■that  one  of  these  systems  is  suffering  from  inflammation.  Which  system  this  is, 
where  is  the  seat,  what  the  extent  and  the  grade  of  the  inflammation,  he  investigates 
with  every  sense,  especially  by  touch  and  with  the  aid  of  the  stethoscope  and  per- 
cussion, with  a  precision  in  which  Louis  is  a  master.  Then  he  orders  the  withdrawal 
of  solid  food,  more  or  less  gentle  remedies,  and  antiphlogistic  and  revulsive  treatment. 
If  death  ensues,  he  investigates  by  means  of  the  pathological  anatomy  how  tar  his 
diagnosis  (not  his  treatment)  may  have  been  correct,  in  accordance  with  the  precise 
details  furnishes  by  Andral,  Cruveilhier  and  numerous  other  authorities."  Wunder- 
lich,  however,  reported  that  "  in  chronic  cases  still  less  therapeutic  interference  was 
admitted  than  in  the  acute",  and  he  says  further,  "there  we  rejoice  in  an  exemplary 
precision  in  the  examination  of  patients,  and  convince  ourselves  how  frequently  the 
affections  of  these  organs,  heretofore  regarded  as  dynamic,  depend  upon  material 
charges,  and  how  often  the  latter  accompany  and  form  the  basis  of  other  troubles, 
where  it  had  not  been  heretofore  anticipated.  I  recall  here  only  the  heart  affection 
in  dropsy  and  in  acute  rheumatism." 

In  such  demonstrations  as  that  last  mentioned  lay' the  strength  of  the  school,  ' 
while  its  weakness  is  manifested  in  the  account  first  quoted. 

The  greatest  injury  inflicted  upon  medicine  by  this  school  was  the 
fact  that  it  made  its  'hobbies",  advanced  with  such  pretensions  of  in- 
fallibility, accepted  as  so  many  actual  and  unique  "acquisitions"  —  and 
as  such  they  were  eveiywhere  received.  By  such  pretensions  it  verified 
the  saying  that  it  is  only  necessary  to  have  confidence  in  one's  self  in 
order  to  make  others  have  confidence  in  you.  Undoubtedly,  however,  the 
school  was  of  permanent  advantage  to  medicine  by  its  eminent  promotion 
of  our  knowledge  and  understanding  of  the  changes  occasioned  by  morbid 
processes,  and  by  its  simplification  of  medication. 

But  among  the  representatives  of  this  school  there  prevailed  abso- 
lutely no  agreement  in  their  views :  some  were  Solidists,  others  inclined  to 
humoral  patnolog}T  or  cultivated  both  of  these  sj-stems  together,  and  others 
still  were  pure  Eclectics. 

Bichat  and  Pinel,  as  well  as  Prost  in  his  "Mt'decine  eclairt'e  par 
l'observation  et  l'ouverture  du  corps",  were  forerunners  of  this  school. 
Its  proper  founders,  however,  were  Corvisart,  Dupuytren  and  Laennec,  both 
the  latter  pupils  of  Bichat  and  Corvisart.  Tn  our  consideration  of  the 
advances  in  diagnosis  and  surgery  we  shall  have  to  return  to  these  physi- 
cians, and  we  will  only  mention  here  that  Laennec  is  regarded  as  the 
founder  of  general  pathological  anatom}-,  though  Dupuytren  likewise 
claimed  this  honor.     Here  we  should  mention  also 

1.  The  influence  of  this  school  upon  Germany  may  be  inferred  readily  from  the  fact 
that  almost  all  its  works  were  at  once  translated,  and  the  booksellers  had  their 
own  translators,  e.  g.  Dr.  Behrends  for  llirschwald,  Dr.  Krupp  for  Kollmann  in 
Leipsic,  Dr.  Eckstein  for  Kaulfuss  in  Vienna  etc. 


—  893  — 

Gaspard  Laurent  Bayle  (1774-1816),  of  Vernet  in  Provence. 

who,  though  originally  designed  for  theology,  turned  his  attention  to  law  and  finally 
to  medicine  in  Montpellier.  Occupying  for  a  long  period  the  position  of  an  army- 
physician,  he  then  became  physician-in-ordinary  and  physician  to  the  Charite,  where 
he  rendered  eminent  service  by  numerous  investigations  of  the  pathological  anatomy 
of  pulmonary  consumption,  a  disease  from  which  he  himself  died.  He  is  also  spe- 
cially distinguished  for  his  investigation  of  gray  miliary  tubercle,  to  which  he  first 
gave  this  name,  and  which  he  regarded  as  a  neoplasm.  In  this  he  was  followed  by 
Laennec,  who  distinguished  miliary  tubercle  and  tuberculous  infiltration,  and,  like 
the  later  Andral,  Dance  and  others,  held  phthisis  to  be  contagious. 

Bayle,  at  Corvisart's  clinic,  was  the  first  to  apply  the  ear  to  the  naked 
thorax  in  diseases  of  the  heart  (feeble  pulsation),  and  thus  became  the 
predecessor  of  Laennec. 

The  new  direction  of  French  pathology  was  also  followed  by  the 
famous  old  clinician 

Auguste  Franqois  Chomel  (1788-1858)  of  Paris. 

Chomel  was  from  1826  a  professor  in  the  medical  faculty  of  Paris,  physician  to 
the  Charite  and  the  Hotel-Dieu,  and  ordinary  physician  of  Louis  Philippe.  After  ihe 
coup  d'  etat  of  Napoleon  III.  he  was  dismissed  because  of  his  unwillingness  to 
recognize  the  new  order  of  things.  He  rendered  special  service  to  medicine  by  his 
doctrine  of  typhus  fever,  and  is  the  godfather  of  typhoid. 

Chomel  for  a  long  time  did  not  belong  to  the  new  school,  and  even  in 
his  later  days  did  not  subscribe  to  all  of  its  teachings.  For  instance,  he 
employed  auscultation  and  percussion  less  than  the  other  representatives 
of  this  school,  and  Piorry's  pleximeter  he  could  not  endure.  On  the  other 
hand  he  practised  mensuration  (compas  dY'paisseur).  He  did  not  defend 
the  stand-point  of  pathological  anatomy  until  after  the  publication  of  his 
first  works  ("Essai  sur  le  rhumatisme",  1813  ;  "Traite  des  fievres  et  des 
maladies  pestilentielles",  1821  ;  "El^mens  de  pathologie  gent'rale,"  1817) 
and  in  his  "Leeons  de  clinique  medicale',  Paris,  1834. 

Fouquier,  at  the  Charite,  Pi^dagnel  and  Jean  Bapt.  Delaroque  (1787- 
1858),  all  of  whom  were  less  eminent  physicians,  occupied  themselves  with 
the  subject  of  typhus. 

The  surgical  and  pathological  anatomist  and  surgeon 

Gilbert  Bresciiet  (1784-1845)  of  Clermont-Ferrand, 
professor  in  Paris,  embraced  more  decidedly  the  anatomical  and  diagnostic  tendency. 
He  established  the  existence  of  phlebitis,  and  showed  its  results  and  its  frequency. 

Finally  we  should  mention  the  eclectic  practitioner, 

Leon  Bostan  (1790-1866),  of  St.  Maximin  in  the  department  of  Var, 
physician  to  the  Salpetriere  and  from  1833  professor  of  the  clinic  at  the  Hopital  de 
1'  Ecole  and  then  at  the  Hotel-Dieu.  He  was  at  first  undecided  between  the  old  and 
the  new  school,  but  finally  lent  his  authority  to  the  latter  in  his  works  on  "Ramollise- 
ment  du  cerveau "  and  his  "  Cours  de  med.  clinique"  in  three  volumes,  works  in 
which  he  embraced  the  localizing  tendency  not  only  in  diagnosis  but  also  in  ther- 
apeutics. 

One  of  the  earliest,  and  certainly  one  of  the  most  ingenious  path- 
ological   anatomists    and   representatives   of  the    pathologico-anatomical 


—  894  — 

tendency  in  Paris,  the  first  occupant  of  the  chair  of  pathological  anatomy 
erected  in  Paris  in  18H5  at  the  expense  of  Dupuytren,  was 
Jean  Cruveilhier  (1791-1873)  of  Limoges, 

at  first  professor  in  Montpellier  and  tlien  in  Paris.  In  the  latter  city  he  revived  the 
Societe  d'  Anatomie  founded  by  Bichat,  and  became  in  1836  chief  physician  to  the 
Maternite.  Cruveilhier  was  a  pupil  of  Dupuytren,  who  induced  him  to  pursue  the 
stud}'  of  pathological  anatomy  by  repeatedly  recommending  to  him  this  subject  in 
response  to  the  question  upon  what  he  should  write  his  dissertalion.  His'Essai 
d'  anatomie  pathologique"  (1810)  was  the  fruit  of  this  advice.  This  work  was  followed 
by  his  "  Medecine  eclairee  par  1'  anatomie  et  la  physiologie  pathologique",  (1821); 
his  famous  'Anatomie  pathologique  du  corps  humain",  with  numerous  magnificent 
plates,  1830—184^,  and  his  '.'Traite  d' anatomie  pathologique  generale",  1849-64,  with 
other  works.  Cruveilhier  did  not  yet  cultivate  microscopic  anatomy.  In  1867  he 
resigned  the  chair  of  pathological  anatomy  to  Vulpian.  His  son  Edouard  Cruveilhier 
is  to-day  one  of  the  best  known  surgeons  of  Paris. 

Cruveilhier,  who,  like  Morgagni,  associated  the  changes  in  pathological  anatomy 
with  the  observations  made  at  the  bedside,  divides  the  former  into  variations  of  form 
or  mechanical  disturbances,  and  abnormalities  of  substance.  To  the  latter  belong  the 
neoplasms,  which  he  divides  info  homologous  and  heterologous.  The  homologous 
neoplasms  again  are  divided  into  those  produced  by  the  metamorphosis  or  exchange 
of  a  tissue,  e.  g.  into  cellular  tissue,  bone  substance  etc.,  those  dependent  upon  pro- 
liferation or  overstepping  the  normal  limits  of  a  structure,  e.  g.  exostoses,  condylomata, 
and  finally  those  which  are  to  be  regarded  as  peculiar  or  independent,  e.  g.  lipomata, 
fibrous  tumors.  Heterologous  tumors  are,  on  the  one  hand,  either  permanent,  con- 
sisting of  either  simple  exchanges  of  tissue  or  proliferations  or  peculiar  forms,  or 
they  may  be  transitory,  in  which  class  belong  the  eruptions.  Cruveilhier  established 
further  a  class  of  inflammations,  to  which  belong  gangrene  and  -atonj*,  and  a  class  of 
neuroses  and  fevers.  He  investigated  the  different  steps  of  development  and  not 
simply  the  final  product.  The  changes  in  homologous,  as  well  as  heterologous  neo- 
plasms arise  from  exudates  into  the  tissues,  which  are  either  expelled  by  inflamma- 
tion, or  lead  a  proper  life  of  their  own,  like  parasites,  or  without  standing  in  con- 
nexion with  the  neighboring  tissue,  simply  supplant  the  latter. 

Cruveilhier's  teachings  regarding  pyaemia  and  phlebitis,  which  latter 
disease  had  been  studied  before  him  by  John  Hunter  first  in  1784,  then  by 
Joseph  Hodgson  (1815)  and  J.  B.  H.  Dance  (1828),  excited  great  attention 
He. regarded  pyaemia  as  always  the  result  of  phlebitis,  referred  the  latter 
disease  to  an  original  coagulation  of  the  blood,  and  concluded  one-sidedly 
that  phlebitis  (capillary  phlebitis)  was  the  general  cause  of  almost  all 
inflammations.  His  maxim  "Phlebitis  rules  the  whole  of  patholog}'" 
reminds  one  of  Broussais.  Cruveilhier  was  the  first  to  observe  that 
primary  suppurative  phlebitis  does  not  occur,  but  that  this  disease  was 
'always  preceded  by  a  coagulation  of  the  blood,  and  in  the  middle  of  this 
coagulum  the  pus  first  made  its  appearance.  Nevertheless  he  assumed 
that  this  pus  was  formed  originally  upon  the  walls  of  the  veins,  and  then 
migrated  by  the  force  of  capillarity  into  the  middle  of  the  coagulum,  for 
he  still  regarded  pus  as  a  fluid  without  corporeal  elements.  Accordingly 
for  Cruveilhier  phlebitis  was,  indeed,  the  ultimate  cause  of  pyaemia,  but 
the  pus  first  made  its  appearance   in  the  blood  from  the  coagulum  which 


—  895  — 

preceded  the  former.     This  doctrine,  as  we  know,   was   first   rectified   h\ 
Virchow. 

In  the  struggle  against  Broussais  a  prominent  part  was  taken  by 

M.  Augustin  Nicol.  Gendrin  (born  179G)  of  Chateaudun. 
physician  to  the  Hopital  Cochin  and  then  to  the  Hopital  de  la  Pitie,  and  editor  of  the 
"Journal  general  de  medecine  "  etc.  In  his  "  Recherches  sur  la  nature  et  les  causes 
prochaines  des  fievres"  (1823),  his  "  Histoire  anatomique  des  inflammations"  (1826) 
and  his  "  Traite  philosophique  de  medecine  pratique"  (1838-41),  he  assailed  the 
doctrines  of  that  Messiah  from  the  stand-point  of  pathological  anatomy.  Gendrin 
was  one  of  the  first  pathological  experimenters  (injection  of  sanies).  He  also 
practised  ausculation  and  percussion  of  the  head  i  "  Lecons  sur  les  maladies  du  cceur" 
etc.,  1840-41). 

But  the  ablest  representative  of  the  new  school,  who  b}-  his  talents 
as  a  lecturer  and  teacher,  and  particularly  by  the  reputation  and  splendor 
of  his  works,  elevated  Paris  to  the  position  of  the  Mecca  of  the  new  doc- 
trine, where  foreigners,  and  especially  Germans,  made  their  pilgrimages  in 
crowds  and  sung  at  home  more  or  less  enthusiastic  stories  concerning 
Parisian  medicine,  was 

M.  Gabriel  Andral  (1797-1876)  of  Paris,  the  most  indefatigable  in- 
Arestigator  and  thinker  of  this  school. 

Andral  was  the  son  of  Guillaume  Andral,  Murat's  physician-in-ordinary,  and 
from  1828  professor  of  hygiene,  1830-39  of  internal  pathology,  and  then  Broussais  - 
successor  in  the  medical  clinic  at  Paris.  In  consequence  of  an  affection  of  the  heart 
however,  he  withdrew  early  (1856)  from  active  exertion  as  a  teacher.  His  first 
observations  he  collected  (though  as  lie  saiu  without  any  view  of  making  tlum  the 
foundation  of  his  chief  work)  at  the  clinic  of  Corvisart's  famous  pupil  Theodore 
Nilamond  Lerminier  (born  1770  at  St.  Valerie  in  the  Somme),  imperial  court  phy- 
sician and  then  director  of  a  division  in  the  Hotel-Dieu  and  finally  in  the  Charite. 
These  observations  Andral  published  under  the  title  "G'linique  medicale,  ou  choix 
d'  observations  recueillies  a  1'  Hopital  de  la  Charite'  i  1823-1840).  The  five  volumes 
contain  descriptions  of  diseases  of  the  thoracic  organs  and  those  of  the  abdomen, 
with  typhus  and  diseases  of  the  brain.  Andral  also  wrote:  'Traite  d'  anatomie 
pathologique ".  1829;  "An  antiquorum  doctrina  de  crisibus  et  diebus  criticis  admit- 
tenda?'',  1824,  and  in  18.">7  appeared  under  the  editorship  of  Amedee  Latour  his 
"  Cours  de  pathologie  interne"  In  conjunction  with  Gavarret  he  also  wrote  several 
treatises  on  the  blood,  and  finally  with  Gavarret  and  de  la  Fond,  his  "  Essai  d' 
hematologie  pathologique  ",  184o. 

The  course  of  Andral's  investigations,  and  his  eclectic,  eminently 
critical  mind,  may  be  well  judged  from  one  of  his  sayings  preserved  by 
Kratzmann  : 

"  I  have  now  1 1840)  begun  medicine  several  times  from  the  very  beginning.  The 
first  time  in  my  studies  concerning  pathological  anatomy;  the  second  on  the  occasion 
of  my  investigations  in  the  sphere  of  auscultation  and  percussion,  and  the  t laird  in 
my  pli3'sical  and  chemical  investigations  of  the  different  fluids  of  the  body.  I 
scarcely  think  this  will  be  the  last  time." 

This  quotation  likewise  gives  us  an  outline  of  the  general  course  of 
development  of  the  school,  whose  followers  embraced  first  the  pathological 
anatomy  offered  by   Biehat.   Corvisart   and  others,  then   the  tendency   to 


—  896  — 

physical  diagnosis  called  into  existence  by  Laennec.  and  finally  the 
chemieo-physiologieal  inquiry  originated  by  Andral  and  (Javarret,  as  well 
as  Magendie.  As  the  result  of  the  latter  Andral  again  advanced  humoral 
views,  and  in  accordance  with  these  taught,  in  opposition  to  Broussais, 
the  existence  of  primary  diseases  of  the  blood,  the  so-called  dyscrasise. 
He  drew  physiology  into  the  service  of  pathology,  elevating  the  latter  "to 
a  pathological  physiology",  and  was  the  creator  of  rmematocheinistry. 
designed  to  complete  the  earlier  iatropbysical  or  Boerhaavian  haemato- 
physics.  In  this  he  was  supported  by  the  numerous  investigations  of 
Lecanu  and  Denis,  and  the  eminent  labors  of  E.  Beoquerel  (TS04-1878) 
and  Rodier.  Andral  investigated  not  only  the  secretions  and  excretions, 
including  the  respired  air,  but  also  the  exudates  and  solid  pathological 
products.  To  disturbances  of  function  without  material  alterations  in  the 
parts  he  at  first  accorded  no  recognition,  but  finally  admitted  a  kind  of 
"vitality"'.  —  Inflammation  Andral  divided  into  hypenemia,  suppuration 
and  secretion,  and  he  admitted  that  its  extension  might  take  place  through 
either  the  blood  or  the  nerves,  for  in  general  he  did  not  assign  distinguish- 
able roles  to  either  the  fluids  or  solids  in  the  life  of  bodies. 

In  therapeutics  Andral  again  laid  great  weight  upon  emetics  and 
cathartics,  even  in  typhus,  but,  in  contrast  to  Broussais.  he  ascribed  little 
importance  to  abstraction  of  blood  or  venesection.  He  also  investigated 
chlorine  and  iodine  and  its  compounds  anew.  Moreover  he  frequently 
administered,  on  the  contrastimulant  system,  large  doses  of  tartar  emetic, 
aconite,  digitalis,  camphor  (particularly  in  enemata)  etc.  On  the  whole, 
however,  he  was  a  defender  of  the  do-little  or  do-nothing  sj'stem  —  ex- 
pectant treatment,  as  he  named  it  —  for  therapeutic  teaching  has  ever 
been  the  weakest  side  of  the  French  fin  contrast  to  the  English),  who 
have  always  inclined  to  one-sidedness.  routine  or  fashion. 

The  chemico-diagnostic  or  pathologico-chemical  tendency  did  not  train  in  France 
the  same  extension  as  it  did  in  Germany,  though  reagents  like  litmus-paper  etc.  were 
employed  tolerably  early.  Its  chief  representatives  were  Andral  and  Gavarret,  Robin 
(Traite  de  cliimie  anatomique  et  physiologique,  1853,  with  an  atlas  of  colored  plates  . 
Bouchardat.  (1806-1886),  a  member  of  the  Acadeinie  de  Medeeine,  chief  pharma- 
ceutist of  the  Hotel-Dieu  and  professor  of  organic  chemistry  in  Paris  and,  V.  A. 
Racle  (Traite  de  diagnostic  medicaid.  Mialhe  was  distinguished  as  a  pharmaco- 
chemist  and  pharmaco-dynamist. 

M.  Andral  devoted  much  attention  to  the  history  of  medicine  and  lectured 
upon  this  subject.  Though  a  weighty  opponent  of  Broussaisism,  he  still  recognized 
the  ability  of  Broussais,  whose  successor  he  had  become.  This  was  much  less  the 
case  with  the  second  important  representative  of  the  new  school,  the  "  Heros  exacter 
Minutiosa"   (Tsensee), 

Pierre  Charles  Alexandre  Louis  (1787-1872).  who  was  the  first 
to  apply  the  "numerical  method"  to  pathology,  and  who  properly  brought 
about  the  downfall  of  Broussais,  with  whom  he  exchanged  polemical 
writings. 

From  the  17th  to  the  33d  year  of  his  life  Louis  was  in  Russia,  where  he  had 
pursued  his  studies.     He  accidentally  returned  to  Paris  in  1818,  when  Broussaisism 


—  897  — 

was  in  its  bloom,  and  remaining  there  began  to  make  observations  at  the  clinic  of" 
Chomel,  to  enumerate  and  to  dissect,  with  the  object  of  subjecting  the  doctrines  of 
Broussais  to  the  proof.  To  this  object  he  devoted  four  to  six  hours  dairy  for  seven 
years,  spending  his  time  in  the  hospital  and  the  dissecting  room,  and  it  was  not 
until  1825  that  he  published  his  "  Recherches  anatomiques,  pathologiques  et  thera- 
peutiques  sur  la  phthisie",  founded  upon  358  dissections  and  19G0  cases  of  the 
disease.  This  work  was  followed  by  "Memoires",  "Recherches  anatomiques, 
pathologiques"  etc.  on  various  diseases,  "Recherches  ....  sur  la  maladie  connue 
sous  les  noms  de  fievre  typhoi'de,  putride,  adynamique",  a  famous  polemic  "Examen 
del'  examen  de  M.  Broussais"  etc.,  and  other  writings,  all  of  them  based  upon 
physical  and  other  forms  of  diagnosis  practised  with  the  most  scrupulous  accuracy, 
as  well  as  upon  dissection  and  enumeration.  The  latter  system  he  employed  in 
etiology,  symptomatology,  prognosis,  therapeutics  and  pathological  anatomy.  By 
all  these  labors  Louis,  who  in  1 8o5  was  appointed  physician  to  the  Hopital  de  la 
Pitie,  became  one  of  the  leaders  of  the  school. 

His  principles  are  expressed  in  the  following  extracts  :  "As  often  as 
I  have  formed  an  a  priori  idea  and  have  afterwards  had  an  opportunity  to 
prove  the  facts,  I  have  invariably  found  that  my  idea  was  false."  "  In 
pathology,  as  well  as  in  therapeutics,  numerical  analysis  is  a  useful  prac- 
tice. By  numbers  only  can  we  ascertain  the  frequency  of  this  or  that 
symptom  ;  by  a  definite  enumeration  alone  is  it  possible  to  utilize  the 
special  relations  of  age,  sex  and  the  constitution  of  our  patients,  for  the 
settlement  of  the  proposition  that  this  or  that  symptom  occurs  in  any 
disease  10,  15  or  50  times  in  1000  cases."  To  attain  mathematical  accuracy 
in  questions  of  this  kind  is  certainly  impossible.  Louis  forgot  the  chang- 
ing idiosyncrasies  of  the  subjects  of  our  art  (upon  which  even  Hippocrates 
laid  stress),  as  well  as  the  Baconian  maxim,  "All  induction  from  simple 
enumeration  is  child's-play;  its  conclusions  are  assailed,  its  decisions  in- 
sufficiently grounded,  and  thus  it  is  exposed  to  an  easy  overthrow."  "By 
means  of  statistics  onl}r  are  we  able  to  find  an  average  number,  from 
which  we  may  conclude  as  to  the  frequency  or  the  duration  of  a  symptom,, 
or  of  an  entire  disease,  and  finall}'  as  to  its  crisis."  The  latter  ma}T,  indeed, 
be  determined  quite  easily  numerically,  while  the  consequence  must  turn 
out  uncertain,  since  no  two  cases  of  one  and  the  same  disease  are  entirely 
similar,  and  even  similar  individual  cases  react  differently  under  the  same 
treatment.  (B}T  the  way  the  belief  that  one  must  always  cany  out  and 
maintain  the  same  treatment  in  diseases  because  of  the  results  of  statistics, 
without  individualizing  sufficiently  each  special  case,  leads  to  great  routine 
in  therapeutics.)  "  In  therapeutics  the  numerical  method  is  the  only  one 
which  suffices  to  decide  the  advantages  of  two  methods  of  treatment  of. 
one  and  the  same  disease."  Here  it  must  be  taken  for  granted  that  the 
disease  always  occurs  in  individuals  of  similar  constitution,  the  same  age 
etc.,  in  order  to  attain  results  mathematically  indisputable.  In  thera- 
peutics Louis  also  fell  into  mistakes  from  the  fact  that  he  had  his  eye 
fixed  upon  hospital  practice  only.  —  For  instance  he  discarded  blisters 
unfairly  as  increasing  fever,  censured  large  bleedings  etc.,  but  gives  in 
pneumonia  large  doses  of  tartar  emetic  in  addition  to  free  bloodletting  etc. 
57 


—  898  — 

How  "unexpectedly"  dry  and  jejune  were  Louis'  registrations  of  patho- 
logical facts  may  be  judged  from  the  following  extract  :  "  The  small 
intestine  in  typhus  was  greatly  inflated  in  14  cases,  the  mucous  membrane, 
filled  with  elliptical  plaques,  was  white  in  probably  a  third  of  the  cases, 
red  in  17  cases,  grayish  in  11,  in  good  condition  in  one  fifth  of  the  cases, 
softened  in  various  degrees  in  the  other  cases'"  —  all  as  we  see  relative 
ideas  and  expressions,  which  exclude  a  strictly  mathematical  method 
admitting  only  absolute  similarity  or  at  least  precise  characteristics,  and 
in  its  place  merely  rendering  possible  the  appearance  of  the  greatest  scien- 
tific precision  and  certainty.  This  was  affirmed  b3-  Double,  for,  after  the 
appearance  of  the  numerical  method  in  France,  livel}*  disputes  concerning 
its  value  began  among  the  more  important  physicians,  and  the  final  settle- 
ment of  this  question  has  not  been  reached  even  at  the  present  cla\~.  In 
diagnosis  Louis  employed  all  the  modern  aids,  even  counting  the  pulse 
most  accurateby  with  the  assistance  of  the  watch  marking  seconds.  In 
fact  the  use  of  the  watch  in  observations  upon  the  pulse  was  chiefly  pro- 
moted by  Louis,  though  Floyer  began  the  practice  with  his  watch  marking 
minutes,  and  Haller  had  introduced  the  practice  into  Germany.  —  Louis' 
stethoscope  was  short,  and  his  pleximeter  was  made  of  caoutchouc. 

Statistics  in  medicine,  or  the  principles  of  numerical  prognosis,  therapeutics, 
etiology  etc.,  were  elaborated  in  accordance  with  the  principles  of  probabilities  and 
the  higher  mathematics  by 

Jules  G-avarret  (born  1816)  professor  of  medical  physics  in  Paris. 
in  his  "  Principes  generaux  de  statistique  medicale,  ou  developpement  des  regies  qui 
doivent  presider  a  son  emploi",  which  appeared  in  LQ40,  and  through  the  influence 
of  this  work  the  numerical  method  continued  to  increase  in  diffusion,  though  up  to 
the  present  time  it  has  not  brought  to  light  any  correspondingly  practical  and  useful 
results,  either  in  etiology,  therapeutics  or  prognosis. 

Yet  as  regards  the  frequency  of  the  appearance  of  diseases  and  the 
ultimate  cause  of  death,  and  above  all  as  regards  the  pathologico-ana- 
tomical  changes  shortly  before  death,  particularly  in  epidemic,  as  well  as 
merely  contagious  diseases,  many  valuable  data  have  been  acquired.  But 
the  practical  and  exceptionalh-  important  relations  of  soil,  residence, 
clothing,  food,  meteorological  and  corporeal  constitution,  and  many  other 
things  are,  for  the  most  part,  entirely  passed  over  in  statistics.  More- 
over the  figures  obtained  from  all  countries  must  be  often  deceptive  in 
consequence  of  the  endless  differences  of  the  registrars  in  the  gift  of 
observation,  in  zeal,  care,  interest  and  scientific  conscientiousness,  so  that 
the  great  number  of  observers  rather  increases  than  diminishes  the  sources 
of  error.  To  this  it  must  be  added  that  statistics  are  of  no  benefit  for 
individual  cases  in  practice,  for  although  we  do,  indeed,  regard  their  general 
results,  we  cannot  apply  them  individually  and  base  our  treatment  upon 
them.  —  J.  Pelletan  also  was  a  representative  of  the  statistical  tendenc}', 
and  in  particular  furnished  some  statistics  of  pneumonia,  while  J.  Ch.  M. 
Boudin  discussed  not  onh-  statistics  but  also  geographical  patholog}' 
(Traite  de  geographie  et  de  statistique  medicale  etc.",  1857). 


—  899  — 

Next  to  Andral  and  Louis, 

Fran<;ois  Magendie  (1782  or  1783-1855)  of  Bordeaux,  professor  of 
general  pathology  in  the  College  de  France  and  physician  to  the  Hotel- 
Dieu,  was  a  most  important  representative;  of  the  new  French  medicine, 
and  thus  of  the  medicine  of  our  century.  Indeed  as  an  experimenter 
Magendie  marks  an  epoch  in  the  history  of  our  art. 

Above  all  as  an  eminent  and  skilful,  though  often  unsystematic  and  unnecessarily 
cruel,  experimental  physiologist,  Magendie  introduced  the  experimental  method  into 
pathology  and  pharmacology,  and  thus  largely  developed  experimental  pathology 
and  the  most  modern  experimental  pharmacodj-namics.  The  latter  science  occupies 
itself  chiefly  with  the  alkaloids,  of  which  Magendie  introduced  a  large  number  into 
practice.  He  sought  to  reduce  medicine  (except  nervous  activity,  in  which  he 
admitted  .the  existence  of  a  vital  principle)  to  physiologico-chemical  and  physiologico- 
physical  laws.  For  this  purpose  he  cultivated  "experience  without  any  admixture  of 
reasoning"  (Guardia),  and  this  experience  with  Magendie  was  equivalent  to  the 
results  of  physiological  and  pathological  experiments  or  vivisections.  Of  the  latter 
Guardia  says  that  they  were  performed  so  frequently  in  France  "  pour  etre  cite  en 
Allemagne".  But  "he  had  not  yet  the  discernment,  nor  did  he  require,  to  make  his 
experiments  exact  in  volume  and  weight"  so  "that  he  has  not  yet  attained  the  high- 
est grade  of  precision"  (Wunderlich).  Magendie  was  a  solido-humorist  in  pathology, 
a  most  accurate  diagnostician,  but  "almost  too  simple  in  his  therapeutics".  As  the 
result  of  Magendie's  own  experiments,  and  of  the  injections  of  ichor  into  the  veins, 
instituted,  as  his  suggestion,  by  Gaspard  (1822,  Memoires  sur  les  maladies,  purulentes 
et  putrides  in  the  Journal  de  Physiologie,  tome  II),  Dupre  (ibidem,  1823),  Legallois, 
M.  A.  N.  Gendnn,  Dupuj'  and  F.  Leuret  (Haller  had  already  done  the  same  thing), 
pyaemia,  ichorrhsemia  and  metastases,  in  the  modern  signification  of  that  term,  were 
introduced  into  pathologj7.  Magendie's  chief  works  were  entitled  "Precis  elementaire 
de  physiologie"  (1816) ;  "Memoire  sur  le  vomissement ";  "Formulaire  pour  1'  emploi 
et  la  preparation  de  plusieurs  nouveaux  medicaments"  etc.  (1821);  "  Lecons  sur  les 
functions  et  les  maladies  du  systeme  nerveux  "  (1839)  ;  "  Lecons  sur  les  phenomenes 
physiques  de  la  vie"  (1835),  etc.  We  owe  to  him  also  our  knowledge  of  the  foramen 
Magendie  in  the  pia  mater,  near  the  vermiform  process.  —  The  tendency  to  ex- 
perimental pathology  was  likewise  pursued  by  Fred.  Dubois  (Prelecons  de  pathologie 
experimentale,  Paris,  1844),  and  by  the  famous  specialist  in  the  diseases  of  children 
and  author  of  the  "  Clinique  medicale  de  l'Hotel-Dieu  de  Paris"  (1861), 

Armand  Trousseau  (1801-1866)  of  Tours, 
professor  in  the  Faculty  of  Medicine  in  Paris  and  physician  to  the  Hotel-Dieu. 
Trousseau  rendered  especial  service  to  medicine  by  his  study  of  the  subject  of  croup 
and  the  employment  of  tracheotomy  in  this  disease,  though  the  operation  as  per- 
formed in  the  Hopital  des  Enfants  Malades  in  the  years  1850-1857  resulted  in  only  86 
recoveries  out  of  398  operations.  Other  works  from  the  pen  of  Trousseau  were  the 
"Traite  de  therapeutique  et  de  matiere  medicale,  par  Trousseau  etPidoux",  1841, 
and  "  Traite  pratique  de  la  phthisie  laryngee,  laryngitis  chronica  etc.,  by  Trousseau 
and  Bellocq,  1837. 

The  new  tendency  in  pathology  was  likewise  embraced  by  Recamier,  Double 
(Semeiologie  generale  etc.),  who  investigated  the  subject  of  phlebitis,  Dance  (Guide 
pour  1'  etude  de  la  clinique  etc.,  1834),  Dalmas,  Fournet,  Guersant,  Coutanceau, 
Calmeil,  Rouchoux,  Gueneau  de  Mussy,  Honore,  Husson,  Jadioux,  Grisolle  (1811- 
1869  ;  Pneumonia),  Marc  d'  Espine,  Caillard,  Aran,  Latour,  Monneret  (author  of  the 
remarkable  criticism  that  Skoda's  work  swarmed  with  errors  and  defects,  whose 
rectification  was  the  business  of  the  clinic),  Lombard,  Ulysse  Trelat  and  numerous 


—  900  — 

others.— Constant  Saucerotte  and  Risueno  d'  Amador,  professor  in  Montpellier,  were 
critics  and  historians  of  the  pathologieo-anatomical  tendency.  (Quelle  a  etc  1'  influ- 
ence de  1'  anatomie  pathologique  sur  la  mcdecine  depuis  Morgagni  jnsqu'  a  nos 
jours?,  1837,  and  the  work  with  the  same  title  by  Amador  in  the  same  year.)  The- 
same  may  be  said  of  Louis  Peisse  and  finally  of  P.  V.  Renouard  (1861). 

Claude  Bernard  (1813-1878),  of  St.  Julien  near  Yillefranche 
(Department  of  the  Rhone), 

the  successor  of  Magendie,  was  a  famous  experimentalist  in  pathology  as  well  as 
physiology  (Lecons  de  pathologie  experimentale,  1871).  Originally  a  tragic  poet,  he 
finally  turned  his  attention  to  the  natural  sciences  and  to  medicine.  In  1854  he  was 
appointed  professor  of  general  physiology  in  the  faculty  of  the  natural  sciences,  and 
in  1855  in  the  College  de  France.  Tn  1869  he  became  a  member  of  the  Academie 
and  Senator.  His  numerous  works  relate  to  the  digestion  of  fat  by  the  aul  of  the 
pancreatic  juice,  the  formation  of  sugar  in  the  liver,  the  production  of  diabetes  bj- 
puncture  of  the  fourth  ventricle,  division  of  the  sympathetic  etc.,  etc.  In  opposition 
to  Magendie  he  maintained  the  conformity  to  law  of  the  phenomena  observed  in  the 
organism,  and  the  legitimateness  of  our  knowledge  of  these  laws  obtained  by  ex- 
periment, while  Magendie  would  confine  these  to  inorganic  nature  (Introduction  a 
1'  etude  de  la  medecine  experimentale,1  Paris  1865).  In  1885  a  monument  to 
Bernard's  memory  was  erected  in  the  University  of  Paris. 

Pierre  Bretonneau  (1771-1862)  of  Tours 

in  1826  studied  the  subject  of  "  diphtherite  ",  though  the  same  had  been  done  already 
by  T.  Capuron  and  Louis  Turine  (1751-1819)  of  Geneva  (croup).  Bretonneau,  how- 
evei-,  did  not  distinguish  it  from  croup  but  regarded  both  as  a  nosological  unity  with 
different  localizations.  He  denied  the  gangrenous  character  of  diphtheritis  and  per- 
formed the  first  successful  tracheotomy  in  croup.  According  as  it  appeared  upon 
the  mucous  membrane  of  the  pharj'nx,  the  larynx,  the  surface  of  wounds  etc.,  he 
regarded  diphtheria  as  an  angina  maligna,  a  croup,  hospital  gangrene  etc. 

C.  P.  Forget  (died  1801), 
professor  in  Strassburg,  wrote  on  the  diseases  of  the  heart,  on  naval  medicine  etc. 
Hermann  Lebert  (1813-1878)  too,  who  displayed  his  activity  first  as  a  pathological 
anatomist  and  particularly  as  a  pathological  microscropist  in  Paris,  and  subsequently 
as  a  famous  clinician  in  Breslau,  belongs  to  this  school  by  virtue  of  a  number  of 
valuable  works.  Behier  (1814-1876)  is  likewise  to  be  mentioned  as  a  famous  clinician' 
of  the  Hotel-Dieu. 

A  result  of  the  French  tendency  to  pathological  anatomy,  to  be  re- 
garded in  many  respects,  and  especially  in  a  practical  point  of  view,  as  an 
unfortunate  outgrowth,  was  the  cultivation  of  specialties  which  accom- 
panies its  termination  and  includes  its  offshoots.  This  cultivation  made 
its  appearance  at  an  early  date,  and  the  tendency  subsequently  spread  to 
other  countries,  but  particularly  to  German}',  so  that  at  last  there  is 
scarcel}'  any  organ  of  the  body  which  has  not  found,  not  its  special  scien- 

1.  A  work  which  exercised  great  influence,  and  is  said  to  have- even  justified  the 
realistic  ''smuttiness"  of  Zola  and  his  companions  in  their  romances.  The  latter,, 
however,  invented  the  "roman  experimental",  whose  nudities  and  brutalities  are 
palliated  and  ostensibly  necessitated  by  Claude  Bernard's  remark  :  "If  1  wished 
to  express  my  feeling  of  the  science  of  life,  1  should  say  it  is  a  noble  salon, 
glowing  with  light,  to  which  one  can  go  only  by  passing  through  a  great  andi 
disgusting  kitchen." 


—  901  — 

tific  students  (which  is  perfectly  proper),  but  likewise  its  special  represen- 
tatives in  practice.  In  the  latter  point  of  view  the  question  is  frequently 
merely  one  of  new  sign-boards,  though  the  practice  leads  to  one-sidedness. 
Moreover,  through  the  specialism  introduced  from  France,  the  position  of 
German  physicians  has  been  gradually  undermined,  and  the  public  concep- 
tion of  the  profession  has  certainly  been  partially  degraded  to  that  of  a 
trade  in  the  art  of  healing. 

In  France  C.  M.  Billard  (died  1828)  cultivated  within  the  anatomical  school  the 
i  specialty  of  the  Diseases  of  Children  in  his  "Traite  des  maladies  des  enfants 
nouveau-nes  et  a  la  mamelle,  fonde  sur  de  nouvelles  observations  cliniques  et  d' 
'anatomie  pathologique,  faites  a  1'  Hopital  des  Enfants  Trouves  de  Paris  ",  1828. 
He  was  followed  by  A.  Berton  (Traite  des  maladies  des  enfants,  ou  recherches  sur  les 
principales  affections  du  jeune  age,  1837);  F.  L.  J.  Valleix  (1807-1855;  Clinique 
des  maladies  des  enfants  nouveau-nes'',  1838);  Rilliet  et  Barthez  (Traite  clinique 
et  pratique  des  maladies  des  enfants,  1838-1848) ;  Duparque  (Nouveau  traite  pratique 
■des  maladies  des  enfants  depuis  la  naissance,  1838) ;  Richard  de  Nancy  (Traite 
pratique  des  maladies  des  enfants,  1839);  the  "Clinique  des  hopitaux  des  enfants", 
edited  by  Vanier  (1841),  in  which  Guersant,  father  and  son,  Jadelot,  Baudelocque, 
Bouneau,  Baron,  Blache,  Thevenot  de  St.  Blaise,  Auvity,  Donne  and  J.  B.  Bousquet 
took  part;  Alf.  Becquerel1  (1814-1862;  Traite  theorique  et  pratique  des  maladies  des 
enfants,  specialement  considerees  depuis  la  fin  de  la  premiere  dentition  jusque'  a  1' 
age  du  puberte,  1842) ;  E.  Bouchut  (Traite  pratique  des  maladies  des  nouveau-nes, 
des  enfants  a  la  mamelle  et  de  la  seconde  enfance,  7th  edition  1873)  ;  and  Alex. 
Donne  (died  1878),  rector  of  the  Academic  de  Montpellier  (Conseils  aux  meres  sur 
la  maniere  d'  elever  les  enfants  nouveau-nes,  1869) ;  J.  H.  A.  D'Espine  and  C.  Picot 
(Manuel  pratique  des  maladies  de  1'  enfance,  1877);  Brochard  (1812-1882),  a  famous 
specialist  in  the  diseases  of  children  at  Paris,  and  others.  In  this  specialty  particu- 
larly the  modern  means  of  investigation  were  very  useful  in  the  attainment  of  accuracy 
in  diagnosis,  and  here  too  the  French  rendered  excellent  service. 

Diseases  of  the  Liver  were  discussed  in  common  by  Ollivier,  Adelon,  Ferrus  and 
Berard  (1828). 

Diseases  of  the  Chest  and  Heart,  after  the  example  of  Laennec,  of  course  found 
a  particularly  large  number  of  students,  among  whom  were  almost  all  the  coryphaei 
of  the  school,  Lombard,  Bouillaud,  Andral,  Piorry  Monneret,  Grisolle,  Beau, 
Forget  etc. 

The  Diseases  of  Old  Age,  after  Gendrin  had  ventilated  the  question  of  the 
influence  of  various  ages  upon  diseases,  formed  the  subject  of  works  by  Hourmann, 
R.  Prus,  M.  Durand-Fardel  (in  his  famous  "  Traite  pratique  des  maladies  des 
vieillards",  2d  edition  1873),  Reveille-Parise  (Traite  de  la  viellesse,  1853)  etc. 

Diseases  of  the  Skin  were  studied  as  a  specialty  in  France  at  a  very  early  date, 
inasmuch  as  they  could  be  observed  in  separate  hospitals  (Hopital  de  St.  Louis)  and 
hospital  wards.  The  labors  of  Jean  Louis  d'  Alibert  (1766-1837)  in  this  department 
began  even  in  the  18th  century  — he  was  appointed  professor  in  1821  —  and  the  same 
may  be  said  of  the  Grison  Laurent  Biett  (died  1840),  who  was  an  eminent  pathologist, 
diagnostician  and  therapeutist  of  empirical  tendencies  in  the  main,  but  enjoyed  a 
European  reputation  in  his  specialty  (Abrege  des  maladies  de  la  peau  etc.,  1829; 
4th  edition  1847).     Most  of  the  French  dermatologists  named  below  proceeded  from 


1.  Not  to  be  confounded  with  the  famous  physicist  Ant.  Cesar  Becquerel  (1788-1878), 
his  father,  who  was  so  deservedly  eminent  for  his  investigations  relative  to 
animal  heat  and  electricity,  as  well  as  medicine. 


—  902  — 

Biett's  school.  Biett  himself  was  educated  in  the  doctrines  of  the  Englishmen  Willan 
and  Bateman,  and  he  preserved  their  classification.  His  lectures  were  published  by 
F.  L.  AIph«e  Cazenave  (1802-1877)  and  H.E.  Schedel  in  1828,  and  those  of  Cazenave 
himself  by  Maurice  Chausit  (Traite  elementaire  des  maladies  de  la  peau  d'  aprt's  1' 
enseignement  theorique  et  les  lecons  de  Cazenave).  Biett's  successor  was  Gibert 
(died  1866;  Lecons  sur  les  maladies  de  la  peau,  1834).  Pierre  Francois  01.  Bayer 
(1793-18(37)  of  the  Charite,  who  also  devoted  special  attention  to  diseases  of  the 
kidneys,  likewise  enjoyed  great  reputation  as  a  dermatologist  (Traite  theorique  et 
pratique  des  maladies  de  la  peau,  with  colored  plates,  2d  edition  1835).  Another 
important  specialist  in  diseases  of  the  skin  was  Giraudeau  de  St.  Gervais  (Guide 
pratique  pour  1'  etude  et  le  traitement  des  maladies  de  la  peau,  1842).  J.  G.  A. 
Lugol,  physician  to  the  ward  for  scrofulosis  in  the  Hopital  de  St.  Louis,  gave  special 
prominence  to  the  constitutional  side  of  the  etiology  and  therapeutics  of  diseases  of 
the  skin,  and,  like  Lepelletier  de  la  Sarthe,  devoted  his  attention  to  the  study  of 
scrofula,  dividing  it  nosographically  into  tuberculosis,  catarrhal,  cutaneous,  cellular 
and  osseous  (Recherches  et  observations  sur  les  causes  des  maladies  scrofuleusesr 
1841).  The  famous  Alphonse  Devergie  (1798-1879)  too,  who  distinguished  himself 
chiefly  in  forensic  medicine,  was  an  important  worker  in  diseases  of  the  skin  at  the 
Hopital  de  St.  Louis,  where  Bazin  (1808-187!))  likewise  labored.  L.  V.  Duchenne- 
Duparc  (Traite  des  maladies  de  la  peau,  1859),  Felix  Rochard  (1860),  Hardy 
(Lecons  sur  les  maladies  de  la  peau,  1859-60),  wlfere  also  eminent  specialists  in 
diseases  of  the  skin.  The  skin  diseases  of  children  found  a  special  student  of  the 
second  class  in  CI.  Caillault  (Traite  pratique  des  maladies  de  la  peau  chez  les  enfanls, 
1859). 

The  specialty  of  Syphilis  is  allied  to  that  of  diseases  of  the  skin  through  the 
identity  of  its  representatives,  the  chief  of  whom  was  and  is  Philippe  Ricord  i  born 
1800),  of  the  Hopital  du  Midi.  He  embraced  the  experimental  or  experimental- 
diagnostic  tendency  in  his  "syphilization "  (practised,  however,  by  Harrison  and 
Hunter  in  the  18th  century ),  by  means  of  which  he  claims  to  have  proven  the  syphil- 
itic character  of  ulcers,  the  contagiousness  of  the  primary  chancre  only,  and  the  non- 
contagiousness  of  secondary  ulcers,  condylomata,  cutaneous  ulcers  and  eruptions. 
His  ideas,  however,  were  opposed  and  refuted  on  many  hands,  particularly  by 
Cullerier  (the  nephew)  and  A.  Vidal  de  Cassis,  Cazenave,  Gibert  and  others.  Ricord 
has,  however,  cleared  up  in  many  points  the  subject  of  Syphilis,  distinguished 
irrefutably  the  contagia  of  the  chancre  and  of  gonorrhoea,  proved  the  latter  disease  to 
be  entirely  independent  of  syphilis  etc.  He  went  too  far,  however,  in  declaring  that 
an  indurated  ulcer  is  a  sign  of  a  constitutional  infection  alreadj'  accomplished,  that 
he  who  has  had  a  "specific"  indurated  ulcer  is  secure  from  the  danger  of  a  second 
etc.  According  to  Proksch,  Auzias-Turenne  in  1850  was  the  first  to  successfully 
inoculate  animals  with  human  syphilitic  virus,  and  then  to  reinoculate  men  from 
these  infected  animals,  and  to  observe  constitutional  symptoms  in  the  victims  of 
these  secondary  inoculations.  Recently  Lancereaux  at  the  Hopital  St.  Antoine 
(Traite  historique  et  pratique  de  la  syphilis,  1866),  Mauriac  at  the  Hnpital  du  Midi, 
and  A.  Fournier  at  the  Hopital  de  St.  Louis,  with  others,  have  distinguished  them- 
selves as  specialists  in  syphilis.  [In  this  connection  we  should  not  omit  to  mention 
the  name  of  Leon  Bassereau  (Traite  des  affections  de  la  peau  symptomatiques  de  la 
Syphilis,  Paris,  1852),  whose  differentiation  of  the  genetic  characteristics  of  the 
<l  chancroid"  and  "  chancre",  however  vulnerable  in  theon-,  has  proven  very  reliable 
and  beneficent  in  practice.  Paul  Diday  and  MM.  Clerc,  Dron  and  Rollet  likewise 
deserve  notice.     H.] 

A  furtherj'specialty  particularly  cultivated  by  the  French  school,  and  which 
might  also  be  called  the  peculiar  specialty  of  the  19th  century,  is  that  of  the  diseases- 


—  903  — 

of  the  nervous  system.  The  French  school  enjoys  the  credit  of  having  been  the 
first  to  develop  in  an  extended  manner  this  department,  heretofore  greatly  neglected. 
Among  those  who  distinguished  themselves  in  this  branch  were  T.  E.  Coindet 
Bricheteau  (hydrocephale  aigue,  1829),  Papavoine  (meningite  tuberculeuse,  1830), 
Ollivier  d'  Angers  (Traite  des  maladies  de  la  moelle  epiniree,  contenant  1'  histoiie 
anatomique,  physiologique  etc.,  1837),  F.  L.  Valleix  (Traite  des  nevralgies  ou  des 
affections  douloureuses  des  nerfs,  1841),  discoverer  of  the  ixjinis  douloureux  and 
like  Blanche  mentioned  above,  a  victim  of  diphtheritic  infection;  Achille  Foville 
(1799-1878)  in  Toulouse,  a  neuropathologist  and  alienist  (Traite  complet  etc.  du 
systeme  nerveux,  1840),  who  was  the  first  to  ascribe  intellectual  disturbances  to 
disease  of  the  gray  substance,  and  disturbances  of  motility  to  that  of  the  white;  Fr. 
Achille  Longet  (1811-1871),  professor  in  Paris  and  an  important  student  of  the 
anatomy  and  physiology  of  the  nervous  system  ;  Magendie  (Lecons  sur  les  functions 
et  les  maladies  du  systeme  nerveux,  1839);  P.  Flourens  (1794-1867),  chiefly  eminent 
as  a  physiologist  and  investigator  of  the  function  of  the  individual  parts  of  the  brain, 
le  nceud  vital,  who  demonstrated  the  seat  of  the  intellectual  functions  in  the  cortical 
substance  etc.  (Recherches  experimentales  sur  les  proprietes  et  les  functions  du 
systeme  nerveux  dans  les  animaux  vertebres,  2d  edition  1842);'  V.  Burq  (1823-1884) 
in  Paris,  the  famous  ventilator  (1850)  of  "  metallotherapy  ";  Claude  Francois  Michea 
(hypochondrie,  1845);  Parchappe  de  Vinay  (Recherches  sur  1' encephale,  sa  struct- 
ure, ses  functions  et  ses  maladies,  1836-38);  J.  A.  Josat  (epilepsie,  1756);  Gintrae 
Sr.  (died  1877)  and  E.  Gintrae  in  Bordeaux  (Cours  theorique  et  clinique  des  maladies 
du  systeme  nerveux,  1853-59);  J.  Moreau  of  Tours  (epilepsie,  1854);  Trousseau 
(ataxie);  Germain  See  (De  la  choree  etc.,  1850);  Th.  Herpin  of  Geneva  (epilepsie, 
1852),  who  likewise  died  from  diphtheritic  infection;  Durand-Fardel  and  Durand  de 
Gros  (epilepsie);  E.  Bouchut  (De  1' etat  nerveux  etc.,  1860);  Sandras  et  Bourguignon 
(Traite  pratique  des  maladies  nerveuses,  1850) ;  Claude  Bernard  (Physiologie  et 
pathologie  du  systeme  nerveux,  1858) ;  Brown-Sequard  his  successor  in  the  College 
de  France  in  1878;  Paul  Bert  (born  1833),  an  emulator  of  Bernard,  for  a  long  period 
Minister  of  Instruction  and  a  resident  of  Tonking,  which  city  he  proposed  to  govern, 
as  he  said,  on  the  principles  of  Claude  Bernard  or  of  nervous  physiology,  '"revancheur" 
and  an  atheist;  Aug.  Tripier  (Manuel  d'  electrotherapie,  1861);  Jaccoud,  Becquerel," 
Leop.  Ordenstein,  a  practitioner  of  Paris  (Paralysie  agitante,  1868);  Paul  Topinard 
(Ataxie  locomotrice,  1864);  Dujardin-Beaumetz  (myelitis);  Axenfeld  (died  1878), 
professor  in  the  Hopital  Beaujon  (Traite  des  nevroses)  and  others.  In  recent  times 
Jean  Martin  Charcot  (born  1825),  who  has  filled  since  1872  the  chair  of  pathological 
anatomy  resigned  by  Vulpian,  has  acquired  great  reputation,  even  in  Germany,  as  a 
specialist  in  diseases  of  the  nervous  system.  —  The  work  of  G.  B.  Duchenne  de 
Boulogne  (1806-1875),  entitled  "  De  1'  electrisation  localisee  et  de  son  application  a 
la  pathologie  et  a  la  therapeutique  ",  Paris  1855,  3d  edition  1872,  gave  a  special 
impulse  to  the  creation  of  a  new  treatment  of  diseases  of  the  nervous  system,  and  to 
the  formation  of  a  practical  specialty  of  Electrotherapeutics  by  means  of  the  induced 
current.  In  consequence  of  the  lectures  of  Robert  Remak  (1815-1865)  of  Posen  in 
the  Charite,  the  new  electrotherapeutics  of  the  constant  current  was  then  crowned 
with  the  laurel  in  France,  and  accordingly  met  with  general  acceptance  in  Germany 
also.  A.  de  la  Rive  wrote  a  work  in  three  volumes  on  theoretical  and  applied 
electricity  (1854-58).  In  the  year  1860,  however,  appeared  a  French  translation  of 
Remak's  "  Galvanptherapie  der  Nerven-  und  Muskelkrankheiten  "  (Berlin  1858),  in 
which  the  author  in  1856  had  recommended  the  galvanic  in  place  of  the  induced 
current,  and  this  was  followed  by  a  treatise  "Principes  d' electrotherapie  "  by  Cyon, 
and  the  "Traite  d'  electricite  medicale "  of  Onimus  and  Legros.  But  electro- 
therapeutics did  not  arouse  in  France  the  same  enthusiasm  as  it  did  in  Germany. 


—  904  — 

Microscopy,  which  has  become  so  influential  in  German}',  had  not  from  the  out- 
set so  many  representatives  in  the  pathologico-anatomical  school  of  France,  and 
never  acquired  here  so  dominant  an  influence  upon  the  course  of  medical  ideas  as  it 
did  in  Germany.  In  later  times,  however,  it  has  increased  its  influence  and  has 
found  some  students  of  reputation.  Microscopic  anatomy  continued  to  be  in  France 
rather  an  accessory  branch  of  physical  diagnosis  or  of  physiology.  One  of  the 
earliest  cultivators  of  histologj'  was  Fr.  Vine.  Raspail  (1794-1878),  author  of  an 
"Essai  de  chimie  microscopique  appliquee  a  la  phj  siologie  ",  1831,  and  one  of  the 
most  important  was  Louis  Mandl,  professor  of  microscopy  in  Paris  (Anatomie 
microscopique,  1838-57).  These  were  followed  by  Alfred  Donne  (Cours  de  micros, 
copie  complementaire  des  etudes  medicales  and  Atlas  du  cours  de  microscopie- 
published  in  conjunction  with  Leon  Foucault  in  1846).  Other  microscopists  worthy 
of  notice  were  M.  Michel,  professor  in  Nancy  (Du  microscope,  de  ses  applications 
etc.,  1857),  and  particularly  Charles  Philippe  Robin  (1821-1885)  in  Paris,  the  founder 
of  histology  in  France  and  one  of  the  editors  of  Littre's  famous  medical  encyclopaedia 
(Memoire  sur  es  objets  qui  peuvent  etre  conserves  en  preparations  microscopiques, 
ISjG,  Histoire  des  vegetaux  parasites,  1S53,  Traite  du  microscope,  son  mode  d' 
■emploi,  son  application  etc.,  1871);  L.  Saurel  (Du  microscope  etc.,  1857);  C.  Basile 
Morel  (1823-1884)  in  Nancy  (Traite  elementaire  d*  histologie  hurnaine,  1864,  with 
an  atlas  by)  A.  Villemin,  professor  in  the  militarj'  hospital  of  Val  de  Grace  in  Paris, 
and  the  discoverer  of  the  communicability  or  infectiousness  of  tuberculosis  (1864), 
A.  Moitissier  in  Montpellier,  who  applied  photography  to  microscopy  (La  photo- 
graphic appliquee  aux  recherches  micrographiques,  (1866),  and  the  most  important 
and  recent  writers  Cornil  and  Ranvier  (Manuel  d'  histologie  pathologique,  1869-73), 
who  incline  to  the  cellular  pathology. 

Otology,  which  received  a  new  and  practical  impulse  through  the  catheterization 
of  the  Eustachian  tubes  in  the  18th  century,  was  first  promoted  to  the  dignity  of  a 
specialty  by  J.  A.  Saissy  in  his  "Essai  sur  les  maladies  de  1"  oreille  interne"  (1827). 
He  had  been  preceded  by  Alard  with  an  "Essai  du  catarrhe  de  1'  oreille  "  (1807) 
and  by  Monfalcon  with  a  treatise  on  the  diseases  of  the  external  ear.  This  specialty, 
however,  entered  upon  a  new  phase  when  Jean  Marc  Gaspard  Itard  (1775-1838)  was 
appointed  (1789)  special  physician  to  the  hospital  for  deaf-mutes.  In  1821  he 
published  his  memorable  work  "  Traite  des  maladies  de  1' oreille  et  de  1'  audition  ". 
Itard  introduced  into  practice  the  injection  of  fluids  through  the  Eustachian  tubes, 
while  N.  Deleau,  after  the  example  of  Cleland,  employed  the  air  douche  by  means  of 
an  elastic  catheter  (1828),  and  made  this  practice  useful  in  diagnosis.  P.  Meniere, 
E.  H.  Triquet,  Simon  Duplay,  C.  Miot,  Gairal  and  Petrequin  developed  this  depart- 
ment still  further.  G.  Breschet  likewise  rendered  good  service  in  this  branch  by 
his  "  Recherches  anatomiques  et  physiologiques  sur  1'  organe  de  1'  ouiie  et  sur  1' 
audition  dans  1'  homme  et  les  animaux  vertebres ",  1836.  Hubert- Valleroux  wrote  on 
catarrh  of  the  middle  ear  (Memoires  sur  le  catarrhe  de  1'  oreille  moyenne  et  sur  la 
surdite,  qui  en  est  la  suite,  1845)  and  its  consequences,  and  J.  M.  D'Espine 
"Recherches  pratiques  sur  le  traitement  de  la  surdite"  1846.  The  French,  however, 
remained  behind  the  English  and  the  Germans  in  the  subject  of  otolog.y.  One  of 
their  most  recent  writers  on  this  branch  of  medicine  is  Jean  Pierre  Bonnafont 
(Traite  th£orique  et  pratique  des  maladies  de  1'  oreille  et  des  organes  de  1'  audition, 
1860,  2d  edition  1873).  Prosper  Meniere  of  Paris,  already  mentioned,  described  in 
1861  the  disease  called  in  his  honor  "Meniere's  disease  ',  and  Benjamin  Benno 
Loewenberg  (born  1836),  an  eminent  otologist  also  in  Paris,  is  the  author  of  numerous 
works  in  the  department  of  the  diseases  of  the  apparatus  of  hearing. 

The  specialty  of  Diseases  of  the  Larynx,  first  taken  up  anew  and  practically  in 
Vienna,  was  introduced   into  France  by  the  works  of  Tiirck  and  Czermak,  but  has 


—  905  — 

not  met  with  the  same  popularitj'  here  as  in  GermanjT.  It  was  cultivated  particularly 
by  the  Hungarian  L.  Mandl  (1813-1881)  in  Paris  (Traite  pratique  des  maladies  du 
larynx  et  da  pharynx,  1872),  and  Emile  Nicolas-Duranty  in  Marseilles.  Emile 
Isambert  (1828-1876),  professor  in  the  Hopital  de  Lariboisiere,  published  "Annales 
de  1'  oreille  et  de  larj^nx",  and  with  Recquerel,  Dariot  and  others  described  diphtheria 
as  a  form  of  gangrene,  differing  in  this  from  Bretonneau.  —  A  new  method  for  the 
treatment  of  diseases  of  the  larynx  (and  lungs)  was  introduced  by  Jean  Sales-Girons 
(1808-1879),  by  his  invention  of  an  apparatus  for  the  pulverization  of  medicated 
solutions,  described  in  his  "  Therapeutique  respiratoire.  Traite  theorique  et  pratique 
des  salles  de  respiration  nouvelles  (a  1'  eau  minerale  pulverisee)  dans  les  etablisse- 
ments  thermaux"  etc.,  1858,  though  the  same  method  had  been  invented  in  1854  by 
Dr.  Pserhofer,  physicus  at  Papa  in  Austria,  and  laid  before  the  Academie  at  Paris 
for  examination.  S.  A.  Fauvel  and  M.  Krishaber,  to  the  latter  of  whom  (shortly 
before  his  death  in  1883),  in  conjunction  with  Dieulafoy,  the  Monty  on  Prize  had 
been  awarded  for  a  treatise  upon  the  inoculation  of  tuberculosis,  and  Dr.  Blanc 
(died  1884)  in  Lyons  likewise  deserve  notice  in  this  place. 

The  specialty  of  Ophthalmolog3r,  heretofore  assigned  to  surgery,  was  in  like 
manner  elevated  into  a  distinct  department  by  Germans,  and  first  by  Julius 
Sichel  (1802-1868)  of  Frankfort-on-the-Main,  a  scion  of  the  Vienna  school.  In  1848 
he  published  his  "  Lecons  cliniques  sur  les  lunettes "  etc.,  and  his  "  Iconographie 
ophthalmologique"  etc.,  1852-59,  furnished  an  excellent  pathologico-anatomical  atlas 
of  the  diseases  of  the  eye.  Sichel  enjoyed  an  extraordinary  experience,  and  was  the 
first  among  our  ophthalmologists  who  had  a  knowledge  of  history  and  officiated  as  an 
historian.  Carron  du  Villards  and  Louis  Aug.  Desmarres  (1810-1882),  familiar  to  us 
through  the  German  translation  of  his  book,  belonged  in  part  at  least  to  the  pre- 
ophthalmoscopic  period.  Desmarres,  originally  steward  of  an  estate,  obtained  the 
means  to  pursue  his  studies  by  giving  lessons  upon  the  violin.  Graduating  in  1839, 
he  became  Sichel's  assistant  and  the  teacher  of  Albrecht  von  Graefe.  Alphonse 
Desmarres,  his  son,  represents,  as  he  says,  the  "  national  French  ophthalmology", 
which  is  mainly  operative  and  eschews  the  German  methods.  Even  after  the  inven- 
tion of  the  ophthalmoscope,  it  has  been  Germans  or  men  of  German  descent  who 
have  cultivated  in  France  this  peculiarly  German  specialty  since  the  time  of  Bartisch. 
Next  to  Sichel  we  may  mention  L.  von  Wecker,  a  native*  of  Frankfort,  a  famous 
operative  ophthalmologist  and  inventor  of  refractive  ophthalmoscopes;  Ed.  Meyer,  a 
Swiss,  professor  in  Paris  and  a  popular  oculist  (Traite  pratique  des  maladies  des 
yeux,  1873)  ;  Richard  Liebreich  (born  1830),  who  settled  first  in  Paris  and  in  1870 
removed  to  London  (Atlas  d'  ophthalmoscopic,  2d  edition  1870,  etc.);  Edmund 
Landolt  and  Photinos  Panas  (a  Greek),  the  latter  of  whom  has  been  since  1879  the 
first  special  professor  of  ophthalmology  in  the  University  ;  Marc  Ant.  L.  F.  Giraud- 
Teulon,  a  native  Frenchman;  V.  F.  Szokalski  (born  in  1811),  a  Pole,  who  graduated 
at  Giessen  in  1834,  then  went  to  Paris  and  became  Sichel's  assistant,  but  was  called 
to  his  native  city  Warsaw  in  1854  to  fill  the  chair  of  ophthalmology ;  Xaver  Gale- 
zowski  (born  1832),  an  eminent  Russian  ophthalmologist  settled  in  Paris;  Castorani ; 
Francesco  Rognetta  (1800-1857),  an  Italian  who  settled  in  Paris;  Victor  Stoeber 
(1803-1871),  professor  of  ophthalmology  in  Strassburg  during  the  French  period,  and 
many  others,  most  of  them,  as  we  see,  foreigners. 

A  specialty  especially  and  eminently  cultivated  by  the  French  in  the  present 
century  and  recently  introduced  by  them  into  German}'  is  that  of  Hygiene,  a  term 
under  which,  however,  the  French  understand  what  we  call  Medical  Police.  This 
specialty,  both  before  and  since  the  appearance  of  the  modern  French  medicine,  has 
had  a  large  number  of  representatives  in  all  conceivable  directions.  Besides  this 
there  is  also  a  Committee  of  Public  Hygiene  for  the  whole  of  France.  ■ —  Among  the 


—  906  — 

French  h}"gienists  we  should  mention  Ratier;  Reveille-Parise ;  Charles  Londe  (Nou- 
veaux  elements  d'  hygiene)  in  the  acceptation  of  Broussais;  H.  Royer-Collard, 
professor  of  hygiene  in  Paris,  one  of  the  most  important  of  French  hygienists 
(Organoplastie  hygienique  ou  essai  d'  hygiene  comparee  etc.,  1843) ;  L.  R.  Villerme 
(Memoire  sur  la  mortalite,  1828);  Fr.  Melier  (De  la  saute  des  ouvriers  employes 
dans  les  manufactures  de  tabac  and  Sur  les  marais  salants,  1844);  Edouard  Seguin 
(1812-1880),  who  wrote  on  the  management  of  idiots  and  persons  of  feeble  mind; 
Tanquerel  ties  Planches  (Traite  des  maladies  de  plomb  ou  saturnines  etc.,  1839); 
J.  Sedillot  (Revaccination,  1840);  Francois  Foy,  (Manuel  d'  hygiene,  1845);  J.  Ch. 
M.  Boudin  (  Etudes  d'  hygiene  publique  etc.,  1846);  Paul  Chevallier;  Gaultier  de 
Oaubry  (hospitals).  One  of  the  most  important  French  hygienists  was  Ambroise 
Auguste  Tardieu  (1818-1879),  the  famous  medico-legal  expert  in  the  cases  of  Dr. 
Couty  de  la  Pommerais,  Troppmann,  Pierre  Bonaparte  and  Victor  Noir  etc.,  suc- 
cessor of  the  famous  experimenter  and  chemist  Oihla  in  the  chair  of  forensic  medi- 
cine, and  president  of  the  committee  of  public  hygiene  (Etude  medico-legale  sur  les 
attentats  aux  mceurs,  7th  edition  1878,  etc.)  ;  likewise  A.  J.  B.  Parent-Duchatelet 
(1790-1836),  member  of  the  Board  of  Health  of  Paris  (Prostitution  etc.);  the  anti- 
mereunalist  Armand  Despres  (venereal  diseases,  1870);  J.  Jeannel  in  Bordeaux  (De 
la  prostitution  dans  les  grands  villes  en  XIX.  siecle,  2d  edition,  1873) ;  Maxime 
Vernois  (died  1877),  a  member  of  the  Academie  (Traite  pratique  d'  hygiene  indus- 
trielle  et  administrative);  M.  Vernois  and  Grassi  (ventilation  and  heating  etc.); 
Fr.  Ribes,  professor  in  Montpellier,  (Traite  d'  hygiene  therapeutique  etc.,  1860), 
equally  famous  with  J.  B.  Fonssagrives,  professor  of  hygiene  in  Montpellier  (Hygiene 
et  assainissement  des  villes,  1874;  Traite  d'  hygiene  navale,  1856;  Hygiene  alimen- 
taire  etc.,  1867)  etc.;  P.  Foissac  (La  longevite  humaine,  1873;  Hygiene  phi- 
losophique,  1863)  etc.  ;  Michel  Lev}-  at  the  Val  de  Grace  (Traite  d'  hygiene  publique 
et  privee,  5th  edition,  1869);  A.  Magne  (Hygiene  de  la  vue,  1866);  Ad.  Motard 
(Traite  d'  hygiene  generale,  1868)  ;  Aug.  Louis  Dominique  Delpech  (1818-1880), 
who  wrote  upon  the  diseases  peculiar  to  artisans;  A.  Layet  (Hygiene  et  maladies  des 
paysans,  1880)  :  Jean  Bapt.  Hillairet  (died  1882),  who  wrote  on  the  diseases  of 
laborers  engaged  in  the  manufacture  of  compounds  of  chromium;  Angel  Marvaud  at 
the  Val  de  Grace  (Hygiene  militaire  etc.,  1873);  Gaffard  (tobacco,  1872) ;  Gubler,  a 
member  of  the  Comite  4'  Hygiene;  Paul  Jolly  (alcohol,  1867,  absinthe  and  tobacco, 
1871);  Hipp.  Jaqueraet  (Des  hopitaux  et  des  hospices,  1866);  Henri  Perrusel, 
professor  in  Paris  (Cours  elementaire  d'  hygiene,  1873);  Elie  Chastang  (naval 
hygiene,  1873);  Andre  Victor  Cornil,  professor  in  Paris  (Lec,ons  elementaires  d' 
hygiene,  1873);  Louis  Adolphe  Bertillon  (1821-1883),  one  of  the  most  eminent 
statisticians;  Vallin,  professor,  and  since  1877  editor  of  the  "Revue  d'  hygiene  et  de 
police  sanitaire";  Napias  and  J.  Martin  (L'  etude  et  le  progres  d'  hygiene  en  France 
de  '78-82);   P.  C.  H.  Brouardel,  and  many  others. 

The  modern  germ-theory,  which  has  attained  such  development  and  dominance 
in  Germany,  was  first  suggested  in  France  by  the  discovery  of  the  yeast  plant  by 
Cagniard  Latour  (1836),  and  the  teachings  of  Pouchet  that  the  germs  of  the  fungi 
which  occasioned  fermentation  and  putrefaction  originated  from  the  air.  The 
existence  of  these  germs  was  subsequently  demonstrated  experimentally  by  Pasteur, 
and  the  germ-theory  applied  to  the  pathological  doctrine  of  infection  or  etiology  by 
Nepven,  Felix  Rochard,  Davaine,  Lagneau,  Leon  Colin  at  the  Val  de  Grace  and 
others. 

[The  modern  specialtj-  of  Gynascology,  called  into  existence  by  the  reinvention 
of  the  speculum  uteri  by  Recamier  in  1801,  and  its  introduction  to  the  medical  pro- 
fession in  1818,  has  found  in  France  many  eminent  cultivators.  Among  these  we 
may  mention  the  well-known  midwife  of  the  Maternite,   Marie  Anne  Victoire  Boivin 


—  907  — 

(1773-1847),  who,  in  conjunction  with  her  nephew  Antoine  Duges,  published  in  1833 
a  "  Traite  pratique  des  maladies  de  1'  uterus  et  de  ses  annexes  ";  Francois  Melier 
(1798-1866),  who  proposed  the  use  of  intrauterine  injections  in  1832;  Adam  Raci- 
borski  (1809-1871)  ;  the  eminent  surgeon  Jacques  Lisfranc  (Maladies  de  1'  uterus, 
edited  by  Pauly,  1836);  Marc  Colombat-de-1'  Isere  (1798-1851;  De  1'  hysterotomie 
etc.,  1828;  Traite  complet  des  maladies  des  femtnes  etc.,  1838);  Blatin  and  Nivet, 
(Traite  des  maladies  des  femmes,  1842);  Pierre  Charles  Huguier  (1804-1873);  Francois 
Amilcar  Aran  (1817-1861 ;  Lecons  cliniques  sur  les  maladies  de  F  uterus  et  de  ses 
annexes,  1858) ;  Alfred  Becquerel  (Lecons  cliniques  sur  les  maladies  de  1'  uterus  1859); 
Bernutz  and  Goupil  (Clinique  medicale  sur  les  maladies  des  femmes,  1860-62)  ;  A. 
H.  P.  Courty  (Traite  pratique  des  maladies  de  1'  uterus,  des  ovaires  et  des  tiomps 
etc.,  1866);  Alphonse  Alex.  Boinet  (Traite  pratique  des  maladies  des  ovaires  et  de 
leur  traitement  etc.,  1867) ;  Auguste  Nonat  (Traite  pratique  des  maladies  de  1' 
uterus  et  de  ses  annexes,  1869);  Eugene  Koeberle,  the  famous  ovariotomist  of 
Strassburg;  Jules  Pean  (ovariotomy,  1867);  T.  Gallard  (Lecons  cliniques  sur  les 
maladies  des  femmes,  2d  edition  1879),  and  many  others.     H.] 

The  early  efforts  of  the  anatomical  school  in  the  sphere  of  the  general 
hygienic  management  of  an  entire  people,  in  contradistinction  to  the  treat- 
ment of  individuals  (the  latter,  in  accordance  with  its  whole  tendency,  this 
school  regarded  as  tolerably  barren  in  results),  exhibit  in  a  somewhat  milder 
light  the  deficiencies  inherent  especially  in  its  therapeutics,  and  show  like- 
wise that  the  French  are  at  bottom  alwa}-s  inclined  to  take  hold  practically 
wherever  success  opens  the  way.  In  this  most  promising  department  of 
hygiene  French  medicine  obtained  again  the  precedence  of  the  German 
school,  which  has  pursued  this  branch  with  energy  in  the  last  few  years 
only,  and  particularly  in  the  sphere  of'  the  prevention  of  epidemic  diseases, 
to  which  the  French  have  paid  less  attention. 

Another  proof  of  the  independence  of  French  medicine  is  found  in  its 
earnest  devotion  to  history  manifested  by  the  publication  of  several 
general  histories  of  medicine,  a  department  in  which  for  nearly  a  century 
France  had  exhibited  almost  perfect  literary  quietude.  Yet  in  the  Uni- 
versity medical  histoiy  has  always  enjoyed  a  chair  of  its  own,  and  has  not 
been  assigned  as  an  incidental  branch  to  the  teacher  of  some  secondary 
department,  as  has  been  the  case  in  Germany,  with  the  exception  of  Vienna.. 
In  this  chair  the  thorough  and  ingenious  Charles  Victor  Daremberg  (died 
1872)  and  Paul  Jos.  Lorain  (1817-1876)  displayed  their  activity.  Here 
too  taught  Bouchut,  while  the  navy  physician  Jules  Eochard  has  recently 
written  a  good  history  of  French  surgery  in  the  19th  century,  and  Frc'dault 
and  Bouchut,  each  a  general  history  of  medicine.  Until  1879  Marie  Jules 
Parrot  occupied  the  chair  of  the  history  of  medicine  in  Paris,  exchanging 
it  at  that  period  for  the  chair  of  the  diseases  of  children,  and  finding  in 
Jean  J.  A.  Laboulbene  his  successor  in  the  department  of  medical  history. 
Louis  Adolph  Bertillon  (1821 — 1883),  at  the  time  of  his  death,  was  the 
professor  of  geographical  pathology.  But  the  greatest  historical  inves- 
tigator among  the  French  during  the  present  century  was  the  academician 
and  senator  Maximilien  Paul  Emile  Littre"  (1801-1881),  the  translator  of 
Hippocrates  (Oeuvres  d'Hippocrate,  10  vols.,  1839-61),  and  author  of  the 
"Dictionnaire  de  la  langue  Francaise"  (4  vols.,  1863-72). 


—  1)08  — 

g.    English  Medicine,  including  the  so-called  Dublin  School  of 
Pathological  Anatomy. 

England,  after  her  excessive  participation  in  the  Iatrochemistry  and 
particularly  the  Tatromechanics  of  the  seventeenth  centuiy,  a  devotion 
which  extended,  as  we  have  seen,  far  into  the  eighteenth,  seems  to  have 
lost  all  confidence  in  S}-stems  and  schools  of  medicine.  For  no  system 
and  no  so-called  school  has  since  that  period  gained  any  large,  permanent 
and  exclusive  number  of  followers.  At  least  Brunonianism  did  not, 
although  the  English,  as  a  rule,  favor  active  therapeutics.  Thus  John 
Armstrong  (1709-1779),  C.  H.  Parry  (1755-1822),  Marshall  Hall  (1790- 
1857)  and  James  Wardrop  (1782-1869)  were  great  partisans  of  bleeding, 
and  the  use  of  alcohol  in  the  treatment  of  febrile  diseases  still  flourishes 
in  England.  This  attitude  of  reserve,  always  characteristic  of  English 
medicine,  it  has  carried  still  further  during  the  present  centuiy,  although 
for  a  time  it  too  followed  the  anatomico-diagnostic  medicine  of  the  French 
school.  Cullen,  and  still  more  Gregory,  who  largely  followed  Cullen's 
views,  were  from  an  earhT  period  very  active  in  the  production  of  this 
result. 

Yet  even  the  sober  English  have  not  kept  entirely  free  from  attempts 
and  h}-potheses  designed  to  secure  classification  and  systematization, 
though  we  ma}"  justly  concede  to  them  greater  freedom  in  this  respect  than 
to  the  Germans.  Ony  they  have  followed  unconsciously  the  requirement 
of  Sydenham  based  upon  the  national  character  of  the  English,  and  which 
demanded  that  lrvpotheses  should  have  a  practical  basis,  that  is  should  be 
derived  from  actual  practice,  and  should  be  useful. 

Accordingly  the  nosological  arrangement  of  the  long  popular  text- 
book entitled  "The  Study  of  Medicine"  (London,  1822)  by 

John  Mason  Good  (176-4-1827), 
is  one  of  the  most  practical,  inasmuch  as  its  main  divisions  are  based  upon  certain 
regions  of  the  body,  without  separating  them  too  artificially.  Good  speaks  of: 
1.  Diseases  of  the  organs  of  the  voice  and  of  respiration  (Pneumonica) ;  2.  Diseases 
of  the  organs  of  digestion  (Cceliaca)  ;  3.  Diseases  of  the  nervous  system,  including 
mental  diseases  (Neurotica);  4.  Diseases  of  the  sexual  organs  (Genetica);  5.  Dis- 
eases of  the  organs  of  secretion  and  excretion  (Eccritica);  6.  Diseases  of  the  blood 
and  bloodvessels,  including  inflammation,  fever,  dyscrasia  |  Hrematica).  In  the  last 
class  he  subscribes  to  the  humoral  doctrine. 

The  memorable  discovery  in  1816  of  Sir  Charles  Bell  (1774-1842) 
that  the  posterior  roots  of  the  spinal  nerves  presided  over  sensation  and 
the  anterior  over  motion,  directed  anew  the  attention  of  the  English 
(which  had  been  alread}*  turned  specially  to  the  nervous  system  by  Cullen) 
to  this  difficult  department,  and  this  tendency  was  subsequentl}-  confirmed 
b}r  the  important  discovery  of  reflex  phenomena,  communicated  to  the 
Boyal  Society  by  Marshal  Hall  in  1833.  The  discovery  of  these  two  fund- 
amental laws  of  nervous  physiology  affords  new  evidence  of  the  physio- 
logical genius  of  the  English.     Both  must  be  considered  as  important  to 


—  909  — 

our  knowledge  of  nervous  activity,  as  were  the  teachings  of  Harvey  to 
that  of  the  circulation  and  development.  The  discoveries  of  Bell  and 
Hall  stimulated  powerfully  the  study  of  the  ptrysiology  and  pathology  of 
the  nervous  system,  so  that  even  the  surgeons  Alexander  Shaw,  Joseph 
Swan,  Herbert  Mayo,  Henry  Earle,  James  Macartney  etc.  devoted  attention 
to  this  subject. 

The  theoretical  views  of 

Benjamin  Travers  (1783-1858),  Serjeant  Surgeon  to  the  Queen  and 
the  first  pupil  of  Sir  Astle}^  Cooper,  though  derived  from  his  surgical 
experience,  seem  to  have  been  influenced  by  the  first  of  the  two  great 
ph}Tsiological  discoveries  mentioned  above,  and  to  have  been  suggested 
chiefby  by  the  doctrines  of  Broussais. 

Travers  proceeded  from  the  fact  that  absolutely  trifling  local  accidents,  e.  g.  a 
traumatic  erysipelas,  may  call  forth  important  general  accidents.  This  action  upon 
the  entire  constitution,  called  by  Travers  "  constitutional  irritation  ",  he  derived  from 
the  nervous  system,  or  rather  he  considered  the  latter  the  route  of  transmission  of  the 
"irritation  ''  to  the  whole  body.  By  constitutional  irritation  he  understood  a  process, 
which,  in  strong  contrast  to  inflammation,  subsides  without  byperaemia  and  without 
the  formation  of  plastic  exudation,  but  which,  on  the  other  hand,  may  occasion  liquid 
products  and  result  in  neoplasms,  like  cancer  and  other  tumors.  He  likewise  divided 
constitutional  irritation  (to  which  belong  fever  and  convulsions)  into:  a<  direct, 
originating  in  purely  local  accidents;  and  b.  reflected,  in  which  the  local,  as  well  as 
general  phenomena  undergo  a  modification. 

These  views  were  followed  by  Sir  Astley  Paston  Cooper  (1768-1841)  the  most 
eminent  English  surgeon  of  his  day,  and  Sir  Benjamin  Collins  Brodie  (1783-1862), 
while  Charles  J.  B.  Williams,  specially  eminent  as  a  cultivator  of  physical  diagnosis 
(William's  "tracheal  tone  "  etc.),  as  well  as  J.  Crawford  (died  1841)  regarded  the 
irritation  of  Travers  merely  as  the  incipient  stage  of  inflammation.  This  "irritation", 
or  its  seat,  the  English  physicians  (including  Bell  himself,  whose  teachings  were 
chosen  as  the  foundation  for  this  view)  sought  at  once  in  the  spinal  cord.  Among 
these  investigators  were  Robert  Allan  (1778-1826),  R.  Brown  (1828)  and  John  Aber- 
crombie  (1780-1844)  of  Edinburgh,  who  adopted  the  pathologico-anatomical  tendency 
in  his  works  "Pathological  and  practical  researches  on  the  diseases  of  the  brain  and 
spinal  cord",  1S27,  and  "Pathological  and  practical  researches  on  the  diseases  of 
the  stomach,  the  intestinal  canal,  the  liver"  etc.,  1828.  The  same  may  be  said  of 
Richard  Bright  (1789-1858)  of  London,  an  extremely  thorough  and  conscientious 
investigator,  who  reformed  our  renal  pathology  by  his  description  of  the  disease  which 
bears  his  name,  and  which  he  described  in  his  "Reports  of  medical  cases"  etc., 
published  in  1827.  Indeed  this  work  of  Bright's  in  many  respects  introduced  the 
whole  of  pathology  to  a  new  path,  so  that  its  author  deserves  a  place  among  the  first 
physicians  of  our  day.  The  term  "spinal  irritation",  subsequently  employed  in 
Germany  as  a  welcome,  new  and  universal  dogma,  seems  to  have  been  first  employed 
by  Dr.  C.  Brown  of  Glasgow  in  1826,  while  T.  Pridgin  Teale,  Sr.  (1801-1868)  of  Leeds 
(A  treatise  on  neuralgic  diseases  dependent  upon  irritation  of  the  spinal  marrow  and 
ganglia  of  the  sympathetic  nerve,  London,  1829),  G.  Tate  (Treatise  on  hysteria, 
London  18301,  Dr.  Isaac  Parish  of  Philadelphia  ("  Remarks  on  spinal  irritation  as 
connected  with  nervous  diseases"  in  American  Journal  of  Med.  Sciences,  1832), 
the  brothers  W.  and  D.  Griffin  of  Limerick  (Observations  on  the  functional  affections 
of  the  spinal  cord  etc.,  London,  1834)  and  Dr.  John  Marshall  (Practical  observations 
on  diseases  of  the  heart,  lungs,  stomach,  liver  etc.,  occasioned  by  spinal  irritation  etc.. 


—  910  — 

London,  1835)  with  others,  collected  cases  and  elaborated  the  theorj-  of  this  disease. 
This '' fashionable  theory  and  fashionable  disease"  was  finallj-  substantially  termin- 
ated by  Aaron  Mayer  (born  1808)  of  Mettenheim  in  Rheinhesse,  a  practising  phy- 
sician in  Mayence,  in  his  eminent  treatise  ''  Ueber  die  Unzulassigkeit  der  Spinal- 
irritation  als  besondere  Krankheit,  nebst  Beitragen  zur  Semiotik  und  Therapie  des 
Ruckenschrnerzes  ",  1849.  Its  defenders  in  Germany  were  Enz,  Kramer,  Benedict 
Stilling  (1810-1879),  Henle,  Loweg,  Tiirck  and  Canstatt,  and  even  to-day  the  term 
"  spinal  irritation"  is  still  preserved  and  again  applied  to  designate  a  special  group 
of  symptoms. 

The  pathologico-anatomical  tendency  in  England  manifested  itself  at 
first  chiefly  as  a  continuation  of  the  labors  of  the  great  English  masters 
of  pathological  anatomy  of  the  18th  century,  a  John  Hunter  and  a 
Matthew  Baillie  (1761— 1823J,  the  latter  of  whom  in  particular  had  always 
preserved  the  stand-point  of  practical  utility.  But  at  a  later  period  too, 
when  the  French  anatomico-diagnostic  school  had  won  considerable  influ- 
ence, the  English  physicians,  in  contrast  to  the  German,  preserved  great 
independence  and  soberness,  never  neglected  entirety  their  own  past  and 
the  practical  duties  of  the  physician  for  the  cultivation  of  the  modern 
requirements  of  professional  knowledge,  in  a  word  they  never  forgot  that 
before  Corvisart,  Ba}le  and  Laennec,  the}T  had  their  own  great  physician 
Sydenham.  Doubtless  this  was  to  some  extent  due  to  the  fact  that  in 
their  political  and  social  institutions  they  had  been  brought  into  less  inti- 
mate contact  with  the  French  spirit  and  the  French  Revolution  than  was 
the  case  with  other  nations.  Moreover  ph}-siolog3r,  since  the  da}*s  of  Har- 
vey the  national  department  of  the  English,  continued  to  hold  the  balance 
-against  pathological  anatomy,  and  at  a  time  when  in  France,  through  the 
influence  of  Broussais,  merely  the  name  of  physiology  and  not  the  thing 
itself  was  in  vogue.  As  the  result  of  her  peculiar  and  antique  mode  of 
organization  of  the  teaching  and  the  practising  faculties,  which  we  have 
alread}'  sketched,  England  too  has  continued  until  the  present  time  free 
from  the  excessive  specialism  which  has  crept  into  France  and  German}*, 
notwithstanding  the  existence  there  of  special  hospitals,  and  notwith- 
standing the  fact  that  the  ever  sober  surgeons  of  that  country  have  had  a 
more  considerable  influence  upon  the  course  of  medicine  than  anywhere 
else.  Even  physical  diagnosis,  practised  there  for  a  long  time  with  great 
predilection  and  success  in  a  manner  intermediate  between  that  of  the 
French  and  Germans,  and  for  which  the  special  hospitals  for  pulmonary 
diseases  etc.  supplied  abundant  material,  did  not  degenerate  into  one- 
sidedness  and  enthusiasm,  nor  even  into  casuistical  pedantry.  English 
medicine  on  the  whole,  like  the  English  in  general,  followed  the  eve^da}', 
practical  and  sober  maxim  of  Sir  Astle}'  Cooper  :  '•  Profound  erudition  is 
good  for  a  man  of  means  —  useful  and  practical  knowledge  for  the  ph3rsi- 
cian  and  surgeon." 

Besides  the  coryphaei  alread}'  mentioned,  the  two  surgeons  named 
Thomson  are  worthy  of  prominence  among  the  more  famous  English  phy- 
sicians.     John    Thomson    (1765-1846)     of    Edinburgh,     besides     works 


—  911   — 

relating  to  operative  and  military  surgery,  wrote  also  on  inflammation 
(1813),  small-pox  (1822)  etc.  He  described,  and  introduced  in  1820  the 
term  "varioloid",  and  advocated  the  treatment  of  syphilis  without  mercury. 
Anthon}-  Todd  Thomson  (1778-1849)  in  London,  on  the  other  hand,  wrote 
on  materia  medica  and  therapeutics,  as  well  as  'Commentaries  on  diseases 
of  the  skin',  1839.  He  also,  like  William  Wallace  (died  1838)  in  Dublin, 
devoted  attention  to  the  inoculation  of  syphilis,  and  Wallace  was  the  first 
to  introduce  into  general  recognition  the  employment  of  iodide  of  po- 
tassium in  the  treatment  of  that  disease  (A  treatise  on  the  venereal  dis- 
ease and  its  varieties,  Dublin,  1832).  Sir  Charles  Hastings  (1794-1866), 
the  founder  of  the  British  Medical  Association,1  distinguished  himself  as 
an  investigator  of  the  subject  of  inflammation  (A  treatise  on  inflammation 
of  the  mucous  membrane  of  the  lungs  etc.,  London,  1820).  He  was  suc- 
ceeded in  the  presidency  of  this  Association  b\"  E.  Wilkinson  (died  1878), 
for  the  English,  unlike  the  Germans,  always  put  considerable  men  at  the 
head  of  their  medical  societies. 

More  decided  followers  of  the  pathologico-anatomical  and  diagnostic 
tendenc}'  were  :  John  Baron  (born  1786),  author  of  "An  inquiry  illus- 
trating the  nature  of  tuberculated  accretions  of  serous  membranes  etc." 
(London,  1819);  Sir  Charles  Scudamore  (1779-1849),  well  known  for  his 
study  of  the  nature  and  treatment  of  the  gout  (1816),  and  author  of 
"Observations  on  M.  Laennec's  method  of  forming  a  diagnosis  of  the  dis- 
eases of  the  chest  b}T  means  of  the  stethoscope,  percussion  etc.",  1826; 
Sir  John  Forbes  (1787-1861),  a  Scotchman,  physician-in-ordinary  in 
London,  translator  of  Laennec's  treatise  on  auscultation  (1821),  and 
founder  of  the  Sydenham  Societ}' in  1843:  Sir  James  Clark  (1788-1870), 
first  physician-in-ordinary  to  queen  Victoria,  and  author  of  "A  treatise  on 
pulmonary  consumption  etc."  (1835),  "The  influence  of  climate  in  the 
prevention  and  cure  of  chronic  diseases  etc."  (1829);  Bobert  Spittal 
(1804-1852)  of  Edinburgh  (A  treatise  on  auscultation  in  diseases  of  the 
chest,  1830);  Richard  Townsend  of  Dublin,  author  of  a  "Tabular  view  of 
the  principal  signs  furnished  by  auscultation  and  percussion  etc."  (1832); 
W.  Henderson,  who  wrote  a  similar  work  ;  David  Cragie  (1793-1866)  of 
Edinburgh  (Elements  of  general  and  pathological  anatomy,  1828);  James 
Hope  (1801-1841)  in  London,  author  of  "A  treatise  on  diseases  of  the 
heart  and  great  vessels  etc.",  1832,  and  "Principles  and  illustrations  of 
morbid  anatomy  etc.",  1834,;  Edward  Turner  (1796-1837)  in  Edinburgh 
and  subsequently  in  London  ;  John  Beid  (1808-1849),  professor  in  the 
Universit}*  of  St.  Andrews,  well  known  for  his  researches  upon  the  influence 

1.  In  1828  Hastings  with  a  few  friends  founded  the  "Midland  Medical  and  Surgical 
Reporter",  the  influence  of  which  led  to  the  organization  in  1832  of  the  "Provin- 
cial Medical  and  Surgical  Association".  The  first  meeting  of  this  association 
was  held  in  the  Worcester  Infirmary  in  July  1832,  under  the  presidency  of  Dr. 
John  Johnstone  of  Birmingham.  In  1856  the  sphere  of  this  society  was  enlarged, 
and  it  assumed  the  title  of  the  "British  Medical  Association".     H. 


—  912  — 

of  section  of  the  glossopharyngeus  ;  Sir  Anthony  Carlisle  (1768-1840)  in 
London,  a  voluminous  writer  on  many  medical  and  surgical  subjects  ; 
Peter  Mere  Latham  (1789-1875),  extraordinary  physician  to  queen  Victoria 
and  author  of  "Lectures  on  diseases  of  the  heart"  (1845),  with  other 
works;  Sir  Robert  Carswell  (1793-1857),  professor  of  pathological  anatom}7 
in  University  College,  and  the  famous  author  of  "Pathological  anatomy. 
Illustrations  of  the  elementary  forms  of  disease",  London,  1833-38  ;  Kier- 
nan  (1833),  an  important  pathological  anatomist  ;  John  O'Brien  (yellow 
atrophy  of  the  liver);  John  Elliotson  (1788-1868),  author  of  a  work  "On 
the  recent  improvements  in  the  art  of  distinguishing  the  various  diseases 
of  the  heart",  London,  1838,  "Human  physiology",  1840,  and  other  writings; 
Bryan  (the  sounds  of  the  heart,  1833);  Golding  Bird  (1815-1854),  author 
of  "Urinary  deposits,  their  diagnosis,  pathology  and  therapeutical  indi- 
cations", London,  1845;  Henr}-  Ancell  (1802-1863)  of  London  (A  treatise 
on  tuberculosis  etc.,  1852)  ;  Thomas  Davies  (Lectures  on  the  diseases  of 
the  lungs  and  heart,  1835);  Charles  Cowan  (1806-1868)  of  Reading,  who 
translated  in  1835  Louis'  work  on  phthisis  and  published  in  the  following 
year  a  "Handbook  of  physical  diagnosis";  Ogier  Ward,  who  interpreted 
correctly  the  bruit  de  diable  observed  by  Laennec,  1837;  John  Davies  ; 
Theophilus  Thompson  (died  1860),  author  of  "Clinical  lectures  on  pul- 
monary consumption,  delivered  at  the  Brompton  Hospital",  1854;  Sir 
Robert  Christison  (1797-1882),  professor  of  materia  medica  in  the  Uni- 
versity of  Edinburgh,  and  the  most  famous  pharmacologist  and  toxicolo- 
gist  of  England,  discoverer  of  the  effects  of  the  Calabar  bean  and  author 
of  a  "Treatise  on  poisons"  (1829);  Robert  Willis  (1798-1878),  librarian 
of  the  Royal  College  of  Surgeons  in  London,  translator  of  the  works  of 
Harvey  for  the  Sydenham  Society,  author  of  "  Illustrations  of  cutaneous 
diseases  etc.",  1839-41,  with  other  works.  Magnificent  cyclopaedias 
devoted  to  the  investigations  of  the  new  tendenc}'  were  Forbes's  "Cyclo- 
paedia of  practical  medicine"  (1833-35)  and  Robert  Bentley  Todd's 
"Cyclopaedia  of  Anatomy  and  Physiology",  London,  1839-59.  Todd 
(1809-1860)  was  equally  famous  as  a  surgeon,  physiologist  and  patho- 
logical and  microscopical  anatomist. 

Contemporaneously  with  the  English  and  Scotch  physicians  just  men- 
tioned, and  who  cultivated  the  new  pathological  views  and  diagnostic 
advances,  there  was  formed  in  Ireland,  a  country  more  accessible  to 
French  influences  and  more  revolutionary  in  its  tendencies  than  England, 
the  so-called 

Dublin  School, 

which  resembled  in  its  tendencies  the  French  school  of  pathological 
anatomy.  Its  progenitors  were  John  Cheyne  (1777-1836),  who  wrote  on 
the  diseases  of  children  (particularly  hydrocephalus  acutus,  1808,  describ- 
ing the  "Cheyne-Stokes"  respiration),  C.  Percival,  Abraham  Colles  (died 
1843),  John   Kirby  who,  in  conjunction  with  Robert  Adams  and  Read, 


—  913  — 

founded  about  1816  the  Peter  St.  School  of  Medicine,  and  Pitcairn,  the 
latter  of  whom  was  the  first  physician  in  England  to  point  out  rheumatism 
as  the  source  of  heart  troubles.  William  Stokes  (1804-1878)  of  Dublin  is, 
however,  to  be  considered  the  most  eminent  representative  of  this  school. 

Stokes,  the  son  of  Whitley  Stokes,  a  professor  in  the  university  of  his  native 
city,  was  physician  to  the  Meath  Hospital  and  the  Infirmary  of  the  county  of  Dublin. 
Here  he  was  active  for  fifty  years,  succeeding  his  father  in  the  professorship  at  the 
University  in  1845.  In  1875  he  received  the  Prussian  order  "  pour  le  merite  ",  an 
extremely  rare  distinction,  if  orders  are  to  be  regarded  as  distinctions.  He  distin- 
guished himself  both  as  an  author  and  as  a  clinical  teacher.  In  many  respects  he 
followed  the  teachings  of  Broussais.  His  great  work  entitled  "  A  treatise  on  the 
diagnosis  and  treatment  of  the  diseases  of  the  chest",  London,  1887,  characterized  by 
quietness  of  description  and  soberness  and  care  in  observation  (though  not  always  by 
correct  interpretation,  particularly  of  the  physical  signs),  contains  the  accounts  of 
many  personal  and  other  cases  of  disease,  whose  pathological  anatomy  had  been 
investigated,  all  contributing  to  the  construction  of  an  excellent  system  of  symptom- 
atology, by  which,  as  well  as  by  its  reasonable  therapeutics,  the  book  is  distinguished. 
Concerning  his  own  merits  Stokes  says:  "Without  desiring  to  praise  myself,  I 
believe  it  necessary  only  to  refer  to  the  dilatation  of  the  air  cells,  the  first  stages  of 
pneumonia  and  phthisis,  to  cancer  of  the  lungs,  to  pericarditis  and  to  the  signs  of  the 
1  Diseases  of  Accumulation  ',  to  show  that  I  have  fully  recognized  the  value  of  phys- 
ical diagnosis,  and  that  my  labors  of  many  years  in  this  great  and  open  field  of 
investigation  have  not  remained  without  reward."  "Pathological  anatomy  in  this 
work  1  have  touched  upon  only  so  far  as  it  was  necessary  to  the  elucidation  of 
diagnosis".     The  following  extract  will  serve  as  an  example  of  his  method. 

The  Physical  Signs  op  Pneumonia. 

"  The  sources  from  which  spring  the  physical  signs  of  this  disease  may  be 
enumerated  as  follows:  1.  Evidences  of  local  excitation.  2.  Evidences  of  congestion 
of  the  blood.  3.  Evidences  of  a  decrease  in  the  quantity  of  air  in  the  affected  lung. 
4.  Signs  of  increasing  solidification  of  the  lung.  5.  Phenomena  of  the  voice. 
6.  Phenomena  referable  to  the  circulatory  sj'stem.  7.  Evidences  of  simultaneous 
morbid  conditions  of  the  pleura.  8.  The  diminished  volume  of  the  lung.  —  In  the 
foregoing  catalogue  the  signs  of  intumescence  or  displacement  of  the  viscera,  which 
in  other  diseases  have  such  great  value,  are  not  introduced.  These  signs  are  wanting 
in  pneumonia,  for  though  the  observation  of  Broussais  that  the  ribs  make  an  imprint 
upon  the  inflamed  lung  is  often  true,  yet  no  marked  increase  of  volume  is  met  with. 
That  appearance  too  is  not  always  present  ....  these  impressions  are  rarely 
more  than  three  lines  deep,  and  though  their  presence  shows  a  certain  swelling  of  the 
lung,  it  is  yet  very  manifest  that  they  can  do  no  harm  to  the  diagnosis  by  leading  us 
to  confound  a  consolidated  lung  with  a  distended  pleura.  In  this  respect  I  can  only 
agree  with  Laennec,  but  his  assertion  that  in  pneumonia  no  swelling  at  all  is  present 
is  not  confirmed  by  experience."  "  The  bold,  and  often  repeated  use  of  the  lancet 
I  consider  in  most  cases  unnecessarj^.  .  .  The  importance  of  local  abstractions  of 
blood  in  the  treatment  of  pneumonia,  and  which  I  consider  the  chief  remedial  agent, 
I  cannot  sufficiently  extol.  .  .  .  In  the  Meath  hospital  we  employ  the  tartar  emetic 
in  accordance  with  Laennec's  prescription,  though  from  a  different  point  of  view. 
This  remedy  also  does  the  best  service  when  we  hear  most  plainty  the  crepitant  rales, 
and  before  complete  consolidation  has  occurred."  The  last  statement  is  manifestly 
a  theoretical  deduction  from  the  physical  signs,  an  error  not  often  observed  in 
Stokes,  who  still  employs,  however,  Brown's  sthenia  and  asthenia  etc. —  Other  workg. 
58 


—  914  — 

by  this  author  are  an  "  Introduction  to  the  use  of  the  stethoscope"  etc.,  Edinburgh, 
1825,  "A  treatise  on  diseases  of  the  heart  and  the  aorta",  London,  1853,  "Lectures 
on  the  theory  and  practice  of  physic"  (first  published  in  book  form  at  Philadelphia, 
1837),  etc. 

A  colleague  and  friend  of  Stokes,  who  evidently  stood  largel}-  under 
French  influences,  though  also  familiar  with  German  medical  literature, 
was  the  other  chief  of  the  Dublin  School,  the  talented 

Robert  James  Graves  (1797-1853),  professor  of  the  Institutes  of 
Medicine  in  King's  and  Queen's  College,  Dublin. 

In  conjunction  with  Stokes  he  published  in  1827  "Clinical  reports 
of  the  medical  cases  in  the  Meath  Hospital  and  County  of  Dublin  In- 
firmary'', institutions  rendered  famous  by  the  labors  of  these  physicians, 
and,  on  his  own  account,  some  clinical  lectures,  "A  S}'stem  of  clinical 
medicine",  Dublin,  1843  etc.  In  physical  diagnosis  he  devoted  attention 
particularly  to  observations  in  the  department  of  the  circulation,  the 
pulse  etc.,  and  in  therapeutics  was  a  great  friend  of  calomel  in  large 
doses  in  inflammations.  In  the  treatment  of  fever  he  was  the  first  (?)  to 
oppose  the  "absolute  diet"  of  the  earlier  physicians,  and  requested  as  his 
sole  epitaph  the  simple  words  "  He  fed  fevers".  A  statue  of  Graves  was 
erected  in  Dublin  in  1878.  Other  prominent  associates  of  the  Dublin 
School  were  : 

Sir  Dominic  John  Corrigan  (1802-1880),  physician-in-ordinary  to  the  Queen  in 
Ireland,  author  of  "  Lectures  on  the  nature  and  treatment  of  fever"  (Dublin,  1853), 
and  numerous  articles  upon  diseases  of  the  heart;  John  Houston  (1802-1845)  of 
Dublin;  James  William  Cusack  (1787-1861),  an  eminent  surgeon;  Ch.  Benson; 
O'Brien  Bellingham  (1805-1857),  author  of"  Observations  on  aneurism  and  its  treat- 
ment by  compression",  London,  1847,  and  a  "Treatise  on  diseases  of  the  heart",  Dublin, 
1853;  Sir  Henry  Marsh  (1790-1860);  Blackley;  Richard  Carmichael  (1779-1849)  an 
eminent  author  on  venereal  disease  and  an  antimercurialist  [who,  in  conjunction  with 
R.  Adams  and  MacDowell,  founded  in  1826  the  so-called  Carmichael  School  of  Medicine 
and  Surgery];  the  members -of  the  so-called  Dublin  Committee  (Macartney,  Mac- 
Donnell,  Kennedy  etc.),  chosen  in  1835  for  the  purpose  of  investigating  the  cause  of 
the  sounds  of  the  heart.  This  committee  was  formed  as  the  result  of  the  teachings 
of  C.  J.  B.  Williams,  based  upon  experiments  made  by  himself  in  conjunction  with 
Hope,  H.  Johnston  and  Malton,  and  its  conclusions  were  followed  in  most  respects 
by  the  so-called  London  Committee  of  August  1835.  The  latter  consisted  of  Williams, 
R.  B.  Todd  M.  D.,  professor  of  physiology  and  general  anatomy  in  the  Royal  College 
of  London  (and  with  Tweedy,  Murchison,  Gairdner  and  others  the  originator  of  the 
alcoholic  treatment  of  febrile  diseases),  and  J.  Clendinning  M.  D.,  member  of  the 
Royal  Medical  and  Surgical  Societj7  of  London,  and  physician  to  the  Marylebone 
Hospital.  These  committees  also  afford  evidence  of  the  scientific  accuracy  and 
conscientiousness  of  English  medicine,  as  well  as  of  its  genuine  physiological 
tendency  at  a  relatively  early  period. 

After  the  forties  the  prominent  influence  of  the  French  views,  and  the 
original  enthusiasm  existing  as  well  in  Dublin  as  elsewhere  with  regard  to 
them,  abated  more  and  more.  The  medicine  of  Great  Britain,  having 
assimilated  the  new  science,  resumed  once  more  its  wonted  practical  and 
national  course.     It  preserved,   however,   and  cultivated  in  its  own  wa}T 


—  915  — 

whatever  was  good  and  useful  —  a  way  hostile  to  every  eccentricity  and 
to  all  schools,  though  from  the  peculiar  character  of  English  institutions 
of  learning  we  might  expect  the  reverse.  The  individual  teacher  in  Eng- 
land, however,  maintains  no  exclusive  following,  for  outside  of  his  official 
position  he  stands  on  a  complete  equality  with  all  other  physicians,  and 
practitioners  (not  simple  teachers  almost  exclusively,  as  in  France  and 
Germany)  are,  likewise,  the  chief  writers  upon  their  practical  science.  But 
on  this  very  account  English  medicine  has  attained  merely  a  "certain" 
exactness  (Wunderlich). 

Many  notable  English  physicians  might  be  mentioned,  but  we  must  be  satisfied 
■with  noticing  the  following:  Sir  Henry  Halford  (properly  Vaughan,  1766-1844), 
•ordinary  physician  of  George  III.,  George  IV.,  William  IV.  and  queen  Victoria; 
S.  Scott  Alison  (1813-1877),  inventor  of  a  "differential  stethoscope"  and  a  sphyg- 
moscope,  and  author  of  "  Observations  on  organic  diseases  of  the  heart"  (1845); 
Walter  H.  Walshe  (Physical  diagnosis  of  diseases  of  the  lungs,  1843;  Practical 
treatise  on  diseases  of  the  heart,  4th  edition  1873,  etc.);  Francis  Sibson  (died  1876), 
inventor  of  a  "  thoracometer  "  and  author  of  a  treatise  "On  the  position  of  the 
internal  organs  in  health  and  disease"  (1844),  with  numerous  other  journalistic 
articles;  John  Hutchinson  (1811-1861)  inventor  of  the  spirometer,  and  author  of  "The 
spirometer,  the  stethoscope  and  scale  balance  .  .  .  their  value  in  life  insurance 
offices"  etc.  (London,  1852);  Sharpe  (physical  diagnosis);  Richard  Quain  (stetho- 
meter).  The  seven  physicians  already  mentioned  enriched  physical  diagnosis  and 
invented  new  methods  in  this  art.  The  following  practical  writers  distinguished 
themselves  in  important  subjects  in  pathology;  George  Budd  (1807-1882),  whose 
treatises  "On  diseases  of  the  liver"  (1845)  and  "On  the  organic  diseases  and  func- 
tional disorders  of  the  stomach"  (1855)  are  so  well  known;  Charles  R.  Pemberton ' 
(A  practical  treatise  on  various  disorders  of  the  abdominal  viscera,  London,  1806)  ; 
William  Pulteney  Alison  (1790-1859),  professor  in  Edinburgh  (Outlines  of  physiology 
and  pathology,  1833)  ;  Charles  Turner  Thackrah  (died  1833),  author  of  "An  inquiry 
into  the  nature  and  properties  of  the  blood  "  etc.,  London,  1819  ;  Benj.  Guy  Babington 
(1794-1866),  William  Stevens  (1786-1868),  George  Owen  Rees  (1836),  Maitland  (1838), 
all  of  whom  wrote  on  the  blood  and  its  diseases;  Ritchie,  Lonsdale  (1847),  Curran 
(scrofula);  Samuel  Ashwell  (A  practical  treatise  on  parturition  etc.,  1828);  Laycock 
(Nervous  diseases  of  women);  Sir  Henry  Holland  (1788-1873),  extraordinary  phy- 
sician of  William  IV.  and  ordinary'  physician  of  queen  Victoria,  whose  "  Medical 
notes  and  reflections"  (1839)  are  so  well  known  to  the  profession;  Edward  Copeman 
(1809-1880)  of  Norwich  (apoplexy,  1848);  James  Copland  (1791-1870)  of  London 
(On  the  causes,  nature  and  treatment  of  palsy  and  apoplexy,  1850;  A  dictionary  of 
practical  medicine,  1832-1858);  S.  Lane  (diseases  of  the  liver  and  uterus);  Sir 
William  Jenner,  ordinary  physician  of  the  Queen  and  Prince  of  Wales  (On  the  iden- 
tity or  non-identity  of  typhoid,  the  specific  cause  of  typhus,  and  relapsing  fevers, 
1850) ;  Robertson  (Contributions  to  the  historj-  and  treatment  of  sexual  diseases, 
1845);  Joseph  Henry  Bennet  (Diseases  of  the  uterus.  1849);  John  Hughes  Bennett 
(1812-1875),  professor  of  medicine  in  Edinburgh,  who  introduced  the  study  of 
histology  and  clinical  instruction  in  accordance  with  the  German  system,  and  was 
the  first  physician  of  England  to  recommend  cod-liver  oil  in  tuberculosis  (1841) ; 
"Clinical  lectures  on  the  principles  and  practice  of  medicine",  1852;  "Pathology 
and  treatment  of  pulmonary  tuberculosis",  1853.  Bennet  also  claimed  to  have  been 
the  discoverer  of  leucocythaemia  (before  Virchow),  on  which  subject  he  published  an 
article  in  1850.     Alfred  Swayne  Taylor  (1806-1880)  who  inaugurated  forensic  medi- 


—  916  — 

cine  in  England  (Elements  of  medical  jurisprudence,  1836);  Mark li am  (Diseases  of 
the  heart,  1856);  Archibald  Billing  (1791-1881;  First  principles  of  medicine; 
Diseases  of  the  heart  and  lungs,  1852)  ;  J.  W.  F.  Blundell  (Medicina  mechanica  etc., 
1852);  W.  F.  Chambers  (1786-1855) ;  J.  Banks  of  Dublin;  William  Tennant  Gard- 
ner of  Glasgow;  Mac  Gregor;  Joseph  Hodgson  (1788-1869)  of  Birmingham  (Essay 
on  diseases  of  the  arteries  and  veins,  1811) ;  Thomas  Hodgkin  (1797-1866)  of  London, 
discoverer  of  "  Hodgkin's  disease"  in  1832;  Thomas  Addison  (1793-1860)  of  Guy's 
Hospital  (On  the  constitutional  and  local  effects  of  disease  of  the  supra-renal  capsules,. 
1855);  William  Prout  (1785-1850)  of  London  (Diseases  of  the  kidneys,  1843;  proved 
that  the  acid  in  the  stomach  was  hydrochloric  acid  in  1824);  Redfern;  James 
Wardrop  (1782-1869) ;  Dr.  H.  Mac  Cormac  (On  the  nature,  treatment  and  prevention 
of  consumption  etc.) ;  Greenhill,  also  a  savant;  Thomas  Bevill  Peacock  (1812-1882), 
who  wrote  on  the  heart  and  its  diseases,  1865;  Norman  Chevers  (valvular  diseases, 
1851);  Andrew  Buchanan  in  Glasgow;  John  Bostock  (1773-1846)  of  London  (hay 
fever);  Edward  Ballard  of  London  (Physical  diagnosis  of  diseases  of  the  abdomen, 
1852);  the  famous  Thomas  Young  (1773-1829),  physician,  physicist,  physiologist  and 
philosopher  as  well,  who  gave  the  first  description  of  astigmatism;  Henry  Marshall 
Hughes  (1805-1858),  author  of  "Clinical  introduction  to  the  practice  of  auscultation, 
and  other  modes  of  physical  diagnosis",  1845;  Sir  James  Paget  (born  1814), 
Sergeant-Surgeon  to  the  Queen,  author  of  "Lectures  on  surgical  pathology"  etc., 
1863;  H.  Jones  and  Sir  Edward  Henry  Sieveking,  authors  of  the  famous  "Manual  of 
pathological  anatomy",  1854;  Samuel  Wilkes  (Lectures  on  pathological  anatomy, 
1859);  William  George  Balfour  (Diseases  of  the  heart  and  aorta,  1876)  ;  William 
Henry  Broadbent,  physician  to  St.  Mary's  Hospital  in  London;  Sidney  Ringer, 
(Manual  of  therapeutics)  ;  Charles  Murchison  (1830-1879),  phj^sician  to  St.  Thomas's 
Hospital  in  London,  a  famous  epidemiologist;  William  Benj.  Carpenter  (1812-1885) 
in  London,  well-known  as  a  physiologist  and  nervous  pathologist ;  the  late  Nestor  of 
English  physicians,  Sir  Thomas  Watson  (1792-1882),  whose  "Principles  and  practice 
of  phj'sic"  (1843),  remarkable  for  both  its  elegance  of  style  and  the  soundness  of  its 
teachings,  continued  a  most  popular  text-book  in  England  and  the  United  States  for 
nearly  30  j'ears  ;   and  numerous  others. 

Iii  microscopic  anatomy  the  quiet  and  persevering  English  accom- 
plished more  than  the  French,  and  in  this  department,  as  in  a  portion  of 
physiology,  they  can  point  to  some  important  names.     We  mention  : 

Sir  Everard  Home  (1763-1832;  On  the  cells  of  the  lungs,  1827,  etc.);  F.  Kiernan. 
(The  anatomy  and  physiology  of  the  liver,  1833);  Sir  David  Brewster  (1781-1868; 
On  the  microscope,  1837;  stereoscope,  kaleidoscope) ;  R.  B.  Todd  and  W.  Bowman 
(Physiological  anatomy  and  physiology  of  men,  1845-57) ;  Richard  Quain  and  William 
Sharpey  (1802-1880),  the  latter  professor  of  physiology  and  anatomy  in  University 
College,  a  pupil  and  friend  of  Rudolphi,  and  an  eminent  teacher  often  styled  the 
"English  Joh.  Midler"  (Elements  of  anatomy,  1843-46);  Sharpey' s  successor, 
H.  Charlton  Bastian  (The  brain  as  an  organ  oi  the  mind  etc.,  1882);  Arthur  Hill 
Hassall  (born  1817;  Microscopic  anatomy  of  the  human  body  in  health  and  disease, 
1846);  John  Goodsir  (1814-1867),  professor  of  anatomy  in  Edinburgh,  and  Henry 
D.  S.  Goodsir  (Anatomical  and  pathological  observations,  1S45);  G.  Rainey  (On  the 
finer  structure  of  the  lungs  and  the  formation  of  pulmonary  tubercle);  Robert  Lee 
(1793-1877),  author  of  "Memoirs  on  the  ganglia  and  nerves  of  the  uterus",  1849; 
Sir  W.  J.  Erasmus  Wilson  (On  the  structure  of  the  skin,  1849);  Thomas  Wharton 
Jones  (born  1808  ;  The  organ  of  hearing,  1838);  George  Harley  (born  1829  ;  Anatomy 
and  physiology  of  the  supra-renal  bodies,  1861  ;  Histological  demonstrations,  1866);. 
[John   Quekett  (1815-1861;    Lectures  on   histology,  1850-52);    Lionel  Smith   Beal 


—  917  — 

(born  1828),  professor  of  the  principles  and  practice  of  medicine  in  King's  College 
(On  the  structure  of  simple  tissues  of  the  human  bodj-,  1861 ;  The  microscope  in  its 
application  to  practical  medicine),,  and  many  others.] 

Ophthalmology  in  England  too  has  always  been  chiefly  in  the  hands 
of  surgeons. 

Among  the  students  of  the  physiology  of  the  eye  we  should  name  here,  among 
others,  the  famous  physicist,  originally  an  apothecary,  Sir  David  Brewster  (1781- 
1868),  at  whose  suggestion,  and  after  the  model  of  the  German  "  Naturforscherver- 
sammlung  ",  the  "  British  Association  for  the  Advancement  of  Science"  was  organized 
in  the  year  1831;  also  William  Hyde  Wollaston  Sr.  (1766-1828;  camera  lucida, 
""Wollaston  doublet"  etc.).  Among  the  distinguished  operative  oculists  of  England 
were  and  are:  Frederick  Tyrrell  (1797-1843) ;  James  Wardrop  (1782-1869) ;  William 
Mackenzie  (1791-1868)  in  Glasgow,  the  first  to  describe  sympathetic  troubles  of  the 
eyes;  Arthur  Jacob  (1790-1874),  an  eminent  anatomist  and  ophthalmologist  of  Dub- 
lin (membrana  Jacobi) ;  Charles  Gardiner  Guthrie  (1817-1859) ;  Sir  William  R.  W. 
Wilde  (1815-1876)  of  Dublin,  likewise  an  aurist;  John  Vetch  (1783-1835),  physician 
to  the  General  Ophthalmological  Hospital  in  London  from  the  year  1817  onward,  who 
described  Egyptian  ophthalmia,  to  which  the  Danish  physician  Bendz  subsequently 
gave  the  name  trachoma;  John  Henry  Wishart  (born  1791),  professor  of  ophthal- 
mology in  Edinburgh;  Benjamin  Gibson  (1774-1812)  of  Manchester,  who  recom- 
mended linear  extraction  of  cataract  in  1807,  and  demonstrated  the  infectious  char- 
acter of  the  vaginal  secretions  in  the  production  of  ophthalmia  neonatorum;  Sir 
William  Bowman;  Wood;  George  Critchett  (1817-1882 ;  iridodesis,  1859) ;  J.  Soel- 
berg  Wells  (1824-1879),  professor  of  ophthalmology  in  King's  College,  a  pupil  of  von 
Graefe,  and  the  introducer  into  England  of  the  ophthalmological  advances  of  Graefe, 
Donders  and  Arlt;  Thomas  Barrows;  H.  Wilson;  John  Hughlings  Jackson,  an  emi- 
nent ophthalmologist  and  neurologist,  physician  to  the  London  Hospital ;  Sir  William 
Lawrence  (1783-1867),  an  eminent  surgeon  of  St.  Bartholomew's  Hospital  and 
Serjeant  Surgeon  to  the  Queen ;  Henry  E.  Juler,  assistant  surgeon  to  the  Royal 
Westminster  Ophthalmic  Hospital;  Carter  R.  Brudenell,  ophthalmic  surgeon  to 
St.  George's  Hospital ;   and  others. 

The  new  era  of  this  specialty  —  one  which,  as  we  have  seen,  has  been 
practised  since  the  earliest  periods  of  histor}-  —  which  was  introduced 
by  Hehnholtz  and  von  Graefe,  has  found  a  memorable  international  repre- 
sentative in  Richard  Liebreich,  who  settled  in  Paris  but  removed  to  Lon- 
don in  1870,  where  he  was  appointed  ophthalmic  surgeon  to  St.  Thomas's 
Hospital.  Recently  he  has  resigned  this  position  and  has  been  succeeded 
by  Edward  Nettleship,  though  Liebreich  still  retains  the  position  of  con- 
sulting ophthalmic  surgeon. 

In  addition  to  Archibald  Cleland  (1741)  and  Jonathan  Wathen  (1755), 
both  of  whom  practised  injection  of  the  Eustachian  tube  by  means  of  a 
catheter  introduced  through  the  nose,  the  science  of  Otology  is  represented 
in  England  by  : 

John  C.  Saunders  (The  anatomy  and  diseases  of  the  ear,  1806);  Sir  John  H. 
Curtis,  aurist  to  king  George  III.,  and  founder  in  1816  of  the  first  aural  hospital  in 
London;  Thomas  Buchanan  of  Hull,  an  eminent  oculist  and  aurist  (1823);  Joseph 
Williams  of  London  (On  the  anatomy,  physiology  and  pathology  of  the  ear  (1839); 
the  famous  ophthalmologist  Thos.  Wharton  Jones  (1838);  William  Dufton  of  Birm- 
ingham (The  nature  and  treatment  of  deafness  and  diseases  of  the  ear,  1844) ;   Hugh 


—  918  — 

Neill  of  Liverpool,  where  he  established  an  Ear  Infirmary  in  1839;  George  Pilcher 
of  London  (1838)  ;  Adam  Warden  of  Edinburgh,  inventor  of  an  "auriscope"  described 
in  1844  ;  James  Yearsley  of  London,  who  described  the  use  of  an  artificial  membrana 
tympani  in  1848;  Sir  William  R.  W.  Wilde,  an  eminent  physician  and  savant  of 
Dublin  (Practical  observations  on  aural  surgery  etc.,  London,  1853)  ;  the  famous 
Joseph  Toynbee  (1815-1866)  of  London,  also  inventor  of  an  artificial  drum-membrane, 
who  fell  a  victim  to  his  own  zeal  in  experimentation  (Diseases  of  the  ear  etc.,  London, 
1860);  Peter  Allen  (1826-1874),  aural  surgeon  to  St.  Mary's  Hospital  in  London 
(Lectures  on  aural  catarrh,  1871)  ;  James  Hinton,  the  assistant  and  friend  of  Toyn- 
bee (Atlas  of  the  membrana  tympani  etc.,  London,  1874);  Llewellyn  M.  Thomas  of 
London,  surgeon  to  the  Central  London  Throat  and  Ear  Hospital;  H.  Macnaughton 
Jones  (Atlas  of  diseases  of  the  membrana  tympani  and  auricle,  London,  1878); 
Peter  Mac  Bride  of  Edinburgh;  Urban  Pritchard,  professor  of  otology  in  King's 
College  Hospital,  and  the  first  professor  (1866)  of  this  specialty  in  England  ;  Edward 
Woakes,  aural  surgeon  to  the  London  Hospital ;  W.  B.  Dalby,  aural  surgeon  to  St« 
George'.s  Hospital  etc. 

The  department  of  Electro-therapeutics,  in  which  the  sober  English 
display  much  less  enthusiasm  than  the  French  and  Germans,  can  point  as 
its  representatives  to  : 

John  Birch,  surgeon  of  St.  Thomas's  Hospital,  who  wrote  as  early  as  1779  a 
treatise  entitled  "  Considerations  of  the  efficacy  of  electricity  in  removing  female 
obstructions"  etc.  He  was  followed  bj-  Joseph  C.  Carpue  (1764-1846)  of  London, 
best  known  probably  for  his  rhinoplastic  operations  according  to  the  Indian  method, 
performed  as  early  as  1814,  but  the  author  also  of  "An  introduction  to  electricity  and 
galvanism  "  etc.,  published  in  1803;  Alfred  Smee  (1818-1878),  surgeon  to  the  Central 
London  Ophthalmic  Hospital  and  inventor  (1840)  of  the  so-called  "Smee's  battery"; 
and  the  coryphau  of  the  most  recent  system;  A.  Hughes  Bennett  (Electricity  as  a 
method  of  physical  diagnosis  in  diseases  of  the  nervous  system,  London,  1880) ; 
Herbert  Tibbits  of  London,  physician  to  the  West  End  Hospital  for  Nervous  Diseases, 
and  with  Dr.  Stretch  Dowse  the  founder  of  the  first  school  of  electricity  and  massage 
in  England;  Armand  de  Watteville  of  London,  editor  of  the  journal  "  Brain  ",  and 
Julius  Althaus,  Senior  Physician  to  the  Hospital  for  Epilepsj-  and  Paralysis.  The 
latter  two  physicians  are,  however,  foreigners,  the  former  a  Swiss  and  the  latter  a 
German. 

The  specialty  of  Diseases  of  the  Throat,  Larynx  etc.  is  represented  by 
Benj.  Guy  Babington  (1794-1866),  an  extremely  erudite  and  versatile  physician 
of  Guy's  Hospital,  who  in  1829  invented  an  imperfect  laryngoscope ;  John  Bishop 
(1797-1873),  who  wrote  upon  the  physiology  of  the  voice  (1836)  and  laryngoscopy 
(1862);  Sir  Edward  H.  Sieveking  (The  laryngoscope,  1862);  Thos.  James  Walker, 
surgeon  to  the  Peterborough  Infirmary  and  Dispensary  (The  laryngoscope  and  its 
clinical  applications,  1863);  Philip  Crafton  Smyly  of  Dublin  (Course  of  lectures  on 
the  use  of  the  laryngoscope,  1864)  ;  Sir  Geo.  Duncan  Gibb  (1821-1876)  of  London 
(Diseases  of  the  throat,  epiglottis  and  windpipe,  1860);  George  Johnson,  Professor 
of  Clinical  Medicine  in  King's  College  Hospital  (The  laryngoscope  etc..  1864) ; 
Ebenezer  Watson  (died  1886);  and  more  recently  by  Lennox  Browne  (The  throat 
and  its  diseases,  London,  1878);  Geo.  Vivian  Poore  ;  W.  Gordon  Holmes  of  London 
(Guide  to  the  use  of  the  laryngoscope  in  general  practice,  1881) ;  M.  Prosser  James, 
Physician  to  the  Hospital  for  Diseases  of  the  Throat  (Lessons  in  laryngoscop.y  and 
rhinoscopj',  1878);  Felix  Semon,  a  German  physician  of  London,  who  translated  the 
work  of  James,  and  finally  Morell  Mackenzie,  founder  in  1863  of  the  Hospital  for 
Diseases  of  the  Throat  in  London  (Diseases  of  the  throat  and  nose,  1880-1884),  who, 


—  919  — 

in  order  to  open  the  way  to  ambition,  undertook  the  unenviable  role  (declined  by  all 
the  German  physicians)  of  denying  the  cancerous  nature  of  the  disease  of  the  late 
emperor  Frederick,  and  even  cynically  and  openly  admitted  the  fact,  when,  with  a 
fee  of  250.000  marks  in  his  pocket,  he  had  turned  his  back  upon  Germany. 

The  Diseases  of  Children,  always  a  favorite  branch  with  English  phy- 
sicians, can  point  with  pride  to  a  long  line  of  eminent  and  successful 
students  and  writers,  among  whom  we  may  enumerate  : 

William  Nisbet  (1759-1822)  of  Edinburgh,  author  of  "  The  clinical  guide;  or  a 
concise  view  .  .  '  .  of  the  diseases  of  infancy  and  childhood,  London,  1800;  the 
famous  John  Cheyne  (1777-183G)  of  Edinburgh  and  Dublin  (Essays  on  the  diseases 
of  children,  1801);  John  Clarke  Jr.  (1815)  of  London;  James  Kennedy  of  Glasgow 
(1825)  ;  John  North  (1790-1873),  professor  of  midwifery  in  the  Middlesex  Hospital 
(Practical  observations  on  the  convulsions  of  infants,  1826);  Henry  Maunsell,  (1806— 
1879)  and  Richard  T.  Evanson  of  Dublin  (A  practical  treatise  on  the  management 
and  diseases  of  children,  18,56);  Charles  Johnson  (1794-1866)  of  Dublin,  who,  with. 
Sir  Henry  Marsh,  founded  the  Children's  Hospital  in  Pitt  St.,  and  in  conjunction 
with  David  H.  Mac  Adams  published  "A  treatise  on  the  diseases  of  children", 
London,  1836;  Charles  West  of  London  (Lectures  on  the  diseases  of  infancj'  and 
childhood,  18-48)  ;  the  eminent  Dublin  obstetrician,  Fleetwood  Churchill  (1808-1878), 
whose  treatise  on  "  The  diseases  of  children ",  Dublin  1850,  long  maintained  a 
deserved  popularity;  Pye  Henry.  Chavasse  (1810-1879)  of  Birmingham;  William  H. 
Daj"  of  London  ;  Edward  Ellis,  Phj-sician  to  the  Samaritan  and  Victoria  Children's 
Hospital  (Practical  manual  of  the  diseases  of  children,  London,  1881 ) ;  Edmund 
Owen  of  London  (The  surgical  diseases  of  children,  1885)  ;  Thomas  Hawkes  Tanner 
(1824-1871  ;   A  practical  treatise  on  the  diseases  of  infancy  and  childhood)  etc. 

The  department  of  Diseases  of  the  Skin  finds  numerous  representa- 
tives, among  whom  we  may  mention  : 

Robert  Willan  (1757-1812),  whose  well-known  "  Description  and  treatment  of 
cutaneous  diseases"  appeared  at  London  1698-1807;  Thomas  Bateman  (1778-1821), 
author  of  "  A  practical  synopsis  of  cutaneous  diseases  "  etc.,  London,  1813  ;  Walter 
C.  Dendj'  of  London,  Surgeon  to  the  Children's  Hospital  (Treatise  on  the  cutaneous 
diseases  incident  to  childhood,  1827)  ;  Samuel  Plumbe  (A  practical  treatise  on  the 
diseases  of  the  skin,  1837);  Jonathan  Green  (Practical  compendium  of  the  diseases 
of  the  skin,  with  cases,  London,  1835)  ;  Anthony  Todd  Thomson  (1778-1849),  author 
of  "Communications  on  diseases  of  the  skin,  London,  1839);  John  Moore  Neligan 
(1815-1863)  of  Dublin,  whose  "  Practical  treatise  on  the  diseases  of  the  skin  " 
appeared  in  1852  ;  Sir  W.  J.  Erasmus  Wilson  (1809-1884),  professor  in  the  College  of 
Surgeons  until  1878,  founder  of  the  chair  of  dermatology  in  this  College  and  of  the 
Museum  of  Dermatolog,y,  founder  also  of  the  chair  of  pathology  in  the  Universitj-  of 
Aberdeen,  a  famous  Eg}-ptologist,  who  removed  Cleopatra's  Needle  to  England  at 
his  own  expense  (Diseases  of  the  skin,  1842,  with  numerous  other  contributions  to- 
dermatology)  ;  William  Frazer  of  Dublin  (Treatment  of  diseases  of  the  skin  "  1864)  ; 
John  L.  Milton  of  London  (The  modern  treatment  of  diseases  of  the  skin)  ;  Tilbury 
Fox  (1836-1879),  author  of  "A  treatise  on  skin  diseases  ",  1864  ;  Thomas  Hillier 
(Handbook  of  Skin  Diseases,  1866)  ;  McCall  Anderson  of  Glasgow  (Contributions  to 
dermatology,  1866);  Henry  Radcliffe  Crocker,  the  successor  of  Tilbury  Fox  in 
University  College,  London  ;  Robert  Liveing,  lecturer  on  dermatology  in  the  Middle- 
sex Hospital ;  Malcolm  Morris,  Lecturer  on  Dermatology  in  St.  Mary's  Hospital 
Medical  School  (Skin  diseases);  Austin  Meldon  of  Dublin  (A  treatise  on  diseases  of 
the  skin  and  its  appendages,  1873);   C.  Hilton  Fagge  (1838-1883)  of  Guy's  Hospital, 


—  920  — 

the  translator  of  Hebra's  treatise;  Alfred  gangster  of  Charing  Cross  Hospital;  James 
Startin;  A.  J.  Balmanno  Squire,  Surgeon  to  the  British  Hospital  for  Diseases  of  the 
Skin,  etc.,  etc. 

In  the  department  of  Alienistic  Medicine  Henry  Maudsley  (born  in 
1835  ;  The  physiology  and  pathology  of  the  mind,  1867),  professor  of 
forensic  medicine  in  the  London  University,  is  specially  well-known  in 
Germany. 

[Other  important  writers  upon  this  branch  are  :  Thomas  Arnold  (Observations  on 
the  nature,  kinds,  causes  and  prevention  of  insanity,  1782-86)  ;  John  Haslam  (1764- 
1844),  author  of"  Observations  on  insanity"  etc.,  London,  1798,  with  numerous  other 
treatises  ;  Sir  Alexander  Crichton  (1763-1856)  of  London  (An  inquiry  into  the  nature 
and  origin  of  mental  derangement,  1798)  ;  Bryan  Crowther  (1765-1840),  surgeon  to  the 
Bridewell  and  Bethlehem  Hospital  (Practical  remarks  on  insanity-,  1807)  ;  Geo.  M. 
Burrows  (1771-1846),  the  proprietor  of  a  private  asylum  at  Clapham  (Commentaries 
on  the  causes,  forms,  symptoms  and  treatment,  moral  and  medical,  of  insanity,  1828)  ; 
Sir  William  Chas.  Ellis  (On  the  nature,  causes  and  treatment  of  insanit}',  London, 
1838);  Thomas  Mayo  (1790-1871),  author  of  ''  Medical  testimony  and  evidence  in 
cases  of  lunacy",  1854;  John  Conolly  (1796-1866),  physician  to  an  insane  asylum  at 
Hanwell  near  London,  and  the  first  alienist  in  England  to  popularize  the  "No 
restraint  system  ".  In  1856  he  reported  that  in  24  English  asylums,  containing  more 
than  10,000  patients,  mechanical  restraint  was  substantially  done  away  with.  James 
Cowles  Pritchard  (1785-1848),  an  eminent  anthropologist  (A  treatise  on  insanity  etc. 
1835)  ;  John  Pagan  (1802-1868),  author  of  "The  medical  jurisprudence  of  insanity", 
(1840)  ;  Forbes  Winslow  (On  obscure  diseases  of  the  brain  and  disorders  of  the  mind, 
London,  1860) ;  John  Charles  Bucknill  (Prize  essay  on  criminal  lunacy)  and  Daniel 
Hack  Tuke  (son  of  Samuel  Tuke,  founder  of  the  York  Retreat  for  the  Insane  in 
1792),  who  published  in  conjunction  "A  manual  of  psychological  medicine"  in  1858. 
The  latter  alienist  also  published  in  1882  "  Chapters  in  the  history  of  the  insane  in 
the  British  Isles".  Robert  Boyd  (1808-1883),  who  perished  in  the  burning  of  his 
own  private  asylum  at  Southall  Park  in  Middlesex  (General  paralyses  of  the  insane, 
1871);  David  Skae  (1814-1873),  physician  to  the  Morningside  Asylum  near  Edin- 
burgh (On  the  legal  relations  of  insanity,  1861);  William  L.  Lindsey  of  Perth 
(Theory  and  practice  of  non  restraint  etc.,  1878);  G.  Fielding  Blandford  (On 
insanity  and  its  treatment);  Thomas  S.  Clouston,  Lecturer  on  Mental  Diseases  in 
the  University  of  Edinburgh  (Clinical  Lectures  on  Mental  Diseases)  etc.] 

Although  various  themes  in  the  department  of  Hygiene  were  discussed 
by  individual  physicians  in  the  first  third  of  the  present  centuiy,  e.  g. 
Sir  Lucas  Pepys  (1742-1830),  President  of  the  Army  Medical  Board,  Sir 
John  Sinclair  (1754-1835),  the  eminent  Scotch  statistician,  Charles  Mac- 
lean  (epidemic  diseases,   quarantine  etc.,  1815),  Charles  Turner  Thackrah 

(died  1833)  of  Leeds  (The  effects  of  the  principal  arts,  trades  etc 

on  health  and  longevity,  London,  1831),  Henry  Belinaye  (1832),  a  surgeon 
of  London,  Francis  Bisset  Hawkins  (Elements  of  medical  police  etc., 
London,  1834),  it  was  not  until  the  advent  of  the  cholera  in  1831  and  the 
earnest  labors  of  Sir  Edwin  Chadwick  (born  1799),  Dr.  William  Farr 
(1807-1883),  Dr.  Thos.  Southwood  Smith  (1788-1861),  Dr.  William 
Augustus  Guy  (1810-1885)  and  others,  that  public  attention  was  specially 
directed  to  this  branch  of  medicine.  The  report  of  the  Health  of  Towns' 
Commission    in  1844    startled   the   public   from    its    indifference  and    led 


—  921  — 

•directly  to  the  adoption  by  Parliament  of  the  Public  Health  Act  of  1848. 
~By  this  Act  a  General  Board  of  Health  was  constituted,  with  a  staff  of 
inspectors  authorized  to  inquire  into  the  sanitary  condition  of  all  towns 
whose  returns  to  the  Registrar-General  showed  an  excessive  mortality. 
The  Public  Health  Act  of  1848  was  followed  by  the  Common  Lodging 
Houses'  Act  (1851),  the  Labouring  Classes  Lodging-Houses'  Act  (1852), 
the  Metropolis  Management  Act  of  1855  and  various  others.  In  1858  the 
powers  of  the  General  Board  of  Health  were  transferred  to  the  Privy 
Council,  and  the  Local  Government  Board  Act  was  passed.  The  appoint- 
ment of  Mr.  John  Simon  (1816-1883)  as  Medical  Officer  of  the  Privy 
Council,  with  a  staff  of  medical  inspectors,  opened  a  new  era  in  the  sanitary 
science  of  England.  The  Local  Government  Board  Act  of  1871,  the  Public 
Health  Acts  of  1872  and  1875  and  various  other  Acts  have  contributed  to 
the  perfection  of  the  system  of  public  hygiene. 

Among  the  individual  representatives  of  this  branch,  without  laying 
claim  to  any  more  completeness  than  in  the  preceding  departments,  we 
may  mention  : 

The  distinguished  pioneers  James  Johnson  (1777-1845);  Sir  Robert  Christison 
(1797-1882)  of  Edinburgh  ;  E.  Symes  Thompson  ;  H.  MacCormac;  Edward  Latham  ; 
H.  Greenway;  Lionel  S.'  Beale;  John  Eric  Erichsen  (Hospitalism,  1874);  R.  Angus 
(.1817-1884)  and  Edward  Smith;  William  Howship  Dickinson;  F.  Chauncey  Perkins; 
Charles  Hilton  Fagge  (1838-1883),  professor  of  hygiene  in  Guy's  Hospital,  and  Dr. 
Cameron,  who  occupies  the  same  position  in  Glasgow.  The  famous  Edmund  A. 
Parkes  (1819-1876)  accepted  in  1860  the  chair  of  hygiene  in  the  Army  Medical 
School  at  Netley  (the  first  chair  of  hygiene  founded  in  England),  and  established  the 
Parkes'  Museum  of  Hygiene.  His  "Manual  of  practical  hygiene  etc."  (1864)  is  one 
of  the  best  known  treatises  in  this  department  of  medicine.  "  Nothing  is  so  dear  as 
sickness,  and  nothing  so  profitable  as  expenditures  which  increase  health,  and  thus 
the  power  to  work"  runs  his  genuine  English  maxim.  To  these  we  may  add  Dr.  Geo. 
Buchanan  (On  the  relation  of  phthisis  to  soil  moisture);  Dr.  George  Wilson  (A  hand- 
book of  hygiene  and  sanitary  science,  1872)  ;  Edward  Cator  Seaton  (1815-1880),  to 
whose  exertions  England  owes  the  Compulsory  Vaccination  Act  of  1853  (Handbook 
•of  vaccination,  1868) ;  Joseph  Snow  (1813-1858;  Report  on  cholera,  1849);  Edward 
H.  Greenhow;  Edward  Ballard;  John  Netten  Radcliffe  (1830-1884);  Sir  Charles 
Alex.  Cameron,  Chief  of  the  Public  Health  Department  of  Dublin  (Manual  of  hygiene 
•etc.);  Richard  Thorne;  Ed.  A.  Mapother  of  Dublin;  H.  Letheby,  Medical  Officer 
•of  Health  for  London  etc. 

As  representatives  of  the  Pathologia  animata  or  Germ  Theory  of 
disease  we  may  mention  John  Burdon  Sanderson,  professor  of  ph\-siology 
in  Oxford,  who  regards  contagia  as  organized  beings,  which  produce  dis- 
ease by  their  development  ;  Lionel  S.  Beale,  who  considers  the  contagia 
to  be  living  particles  of  an  organism  (bioplasts),  which  plant  themselves 
•upon  another  organism  and  multiply  within  the  latter  ;  Sir  Joseph  Lister 
(The  germ  theory  of  fermentation  and  its  bearings  on  pathology  1878), 
founder  of  the  well-known  system  of  "Listerism";  and  Alexander  Ogston, 
Begins  Professor  of  Surgery  in  the  University  of  Aberdeen  (Report  upon 
micro-organisms  in  surgical    diseases,    1881).     Among  the  opponents  of 


_  922  

this  theory  are  Henry  Charlton  Bastian,  professor  of  pathological  anatomy 
in  University  College  (The  modes  of  origin  of  the  lowest  organisms, 
1S71  ;  The  beginnings  of  life,  1872)  ;  Benjamin  Ward  Richardson  of 
London  (Hygiea:  a  city  of  health,  1875);  Joseph  Snow  (1813-1858)  of 
London,  and  others. 

The  department  of  Diseases  of  the  Nervous  System  was  cultivated  in 
the  first  half  of  the  century  by: 

Samuel  Fothergill  (tic  douloureux,  1804),  the  eminent  John  Abercrombie  ( 1781— 
1844)  of  Edinburgh,  John  Cheyne  of  Dublin  (acute  hydrocephalus,.  1808),  James 
Parkinson  (Essay  on  the  shaking  palsy,  1817),  Herbert  Mayo  (died  1852),  David 
Urwins  (1780-1837)  of  London,  the  brothers  William  and  Daniel  Griffin  of  Limerick 
(spinal  irritation,  1834),  and  numerous  others,  while  the  latter  half  of  the  century  can 
point  to  the  eminent  neurologists  :  Thomas  Buzzard,  J.  Spence  Ramskill,  Chas.  Bland 
Radcliffe,  J.  Hughlings  Jackson,  H.  Charlton  Bastian,  William  Henry  Broadbent, 
Francis  Edmund  Anstie.  James  Warburton  Begbie  (1826-1876),  J.  Russell  Reynolds, 
Julius  Althaus,  and  a  host  of  others. 

Finally  the  specialty  of  Venereal  Disease  has  been  well  cultivated  b}T 
Langston  Parker  (1805-1871)  of  Birmingham,  author  of  "A  manual  of  the 
modern  treatment  of  syphilitic  disease",  London,  1839  ;  William  Acton 
(1813-1875),  a  pupil  of  Ricord  (A  complete  practical  treatise  on  venereal 
diseases  etc.,  1841);  Richard  Carmichael  (1779-1849)  of  Dublin  (An  essay 
on  the  venereal  diseases  which  have  been  confounded  with  syphilis  etc., 
Dublin,  1814);  William  Wallace  of  Dublin  (died  1838),  the  first  in  1836 
to  introduce  the  use  of  iodide  of  potassium  in  syphilis  into  general  recog- 
nition by  the  profession  ;  Henry  Lee,  Consulting  Surgeon  to  St.  George's 
Hospital  (Calomel  fumigation  in  the  treatment  of  syphilis,  1856);  John 
Laws  Milton  ;  Frederic  Carpenter  Skey  (1798-1872),  author  of  "A  prac- 
tical treatise  on  the  venereal  disease",  London,  1841  ;  Jonathan  Hutchin- 
son (Clinical  memoir  on  certain  diseases  of  the  eye  and  ear  consequent  on 
inherited  syphilis,  1862,  etc.);  Berkeley  Hill,  Surgeon  to  the  Lock  Hospital 
(Syphilis  and  local  contagious  disorders,  1868);  Sir  Henry  Thompson 
(The  pathology  and  treatment  of  stricture  of  the  urethra,  1852)  ;  with 
many  others. 

It  is  a  striking  peculiarity  of  English  medicine,  by  which  it  is 
distinguished  from  the  French,  as  well  as  the  Italian,  Spanish  and 
German,  that  while  it  cultivates  the  historical  in  particulars  and  in  its 
own  career,  it  has  lacked,  since  the  time  of  Freind,  any  writer  of  its  own 
upon  the  subject  of  general  medical  histor}-.  This  want  manifestly  origi- 
nates from  the  avoidance  of  the  appearance  of  pedantry,  so  characteristic 
of  English  physicians,  and  still  more  from  their  constant  inclination  to  the 
pecuniary  and  practical  advantages  of  their'" profession  —  a  profession 
which  they  regard  half  in  the  light  of  an  ordinary  business.  Hence  the 
history  of  medicine  seems  a  purely  literary  undertaking,  unsuited  to  the 
practical  programme  laid  out  for  physicians  and  surgeons  b}r  Sir  Astley 
Cooper  —  a  programme,  by  the  way,  which  seems  to  us  Germans  rather 
narrow-minded  in  its  conception. 


—  923  — 

[Among  the  more  important  general  physicians  of  the  United  States 
during  the  first  half  of  the  present  centur}"  were :  Caspar  Wistar  (1761- 
1818)  of  Philadelphia,  author  of  "A  system  of  anatomy"  (1812)  highly 
prized  as  a  text-book  in  its  day;  David  Hosack  (1769-1835)  of  New  York, 
a  partner  of  Dr.  Samuel  Bard  and  professor  of -Theoiy  and  Practice  in  the 
College  of  Physicians  and  Surgeons  (1813).  He  published  a  "System  of 
Nosology",  which  reached  two  editions,  and  his  "Lectures  on  Theory  and 
Practice"  were  edited  by  Dr.  Dncachet  and  published  at  Philadelphia  in 
1838  ;  John  Redman  Coxe  (1773-186-4)  of  Philadelphia,  a  student  of  Benj. 
Rush,  who  completed  his  medical  education  in  Edinburgh,  London  and 
Paris.  He  occupied  the  chair  of  Materia  Medica  and  Pharmacy  in  the 
University  of  Pennsylvania,  1818-1835,  and  published  "The  American 
Dispensatory"  (1806),  "The  Philadelphia  Medical  Dictionary"  (1808)  and 
"  The  Writings  of  Hippocrates  and  Galen"  (1846);  Nathaniel  Chapman 
(1780-1853),  a  pupil  of  Rush  and  Abernethy,  professor  of  the  Theory  and 
Practice  of  Medicine  in  the  University  of  Pennsylvania,  1816-1850,  and 
author  of  a  treatise  on  "Therapeutics  and  Materia  Medica"  (1817),  the  first 
of  its  kind  in  the  United  States,  and  the  best  at  that  period  in  the  English 
language  ;  Dr.  John  Eberle  (1788-1838),  professor  of  Theory  and  Practice 
in  the  Jefferson  School  of  Philadelphia,  1825-1831,  and  author  of  a  popular 
"Practice  of  Medicine"  (1829);  Samuel  Jackson  (1787-1872),  professor  of 
the  Institutes  of  Medicine  in  the  University  of  Pennsylvania,  1825-1863, 
who  published  in  1832  his  "Principles  of  Medicine",  in  which  he  follows 
the  pathological  doctrines  of  Broussais  ;  James  Jackson  (1777-1867)  of 
Boston,  a  graduate  of  Harvard  and  European  schools,  first  physician  to 
the  Massachusetts  General  Hospital  in  1810,  and  professor  of  Theory  and 
Practice  in  the  Massachusetts  Medical  School  (1812).  He  published  in 
1816  a  Syllabus  of  his  lectures  on  practice,  but  his  best  known  work  is 
his  "  Letters  to  a  young  physician"  (1855) :  William  Tully  (1785-1859), 
professor  of  Materia  Medica  and  Therapeutics  in  Yale  College,  1829-1841, 
and  author  of  an  elaborate  and  profound  treatise  on  "  Materia  Medica,  or 
Pharmacology  and  Therapeutics",  Springfield,  1857-58  ;  John  W.  Francis 
(1789-1861)  of  New  York,  a  partner  of  Dr.  Hosack,  professor  of  Obstetrics 
in  the  College  of  Physicians  and  Surgeons  and  in  Rutgers  Medical  College. 
1826-30;  Joseph  Mather  Smith  (1789-1866)  of  New  York,  professor  of 
Materia  Medica  in  the  College  of  Physicians  and  Surgeons,  1855-66  ;  John 
K.  Mitchell  (1793-1858)  of  Virginia,  professor  of  Practice  in  Jefferson 
Medical  College,  Philadelphia,  1841-1858,  and  author  of  a  dissertation 
"On  the  cryptogamous  origin  of  malarious  and  epidemic  fevers"  (1849), 
distinguished  for  its  ingenuit}*  and  completeness  ;  Franklin  Bache  (1792— 
1864)  of  Philadelphia,  another  pupil  of  Rush,  professor  of  Chemistiy  in 
Jefferson  Medical  College,  and  well-known  as  one  of  the  authors  of  "  The 
Dispensatory  of  the  United  States  of  America",  first  published  in  con- 
junction with  Dr.  Geo.  B.  Wood  in  1833;  Samuel  Henry  Dickson  (1798- 
1872)  of  Charleston,  S.  C,  professor  in   the  Charleston  Medical   School, 


—  924  — 

1824-31,  1833-34  and  1850-57,  and  an  eminent  journalistic  writer  and 
lecturer;  Robley  Dunglison  (1798-1869),  a  native  of  England,  educated  in 
London,  Edinburgh  and  Paris.  In  1824  he  was  invited  by  Thomas  Jeffer- 
son to  occupy  the  chair  of  Anatomy,  Ph}rsiology,  Materia  Medica  and 
Pharmacy  in  the  University  of  Virginia,  in  which  institution  he  continued 
to  teach  until  1833.  In  the  latter  year  he  accepted  several  chairs  in  the 
University  of  Maryland,  but  in  1836  removed  again  to  Philadelphia,  where 
he  occupied  the  professorship  of  the  Institutes  of  Medicine  in  the  Jeffer- 
son Medical  College,  1836-1868.  His  industry  as  a  writer  was  enormous, 
and  extended  to  almost  all  branches  of  medicine.  His  Physiology  (1832), 
Medical  Dictionary  (Boston,  1833),  Hygiene  (1835),  Therapeutics  (1836), 
Practice  (1842)  and  Materia  Medica  (1843)  were  all  popular  text-books 
in  their  day,  and  the  last  edition  (1874)  of  his  Medical  Dictionary,  edited 
by  his  son,  Richard  J.  Dunglison,  is  the  most  complete  work  of  its  kind 
in  existence.  Even  a  course  of  lectures  upon  the  history  of  medicine; 
delivered  at  the  University  of  Virginia  by  Dr.  Dunglison,  has  been  pub- 
lished by  his  son  under  the  title  "  History  of  Medicine  from  the  Earliest 
Ages  to  the  Commencement  of  the  Nineteenth  Century"  (Philadelphia, 
1872)  ;  Rene  la  Roche  (born  1795)  of  Philadelphia,  whose  treatise  on 
"  Yellow  Fever"  (1855)  is  well  known  to  all  physicians  ;  George  B.  Wood 
(1797-1879)  of  Philadelphia,  author  of  "A  treatise  on  the  practice  of  med- 
icine" (1847),  "  Therapeutics  and  Pharmacology"  (1856),  and  co-editor  of 
the  U.  S.  Dispensatory  ;  Daniel  Drake  (1785-1852),  founder  of  the  Medical 
College  of  Ohio  at  Cincinnati  in  1819,  and  author  of  the  well  known  and 
very  valuable  "Systematic  treatise  on  the  principal  diseases  of  the  in- 
terior valley  of  North  America  etc.",  1850-1854  ;  the  versatile  Nathan 
Smith  (1762-1S29),  whose  professional  energy,  unsatisfied  by  representing 
in  himself  for  twelve  years  (1798-1810)  the  entire  Faculty  of  the  Medical 
Department  of  Dartmouth  College,  led  him  to  lecture  on  medicine  also 
in  the  University  of  Vermont  and  Bowdoin  College,  and  to  accept  likewise 
a  professorship  in  the  new  medical  school  of  Yale  College  in  1813.  His 
"  Essay  on  Typhus  Fever",  published  in  1824,  recognizes  the  self-limited 
character  of  that  disease  (now  called  typhoid),  and  its  dependence  upon 
a  specific  cause.  Joseph  Parrish  (1779-1840),  surgeon  to  the  Pennsyl- 
vania Hospital,  1816-1820  ;  Jacob  Bigelow  (1787-1879)  of  Boston,  whose 
"American  Medical  Botany"  (1817-1821)  has  been  already  mentioned, 
and  who  recognized  in  his  "Discourse  on  Self-limited  Diseases"  (1835) 
the  general  law  of  self-limitation  now  known  to  exist  in  many  morbid 
processes  ;  William  Beaumont  (1785-1853),  an  arm}-  surgeon,  whose  re- 
searches in  connection  with  the  case  of  Alexis  St.  Martin  threw  much  light 
upon  the  subject  of  stomach  digestion  (The  physiolog}'  of  digestion, 
with  experiments  on  gastric  juice,  by  William  Beaumont,  M.  D.,  U.  S.  A. 
Plattsburgh,  1833)  ;  William  E.  Horner  (1793-1853)  of  Philadelphia, 
professor  of  anatonry  in  the  University  of  Pennsylvania,  author  of  various 
treatises  on  anatomy,  histology  and  pathology,  and  the  first  physician  to 


—  925  — 

demonstrate  the  true  character  of  the  "rice-water"  discharges  in  cholera  ; 
the  accomplished  brothers  Beck,  viz.  Theodoric  Romeyn  (1791-1855), 
professor  of  Materia  Medica  in  the  Albany  Medical  College,  1840-1854, 
and  author  of  a  valuable  and  extremely  popular  treatise  on  Medical 
Jurisprudence  (1823)  ;  John  B.  Beck  (1794-1851),  professor  of  Materia 
Medica  in  the  College  of  Pl^-sicians  and  Surgeons  (1826),  and  author  of 
"  Essays  on  Infant  Therapeutics"  (1849),  "  Historical  Sketch  of  the  State 
of  Medicine  in  the  American  Colonies"  (1842),  "  Lectures  on  Materia 
Medica"  (edited  by  C.  R.  Oilman,  1851)  ;  Lewis  C.  Beck  (1798-1853), 
professor  of  chemistry  and  pharmacy  in  the  Alban}-  Medical  College  (1840), 
and  author  of  a  Report  on  Cholera,  made  to  the  Governor  of  New  York  in 
1832  ;  Caspar  Wistar  Pennock  (1800-1867)  of  Philadelphia,  (Report  of 
experiments  on  the  action  of  the  heart,  1839);  John  Ware  (1795-1864)  of 
Boston,  professor  of  Theory  and  Practice  in  Harvard  College,  1832-58, 
author  of  "  Contributions  to  the  History  and  Diagnosis  of  Croup",  1842, 
etc.;  Elisha  Bartlett  (1804-1855).  professor  in  the  University  of  the  City 
of  New  York,  1850,  and  a  fertile  author,  whose  work  on  "The  history, 
diagnosis  and  treatment  of  the  fevers  of  the.  United  States"  (1847)  is  a 
standard  authority  in  its  department  ;  W.  W.  Gerhard  (1809-1872)  of 
Philadelphia,  author  of  a  "Treatise  on  the  diagnosis  of  diseases  of  the 
chest"  (1836),  and  among  the  first  physicians  to  emphasize  the  essential 
distinction  between  typhus  and  typhoid  fevers  (1837);  John  William 
Draper  (1811-1882),  a  native  of  England,  professor  of  chemistry  in  the 
University  Medical  College  of  New  York  (1841)  and  an  eminent  scientist, 
whose  "  Human  Physiology"  (1853)  was  the  first  work  in  this  country 
illustrated  by  micro-photographs  ;  Alonzo  Clark  of  New  York  (1807-1887), 
Professor  of  Physiology  and  Pathology  in  the  College  of  Physicians  and 
Surgeons,  1840-1855,  and  of  Patholog}T  and  Practical  Medicine,  1855-1884, 
the  introducer  of  the  opium  treatment  of  peritonitis  in  1840,  and  for  many 
years  the  first  consulting  practitioner  and  most  highly  esteemed  medical 
teacher  of  New  York  City,  and  numerous  others. 

Among  the  more  eminent  living  general  physicians  of  the  United 
States  it  is  sufficient  to  notice  :  Alfred  Stille  of  Philadelphia,  author 
of  numerous  valuable  treatises  on  medical  subjects ;  Nathan  Smith  Davis 
of  Chicago  ;  Henry  I.  Bowditch  of  Boston,  who  was  the  first  to  announce 
the  dependence  of  phthisis  upon  dampness  of  the  soil  (1862)  ;  William 
H.  Thompson,  Alfred  L.  Loomis,  William  H.  Draper,  John  T.  Metcalfe, 
Abraham  Jacobi,  Francis  Delafield,  PMward  G.  Janeway  etc.  of  New  York, 
Henry  Hartshorne,  William  Pepper,  John  Forsyth  Meigs,  Roberts  Barth- 
olow,  J.  M.  Da  Costa  etc.  of  Philadelphia. 

The  cultivation  of  specialties  in  the  United  States,  now  carried  per- 
haps to  an  excessive  extent,  began  about  the  middle  of  the  present  cen- 
tury. The  earliest  specialist  is  said  to  have  been  Dr.  Horace  Green  (1802- 
1866),  professor  of  Theory  and  Practice  in  the  New  York  Medical  College, 
who  devoted  his  chief  attention  to  diseases  of  the  throat  and  larynx,  and 


—  926  — 

whose  claim  to  have  passed  a  sponge  probang  through  the  larynx  excited 
much  acrimonious  discussion  and  occasioned  the  appointment  of  a  com- 
mittee of  investigation.  He  published  a  "Treatise  on  the  Diseases  of  the 
Air  Passages"  (1846),  "The  Pathology  and  Treatment  of  Croup"  (1849), 
with  other  works.  The  invention  of  the  laryngoscope  by  Czermak  and 
Tiirck  (about  1858)  of  course  revolutionized  the  study  of  diseases  of  the 
air  passages,  and  placed  the  specialty  of  laryngoscopy  upon  a  sure  basis. 
Czermak's  first  class  in  laryngoscopy  consisted  of  Prof.  Stoerck  of  Vienna,' 
Prof.  Lewin  of  Berlin,  Dr.  Semeleder,  subsequently  surgeon  to  the  no- 
fortunate  Emperor  Maximilian  in  Mexico,  and  Louis  Elsberg  (1837-1885), 
a  native  of  Iserlohn,  Prussia,  but  a  resident  of  Philadelphia.  Dr.  Els- 
berg, on  his  return  to  the  United  States,  was  appointed  Professor  of 
Laiyngology  and  Throat  Diseases  in  the  Medical  Department  of  the  Uni- 
versity of  New  York  (1861),  where  he  established  the  first  clinic  for 
diseases  of  the  throat  ever  instituted.  He  was  also  the  founder  of  the 
New  York  Laryngological  Society  (1873),  the  American  Laryngological 
Association  (1878)  and  the  "Archives  of  Laryngology"  (1880).  To  the 
energy  and  enthusiasm  of  Dr.  Elsberg  the  specialty  of  laiwngoscopy  owes 
much  of  its  success  in  this  country. 

Among  the  very  numerous  successful  laryngoscopists  in  the  United 
States  we  ma}'  mention  J.  Solis  Cohen  of  Philadelphia  (Diseases  of  the 
Throat,  1872),  Carl  Seiler  (Handbook  of  the  diagnosis  and  treatment  of 
diseases  of  the  throat,  nose  and  naso-pharynx.  2d.  ed.  1883)  and  Charles 
E.  Sajous,  likewise  of  Philadelphia  ;  George  M.  Lefferts,  F.  H.  Bosworth, 
Beverly  Robinson,  Andrew  H.  Smith,  Luis  Sass,  Clinton  Wagner,  Rufus 
P.  Lincoln  etc.  of  New  York,  F.  H.  Hooper  of  Boston,  E.  Fletcher  Ingalls 
of  Chicago,  John  N.  Mackenzie  of  Baltimore  etc. 

The  subject  of  the  Diseases  of  the  Skin  attracted  attention  in  this 
country  at  an  early  period.  The  "Abrt'ge  pratique  des  maladies  de  la 
peau  etc."  of  Cazenave  and  Schedel  (1828)  was  translated  and  published 
in  1829  by  R.  E.  Griffith  of  Philadelphia,  and  the  English  translation  of 
the  same  work  by  Thomas  H.  Burgess  (1842)  was  republished  in  New 
York,  under  the  editorial  care  of  H.  D.  Bulkle}',  in  1845  and  again  in  1852. 
Dr.  Bulkley  who,  in  conjunction  with  Dr.  John  Watson  (1807-1862),  estab- 
lished in  1836  a  dispensary  for  cutaneous  diseases,  subsequently  known  as 
the  "Broome  St.  School  of  Medicine",  in  his  preface  to  the  edition  of  1845 
speaks  of  having  used  the  manual  of  Cazenave  and  Schedel  "  in  several 
successive  courses  of  lectures  on  the  subject  in  this  city",  and  was,  so  far 
as  I  know,  the  earliest  lecturer  on  dermatology  in  this  country.  Wilson's 
"Lectures  on  Diseases  of  the  Skin"  (1842)  had  reached  a  fourth  American 
edition  in  1859,  and  the  "Practical  Treatise  on  Diseases  of  the  Skin"  b}' 
J.  Moore  Neligan  of  Dublin,  published  in  1852,  had  attained  its  fourth 
American  edition  likewise  in  1864.  The  New  York  Dermatological  Society 
was  organized  in  1869,  and  the  American  Dermatological  Association  in 
1876.     A  series  of  photographs  of  diseases  of  the  skin  taken  from  life  was 


—  927  — 

published  by  Howard  F.  Damon  of  Boston  in  1867,  and  a  treatise  on  the 
recent  advances  in  the  pathology  and  treatment  of  diseases  of  the  skin 
by  B.  Joy  Jeffries  of  Boston  formed  the  Boylston  Prize  Essay  of  1871. 
A  valuable  monograph  on  "  Herpes  Gestationis"  was  also  published  bjT  L. 
Duncan  Bulkley  of  New  York  in  1874,  and  an  "Analysis  of  1000  cases  of 
Skin  Diseases"  by  the  same  author  appeared  in  1875.  But  the  first 
systematic  treatise  on  dermatology  by  an  American  author  was  "An  Ele- 
mentary Treatise  on  Diseases  of  the  Skin  etc."  by  Henry  G.  Piffard  of 
New  York,  which  was  published  in  1876.  In  the  same  }"ear  appeared  the 
First  Part  of  Louis  A.  Duhring's  "Atlas  of  Skin  Diseases",  and  in  1877 
"A  Practical  Treatise  on  Diseases  of  the  Skin"  by  the  same  author  (J.  B. 
Lippincott  &  Co..  Philadelphia). 

Among  the  very  numerous  American  dermatologists  of  the  present 
day  we  may  mention,  besides  those  already  noticed  :  R.  W.  Taylor,  G-.  H. 
Fox,  C.  Heitzmann  and  A.  R,  Robinson  of  New  York  ;  F.  B.  Greenough, 
J.  C.  White  and  Edward  Wigglesworth  of  Boston  ;  H.  W.  Stelwagon  of 
Philadelphia ;  W.  A.  Hardaway  of  St.  Louis  and  J.  Nevins  Hyde  of 
Chicago  (A  Practical  Treatise  on  Diseases  of  the  Skin,  1883). 

In  the  department  of  the  Diseases  of  Children  the  works  of  William 
Potts  Dewees  (1768-1841  ;  A  Treatise  on  the  Physical  and  Medical  Treat- 
ment of  Children,  1825),  whose  treatise  reached  a  tenth  edition;  D.  Francis 
Condie  (1796-1875  ;  Diseases  of  Children,  1850)  and  John  Forsyth  Meigs 
(Practical  Treatise  on  the  Diseases  of  Children,  1857,  with  numerous  later 
editions)  are  well-known.  More  recently  the  "  Treatise  on  the  Diseases  of 
Infancy  and  Childhood"  of  J.  Lewis  Smith  of  New  York,  which  appeared 
in  1869  and  is  now  enjoying  its  sixth  edition,  has  almost  monopolized  the 
field  in  this  department.  The  various  monographs  of  Abraham  Jacobi, 
Clinical  Professor  of  the  Diseases  of  Children  in  the  College  of  Physicians 
and  Surgeons,  New  York,  also  deserve  mention  in  this  connection. 

During  the  earl}-  years  of  the  present  centuiy  the  chief  authorities 
for  American  physicians  in  the  department  of  Venereal  Diseases  were 
John  Hunter  (On  the  Venereal  Diseases,  1786)  and  F.  X.  Swediaur  (1748- 
1824),  whose  "  Traite  complet  sur  les  S3'inptomes,  la  nature  et  le  traite- 
ment  des  maladies  syphilitiques",  Paris  1798,  was  translated  into  English 
by  Thomas  T.  Hewson  of  Philadelphia  in  1815.  A  treatise  "On  Gonor- 
rhoea and  Syphilis"  by  Dr.  Silas  Durkee,  Fellow  of  the  Massachusetts 
Medical  Soeiet}-,  seems  also  to  have  enjo}Ted  considerable  popularit}',  claim- 
ing a  fifth  edition  as  late  as  1870.  It  was  not,  however,  until  the  transla- 
tion of  Ricord's  edition  of  the  treatise  of  John  Hunter,  made  b}-  Freeman 
J.  Bumstead  (1826-1879),  Lecturer  on  Venereal  at  the  College  of  Physi- 
cians, New  York,  in  the  year  1859,  and  particularly  not  until  the  appear- 
ance of  the  treatise  on  "  The  Pathology  and  Treatment  of  Venereal  Dis- 
eases" by  the  same  author  in  1861,  that  the  subject  of  venereal  disease 
.  assumed  in  this  country  a  thoroughby  scientific  position.  This  last  work 
presented  to  the  American  medical  profession  for  the  first  time  a  complete 


—  928  — 

and  systematic]  view  of  the  advances  made  by  Bassereau,  Fournier  etc.  in 
the  differentiation  of  the  "chancroid"  and  the  "true  chancre",  and  opened 
the  way  for  a  scientific  system  of  treatment  in  the  management  of  the 
various  diseases  arising  from  impure  sexual  intercourse. 

Among  the  more  eminent  specialists  in  the  department  of  Venereal 
were  and  are  :  the  distinguished  surgeon  of  New  York,  William  Holme  Van 
Buren  (1819-1883),  Professor  of  the  Principles  of  Surgery  in  Bellevue 
Hospital  Medical  College,  who,  in  conjunction  with  Edward  L.  Ke3'es,  pub- 
lished in  1874  an  excellent  "Practical  Treatise  on  the  Surgical  Diseases  of 
the  Grenito-Urinary  Organs,  including  Syphilis";  R.  W.  Taylor,  the  present 
editor  of  Bumstead's  standard  work  and  author  of  numerous  and  valuable 
monographs  on  the  subject  of  Venereal  (Syphilitic  Dactylitis,  1871,  etc.); 
Fessenden  N.  Otis  of  New  York  ;  F.  R.  Sturgis  and  M.  H.  Henr}',  also  of 
New  York,  the  latter  the  editor  of  the  American  Journal  of  S}'philography 
and  Dermatology  (1870-75),  and  numerous  others. 

In  the  department  of  Diseases  of  the  Mind  and  the  Nervous  System 
Benj.  Rush's  "Medical  Inquiries  and  Observations  upon  Diseases  of  the 
Mind"  (1812),  and  the  "  Medical  Jurisprudence  of  Insanity"  (1838)  by  Dr. 
Isaac  Ray  (1807-1881)  are  old  and  valued  works.  The  treatise  of  Isaac 
Parish  of  Philadelphia  on  "  Spinal  Irritation"  (1832)  has  been  already 
noticed.  We  should  also  mention  the  names  of  the  eminent  alienists  : 
Amariah  Brigham  (1798-1849),  Superintendent  of  the  Utica  Insane  Asy- 
lum from  1842  until  his  death,  and  editor  of  the  "American  Journal  of 
Insanity  (1844-49);  Pliny  Earle  (born  1809),  Supt.  of  the  Bloomingdale 
As\-lum  in  New  York  City  (1844-49),  and  subsequently  Supt.  of  the  Mas- 
sachusetts Asylum  at  Northampton  ;  Thomas  S.  Kirkbride  (1809-1883), 
Supt.  of  the  Philadelphia  Asylum  for  more  than  forty  years  ;  John  P.  Gray 
(1825-1886),  Supt.  of  the  Utica  Insane  Asylum  for  32  3'ears  and  editor  of 
the  "Journal  of  Insanity";  Charles  H.  Nichols  of  the  Bloomingdale  Asy- 
lum ;  John  C.  Curwen  of  Pennsylvania  ;  Walter  K.  Kempster  of  Wis- 
consin ;  Joseph  Parrish  of  Philadelphia,  founder  in  1870  of  the  American 
Association  for  the  Cure  of  Inebriates,  and  Daniel  H.  K.  Kitchen  of  New 
York,  Physician  to  the  Inebriate  Asj'lum  at  Binghampton.  Among  the 
more  recent  cultivators  of  this  branch  of  medicine  we  may  mention 
Meredith  Clymer  (Notes  on  the  Physiology  and  Patholog}T  of  the  Nervous 
S}rstem  etc.,  1870,  with  numerous  monographs  on  nervous  diseases); 
S.  Weir  Mitchell  of  Philadelphia  (Injuries  of  nerves  and  their  conse- 
quences, 1872,  with  very  numerous  monographs);  William  A.  Hammond 
of  Washington  (A  Treatise  on  the  Diseases  of  the  Nervous  S^vstem,  1871, 
etc.);  Allan  McLane  Hamilton  of  New  York  (Nervous  Diseases,  1878); 
Edouard  S.  Seguin  (1812-1880)  of  New  York,  a  native  of  France  and 
founder  in  1839  of  the  first  institution  for  the  instruction  of  idiots  and 
feeble  minded  children,  a  class  of  unfortunates  in  whose  behalf  his  talents 
were  exercised  likewise  in  his  adopted  country  ;  his  son  Ed.  C.  Seguin.; 
Edward  C.  Spitzka,  Ambrose  L.  Ranney  and  Allen  M.  Starr  of  New  York.; 


—  929  — 

Horatio  C.  Wood,  Charles  K.  Mills,  James  A.  Meigs  (1829-1879)  and 
Wharton- Sinkler  of  Philadelphia;  Charles  F.  Folsom,  James  J.  Putnam 
and  Francis  Minot  of  Boston  ;  Hemy  M.  Lyman  of  Chicago  ;  Francis  T. 
Miles  of  Baltimore  ;  Landon  Carter  Gray  of  Brooklyn  ;  J.  S.  Jewell  of 
Chicago,  etc.  etc. 

The  specialty  of  Electrotherapeutics  is  represented  by  George  M. 
Beard  (18-10-1883)  and  A.  D.  Rockwell  of  New  York,  authors  of  "A  Prac- 
tical Treatise  on  the  Medical  and  Surgical  Uses  of  Electricity  etc.",  1871; 
William  B.  Neftel  of  New  York  (Galvano-Therapeutics,  1871)  ;  D.  F. 
Lincoln  of  Boston  (Electro-Therapeutics,  1874)  ;  Roberts  Bartholow  of 
Philadelphia  (Medical  Electricity,  3  eel.,  1887);  Allan  McLane  Hamilton 
(Clinical  Electro-Therapeutics,  1873),  Charles  K.  Mills  of  Philadelphia,  John 
Byrne  of  Brooklyn  (electro-cautery)  and  numerous  others. 

Ophthalmic  Medicine,  particularly  its  operative  department,  continued 
a  branch  of  general  surgery  until  quite  the  middle  of  the  century.  Indi- 
cations of  the  coming  separation,  however,  w7ere  manifested  early  in  the 
century  by  the  foundation  of  the  New  York  Eye  and  Ear  Infirmar}'  in 
1820,  the  Pennsj'lvania  Infirmary  for  Diseases  of  the  Eye  and  Ear  in  1822, 
the  Massachusetts  Eye  and  Ear  Infirmary  in  1829  and  the  Wills  Ophthalmic 
Hospital  in  1834.  The  earliest  independent  writer  upon  ophthalmic  dis- 
eases in  the  United  States  was  Br.  George  Frick  (1793-1870)  of  Maryland, 
who  published  in  1824  "A  Treatise  on  Diseases  of  the  Eye,  including 
Doctrines  and  Practice  of  the  Most  Eminent  Surgeons,  and  particularly 
those  of  Prof.  Beer."  Dr.  Frick,  though  a  native  of  the  United  States, 
was  of  German  descent  and  died  in  Dresden.  His  work  was  quoted  with 
respect  by  European  writers,  and  the  book  survived  three  editions  (Quinan). 
Other  earl}-  ophthalmologists  were :  Edward  Delafield  (1794-1875),  Presi- 
dent (1858-1875)  of  the  College  of  Physicians  and  Surgeons  of  New  York, 
and  one  of  the  most  highly  esteemed  physicians  of  that  city.  As  early  as 
1828  Dr.  Delafield,  then  Prof,  of  Obstetrics  and  -the  Diseases  of  Women 
and  Children  in  the  College  of  Physicians  and  Surgeons,  delivered  a 
special  course  of  lectures  upon  diseases  of  the  e}-e,  and  at  the  same  time 
the  Eye  and  Ear  Infirmary  was  thrown  open  for  clinical  instruction.  Dr. 
Isaac  Hays  (179(5-1879)  of  Philadelphia,  the  eminent  editor  of  the  "Amer- 
ican Journal  of  the  Medical  Sciences",  was  also  much  interested  in  the 
subject  of  ophthalmology,  was  one  of  the  surgeons  of  the  Penns}4vania 
Infirmary  for  Diseases  of  the  Eye  and  Ear  and  of  the  Wills  Hospital,  and 
edited  in  1843  Sir  William  Lawrence's  famous  "  Treatise  on  the  Diseases 
of  the  Eye",  to  which  he  made  numerous  and  valuable  additions.  Dr. 
Hays  also  invented  a  peculiar  cataract-knife,  a  new  operation  for  stra- 
bismus, was  one  of  the  earliest  oculists  to  detect  astigmatism  and  one  of 
the  early  investigators  of  color-blindness.  John  Dix  of  Boston  is  said 
to  have  written  on  strabismus  in  1841,  and  James  Bolton  (1812-1869) 
of  Richmond,  Virginia,  published  in  1842  "A  treatise  on  strabismus  — 
with  a  description  of  new  instruments  etc."  —  The  specialty  of  ophthal- 
59 


—  930  — 

mology,  however,  may  be  said  to  have  been  created  by  the  invention  of  the 
ophthalmoscope  by  Helraholtz  in  1852,  and  from  that  date  forward  the 
subject  of  diseases  of  the  eye  has  become  more  and  more  markedly  sep- 
arated from  general  surgery.  The  earliest  physician  in  the  United  States 
to  cultivate  ophthalmology  as  an  exclusive  specialty  is  said  to  have  been 
Dr.  Elkanah  Williams  (1822-1888)  of  Cincinnati,  who  studied  in  Prague, 
Vienna  and  Berlin,  and  on  his  return  to  this  country  in  1855  began  an 
exclusive  practice  in  diseases  of  the  eye.  Among  the  more  eminent 
ophthalmologists  of  recent  date  we  may  mention  :  Drs.  H.  W.  Williams, 
Oliver  Wadsworth,  Hasket  Derby  and  B.  Joy  Jeffries  of  Boston  ;  the 
lamented  C.  R.  Agnew  (1831-1888),  Hermann  Knapp,  Edward  Loring 
(1837-1888),  Richard  H.  Derby,  F.  D.  Noyes,  D.  B.  St.  John  Roosa, 
David  Webster,  etc.  of  New  York  ;  George  C.  Harlan,  Wm.  F.  Norris, 
William  Thomson,  George  Strawbridge,  Edward  0.  Shakespeare  and 
others  of  Philadelphia ;  Swan  M.  Burnett  of  Washington  ;  George 
Reuling  and  J.  G.  Chisholm  of  Baltimore  ;  John  Green  of  St.  Louis,  and 
very  man}'  others. 

The  specialt}'  of  Otolog}',  almost  universally  associated  in  practice 
with  ophthalmolog}',  is  represented,  besides  the  ophthalmologists  already 
mentioned,  by  Albert  H.  Buck  and  Oren  D.  Pomeroy  of  New  York  ; 
Charles  H.  Burnett  and  Laurence  Turnbull  of  Philadelphia ;  Samuel 
Sexton  of  New  York  ;  Clarence  J.  Blake  and  J.  Orne  Green  of  Boston  ; 
Samuel  Theobald  of  Baltimore  ;  W.  W.  Seel}'  of  Cincinnati,  and  numerous 
others. 

The  department  of  Forensic  Medicine  or  Medical  Jurisprudence  has 
found  able  representatives  in  James  Stringham  (died  1817),  Professor  of 
Legal  Medicine  in  Columbia  College  and  subsequently  (181 4)  in  the  Col- 
lege of  Physicians  and  Surgeons,  N.  Y.,  and  the  earliest  (1803)  lecturer 
on  this  subject  in  the  United  States  ;  his  successor  in  the  latter  institu- 
tion, John  W.  Francis  (1789-1840);  Theodoric  Romeyn  Beck  (1791-1855  ; 
Elements  of  Medical  Jurisprudence,  Alban}',  1823),  whose  treatise  sur- 
vived 12  editions  and  was  translated  into  German  and  Swedish  ;  Stephen 
W.  Williams  (1790-1855),  Prof,  of  Legal  Medicine  in  the  Berkshire  Med- 
ical Institute  (1823-1831)  and  subsequently  in  Dartmouth  College,  who 
published  "A  catechism  of  medical  jurisprudence",  Northampton,  1834  ; 
Isaac  Ray,  who  has  been  already  mentioned  ;  Moreton  Stille  (1822-1855), 
whose  "  Medical  Jurisprudence",  published  in  conjunction  with  Francis 
Wharton,  appeared  at  Philadelphia  in  1855  ;  William  A.  Hammond 
(Insanity  and  its  medico-legal  relations,  New  York,  1866)  ;  John  James 
Reese,  Prof,  of  Medical  Jurisprudence  and  Toxicology  in  the  University  of 
Pennsylvania,  and  editor  of  the  8th  American  edition  of  Alfred  S.  Taylor's 
well-known  and  popular  "  Manual".     H.] 


—  931  — 

h.  The  School  of  Natural  Philosophy 

in  Germany  ran  parallel  with  that  of  Broussais  and  the  beginning  of  the 
tendency  to  pathological  anatomy  in  France,  and  in  its  offshoots  reached 
to  the  golden  age  of  these  systems,  and  of  the  Dublin  School  which  we 
have  just  discussed.  It  was,  on  the  one  hand,  the  ultimate  branch  of  the 
medical  philosophy  of  the  18th  century,  which  had  originated,  indeed,  in 
■Germany,  and  it  must  be  regarded,  on  the  other  hand,  as  a  revival  in 
our  land  of  opposition  to  medical  philosophy  on  the  side  of  Realism. 
In  both  points  of  view  it  is  equally  important  and  remarkable  in  the 
histoiy  of  culture.  In  the  direction  last  mentioned  its  influence  was, 
indeed,  only  indirect,  yet  was  it  none  the  less  powerful.  It  led  specula- 
tion into  extremes,  and  nothing  could  better  level  the  way  in  Germany  for 
the  opposite  philosophy  than  precisely  those  excesses  of  which  the  school 
■of  natural  philosophy  was  guilt}'.  These  finally  sobered  down  through  the 
inanity  of  scholastic  phrases,  with  their  often  obscure  and  "half-born" 
ideas,  and  thus  broke  a  broad  road  for  the  subsequent  enthusiasm  in  be- 
half of  the  one-sided  and  positive  French  medicine.  For  throughout  all 
the  history  of  medical  culture  it  is  a  manifest  law,  that  the  one-sidedness 
and  exaggeration  of  any  existing  school  prepare  the  way  for,  and  lend  the 
most  active  aid  to,  the  opposition  of  the  future.  This  historical  task, 
albeit  a  thoroughly  negative  one,  the  medicine  of  natural  philosophy  per- 
formed, and  so  thoroughly  too,  that  ultimately  the  realistic  school  could, 
and  did,  without  an}*  serious  struggle,  step  into  its  place. 

How  nearly  the  two  extremes  meet  is  proven,  among  other  things,  by  a  lecture 
received  "with  loud  applause"  in  the  Convention  of  Naturalists  (Naturforscher- 
versammlung)  at  Gratz  in  the  year  1875,  and  which  by  its  natural  scientific  specu- 
lation on  the  subject  of  inductive  morals  etc.  approximates  so  closely  in  its  conclu- 
sions and  mode  of  expression  —  le  style  c'est  1'  ecole  is  in  medicine  more  accurate 
than  le  style  c'est  1'  horn  me,  even  in  the  age  of  the  natural  sciences  —  to  the  earlier 
speculations  of  natural  philosophy,  that  the  new  method  cannot  be  distinguished 
from  the  old.  In  this  lecture  the  anthropology  of  the  present  day  supplies  the  sphere 
in  which  both  extremes  come  into  such  wonderfully  close  contact,  as  a  comparison 
with  the  following  statements  will  show.  The  whole  lecture  is  a  kind  of  cerebral 
phrenology,  instead  of  the  craniology  of  Gall.  Among  other  things,  the  speaker, 
while  laying  express  claim  to  a  thoroughly  natural  scientific  stand-point  —  he  even 
speaks  of  "individuals  ethically  stunted  in  a  natural  scientific  sense",  and  none  of  the 
naturalists  entered  any  protest — declares:  "The  laws  of  equilibrium  of  the  moment- 
ary feelings  of  pleasure  and  dislike  in  contrast  to  the  purposes  of  life  and  the 
interests  of  the  preservation  of  the  species,  and  between  the  feelings  of  pleasure  and 
dislike  of  individuals  and  those  of  the  community,  are  the  laws  of  equilibrium  of 
moral  perception."  After  speaking  of  ethical,  intellectual  and  motor  talents,  the 
orator  (his  name  is  unimportant  in  this  connection)  brings  forward  the  scientific 
analysis  of  the  brains  of  three  homicidal  robbers,  and  on  this  occasion  uses  the 
following  language:  "  When  I  had  freed  the  first  brain  from  its  envelopes  the  crime 
at  once  met  my  view  with  unmistakable  anatomical  (!)  clearness"  (something  as  it 
did  the  prophet  Lavater  when  he  looked  upon  a  silhouette).  But  then  he  asks  himself 
the  question:   "  Is  this  a  scientific  accident,  or  a  typical  occurrence?"  and  comes  to 


—  932  — 

the  elevating  conclusion:  "It  seems  to  me  as  if  from  the  sight  of  the  brains  of  these 
robbers  ar.d  murderers  a  movement  will  go  forih  over  distant  zones  and  remote  ages, 
which  will  draw  the  doctrine  of  right  and  justice  into  the  ethically  emancipating 
domain  of  anthropology." 

Yet  the  school  of  natural  philosoph}',  which,  by  the  way,  consisted 
almost  entirely  of  men  of  importance,  physicians  worthy  of  being  called 
••men  of  two  centuries",  won  a  following  in  Germany  alone,  manifestly  in 
consequence  of  the  alwa}-s  speculative  tendenc}-  of  German  thought,  a 
tendenc}'  measurably  lacking  in  other  people.  In  this  tendenc}-  the  school 
of  natural  philosophy  must  have  largely  rooted  itself,  since  otherwise  it 
cannot  be  readily  explained  how  so  many  intelligent  and  really  important 
investigators  and  savants  belonged  to  its  fold.  For  however  justly  the 
one-sided  speculative  tendency  of  this  school  is  despised,  the  intellectual 
eminence  of  the  majority  of  its  representatives  must  extort  the  greatest 
respect.  An  abundance  of  imbecile  representatives,  such  as  was  plainly 
manifested  by  the  so-called  "  Natural-Scientific  School"  (in  spite  of 
"zealous  investigators'',  who,  inasmuch  as  they  were  ever  investigating, 
did,  indeed,  all  discover  something,  although  often  this  something  was  of 
no  importance),  cannot  certainly  be  charged  upon  the  school  of  natural 
philosophy,  which,  above  all  other  schools  of  our  centur}-,  includes  physi- 
cians eminent  for  their  universal  culture.  Its  fault  is  merel}*  a  too  one- 
sided, and  therefore  erroneous  conception  and  consideration  of  the  subjects 
of  medical  science.  Indeed,  even  to-day  we  adopt  for  the  foundation  of 
our  knowledge  many  of  the  definitions  which  originated  in  this  school, 
e:  g.  that  of  disease  etc.  The  school  of  natural  philosoph}-  brought  forth 
inainly  a  speculative  philosophy  of  medicine,  not  a  philosophical  medicine 
such  as  Hippocrates  demanded,  although  man}*  of  the  followers  of  this 
school  believed  that  the}'  had  attained  the  latter  desideratum.  It  did 
not  create  a  medicine  which  cultivates  assiduously  realistic  investigation 
with  the  assistance  of  sensible  observation,  though  without  crowding 
speculative  thought  entirely  out  of  the  science.  Its  medicine  was  purely 
speculative. 

This  result  was  based  upon  the  very  nature  of  the  intellectual  and 
actual  founder  of  the  school  —  Schelling  —  who,  though  originally  a 
ph}*sician,  became  ultimately  exclusively  a  philosopher.  Next  to  Schel- 
ling, Marcus,  who  with  the  former  edited  the  "Jahrbiicher  der  Medicin  als 
Wissenschaft",  had  a  decisive  influence  upon  the  origin  and  tendencies 
of  the  school. 

In  the  school  of  natural  philosophy  use  was  made  of  the  abstract 
doctrines  of  the  philosopln-  of  identity,  and  the  imponderables  —  elec- 
tricity, chemical  forces,  magnetism  —  with  their  "polarities"  and  indiffer- 
ences, were  especiall}'  employed  as  its  scientific  basis.  Contrasted  with 
the  imponderables  were  the  "dimensions"  of  matter,  as  well  as  the  quali- 
ties of  sensibility,  irritability  and  reproduction  or  metamorphosis.  The 
undisturbed    or   changed    co-operation   of  these    agencies  furnished  the 


—  933  — 

abstract  conceptions  of  health  etc.  In  such  formulated  distinctions, 
stated  differently  by  each  physician  of  the  school,  and  expressed  in  the 
most  affected  scholastic  and  artificial  terms,  distinctions,  however,  which 
not  infrequently  contained  a  sound  germ  of  actual  truth  (obscure,  alas,  in 
phraseology  and  misinterpreted),  the  school  of  natural  philosophy  wasted 
its  strength  and  its  credit.  For  of  course  in  this  characteristic  la}-  the 
germ  of  endless  sports  of  fancy  and  of  the  maddest  phraseological  subtil- 
ties,  into  which  its  efforts  at  systematization  finally  degenerated. 

On  the  side  of  actual  facts,  however,  the  school  of  natural  philosophy 
did  not  entirely  fail  in  attaining  great  benefit  for,  and  bringing  considerable 
profit  to,  the  medicine  of  the  following  age.  It  exercised  its  greatest,  and 
in  many  respects,  undoubtedly,  a  very  serviceable,  influence  upon  the 
department  of  the  history  of  development  or  physiology,  where  a  Job.. 
Miiller  displayed  his  thorough  profundity. 

Distinguished  representatives  of  this  school  in  both  its  best  and 
worst  aspects,  and  physicians  who  enjo}*ed  in  their  own  clay  an  extraor- 
dinary reputation,  to  which,  if  we  011I3'  eliminate  this  worst  side  as  belong- 
ing to  the  spirit  of  the  age,  the}'  might  likewise  lay  claim  among  posterity, 
were  :  the  naturalist 

Lorenz  Ok  en  (properly  Okenfuss,  1779-1851)  of  Bohlsbach  in  the 
Bavarian  highlands, 

successively  professor  of  medicine  (1807),  natural  history  and  philosophy  (1812)  in 
Jena.  Subsequently  becoming  involved  in  some  examinations  connected  with  the 
"Isis",  in  which,  however,  he  was  acquitted,  he  became  a  private  savant.  In  1828 
Oken  was  again  made  professor  of  physiology  in  Munich,  from  which  place  he  was 
'transferred"  to  Erlangen,  and  in  consequence  resigned  his  professorship.  In  1832 
he  was  appointed  professor  in  Zurich.  Oken  was  likewise  the  founder  of  the  "Wan- 
derversainmlungen  der  Naturforscher",  the  first  of  which  met  in  Leipsic  in  1822, 
By  his  "Naturgeschichte",  a  book  which  had  a  most  extensive  circulation  (its  atlas  a 
short  time  ago  was  sold  as  a  Christmas  picture-book  lor  children  —  sic  transit  gloria 
libroruin  !),  he  contributed  greatly  to  the  popularization  of  natural  history,  and  his 
journal,  the  "  Isis",  united  the  labors  of  the  best  minds  of  the  day.  Politically  Oken 
belonged  to  the  democrats,  then  known  as  "Demagogen"  (Burschenschaftler,  Tugend- 
biindler),  a  party  which  also  counted  among  its  adherents  Dr.  E 11  gen  Honing  (born  in 
Fulda  in  1808,  for  a  long  time  a  privatdocent  in  Heidelberg,  then  a  practitioner  in 
Eschwege,  where  he  died  in  1880),  the  poet  and  author1  of  the  famous  students'  song 
"0  alte  Burschenherrlichkeit "  etc.,  with  many  other  followers  of  the  school  of 
natural  philosophy.  The  members  of  this  party  were  persecuted  and  frequently 
punished  with  prolonged  imprisonment. 

Oken  explained  the  skeleton  as  a  vertebra,  discovered  the  Wolffian  bodies  in  the 
mammalia  etc.,  but  regarded  the  "infusoria"  (by  which  he  understood  what  we  now 
call  cells),  and  particularly  the  infusoria  in  the  semen,  as  the  essential  agents  in 
generation.  "Putrefaction  is  nothing  but  a  separation  of  organic  matter  into  simple 
little  cellules  or  points,  the  infusoria.  If  these  adhere  again,  they  give  rise  to  higher 
plants  or   animals,  so  that  we   may  regard  flesh  as  a  crowd  of  numerous  infusoria 

3.  We  mention  this  fact  because  the  man  has  impressed,  elevated  and  refreshed  by 
his  poem  more  youthful  hearts,  than  he  could  ever  have  done  in  the  position  of  a 
professor  of  medicine  by  his  writings  on  natural  philosophy  ! 


—  934  — 

grown  together,  and  thus  forming,  as  it  were,  the  seed  for  the  entire  animal  kingdom." 
He  also  believed  that  it  might  be  assumed  that  the  first  generations  of  women  had 
lived  without  menstruating,  and  that  the  process  of  menstruation  first  orginated  when 
the  natural  desires  of  women  were  not  satisfied  etc.  "  Life  in  his  view  is  the  self- 
generation  of  the  individualized  elements;  the  principle  of  life  is  galvanism;  vital" 
force  is  galvanic  polarity.  Carbon  is  the  fundamental  matter  of  the  universe.  Mixed 
with  water  and  air  it  produces  mucus.  Everything  has  been  created  from  the 
"  Meerschleim  "  (sea-ooze),  the  primeval  mucus,  a  doctrine  in  which  a  very  manifest 
sympathy  with  the  "  newest"  and  synthetic  tendency  of  natural  philosophy  is  to  be 
recognized,  though  in  Oken's  da}-  philosophers  were  as  yet  in  no  condition  to  con- 
struct a  scientific  genealogical  tree  of  creation.  With  Kieser  and  Dollinger,  Oken 
contributed  greatl}"  to  the  establishment  of  the  modern  theory  by  the  introduction 
of  the  microscope  into  medicine  (Rohlfs),  and  by  his  "infusoria  ',  from  which  he  believed 
the  whole  body  to  be  constructed,  he  approximated  in  principle  to  the  cellular  theory 
of  Virchow.  Agassiz  in  his  "Memoirs"  declared  Oken  "a  master  in  the  art  of  teach- 
ing, a  courageous  and  rulin»;  spirit,  who  constructed  the  entire  universe  out  of  his 
own  brain,  and  derived  from  a  priori  conceptions  the  connexion  of  the  three  kingdoms 
into  which  he  divided  all  living  creatures."  Alex.  Braun,  the  botanist  of  Giessen 
and  one  of  Oken's  pupils,  said  "  His  auditors  were  compelled  occasionally  to  yield 
their  ears  to  a  little  nonsense",  as  e.  g.  the  following  passage:  "  Man  stands  as  much 
higher  than  woman  as  the  sexual  plant  stands  above  the  sexless  ....  the  male 
in  the  entire  animal  kingdom  stands  higher  than  the  female.  Snails,  fish  and 
aquatic  animals  are  the  woman;  birds,  and  mammals  the  man.  Jdeall}-  every  child 
should  be  a  boy.  When  female  children  are  produced,  it  occurs  through  a  mis- 
carriage of  the  female  plan.  Nature  desires  to  attain  the  highest  onlj*,  that  is  the 
man."   (I.e.) 

Joh.  J.  DOmling.  professor  in  Wiirzburg  (1771-1803),  August  Winkel- 
mann.  K.  Chr.  E.  Schmidt  (died  1813),  professor  in  Jena  (plrysiology 
treated  philosophically)  and  Windischmann  S3*mpathized  with  Brunon- 
ianism.     The  same  may  be  said  of  the  able,  highly  esteemed  and  versatile 

Ph.  Franz  von  Walther  (1782-1849).  professor  of  surgery  in  Lands- 
hut,  Bonn  and  Munich, 

who  held  the  true  essence  of  the  organism  to  be  that  "it  admitted  no  division  of  the 
idea  of  life.  The  fundamental  functions  of  life  are  self-production,  irritability  and 
sensibility,  to  which  correspond  in  organic  nature  magnetism,  electricit}-  and  chemi- 
cal action  (Chemismus)"  etc. 

Ignaz  Dollinuer  (1770-1841)  of  Bamberg,  professor  in  Wiirzburg 
and  Munich, 

the  distinguished  father  of  the  cautious  leader  of  the  "Old  Catholics",  rendered 
special  service  in  the  departments  of  the  history  of  generation  and  development, 
physiology  and  comparative  anatomj'.  He  was  one  of  the  most  influential  members 
of  the  school  of  natural  philosophjr,  the  teacher  of  many  eminent  men,  e.  g.  E.  0. 
Baer  etc.  Agassiz,  also  one  of  his  pupils,  calls  him  in  his  "Memoirs"  a  persevering 
and  exact  investigator  and  observer,  who  gave  unreservedly  to  his  pupils,  the  lesnlts  of 
his  investigations,  though  he  published  them  with  reluctance.  He  regard  "coitus  as 
something  intermediate  between  irritation  and  infection.  The  seed  of  the  uterus  is 
the  blood,  which  mingles  with  the  male  blood,  and  from  this  commingling  originates 
a  polypus."  Dollinger  held  that  the  Graafian  vesicles  reached  the  uterus  and  so 
worked  upon  the  semen  "that  it  follows  the  laws  of  woman's  nature  and  also  becomes 
a  vesicle,  .between  which  two  vesicles  there  exists  an  opposition  that  the  polypous 


—  935  — 

structure  of  the  uterine  blood  adjusts.     Thus  occurs  conception,  and  all  subsequent 
cohabitations  are  repeated  between  the  individuals  as  mere  acts  of  the  species." 

Karl  Friedrich  Kielmeyer  (1765-18-44), 
professor  in  Stuttgart  and  Tubingen,  who  labored  in  behalf  of  comparative  anatomy,, 
did  honor  to  himself  in  this  respect  by  his  pupil  Cuvier. 

Jac.  Jos.  Gorres  (1778-1848)  of  Coblenz, 
the  much  persecuted  and  most  fruitful  writer  of  this  school,  deserves  notice,  not, 
indeed,  as  a  physician,  but  merely  in  a  wider  sense  for  his  influence  upon  its  tenden- 
cies. "We  find  in  external  nature  three  positive  factors:  light,  electricity  and 
oxygen:  and  three  negative :  phlogiston,  magnetism  and  combustible  matter.  From 
the  reaction  of  both  of  these  factors  there  result  three  ideals:  warmth,  galvanism  and 
combustion.  Three  positive  factors  meet  us  in  internal  nature:  idea,  affection, 
motion  etc. 

Eminent  followers  of  the  philosophy  of  nature,  and  physicians  and 
investigators  who  rendered  special  service  in  physiology,  anatomy  and 
the  history  of  development,  were  also  :  Reil  ;  Georg  Prochaska  (1749- 
1820),  Leopold  Reinhold  (1769-1809)  and  Ignaz  Paul  Vitalis  Troxler 
(1780-1866), 

a  professor  in  Bern.  Troxler  was  one  of  the  most  decided  followers  of  Schelling,  and 
like  his  master  rather  a  philosopher  than  a  physician.  He  finally  lapsed  into 
Catholicism.  ''  Everything  therefore  which  we  characterize  with  life,  is  merely  the 
life  of  a  definite  individuality.  Absolute  life  is  expressed  in  the  universe  and  in  its 
highest  individuals.  On  its  material  side  it  is  modeled  in  the  forms  of  the  terrestrial 
system,  in  the  stars;  on  its  dynamic  side,  in  the  motions  of  that  system.  The  life  of 
substance,  in  and  for  itself,  is  nothing  but  the  unity  of  the  principles  of  light  and 
gravity. —  Life  in  its  inmost  character  is  individual  productivity,  in  which  the  pro- 
ducing agent  and  the  product  are  interwoven  under  the  form  of  self-determination 
and  determinability.  As  the  factors  of  life  are  the  principles  of  light  and  gravity, 
so.  on  its  side,  life  itself  is  the  principle  of  light  and  gravity.  —  Excretion  is  secretion, 
directed  externally,  and  secretion  is  excretion  directed  internally.  —  Respiration  and 
digestion  are  identical  in  their  essential  tendency,  and  differ  only  in  their  relative 
direction."     (SeeRohlfs:  Umrisse  etc.) 

Gottfr.  Reinhold  Treviranus  (1776-1837)  in  Bremen 
introduced  the  use  of  the  microscope  into  general  anatomical  investigations  and  "laid 
the  foundation  of  our  present  microscopic  anatomy."  He  discovered  in  1835  the 
rods  of  the  retina,  and  regarded  them  as  the  terminations  of  the  optic  nerve,  an  idea 
confirmed  subsequently  by  Heinrich  Miiller  in  his  famous  "Anatomisch-physiolo- 
gischen  Untersuchungen  iiber  die  Retina",  1856.  Treviranus  also  made  the  first 
accurate  measurements  of  the  human  eye  in  1828.  Zehender  in  Rostock  says  of  him  : 
"Treviranus  was  an  ingenious  and  thoughtful  man,  a  characteristic  which  must, 
indeed,  have  justly  gained  him  many  followers,  but  which  renders  his  qualifications 
for  a  naturalist,  in  the  present  sense  of  that  term,  somewhat  doubtful."  Does  this 
view  of  the  doubtfulness  of  the  possession  of  spirit  and  ideas  as  a  qualification  for  a 
naturalist,  in  the  modern  sense  of  the  term,  hold  good  to-day? 

To  these  we  may  add  :  W.  A.  Stiitz  ;  Carl  Eberhard  Schelling  (1783- 
1854),  a  physician  in  Stuttgart;  Joh.  Bernhard  Wilbrand  (1789-1846), 
author  of  -Grundsiitze  der  philosophischen  Naturwissenschaft",  1806,  etc., 
and  a  professor  in  Giessen,  who  up  to  the  da}'  of  his  death  denied  the 
circulation  of  the  blood  ;    the    obstetrician    Ritgen  ;    Karl    E.  von    Baer 


—  936  — 

(1792-1876)  of  Esthland,  professor  in  Dorpat,  Petersburg  and  Koriigsberg, 
the  famous  naturalist  and  embryologist,  who  discovered  the  ovum  of  mam- 
mals in  the  3-ear  1827  and  "fifty  years  ago  gave  to  morphology  its  genetic 
foundations",  as  Hiickel  says  in  his  dedication.  Yon  Baer  was  incited 
to  his  investigations  b}  those  of  Christ.  Pander  (1793-1805)  on  the  devel- 
opment of  the  chick  (1817).  He  distinguished  himself  as  an  anthro- 
pologist, geographer  and  writer  on  natural  science,  and  in  conjunction  with 
Rudolph  Wagner  (1805-1864),  author  of  the  "  Handworterbuch  der  Phy- 
siologie,  1843-53,  an  investigator  of  merit  but  involved  in  Pietism,  called 
in  1861  an  anthropological  convention,  at  which  the  anatomists  Vrolik  of 
Amsterdam,  Weber  of  Leipzig,  Bergmann  of  Rostock  and  others  made 
their  appearance.  This  was  the  origin  of  our  "Anthropological  Congress" 
of  the  present  day.  Franz  Jos.  Schelver  (1778-1832),  professor  in  Heidel- 
berg ;  Joh.  Heinrich  Ferd.  Autenrieth  (1772-1835),  professor  in  Tubingen, 
who  like  the  already  mentioned  Brandis,  Humboldt  and  others,  regarded 
the  physical  imponderables  as  the  first  cause  of  life.  He  also  brought  for- 
ward the  so-called  "  Kratzmetastasen",  and  may  be  considered  in  many 
respects  the  predecessor  of  Schoenlein.  Ernst  Bartels,  professor  in  Helm- 
stiidt  ;  J.  Chr.  Aug.  Heinroth  in  Leipzig  ;  the  pharmacologist  Sobernheim  ; 
K.  F.  Burdach  (1770-1847),  professor  in  Leipzig,  Dorpat  and  Konigsberg  ; 
C.  Gr.  Carus ;  the  Wurzburg  physiologist  Johann  Jacob  Wagner  (1775- 
1821),  author  of  a  treatise  entitled  "Von  der  Natur  der  Hinge",  1803. 

Wagner  applied  natural  philosophy  not  onlj-  to  medicine  but  also  to  the  natural 
sciences.  Yet  "  he  shed  no  light  upon  the  principles  of  those  sciences,  but  rather 
clothed  them  in  a  dark  mystical  cloak"  (Hohlfs).     The  "  Turnerfeind" 

Henrik  Steffens  (1773-1845),  author  of  "Grundsatze  der  philosoph- 
.  ischen  Naturwissenschaft",  1806,  and  other  works. 

"  He  endeavored  to  divide  remedies  in  accordance  with  conceptions  of  the  ideal 
and  the  real."  Heine  said  of  him:  "  Herr  Steff'ens  might  complain  more  than  his 
master  that  his  ideas  were  stolen.  Among  his  ideas,  however,  there  was  one  which 
no  one  has  appropriated,  and  this  is  his  chief,  his  sublime  idea  :  1,  Henrik  Steffens, 
born  the  second  of  May,  177!!,  at  Stavanger,  near  Drontheim  in  Norway,  am  the 
greatest  man  of  my  century.''  (See  Rohlfs.  Umrisse.)  Gofhe  thought  Steffens  gave 
one  enough  to  think  about,  since  ordinarily  one  lived  with  him  in  discordant  concoid. 
Besides  Windischmann,  who  has  been  already  mentioned,  we  must 
reckon  among  the  Mystics  of  the  school  of  the  philosophy  of  nature,  or 
the  Supernaturalists,  many  of  whom  also  cultivated  animal  magnetism,  the 
following  physicians:  Jos.  Ennemoser  (1787-1854)  of  Tyrol,  private 
secretary  of  Hofer  in  1809,  professor  in  Bonn,  and  finally  a  private  physi- 
cian in  Munich  ;  K.  Ad.  Aug.  von  Eschenmayer  (1768-1852),  professor  in 
Tubingen  ;  Joh.  Nep.  von  Ringseis  (1785-1880)  of  Schwarzhofen  in  the 
Oberpfalz,  professor  in  Munich,  ordinary  physician  and  travelling  com- 
panion of  Ludwig  I.,  and  author  of  a  ''System  der  Medicin"  (1841),  which 
defines  the  task  of  medicine  as  follows  :  "  To  prevent  and  cure  diseases, 
and  to  assist  in  the  improvement  of  humanity,  a  task  whose  thorough 
performance  can  be  accomplished  only  in  organic  union  with  church,  state 


—  937  — 

and  nature.  The  sole  practical  watchword  is  professional  art ;  its  condi- 
tion, medical  science."  He  also  believed  in  the  demoniacal  origin  of  many 
diseases  !  Gotth.  Heinrich  von  Schubert  (1780-1860),  professor  in  Er- 
langen  and  Munich;  Franz  Xaver  von  Baader  (1765-1841),  placed  as  a 
philosopher  above  Rebelling  and  often  made  use  of  by  the  latter,  a  friend 
of  the  visionary  Justinus  Kerner,  and  according  to  David  Strauss,  "no  poet, 

and  just  as  little  an  observer,    but  a gloomy,  religious  fanatic"; 

Leupoldt,  who  studied  medicine  historically  on  its  objective  and  subjective 
sides,  from  the  stand-point  of  a  Christian  and  a  German  ;  and  others. 

From  among  the  number  of  important  practical  pbjsicians  of  this 
school  we  mention  :  Joh.  Malfatti  and  the  already  noticed  Joh.  Ad. 
Schmidt  of  Aub,  both  professors  in  Vienna  ;  Carl  Himly  (born  1772, 
drowned  1837),  professor  in  Braunschweig,  Jena  and  Guttingen,  who  has 
also  been  mentioned  ;  his  son  Wilhelm  (1800-1881),  who  was  likewise 
professor  in  the  university  'of  Guttingen.  —  Among  the  oculists  of  this 
school  belonged  Beer  (in  part),  and  particularly  Weller  and  Beck.  The 
first  believed  that  in  the  formation  of  cataract  a  galvano-electric  process 
existed,  inasmuch  as  there  was  a  definite  attraction  of  the  plastic,  crys- 
tallizing material  between  the  uvea  and  capsular  membrane,  as  well  as 
between  this  and  the  ciliary  processes  etc.  Weller  explained  staphyloma 
as  follows  :  cornea  and  iris  are  different  from  each  other,  and  between  both 
is  the  indifferent  aqueous  humor.  If  this  dualism  ceases,  "the  cornea 
loses  the  property  of  expansion  to  correspond  with  the  light,  and  the  iris 
its  peculiarity  as  an  irritable  structure  of  checking  the  light.  Thus  the 
point  of  indifference,  the  aqueous  humor,  disappears,  and  both  fuse  into 
an  organic  mass.  In  this  productive  activity  now  prevails,  the  new 
structure  will  abandon  its  active  sense  and  now  develops  in  the  shape  of 
spheres  or  cones"  —  an  explanation  which  rather  befogs  than  clears  up 
the  formation  of  staphyloma. —  Friedr.  Aug.  Pnchelt  (1784-1856),  a 
famous  professor  in  Heidelberg,  and  Conrad  Jos.  Kilian  (1771-1821), 
Docent  in  Jena,  Wiirzburg,  Leipzig  and  Bamberg,  and  then  a  practising 
physician  in  Petersburg. 

Kilian  was  the  proper  systematist  among  the  physicians  of  the  philosophy  of 
nature,  and  believed  that  it  was  impossible  to  define  disease  from  the  stand-point  of 
experience.  That  this  had  been  done  hitherto  he  believed  to  have  been  the  ruin  of 
the  sciences  up  to  his  own  time.  In  his  practice  he  professed  to  have  lost  but  thirteen 
patients  among  2000  whom  he  had  treated;  to  be  sure  most  of  them  suffered  from 
nothing  worse  than  the  itch. 

Joh.  Spindler  (born  1777),  professor  in  Wiirzburg  ;  Karl  Georg  Neu- 
mann (1774-1850),  professor  in  Berlin  from  1818  and  finally  a  practitioner 
in  Aachen  ;  Christian  Friedr.  Nasse  (1778-1851),  professor  in  Halle  and 
Bonn  ;  Ludwig  Yogel,  a  philosopher  of  nature  on  the  subject  of  syphilis, 
who  thought  "that  chemistiy  will  succeed  in  liberating  and  separating  the 
two  spirits  of  the  sublimate  from  the  poisonousness  which  adheres  to  them 
from  the  depths  of  the  earth",  with  others,  were  likewise  followers  of  the 
philosophical  school. 


—  938  — 

Dietrich  Georg  Kieser  (1779-18G2),  professor  in  Jena, 
who  with  Oken,  Luden,  Fries  and  others  stood  upon  the  political  proscription  list  or 
the  (Jentz-Metternich  era,  but  with  Oken,  Doebereiner  etc.  made  Jena  in  the  begin- 
ning of  the  present  century  the  pioneer  university  of  Germany  in  the  natural  sciences, 
taught  "that  polarity,  conceived  as  a  phenomenon,  is  the  basis  of  everything,  since 
life  is  understood  as  an  oscillation  between  a  positive  and  negative  pole,  and  the  vital 
principle  as  the  organic  tension  which  kindles  and  supports  this  oscillation."  He 
assumed  for  ever}7  disease  a  sensitive,  animal  and  vegetative  stadium,  and  regarded 
diseases  as  parasites,  all  capable  of  generation  or  infectious  during  their  acme,  a 
doctrine  in  which  he  was  the  forerunner  of  the  theorj-  of  Parasitism  subsequently  so 
widely  developed.  This  theory,  indeed,  is  revived  at  the  present  day  mvtalis 
mutandis  in  the  germ  theory  of  disease,  for  in  the  "  School  of  the  Natural  Sciences" 
much  has  been  resurrected  and  become  an  article  of  faith  which  held  a  similar 
position  in  the  school  of  the  philosophy  of  nature.  Even  Mesmerism,  which 
numbered  Kieser,  among  others,  with  its  followers,  was  almost  restored  to  reputation. 
Kieser  also  held  the  horse-radish  to  bean  "  antitelluric  "  remedy,  which  dispersed' 
somnambulism  (System  des  Tellurismus  oder  thierischen  Magnetismus,  1822  etc.) 

Among  the  opponents  of  the  school  of  the  philosophy  of  nature  we- 
may  give  a  prominent  place  to  A.  F.  Hecker ;  Ph.  C.  Hartmann  and 
Hahnemann. 

From  the  names  alreatty  mentioned  of  the  followers  of  this  school  — 
we  have  designedly  pointed  out  chiefly  the  extravagances  of  their  doc- 
trines —  it  becomes  evident  how  many  important  men  of  science  belonged 
to  its  fold.  Apart  too  from  philosophical  technicism,  and  what  seems  at 
the  present  day  like  fancy,  the}-  introduced  many  permanent  improvements 
into  medicine. 

The  school  was  also  of  service  in  promoting  the  cultivation  of  medical 
subjects  in  the  German  language,  and  in  aiding  the  latter  to  gain  the 
supremacy.  In  comparison  with  the  stereotyped  therapeutics  of  the  sys- 
tems of  the  past,  it  likewise  reawakened  a  better  conception  of  medical 
practice,  inasmuch  as  it  kept  itself  free  from  therapeutic  monstrosities. 
It  is  too  an  indirect  service  of  this  school  that  it  did  not  create  any  sys- 
tem of  natural-philosophical  therapeutics.  - —  Besides  all  this,  it  cultivated 
the  study  of  the  history  of  medicine,  and  in  its  method  (by  the  way  at 
least  an  ingenious  and  artistic  one)  did  not  satisfy  itself  with  bibliograph- 
ical notices  etc. 

As  already  pointed  out,  the  catholicising,  beatifying  and  hypocritical 
tendency  of  some  physicians  of  the  school  of  the  philosophy  of  nature, 
and  the  play  with  words  and  disposition  to  half-true  ideas  and  foggy  con- 
ceptions of  many  of  them,  exercised  a  sobering  influence  upon  the  brains 
of  other  mortals.  The  philosophers  of  nature  must  be  regarded  in  many 
respects  as  the  Romancists  (or  "  Teutomaniacs  ")  of  medicine.  The  med- 
ical, as  well  as  the  poetical,  emotional,  sentimental  and  idealistic  Roman- 
cists.1 who  shuddered  at  anything  sober,  beclouded  everything,  the  one  the 

1.  Among  the  latter  belonged  in  fact  the  physicians  Achim  von  Arnim,  Varnhagen 
von  Etise,  Justinus  Kerner  and  others.  In  painting,  the  Idealists  Cornelius  (1783- 
1867),  J.  Fr.  Overbeck  (1789-1870)  and  the  other  Nazarenes  belonged  in  this  class, 
whose  strength  and  weakness  they  shared. 


—  939  — 

subjects  of  their  poesy,  the  other  the  objects  of  their  science.  Both  cul- 
tivated a  tendency  unproductive  for  the  future  on  this  very  ground.  Yet 
the  philosophers  of  nature  are  of  great  importance  and  interest  as  an  ex- 
pression of  the  more  ideal  tendency  of  the  age,  of  the  spirit  of  the  time 
which  prevailed  before  our  realistic  philosophy,  and  the}*  were  too  in 
several  points  of  view  of  permanent  value  for  the  medical  sciences,  but 
more  particularly  in  physiology  and  the  history  of  development.  They 
must  be  looked  upon  as  the  speculative  predecessors  of  our  present  in- 
ductive anthropolog}',  a  department  in  which  both  by  different  methods  of 
investigation  meet. 

The  downfall  of  the  school  of  the  philosophy  of  nature  was  brought  about  by  that 
change  in  the  intellectual  bent  of  the  time  which  was  completed  in  the  Revolution  of 
July,  and  which  occasioned  in  Germany  also  the  transition  from  the  earlier  idealistic- 
era  to  the  later,  and  now  existing  era  of  Realism  and  Materialism.  Lange,  in  his- 
ingenious  history  of  Materialism,  says  on  this  subject:  "  Not  only  was  the  classical 
period  over,  but  the  Romancists  had  likewise  sung  themselves  out;  the  Suabian 
school  had  passed  beyond  its  bloom,  and  even  almost  everything  of  Heine's  (a  man. 
who  exercised  a  very  important  influence  upon  the  new  period),  which  is  animated 
by  an  ideal  spirit,  precedes  this  turning-point.  .  .  .  Schelling,  once  the  most  con- 
scientious supporter  of  the  idea  of  the  age,  an  overflowing  apostle  of  production, 
produced  nothing  more.  .  .  .  Hegel,  who  seemed  to  rule  the  age,  endeavored  to 
confine  the  idea  in  ossified  formulas  .  .  .  Gervinus  .  .  .  entertained  the  idea 
that  a  period  of  politics  must  now  follow.  .  .  .  He  forgot  ....  that  for  the- 
realistic  period  which  now  began,  material  charity  and  the  development  of  industry 
occupied  the  first  rank.  .  .  Trade-unions  and  similar  associations  shot  up  during 
the  thirties  like  mushrooms  out  of  the  ground;  in  the  department  of  education, 
polytechnic  institutions,  schools  for  the  education  of  artisans  and  commercial  schools 
were  founded  by  the  citizens  of  flourishing  cities.  .  .  It  is  a  characteristic  minor 
feature  of  this  period  that  gymnastic  instruction,  which  had  been  done  away  with  in 
consequence  of  its  idealistic  tendencies,  was  now  again  admitted  from  considerations 
of  health.  The  chief  activity  of  governments  was  devoted  to  matters  of  commerce, 
and  the  most  important  social  and  political  creation  of  the  entire  decennium  was  the 
German  "  Zollverein ".  The  railroads  were  still  more  important  in  their  results. 
Just  about  the  same  time  the  interest  in  the  natural  sciences  finally  opened  a  road 
for  itself  in  Germany,  and  the  leading  role  was  played  by  the  science  of  chemistry. 
Berlin,  by  the  labors  of  Alexander  von  Humboldt,  Ehrenberg,  Dove  and  the  two 
Roses,  the  chemist  and  mineralogist,  became  one  of  the  most  important  nurseries  of 
science.  With  the  men  named  was  associated  Johannes  Midler,  who,  indeed,  in  his 
3*outh  had  passed  through  the  school  of  the  philosophj-  of  nature,  but  without  thus 
losing  the  sober  energy  of  the  investigator.  By  means  of  his  "  Handbuch  der  Phy~ 
siologie  "  (1833),  as  well  as  his  indefatigable  activity  as  a  teacher,  he  became  the 
most  influential  pioneer  of  the  strictly  scientific  direction  of  physiology.  The 
works  of  Ernst  Heinrich  Weber  (1795— 1878),  still  more  profound  so  far  as  regards 
mathematical  accuracy,  were  a  powerful  support  of  this  same  tendency.  To  all  this 
was  added  the  fact  that  the  French  influence,  at  this  time  again  very7  considerable  in 
Germany,  was  entirely  directed  to  the  same  side.  The  investigations  of  a  Flourens, 
a  Magendie,  a  Leuret.  and  Longet  in  the  department  of  physiology-  created  an 
immense  sensation  in  Germany,  and  prepared  the  ground  for  the  subsequent  appear- 
ance of  Vogt  and  Moleschott.  The  greatest  impulse  towards  the  reform  of  Psy- 
chiatry came  also  from  France  ;  for  nothing  was  suited  to  put  an  end  for  ever  to  the 


—  940  — 

transcendental  dreams  of  the  theologising  Heinroth  and  liis  followers,  so  much  as  t lie 
•study  of  the  works  of  the  worthy  Esquirol,  which  were  translated  into  German  in 
1838.  In  the  same  year  appeared  also  a  translation  of  Quetelet's  work  '' Sur  1' 
homme  "  etc.,  in  which  that  famous  Belgian  statistician  sought  to  furnish  a  phy- 
siology of  human  actions  based  upon  numbers.  The  writings  of  "young  Gei many  " 
received,  through  the  spirit  of  opposition,  an  importance,  which  raised  them  fat- 
above  their  intrinsic  value Poesy  might  be  terminated  with  the  year  1880 

and  little  of  genuine  importance  would  be  missed.  .  .  .  A  book  "  Das  Leben  Jesu  '' 
by  Strauss,  which  appeared  in  1835,  struck  at  tiie  very  roots  of  the  prevailing 
Christianity.  With  this  book  Germany  undertook  the  role  of  leader  in  the  struggle 
for  free  criticism  of  religious  traditions.  Historico-philological  criticism  too  had 
already  become  the  glory  of  German  science.'' 

From  the  intellectual  substratum   thus  ingeniously  sketched  by  Lange  grew  up 
the  following  new  tendency  in  medicine. 

i.  The  School  of  Natural  History 

was  the  immediate  successor  of  the  school  of  the  philosophy  of  nature 
and  made  already  important  concessions  to  modern  Realism. 

A  picture  so  perfect,  on  the  whole  so  profitable  and  so  complete  in 
itself,  as  the  so-called  school  of  natural  history,  is  presented  fry  none  of  the 
schools  which  have  as  yet  risen  during  the  19th  century,  whether  we  regard 
the  characteristics  of  its  most  important  representatives,  the  solidity  of 
their  works,  or  even  the  time,  duration  and  the  country  from  which  it  de- 
rived its  supporters  and  its  fame. 

The  most  prominent  physicians  of  the  school  of  natural  history  were 
from  South  Germany,  especiall}T  from  Bavaria,  and  were  sons  even, of  one 
and  the  same  cit}'.  The  same  was  the  case,  though  not  to  the  same  de- 
gree, with  the  representatives  of  the  school  of  the  philosoph}-  of  nature. 
To  this  fact  may  perhaps  be  ascribed  their  similaritj"  of  character  and 
their  disposition  to  systematization,  as  well  as  the  common  aim  of  their 
literary  services.  The  writers  of  this  school  cultivated  more  particularly 
the  department  of  text-books,  in  fact  that  of  clinical  text-books,  a  depart- 
ment which  corresponded  to,  and  originated  in,  their  tendency  to  the  prac- 
tical, in  spite  of  all  artificial  nosological  arrangement.  In  this  lies  the 
chief  merit  of  the  school,  for  it  was  this  course  precisel}'  which  finally 
opened  an  unobstructed  path  to  the  clinical  method  in  Germany. 

The  period  of  existence  of  the  school  of  natural  history  embraced 
about  the  years  between  1830  and  1850  ;  that  of  its  fame,  the  forties. 
This  fame  expired  not  by  a  gradual  extinction,  but  almost  at  once.  The 
adherents  of  this  school  were  almost  all  men  of  political  enlightenment 
and  independence,  and  observers  as  capable  as  clear  and  careful.  None  of 
them  were  bigoted  enthusiasts  or  fanatics.  Though  a  few  of  them  com- 
mitted theoretical  and  monstrous  excesses,  this  only  shows  once  again  the 
ultimate  destiny  of  almost  all  schools.  Among  these  zealots  belonged 
particularly  those  who  were  most  devoted  to  the  system  of  the  philosophy 
of  nature,  and  who,  accordingly,  were  to  be  counted  substantial!}-  followers 


—  941   — 

and  adherents  of  the  latter  school,  rather  than  of  the  school  of  natural 
histoiy,  as  e.  g.  the  followers  of  the  theory  of  Parasitism. 

The  new  school  was  manifestly  based  partially  upon  that  of  the  phil- 
osophy of  nature.  On  its  practical  side,  however,  it  sprung  (though  rather 
in  accordance  with  its  essence  than  its  demonstrable  source)  from  the  more 
independent  tendency  of  individual  professors  and  famous  physicians,  who 
knew  how  to  preserve  themselves  from  domination  by  the  omnipotence  of 
the  philosophers  of  nature.  On  both  sides  we  enumerate  here  the  physi- 
cians already  mentioned  :  Frank,  Joh.  Heinr.  Autenrieth,  the  pupil  of 
Peter  Frank  ;  Nasse  ;  Ernst  von  Grossi  (1782-1829),  -professor  in  Munich 
and  author  of  a  famous  treatise  upon  semeiology;  Ferdinand  Gottlieb 
Gmelin  ;  Karl  Heinrich  Baumgartner  (1798-1886),  the  later  cell-theorist, 
who  appeared  in  this  role  even  before  Schwann  (Rohlfs),  and  who  was  from 
1824  clinical  professor  in  Freiburg  ;  above  all,  however,  the  model  practi- 
tioners ';old"  Ernst  Ludwig  Heim  (1747-1834)  in  Berlin.  Stieglitz  and 
Peter  Krukenberg'  (1788-1865)  in  Halle,  the  latter  of  whom  was  equal  as 
a  clinical  teacher  to  the  founder  of  the  so-called  school  of  natural  histoiy, 
and,  indeed,  in  many  respects  surpassed  him. 

Krukenberg' s  therapeutic  creed  ran  as  follows:  "The  pl^sician  sbould  be 
filled  with  a  pious  reverence  towards  nature.  The  organism  is  a  whole,  and  must  be 
contemplated  in  this  sense.  Our  art  is  undoubtedly  capable  of  decisive  action,  but 
let  us  not  mistake  the  fact  that  in  many  cases  its  activity  is  quite  superfluous,  in  very 
many  null  and  inadequate,  in  many  injurious.  Indeed,  what  virtues  are  assigned  to 
one  and  the  same  remedy  !  When  we  read  these  commendations  we  sometimes  seem 
to  be  actually  standing  before  the  booth  of  a  mountebank!  "  (See  Rohlfs.)  Words 
freighted  with  the  spirit  of  truth,  which  cannot  be  reflected  upon  sufficiently,  and 
which  sbould  be  stored  in  the  heart  of  all  professional  enthusiasts  in  medication  ! 

In  its  special  character  as  the  result,  as  well  as  the  successor,  of  the 
school  of  the  philosophy  of  nature,  the  school  of  natural  histoiy  —  and 
still  more  its  founder  —  borrowed  and  adopted  a  few  abstractions  of  the 
former  school,  as  e.  g.  certain  fancies  relating  to  eleetricit}-  and  certain 
chemical  views.  To  these  were  added  some  ideas  from  S}"denham  and 
even  those  of  Paracelsus  somewhat  modernized  (doubtless  as  the  result 
of  the  study  of  that  ingenious  physician  of  the  16th  century  —  a  study 
prosecuted  with  special  assiduity  at  this  period),  whose  Tartaric  diseases 
were  already  a  sort  of  natural  family,  and  who,  accordingly,  had  already 
taken  the  direction  of  natural  history.  The  most  striking  influence,  how- 
ever, was  exerted  by  the  botanical  acquisition  of  a  new  classification,  based 
upon  so-called  natural  families,  the  principle  of  which  was  transferred 
into  pathology.  That  this  principle  could  be  carried  out  only  imperfectly, 
as  well  as  that  it  was  tortured  b}'  individual  representatives  of  the  school 
into  an  unnatural  and  strained  position,  although  a  germ  of  good  derived 
from   observation   lay  everywhere  at    the    base  of   the  whole,   cannot  be 

1.   The  one  hundredth  anniversary  of  his  birth  was  celebrated  with  high  festivities 
in  Halle  —  an  evidence  of  his  importance  in  Lessing's  sense  ! 


—  942  — 

wondered  at,  when  we  take  into  consideration  and  comparison  the  history 
of  other  schools. 

The  school  of  natural  history  was  the  expression  of  the  turn  which 
medicine  was  compelled  to  take  to  escape  from  the  after-effects  of  the 
one-sided,  ideal  or  systematizing  tendency  of  the  18th  century  (of  which 
natural  philosophy  was  the  final  product),  and  to  enter  upon  the  realistic 
or  positive  tendency  of  science  and  culture  in  the  19th  century  in  both 
medicine  and  the  other  sciences.  It  is  in  the  most  peculiar  sense  the 
school  of  transfer  or  mediation,  historically,  between  the  two  tendencies, 
and  therefore,  besides  systematic  and  merely  nosological  principles  of 
arrangement,  already  displays  a  great  number  of  realistic  principles.  It 
shows  everywhere  its  mediatorial  position  between  the  old  traditions  and 
the  most  recent  times.  Thus,  for  the  purpose  of  careful  observation,  it 
fostered,  indeed,  the  ancient  Hippocratic  diagnosis  and  method,  by  which 
it  preserved  its  connexion  with  the  earlier  medicine,  and  which  the  later 
school  of  natural  science  almost  entirely  set  aside.  In  addition,  however, 
it  cultivated  considerably  the  physical,  and  particular^  the  microscopic 
diagnosis  adopted  from  France.  Indeed  this  school  gave  a  decisive  im- 
pulse to  microscopic  investigation  in  general,  so  that  Virchow,  one  of  its 
scions,  subsequently  founded  upon  it  his  cellular  pathology,  and  thus- 
elevated  the  microscope  to  the  fundamental  instrument  in  pathology  and 
pathological  anatomy.  It  also  appropriated  chemistry  and  pathological 
anatomy,  without,  however,  making  the  latter  the  main  foundation  of  med- 
ical science  and  treatment,  and  without  completely  overlooking  the  dy- 
namic element.  "  Physics  or  mechanics,  on  the  other  hand,  it  entirely  neg- 
lected." It  was  too  not  yet  entirely  exact,  though  it  concealed  within 
itself  the  germ  of  that  excellence  and  planted  it  in  the  field  of  medicine, 
inasmuch  as  it  "considered  medicine  a  part  of  the  natural  sciences  and, 
accordingly,  strove  to  cultivate  it  by  the  same  method"  from  which  the 
roots  of  exact  investigation  drew  their  nourishment.  In  therapeutics  the 
school  of  natural  history  performed  eminent  service,  and,  indeed,  it  was 
the  pioneer  in  a  new  s}'stem  of  therapeutics  and  practice.  It  did  not  sink 
into  "scientific"  medicine,  and  was  unable  to  find  satisfaction  in  purely 
expectant,  symptomatic,  ph3*sico-mechanical  treatment. 

The  school  too  found  its  characteristic  bond  of  union  less  in  a  system, 
than  in  the  more  external  force  of  the  nosological  principle  which  it  ac- 
cepted.    Its  founder, 

Joiiann  Lukas  Schonlein  (1798-1864)  of  Bamberg, 
had  pursued  his  studies  in  Landshut,  Wiirzburg,  Gottingen  and  Jena  from  the  year 
1811,  and  in  181!)  settled  as  a  privatdocent  in  Wiirzburg.  By  the  next  year  he 
became  a  professor  in  the  hitter  city,  where  he  remained  until  1832,  in  which  year, 
half  compelled  by  his  enlightened  views  in  politics,  he  emigrated  to  Zurich,  where  he 
passed  the  period  of  his  greatest  fame.  Here  he  remained  until  1840,  when,  tired 
of  Swiss  republicanism,  he  went  to  Berlin  to  become  a  professor,  physician-in-  ' 
ordinary  and  ministerial  counsellor,  and  to  reap  (although  as  Fanny  Hensel- 
Mendelssohn   relates,   he  was  very  rude)  greater  external,  and  particularly  greater 


—  943  — 

pecuniary  success,  than  he  could  have  attained  in  little  Switzerland.  He  made 
greater  and  greater  concessions  to  the  dominant  French  school,  and  finally  voluntarily 
vacated  his  place  to  the  latter,  in  order  to  live  until  the  close  of  his  life  in  retirement 
in  his  native  citj',  where  he  saw  his  system  superseded.  This  retirement  at  the  right 
time,  as  well  as  the  fact  that  Schonlein  himself  wrote  nothing  except,  his  inaugural 
thesis  on  "  Hirnmetamorphose  "  (1816)  and  a  paper  on  the  triple  phosphates,  furnish 
rare  evidence  of  practical  judgment  and  self-restraint  on  the  part  of  a  university 
teacher.  These  virtues,  so  far  as  he  did  not  possess  them  originally  (which  was  very 
largely  the  case),  he  may  have  acquired  particularly  in  Switzerland,  the  land  of 
practical  worldly-wisdom  and  practical  tendencies.  The  lack  of  any  book  from  his 
pen  could  only  increase  the  number  of  his  hearers,  and  the  heightened  impression  of 
his  living  words  was  thereby  attained  to  a  degree  which  numerous  editions  of  a 
written  treatise  could  not  have  accomplished.  The  substance  of  his  doctrines,  how- 
ever, is  found  in  his  clinical  lectures  at  the  Charite,  edited  by  Giiteibock  in  1842. 
As  a  clinical  teacher  and  practitioner  Schonlein  was  one  of  the  greatest  men  of  our 
century.  His  only  son  Philipp  died  of  climatic  fever  at  the  age  of  Tl  at  Cape 
Palmas  during  a  journey  in  Africa.  Gust.  Nachtigal  (1834-1885)  died  of  the  same 
disease,  and  is  also  buried  at  the  same  place.  —  It  may  also  be  mentioned  that 
Schonlein  discovered  the  Achorion  Schoenleinii  (1839)  and  the  Acarus  folliculorum. 

Schonlein's  doctrine  of  disease  is  founded  in  many  respects  upon 
earlier  ideas,  particularly  those  of  Autenrieth  and  Stark  (or  rather  on  the 
dissertation  of  Stark's  brother),  and  is  on  the  whole  decidedly  ontological, 
though  in  particulars  it  is  never  held  and  carried  out  with  inflexibility,  a 
quality  not  characteristic  of  its  inventor.  Discoveries  in  pathological 
anatoni}-  he  regarded  e.  g.  not  as  the  results  of  previous  disease,  but  as  the 
concrete  expression  of  the  abstract,  independent  entity,  "disease",  whose 
relation  to  the  organism  he  looked  upon  as  that  of  a  parasite  sojourning 
temporarily  in  it,  as  a  foreign  organism  in  the  originally  simple  organism 

—  Paracelsus  spoke  of  a  microcosm  within  a  microcosm  —  which  in  dis- 
eases of  the  skin  e.  g.  blooms,  deposits  its  fruit  in  the  granary  of  the  body 
etc.,  etc.  In  contrast  with  this  botanical  parallel,  Schoenlein  further  dis- 
tinguished the  independent  development  of  a  disease  as  a  kind  of  equiv- 
ocal generation  of  infusoria,  which  brought  about  disease  b}^  means  of 
infection,  but  as  a  true  generation  of  a  new  individual  disease.  Against 
this  entit}',  disease,  pressing  in  from  without,  the  body  (as  with  ParacelsUs) 
finds  itself  constantPy  in  a  state  of  defence.  If  this  defence  is  successful, 
the  body  is  healthy,  or  as  Schonlein  says  :  health  is  the  balance,  or  better 
still  the  preponderance  of  the  egoistic  principle  against  the  planetary,  a 
definition  which  conceals  a  certain  sympathy  with  the  views  of  Paracelsus. 
Again,  however,  disease  is  the  expression  of  the  "reaction"  of  the  organism 

—  the  fundamental  constituents  of  which  are  "zoogen",  blood  and  nervous 
tissue  —  against  the  inroads  of  the  entity,  disease.  Fever  in  particular 
manifests  itself  as  such  a  reaction,  and  accordingly  essentiality  does  not 
belong  to  it,  for  it  is  not  a  disease,  and  is  to  be  considered,  both  in  itself 
and  in  its  form,  as  merePy  an  expression  of  the  degree  in  which  the  system 
reacts  against  the  local  lesion,  and  opposes  the  hostile  exciter  of  disease. 
The  fever  is  S}rnochal  when  the  reaction  is  too  strong,  torpid  when  this  is 


—  044  — 

too  weak,  and  it  is  called  erethitie  when  the  reaction  and  the  force  of  the 
injury  are  equally  balanced.  The  crises,  in  case  the}*  are  general,  follow 
only  through  the  perspiration  and  the  urine,  but  when  they  are  local  they 
manifest  themselves  in  numerous  ways,  through  all  the  other  evacuations. 
What  Schonlein  says  in  this  last  respect  of  critical  haemorrhages  reminds 
us  at  once  of  the  views  of  Stahl. 

"If  the  subject  is  young,  critical  haemorrhages  take  place  easily  from  the  chest 
or  from  the  nose,  because  in  these  years  particularly  the  blood  flows  to  the  chest  and 
the  head.  On  the  other  hand,  in  old  people  haemorrhages  occur  readily  from  the 
anus,  because  at  this  period  of  life  the  blood  flows  readily  downward.  Sex  too  has  an 
influence  upon  the  kind  of  haemorrhage.  Moreover  in  young  subjects,  particularly  in 
s3*nochal  diseases  above  the  diaphragm,  nasal  haemorrhages  are  frequent"  (this  recalls 
Borden's  doctrine  of  the  pulse),  "  but  in  diseases  below  the  diaphragm  they  occur 
from  the  nasal  fossa  of  the  same  side,  e.  g.  in  inflammation  of  the  liver,  from  the 
right  fossa.  In  females  haemorrhages  ensue  from  the  sexual  organs,  even  in  diseases 
above  the  diaphragm.  Individuals  beyond  maturity  bleed  from  the  rectum. 
Haemorrhages  from  the  lungs,  the  stomach  and  the  urinary  passages,  if  either  too 
small  or  too  larjre,  are  for  the  most  part  neither  critical  nor  salutary.  Local  crises 
of  the  organs  of  secretion  appear  only  in  diseases  of  these  organs  themselves,  or  of 
those  organs  whicli  stand  in  connexion  with  them.  Thus  in  inflammation  of  the  liver 
bilious  fluxes  arise;  in  inflammation  of  the  spleen,  vomiting  of  blood.  If,  however, 
the  disease  fastens  upon  an  organ  which  presides  over  no  secretion,  the  local  crisis 
consists  in  an  alteration  in  the  functions  of  the  part,  e.  g.  when  the  brain  is  affected 
the  crisis,  in  consequence  of  the  importance  of  the  injured  part,  is  a  fever-crisis,  but 
the  deep  sleep  may  still  be  considered  a  local  crisis.  In  seizures  of  the  ganglionic 
nervous  system,  convulsions,  e.  g.  in  hysterical  persons,  are  the  change  of  function 
(See  Wunderlich). 

Natural  history  proper  is  first  manifested  in  the  ''natural''  classifica- 
tion of  diseases,  which  are  divided  into  classes,  families  and  species  or 
kinds,  like   the  plants  with  de  Candolle.      These  classes  bear  the  names  : 

1.  Morphen  ;  II  Hiimatosen  ;  III.  Neurosen,  to  which  the  "Syphiliden" 
are  annexed. 

Class  I.  consists  of  those  diseases  in  which  the  "zoogen"  (an  arbitrarily  assumed 
fundamental  constituent  of  the  living  body)  is  altered,  and  it  is  divided  into  the 
following  families :  1.  Dysmorphen,  or  congenital  malformations;  2.  Theromorphen, 
or  formations  like  the  lower  animals;  ?>.  Hypertrophieen  ;  4.  Atrophieen  ;  5.  Stenosen  • 
6.  Ectopieen  ;  7.  Wunden. 

Class  II.  contains  diseases  arising  from  changes  in   the  blood:   1.  Erythrosen  ; 

2.  Phlogosen;  3.  Neurophlogosen ;  4.  Typhen;  5.  Cyanosen ;  6.  Hamorrhagie ;  7. 
Katarrhe;  8.  Rheumatismen ;  9.  Erysipelaceen  ;  10.  Impetigenes;  11.  Skropheln  ; 
12.  Tuberkeln  ;  13.  Phtisen  ;  14.  Colliquationen  ;  15.  Hydropsieen  ;  16.Dyschymosen  ; 
17.  Arthritiden;    18.  Carcinomen. 

Class  III.  is  composed  of  disturbances  of  the  nervous  tissue:  1.  Intermittentes ; 
2.  Neuralgien  ;  !!.  Neurosen. 

That  the  forcing  diseases  into  genera  and  species  must  develop  much 
arbitrariness  is  evident  from  the  names  of  the  various  classes.  Thus  e.  g. 
cancer  of  the  liver  falls  into  the  family  of  "Tuberkeln";  chlorosis,  into 
that  of  ••Cyanosen";  gangrene  of  the  uterus,  among  the  "Neurophlogosen", 
and  cholera  among;  the  "Katarrhe"!     Nevertheless  the  school  of  Schonlein 


—  945  — 

"brought  forward  a  sharper  individualizing  and  characterization  of  the 
different  diseases,  as  morbid  processes  of  development  of  essential  phe- 
nomena remaining  identical  in  each  individual  case. 

In  therapeutics  Schonlein  was  free  from  extremes,  and  for  his  age 
especially  free  from  decided  activity,  in  that  he  set  aside  the  exciting 
metliod  of  treatment  of  Brown  and  Roschlaub  and  inculcated  respect  for 
the  so-called  critical  efforts  of  the  body.  He  also  toned  down  the  ener- 
getic venesection  of  a  Marcus  into  a  mild,  antiphlogistic  treatment,  but 
yet  in  an}-  given  case  did  not  recoil  from  energetic  procedures.  Among 
other  methods,  Schonlein  laid  stress  again  upon  mineral  springs  more  tban 
had  been  done.  If  too,  on  the  whole,  he  kept  himself  free  from  absolute 
faith  in  drugs,  still  he  believed  in  a  therapeutics,  and  was  undoubtedly  one 
of  the  most  important  practitioners  of  our  century,  resembling  in  many 
respects  tbe  English  physicians. 

Schonlein  had  the  good  fortune  and  the  address  to  receive  and  to 
educate  a  number  of  eminent  pupils,  who  honored  him  in  their  hearts  and 
reflected  upon  him  a  portion  of  their  own  fame.  He,  however,  accepted 
the  calling  and  duties  of  an  academic  teacher  most  conscientiously,  con- 
sidering his  position  created  by  no  means  for  himself  but  for  the  benefit 
of  his  pupils.  Nor  did  he  regard  the  reputation  which  he  attained  as  a 
stepping-stone  to  a  lucrative  private  practice,  though  the  latter  neverthe- 
less fell  to  his  lot  and  presented  him  with  rich  rewards. 

One  of  the  best  known  and  most  important  of  his  pupils  was  the  ever 
zealous  Karl  Canstatt  (1807-1850)  of  Regensburg,  professor  in  Erlangen. 
who  was  carried  off  prematurely   by  consumption.     His  "Jahvesbericht" 
preserves  the  memoiy  of  his  name,  while  his  "Handbuch  der  medicinischen 
Klinik,"  2d.  edition,  Erlangen,  1847,   deserves  to  be   studied  even  to-day 
and  to  serve  as  a  model  of  instruction.     We  need  disregard  only  its  noso- 
logical, antiquated  arrangement,  which  necessarily  appears   artificial,  often 
strained  and  in  fact  incomprehensible,  but  }-et  does  no  harm  to  the  sub- 
stance of  the  work,  which   considers  pathological  anatomy,  physical  diag- 
nosis etc.,  and  furnishes  a  good  system  of  therapeutics,  save  that  it  is  often 
too  much  of  a  compilation.     It  makes   numerous  concessions  to  the  ana- 
tomical tendency  and  to  the  doctrine  of  erases. 
Canstatt's  nosological  arrangement  is  as  follows: 
I.  Morphological  part  of  the  clinic.     Elemental-}"  forms  of  disease. 
II.   Specific  morbid  processes. 

a.  First   class.    1.   Order:     specific    exanthematous    processes.      2.    Order: 

malarious  diseases,  o.  Order:  Typhus.  4.  Order:  Atmospheric  dis- 
eases (diseases  due  to  taking  cold,  Cholosen).  5.  Order:  Diseases  due 
to  animal  poisons.  Appendix:  Toxicoses  and  developmental  diseases. 
6.  Order:   Chronic  diseases  (Syphilis,  Lepra,  Plica  Polonica). 

b.  Second  class.      Constitutional  dyscrasire   (Scorbutus,  Werlhof's  disease 

or  purpura  hasmorrhagica  etc.) 
III.   Special  local  pathology. 
60 


—  946  — 

I.   Diseases  of  the  head.     1.    Prolegomena  to  pathology   and   therapeutics. 
'_'.    Elementary   forms  of  diseases  of  the   head.      I.   Hypertrophy.     II. 
Atrophy.     III.    Anaemia  and   hydraemia.     IV.   Hyperemia,   Stasis,  In- 
flammation lie. 
II.    Diseases  of  the  spinal  cord. 

III.  Topographical  pathology  of  individual  nerves  and  nerve  district-. 

IV.  Diseases  of  the  air-passages. 

Y.    Diseases  of  the  organs  of  circulation. 
VI.    Diseases  of  the  arteries  and  veins. 
VII.   Diseases  of  the  ehylopoetic  sj'stem. 
VI 1 1.   Diseases  of  the  uropoetic  s}-stem. 
IX.  Diseases  of  the  genital  system. 

X.   Diseases  of  the  peritoneum. 
XI.   Diseases  of  the  external  integument. 
Hydrophobia,  glanders,  syphilis,  and  gonorrhoea  look  curiously  enough,  accord- 
ing to  our  present  views,    in  the   class   of  cosmic  diseases,  and  jaundice  among  the 
constitutional    dyscrasiae !     Canstatt's    "  Krankheiten    des    hoheren    Alters"    (1839) 
should  also  be  mentioned. 

Very  popular  too  in  its  day  was  the  "Lehrbuch  tier  speciellen  Noso- 
logic unci  Therapie",  1845-48,  of 

Con  RAD  Heinricii  Fuchs  (1803-1855)  of  Bamberg, 
professor  in  Gottingen,  whose  classification  of  diseases  dazes  one  with  its  uncommon 
names,  e.  g.  Hamopexieen  for  diseases  characterized  by  increased  coagulability-  of 
the  blood:  Phlogose  and  Erysipelaceen  ;  Parakrisien,  for  the  diseases  of  secretion, 
among  which  figure  Hydrochysen  and  Chymozemieen ;  Hamatophtlioren  (Typhus 
etc.)  ;  D3'scrasien  with  Chymoplanien,  Kakochymien,  Phymatosen,  Carcinogen  and 
Phtiseu  etc.  Fuchs  enjoyed  especial  reputation  as  a  dermatologist,  in  which  capacity, 
as  iu  everything  else,  he  proceeded  to  classify  diseases  after  the  method  of  natural 
history.  His  "Lehrbuch",  with  its  curious  nomenclature  and  arrangement,  contains 
some  good  and  acute  observations,  diagnosis,  etiology  and  therapeutics.  •  The  last 
subject  is  treated  even  much  better  than  in  many  more  comprehensive  handbooks  of 
the  school  of  the  natural  sciences.  In  this  book  on  diseases  of  the  skin,  in  its  day 
so  famous,  he  divides  these  diseases  into:  Rheumatic  exanthemata  (among  which 
were  Flussflecken  and  Giraffenausschlag) ;  Gastric  enanthemata  and  exanthemata 
(aphtha?,  erythema,  urticaria,  phlyctaeriosis) ;  Smegmorrhoeen  (gneis,  comedonen, 
acne);  Acarpae  (Fratt  or  amorpha,  lentigo,  chloasma,  argyria,  pityriasis);  Poly- 
earpae ;  Monocarpae;  R-osenformen ;  Scharlachformen ;  Blatternformen.  Measles 
belongs  in  the  class  of  Dlennorrhoen.  The  character  of  the  "A  carpae"  family  is  as 
follows:  "Paracrisis  of  the  parts  of  the  skin  which  secrete  the  pigment  or  the  epider- 
mis; sometimes  merely  the  formation  of  pigment,  sometimes  that  of  the  epidermis 
only,  is  increased"  etc.  Characteristics  of  the  family  of  "  Polycarpie  "  "Paracrises, 
in  which  the  abnormal  products  (exudates)  of  the  cutis  are  retained  between  it  and 
the  epidermis  in  the  form  of  papules,  vesicles,  pustules,  and  numerous,  usually 
slightly  developed  fruits  of  these  germinale  upon  a  common  soil"  etc. — At  that  time, 
;is  we  may  judge  from  these  short  extracts,  greater  importance  was  laid  upon  the 
♦•(institutional  origin  of  diseases  of  the  skin,  than  is  done  by  the  school  of  Hebra  at 
the  present  day. 

A  pupil  and  assistant  of  Schonleia  was   Dr  F.  Simon  in  Berlin,  who 
died  at  an  early  age. 

Karl   Friedrich   Marcus,  Jr.  (1802-1856),  professor  in  Wurzburg, 


—  947  — 

acquired  an  eminent  reputation  as  a  clinician  and  diagnostician,  though  he 
became  blind. 

Gottfried  Eisenmann  (1793-1867)  of  Wiirzburg,  in  spite  of  his 
classification,  was  a  distinguished  observer  and  a  good  therapeutist.  He 
discussed  in  monographs  several  "Families",  e.  g.  the  vegetative  diseases 
in  1835,  the  families  of  Typhen,  Pyren  etc. 

G.  L.  Dittrich  (1815-1859),  professor  in  Erlangen,  the  famous  syphil- 
ographer  and  clinician,  who  specially  developed  the  subject  of  visceral 
syphilis,  and  particularly  its  pathological  anatomy,  wrote,  among  others,  on 
the  family  Syphilis.  Bernard  Mohr  (died  1849)  in  Wiirzburg  also  belonged 
to  this  school,  as  well  as  the  physiologist  and  pathologist  C.  H.  Schultz- 
Schultzenstein  (1798-1871)  in  Berlin,  who  was  still  a  half-follower  of  the 
school  of  the  philosophy  of  nature  (Lehrbuch  der  allgem.  Krankheitslehre; 
Die  natiirlichen  Familien  der  Krankheiten  etc.). 

The  diagnostician  of  the  school  was  A.  Siebert,  professor  in  Jena, 
whose  book  (-'Technik  der  medicinischen  Diagnostik",  1844  and  1845,  con- 
tinued by  a  "Diagnostik  der  Krankheiten  des  TTnterleibs",  1855)  discussed 
at  length,  and  from  the  stand-point  of  natural  history,  both  general  and 
special  diagnosis,  and  was  distinguished  by  great  excellence  in  particulars 
combined  with  much  oddit}-  and  mannerism  in  general  style.  The  latter 
peculiarity  may  be  illustrated  by  the  following  extract. 

"  Friend!  I  am  sitting  in  a  mountain  cot;  my  window  looks  out  upon  a  mirror- 
like sea,  and  good]}-  mountains,  of  elegant  form,  supply  the  background  etc.  Mean- 
while we  have  to  thank  you  physiologists  for  the  best  part  of  what  we  know  and  can 
make  use  of.  Where,  however,  is  your  exactness?  What  was  exact  to  you  fifty 
years  ago,  is  not  so  now,  and  him,  who  now  looks  around  with  the  feeling  of  a  lord 
from  his  petty  mole-hill,  the  pioneer  of  half  a  century  later  looks  down  upon  as  a 
wanderer  upon  the  clods  of  the  marsh."  Of  the  diagnostician  Siebert  demands: 
"The  diagnostician  must  accustom  himself  to  the  government  of  all  his  moral  and 
physical  pathemata.  He  must  keep  his  senses  sharpened,  and  especially  must  he 
regard  the  relatives  of  the  patient  with  a  knowledge  of  human  nature.  Nothing 
should  be  undertaken  regarding  the  sick  which  can  make  their  sufferings  worse,  but 
in  general  we  should  treat  them  as  far  as  possible  with  indulgence  " —  a  piece  of  advice 
well  worth  consideration.  "  Do  not  question  half-grown  maidens  on  things  which 
they  cannot  and  should  not  know.  Boys  and  <iirls  and  young  persons  often  cannot 
be  brought  to  speak  until  those  under  whose  surveillance  (!)  they  are  placed  have  gone 
away" — and  many  similar  precepts.  According  to  his  27th  precept,  the  physician 
'•  must  be  calm  and  earnest,  gentle  and  firm,  but  in  all  cases  sympathetic." 

From  this  school  sprung  also  Heinrich  Haeser,  the  widely  famous 
medical  historian,  particularly  eminent  for  his  history  of  epidemic  diseases, 
and  the  author  of  many  excellent  works,  all  of  which  are  composed  from 
the  philosophical  (pragmatischen)  stand-point,  and  devote  but  little  atten- 
tion to  the  history  of  culture.  His  "Lehrbuch  der  Geschichte  der  Medicin 
und  der  epidemischen  Krankheiten",  3d.  edition,  1875-1882,  written 
largely  from  original  sources,  with  the  greatest  erudition  and  devoting 
more  attention  to  bibliography  than  the  work  of  Sprengel,  has  secured  a 
very  wide  circulation. 


—  1)48  — 

Haeser  (born  in  Koine  in  1811,  died  in  Breslau  in  1885)  was  succes- 
sive^' a  professor  in  Jena  (he  graduated  here  in  183-1),  Greifswald  and 
Breslau  (1863).     In  his  day  he  was  classed  among  the  so-called 

Parasitists, 
that  is  among  that  section  of  Schunlein's  pupils  who  considered  diseases 
genuine  second  organisms  in  the  diseased  bod}",  generated,  developing  and 
dying,  the  last  either  of  themselves,  i.  e.  through  the  activity  of  the  mother 
organism,  or  by  the  power  of  drugs.  In  case  of  recovery  the}'  were  sup- 
posed to  be  removed  by  the  crisis  as  corpses  of  disease,  and  they  were  even 
regarded  as  capable  of  sickness  in  themselves. 

Schonlein,  about  the  close  of  the  thirties,  was  the  first  clear  supporter  of  the 
parasitic  theory  in  many  diseases,  a  theory  inaugurated  by  Bassi's  discovery  of  the 
fungoid  nature  of  muscardine  (demonstrated  by  Lebert  in  all  tissues  of  the  silkworm), 
and  now  popularized  by  the  discovery  of  the  bacilli   etc. 

Among  those  who  elaborated  this  portion  of  Schonlein's  doctrine 
.belonged  the  "Ideal  Parasitist",  Haeser's  teacher,  Karl  Wilhelm  Stark 
(1787-1845),  professor  in  Jena,  ordinary  physician  of  Karl  August  after 
the  death  of  his  father,  and  himself  the  father  of  the  famous  archaeologist 
of  Heidelberg,  Karl  Bernhard  Stark  (1806-1882).  He  was  the  author 
of  a  treatise  entitled  "Allgemeine  Pathologie  oder  allgemeine  Naturlehre 
der  Krankheit".  Robert  Yolz  (1806-1882),  chief  medical  counsellor  in 
Karlsruhe  and  finally  a  member  of  the  German  Board  of  Health,  and 
Ferd.  Jahn,  ordinary  physician  in  Meiningen  ('-System  der  Physiatrik  oder 
der  hippokratischen  Medicin),  who  accepted  the  existence  of  a  natural 
healing  power,  which  always  acted  suitably  against  the  parasitic  '-disease" 
(Physiatrist). 

An  utterly  fantastic  direction  was  taken  by 

Carl  Richard  Hofjiann  (died  1851)  in  Erlangen  and  Wiirzburg, 
then  medical  counsellor  in  lower  Bavaria,  in  his  ''Yergleichende  Ideal- 
pathologie'. 

He  defines  disease  as  "  an  ideal  organism,  which  must  stand  in  harmony  with 
the  real  organisms,  and  holds  that  the  former  develops  after  an  abnormal  type, 
regarding  it  as  a  reversion  to  a  lower  grade,  so  that  the  abnormality  of  the  diseases 
of  man  may  be  found  normal  in  beasts. 

"  Rhachitis  consists  in  an  unwinding  ( Herausschlingung)  from  the  totality  ot 
human  life,  and  a  free,  independent  representation,  of  the  ideas  of  the  invertebrate 
animal.  In  rhachitis  man  endeavors  to  change  himself  into  a  soft  animal  or 
mollusk  (!).  Chlorosis  is  the  chrysalid  transformation  of  the  human  being;  men- 
struation is  the  same  as  moulting  in  the  lower  animals;  the  phthisical  is  the  human 
sylph  (!  !).  Gout  is  a  revival  in  men  of  the  mures  articulares  (Gelenkmauser),  re- 
generation through  the  joints.  Hemorrhoids  are  not  varices,  but  crooked,  animal 
limbs,  crooked  intestinal  limbs  (!!!)  The  cancerous  dyscrasia  consists  in  the  effort 
of  the  organism  to  go  apart  again  into  the  opposition  of  stock  and  polypi."  This 
is  nonsense,  everyone  thinks  involuntarily;  still  there  is  method  in  it.  We  must 
certainly  agree  with  Marx  when  he  says:  "There  are  books,  like  the  one  before  us, 
which  admit  of  no  criticism  from  the  stand-point  of  searching  consideration."  (See 
Rohlfs,  "  Die  med.  Klassiker  Deutschlands,"  p.  396). 


—  949  — 

That  such  arbitrary  and  absurd  ideas  equalled  the  maddest  whimsies 
of  the  philosophers  of  nature  is  quite  manifest.  It  would  be  amazing  that 
such  things  could  have  been  done  in  our  age,  if  the  preceding  history  had 
not  shown  that  our  century  has  avoided  theoretical  monstrosities  quite  as 
little  as  any  of  the  earlier  ages. 

Opponents  of  the  school  of  natural  history  on  the  side  of  the  phil- 
osophy of  nature  sprung  up  in  Conradi,  (jr.  W.  Scharlan,  Lehrs  and  Ring- 
seis.  The  latter  called  Schonlein,  after  his  death,  a  plagiarist.  The 
weightiest  opponent,  however,  was  Bud.  Hermann  Lotze  (1817-1881)  in 
Gottingen  (called  to  Berlin  before  his  death),  a  physician  and  philosopher, 
and  as  such  a  follower  of  Herbart,  who  appeared  as  a  special  opponent  of 
Stark.  Besides  these,  the  following  physicians  combated  both  the  natural 
philosophical  and  natural  historical  theories,  though  onh"  substantially, 
and  not  b}'  direct  opposition,  like  those  just  mentioned.  A.  F.  Schill 
(died  1839,  Allgemeine  Pathologie,  1840,  published  by  V.  A.  Biecke)  in 
Tubingen,  who  spoke  in  behalf  of  English  medicine  or  rather  of  "Irrita- 
tion"; Julius  Vogel  (1814-1880)  of  Wunsiedel,  professor  in  Giessen  and 
subsequenth'  in  Halle  (Pathol.  Anat.  des  menschl.  Korpers,  1845  ;  Anlei- 
tung  der  qualit.  und  quantit.  Analyse  des  Haras,  in  conjunction  with 
Xeubauer),  and  Karl  Ewald  Hasse  (born  1810),  professor  in  Leipsic, 
Heidelberg  and  Guttingen  (Anatomische  Beschreibung  der  Krankheiten 
der  Circulations-  und  Bespirationsorgane,  1841  ;  Krankheiten  des  Nerven- 
systems  in  Yirchow's  "Handbuch  der  Pathologie'"),  who  were  flrml}'  rooted 
in  the  system  of  natural  history.  After  the  earlier  J.  L.  Casper  (1790- 
1864),  C.  J.  Lorinser  (died  1853),  the  latter  with  an  excellent  book  on  the 
theory  of  diseases  of  the  lungs  (1823),  Adolf  Miihry  (1810-1888)  in 
Hanover  (Darstellungen  und  Ansichten  zur  Yergleichung  der  Medicin  in 
Frankreich,  England  und  Deutschland,  1830)  and  the  Berlin  practitioner 
P.  J.  Philipp  (Zur  Diagnostik  der  Lungen-  und  Herzkrankheiten  mittelst 
plrysicalischer  Zeichen  etc.,  1830),  with  others,  remained  as  it  were  mere 
skirmishers,  they  prepared  the  way  for  the  French  school  of  pathological 
anatomy  and  diagnosis,  now  coming  forward  in  place  of  the  school  of  nat- 
ural history.  An  offshoot  of  the  latter  school  in  Germany,  like  the  Dublin 
School  in  England,  was  the  so-called 

k.  New  Vienna  School.1 

which  aided  the  French  system  to  obtain  complete  domination  in  German 
medicine.  The  chief  representatives  of  this  school  labored  quietly,  after 
the  method  of  their  model,  while  the  preceding  school  was  in  its  full  glory, 
but  without  being  able  at  first  to  obtain  any  extended  influence.     This  was 

1.  G.  Wolf,  in  his  book  "Zur  Geschichte  der  Wiener  Universitat "  (1883),  says  that 
this  university  stood  for  a  century  and  a  half  under  the  influence  of  the  Jesuits, 
and  then  for  three  quarters  of  a  century,  until  1848,  was  a  mere  training  school 
for  officials.  Before  the  latter  year  the  medical  faculty  alone  rendered  any 
service  to  genuine  science. 


—  950  — 

not  accomplished  until  it  had  found  in  K.  A.  Wunderlich  (1815-1877)  of 
Sulz-on-the-Neckar,  the  panegyrist  as  well  as  critic  of  French  medicine,  an 
enthusiastic  herald  in  Germany  proper  (1841). 

A  connexion  between  the  new  Vienna  school  and  the  old  school  of  the  18th 
century,  distinguished  in  its  day  for  its  soberness  and  its  Hippociatic  tendencies,  is 
not  directly  demonstrable.  At  most  it  is  manifest  that  certain  common  points  of 
both  remained,  inasmuch  as  the  active  teachers  of  Vienna,  with  few  exceptions, 
kept  themselves  tolerably  free  from  the  systems  which  flourished  in  the  first  third  of 
our  own  century,  and  practised  a  comparatively  simple  old-Vienna  therapeutics. 
This  was  the  case  with  the  famous  clinician  Joh.  Val.  von  Hildebrandt  (1768-1818)* 
the  successor  of  Dr.  Nord  (who  taught  after  the  departure  of  Frank  from  1805  to 
1811)  and  Joh.  Nep.  Edler  von  Itaimann  (died  1847;  the  son-in-law  of  Stirrt),  who 
was  a  professor  in  the  university  from  1^12,  succeeded  Hildebrandt  in  1818,  and 
distinguished  himself  as  well  by  clear,  convincing  views,  as  by  his  freedom  from  the 
abuse  of  venesection,  so  flourishing  at  that  period,  and  in  general  by  his  expectant 
treatment  (Handbuch  der  spec.  med.  Pathologic  und  Therapie,  f>tb  edition,  1839). 
He  was  succeeded  in  the  "Allgemeine  Krankenhaus "  by  Giintner,  who  held  the 
position  until  1837.  The  same  was  the  case  with  the  alieady  mentioned  Ign.  Rud. 
Bischoff  von  Altenstern  at  the  "Josephsakademie ''  (Grundsatze  zur  Erkenntniss  und 
Behandlung  der  Entziindungen  und  der  Fieber,  2d  edition,  1830),  and  with  A.  J.  von 
Wawruch,  but  particularly  with  Dr.  Schiff'ner,  director  of  the  "Allgemeine  Kranken- 
haus" from  1837-1848,  who  represented  in  the  twenties  the  traditional  therapeutics 
of  the  old  school.  Pathological  anatomy  was  at  that  time  represented  by  Biermaver, 
whom,  as  he  was  addicted  to  drunkenness,  Dr.  Johann  Wagner  (died  1834),  origin- 
ally his  assistant,  succeeded  in  the  professorship  in  1829. 

An  assistant  of  the  last-mentioned  ph}'sician  from  1829  was  Karl, 
Baron  von  Rokitansky  (born  1804,  retired  1875,  died  July  23,  18781)  of 
Koniggriitz  in  Bohemia,  one  of  the  famous  founders  of  a  new  school  which 
at  once  extended  its  ideas  over  all  Germany,  and,  indeed,  exercised  an  in- 
fluence upon  all  foreign  countries,  an  influence  particularly  marked  in  Italy 
and  Russia,  and  felt  too,  though  less  strongly,  in  England. 

Rokitansky  was  the  son  of  the  Circle-Commissioner  Prokop  Rokitansky  in 
Leitmeritz,  who  died  in  1813  at  the  age  of  42  j-ears.  By  birth  he  was  a  Czech,  and 
like  Skoda,  clung  during  his  whole  life  with  love  to  his  race.  In  Leitmeritz  and  in 
Koniggratz,  where  his  mother  settled  after  his  father's  death,  Rokitansky  enjoyed 
his  primary  and  preparatory  gymnasial  instruction,  after  which  he  pursued  in  Prague 
the  prescribed  course  of  three  years  in  philosophical  studies,  and  undertook  heie  and 
in  Vienna  the  study  of  medicine.  In  the  midst  of  financial  straits  he  completed  a 
three  .years'  course  in  Prague,  and  one  of  two  years  in  Vienna.  On  March  1,  1827 
he  passed  in  the  latter  city  his  first  examination  (Rigorcsum)  with  the  note  "Satis- 
factory'', and  on  Nov.  12th,  his  second  witli  the  remark  "Good  enough".  Before 
becoming  Wagner's  assistant,  Rokitansky  was  —  from  1827  —  assistant  in  the 
Museum  of  Pathological  Anatomy  of  that  day.  In  the  first  position  he  vainly 
solicited  the  professorship  of  anatomy  in  Klagenfurt,  and  two  years  later  that  of 
circle-physician  in  Hradisch.  In  1831  he  was  appointed  cholera  physician. in  Galicia. 
After  Wagner's  death  he  occupied  his  chair  for  two  years,  and  in  1834  was  advanced 
to  the  position   of  extraordinary  professor,  uniting  with    this  the  office  of  judicial 

1.  Skoda,  himself  mortally  ill,  accompanied  his  coffin  to  the  grave  —  this  one  man 
outweighing  a  whole  glittering  train  of  mourners  ! 


—  951  — 

anatomist  for  the  Residency  of  Vienna.  On  March  17th  of  the  same  year  he  began 
his  lectures,  "confining  himself  to  special  nosology;  for  upon  this  depends  the  fruit- 
fulness  of  pathological  anatomy".  His  assistants  were  J.  Kolletschka  (1803-1847; 
died  of  cadaveric  poison),  subsequently  professor  of  forensic  medicine  and  state- 
medicine  in  Vienna,  and  Schuh.  From  1836  papers  of  Rokitansky,  at  the  suggestion 
of  the  assistants  last  mentioned,  appeared  in  the  Austrian  "  Jahrbiieher  ",  and  in 
1 S41  his  "  Handbuch  der  patholoirischen  Anatomie"  was  published.  The  special 
(third)  part,  which  contained  the  anatomy  of  the  thoracic  and  abdominal  organs, 
appeared  first.  In  1844  Rokitansky  was  appointed  ordinary  professor,  and  in  this 
position  published  two  jears  later  the  last  or  general  part  of  his  famous  work,  which 
has  been  often  republished  as  well  as  translated.  He  also  made  use  of  microscopic 
anatomy,  but  only  slightly.  Rokitansky  worked  for  a  long  time  in  a  miserable  place, 
until  finally  a  magnificent  anatomical  building  was  erected  for  him.  In  186fi  he 
celebrated  his  thirty  thousandth  post  mortem  !  Finallj-  for  fourteen  years  he  occupied 
himself  with  the  study  of  the  defects  of  the  septum  cordis  and  the  comparative 
anatomy  of  the  urogenital  organs.  At  a  later  period,  from  his  character  and  his 
great  general  information — he  was  an  enthusiastic  admirer  of  Kant  —  Rokitansky 
was  loaded  with  honors,  introduced  many  improvements,  and  took  his  seat  in  the 
House  of  Deputies,  an  eminent  champion  of  freedom  of  instruction.  From  his 
activity  as  a  member  of  the  Ministry  of  Instruction,  however,  he  finally  met  with 
opposition  on  many  sides  with  respect  to  his  nominations  to  medical  professorships. 
His  sons:  Procop  von  Rokitansky.  professor  in  Innsbruck,  is  known  for  his  re- 
searches on  the  cure  of  consumption  ;  Carl  von  Rokitansky,  a  gynaecologist  in  Vienna, 
is  devoted  to  the  restoration  of  useful  vaginae  (vaginoplast#y).  Two  other  sons  are 
singers  (Rokitansky's  wife  was  a  singer),  and  this  fact  Rokitansky  embodied  in  the 
ho/i  mot  that  two  of  his  sons  "howled"  (heulten)  and  two  "healed"  (heilten). 

Rokitansky  transplanted  in  Vienna  the  pathologico-anatomical  ten- 
dency of  the  school  of  Paris,  whose  researches  and  results  he  had  already 
appropriated.  Through  the  contrast  which  the  soberness  and  positiveness 
of  that  school  (qualities  which  Rokitansky  had  adopted  in  his  works) 
formed  with  the  luxuriant  phantasies  of  the  philosophy  of  nature  hereto- 
fore flourishing  in  Germany,  and  the  nosological  efforts  of  natural  history, 
he  also  aided  the  French  school  to  secure  the  leadership,  just  as  soon  as 
attention  was  directed  to  his  works. 

If  the  contrast  of  the  methods  of  the  two  schools  won  favor  for  the 
French  system,  still  more  were  all  captivated  by  the  novelty  of  the  subject, 
which,  in  spite  of  the  ability  of  a  Job..  Friedr.  Meckel1  (died  in  1823),  had 
remained  up  to  this  time  unknown,  so  to  speak,  in  Germany.  To  these 
recommendations  were  added  the  excellence  and  comprehensiveness  of 
Rokitansky's  study  of  the  subject,  and  his  exhaustive  method. 

The  palpableness  of  the  objects  and  results,  which  were  interpreted  as 
so  many  irrefragable  scientific  facts,  now  gave  the  preponderance  to  simple 
observation  of  the  senses  and  to  Realism.  In  this  Rokitansky  fulfilled 
for  Germany,  in  the  department  of  medicine,  an  historical  task.  It  was  he 
and  Skoda  who  were  destined  to  win  for  this  department  the  Realism  of 
the  19th  century. 

1.  Rokitansky's  first  impulse  was  received  from   Meckel,  together  with  Lobstein. 
Andral  and  others. 


—  052  — 

The  demonstrated  succession  of  the  pathologico-anatomical  changes, 
however,  impressed  the  observer  with  the  idea  that  an  insight  had  been 
attained  into  the  process,  and  particularly  the  process  of  development, 
of  the  diseases  themselves,  though  there  lay  before  him  merely  the  con- 
necting external  sequence  of  the  products  deposited  during  the  contin- 
uance of  this  process.  The  dynamic  side  of  morbid  life,  which  withdraws 
itself  from  the  knife,  the  microscope  and  chemical  reagents,  was  now  sys- 
tematically overlooked,  and  mere  anatomical  facts  were  studied  and  re- 
corded in  their  mode  of  origin  and  retrogression,  although  the  clinical 
course  of  the  disease  was  taken  into  consideration.  This  stud}'  of  the 
finished  product  was  undoubtedly  begun  with  ingenuity  and  practised  with 
great  skill  and  consequent  success  at  a  period  historically  favorable  there- 
to, and  in  addition  to  all  this  was  carried  out  upon  a  magnificent  scale. 
The  founder  of  this  system  had  the  annual  disposal  of  1500-1800  bodies  ! 
From  this  latter  circumstance  it  followed,  as  a  matter  of  course,  that 
pathological  anatomy  was  utilized  from  the  standpoint  of  statistics. 
From  the  frequency  or  infrequency  of  the  association  of  certain  diseases, 
their  disposition  to  combination  or  exclusion  was  derived.  Another  point 
of  view  from  which  Rokitansky  investigated  and  utilized  the  material  of 
pathological  anatomy  was,  as  already  pointed  out,  that  of  the  study  of  the 
succession  of  established  changes,  and  of  the  stadia  of  the  formation  of 
products,  particularly  in  the  inflammation  of  certain  organs  (hyperemia, 
infiltration,  increased  plasticity,  stasis  etc.),  in  which  he  regarded  the 
exudates  thus  arising  as  the  essential  characteristic  of  inflammation,  and 
understood  the  process  as  one  of  new  formation.  In  this  conclusion  the 
aid  of  microscopy  and  of  chemistry  was  also  called  in.  In  the  products 
discovered  b}'  the  latter  was  at  once  seen  the  essence  of  morbid  processes, 
and  they  were  employed  theoretically  to  establish  a  new  humoral  path- 
olog}',  the  so-called  doctrine  of  erases  (dyscrasiae).  This  was  an  imitation, 
under  a  new  name  indeed,  of  the  method  of  Andral  and  Gavarret.  Imme- 
diately there  arose  a  whole  multitude  of  desirable  erases,  a  hyperinotic 
and  hypinotic,  albuminous,  croupous,  puerperal,  variolous,  aphthous,  and 
any  others  }'ou  please,  all  of  which  were  employed  in  books  and  lectures, 
and  upon  which  plans  of  treatment  could  be  constructed  at  the  bedside. 
According  to  Rokitansky,  pyaemia,  tuberculosis  and  the  aphthous  and 
croupous  erases  belong  to  the  hyperinotic  erases  ;  typhus,  acute  tuber- 
culosis, plethora,  the  exanthematous  crasis,  the  cancerous  dyscrasia,  the 
erases  in  diseases  of  the  nervous  system  etc.  belong  to  the  h}-pinotic  erases. 
To  these  were  added  the  "stases",  which  formed  a  shibboleth  of  equally 
facile  employment.  —  Rokitansky,  however,  speedily  and  silently  abandoned 
this  doctrine  and  returned  to  his  earlier  mode  of  thought  and  investigation, 
which  was  exempt  from  speculation  ;  for  the  enthusiastic  reception  of  this 
theory  of  his  warned  him  of  the  danger  of  such  theories  to  others  who 
were  less  capable  of  reflection  than  himself. 

Rokitansky  was  at  all  events  the  chief  of  the  new  Vienna  school,  and 


—  1)53  — 

its  Van  Swieten  in  his  influence  upon  Austrian  medical  educational  affairs, 
though  the  latter  at  last  occasioned  him  numerous  opponents.  He  was  a 
master  of  spoken,  as  well  as  written  language,  and  in  speaking  possessed 
the  gift  of  humor.  —  His  works  are  distinguished  by  the  simplicity,  clear- 
ness and  plasticity  of  their  statements,  and  his  restoration  of  pathologico- 
anatomical  observation  must  be  regarded  as  a  model  of  scientific  labor. 

On  interstitial  pneumonia,  a  morbid  process  brought  forward  by  Rokitansky,  he 
writes  as  follows:  "  So  far  as  individual,  rare  observations  extend,  the  tissue  in  the 
interstices  of  the  pulmonary  lobules,  and  between  the  smaller  groups  of  pulmonary 
cells,  at  the  outset,  when  too  much  dark  pulmonary  tissue  is  not  present,  appears  of 
a  pale  reddish  hue,  and  swollen  with  an  albuminous  infiltration.  The  pulmonary 
vesicles  are  either  pale,  and  according  to  the  degree  of  swelling  more  or  less  com- 
pressed, or  if  they  participate  in  the  inflammation  they  are  reddened  and  occasion- 
ally granulated,  though  always  very  finely  granulated  only.  In  process  of  time  the 
infiltration  of  the  interstitial  tissue  becomes  organized  and  blended  with  the  latter 
into  a  dense,  fibro-cellular  substance,  in  which  the  pulmonary  vesicles,  as  the  result 
of  the  compression,  are  obliterated  and  finally  disappear,  changed  into  a  homogene- 
ous cellular  tissue.  We  then  find  whitish,  dense  bands,  often  creaking  under  the 
knife,  or  shapeless  masses  of  the  same  structure  interwoven  with  the  substance  of 
the  lung.  In  some  cases  this  form  of  pneumonia  may  result  in  a  suppuration,  which 
as  it  were  dissects  and  separates  the  lobules.  This  pneumonia,  when  chronic,  creeps 
from  one  lobule  to  another,  and  the  apices  of  the  upper  lobes  are  its  ordinary  seat. 
The  devastated  portions  of  the  lungs  sink  in,  dragging  after  them  the  surrounding 
parenchyma  in  the  form  of  cicatricial  folds  and  widening  the  neighboring  bicnchial 
tubes.  Frequently  this  cicatricial  tissue  contains  a  considerable  quantity  of 
pigment." 

Historically  too  the  following  expressions  of  Rokitansky  (the  earliest  representa- 
tive of  Realism  in  Germany),  spoken  on  retiring  from  his  professor's  chair  July  If), 
1875,  are  extremely  remarkable,  especially  as  they  come  from  one  of  the  most  prom- 
inent founders  of  the  realistic  tendency  of  our  century.     "We  are  borne  along  by  a 

great  common  stream,  into  which  How  many  pure,  peaceful  and  clear  rivulets 

In  accordance  with  the  pressing  needs  of  my  time,  I  have  won  for  pathological 
anatomy'  in  the  department  of  German  science  such  importance,  that  I  may  designate 
this  as  a  basis  for  a  science  of  pathological  physiology,  and  as  a  foundation  for 
scientific  investigation  in  the  sphere  of  medicine Individualism  begets  a  dis- 
ease; it  is  over-appreciation  of  self,  which  manifests  itself  in  vanity.  .  .  .  Gentlemen, 
I  do  not  hesitate  to  say  that  we  stand  upon  the  threshold  of  a  form  of  degeneration, 
the  so-called  modern  Individualism.  This,  in  co-operation  with  a  realistic  conception 
of  the  individual,  biased  in  its  very  foundations,  is  to  degenerate  into  a  cultus  of  the 
latter"  etc. 

A  proof  of  his  Kantian  mode  of  philosophizing  may  be  taken  from  his  address 
"On  the  independent  value  of  knowledge  ",  in  which  he  says :  "that  from  the  dis- 
proportion of  the  human  organs  to  the  external  world,  e.  g.  that  of  the  eye  or  the 
small  retinal  pictures  to  space,  correct  ideas  are  always  unattainable  for  us,  and 
accordingly  things  must  possess  an  inmost,  invisible  essence,  lying  beyond  all  ex- 
perience, of  which  we  know  nothing."     (The  very  idea  of  Kant). 

Rokitansky  did  not  occup}"  himself  with  microscopy,  and  still  less 
with  the  subjects  of  practical  medicine.  Like  Cruveilhier  in  the  French 
school  of  pathological  anatomy,  he  was  a  pure  pathological  anatomist.  His 
influence  upon  practice,  therefore,  was  indirect  only,  inasmuch  as  his  inves- 


—  954  — 

tigations  resulted  in  the  fact  that  from  this  period  forward  pathologico- 
anatomieal  pathology  and  local  therapeutics  were  taught  and  practised  in 
Cermaivy,  though  Rokitansky  himself  did  not  exercise,  nor  even  strive  to- 
exercise,  any  dominant  influence  therein.  Such,  however,  was  not  the  case 
with  the  physician  to  be  next  mentioned. 

If  Rokitansky  deviated  in  no  main  point  from  the  views  of  the  chief 
pathological  anatomists  of  France,  the  same  was  not  the  case  in  essential 
respects  as  regards  physical  diagnosis  with  the  second  great  man  of  the 
new  Vienna  school, 

Joseph  Skoda  (born  Dec.  10,  1805,  died  June  13,  1881)  of  Pilsen, 
who  introduced  a  genuine  reform  in  the  interpretation  and  conception  of 
physico-diagnostic  phenomena  by  adapting  them  to  phj-sical  laws  — ■  the 
laws  of  sound. 

Skoda,  like  Rokitansky,  of  Czech  descent,  and  the  son  of  a  locksmith,  aniid  great 
privations  and  by  constantly  giving  private  lessons,  completed  his  gymnasial  and 
philosophical  preparatory  studies  in  his  native  city,  and  at  the  age  of  twenty  years 
went  to  Vienna  as  a  student  of  medicine.  After  a  sojourn  of  six  years  in  the  univer- 
sity of  Vienna  he  became  a  doctor  of  medicine,  and  as  his  means  were  small,  accepted 
the  position  of  cholera  physician  in  Bohemia  in  1881,  as  Rokitansky  had  done  in 
Galicia.  In  18153  and  for  five  years  thereafter  he  was  second  physician  to  the 
"Allgemeine  Krankenhaus  ".  In  1889,  having  published  three  years  before  a  treatise 
on  percussion,  and  shortly  before,  in  conjunction  with  Kolletschka,  another  on 
pericarditis,  he  issued  his  famous  work  entitled  "Abhandlung  iiber  Percussion  und 
Auscultation",  now  in  its  sixth  edition.1  As  he  annoyed  his  patients,  he  was  assigned 
to  the  section  occupied  by  the  insane,  but  after  he  had  been  for  nine  months  district 
physician  to  the  poor  in  St.  Ulrich,  he  obtained  in  1840  the  position  of  prescribing 
physician  to  a  special  section  of  the  "Allgemeine  Krankenhaus",  assigned,  in  imita- 
tion of  Paris,  to  diseases  of  the  chest  as  a  "  Specialty  ".  The  next  year  Skoda  became 
a  physician  of  the  first  class,  and  received  in  addition  the  sections  for  diseases  of  the- 
skin  and  for  internal  diseases.  It  was  not  until  18-1-7  that,  on  a  recommendation  from 
Prague,  he  was  appointed  professor  in  the  clinic  for  internal  diseases.  Here  he  was 
the  first  professor  to  lecture  in  German.  In  spite  of  his  bachelor  peculiarities,'  his 
taciturnity  and  his  heedlessness,  he  was  a  very  popular  physician,  and,  in  contrast 
with  Rokitansky  who  died  poor,  Skoda  left  to  his  brother  Franz  a  fortune  of  two 
millions  of  marks,  bequeathed  200,000  marks  for  scientific  and  medical  objects,  and 
remembered  his  servants  generously.  Two  years  after  his  death  the  street  in  which 
he  had  resided  was  honored  by  the  magistracy  with  the  title  of  "Skodagasse  ",  and  a 
tablet  was  placed  upon  his  dwelling.  When  retiring  from  his  position  as  an  active 
teacher  he  said:  "Now  the  microscope  and  chemistry1,  may  take  their  turn!" 
Nobility,  so  easily  obtained  in  Austria,  he  scorned.  Besides  his  chief  work,  the 
labors  of  Skoda,  like  those  of  Rokitansky,  were  not  very  extensive.  He  wrote,  how- 
ever, on  the  impulse  and  sounds  of  the  heart,  on  examination  of  the  abdomen  etc. 


Edited  by  Prof.  Dr.  Gustav  L;;bel  (1817-1880)  of  Nowarow  in  Bohemia,  for  many 
years  Skoda's  assistant  and  a  popular  practitioner  of  Vienna,  though  he  himself 
always  avoided  practice. 

For  the  benefit  of  his  tailor,  who  had  befriended  him  during  his  student  life,  he 
wore  "barn-door"  breeches  until  the  day  of  his  death,  although  he  might  have 
aided  him  in  an  easier  way  ;  and  yet  he  even  sued  a  minister  on  one  occasion  to 
obtain  his  honorarium. 


—  955  — 

To  a  still  greater  degree  than  Rokitansky,  in  whom  there  dwelt  a  cer- 
tain amount  of  artistic  warmth  and  enthusiasm,  in  spite  of  the  purely 
realistic  subject  upon  which  he  labored,  the  "utterly  unimaginative"  Skoda 
influenced  the  realistic  tendency  which  German  medicine  was  destined  to 
take.  For  he  it  was  without  doubt,  who  by  his  physical  and  experimental 
system  was  the  author  of  that  method  which  we  are  in  the  habit  of  calling 
a  la  Francaise  the  exact  or  objective  method,  and  which  regards  the  patient 
as  a  purely  scientific  or  physical  problem,  and  especialty  as  an  object  of 
exact  diagnosis.  In  this  method  the  curative  aim  of  medicine  steps  into 
the  background  ;  indeed,  this  aim,  as  we  know,  became  for  a  long  time  an 
almost  absolutely  mythical  idea,  and  as  at  an  earlier  period  in  France 
finesses  in  diagnosis,  so  in  Germany  now  merely  nominal  physical  explana- 
tions often  formed  the  reputation  of  a  clinician,  as  of  a  physician  who  oc- 
cupied the  very  summit  of  knowledge  of  his  age,  while  the  pretension  to 
therapeutical  service,  for  the  sake  of  which  the  plrysician  is  a  physician, 
became  almost  a  subject  of  derision. 

The  scientific  merit  of  Skoda  is  based  upon  the  fact  that  he  overturned 
the  specific  and  pathognomonic  arrangement  of  sounds  made  by  the  French 
school,  e.  g.  gastric  sound,  thigh  sound,  cavernous  respiration  etc.,  and  sub- 
stituted categories  of  sonorous  phenomena  based  upon  the  physical  con- 
stitution and  configuration  of  the  organs  and  tissues  ;  and  further  that  he 
tried  to  develop  the  purely  empirical  French  doctrine  of  physical  signs  into 
a  strictly  scientific  s}*stem  of  physics.  The  latter  object,  however,  he  did 
not  completely  attain,  as  he  relied  too  much  upon  individual  would-be 
acoustic,  but  really  merelj'  empirical  principles,  as  e.  g.  in  his  terms  "tym- 
panitic" and  -non-tympanitic".  Great  credit  is  also  due  to  him  for  his 
elucidation  of  the  phenomena  of  cardiac  diseases. 

Skoda  made  his  famous  physical  scale  the  chief  basis  of  percussion, 
and  arranged  sounds  into  the  well-known  and  much-disputed  classes  : 
1.  From  full  to  ernpt}-;  2.  From  clear  to  dull  ;  3.  From  tympanitic  to 
non-tympanitic  ;  4.  From  high  to  deep.  He  likewise  brought  auscultatory 
phenomena  under  the  laws  of  acoustics,  both  those  relating  to  the  voice 
and  the  other  auditor}-  phenomena  observed  in  the  chest.  The  respiratory 
sounds  he  divided  into  vesicular,  indeterminate  and  bronchial.  As  Skoda, 
however,  found  acoustics  in  a  very  rudimentary  condition,  he  created  a 
system  of  his  own.  by  means  of  which  he,  according  to  our  pi'esent  knowl- 
edge, was  able  to  interpret  acoustic  phenomena  rather  medico-physically 
than  strictly  physically.  Moreover  he  always  went  to  work  upon  an  ex- 
perimental basis,  studying  particularly  upon  the  cadaver  the  legitimate 
conditions  of  the  diagnostic  acoustic  phenomena,  so  as  to  employ  these  as 
the  basis  for  judging  of  the  physical  variations  from  the  norm  in  the  sick. 
This  must  be  regarded  as  a  great  excellence,  when  we  compare  his  method 
with  that  of  other  experimenters  who  experimented  with  all  sorts  of 
heterogeneous  things. 

Skoda's  style  is  also  peculiar.     Contrasted  with  the  artistic  style  of 


—  956  — 

Rokitansky,  it  is  succinct,  indeed,  often  harsh  and  dry,  so  that  it  is  no  easy 
task  to  master  his  book.  Matters  of  fact  in  particular  are  as  dryly  stated 
as  the}'  are  clumsily  incorporated. 

The  preface  to  the  fifth  edition  of  his  famous  work  may  serve  as  an  example  of 
Skoda's  style.  ''This  edition  is  not  essentially  different  from  the  earlier  ones.  The 
chapter  on  the  sound  of  percussion  is  enlarged  by  the  introduction  of  the  views  of 
Dr.  Hans  Locher  and  Dr.  Mazonn.  The  papers  of  Dr.  Hoppe  '  On  the  theory  ot 
Percussion'  and  theoretical  considerations  on  the  so-called  consonant  auscultatory 
phenomena,  especially  bronchophony,  did  not  reach  me  until  the  printing  of  the 
corresponding  chapter  was  completed.  The  chapter  on  the  impulse  of  the  heart  is 
thoroughly  revised,  and  the  diagnosis  of  adhesion  of  the  pericardium  to  the  heart  is 
given  in  accordance  with  the  paper  contained  in  the  Reports  of  the  "Imperial 
Academy  of  Sciences"  for  Nov.  1851.  The  views  of  Kapp,  Kiwisch,  Baumgarten, 
Hamernjk,  Nega  and  Wachsmnth  on  the  origin  of  the  sounds  of  the  heart  have  not 
changed  my  ideas  upon  this  subject. "  The  preface  shows  too  how  very  carefully 
Skoda  always  considered  the  views  of  others,  without,  however,  reposing  upon  the 
laurel  of  "authority  ".  This  is  a  peculiarity  of  Skoda's,  quite  as  conspicuous  as  the 
quiet  criticism  which  confutes  an  opponent  entirely  by  the  contrast  which  his  own 
soberness  forms  with  the  method  of  his  adversaries,  and  in  which  not  infrequently 
there  lies  a  characteristic  irony:  e.  g.  "While  1  am  of  the  opinion  that  it  is  not 
worth  the  trouble  to  criticise  the  physical  ideas  contained  in  the  above  quotation"  etc. 
Piorry  and  Briancon  had,  as  we  know,  laid  down  a  "Son  hydatique".  Skoda  says: 
"  I  do  not  know  whether  anyone  besides  Piorry  and  Briancon  has  had  such  experience. 
Experiment  with  the  stomach,  however,  proves  that  hydatids  are  not  necessary  to  the 
production  of  the  hydatid  tone".  "Since  Hans  Locher  does  not  specify  my  offences 
against  logic  and  acoustics,  and  I  myself,  have  not  discovered  them,  I  simply 
remark"  etc.  '  In  conclusion  I  must  quote  a  passage  from  which  it  is  very  evident 
that  Dr.  Hans  Locher  has  not  read  my  treatise  on  percussion  and  auscultation  with 
spscial  attention".  Moreover  Skoda  was  a  complete  master  of  the  literature  of 
physical  diagnosis,  without,  however  (like  those  who  plume  themselves  particularly 
upon  this  familiarity"),  becoming  pedantic  in  his  treatment  of  the  subject. 

Skoda,  by  his  views  on  physical  diagnosis,  showed  himself  an  inde- 
pendent spirit,  who  received,  indeed,  his  impulse  from  France,  but  yet  far 
outstripped  and  overtopped  scientifically  the  French  diagnosticians.  It 
should  be  further  emphasized  that  Skoda  was  the  first  in  Germany  to  assist 
Auenbrugger,  the  diagnostician  of  the  time  of  the  Old  Vienna  School,  in 
securing  a  merited  recognition.  As  already  remarked,  he  was  the  first  for 
whom  was  created  in  Vienna,  after  the  French  model,  a  ''specialty",  that  is 
a  special  division  for  patients  suffering  from  thoracic  diseases.  In  this  he 
was  followed  by  Hebra  and  others  with  other  specialties.  Thus  was  laid 
in  Germany  the  foundation  for  the  dismemberment  of  clinical  and  prac- 
tical medicine,  with  whatsoever  of  advantage  science  has  drawn  from  the 
system  of  specialties  through  more  assiduous,  as  well  as  more  minute 
cultivation. 

On  the  other  hand,  practical  medicine,  in  the  hands  of  Skoda  (and 
chiefiy  through  his  influence,  first  in  Vienna,  and  thence  throughout  almost 
all  Germany  until  far  into  the  fifties)  degenerated  into  simple  diagnosis. 
By  his  observations  on  the   "natural   course  of    disease   undisturbed  by 


—  957  — 

therapeutics"  he  became  the  direct  and  proper  founder  of  purely  expectant 
or  nihilistic  therapeutics  in  Germany,  and  the  author  of  a  cheerless  period 
in  clinical  practice,  to  which  are  well  adapted  the  words  of  Alphonse  Karr: 
"  Tout  ce  que  les  mexlecins  ont  fait  pour  guerir  le  rhume  de  c'erveau  c'a 
^te  de  l'appeler  coryza".  During  this  period,  instead  of  conceding  (as 
would  have  been  just)  that  practical  medicine  can  lay  claim  to  only  a  slight 
active  influence,  it  finally  became  an  obligatory  rule  of  faith  to  plead  for 
the  complete  impossibility  of  any  medical  influence  upon  diseases  —  and  to 
manage  at  the  bedside  accordingly.  Hence  it  resulted  that  university 
professors  and  clinicians,  followers  of  Skoda,  were  able  to  make  extremely 
nice,  so-called  exact  diagnoses,  b}-  the  assistance  of  percussion  etc.,  but 
could  no  longer  teach  how  to  write  a  prescription,  though  the}'  had  for 
pupils  future  practising  physicians  alone,  who  accordingly  from  the  outset 
must  regard  themselves  as  mere  superfluities  or  impostors. 

A  necrologist  said  of  Skoda:  "Skoda  was  through  and  through  a  medical  savant 
and  investigator.  For  him  man  was  an  object  of  investigation  (sic I.  He  could  be 
candid  even  to  the  point  of  recklessness.  Accordingly  the  patient  had  the  con- 
solation (?)  of  standing  in  the  presence  of  a  man  who  gazed,  as  with  the  eye  of 
clairvoyance,  into  the  very  vitals  of  the  sufferers,  and  explored  the  seat  of  disease  ". 
Skoda's  sj'Stem  had,  however,  the  advantage  of  casting  injudicious  medication  and 
over-medication  into  the  background  and  replacing  it  by  knowledge,  and  of  teaching 
that  the  conditions  of  health  and  convalescence  for  the  most  part  lay  in  other 
directions  than  the  swallowing  of  drugs.  "Air,  water,  cleanliness  and  temperance 
are  the  best  pills"  said  Skoda.  "And  the  drug-store?"  "  Well,  perhaps  there  is 
some  good  in  this  too!"  At  a  consultation  where  he  was  asked  about  the  medicine 
to  be  prescribed,  he  replied:  "Oh!  that  is  immaterial!"  (Ach,  das  ist  ja  alles 
eins  !). 

If  it  was  a  peculiarity  of  the  two  great  men  of  the  new  system 
already  mentioned  that  each  of  them  wrote  substantially  only  a  single 
work  of  controlling  influence,  and  this  upon  his  own  special  branch,  the 
proper  practitioner  and  clinician  of  the  new  Vienna  school  is  characterized 
by  the  fact  that  he  wrote  no  extensive  work  at  all.  This  may  have  been 
the  sole  reason  why  his  activity  as  a  teacher  of  so  very  large  a  number  of 
pupils  and  as  a  practitioner  was  so  intense  —  like  that  of  Schunlein,  whom 
he  followed  in  this  respect,  though  he  lacked  his  therapeutic  fertility.  For 
teachers  who  are  fertile  authors  seek  reputation  rather  in  writing  than  in 
teaching,  in  the  number  of  their  pupils  and  in  practice. 

Johannes  von  Oppolzer.  (1808-1871)  of  Gratzen  in  Bohemia, 
was  from  1841  professor  of  clinical  medicine  in  Prague,  where  he  had  completed  his 
entire  education  from  the  gymnasium  up.  After  the  completion  of  his  studies,  he 
was  for  a  long  time  assistant  in  the  clinic  of  the  professor  of  surgery,  Fritz,  and  of 
the  professor  of  medicine  Vincenz  Julius  Krombholz  (1783-1844).  After  a  residence 
of  seven  years  in  Prague,  Oppolzer  received  a  call  to  Leipsic  and  was  one  of  the  first 
to  introduce  the  new  system  into  Germany.  After  two  years,  however,  he  returned  to 
Austria,  and  in  fact  to  Vienna.  Here  he  founded  in  1861  the  "  Verein  zur  Pflege 
erkrankter  Studirender",  which  in  188G,  after  an  existence  of  20  years,  had  at  its 
disposal  an  annual  income  of  100,000  marks  —  Oppolzer  wrote  but  little.  His 
"  Vorlesungen  iiber  specielle  Pathologie  und  Therapie"  were  edited,   however,   and 


—  958  — 

published  by  Dr.  Emil  Ritter  von  Stoffella  from  the  year  1866  onward.  —  A  much 
more  fertile  author  in  his  department  is  Oppolzer's  son  Theodore  (born  1841), 
Doctor  of  Medicine,  a  popular  astronomical  writer  and  professor  of  astronomy  in 
Vienna. 

If  Oppolzer  wrote  no  independent  works  adapted  to  direct  the  ten- 
dencies of  the  school  to  which  he  belonged,  on  the  other  hand,  he  supplied 
to  the  latter  probably  the  most  substantial  aid  b}T  proving  in  his  time  its 
clinical  and  practical  usefulness  by  his  own  labors.  This  perhaps,  was  the 
more  readily  accomplished  because  Oppolzer,  from  all  accounts,  possessed 
in  an  eminent  degree  the  characteristics  of  the  born  physician  and  practi- 
tioner. By  means  of  this  gift  he  popularized  physical  and  anatomical 
local  diagnosis,  as  well  as  local  therapeutics,  at  the  sickbed  of  daily  life, 
without  himself  opening  any  new  therapeutic  paths  which  might  have 
sustained  him  in  his  task.  He  was  particularly  admired  for  his  '-objective" 
"snap-diagnoses"  (Schnelldiagnosen).  What  difficulties  at  first  lay  in  the 
way  of  the  introduction  of  physical  diagnosis  may  be  judged  from  the 
fact  that,  as  late  as  1845,  Kruger-Hansen  still  argued  against  the  method, 
that  a  lady  would  hesitate  to  expose  her  bosom  to  airy  3*011  thful  iEscul- 
apius,  who  probabty  did  not  bear  the  best  reputation,  and  that  he  only  who 
suffered  from  impaired  hearing  could  regard  the  stethoscope  as  particularly 
necessar3*,  while,  on  the  other  hand,  deaf  physicians,  who  were  still  prac- 
tising, could  not  use  the  instrument  at  all.  Such  objections  continued  to 
be  presented  as  late  even  as  the  beginning  of  the  fifties.  In  return,  the 
method  was  also  undoubtedly  cultivated  so  one-sidedl3"  that  Hippocratic 
diagnosis  was  almost  entirety  thrust  aside  and  remained  in  the  background 
even  down  to  the  present  da3*.  That  the  popularization  of  physical  aids 
in  the  labors  of  the  physician  is,  however,  an  actual,  practical  gain,  though 
not  such  an  immeasurable  advantage  as  was  fondly  imagined  in  the  time 
of  the  greatest  enthusiasm  for  the  new  method,  has  been  thoroughly 
demonstrated.  And  the  merit  of  having  accomplished  this  popularization 
belongs  in  an  essential  degree  to  Oppolzer.  He  likewise  began  to  restore 
therapeutics  to  its  rights,  and  thus  became  the  father  of  the  "Young- 
Vienna  School",  the  chief  organs  of  which  are  the  "Wiener  medic.  Presse" 
and  "Die  medic.  Rundschau",  under  the  control  of  Prof.  Joh.  Schnitzler 
(born  1835),  of  G-roszkamsza,  and  K.  Bettelheim.  The  clinical  institution 
of  the  latter  physicians  has  become  the  general  policlinic.  Oppolzer  was 
succeeded  in  1872  by  Heinrich  von  Bamberger  (1822-1888  ;  Lehrbuch  der 
Krankheiten  des  Herzens,  1857  ;  Die  Krankheiten  des  chylopoetischen 
Systems),  who  was  succeeded  in  turn  b3*  Hermann  Nothnagel.  Bamberger 
was  a  pupil,  and  for  a  long  time  an  assistant  of  Oppolzer,  and  then  a  pro- 
fessor in  Wiirzburg,  whence  he  was  called  to  Vienna. 

Along  with  Oppolzer,  Ferdinand  Ritter  von  Hebra  (1816-1880),  of 
lbiinn  in  Moravia,  was  an  important  agent  in  opening  new  and  permanent 
routes  in  practice,  or  rather  in  the  therapeutics  of  the  diseases  of  the 
skin,  a  branch  of  science   in   which    he    worked   a    complete   revolution. 


—  059  — 

Hebra  was  as  independent  an  investigator  as  a  physician,  and  his  services 
in  the  treatment  of  the  sick  are  unquestionably  the  greatest  which  the 
Vienna  school  or  any  of  its  members  has  rendered  to  medicine,  though  it 
was  he  again  who  supplied  notable  support  to  the  nihilism  of  the  Vienna 
or  Skodaic  sj'stem  of  therapeutics.  For,  in  opposition  to  all  precedents, 
he  acted  with  a  positiveness  almost  reckless,  a  course,  however,  which  he 
could  justly  pursue  in  his  specialty  in  opposition  to  the  numerous  absur- 
dities of  an  earlier  age,  and  one  which  he  was  likewise  able  to  follow  out 
with  great  success. 

Hebra  studied  in  Vienna  and  graduated  there  in  1841.  lie  was  then  appointed 
assistant  to  Skoda,  and  received  charge  of  the  division  for  patients  suffering  with  t lie 
itch.  In  1842,  having  previously  held  very  popular  courses  of  private  insti  uction,  he 
obtained  permission  to  lecture.  There  was  then  created  for  him  a  special  section  for 
diseases  of  the  skin,  over  which  he  presided  as  professor  from  the  year  1849.  His 
clinic  became  one  of  the  most  popular  in  the  University,  a  result  due  not  only  to  the 
novelty  of  his  views,  but  also  to  his  style  of  lecturing,  which  was  quite  free  horn  the 
ex  cathedra  tone  and  was  mingled  with  humor,  occasionally  of  a  caustic  nature. 
His  chief  works  are  the  "Acute  Exantheme  und  Hautkrankheiten'",  forming  the  3d 
volume  of  Virchow's  "  Pathologie  "  (now  appearing  in  its  2d  edition);  the  "Atlas  der 
Hautkrankheiten",  from  original  cases  by  Prof,  von  Barensprung  in  Berlin  and  Prof. 
Hebra  in  Vienna.  Text  by  Prof.  Hebra.  (18C>7);  "Aufsatze  iiber  Knitze ",  1842; 
Herpes  tonsurans,  norwegische  Kvatze  etc.  —  Hebra's  chief  work  is  distinguished  by 
the  fact  that  in  it  alone,  among  the  works  of  the  new  Vienna  school,  some  attention 
is  also  paid  to  the  history  of  individual  diseases  of  the  skin.  —  Hebra  educated 
numerous  pupils  most  of  whom,  however,  for  a  long  time  left  literary  reputation  to 
him  alone.  Recently,  however,  the  professors,  Dr.  Isidor  Neumann  (Lehrbuch  der 
Hautkrankheiten,  2d  edition,  1875,  with  wood-cuts  after  excellent  drawings  by-  Dr.  C. 
Heitzmann,  now  in  New  York),  and  Dr.  Heinrich  Auspitz  (1835-1886),  Director  of 
the  Policlinic,  who  recently  published  a  "System  der  Hautkrankheiten"  differing 
from  that  of  Hebra,  have  distinguished  themselves  as  authors.  Hebra's  most  eminent 
pupil,  however,  is  Prof.  Moritz  Kaposi  (properly  Kohn),  his  son-in-law,  and  an 
associate  in  the  preparation  of  his  chief  work.  Other  pupils  are  Gustav  Vfertheim, 
Pick  in  Prague  and  Lang  in  Innsbruck. 

Hebra  divided  diseases  of  the  skin  according  to  the  following  artificial 
system  (1845): 

1.  Diseases  occasioned  by  congestion  of  the  skin;  Hyperasmias  cutanea'. 
2.  Diseases  due  to  anaemia  of  the  skin;  Anaemias  cutanea-.  '.).  Diseases  due  to 
morbid  secretion  of  the  cutaneous  glands;  Anomalise  secretionum  glandularum 
cutanearum.  4.  Lesions  due  to  the  products  of  inflammation  and  to  exudations  ; 
Ivxudationes.  5.  Lesions  due  to  transudations  of  blood :  Haemorrhagiae  cutanea?. 
G.  Diseases  of  the  skin  originating  in  an  increase  of  its  mass;  Hypertrophia'. 
7.  Lesions  of  the  skin  due  to  a  decrease  in  its  mass;  Atrophias  8.  Diseases  occa- 
sioned by  benign  new  formations;  Neoplasmata.  9.  Diseases  of  the  skin  originating 
in  malignant  new  formations;  Pseudoplasmata.  10.  Ulcerations  of  the  skin; 
Ulcerationes.  11.  Nervous  diseases  of  the  skin  ;  (Anaesthesia:  and  Hypenesthesiae) 
Neuroses.     12.  Animal  and  vegetable  parasites  of  the  skin  ;   Parasitas. 

Hebra,  as  we  see,  selected  pathological  anatomy  as  the  foundation 
of  his  system. — Eczema  is  regarded  as  the  most  frequent  kind  of  skin- 
disease,  and  its  fundamental  forms  are  papules  and  vesicles.     He  considers 


—  960  — 

this,  as  well  as  the  great  majority  of  all  diseases  of  the  skin,  a  local  lesion. 
Yet,  in  spite  of  his  principle  of  regarding  diseases  of  the  skin  as  local 
troubles,  Hebra  does  not  one-sidedly  entirely  exclude  a  constitutional 
foundation  for  them.  In  this  emphasis  laid  upon  the  local  nature  of  many 
diseases  of  the  skin,  particularly  those  of  a  non-febrile  nature,  lies,  how- 
ever, a  chief  characteristic  of  Hebra,  inasmuch  as  he  combined  therewith 
the  principle  (here  frequently  correct)  of  simple  local  treatment,  as  dis- 
tinguished from  the  general  treatment  of  skin  diseases  which  had  existed 
almost  exclusively  before  his  da}-.  In  connexion  with  this  simple  local 
treatment,  attention  was  paid  to  the  nature  of  the  case,  and  thus  undoubt- 
edly many  successes,  though  not  always  radical  ones,  were  attained.  In 
this  way  Hebra  became  the  author  of  many  excellent  methods  of  treat- 
ment. On  the  other  hand,  as  a  pupil  of  Skoda,  he  was  among  the  cham- 
pions of  the  nihilistic  therapeutics  of  the  Vienna  school,  influential  chiefly 
in  his  own  specialty,  but  also  secondarily  upon  the  whole  science  of  thera- 
peutics. Like  Skoda  too,  he  instituted  numerous  observations  in  which  a 
mere  pretence  of  treatment  was  pursued,  by  which  it  was  established  that 
many  lesions  get  well  of  themselves,  a  conclusion  which  had  been  taught, 
even  as  regards  diseases  of  the  skin,  bj*  the  most  important  and  the  better 
physicians  of  an  earlier  day.  though  without  experimental  proof.  — 
Another  of  Hebra's  merits  was  his  acceptance  of  the  itch-mite  as  the  cause 
of  the  itch,  a  doctrine  in  which  he  unreservedly  followed  Wichmann.  His 
teaching  that  the  eruptions  of  the  itch  are,  for  the  most  part,  scabious 
eruptions  is  not  so  well  established.  On  the  other  hand,  Hebra's  doctrine 
of  the  so-called  recession  of  eruptions,  to  the  effect  that  the  disappearance 
of  external  eruptions  is  due  to  their  jugulation  b}'  some  internal  disease, 
but  not  that  the  latter  is  the  result  of  this  disappearance,  has  been  proven 
by  experience.  In  s}-philis  Hebra  again  called  in  the  aid  of  that  almost 
interdicted  drug,  mercury,  a  course  in  which  he  was  followed  by  the  most 
famous  s}Tphilographer.  of  the  new  AHenna  school, 

Carl  Ltjdwig  Sigmund,  Ritter  von  Ilanor  (1810-1883,  died  in  Padua) 
of  Schassburg  in  Transylvania,  author  of  the  "  Einreibungscur  bei  der 
Syphilis"  (1856). 

Siginund,  the  son  of  a  minister,  is  also  of  interest  in  an  historical  point  of  view 
as  the  first  Protestant  professor  of  modern  times  (since  18-1-9)  in  Austria,  a  result  to 
which  the  successful  treatment  of  the  social  disease  in  the  highest  circles  probabl}' 
contributed  more  than  religious  toleration.  He  won  a  reputation  as  one  of  the  first 
champions  of  international  h.ygiene  (in  the  plague,  cholera  etc  )  and  (like  Ricord) 
as  a  sprightly  writer  on  bathing  resorts  in  his  book  of  travels. 

Sj'philis  he  classified  (a  classification  likely  to  occasion  more  em- 
barrassment in  its  application  to  the  diagnosis  and  immediate  treatment 
of  any  given  case,  than  the  precise  division  itself)  into  :  1.  A  gonorrheal 
group,  or  specific,  contagious,  local,  venereal  catarrh  ;  2.  Group  of  con- 
tagious, venereal  ulcers,  without  resulting  general  contagion.  Both  these 
classes  are  purely  local  troubles,  and  therefore  to  be  also  treated  locally. 


—  961  — 

3.  Group  of  infectious,  syphilitic  forms  of  disease,  to  be  treated  with  mer- 
cury after  the  accomplishment  of  infection.     4.  Pseudosj'philis. 
Jon.  von  Waller  (1811-1880)  in  Prague 

made  himself  well-known  as  a  experimental  syphilographer.  He  was  one  of  tbe  first 
to  inoculate  syphilitic  pus  upon  the  healthy  for  prophylactic  purposes  —  certainly  a 
bad  beginning:. 

Jos.  Hermann, 
another  syphilographer  of  Vienna,   is  a  fanatical  opponent1  of  the  mercurial  treat- 
ment (Die  Behandlung  der  Syphilis  ohne  Merkur,  2d  edition,  Vienna,  1857,  and  other 
works).     He  desired  even  to  have  the  use  of  mercury  prohibited  by  law. 

Fr.  W.  Lorinser 

was  likewise  an  anti-mercurialist.     Another  Viennese, 

Albert  Julius  Carl  Michaelis, 
in  his  compendium  of  the  theory  of  syphilis  advocated  a  more  eclectic  treatment. 

Hermann  Zeissl  (1817-1884 ;  Lehrbuch  and  Compendium  der 
Syphilis) 

shows  himself  in  his  works  a  gifted  and  thorough  investigator  of  the  theory  and 
literature  of  syphilis. 

Jon.  Karl  Proksch  (born  1839)  in  Vienna, 
an  anti-mercurialist  in  therapeutics,  is  the  author  of  numerous  bitter  critiques. 

The  nihilistic  tendency  in  therapeutics  was  carried  to  excess  by 

Jos.  Hamernjk,  professor  in  Prague, 
then  a  practising  physician  in  that  city  and  a  frequent  and  active  cultivator  of  the 
subject  of  physical  diagnosis  (Carditis  als  Ursache  von  Klappeninsufficienz,  1843; 
phj'siological  and  pathological  investigations  on  the  mechanism  by  which  the  venous 
and  arterial  valves  of  the  heart  are  closed,  and  by  which  the  sounds  of  the  heart  are 
produced,  and  similar  researches  on  the  appearances  in  the  arteries  and  veins  etc., 
1847;  Das  Herz  und  seine  Bewegung,  1858;  Grundziige  der  Physiologie  und  Patho- 
logie  des  Herzbeutels,  1864,  etc.).  He  based  his  nihilism  upon  tne  maxim,  that,  as 
we  have  no  precise  knowledge  concerning  the  advantages  of  drugs,  and  especiallj-  on 
those  of  bloodletting,  we  should  follow  the  rule  of  doing  no  harm  by  unsafe  treatment. 
The  opposition  of  Hamernjk  and  Dietl  to  bloodletting  recalls  that  of  the  followers  of 
Erasistratus  —  all  an  old  story  ! 

Anton  Jaksch,  Ritter  von  Wartenhorst  (born  1810),  professor  in 
Prague,  and  Joseph  von  Halla  (181(1-1887)  a  clinician  of  the  same  place 
and  a  pupil  of  Skoda  and  Rokitansky,  also  belonged  to  this  school.  Its 
most  extreme  representative,  however,  must  undoubtedly  be  considered 

Jos.  Dietl  (1804-1878),  of  Podbuj  in  Galicia, 
who  graduated  in  1829,  was  from  1833  assistant  to  the  chair  of  mineralogy  and 
zoology  in  Vienna,  became  in  1841  "Primararzt"  to  the  Wiedener  Hospital,  was  from 
1848  to  1851  its  Director,  then  a  professor  in  Cracow  and  burgomaster  of  the  same 
place  until  1874.  and  from  1869  a  member  of  the  "  Herrenhaus".  He  wrote  in  favor 
of  absolute  inactivity,  trust  in  God,  particularly  in  diseases  of  the  lungs  ("Der 
Aderlassin  der  Lungenentzundung.  Klinisch  und  physiologisch  bearbeitet",  Vienna, 
1848;   "Anatomische   Klinik  (!)   der  Gehirnkrankheiten  ",    1846),   and  supported  his 

1.  The  antagonism  between  the  mercurialists  and  anti-inercnrialists  was  moderated  by 
the  introduction  of  the  preparations  of  iodine  by  William  Wallace,  a  physician  of 
Dublin,  in  1835. 
61 


—  962  — 

words  by  statistics  (of  750  cases  of  pneumonia  treated  without  bleeding,  6!>,  about  10 
per  cent.,  died,  and  these  from  complications).  This  doctrine  in  its  day  aroused  a 
genuine  storm  of  pros  and  cons,  made  its  author  the  most  talked  about  member  of  his- 
school,  and  won  for  him  in  the  future  the  importance  of  an  exponent  of  its  teachings. 
In  particular  Dietl  taught  as  regards  venesection  that  it  was  never  indicated  in 
pneumonia,  and,  indeed,  was  only  injurious,  a  statement  which  in  its  doctrinaire 
exclusiveness  could  not  claim  general  acceptance.  According  to  him,  it  woiked 
injury  "because  it  favors  the  formation  and  extension  of  the  hepatization,  purulent 
softening  and  the  exhaustion  of  the  patient,  increases  the  blood-crasis,  conduces  to 
the  formation  of  fibrinous  coagulations  in  the  heart  and  great  vessels,  and  the 
simultaneous  origin  of  other  exudative  processes,  and  thus  increases  the  mortality", 
a  doctrine,  which,  sober  as  it  sounds,  was  yet  entirely  theoretical.  —  Dietl  was  a  most 
fanatical  panegyrist  of  learning  and  scorner  of  the  treatment  of  modern  times.  "  By 
the  sum  of  his  knowledge  must  the  phj-sician  be  judged;  in  the  physician  we  should 
prize  the   naturalist,    not  the  empiric   and   his  success.     As  long  as  there  are  lucky 

physicians,  so  long  there  are  no  scientific  physicians but  the  patient  will 

avoid  the  scientific  physician.  Of  course  the  scientific  physician  lays  no  weight 
upon  the  treatment;  in  science  alone  he  seeks  his  power.  Nature  only  can  cure. 
To  this  maxim  we  must  cling  then,  when  we  have  discovered  a  principle  of  treatment 
subordinate  to  the  same  ",  a  sophistical,  sublimated  skepticism,  so  exaggerated  that 
fortunately  e\ery  hour  of  practice  shows  its  absurdity. 

The  nihilistic  doctrines  of  the  followers  of  the  Vienna  school,  the 
further  the}'  spread  from  their  place  of  origin,  the  more  the}-  increased  in 
acceptance  and  reputation.  Indeed,  so  far  was  this  the  case,  that  for  a 
long  time  here  and  there  in  the  empire  the  question  as  to  the  treatment 
of  any  given  disease  was  met  with  an  incredulous  or  ironical  shrug  of  the 
shoulders,  or  with  the  standing  prescription  :  "R.  —  A  little  bitter-almond 
water  mixed  with  considerable  common  water,  sweetened  and  fortified  with 
syrup''.  Yet  these  doctrines  had,  doubtless,  the  advantage,  which  always 
attaches  to  skepticism  as  such  —  they  opened  the  way  for  the  truth.  But 
the  one-sidedness  and  recklessness  with  which  the  whole  past  of  medicine 
was  opposed,  and  which  now  denied  to  that  past,  as  it  were,  all  therapeutic 
service,  as  the  French  school  'had  already  denied  to  it  almost  all  patholog- 
ical.and  diagnostic  knowledge,  can  be  in  no  wa}-  supported,  and  could  in 
the  long  run  prove  nothing  but  injurious.  From  this  sprang  manifestly 
the  almost  absolute  neglect  by  the  new  Vienna  school '  (Hebra  perhaps 
excepted)  of  all  historical  study  of  the  individual  branches,  as  well  as  of 
medicine  in  general.  For  this  school,  in  contrast  to  those  of  the  phil- 
osophy of  nature,  of  natural  history  and  even  of  homoeopathy,  is  pecu- 
liarly characterized  by  the  fact  that  it  has  produced  no  independent  his- 
torical work,  but  in  this  department  allows  itself  to  be  represented  by  a 
homoeopath.  Thus  it  happened  that  (granting  even  the  propriet}-  of 
doubts  in  the  successful  action  of  drugs)  the  old  Hippocratic  science  of 
hygiene,  which  had  been  also  cultivated  by  the  old  Vienna  school,  received 
no  aid  of  the  slightest  importance  from  the  new.  We  say  nothing  of  the 
neglect  of  the  humane  side  of  the  medical  profession,  which  certainly  in 
the  so-called  "exact,  objective,  unimaginative,  experimental,  scientific" 
and  now  exclusively  dominating  hospital  practice,  whose  influence  (in  con- 


—  963  — 

trast  to  that  of  private  practice)  through  the  new  school  now  occupies  the 
foreground,  as  it  did  at  an  earlier  period  in  France  —  this  humane  side,  I 
sa}*,  could  not  and  did  not  readil}'  find  any  considerable  promotion  and 
cultivation. 

In  spite  of  the  incredulity  which  prevailed  in  this  school  with  respect  to  the 
treatment  of  disease  by  drugs,  an  incredulity  originating  in  the  French  school  and 
due  partly  also  to  the  ill  success  of  all  medication  as  demonstrated  in  the  time  of  the 
cholera,  there  yet  sprung  from  its  fold  a  famous  pharmacologist, 

Karl  D  ami  an,  Hitter  von  Schroff  (born  1802)  of  Kratzau  in  Bohemia, 
a  country  from  which  the  most  numerous,  and  most  important  physicians 
of  the  new  Vienna  school  took  their  origin. 

Schroff  studied  in  Graz  until  1825,  when  he  went  to  Prague  and,  like  Oppolzer, 
became  the  assistant  of  Krombholz.  For  a  long  time  he  also  managed  here  the 
insane  asylum,  and  then  an  institution  for  the  deaf  and  dumb.  In  1830  Schroff  went 
to  Olmutz  as  a  professor,  officiated  here,  like  the  original  founder  of  the  new  Vienna 
school,  as  cholera  physician  in  1832,  removed  to  Vienna  in  1835  to  assume  the 
position  of  a  professor,  and  from  this  place  in  the  following  }rear  made  scientific 
tours  to  the  cliief  countries  of  Europe.  It  was  not  until  1849  that  he  received  the 
chair  of  pharmacology  and  a  pharmacological  laboratory.  His  chief  works  are : 
"  Lehrbuch  der  Pharmakognosie  ",  1853;   "  Lehrbuch  der  Pharmakologie",  1856. 

Schroff  proved  numerous  drugs,  particularly  the  poisons  proper  or 
alkaloids.  Like  Wepfer,  Harder  and  Brunner  in  the  17th  century,  he  in- 
vestigated experimentally  the  action  of  drugs,  or  their  most  active  con- 
stituents, upon  animals,  and,  as  William  Alexander  and  Hahnemann  had 
done  at  an  earlier  period,  upon  healthy  men  also.  Besides  Schroff  Sr., 
professor  Wenzel  Bernatzik  (Handbuch  der  allgem.  und  spec.  Arzneiverord- 
nungslehre,  1876)  and  Dr.  C.  von  Schroff  Jr.,  who  in  1876  succeeded  Clar 
in  Graz,  should  be  noticed  as  pharmacologists. 

An  opponent  of  all  theoretic  tendencies,  and  especially  of  the  humoral 
doctrine  of  erases,  appeared  within  the  school  itself  in  the  person  of 

Jos  Engel  (born  1816)  of  Vienna,  who  originally,  like  R.  Grub}-, 
Franz  Ragsky  (died  1875),  Florian  Heller  (1813-1871)  and  others,  had 
been  a  follower  of  this  school. 

Engel  studied  in  Vienna,  and  after  his  graduation  in  1839  became  an  assistant 
to  his  teacher  Rokitansky  and  conducted  a  course  of  lectures  on  pathological 
histology.  From  Zurich  (where  in  1844  he  relieved  Henle  and  his  earlier  assistant 
Kolliker  of  Zurich)  and  Prague  (where  in  1849  he  taught  pathological  anatomy  in 
the  university)  he  returned  in  1854  to  Vienna  and  took  a  position  in  the  Josephinum, 
in  which  until  its  closure  two  years  ago  (1874),  he  taught  pathological  and  topo- 
graphical anatomy.  Engel  is  a  very  fruitful  writer.  His  chief  works  are:  "Ent- 
wicklung  einer  patholog.-anatom.  Propadeutik  ",  1845;  "Das  Knochengeriiste  des 
menschlichen  Antlitzes",  1850;  Untersuchungen  iiber  Schadelformen  ",  1851; 
"Darstellungen  der  Leichenerscheinungen  und  deren  Bedeutung",  1855;  "  Specielle 
pathologische  Anatomie",  1856;  "Compendium  der  topographischen  Anatomie", 
1860,  etc. 

Engel  ever  strove  to  render  pathological  anatomy  a  practical  science, 
and  is  one  of  the  most  important  of  Rokitansky 's  pupils. 


—  964  — 

The  following  physicians  should  also  be  mentioned  anions  the  pathological 
anatomists  of  reputation  :  Th.  Helm,  as  early  as  1848-1851  provisor}-  Director  of  the 
General  Hospital  at  Vienna,  and  permanent  Director  of  the  same  institute  n  from 
1855  to  1869,  where  he  succeeded  Haindl  (1851-1855),  and  was  himself  succeeded  by 
J.  Hofmann.  Helm  wrote  a  "  Monographie  der  Puerperalkrankheiten ",  1S40. 
A.  Biesiadecki,  professor  in  Cracow  and  subsequently  Protomedicus  in  Lemberg 
(Beitrage  zur  physiol.  und  pathol.  Anatomie  der  Haut ;  Ueber  Tuberfcelbildimg  in 
Blutkoagulis ;  Untersuchungen  aus  dem  pathol. -anat,  Institut  in  Krakau,  1872); 
Jul.  Max  Klob,  now  professor  in  the  "  Rudolfsspitale"  (Pathol.  Anatomie  der  weib- 
lichen  Sexualorgane,  1864;  Pathol. -anat.  Studien  iiber  das  Wesen  des  Cholera- 
processes,  1867,  etc.);  J.  Dlauhy,  professor  of  pathological  anatomy  in  Prague ; 
Th.  Wislocki  (Compendium  der  patholog.  Anatomie,  1853);  Rich.  Heschl  (1824- 
1881),  Rokitansky's  successor  in  Vienna  in  1875  (Compendium  der  allgemeinen  und 
speciellen  pathologischen  Anatomie,  1854,  etc.).  The  latter  physician  rendered  good 
service  to  craniology  and  pathological  histology,  and  established  the  first  collection 
of  specimens  in  the  latter  department  founded  in  Vienna. 

If  the  number  of  Rokitansky's  pupils  and  disciples  who  emulated 
and  followed  their  teacher  in  the  scientific  and  literary  departments  is 
relatively  small,  the  reverse  was  the  case  with  respect  to  Skoda.  No  doc- 
trine in  recent  days  has  found  so  many  devotees  as  that  of  physical  diag- 
nosis. Thus  man}'  amplifications  of  Skoda's  original  doctrines,  and  some 
adaptations  of  the  same  to  a  more  refined  acoustics,  have  been  introduced, 
but  the  principles  had  been  given  by  the  master,  once  for  all  and  unchange- 
able. Useful,  for  the  most  part,  as  were  such  labors  per  se,  they  have  yet 
been  parti}'  and  in  spite  of  themselves  very  prejudicial  to  private  practice 
by  the  one-sided  interest  in  a  special  tendency  which  they  continually 
aroused  and  kept  awake,  a  tendency  to  which,  as  we  have  seen,  Skoda  gave 
the  impulse.  For  they  diverted  the  acumen  and  reflection  of  physicians 
from  therapeutics  more  than  had  been  done  already  by  Skoda,  and  they 
promoted  the  belief  that  the  most  capable  practical  physician  was  he  who 
made  the  most  "exact"  diagnoses.  If  the  maxim  of  Baglivi  (often  ap- 
pealed to  with  some  justice),  that  he  treats  well  who  diagnosticates  well, 
is  true  as  a  whole,  yet  its  application  appears  at  once  false  when,  in  behalf 
of  the  diagnosis,  the  second  requisite  of  the  physician  is  either  forgotten 
or  neglected.  This,  as  we  know,  was  long  the  case  in  private  practice 
everywhere.  Here  the  doctrines  of  general  therapeutics  especially,  the 
most  useful  and  effective  of  all,  continue  to  be  laid  aside  almost  entirely, 
and  this  to  a  degree  such  as  has  scarce!}-  ever  been  the  case  in  any  period 
of  the  past  history  of  German  medicine.  In  the  demonstration  of  local 
changes  too,  the  patient  and  the  fundamental  principles  of  treatment  re- 
lating to  the  entire  organism  and  etiology  in  its  widest  sense,  principles 
which  must  be  the  main  object  to  the  practical  physician  in  presence  of  his 
patient,  were  neglected  almost  more  than  in  the  French  school,  the  mother 
of  this  system. 

No  medical  specialty  in  Germany  since  the  beginning  of  the  Vienna  school  could 
point  to  so  man}'  clever  works  (besides  numerous  translations)  based  in  part  upon 
ingenious  experiments,  as  that  of  physical   diagnosis,   particularly  the  diagnosis  of 


—  965  — 

thoracic  diseases.  Many  of  these  experiments,  however,  were  not  at  all  applicable 
to  the  relations  of  the  bod}-,  yet  they  prove  in  themselves  that  professional  thought 
gravitated  for  a  very  long  period  to  diagnosis.  Besides  the  chief  work  of  Skoda 
already  mentioned  and  that  of  L.  A.  Siebert  (1805-1855),  professor  in  Jena,  we  must 
content  ourselves  with  mentioning  only  a  few  works  and  writers,  who  either  incident- 
ally, or  in  treatises  and  special  works,  discussed  or  enriched  physical  diagnosis,  and 
who  either  proceeded  directly  from  the  Vienna  school  or  were  connected  with  it. 
Ed.  Mayer,  "Die  Percussion  des  Unterleibes",  1839;  Franz  Zehetmayer,  subsequently 
professor  in  Lemberg,  "  Grundziige  der  Percussion  und  Auscultation  in  ihrer  An- 
wendung  auf  die  Diagnostik  der  Brustfell-  und  Lungenkrankheiten,  als  Leitfaden  zum 
Selbstunterricht  fur  Aerzte  dargestellt ",  1842;  C.  D.  Leichsenring,  "Die  physikal. 
Exploration  der  Brusthohle",  1843,  2d  edition  1853;  3d  edition  by  Joh.  Oppolzer 
1854;  by  the  same  author  "  Die  Herzkrankheiten.  Leitfaden  zum  Selbstunterricht 
fur  Aerzte",  1845;  Moritz  Korner  (1820-1876)  of  Kratzau  in  Bohemia,  professor  of 
special  pathology  and  therapeutics  in  Graz,  discussed  special  branches  of  physical 
diagnosis  in  some  journal  articles;  C.  Canstatt,  who  wrote  on  the  practical  advan- 
tages of  physical  examination  of  the  thoracic  organs  (in  Latin),  1844;  Eugen  Kolisko 
(1811-1884),  Primarzt,  "  Ueber  amphorischen  Wiederhall  und  Metallklang  in  der 
Brusthohle",  osterr.  Jahrb.,  1844,  etc.  ;  Gustav  von  Gaal,  "Physikal.  Diagnostik  und 
deren  Anwendung  in  der  Medicin,  Chirurgie,  Oculistik,  Otiatrik  und  Geburtshilfe, 
enthaltend  etc.,  nebst  Anhang  iiber  die  mikroscopisch-chemisch-pathologische 
Untersuchung  von  Dr.  Job.  Flor.  Heller",  2d  edition,  1849;  Dr.  Georg  Weber, 
practitioner  in  Kiel,  "Theorie  und  Methodik  der  physikalischen  Untersuchungs- 
methode  bei  den  Krankheiten  der  Athmungs-  und  Kreislaufsorgane  ",  1849;  "Percus- 
sion und  Auscultation  des  Herzens  im  gesunden  und  krankhaften  Zustande,  nebst 
tabell.  Uebersicht  der  Herz-  und  Lungenleiden,  in  diagnostiseher  und  pathologisch- 
anatomischer  Beziehung  nach  Skoda  und  Rokitansky,  mit  einem  Anhange  liber  die 
Behandlung  derselben,  bearbeitet  von  Dr.  Liberal  Giinsburg",  1845;  F.  H.  Miihl- 
baner  "Die  Lehre  von  der  Percussion  und  Auscultation,  mit  Beriicksichtigung  der 
pathol.  Anntomie  der  Brustorgane  fur  den  praktischen  Arzt  zusammengestellt ", 
1847;  Rapp,  "  Beitrage  zur  Diagnostik",  1849;  J.  Fr.  Conradi,  now  practising  at 
Wollstein  in  Rheinhesse,  "Ueber  die  Lage  und  Grosse  der  Brustorgane,  der  Leber 
und  Milz  beim  gesunden  Manne  und  ihre  Bestimmung  durch  die  Percussion,  praes. 
Jul.  Vogel  in  Giessen",  1848;  Dr.  J.  F.  H.  Albers  (1806-1867)  professor  in  Bonn, 
"Die  Erkenntniss  der  Krankheiten  der  Brustorgane  aus  physikalischen  Zeichen,  oder 
Auscultation,  Percussion  ujid  Spirometrie.  Nach  Herbert  Davies'  Vorlesungen  und 
eigenen  Beobachtungen  bearbeitet",  1850;  J.  Gutbrod  (died  1886),  a  physician  in 
Stuttgart,  who  originated  the  theory  of  recoil  in  explanation  of  the  impulse  of  the 
heart,  a  theory  adopted  by  Skoda  but  now  abandoned;  H.  Locher  (died  1873),  a 
practising  physician  and  subsequently  a  professor  in  Zurich,  "  Die  Erkenntniss  der 
Lungenkrankheiten  vermittelst  der  Percussion  und  Auscultation.  Ein  Lehrbuch, 
bearbeitet  fur  Studirende  und  prakt.  Aerzte",  1S53.  "Somewhat  more  attractive 
perhaps  in  externals  and  more  elegant  in  form;  the  crust  somewhat  harder,  the 
crumb  a  little  whiter,  with  less  bran  and  only  a  shade  less  oppressive  in  the  stomach" 
(see  Preface),  a  work  ingeniously  written  and  distinguished  by  historical  remarks. 
By  the  same  author,  "Zur  Lehre  vom  Herzen ",  1860;  Dr.  Fr.  Willielm  Theile 
(1801-1879)  of  Buttstiidt  near  Weimar,  in  1827  a  professor  in  Jena,  1831-1853  pro- 
fessor in  the  newty  erected  university  of  Bern,  which  latter  position  he  resigned  in 
the  year  last  mentioned  to  become  medical  counsellor  and  a  practising  physician  in 
Weimar  (Die  physikalische  Untersuchungsmethode  oder  Anwendung  der  Inspection, 
Palpation,  Mensuration,  Succussion,  Percussion,  Auscultation  und  auscultatorischen 
Percussion  im    gesunden    und   kranken  Zustande.     Nach    Barth  und    Henri    Roger 


—  96G  — 

Traite  pratique  d'  auscultation  suivi  d'  un  Precis  de  percussion,  4.  Ausg.,  1S54,  und 
H.  M.  Hughes'  Practice  etc.,  1855);  F.  Giinsburg,  "Klinik"  etc.,  1856;  H.  Bamber- 
ger (1822-1888),  born  near  Prague,  Oppolzer's  assistant  in  1850,  professor  in  Wiirz- 
burg  1854  and  in  Vienna  1872,  "  Herzkrankheiten  ",  1856,  etc.  ;  Alois  Geigel,  (1829- 
1887)  of  Wiirzburg,  professor  of  hygiene  and  of  the  policlinic  in  that  city,  specially 
known  as  a  hygienist  and  for  a  pneumatic  apparatus  (Schopfradgebliise,  hydraulic 
bellows?),  "  Beitrage  zur  physikalischen  Diagnostik  mit  besonderer  Rvicksicht  auf 
Form  and  Bewegung  der  Brust",  1855;  Louis  Traube  (1818-1876),  professor  in  Berlin, 
where  he  popularized  physical  diagnosis  and  cultivated  experimental  pathology, 
"  Zusammenhang  der  Herz-  und  Nierenkrankheiten  ",  1856,  etc.;  Dr.  M.  Schwanda 
(1823-1885),  chief  physician  and  professor  of  the  theory  of  medicine  in  the  late 
"Josephs-Academie  ",  and  subsequently  in  the  University,  "Anleitung  zur  physika- 
lischen Krankenuntersuchung  und  Diagnostik",  etc.,  1857;  M.  A.  Wintrich,  professor 
in  Erlangen,  "Einleitung  zur  Darstellung  der  Krankheiten  der  Respirationsorgane  ", 
1854,  the  best  work  after  Scoda's  book;  Dr.  Eugen  Seitz,  professor  in  Giessen,  and 
Fr.  Zamminer  (died  1859),  "Die  Auscultation  und  Percussion  der  Respirations- 
organe", with  numerous  dissertations  under  his  presidency  by  Piersch,  Kobelt,  K. 
Drescher,  H.  Steinhauser,  Conrad,  Dikore,  K.  Heyer,  C.  Schmidt,  K.  Schuster,  H. 
Salzer  and  others;  Dr.  E.  Harless  (1820-1862,  son  of  the  famous  theologian  Ch.  Fr. 
Harless  —  1773-1854  —  in  Jena  and  Bonn,  author  of  a  "  Lehrbuch  der  plastischen 
Anatomie",  1856),  "  Tabellen  zur  Auscultation  und  Percussion";  Kail  Christian 
Adolph  Jacob  Gerhard  (born  1833)  of  Speier,  formerly  professor  in  Wiirzburg  and 
now  Frerich's  successor  in  Berlin,  "Lehrbuch  der  Auscultation  und  Percussion  mit 
besonderer  Beriicksichtigung  der  Inspection,  Betastung  und  Messung  der  Brust  und 
des  Unterleibes  zu  diagnostischen  Zwecken",  1866;  Dr.  0.  Leichsenring  in  Cologne, 
"  Physikalisch-diagnostische  Bemerkungen  zu  H.  v.  Luschka's1  Lage  der  Bauch- 
Organe  des  Menschen";  P.  Guttmann,  "Lehrbuch  der  klin.  Untersuehungs-methoden 
fiir  die  Brust-  und  Unterleibsorgane",  2d  edition,  1874;  with  numerous  journalistic 
articles  by  Bamberger,  F.  Betz  in  Heilbronn  (editor  of  the  "Memorabilien  "  of  C. 
Bartels,  1811-1878)  professor  in  Kiel;  Adalbert  von  Ducheck  (1824-1882),  one  of  the 
most  popular  of  physicians  and  a  professor  in  Vienna,  succeeded  by  Nothnagel  from 
Jena;  and  numerous  others.  Duchek  as  early  as  1860  reproached  the  representatives 
of  the  new  Vienna  school  with  confining  themselves  to  the  investigation  of  the 
products  of  disease,  instead  of  investigating  its  origin.  Nothnagel  too  in  1882,  in 
his  inaugural  address,  attacked  the  specialism  which  the  new  Vienna  school  had 
called  into  existence,  and  emphasized  once  more  practice. and  its  demands  as  a  chief 
duty  of  the  physician  —  a  thing  which  the  new  Vienna  school,  with  Skoda,  Dietl  etc. 
at  the  head,  fairly  shuddered  at.  "One  thing  can  never  be  learned,  but  this  they 
(students  of  medicine)  must  themselves  bring  with  them  as  their  best  endowment  in 
their  future  calling.  All  knowledge  attains  its  ethical  value  and  its  true  significance 
onl}'  by  the  humane  sense  in  which  it  is  employed.  Only  a  good  man  can  be  a  great 
phj'sician.  All  your  knowledge  and  ability  receives  the  stamp  of  genuine  nobility 
only  by  the  spirit  of  true  humanity  in  which  it  is  employed.  With  the  intellectual 
and  the  scientific  education,  the  education  of  the  feelings  and  the  manners  must  run 
parallel.  You  know  that  it  is  not  the  duty  of  the  clinic  to  teach  the  latter,  but,  as 
your  future  instructor,  I  hold  it  my  duty  at  the  commencement  of  our  common  labors 
to  at  least  point  out  this  question,  which  I  look  upon  as  one  of  the  weightiest  impoit- 
ance  for  all  professional  treatment."     These  maxims  should  likewise  be  laid  to  heart 

1.  Luschka  (1820-1875)  of  Constance  was  professor  of  anatomy  in  Tubingen  and  the 
discoverer  of  the  coccygeal  gland  in  man  etc.  He  wrote  "Die  Brustorgane  des 
Menschen  in  Hirer  Lage",  1857,  with  numerous  other  works. 


—  967  — 

by  those  professors,  who  for  colossal  fees  bestow  their  care  upon  the  wealthy,  but 
"  utilize"  the  poor  as  "  material "  and  "objects"  in  their  clinics.- — The  great  com- 
pilation of  Dr.  Paul  Niemeyer  entitled  "Handbueh  der  theoretischen  und  klinis-chen 
Percussion  und  Auscultation  vom  historischen  und  kritischen  Standpunkte", 
1870,  ma}7  be  regarded  in  a  certain  degree  as  a  summing-up  of  the  department  of 
percussion  and  auscultation.  Niemeyer  (born  1832)  is  the  brother  of  Felix  von 
Niemeyer  (1820-1872),  the  popular  clinician  and  practitioner  of  Tubingen,  whose 
famous  "  Lehrbuch  der  Pathologic  und  Therapie  "—  recently  thoroughly  revised  and 
edited  by  E.  Seitz,  who  lectured  from  it  and  therefore  knew  it  perfectly  —  spoke  in 
behalf  of  therapeutics  at  a  time  when  the  Nihilists  of  Vienna  still  gave  the  tone  to 
medicine.  After  being  translated  into  the  chief  languages  of  Europe,  it  was  also 
published  in  Arabic  by  Selim  Bey,  physician  to  the  Viceroy  of  Egj-pt. 

The  new  Vienna  school  as  early  as  1848  attained  the  summit  of  its 
greatness,  and  maintained  its  original  tendency  only  until  the  sixties, 
though  its  founders  and  their  immediate  pupils  occupied  the  chief  pro- 
fessorial chairs  still  longer.  Its  successor,  the  "Young  Vienna  School", 
enlarged  still  further  the  field  of  specialties  and  emphasized  more  the 
department  of  therapeutics,  but  it  created  no  new  system  proper  or  new 
field  of  investigation,  as  e.  g.  Koch  in  Berlin  has  done. 

It  is  singular  that  within  the  new  Vienna  school,  in  contrast  to  the 
school  of  natural  history,  no  work  on  the  general  subject  of  pathology  and 
therapeutics  was  written  by  any  of  its  chiefs,  unless  we  consider  the  pub- 
lished lectures  of  Oppolzer  such  a  work.  This  very  fact  is  an  open  ex- 
pression ot  its  tendency  to  specialism. 

Besides  the  two  chief  branches  of  pathological  anatomy  and  physical 
diagnosis,  still  other  specialties  were  cultivated  or  created  by  the  new 
Vienna  school. 

Up  to  the  present  time  microscopic  anatomy  has  not  occupied  in  Vienna  that 
important  position,  which  has  been  assigned  to  it  in  German}'.  In  addition  to  Roki- 
tansky,  it  was  chiefly  developed  by 

Carl  Wedl  (born  1815)  of  Vienna, 
from  183^5  professor  of  histologj',  who  cultivated  particularly  the  department  of 
pathology  (Grundzuge  der  pathologischen  Histologie,  1854;  Atlas  der  pathologischen 
Histologie;  Beitrage  zur  Pathologic  der  Blutgefasse;  Pathologie  der  Zahne  mit 
besonderer  Bervicksichtigung  der  Anatomie  und  Phys'ologie,  1870,  etc.).  Damian 
von  Lambl  and  S.  Strieker  (Studien  aus  dem  Institute  fiir  experimented  Pathologie 
in  Wien,  1870;  Handbueh  der  Lehre  von  den  Geweben  des  Menschen  und  der  Thiere, 
2  vols.  1872)  have  also  devoted  attention  to  microscopic  anatomy. 

An  indigenous  specialty  proceeding  from  the  new  Vienna  school  is  that  of 
Laryngoscopy  or  Laryngo-therapeutics,  which  owes  its  existence  to  the  application  of 
the  investigations  and  researches  of  Liston  and  Garcia  in  the  hands  of 

Johann  Nepomuk  Czermak  (born  1828,  died  of  diabetes  1873)  of 
Prague, 

professor  in  Gratz,  Cracow,  Pesth,  and  finally  a  private  savant  in  Leipsic.  His 
work  was  entitled  "  Der  Kehlkopfspiegel  und  seine  Verwerthung  fiir  Phjsiologie  und 
Medicin",  1860.  Czermak  also  cultivated  Rhinoscop}'.  Contemporaneously  with 
Czermak  the  laryngoscope  was  adapted  to  practical  purposes  by 


—  968  — 

Ludwig  Turck  (1810-18(38), 
professor   in    Vienna,    who  published   "Praktische    Anleitung    zur    Laryngoscopie  ", 
1860;   "  Klinik  der  Krankheiten  des  Kehlkopfs  und  der  Luftrohre"  etc  ,  1866;  Atlas 
zur  Klinik  der  Kehlkopfkrankheiten,  Tafeln   von  Dr.  A.  Elfinger  und  Dr.  C.  Heitz- 
mann,  1866.     Their  footsteps  were  followed  by 

Dr.  Friedrich  Semeleder  in  his  work  "  Die  Laryngoscopie  und  ihre  Verwei thung 
fur  die  arztliche  Praxis",  18GH,  and  professors  Joh.  Schnitzler,  a  skilful  Iaryngo- 
surgeon  (Entfernung  von  Kehlkopfspolypen  ohne  vorausgeschickte  Tracheotomie, 
1880,  etc.),  Stork  and  von  Sckrotter,  the  latter  a  favorite  pupil  of  Skoda. 

Undoubtedly  the  most  famous  and  important  specialty  of  the  new  Vienna  school, 
however,  is  that  of  Ophthalmology.  It  is  sufficient  to  merely  mention  the  names  of 
the  representatives  of  this  branch  to  render  it  clear  what  a  height  the  latter  has 
attained  in  Vienna.  At  the  head  should  be  named  Anton  von  Rosas  (1791-1855)  of 
Funfkirchen,  "a  leader  of  the  reactionary  movement",  whose  "  Handbuch  der  theor- 
etischen  und  praktischen  Augenheilkunde  ",  Vienna,  1830,  contains  also  an  abridged 
history  of  this  branch.  No  less  important  was  Beer's  pupil  and  son-in-law,  Friedrich 
Jager  (1784-1871 ),  Hitter  von  Jaxtthal,  of  Kirchberg  in  Wiirtemberg,  who,  like  Rosas, 
performed  the  extraction  of  cataract  through  a  flap  in  the  upper  segment  of  the 
cornea,  discovered  the  contagiousness  of  blenorrhoeal  ophthalmia  (1811),  practised 
the  inoculation  of  gonorrhceal  pus  in  pannus,  removed  the  edge  of  the  lid  in  entropium 
etc.  His  elder  brother  Carl,  as  well  as  his  son  Eduard,  famous  as  an  ophthalmo- 
scopist  (particularly  in  the  investigation  of  the  upright  image  and  in  refractive 
ophthalmoscopy,  which  latter  he  created)  and  as  a  brilliant  operator,  likewise  enjoyed 
great  reputation  as  oculists.  The  latter,  who,  in  spite  of  all  the  fame  acquired  by 
his  immortal  "Atlas",  had  been  for  25  years  (!)  only  an  extraordinary  professor  of 
ophthalmology,  one  year  before  his  death  received  the  appointment  of  ordinary  pro- 
fessor of  this  branch.  He  published  "Staar  und  Staaroperationen",  "Ophthalmologi- 
scher  Atlas",  and  gave  to  the  profession  "  Jiiger's  Test-Type  "  and  "Jager's  Ophthalmo- 
scope". Joh.  Xepomuk  Fischer  (1787-1847)  in  Prague.  Ferdinand  Arlt  (born  1811), 
besides  his  excellent  handbook  in  three  volumes  "Die  Krankheiten  des  Auges  fur 
praktische  Aerzte",  is  best  known  as  associate  editor  of  the  "Archiv  fiir  Augenheil- 
kunde", published  in  conjunction  with  the  great  Dutch  physiologist  and  ophthal- 
mologist Donders,  and  the  famous  Albrecht  von  Grtife  (1827-1870),  cut  off  prema- 
turely by  death.  K.  Stellwag  von  Carion,  author  of  "  Die  Ophthalmologic  vom 
naturwissenschaftlichen  Standpunkte "  and  "  Lehrbuch  der  praktischen  Augenheil- 
kunde". Prof.  Jos.  Pilz  in  Prague;  Hasner  von  Artha  of  the  same  city;  Otto 
Becker  (born  1828)  in  Heidelberg,  a  scion  of  the  Vienna  school  (Linsenkrankheiten, 
Pathol,  anat.  Atlas  der  Augenkrankheiten  etc.,  etc.) ;  Leber  in  Gottingen,  L.  Mauthner 
in  Vienna,  Fuchs  in  Prague,  von  Reuss  in  Vienna  etc. 

The  semi-surgical  specialty  of  Dentistry1  also  found  in  Vienna  an  honored  place, 
at  a  period  when  it  was  scarcely  taught  in  other  universities.  Among  its  active 
cultivators  were  Gg.  Carabelli  (born  1787),  professor  Franz  Nessel,  and  others  who 
had  private  schools  of  their  own. 

Tin;  later  specialty  of  Otolog}'  likewise  had  within  the  Vienna  school  some 
famous  representatives,  particularly  recently  in  Josef  Gruber  and  A.  Politzer,  the  latter 
the  discoverer  of  the  so-called  "  Pulitzer's  method  "  of  forcing  air  into  the  Eustachian 
tubes  during  the  action  of  swallowing. 

1.  The  earliest  dental  clinic  in  Germany  was  established  by  Prof.  E.  Albrecht  (1823- 
1883)  in  the  year  1855.  As  the  manifest  result  of  the  reformation  of  odontology 
which  began  in  America,  dental  institutions  connected  with  the  universities  have 
been  already  established  in  Berlin.  Halle  and  Munich,  and  a  similar  institution 
is  planned  even  in  Vienna. 


—  9(39  — 

Hydrotherapeutics  too  is  taught  in  Vienna,  and  Andr.  Pleniger  (Physiologie  des 
Wasserheilverfahrens,  1863)  and  Wilhelm  Wiuternitz  are  especially  eminent  in  this 
•department. 

Electrotherapeutics  is  represented  by  Prof.  M.  Benedikt,  who,  however,  has 
recently  devoted  his  attention  to  abstract  questions  of  natural  philosophy,  reducing 
ths  feelings  of  pleasure  and  dislike  under  laws,  as  mentioned  above.  Other  electro- 
therapeutists  are  Friedrich  Fieber  ( 1836-1883)  of  Prague,  privatdocent  and  Primararzt, 
"who  likewise  lectured  on  the  therapeutics  of  inhalation ;  Franz  Chvosteck  (1834- 
1884),  Professor  extraordinary  and  Chief  Staff-physician  :  Professor  Dr.  M.  Rosenthal 
and  others. 

Psychiatry  is  represented  by  Ernst  von  Feuchtersleben  (1806-1849),  M.  Leides- 
dorf,  Th.  Meynert,  the  latter  a  professor  in  Zurich  and  founder  of  a  clinic  for 
diseases  of  the  cerebrum.  State-medicine,  by  Prof.  J.  Dominik  Hauschka.  The 
Diseases  of  Children  have  received  excellent  study  at  the  hands  of  L.  von  Mauthner 
(Kiuderdiatetik,  1853);  Leopold  Politzer  (1815-1888),  from  1850  conductor  of  the 
first  institution  for  sick  children,  founder,  together  with  Schaller  and  Mayer,  of  the 
"Jahrbuch  der  Kinderheilkunde  ",  and  at  an  earlier  period  Schaller' s  assistant; 
Alois  Bednar  (Lehrbuch  der  Kinderheilkunde);  Joseph  Eaulich  (1830-1886),  pro- 
fessor of  the  diseases  of  children  and  of  medicine  in  Prague;  Hermann  Wiederhofer 
in  Vienna;  Joh.  Steiner  i  died  1876),  professor  in  Prague  (Compendium  der  Kinder- 
heilkunde): the  ingenious,  but  unfortunate — he  died  of  epilepsy  —  Gottfried  Ritter 
von  Rittershain  (1823-1883)  in  Prague;  L.  Fleischmann  (1840-1878)  in  Vienna,  who 
belonged  to  the  Young  Vienna  School;   Hutfcenbrenner,  A.  Monti  and  others. 

Physiological  and  pathological  chemistry  has  its  representatives  in  Florian 
Heller,  F.C.Schneider,  Vincenz  Kletzinsky  (1826-1882)  of  Guttenbrunn  in  Lower 
Austria,  Rochleder  (died  1872)  and  Ludwig  Jr.  The  anatomist  of  the  Vienna  school 
is  the  classic  author  in  his  department,  Joseph  Hyrtl  (born  1811),  of  Kis-Marton  in 
Hungary,  the  17th  edition  of  whose  "Lehrbuch"  appeared  in  1884.  He  also  wrote 
"Das  Arabische  und  Hebraische  in  der  Medicin",  1879,  and  "Onomatologia  anatomica", 
1880.  In  Prague  anatomy  was  represented  by  Karl  von  Patruban  (1816-1880),  who 
was  likewise  active  as  a  surgeon.  The  physiologist  of  the  Vienna  school  is  Ernest 
Wilhelm,  Ritter  von  Briicke  (born  1819)  of  Berlin,  who  in  187?  was  the  first  Protestant 
to  attain  the  Rectorate  in  Vienna.  At  an  earlier  period  he  had  been  a  professor  in 
Konigsberg.      His  chief  works  relate  to  the  physiology  of  the  eye  and  the  voice. 

Experimental  pathology  is  represented  by  Prof.  S.  Strieker  and  Hans  Kundrat, 
and 

Hygiene,  quite  recently  by  Prof.  J.  Xowack. 

Leopold  Wittelshofer  (1818-1888  I,  the  founder  of  the  first  German  weekly  medical 
journal,  the  "Wiener  med.  Wochenschrift",  and  one  of  "the  most  talented  conductors 
of  such  organs,  must  be  regarded  as  the  most  eminent  journalist  of  the  "New  Vienna 
School".  In  the  "Young  Vienna  School"  his  place  is  taken  by  Joh.  Schnitzler 
(born  L835  in  Gross-Kanisza)  and  Willi.  Sehlesinger  (born  1839),  the  former  Editor- 
in-chief  of  the  "Wiener  med.  Presse"  and  now  of  the  "Internationalen  Rundschau", 
the  latter  of  the  "Wiener  med.  Blatter";  Karl  Bettelheim  (Medic.-chirurg.  Rund- 
schau) and  others. 

In  spite  of  some  variations  from  the  new  Vienna  school  (which,  in- 
deed, laid  claim  to  the  character  of  a  natural  scientific  school),  as  regards 
manner  and  ideas  the  schools  of  physiological  and  rational  medicine. 
which  partly  preceded  and  were  partly  contemporaneous  with  it.  as  well 
as  natural  scientific  or  exact  medicine  (now  first  properly  so  called),  may 


—  970  — 

be  counted  among  its  offshoots.  The  latter  system,  however,  should  be 
regarded  rather  as  a  development  of  the  Vienna  school,  inasmuch  as  its 
chief  representatives  were  either  educated  in  Vienna  or  received  a  lasting 
impulse  from  the  school  in  that  city. 

Among  the  champions  of  the  German 

a)  Physiological  Medicine 

—  a  title  which  Broussais,  as  we  know,  was  the  first  to  claim  for  his  sys- 
tem—  appeared  in  his  own  "Archiv  fur  phj-siologische  Heilkunde",  from 
1842  onward,  the  eminent  Marburg  surgeon,  surgical  anatomist  and  oper- 
ator, W.  Roser  (1817-1888)  of  Stuttgart,  1841-51  a  privatdocent  in 
Tubingen,  and  from  1851  professor  of  surgery  in  Marburg  ;  W.  Griesinger 
(1817-1868)  and  Karl  Reinhold  August  Wunderlich. 

Wunderlich  (1815-1877),  the  son  of  an  Oberamtsarzt  in  Wiirtemberg  who  sub- 
sequently lived  as  medical  counsellor  in  Ludwiysburg,  graduated  in  Tubingen  in 
1837.  Continuing  his  education  in  other  German  and  French  universities,  he  was 
appointed  in  1841  assistant  to  the  medical  clinic  in  Tubingen.  In  1843  he  became 
extraordinary  professor  in  place  of  the  clinician  Hermann,  and  in  1846  received  the 
position  of  ordinary  professor  in  the  same  clinic.  From  1850  onward  he  occupied  a 
similar  position  in  Leipsic,  where  he  succeeded  Oppolzer.  He  died  of  cancer  of  the 
retroperitoneal  glands.  Wunderlich  was  famous  for  the  general  excellence  of  his 
character,  which  was  exempt  from  excessive  self-esteem,  intrigue  and  lust  for  power, 
and  continued  benevolent,  just,  mild  and  truly  noble.  Besides  his  chief  works  men- 
tioned below,  he  wrote  "Wien  und  Paris",  1841;  '  Geechicbte  der  Medicin  ",  1859 ; 
"Grundriss  der  speciellen  Pathologie  und  Therapie",  1858,  and  "Versuch  einer 
pathologischen  Physiologie  des  Blutes",  1844.  His  successor  in  Leipsic  was  E. 
Wagner,  author,  in  conjunction  with  Uhle,  of  a  treatise  on  general  pathology. 

These  champions  formulated  "the  demand  that  we  must  break  away 
from  the  current  ideas  and  gain  a  refined  foundation  for  experience  by 
means  of  a  different  method,  and  one  associated  with  physiology."  u  The 
attack  was  directed  against  the  antiquated  views  of  the  German  S^ymptom- 
atologists  and  Idealists,  and  particularly  against  the  school  of  natural 
history  which  reposed  in  the  most  absolute  domination  .  .  .  and  a  single 
powerful  thrust,  the  unconcealed  expression  of  the  word  .  .  .  must  be  able 
to  complete  the  passage  from  the  old  to  the  new  era."  "  The  doctrine  of 
the  organism,  or,  what  amounts  to  the  same  thing,  the  doctrine  of  life  is 
plrysiology.  Physiology  therefore,  in  its  strict  sense,  must  include  all  vital 
phenomena.  That  from  a  certain  portion  of  these  phenomena,  to  wit  those 
called  morbid,  a  special  science  has  been  formed,  is  an  artificial,  but  yet  a 
practical  division".     (Wunderlich.) 

Physiological  medicine  also  departed  from  the  Vienna  school  in  the 
fact  that  it  did  not,  like  the  latter,  occupy  itself  exclusively  with  path- 
ological anatomy  and  diagnosis,  but  also  utilized  physiolog}'  to  explain 
pathology. 

Wunderlich's  "  Handbuch  der  Patholoiiie  und  Therapie",  2d  edition,  1852,  is 
one  of  the  best  of  our  modern  text-books,  and  in  particular  is  distinguished  by  devo- 
ting sufficient  attention  to  the  historical  element  of  individual  diseases,  as  well  as  by 


—  971  — 

the  fact  that  it  leaves  to  thought  and  the  ordinary  senses,  that  is  to  the  Hippocratic 
methods  of  investigation,  their  just  rights  Unfortunately  it  has  not  recently 
appeared  in  a  new  edition,  in  which  the  wreck  of  its  sj'inptomatology  etc.  might  have 
been  avoided.  The  general  conceptions  of  organism,  health,  disease  and  convales- 
cence were  developed  as  follows:  "The  idea  of  sickness  presupposes  the  idea  of 
organism.  Each  organism  is  a  system  of  individualities,  of  organs.  Its  essence, 
however,  is  more  sharply  distinguished  in  the  historj-  of  the  organism,  than  in  its 
existence.  ...  Its  essence  consists  in  a  perpetual  change,  as  well  in  its  relations 
to  the  outer  world,  as  in  its  own  internal  relations.  The  sum-total  of  the  processes  in 
and  upon  the  organism  we  call  its  life.  Manjr  of  these  processes  correspond  more 
or  less  completely  to  the  other  processes  of  nature  which  we  are  in  the  habit  of  calling 
physical  (mechanical)  and  chemical.  In  apparently  similar  conditions  certain 
actions,  e.  g.  endosmosis,  do  not  occur  in  the  organism.  .  .  .  The  organism  does  not 
form  the  so-called  organic-chemical  combinations:  it  is  only  when  occasion  is  given 
in  it  that  these  are  formed.  .  .  .  Besides  mechanical  and  chemical  processes,  which 
too  undoubtedly  differ  essentially  from  those  in  the  retoit  in  accordance  with  their 
cause,  Wunderlich  distinguishes  the  "vital  processes  in  a  more  limited  sense',  over 
which  "the  nervous  S3-stem  "  presides. — "Health  is  that  condition  in  which  the 
internal  processes  of  the  organism  take  place  and  succeed  each  other  in  a  quiet, 
precise,  uniform  way,  so  as  to  correspond,  for  the  most  part,  to  the  idea  of  the 
organism,  and  to  furnish  the  greatest  guarantee  for  its  continuance"- — a  pure  ab- 
straction, which  appears  no  more  phj-siological  than  the  well-known  definitions  of 
earlier  date.  "  The  constituents  of  the  organism  manifest  abnormal  processes, 
functionate  abnormally,  something  abnormal  takes  place  in  them  ;  this  is  to  be  sick 
in  its  proper  sense."  "There  is  a  difference  between  this  and  the  disease,  which 
properly  only  defined  the  'trivial  consciousness',  in  which  science  always  over- 
looked  the   principle    of  this   definition We  can   say   in    a   certain   sense, 

however,  that  there  are  no  diseases  at  all,  only  disturbed  organisms,  s;ck 
individuals,  sick  organs."  If,  however,  one  has  obtained  a  clear  idea  of  the 
want  of  scientific  accuracy  in  the  conception,  he  may  employ  the  exjjressinn  without 
harm  or  danger.  Wunderlich  rejects  any  vis  medicatrix  naturae.  "  Convales- 
cence presupposes  that  all  disturbances  of  function  are  adjusted,  organic  dis- 
turbances, which  impair  the  integrity  of  the  tissues,  removed,  lost  portions  of  tissue 
restored  and  the  diseased  products,  incapable  of  use  in  the  latter  way,  carried  off. 
Recovery  is  to  be  regarded  as  a  result  which  has  its  complete  and  adequate  foun- 
dation in  the  totality  of  the  preceding  relations,  as  the  consequence  of  favoiable 
constellations,  and  not  as  the  work  of  a  special  and  active  force  (Naturheilkraft) 
existing  for  this  purpose."  Wunderlich  laid  down  as  methods  of  cure  the  directly 
curative  (abortive)  and  the  expectant,  the  latter  of  which  he  considered  valid  so 
much  the  more  frequently,  because  many  diseases  end  favorably  without  treatment, 
indeed  in  spite  of  the  most  preposterous  treatment.  In  opposition  to  the  nihilism  of 
the  new  Vienna  school  he  raises  his  voice  in  the  defence  of  therapeutics —  he  was  a 
good  theorist  as  well  as  practitioner  —  but  without  specially  emphasizing  the  humane 
side  of  medical  treatment.  '^Although  in  almost  all  forms  of  disease  a  number  of 
cases  get  well  without  the  ph3-sician,  and  in  many  diseases  numbers  are  lost  in  spite 
of  all  medical  efforts,  there  yet  remains  a  considerable  number  of  cases,  where  an 
intelligent  interference  on  the  part  of  the  physician  is  of  the  most  decided  consequence. 
It  is  too  a  very  limited  conception  of  professional  activity  to  believe  that  its  sole 
object  is  to  restore  health  to  the  sick.  The  shortening  of  suffering,  the  removal  and 
mitigation  of  inconveniences,  the  alleviation  and  rendering  endurable  of  the  con- 
dition, the  protection  from  threatening  dangers,  all  these  are  quite  as  serious  and 
quite  as  worthy  duties  for  professional  exertion",  in  which  ur.doubtedlj'  philanthropj7 


—  972  — 

must  be  the  chief  support  of  the  physician.  —  Recently,  as  we  know,  Wunckilicli,  by 
his  revival  of  the  thermometry  practised  by  Santoro,  Boerhaave,  de  Ha  en  and  others, 
has  acquired  many  fruitful  ideas  in  diagnosis  and  prognosis,  without  himself  building 
u  j>  >n  this  single  symptom  a  one-sided  system  of  therapeutics.  His  work  on  this  subject 
was  entitled  "  Das  Verhalten  tier  Eigenw'arme  in  Krankheiten  "  etc.,   1868. 

Willielm  Griesinger,  born  in  Stuttgart,  for  four  years  (1850-1854)  Director  of  the 
medical  college  at  Kassr-el-Ain  near  Cairo,  President  of  the  Egyptian  Board  of 
Health  and  then  a  professor  in  Zurich,  Tubingen  and  Berlin  (from  I8n'5),  was  specially 
influential  in  the  development  of  alienistic  medicine  in  Germany  (Pathologic  und 
Therapie  der  psycbischen  Krankheiten,  4th  edition,  1876),  and  upon  the  theory  of 
nervous  and  infectious  diseases.  The  latter  subjects  he  discussed  in  Yirehow's 
"  Handbuch  ". 

Wilhelm  Roser,  the  third  associate  in  the  foundation  of  the  school  of  physiolog" 
ical  medicine,  was  its  representative  in  the  department  of  surgery,  and  particularly 
in  topographical  and  surgical  anatomy. 

A  phase  of  the  New  Vienna  or  positive  school,  differing  in  scarcely 
anything  but  its  definition  from  physiological  medicine,  is  the  so-called 

/?)  Eational  Medicine. 

originated  by  the  clinician  C.  Pfeufer  (1806-1869)  of  Bamberg,  professor 
in  Heidelberg  and  ultimately  in  Munich,  and  the  famous  and  important 
anatomist  Fr.  G.  Jac.  Henle  (1809-1885)  of  Fiirth,  professor  successively 
in  Zurich,  Heidelberg  (18-14)  and  from  1852  in  Gottingen.  This  school- 
has  also  been  represented  by  a  special  journal,  the  ''  Zeitschrift  fiir  ratio- 
nelle  Medicin",  since  1841. 

While  Wunderlich  claimed  patholog}'  as  "the  physiology  of  sick  men," 
Henle  declares  this  idea  questionable,  and  makes  no  distinction  at  all  be- 
tween the  physiology  of  the  healthy  and  the  sick  :  "for  the  physiology  of 
the  health}'  and  of  the  sick  are  not  different,  physiology  and  pathology  are 
one."  This  is  established  as  follows  :  "  We  may  call  the  destruction  of  a 
house  attacked  by  fire  a  misfortune  ;  it  is  nevertheless  physical.  We  may 
likewise  call  the  expression  of  life  produced  by  an  injury  a  disease  ;  never- 
theless it  remains  physiological.  From  the  action  of  such  abnormal  in- 
fluences, out  of  which  disease  arises,  we  even  learn  to  recognize  the  fruits 
-of  the  healthy  organism." 

Henle,  a  Doctor  of  Philosophy,  Law  and  Medicine,  born  at  Fiirth  in  Bavaria, 
studied  from  1827  in  Bonn.  Heidelberg  and  Berlin  under  Job.  Miiller.  Imprisoned 
as  a  member  of  the  "Burschenschaft",  he  became  a  privatdocent  in  Vienna  in  1837, 
professor  in  Zurich  1840,  in  Heidelberg  1844,  professor  of  anatomy  in  Gottingen  1852 
(Handbuch  der  systematischen  Anatomie,  with  an  "Atlas  " ).  He  also  wrote  numer- 
ous treatises  on  anatomical,  physiological,  pathological  and  microscopic  subjects, 
and  in  conjuetion  with  Kud.  Alb.  Kolliker  (born  in  Zurich  1817,  und  since  1847  pro- 
fessor of  physiology  and  anatomy  in  Wurzburgl,  was  a  very  eminent  promoter  of 
the  study  of  microscopic  anatomy  in  Germany.  The  epithelium,  in  our  present  sense 
of  that  term,  was,  among  other  things,  named  and  discovered  by  Henle. 

The  leader  of  '-Rational  Medicine"  (Hegel  may  be  regarded  as  the 
indirect  godfather  of  this  science),  in  contrast  to  the  founders  of  the  New 
Vienna  school,  distinguished  himself  also  by  an  historical  sense,  inasmuch 


—  973  — 

as  his  "Handbuch  der  rationellen  Pathologie",  1846,  exhibits  a  very  good 
historical  sketch  as  its  introduction. 

The  language  too  of  this  school,  in  contrast  to  the  preceding  schools  of  the 
philosophj'  of  nature  and  natural  history  which  it  directly  assisted  in  setting  aside, 
was  in  the  time  of  its  origin  confident  and  ingeniously  triumphant.  But  in  spite  of 
its  realistic  efforts  it  did  not  forget  philosophic  speculation,  i.  e.  hypothesis.  On  the 
contrary,  it  paid  formal  honors  to  the  latter.  "However  sober!}-  we  review  the 
phenomena  of  disease  aud  recover}^  in  themselves,  the  arbitrary,  therapeutic  assault 
is  inconceivable  without  presupposing  that  in  corresponding  cases  a  curative  method 
and  the  subsidence  of  the  disease  may  have  stood  in  a  definite  causative  relation. 
Now  on  this  ground  it  is  a  delusion  to  believe  that  in  medicine  we  can  ever  stand 
upon  a  purely  empirical  basis.  Through  this  single  conclusion  all  medical  experi- 
ence, in  so  far  as  it  ma}'  be  controlling,  becomes  an  hypothesis.  .  .  .  We  have, 
therefore  to  test  practical  facts,  not  according  to  the  rule  by  which  we  judge  the  nor- 
mal in  the  phenomena  of  the  senses,  but  by  the  rule  according  to  which  we  try 
hypotheses  concerning  the  internal  connexion.  .  .  .  The  true  touchstone  of  such 
hypotheses  is  experiment.  .  .  .  Medicine  has  become  conscious  that  il  has  no 
advantage  of  the  other  experimental  sciences;  that  it  can  take  no  step  forward  which 
has  not  been  first  marked  out  b}r  an  hypothesis.  The  day  of  the  last  hypothesis  would 
be  likewise  the  dajr  of  the  last  observation.  .  .  .  From  their  ephemeral  existence 
we  are  led  to  believe  that  we  can  deny  to  hypotheses  any  participation  in  our  know- 
ledge. This  is  never  just.  .  .  .  An  hypothesis  displaced  by  new  facts  dies  an 
honorable  death.  If  it  has  itself  summoned  to  its  trial  the  facts  by  which  it  is  anni- 
hilated, it  deserves  even  a  monument  of  gratitude." 

Such  hypotheses,  however,  are  essentially  nothing  but  theories,  or  rather  a  con- 
cession to  the  demands  of  the  reflecting  mind,  in  contrast  to  the  perceptions  of  the 
senses.  They  are,  therefore,  distinguished  from  the  systematic  thought  of  preceding 
times  only  by  their  transitoriness  and  their  lack  of  comprehension  of  greater  spheres. 

Henle  defines  the  duty  of  the  physician  to  be  the  prevention  and  cure  of  diseases. 
Here  two  methods  of  proceeding  are  to  be  distinguished,  the  empirical  and  the 
rational  (theoretic,  physiological).  The  latter  is  likewise  the  method  of  physiology; 
it  is  the  method  of  all  experimental  sciences  and  particularly  of  the  natural  sciences. 
Moreover  the  genuine  scientific  spirit  is  said  to  consist  not  in  ignoring  or  scorning 
philosophy,  but  "in  the  conscious  and  provisional  renunciation  of  the  knowledge  of 
the  first  cause  of  things,  because  the  time  of  proof  is  not  yet  past".  "Accordingly  if 
the  collection  of  experiences  is  the  chief  thing,  yet  hypotheses  must  form  a  balance 
to  its  instability."  "The  means  of  advancing  from  the  observation  of  the  individual 
and  the  approximate  to  more  comprehensive  conclusions  is  found  in  the  interchang- 
ing method  between  hypothesis  and  experience,  between  asking  and  hearing,  to  which 
the  physical  sciences  owe  their  lustre.  Perfectly  pure  and  unprejudiced  experiences 
are  impossible,  not  only  in  the  department  of  medicine,  but  generally.  To  express  a 
perception  of  the  senses  is  to  separate  the  essential,  as  subject,  from  the  accidental, 
as  predicate,  to  concede  hypothetically  at  least  that  the  subject  could  also  be  con- 
ceived of  without  that  predicate,  or  with  other  predicates."  "The  causal  connexion 
of  i>henomena  is  concluded  from  the  coincidence  of  the  latter  with  definite,  material 
changes.  In  experimenting  we  fix  arbitrarily  the  cause,  so  far  as  possible,  and  by 
observing  the  results  we  assure  ourselves  of  the  correctness  of  our  conclusions.  In  this 
process  the  so-called  localization  of  symptoms,  that  is  the  search  for  the  organ  from 
which  the  symptoms  proceed,  is  aimed  at,  but  in  addition  too,  a  knowledge  of  the 
quality  of  pathological  changes,  by  a  comparison  of  the  altered  form  and  composi- 
tion with  the  normal Pathology  owes  its  weightiest  facts  to  the  employ- 


—  974  — 

merit  of  the  microscope  and  to  organic  chemistry.'-  Moreover  the  hypothesis  of  a 
vital  force  is  admissible,  and  is  just  as  good,  or  as  weak,  as  that  of  electric  attraction 
or  of  gravitation. 

Disease  is  "a  deviation  from  the  normal,  typical,  i.  e.  healthy,  process  of  life,  a 
modification  of  health,  a  removal  from  the  relative  norm.  The  essence  of  disease, 
however,  is:  an  expression  of  typical  force  under  unwonted  conditions."  Disease 
too,  like  life  itself,  is  a  process.  Diseases  are  anomalies  of  this  process.  Any  alter- 
ation which  completely  abolishes  this  process  occasions  not  disease,  but  death.  Death 
is  the  cessation  of  the  interchange  of  material.  The  termination  in  health  follows 
spontaneous!}',  or  through  artificial  or  accidental  influences.  The  transition  to 
health  ensues  gradually  in  most  chronic,  and  in  many  acute  diseases;  in  others, 
especially  in  acute  cases,  the  symptoms  disappear  suddenly.  The  first  and  slower 
method  is  called  lysis,  the  last  method,  crisis  —  the  latter  term  a  relic  handed  down 
from  the  mythical  beginnings  of  medicine.  If  we  desire  to  preserve  the  expression 
critically  and  definitely  for  certain  morbid  symptoms,  it  may  be  done  (the  few  cases 
where  it  holds  excepted)  without  the  active  secondar}-  signification  which  the  use  ot 
language  has  connected  with  these  words.  A  critical  secretion  is,  in  the  main,  noth- 
ing more  than  a  secretion  belonging  to  the  stadium  of  the  crisis.  "The  belief  in 
•crises,  according  to  Henle,  stands  upon  the  same  footing  as  belief  in  the  devil.  That 
the  exorcist  had  expelled  a  devil  was  demonstrated  by  the  foul  odor  left  behind  bj- 
the  evil  spirit.  The  odor  was  a  fact ;  that  it  could  be  diffused  in  no  way  except  by 
the  devil — was  perfectly  self-evident."  The  same  was  the  case  with  critical  per- 
spiration, urine  etc. 

The  earliest  eminent  representatives  of  French  precision  in  Germany 
proper,  whom  we  have  just  considered,  took  sides  in  their  own  wa}'  and 
with  lively  enthusiasm  for  the  new  scientific  system,  without,  however, 
themselves  following  it  exclusively.  Henle.  especially,  as  we  have  seen, 
even  inclined  to  philosophical  abstractions  and  speculations,  and  openly 
confessed  that  "true  science  does  not  consist  in  ignoring  or  despising 
philosophy."  He  likewise  leaves  open  to  deductive  treatment  a  door 
which  was  at  first  entirely  closed,  as  the  originally  justifiable,  but  finally 
■exaggerated,  reaction  against  the  earlier  and  one-sided  synthetic  cultiva- 
tion of  medicine  now  degenerated  into  the  opposite  extreme  of  one-sided 
analysis.  The  latter  is  the  case  with  exact  or  natural-scientific  medicine 
properly  so  called,  which  dates  from  the  last  fift}T  years,  and  of  which 
the  last  theoretic  offshoot  in  order  of  time  is  found  in  the  cellular  path- 
ology to  be  discussed  hereafter.  The  latter,  under  the  leadership  of  nat- 
ural scientific  methods,  characteristically  heaps  up  inductive  material, 
without  the  ability,  like  the  natural  sciences,  to  arrange  this  mass  upon 
deductive  principles,  since  such  principles  have  up  to  the  present  time 
been  wanting  in  medicine.  From  its  exclusively  realistic  tendency,  sooner 
or  later,  as  the  result  of  all  historical  experience,  it  will,  however,  awaken 
the  contrary  current.  Such  seems  to  be  a  requisite  for  the  historical 
•development  of  medicine,  as  it  has  shaped  itself  since  the  beginning  of 
modern  times. 

It  is  a  striking  and  curious,  though  not  absolutel}'  inexplicable  phe- 
nomenon, that  beside  the  Vienna  system  the  Pseudo-Paracelsian 


—  975  — 

1.  System  of  Rademacher 

was  able  not  only  to  make  its  appearance,  but  even  to  find  followers. 

Paracelsus,  that  great  star,  which  emerged  like  a  comet  from  the  intellectual  hori- 
zon of  the  LHth  century,  its  long  train  reaching  and  sparkling,  as  we  know,  throughout 
the  whole  17th,  while  its  head  and  nucleus  had  long  disappeared,  had  the  fortune  in 
the  19th  century  to  awaken  two  astrologers,  the  one  shrewd,  the  other  credulous,  who 
sought,  each  for  his  own  purposes  and  in  his  own  method,  to  interpret  him  to  the 
physicians  of  his  own  time.  But  the  great  physician  and  thinker  of  the  16th  century, 
who  formed  a  brilliant  picture  within  the  frame  of  the  civilization  of  that  day,  could 
appear  only  as  an  historical  caricature  and  an  anachronism  in  the  19th  century,  with 
its  realistic  and  advanced  methods,  even  if  transferred  in  his  entirety  to  its  civiliza- 
tion How  much  more  must  this  be  the  case  when  his  interpreters  elaborated  only 
two  of  his  dogmas,  i.  e.  each  of  them  one !  Yet  it  is  an  evidence  of  the  greatness  of 
the  man,  that  from  the  treasures  of  his  mind  two  dogmas  were  important  enough  to 
form  the  basis  of  two  "schools"  in  the  19th  eenturj-.  But  this  very  mistake  of  both 
his  interpreters  served  —  and  this  is  the  sole  advantage  to  compensate  for  the  great 
injuries  which  it  inflicted  upon  medicine  —  at  least  to  vindicate  the  memory  of  one 
long  misjudged,  and  to  verify  what  he  declared  to  his  contemporaries:  "Truly  I  shall 
accomplish  more  against  you  after  m}T  death  than  before." 

One  of  these  Epigoni,  Hahnemann,  we  have  already  considered.  The 
other  was 

Joh.  Gottfried  Rademacher  (1772-1849)  of  Hamm  in  the  county 
Mark,  a  practising  physician  at  Goch  on  the  lower  Rhine,  who  studied 
Paracelsus  kindly,  with  honest  sincerity  and  with  a  simple  heart,  while 
Hahnemann  had  falsified  him. 

"Probably  to  the  very  end  of  my  life  I  should,  alas,  have  been  unable  to  attain 
the  power  of  healing — having  my  understanding  partially  crippled  by  scholasticism 
—  if  a  c  mcurrence  of  circumstances  had  not  determined  me  to  read  the  works  of 
Paracelsus  with  attention,  and  if  he  had  not  lighted  for  me  a  candle,  which  I  sought 
in  vain  from  other  physicians.  That  1  followed  this  light  is  no  special  merit.  Many 
of  my  colleagues,  in  whose  heads,  as  well  as  in  mine,  there  glimmered  an  obscure 
notion  that  between  the  rude  empiric  and  rational  empiric  systems  of  medicine  there 
must  still  lie  a  third  intelligible  system  of  empiricism,  had  thej-,  like  me,  been  driven 
by  the  force  of  external  circumstances  to  an  earnest  study  of  the  writings  of  Paracel- 
sus, would  have  trod  the  same  path  and  followed  the  same  light.  I  think  also  that 
my  assertion  furnishes  evidence  of  an  honorable  feeling,  and  far  more  of  an  humble, 
than  a  boastful  mind.  If  I. were  a  rascal  or  proud  coxcomb,  my  friends,  who  wished 
to  torment  you,  I  should  have  kept  entirely  silent  about  Paracelsus,  and  have  posed 
as  if  everything  that  I  said  to  you  was  mj'  own  idea  etc."  (See  Wunderlich).  —  The 
book  in  which  Rademacher,  after  46  3-ears  of  practice,  expounded  his  doctrine  in 
more  than  1800  pages,  was  entitled  :  "  Rechtfertigung  der  von  den  Gelehrten  niiss- 
kannten  verstandesrechten  Erfahrungsheillehre  der  alten  scheidekiinstigen  Geheim- 
arzte  und  treue  Mittheiluug  des  Ergebnisses  einer  f  unfundzwanzigjahrigen  Erfahrung 
dieser  Lehre  am  Krankenbette,"  1841,  4th  edition  1852. 

The  teachings  of  Rademacher  were  based  upon  the  precept  of  Para- 
celsus :  "A  natural,  genuine  physician  says  this  is  a  morbus  helleborinus, 
terpenthinus,  not  this  is  phlegma,  chorryzza,  catarrhus."  Accordingly 
Rademacher  classifies  diseases  in  accordance  with  the  remedies  which 
experience  proves  curative  in   each.     For  it  is  impossible  to  distinguish 


—  976  — 

the  ultimate  essence  of  the  disease,  its  special  point  of  origin  and  issue  in 
the  organism,  but  we  learn  by  experience  to  use  and  to  know  the  remedy 
which  has  accomplished  the  cure,  and  we  should  name  the  disease  after 
this  remedy.     How  experience  is  acquired  the  following  history  will  teach. 

A  woman  suffered  from  chronic  vomiting  and  finally  from  pain  in  the  abdomen, 
especiall}'  in  the  neighborhood  of  the  ca?cum,  and  neither  Rademacher,  nor  any 
other  physician,  was  able  to  get  at  the  bottom  of  the  trouble.  "Weighing  everything 
well"  it  was  a  primary  affection  of  the  liver,  transferred  by  sympathy  to  the  in- 
testines. Rademacher,  however,  "  was  quite  at  the  end  of  his  experience",  but 
remembered  that  Stahl  recommended  the  seed  of  St.  Mary's  thistle  (semen  cardui 
Marine)  as  "curative  in  those  thoracic  inflammations,  which  are  associated  with 
bilious  fevers."  Now  Stahl's  experience  ran  differently  from  Rademacher's,  for  "he 
had  used  the  seed  of  St.  Mary's  thistle  in  diseases  of  the  liver,  and  had  removed 
sympathetic  diseases  of  the  chest,  which  are,  as  we  know,  not  rare  in  these  cases, 
better  than  with  other  remedies.  Hence,  thought  I,  it  is  probable  that  the  seed  of 
St.  Mary's  thistle  acts  favorably  upon  the  liver  and  not  upon  the  lungs."  His  idea 
was  correct,  for  it  was  useful  not  only  in  the  case  mentioned,  but  likewise  in  coughs, 
uterine  discharges,  epistaxis,  ischias,  associated  with  primary  troubles  of  the  liver  or 
spleen,  and  once  also  in  jaundice.  It  was  now  recognized  as  a  "general  chest-remedy", 
and  Rademacher  gave  it  in  the  form  of  a  mixture  obtained  by  boiling  15-30  grammes 
of  the  seed  of  St.  Mail's  thistle  in  480  grammes  of  water  over  an  open  fire  until 
reduced  to  240  grammes. 

According  to  the  teachings  of  Rademacher  there  are  three  universal 
remedies  :  cubic-nitre,  copper  and  iron,  and  accordingly  also  three  primary 
diseases  of  the  body  in  general,  whose  essence  and  seat  are  not  known, 
but  which  must  be  called  cubic-nitre  disease,  copper  disease  and  iron  dis- 
ease, since,  in  spite  of  the  fact  that  they  are  themselves  unknown,  they 
are  certainly  cured  by  these  remedies.  The}-  are  especially  the  basis  of 
epidemic  diseases  —  sometimes  the  one,  sometimes  the  other,  always,  by 
the  way,  first  recognized  by  the  previous  efficacy  of  the  universal  remedy 
—  but  interchangeably,  so  that  e.  g.  in  one  epidemic  disease,  one  and  the 
same  disease  of  the  brain  may  be  at  one  epoch  a  copper  disease,  at 
another  an  iron  disease.  We  should  also  continually  make  other  inves- 
tigations until  the  remedy  is  found.  If,  however,  the  patient  dies,  the 
physician  has  probably  not  had  time  or  skill  enough  to  discover  the  cor- 
rect remedy. 

The  three  primary  diseases,  cubic-nitre,  copper  and  iron  disease,  for 
the  most  part  do  not  remain  purely  such,  but  almost  always  throw  an  organ 
into  a  condition  of  sympathy,  and  thus  it  results  that  an  iron  disease  e.  g. 
ma}7  express  itself  under  the  form  of  consumption,  mania  a  potu  etc.,  while 
a  copper  disease  may  appear  as  worms,  paralysis,  jaundice  etc.  Besides 
universal  diseases  and  universal  remedies,  there  are  diseases  of  organs, 
diagnosticated  by  the  efficacy  of  organ-remedies,  and  manifesting  them- 
selves as  primary  organ-diseases  or  as  sympathetic  organ-troubles.  The 
latter,  however,  may  in  turn  be  transformed  into  primary  organ-diseases. 
Again  there  are  four  great  groups  :  abdominal  diseases  and  corresponding 
abdominal  remedies  ;    head  diseases    with  the  Jnecessary  head    remedies  ; 


—  977  — 

chest  diseases  and  chest  remedies  ;  diseases  of  external  organs,  e.  g.  the 
skin,  with  the  appropriate  external  or  skin  remedies,  among  which  belongs 
cinchona,  since  intermittent  fever  is  a  sympathetic  skin-disease.  For  each 
viscus  again  there  is  a  special  remedy,  as  for  instance  liver,  spleen,  kidne}', 
pancreas,  lung,  heart,  brain  remedies  etc.,  etc. 

The  followers  of  this  doctrine,  who  modified  it  in  some  points,  were  some  of  them 
very  capable  observers.  Among  them  were  C.  Kissel  at  Westerburg  in  Nassau 
(Handbuch  der  naturwissenschaftlichen  Therapie,  1853;  Handbuch  der  physiolo- 
gischen  Arzneiwirkungslehre)  ;  Gottlieb  Latz  (born  1818)  of  Cleves,  a  practicing 
physician  near  Essen  (Die  specifische  Heilmethode)  and  others.  Among  the  journals 
of  Rademacher's  followers  were:  Lofflers  "  Zeitschrift  fur  Erfahrungsheilkunst"  and 
Bernhardi's  "Zeitschrift  fur  wissenschaftliche  Therapie".  Auerbach  collected 
together  the  remedies  of  Rademacher,  and  the  Gem  an  Otlerbourg,  auihor  of  a  book 
on  medical  Paris,  introduced  them  into  France.  Prof.  Ph  Phobus  (1804-1880)  of 
Markisch-Friedland  (son  of  the  physician  Ludwig  Phobus,  a  pharmacologist  at  Giessen 
and  founder  ot  a  scientific  theory  of  prescribing),  a  savant  as  thorough  as  he  was 
modest,  at  least  recognized  the  fact  that  Rademacher,  "  who  unfortunately  did  not 
possess  sufficient  scientific  education,  benefited  medicine  by  once  again  making 
the  cure  more  important  to  physicians  than  simple  diagnosis."  In  this  Phobus 
charged  the  new  Vienna  school,  as  well  as  the  physiological  and  rational  schools 
(including  Schonlein  himself),  with  too  much  skepticism,  with  breaking  too  rashly 
with  the  old  medicine  and  with  having  frequently  merely  repeated  what  was  in 
France  already  a  thing  of  the  past. 

11.  Hydrotherapeutics, 

invented  (or  rather  revived  after  Halm)  and  generalized  by  the  peasant  Vincenz 
Priessnitz  (1799-1852),  should  be  mentioned  among  the  medical  theories,  inasmuch 
as  it  is  based  upon  gross  views  of  the  humoral  pathology,  according  to  which  a 
materia  peccans  is  to  be  expelled  in  the  form  of  sweat,  eruptions  etc.  Priessnitz 
accordingly  laid  great  weight  upon  rustic  and  substantial  fare  and  physical  labor, 
and  employed  water  therapeutically  under  the  form  of  cold  packs,  girdle-poultices 
(Priessnitz  poultices),  frictions  with  cold  water,  general  and  local  cold  baths  etc. 
He  knew  nothing  of  diagnosis  and  patholog}',  and  as  little  of  the  individualizing  of 
patients  in  accordance  with  their  constitution,  sex  and  age.  The  popularity  of  his 
establishment,  which  was  erected  with  the  permission  of  the  authorities  in  1830, 
gradually  became  enormous.  Besides  some  successes,  he  had  of  course  some  failures 
also,  but  personally  at  least  he  reaped  great  profit  and  died  worth  several  millions. 
Even  before  Priessnitz,  E.  F.  Christian  Oertel,  a  teacher  in  Ansbach,  was  a  particu- 
larly active  propagandist  of  the  new  treatment.  There  speedily  arose  a  lively  literary 
feud  and  agitation  over  the  new  system,  not  always  carried  on  with  the  greatest 
courtesy,  and  in  which  J.  H.  Rausse  ( Anleitung  zur  Ausiibung  der  Wasserheilkunde, 
3  vols.,  1852),  C.  Munde  (Die  Grafenberger  Wasserbeilanstalt,  1839;  Hydrotherapie, 
2d  edition,  1868,  etc.)  and  others  took  a  specially  prominent  part.  In  the  hands  of 
scientific  physicians  the  treatment  has  been  recently  considerabl}"  elevated  and 
improved  Among  these  physicians  are  A.  Pleniger  (Physiologie  des  Wasserheil- 
verfahrens,  1863),  F.  Runge  (Wasserkuren  und  andre  physiologischen  Heilmethoden, 
1872)  and  Wilhelm  Winternitz  (Die  Hydrotherapie  auf  physiologische  Grundlage, 
1877).  —  The  teachings  of  Priessnitz  were  opposed  by  Joh.  Schroth,  a  peasant  in 
Lindenwiese,  near  Grafenberg,  who  advocated  the  dry  treatment,  wheat  bread  and 
abstinence  from  fluids.  He  also  found  some  followers.  [According  to  Dr.  Trail,  the 
system  of  Hydropathy  was  popularized  in  England  by  the  writings  of  Claridge,  Sir 
62 


—  078  — 

Charles  Scudamore  (A  medical  visit  to  Graefenberg  to  investigate  the  water-cure 
treatment,  1843)  Johnson,  James  Wilson  and  James  Manby  Gully  (1808-1881). 
The  latter  physician  established  a  hydropathic  institution  at  Malvern  about  1842, 
and  was  the  author  of  several  treatises  upon  the  water-cure  system,  as  well  as  co- 
editor  ot  'The  Water-Cure  Journal  and  Hygienic  Magazine'',  London,  1847-48.  The 
system  was  introduced  into  the  United  States  in  1843  by  Drs.  Russell  Thacher  Trail 
(1812-1877),  of  Vernon,  Connecticut,  and  Joel  Shew  of  Providence,  N.  Y.  The 
former  opened  a  hydropathic  institution  in  New  York  in  the  spring  of  1844,  and  a  similar 
establishment  was  founded  at  Lebanon  Springs,  N.  Y.  by  Dr.  Shew  and  David  Camp- 
bell in  181,3.  A  ''Water-Cure  Journal"  was  also  started  by  Dr.  Shew  in  1844,  but 
transferred  in  the  following  year  to  Messrs.  Fowler  and  Wells  of  New  York,  who  con- 
tinued its  publication  for  about  twent}-  years.     H.] 

m.  The  Modern  Chemical  System 

(in  opposition  to  the  chemical  system  of  the  preceding  century,  which  was 
founded  in  inorganic  chemistry),  in  accordance  with  the  present  great 
advances  in  organic  chemistry,  derived  from  this  science  its  doctrines.  It 
was  called  into  life  specially  by  Liebig's  "  Die  organische  Chemie  in  ihrer 
Anwendung  auf  Physiologie  und  Pathologie",  1842,  and  upon  it  our 
present  theory  of  metabolism  ( Stoffwechsel  —  a  term  introduced  by  Liebig) 
is  based. 

According  to  this  theory,  the  physical  changes  in  the  bod}-,  so  far  as 
they  cannot  be  reduced  to  mechanical  processes,  are  nothing  more  than  a 
process  of  oxidation  or  combustion  of  the  bodies,  effected  by  the  oxygen 
of  the  inspired  air  ;  the  body  itself  is  a  mere  living  retort  or  higher  class 
oven.  The  parts  of  the  body  are  supposed  to  be  thus  destroyed  and  then 
regenerated,  a  theoiy  refuted  by  Miescher  and  Voit. 

This  oxidation  is  a  twofold  process,  in  accordance  with  the  two  great 
groups  of  organic  matter  which  compose  the  body  or  are  introduced  into 
it  by  the  food.  The  so-called  respirator}'  foods  (hydrocarbons,  fats)  are 
burned  in  the  lungs  during  respiration  and  chiefly  excreted  there  as  car- 
bonic acid.  The  so-called  nutritive  materials  (nitrogenous,  plastic,  blood- 
forming  foods),  which  compose  the  tissues  proper  (except  the  adipose 
tissue),  are  consumed  within  the  tissues,  and  are  mainly  discharged  under 
the  form  of  urea  by  the  renal  secretion.  The  quantity  of  urea  excreted  is 
regarded  as  a  measure  of  muscular  tissue  converted  in  labor.1  —  If  an  in- 
sufficient quantity  of  the  required  materials  is  introduced  into  the  body, 
the  corresponding  parts,  composed  of  this  material,  are  themselves  con- 
sumed, a  process  manifested  by  emaciation  or  death  by  starvation,  i.  e.  a 

1.  Voit  proved,  on  the  contrary,  that  the  excretion  of  nitrogenous  matters,  and  par- 
ticularly of  urea,  was  only  slightly  affected  by  muscular  activity. 

[On  the  other  hand.  Prof.  Austin  Flint  Jr.  in  1870,  from  an  analysis  of  the 
urine  of  the  pedestrian  Weston  while  walking  one  hundred  miles  in  twenty-one 
hours  and  thirty-nine  minutes,  came  to  the  conclusion  "  that  excessively  severe 
and  prolonged  muscular  exertion  increases  immensely  the  amount  of  nitrogenized 
excrementitious  matters  in  the  urine,  particularly  the  urea,  and  produces  a 
corresponding  increase  in  the  elimination  of  most  of  the  inorganic  salts."     H.] 


—  079  — 

discontinuance  of  the   normal   chemical   metamorphosis.     In  diseases  the 
normal  reception  or  combustion  is  wanting. 

Animal  heat  is  the  result  of  the  process  of  oxidation  or  combustion 
in  the  oven  of  the  body.  The  one  class  of  foods  —  albuminoid,  nitro- 
genous —  serves  for  the  formation  of  the  blood  and  the  construction  of  the 
formed  parts  of  the  body  ;  the  other  class  —  non-nitrogenous,  carbo- 
hydrates—  is  similar  to  ordinary  fuel,  and  serves  merely  for  the  production 
of  heat.  "  We  heat  our  bodies,  just  as  we  do  an  oven,  with  combustible 
material  contained  in  the  elements  above  mentioned,  as  in  wood  and  coal. 
The  combustible  elements  consumed  in  the  body  are,  however,  essentially 
distinguished  by  their  solubility  in  the  bodily  fluids."  —  This  heating- 
process  requires  to  be  more  active  in  cold  weather,  and  hence  a  larger 
quantity  of  respiratory  food  must  be  ingested  and  converted  during  the 
prevalence  of  such  weather —  in  winter  and  in  northern  climates. 

Fever  is  an  abnormal  increase  in  the  process  of  combustion,  disease  a 
defect  in  this  process. 

If  a  portion  of  one  group  of  materials  is  lacking  in  normal  and  dis- 
eased processes,  and  if  this  is  omitted  or  insufficiently  regarded  in  nourish- 
ment, the  deficiency  is  to  be  repaired  b}*  the  introduction  or  increased  in- 
gestion of  this  group.     This  is  the  practical  side  of  the  doctrine. 

The  theory  also  regards  the  living  organism  from  the  stand-point  of 
the  chemist,  the  chemical  retort  and  chemical  anal}-sis,  and  does  not  pajr 
sufficient  attention  to  the  elective,  adaptable  side  of  the  physical  life  of 
the  organism,  nor  to  the  ever  changing  and  powerful  influences  and  rela- 
tions in  which  individuals  find  themselves.  Hence  in  practical  life  and  at 
the  sickbed  it  too,  like  all  theories,  left  the  physician  in  the  lurch,  and 
was  soon  combated  by  chemists  and  physiologists.  Thus  C.  Yoit  seeks 
out  merely  the  losses  in  metabolism,  adopts  a  special  class  of  "Genuss- 
mittel "  which  excite  the  nerves  of  digestion,  thinks  that  fat  ma}T  be 
formed  by  the  splitting  of  albuminous  bodies,  when  it  does  not  exist  in 
the  food.  He  distinguishes  "  Nahrungsstoffe"  —  including  water  —  "Nah- 
rungsmittel"  —  the  mixture  of  food  —  "Genussmittel",  and  "Nahrung", 
the  combined  mass  of  the  last  three. 

Yet  the  theory  had  the  advantage,  bj'  no  means  to  be  underestimated 
in  the  development  of  medicine,  that  it  placed  dietetics  once  more  in  the 
foreground  in  the  very  period  when  therapeutic  nihilism  was  in  its  bloom, 
and  that  it  taught  us  to  consider  the  quantity  and  quality  of  the  food 
from  new,  and  often  better,  points  of  view  than  had  been  the  case  here- 
tofore. 

That  in  the  sequel  the  mental  and  moral  peculiarities  of  individuals, 
indeed  of  whole  nations,  were  deduced  from  their  nourishment  or  food  (as 
was  done  particularl}1  by  Moleschott),  was  an  exaggeration  as  wonderful  as 
the  anthropological  idea  which  is  nowadays  becoming  prevalent,  and  which 
appeals  to  the  form  and  structure  of  the  brain,  that  is  to  its  human  or 
animal  conformation,  in   support  of  a  system  of  inductive   morals.     Both 


—  980  — 

are  emanations  of  the  realism  and  materialism  of  our  age,  which  a  future 
tendency  of  culture  with  historic  necessity  must  and  will  bring  again 
within  narrower  limits  and  correct. 

n.   Modern  (Cellular)  Vitalism. 

The  modern  vitalistic  theory  of  Rudolph  Virchow  (born  in  1821  at 
Schievelbeiu  in  Pomerania),  announced  in  1858  and  borrowed  from  the 
natural  scientific  medicine,  is  distinguished  from  that  of  the  18th  century 
substantially  by  the  fact  that  it  breaks  up  the  old,  indivisible  ''vital  force", 
distributed  throughout  the  entire  bodj'  or  located  in  a  few  organs,  into  an 
infinite  number  of  individual  "associated"  vital  forces,  working  together 
and  yet  separately,  and  assigns  to  them  in  the  elementary  parts  (which 
latter  are  considered  to  be  the  cells)  a  definite  microscopic  seat.  It  is 
simply  a  modified  employment  of  the  old  idea  of  the  vital  force,  referring 
the  latter  to  the  concrete,  minutest  parts,  the  so-called  "corporeal  elements" 
in  the  modern  sense,  which  are  entirety  different  from  those  of  Bichat. 
"Every  animal  appears  as  a  sum  of  vital  unities,  each  of  which  bears  all 
the  characteristics  of  life.  The  characteristics  and  unity  of  life  cannot  be 
found  in  any  determinate  point  of  a  higher  organization,  e.  g.  in  the  brain 
of  man,  but  only  in  the  definite,  ever  recurring  arrangement  which  each 
element  presents.  Hence  it  results  that  the  composition  of  a  large  body 
amounts  to  a  kind  of  social  arrangement,  an  arrangement  of  a  social  kind 
in  which  each  of  a  mass  of  individual  existences  is  dependent  upon  the 
others,  but  in  such  a  way  that  each  element  has  a  special  activity  of  its 
own,  and  that  each,  although  it  receives  the  impulse  to  its  own  activit}- 
from  other  parts,  still  itself  performs  its  own  functions." 

Attention  had  been  directed  to  the  importance  of  the  cell  in  vegetable 
and  animal  organisms  at  an  earlier  period  by  Sir  Robert  Hooke  (who  in 
1677  discovered  the  cells  of  plants),  Baumgartner,  Schleiden,  Schwann 
(the  discoverer  of  the  animal  cells,  and  also  of  pepsin)  and  Robert  Brown 
(the  discoverer  of  the  cell  nucleus).  But  it  was  not  3^et  formally  stated 
in  medical  theory  that  the  cell  was  to  be  regarded  as  the  proper,  ultimate, 
vital  element.  This  deficiency,  or  rather  the  gap  which,  through  neglect 
of  microscopic  results  in  general,  had  arisen,  and  even  obtruded  itself,  as 
it  were,  into  medicine  and  medical  theory.  Virchow,  as  a  leading  histolo- 
gist  and  pathologico  anatomical  investigator,  filled  at  once  and  completely 
(taking  into  account  the  condition  of  microscopic  investigation  in  that 
day)  with  his  cellular  pathology,  and  since  that  time  the  cell  has  assumed 
a  position  similar  to  that  which  the  "fibre"  occupied  in  the  theories  of  the 
17th  and  18th  centuries.  Time  will  decide  as  to  the  vitality  of  this 
theory,  which,  like  almost  all  earlier  theories,  found  eveiywhere  and  im- 
mediately an  enthusiastic  reception.  Virchow  himself,  like  Rokitansky 
with  his  crasiology,  seems  to  have  been  almost  startled  with  his  success. 
At  least  we  ma\T  infer  this  from  his  subsequent  silence  with  respect  to  his 


—  981  — 

theory,  and  from  some  of  his  expressions  in  his  address  before  the  50th 
Congress  of  Naturalists. — The  principles  of  the  Cellular  Pathology  are 
given  in  the  following  passage  :  "  It  would  not  suffice  for  me,  as  has  been 
customary  in  the  last  decennium,  to  take  pathological  anatomy  alone  as 
the  basis  of  1113'  views.  We  must  add  thereto  the  facts  of  general  anatomy, 
from  which  the  temporary  formation  of  the  science  has  been  acquired.  .  .  . 
In  this  application  of  histology  to  physiology  and  pathology",  which,  as 
such,  was  not  employed  as  something  entirely  new,  for  its  application  had 
been  already  made  as  early  as  the  17th  century  —  the  realistic  predecessor 
of  our  own  in  almost  all  directions,  and  particularly  in  medicine  —  "  it  is  a 
question",  as  he  himself  concedes,  "chiefly  of  the  recognition  of  the  fact 
that  the  cell  is  actually  the  ultimate,  proper  morphological  element  of 
eveiy  vital  manifestation  —  omnia  cellula  e  cellula  —  and  that  we  must 
not  remove  the  proper  action  beyond  the  cell."  In  this  lies  the  distinctive 
novelty  of  the  theory,  which,  however,  remains  theoretic  until  the  ultimate 
elements  of  the  bod}',  their  action  and  their  powers,  shall  be  no  longer  a 
subject  of  discussion.  This  discussion,  however,  when  we  take  into  con- 
sideration the  always  rapid  changes  in  microscopic  interpretation,  cannot, 
it  would  seem,  for  a  long  time  be  regarded  as  closed  ;  for,  as  we  know,  its 
continuance  being  granted,  the  investigations  of  Cohnheim  have  already 
invalidated  much  of  Virchow's  theory.  An  element,  as  such,  is  character- 
ized above  all  by  its  constancy.  Its  best  criterion  is  "that  we  have  in  it 
the  proper  elementary  structure  which  characterizes  ever}'  living  body, 
without  the  pre-existence  of  which  no  living  forms  arise,  and  to  which 
the  proper  continuance,  the  maintenance  of  life,  is  bound  "  The  most  con- 
stant of  all  parts  of  the  cell  is  the  nucleus,  not  the  so-called  nucleolus, 
which  is  "no  necessary  desideratum",  since  it  is  lacking  in  many  young 
elements.  Next  to  the  nucleus  is  the  membrane.  "  The  nucleus  plays  an 
extraordinarily  important  role,  which  relates  less  to  the  function,  the 
specific  action  of  the  elements,  than  to  the  maintenance  and  increase  of 
the  element  as  a  living  part."  The  development  or  increase  of  cells  is 
continuous,  it  takes  place  by  continual  growth  of  cells,  and  a  new  growth 
of  cells  presupposes  existing  cells.  For  the  function,  the  contents  of  the 
cell,  or  even  the  material  deposited  outside  of  the  cell,  are  of  controlling 
importance.  The  tissues  accordingly  are  functionally  different.  For 
instance,  the  contractile  substance  deposited  within  the  smooth  muscle-cell 
appears  to  contain  the  contractile  force,  and  the  cellular  element  of  the 
nerves  may  develop  into  nerve-fibres,  in  which  "the  nucleus  remains  outside 
of  the  medullary  substance  as  a  constant  form."  In  contrast  to  the  cell- 
elements  themselves,  however,  the  intercellular  substance  also  plays  an 
extremely  important  part,  and  it  is  "governed"  always  within  definite  limits 
by  a  neighboring  cell-element.  Hence  arise  the  cell-territories,  i.  e.  dis- 
tricts within  the  intercellular  substance  upon  which  a  certain  cell  exercises 
its  nutritive  etc.  influence. 

In  this   assignment  to  the  intercellular  substance  of   a  pre-eminent 


—  982  — 

and  controlling  part  lies  an  important  and  distinctive,  though  very  vulner- 
able and  speculative,  characteristic  of  the  theory  of  Yirchow,  as  contrasted 
with  the  earlier  blood  or  humoral,  and  nervous  or  solid  pathologies.  In- 
deed this  feature  of  the  theoiy  is  even  more  novel  than  the  emploj'ment 
of  the  cell  itself.  It  elevates  the  part  heretofore  regarded  as  mere  ballast, 
the  true  pariah  of  the  body  in  the  past,  the  connective  tissue  or  interstitial 
substance  of  Bichat,  to  a  position  of  veritable  supremacy,  and  thus  creates 
a  trinity  of  bodily  constituents  laboring  in  unison.  "Thus  then  it  is  cer- 
tainly a  just  demand  that  a  certain  recognition  should  be  granted  to  the 
larger  part  of  the  body,  and  if  this  recognition  is  allowed,  that  we  should 
no  longer  be  satisfied  with  the  simple  idea  of  the  nerves  as  integral  parts, 
as  a  connected,  simple  apparatus,  or  of  the  blood  as  a  simple  fluid  material, 
but  that  we  should  admit  also  within  the  blood  and  the  nervous  apparatus 
a  mass  of  active,  minute  centers."  ....  "  We  must  remember  that  besides 
vessels  and  blood,  besides  nerves  and  central  apparatus,  there  are  still 
other  things,  which  are  not  a  simple  substratum  for  the  action  of  the  nerves 
and  blood,  upon  which  the  latter  cany  on  their  functions." 

Among'the  three  great  tissue-groups  which  are  alone  to  be  admitted 
in  the  body,  of  which  one  comprises  those  forms  composed  of  cells  alone 
(cellular  tissue  in  the  modern  sense),  while  another  contains  onh*  those 
parts  which  display  cells  of  specific  action  in  the  animal  econom}-  (the 
nervous  and  muscular  apparatus,  vessels  and  blood),  there  is  still  a  third, 
the  connective  tissue  (called  at  an  earlier  period  the  general  cellular  tissue), 
characterized  by  the  fact  that  in  it  "each  cell  is  regularly  separated  from 
the  others  by  a  certain  intermedium",  so  that  in  this  tissue  the  role  of  the 
intercellular  substance  is  best  studied. 

The  elements  imbedded  in  the  intercellular  substance  of  the  last 
group  have  very  various  forms,  are  long,  angular  or  round.  Some  of  them 
anastomose  with  the  others,  in  which  case,  according  to  Virchow,  they  pro- 
duce a  new,  third  sj'stem  of  canals  in  the  body  (besides  the  well-known 
canalicular  systems  of  the  blood  and  bymph  vessels),  which  "must  be  re- 
garded as  a  new  acquisition  to  our  views,  a  kind  of  supplement  to  the  old 
vasa  serosa,  which  do  not  exist.  This  formation  may  occur  in  cartilage, 
connective  tissue,  bones,  mucous  tissue  in  the  most  various  parts,  but  in 
all  cases  the  tissues  which  possess  these  anastomosing  cells  differ  from 
those  in  which  the  cells  are  isolated,  by  the  greater  readiness  with  which 
the}'  originate  morbid  processes."  This  tubular  system  was  a  third  new 
side  of  Virchow's  original  doctrines,  equally  important  in  the  explanation 
of  physiological  nutrition  and  in  that  of  pathological  processes.  Accord- 
ing to  his  views,  such  a  S3stem  of  canals  supplies  a  stream  of  plasma  to 
places  which  are  poorly  provided  with  capillaries,  e.  g.  in  the  bones,  the 
interarticular  cartilages,  tendons,  the  cornea  etc. 

To  each  of  these  capillaries,  however,  is  assigned  a  definite  tissue- 
district,  so  that  besides  the  cell-territories  there  are  also  vascular  terri- 
tories, i.  e.  districts,  which,  as  thrombosis,  embolism  and  metastasis  prove, 


—  983  — 

are  dependent,  both  physiologically  and  pathologically,  upon  one  particular" 
minute  vessel,  districts  which  manifest  a  vascular  unit}',  from  which  we 
must  return  to  the  cell-territories  in  order  to  understand,  how,  in  spite  of 
so  favorable  an  arrangement  of  the  capillaries,  the  nutrition  of  the  smallest 
cell-districts  is  accomplished. 

The  reception  of  nutritive  material  is  effected  through  the  activity 
of  the  tissue  elements,  in  the  form  of  an  attraction  of  this  material  by 
these  elements  in  proportion  to  their  needs.  If  this  eclectic  reception  (so 
to  speak)  by  the  tissue  elements  did  not  exist,  it  would  be  inconceivable 
"that  the  individual  districts  should  not  be  exposed  every  moment  to  in- 
undation by  the  blood."  This  assumption  furnishes  the  first  explanation 
of  the  fact  "that  the  offered  material  is  received  into  the  different  parts 
only  in  proportion  to  their  occasional  needs,  and  is  carried  to  the  indi- 
vidual districts  in  such  quantit}r,  that,  generally  at  least,  so  long  as  any 
possibility  whatever  of  maintenance  continues,  one  part  cannot  b>e  materi- 
ally injured  by  the  others." 

This  attraction  of  material  in  certain  cases  takes  place  in  such  a  way 
that  certain  elements  exercise  a  quite  specific  action,  and  manifest  an 
elective  affinity  —  specific  affinit}'  —  for  certain  materials.  Thus  the 
hepatic  cells  attract  sugar  and  bile  from  the  passing  blood,  "reconstruct 
these  materials  within  themselves,  and  either  return  them  thus  metamor- 
phosed to  the  blood,  or  transmit  them  in  the  form  of  bile  to  the  biliary 
ducts."  What  is  true  of  the  great  secretoiy  organs,  cellular  pathology 
applies  also  to  the  more  minute  elements.  Thus  "it  concedes  to  an  epi- 
dermic cell,  a  lens- fibre  or  a  cartilage-cell,  the  capacity  to  take  from  the 
nearest  vessels  (not  directly,  but  frequently  by  a  long  process  of  trans- 
mission) certain  quantities  of  material,  proportioned  always  to  its  special 
needs,  to  recompose  this  material  for  its  own  use  or  otherwise,  and  possibly 
even  to  its  own  destruction." 

According  to  Virchow,  the  vascular  system  is  completely  closed  by 
membranes,  in  which  no  pores  can  be  recognized.  "  When  we  speak  of  the 
porosity  of  the  walls  of  the  vessels,  this  can  only  consist  in  the  physical 
sense  of  invisible  and  properly  molecular  interstices of  the  im- 
possibility of  a  'transudation'  or  diapedesis  of  the  blood  through  the  vas- 
cular walls,  without  rupture  of  their  coats,  there  can  be  no  possible  ques- 
tion ;  and  though  we  cannot  in  each  special  case  furnish  evidence  of  the 
place  of  rupture,  it  is  yet  inconceivable  that  the  blood  with  its  corpuscles 
can  escape  in  any  other  way  than  through  a  hole  in  the  wall  of  the  vessel. 
This  is  so  perfectly  evident  from  histological  experiments  that  no  dis- 
cussion of  the  subject  is  possible",  a  discussion  which,  however,  in  spite 
of  Virchow's  apodictic  proposition,  was  soon  after  opened  by  Cohnheim, 
and  is  still  carried  on. 

A  fourth  view  essentially  distinguishing  the  cellular  pathology  from 
other  systems,  and  especially  from  the  humoral  pathology,  is  found  in  the 
doctrine  that  the  blood  itself,  whose  cells  are  renewed  from  the  corpuscular 


—  984  — 

elements  of  the  lymph,  is  not  the  proper  and  original  cause  of  dycrasiae, 
and  particularly  is  not  the  cause  of  a  continuous  alteration  of  the  tissues, 
the  admissibility  of  which  in  chronic  dyscrasiae,  according  to  Virchow, 
cannot  be  doubted.  These  dyscrasiae  arise  because  the  blood,  according 
to  the  new  idea,  is  not  an  independent  structure,  but  one  dependent  upon 
the  condition  of  the  tissues,  in  consequence  of  its  continual  conveyance 
of  noxious  constituents  from  certain  points  of  the  body.  The  blood, 
accordingly,  is  merely  the  medium  for  the  production  of  the  dyscrasiae. 
The  earlier  humoral  pathology,  on  the  contraiy,  ascribed  disease  in  its 
entirety  to  the  blood  itself,  while  the  cellular  pathology  recurs  to  the 
organs  for  the  ground  and  cause  of  blood  diseases,  and  regards  the  blood 
changes  as  symptomatic  and  not  the  essence  of  disease.  'As  a  continual 
conve}*ance  of  noxious  nutritive  material  —  e.  g.  alcohol  in  drunkards  — 
may  produce  a  permanent  adulteration  of  the  blood,  so  the  continual  dis- 
ease of  a  certain  organ  may  continually  convey  to  the  blood  unhealth}- 
material."  In  this  cellular  crasiology  the  modern  principle  of  localization 
attains  the  utmost  importance,  since  now  the  question  in  '^'scrasire"  is  to 
determine  the  place  from  which  the}'  take  their  origin  — e.  g.  in  the  syph- 
ilitic dyscrasia,  the  local  focus  —  a  doctrine  which  would  prove  eminently 
useful  in  practical  medicine  if  the  local  changes  were  alwaj-s  as  accessible 
to  treatment  eveiywhere  and  at  the  proper  moment,  and  would  yield  as 
readily  to  treatment,  as  a  syphilitic  ulcer. 

The  blood-crasis  too  in  inflammation  —  it  should  be  stated  here  that 
Virchow  does  not  admit  the  existence  of  an  active  hyperaemia,  because 
the  vessels  in  general  must  be  paralyzed  to  permit  hyperemia,  (if  they 
are  "active"  the  result  must  be  an  ischaemia)  — -  is  one  depending  upon  a 
local  condition.  The  crasis  presupposes  this  condition  and  does  not 
occasion  it,  as  was  formerly  assumed.  The  "phlogistic  crasis"  —  i.  e.  the 
hyperinosis  in  inflammations  particularly  of  the  thoracic  organs,  depending 
upon  an  increased  supply  of  "fibrinogenous"  substance  from  the  lymph, 
which  is  changed  in  the  blood  into  fibrin,  while  the  latter  may  be  con- 
sidered a  morphological  constituent  of  the  blood  —  is  an  event  depending 
upon  the  local  inflammation.  Wherever  too  fibrin  is  found  outside  of  the 
blood  it  is  not  separated  from  the  latter,  but  is  of  local  origin,  and  it  may 
be  conveyed  from  this  local  point  into  the  blood  and  produce  there  the 
inflammatoiy  crasis.  particularly  when  such  organs  as  contain  many 
lymphatic  glands  are  attacked. 

The  new  theory  gained  for  the  pathology  of  the  blood  several  peculiar, 
symptomatic  or  morphological  forms  of  disease,  through  a  combination  of 
the  numeric  method  heretofore  practised  in  regard  to  the  corpuscular  ele- 
ments of  the  blood,  with  the  new  (cellular)  localizing  idea  which  looked 
back  of  the  blood  to  the  tissues. 

The  increase  of  fibrin  (hyperinosis)  is  either  associated  with  an  in- 
crease of  the  colorless  lymph-cells,  which  occurs  under  the  condition  men- 
tioned above  that  the  inflamed  part  is  rich  in  lymph-glands  ;  or,  when  the 


—  985  — 

fibrin  is  diminished  (hypinosis),  the  number  of  the  lymph-cells  alone  is 
increased,  as  e.  g.  in  typhous  processes.  The  condition  in  which  the  color- 
less blood-corpuscles  are  increased  in  number  as  the  result  of  an  affection 
of  the  lymph-glands,  together  with  an  increased  or  diminished  proportion 
of  fibrin  in  the  blood,  Virchow  calls  leucocytosis.  It  occurs  even  phy- 
siologically  after  meals,  inasmuch  as  the  constituents  of  the  chyle  remain 
for  a  long  period  in  the  mesenteric  glands  and  constitute  for  these  a  path- 
ological irritant.  In  the  so-called  leucaemia,  a  most  fatal  disease,  in  whose 
discover}-  J.  H.  Bennett,1  as  already  mentioned,  claimed  priority  (1846), 
the  proportion  of  fibrin  in  the  blood  is  not  the  controlling  element  - —  it 
may  be  either  increased,  diminished  or  normal  in  quantity  —  but  the  num- 
ber of  the  corpuscles.  The  lymph  corpuscles  appear  to  be  increased  in 
number,  while  the  red  blood-corpuscles,  on  the  other  hand,  seem  diminished 
in  number,  and  this  may  proceed  so  far  that  the  red  and  white  cells  may 
exist  in  equal  numbers.  Indeed  it  may  happen  that  to  every  three  red 
corpuscles  we  find  two  of  the  colorless,  or  even  that  the  number  of  the 
latter  ma}-  exceed  that  of  the  former  (while  normally  only  one  white  cor- 
puscle corresponds  to  BOO  red)  and  the  blood  ma}-  seem  to  be  purulent. 
The  primary  seat  of  disease  in  leucaemia  we  find  to  be  the  spleen  or  the 
lymphatic  glands,  and  we  thus  distinguish  a  splenic  and  a  lymphatic 
leucaemia,  both  of  which,  however,  are  occasionally  combined.  To  these 
two  varieties  a  myelogenous  leucaemia  was  subsequently  added. 

Leucocytosis,  leucaemia  and  hyperinosis  are  also  related  to  the  lymph. 

Pyaemia,  in  the  sense  of  an  absorption  of  actual  pus,  or  rather  of  the 
passage  of  actual  pus  corpuscles,  undistinguishable  from  white  blood- 
corpuscles,  into  the  blood,  does  not  exist,  for  pus  as  pus  can  never  be  ab- 
sorbed. In  one  case  only  may  entire  pus  reach  the  circulation,  that  is 
when  a  vein  is  in  open  connection  with  a  focus  of  suppuration,  in  which 
■case  a  genuine  intravasation  occurs.  In  all  other  cases  only  the  fluid 
portions  of  the  pus  can  be  absorbed,  the  pus  becomes  merely  inspissated, 
and  the  corpuscular  elements  are  left  as  a  caput  mortuum  :  or  the  whole 
■of  the  pus  may  disappear,  though  only  after  it  has  become  absorbable  by 
a  previous  fatty  metamorphosis  of  its  cells.  The  pyaemia  of  past  writers 
is  frequently  nothing  but  an  increase  of  the  white  blood-cells,  the  result 
of  a  preceding  and  general  irritation  of  the  glands,  occasioned  by  a  local 
inflammation  or  suppuration,  that  is  a  pathological  leucocytosis.  .  Genuine 
internal  suppurative  phlebitis,  which  also  exists  but  has  its  seat  in  the 
walls  of  the  veins,  is  never  the  cause  of  pyaemia,  though  it  has  been 
generally  assumed  to  be  such  since  the  time  of  Cruveilhier.  In  many 
cases  the  pyaemia  depends  upon  the  fact  that  a  thrombus  (or  local  coagu- 
lation of  fibrin),  which  may  remain  in  its  place  of  origin  or  prolong  itself 
into  a  vessel  of  larger   caliber,    softens    centrallv.   and    the  white  blood- 


1.    O.  Sclmlten  (born  1818)  in   Odernheim,  a  practitioner  of  Rheinliesse,  made  the 
same  discovery  independently  in  1858. 


—  !»SG   — 

corpuscles  included  between  its  fibres  during  coagulation  are  accordingly 
set  free  and  reach  the  blood-current.  Or  a  portion  of  the  thrombus  may 
break  off,  and  by  means  of  (capillary)  embolism  (discovered  by  Virchow 
as  early  as  1846  while  studying  leucaemia)  excite  metastatic  inflammation, 
e.  g.  in  the  lungs,  by  which  a  leucocytotic  condition  is  then  produced  in 
the  blood.  Frequently  the  metastatic  inflammation  becomes  the  sole 
evidence  of  a  preceding  destruction  of  a  thrombus,  so  that  we  might  speak 
of  a  latent  pyaemia.  In  a  third  case  corrupt,  ichorous  humors  are  taken 
into  the  body,  and  we  must  admit  a  dyscrasia  (ichorous  infection)  occa- 
sioned by  the  ichorous  substance  which  has  gained  an  entrance  into  the 
bod}'  in  an  acute  way  —  something  like  cadaveric  poison  —  or  rather  a 
chemical  infection. 

';  These  three  different  conditions  may  complicate  each  other,  but  do 
not  always  or  necessarily  occur  together.  If  we  wish  to  retain  the  idea  of 
pyaemia,  the  term  ma}*  be  used  for  such  complications  ;  only  we  must  not 
seek  a  single  central  point  in  a  purulent  infection  of  the  blood,  but  consider 
the  term  a  collective  name  for  several  processes  differing  in  themselves." 

While  in  leucaemia  the  white  blood-corpuscles  alone  are  increased  in 
number,  in  chlorosis  we  find  both  the  corpuscular  elements  of  the  blood 
diminished  "without  any  definite  disturbance  of  the  mutual  relations  of 
the  colored  and  colorless  corpuscles."  The  lymphatic  glands  may  be 
affected  here  also,  though  just  how  is  not  demonstrable.  But  the  way  for 
the  disturbance  may  have  been  paved  at  an  early  period,  for  we  frequently 
find  the  heart,  the  arteries  and  larger  vessels,  and  the  sexual  apparatus 
imperfectly  developed,  a  fact  which  leads  us  to  infer  a  congenital  dispo- 
sition." 

Melanaamia  is  characterized  by  the  presence  in  the  blood,  in  causative 
connexion  with  lesions  of  the  spleen  or  severe  intermittents,  of  minute^ 
colored  particles,  sometimes  enclosed  in  forms  similar  to  the  colorless 
blood-corpuscles,  at  other  times  in  more  oval  forms.  —  In  typhous  patients 
and  those  cyanotic  from  affections  of  the  heart,  in  the  infectious  fevers  of 
patients  who  have  undergone  an  operation,  in  the  course  of  epidemic  dis- 
eases and  even  in  mild  intermittent  fevers,  we  find  increased  numbers  of 
'•melanotic"  (red)  blood  corpuscles,  i.  e.  cells  to  be  considered  most  prob- 
ably old  and  decaying  red  corpuscles,  and  to  be  looked  upon  as  forerunners 
of  a  blood-moulting,  as  one  of  the  processes  '-in  which  from  a  clinical 
stand-point  too  the  probability  of  an  extensive  destruction  of  the  constitu- 
ents of  the  blood  within  the  circulation  may  be  inferred." 

Another  alteration  of  the  red  blood-corpuscles,  or  rather  most  prob- 
ably of  their  contents  only  (the  respiratory  substance),  occasionally  occurs 
in  typhoid  fevers,  when  the}-  assume  an  acute,  severe  course.  It  may  be 
distinguished  as  toxiciemia,  because  no  morphological  change  occurs,, 
though  the  function  of  the  corpuscles  to  take  up  oxygen  is  abolished, 
and  they  are,  as  it  were,  paralyzed  in  the  same  way  as  in  poisoning  by 
carbonic  oxide. 


—  987  — 

As  regards  the  cancerous  clyscrasia,  it  should  be  remarked  that  a 
more  or  less  rapid  infection  occurs  in  proportion  to  the  richness  of  the 
respective  forms  of  cancer  in  parenchimatous  juices.  Indeed  in  the 
majority  of  cases  this  infection  takes  place  by  way  of  the  lymphaticsr 
which  are  totally  unable  to  absorb  actual  cancer-cells.  "A  peripheral 
lymphatic  vessel  can  never  simply  wash  away  into  the  blood  the  cells  of 
cancer  as  it  does  the  juices  ;  this  is  conceivable  and  possible  in  the  veins 
only",  or  through  the  lymphatics  only  when  the  glands  have  already  be- 
come cancerous.  The  walls  of  the  veins,  however,  must  also  have  become 
cancerous  for  a  dissemination  of  cancer  to  occur  by  way  of  the  blood- 
current  after  the  manner  of  an  embolism.  This  kind  of  dissemination  by 
embolic  metastasis  is  at  all  events  rare.  "The  ordinary  form  of  metastatic 
dissemination  in  cancer  corresponds  in  direction  rather  to  the  organs  of 
secretion." 

In  the  doctrine  of  inflammation  Yirchow,  in  addition  to  the  four  well- 
known  phenomena  of  inflammation,  redness,  heat,  pain,  swelling,  has  again 
taken  up  disturbance  of  function,  which  the  surgeon  Walther  had  alread}' 
brought  forward  as  characteristic  of  that  process.  In  fact  Yirchow  makes 
the  latter  the  '-ruling"  symptom,  so  that  in  his  theory  it  assumes  the 
leadership  among  the  phenomena  of  inflammation,  taking  the  place  of 
Galen's  '-heat",  the  'redness"  of  Boerhaave,  the  hyperemia  of  Broussais, 
the  "exudation"  of  the  Vienna  school  (corresponding  to  the  "tumor"  of 
the  Ancients)  and  the  "pain"  of  the  Neurists.  "  No  one  expects  an  in- 
flamed muscle  to  perforin  its  functions  normally  ;  eveiyone  supposes  that 
the  contractile  substance  of  the  muscle  has  experienced  certain  alterations. 
No  one  expects  an  inflamed  gland-cell  to  secrete  normally,  but  we  regard 
a  disturbance  of  secretion  as  a  necessary  result  of  the  inflammation.  No 
one  expects  an  inflamed  ganglion-cell  or  an  inflamed  nerve  to  perform  its 
functions,  to  react  normally  to  irritation.  According  to  our  commonest 
experience,  inflammation  necessarily  implies  that  changes  in  the  composi- 
tion of  the  cellular  parts  must  have  occurred,  which  alter  the  natural 
functional  capacity  of  these  parts."  Such  "alterations  of  nutrition",  which 
at  last  involve  once  more  a  consideration  of  the  cell,  are  manifested  now 
as  the  result  of  the  "inflammatory  irritation'',  which  is  of  a  nutritive  or 
formative  kind.  By  this  expression  "we  can  properly  imply  nothing  else 
except  that,  in  consequence  of  some  cause  or  other  external  to  the  part 
which  falls  into  a  state  of  irritation,  and  which  acts  upon  it  either  directl}1 
or  through  the  medium  of  the  blood,  the  composition  and  constitution  of 
this  part  undergo  alterations  which  at  the  same  time  alter  its  relations 
to  the  neighboring  parts  (whether  they  be  blood-vessels  or  other  struct- 
ures), and  enable  it  to  attract  to  itself,  and  to  absorb  from  them,  a  larger 
quantit}'  of  matter  than  usual,  and  to  transform  it  according  to  circum- 
stances. Every  form  of  inflammation  with  which  we  are  acquainted  finds 
in  this  its  natural  explanation.  Of  each  it  is  true  that  it  begins  as  an 
inflammation  from  the  moment  when  the  increased  appropriation  of  material 


—  988  — 

in  the  tissue  ensues,  and  the  further  transformation  of  this  material  is 
_un."  Virehow  opposes  the  ••exudation"  theory  of  the  Vienna  school 
so  strongly  that  he  affirms  --that,  in  the  sense  ordinarily  accepted,  there  is 
no  such  thing  as  an  inflammatory  exudation,  but  that  the  exudation  usually 
met  with  is  actually  formed  from  the  material  engendered  by  the  altered 
condition  of  the  inflamed  part  itself,  and  from  the  transuded  fluids  which 
originate  from  the  vessels  of  the  neighborhood"  —  that  the  exudation  is 
properly  an  "educt". 

Accordingly  Yirchow  distinguishes  two  forms  of  inflammation  :  -the 
purely  parenchymatous,  in  which  the  process  runs  its  course  within  the 
tissue,  without  our  being  able  to  observe  any  exudation  of  the  fluid  of 
the  blood  :  and  secretory  (exudative  )  inflammation,  which  belongs  rather 
to  the  superficial  organs,  in  which  an  increased  exudation  of  fluids  from 
the  blood  ensues,  earning  with  it  the  peculiar  parenchymatous  materials 

to  the  superficies  of  the  organs There  are  certain  organs  which 

under  all  circumstances  manifest  parenchymatous  disease  only  :  others 
which  almost  always  exhibit  a  superficial  exudative  inflammation." 
Moreover  the  parenchymatous  form  assumes  the  character  of  a  degenera- 
tion, inasmuch  as  it  has  a  tendency  to  alter  the  histological  and  functional 
constitution  of  an  organ.  "Every  inflammation  with  free  exudation 
occasions  generally  a  certain  amount  of  relief  to .  the  part  ;  it  carries  off 
a  great  portion  of  the  noxious  agents,  and  thus  the  part  seems  to  suffer 
proportionately  much  less  than  one  which  is  the  seat  of  parenchymatous 
diseae 

Besides  inflammation,  there  are  still  allied  to  this  two  processes, 
passive  congestion  i  stagnation  in  the  venous  system  I,  that  is  a  local  in- 
crease of  the  blood  with  retardation  of  its  current  due  to  an  increase  of 
resistance  and  a  diminution  of  the  heart's  force  :  and  fluxion  (active 
hyperemia,  fluxion  of  Barthez.  "Wallung"),  i.  e.  increased  and  usually 
accelerated  influx  of  the  blood  into  a  part,  the  result  of  a  decrease  in 
resistance  as  compared  with  the  impetus  of  the  blood.  Both  may  exist 
together,  for  every  passive  congestion  in  the  venous  system  brings  with 
it  a  collateral  active  congestion.  —  Fluxion  manifests  itself  by  a  pretty 
strong  injection  of  the  vessels,  either  sharply  defined  or  fading  gradually 
into  the  adjacent  tissues,  and  finds  its  expression  in  redness  (Inpersemiaj, 
pulsation  and  a  local  elevation  of  temperature,  frequently  more  evident  to 
the  touch  alone,  than  demonstrable  by  the  thermometer. 

If  in  the  morphological  portion  of  Virchow's  cellular  theory  the 
vitalistic  idea  appears  prominent,  his  views  on  the  life  and  activity  of  the 
nerves  show  too  a  marked  leaning  towards  the  doctrines  of  Brown  and 
Haller —  a  new  evidence  that  in  every  theory,  even  in  one  which  appears 
entirely  new  in  name,  old  ideas  continue  to  recur  —  for  Virchow's  custom 
of  maintaining  the  rights  of  the  past  is  one  altogether  commendable.  "  It 
is  probably  profitable  to-day"  —  that  it  surely  is  —  '-to  recognize  historic 
riirhts,  for  in  fact  it  is  astonishing  with  what  heedlessness  those  who  prize 


—  9S9    — 

as  a  discovery  every  trifle  which  they  have  themselves  found  out.  condemn 
the  results  of  their  predecessors.  I  maintain  my  rights,  and  therefore  I 
also  recognize  the  rights  of  others."  What  would  the  modern  physician, 
who  desires  even  the  laity  to  be  so  ••informed"'  in  medicine  that  they  eom- 
passionatel\-  pity  those  who  take  any  notice  of  the  antiquated  heroes  of 
our  art,  think  of  Virchow  ? 

Yirehow  also  assumes  nerve-territories  analogous  to  the  vascular 
territories,  though  larger  than  the  latter.  Both  assert  a  certain  inde- 
pendence of  each  other,  so  that  very  extensive  parts  may  exist  without 
vessels,  others  without  nerves,  "without  throwing  their  nutritive  condi- 
tions into  disorder".  In  this  he  contradicts  the  neuropathological  idea  ; 
for  ''the  idea  of  a  neuro-pathologist  of  the  purest  water  is.  as  we  know, 
that  a  nervous  center  is  able  b}-  means  of  the  nerve-fibres  to  exercise  a 
special  influence  upon  every  minute  portion  of  its  territory.  If  in  any 
small  point  of  the  body  a  mass  of  cancer  or  of  pus  arises,  or  a  simple 
disturbance  of  nutrition  ensues,  the  neuro-pathologist  requires  an  arrange- 
ment b}*  means  of  which  the  central  organ  is  able  to  extend  its  action  to 
the  smallest  districts  of  the  periphery  ;  some  way  or  other  by  which  its 
messengers,  who  are  designed  to  convey  its  orders  to  the  remotest  points 
of  the  organism,  can  pass  to  their  destination.  Actual  experience  teaches 
nothing  of  the  kind.  Precisely  in  those  places  where  we  recognize  term- 
inal apparatus  so  extraordinarily  complicated  as  in  the  organs  of  sense, 
the  nerves  have  no  relation  to  the  nutrition  of  the  part,  and  particularly 
no  demonstrable  influence  upon  elementary  parts." 

In  the  central  apparatus  of  the  nervous  system  each  special  function 
has  its  special  elementary  cellular  organs,  each  kind  of  conduction  finds 
its  routes  definitely  marked  out.  Hence  '-that  view  which  sees  in  the 
nervous  system  the  special  center  of  life  is  met  with  the  enormous  diffi- 
cult}' that,  in  the  same  apparatus  in  which  it  falsely  locates  unity,  it  finds 
once  more  the  same  division  into  many  individual  centers  which  the  rest 
of  the  body  presents,  and  that  it  can  point  out  nowhere  in  the  nervous 
S}'stem  any  actual  center  by  which  all  parts  are  controlled  as  by  a  dic- 
tator." The  nervous  system  in  no  respect  represents  the  proper  unity  of 
the  body. 

There  are,  it  is  true,  certain  small  cellular  organs  which  serve  as 
centres  of  motion,  but  there  is  no  one  ganglion  to  which  all  motion  can  be 
referred.  The  same  numerous  centers  are  also  found  in  the  ganglia  which 
preside  over  sensation.  Unity  exists  in  our  consciousness  alone,  and  an 
anatomical  or  physiological  unity  has  been  up  to  the  present  time  nowhere 
demonstrated. 

The  characteristic  of  life  is  activity.  The  latter,  however,  -takes 
place  in  no  single  part  through  a  cause  belonging  to  it  from  the  beginning 
and  entirely  confined  to  it"',  but  there  is  everywhere  required  a  certain 
excitement  or  irritation,  the  cause  of  which  is  irritability  —  a  theory 
agreeing  entirely  with   that  of   Haller  or  Brown.     This   activity  is   "the 


—  990  — 

criterion  by  which  we  decide  whether  the  part  lives  or  does  not  live".  It 
is  feeblest  in  tissues  of  low  organization,  and  in  connective  tissue  it  is 
often  difficult  to  determine  whether  a  part  lives  or  not. 

The  activities,  which  (like  the  tota'ity  of  life  with  Brown)  may  be 
called  forth  by  an  external  influence,  are  either  functional,  nutritive  or 
formative.  The  boundaries  of  these  processes,  indeed,  shade  awa}-  into 
each  other,  but  yet  in  the  internal  changes  which  the  irritated  part  suffers, 
the}'  are  very  different.  "  The  result  of  an  excitation  or  an  irritation  may 
be,  according  to  circumstances,  simply  a  functional  process,  or  the  institu- 
tion of  a  stronger  or  weaker  nutrition  of  the  part,  without  necessary  ex- 
citement of  its  function,  or  the  establishment  of  a  formative  process,  which 
creates  more  or  less  new  elements."  The  function  of  every  activity  suffers 
fatigue,  which  need  not  alwa3"s  be  removed  primarily  by  nutrition,  but  may 
be  dissipated  by  simple  rest  and  restitution. 

By  nutritive  irritability  we  understand  -'that  faculty  of  individual 
parts,  which  leads  them  under  the  influence  of  definite  irritations  to  take 
up  and  transform  within  themselves  more  or  less  material.  '  To  this  are 
united  the  formative  changes,  which  begin  with  division  of  the  germ  and 
are  continued  in  the  new  formation  of  the  elements. 

In  the  doctrine  of  new  formations  Virchow  rejects  the  theory  of  the 
blastema,  of  the  plastic  lymph  of  older  writers,  as  well  as  that  of  exuda- 
tion. Instead  of  these  he  assumes  a  continual  development  upon  soil 
already  existing,  and  regards  the  connective  tissue,  with  its  equivalents, 
as  the  common  gertninative  trunk  of  the  body.  From  this,  in  the  vast 
majorit}*  of  cases,  he  thinks  that  neoplasms  take  their  origin.  The  process 
of  new  formation  consists  in  either  simple  division  of  the  cells  or  germs 
(and  the  development  of  physalides),  in  which  the  new  elements  corres- 
pond with  those  of  the  mother  soil  —  what  we  commonly  designate  ;is 
hypertrophies  or  better  hyperplasia?  —  or  in  a  very  rapid  division  into 
smaller  and  smaller  elements,  which  occasionalh-  become  so  small  at  last 
that  they  fairly  reach  the  limit  of  cells.  "The  proliferation  of  the  cells 
may  cease  at  this  point ;  the  individual  elements  then  begin  to  grow 
again,  to  increase  in  size  and,  under  certain  circumstances  a  form  may  by 
produced  again  here,  quite  analogous  to  that  from  which  the  development 
proceeded."  Yet  ordinarily  this  is  not  the  case.  As  a  rule  the  young, 
minute  elements  strike  out  a  somewhat  different  course  of  development, 
and  there  begins  a  "hetei'ologous  plastic  development",  which  has  always 
a  destructive  character,  besides  that  of  contagion  in  continuity.  This 
development  extends  to  the  neighboring  and  anastomosing  tissues,  with- 
out any  intervention  of  vessels  and  nerves,  though  these  latter,  from  the 
softness  of  their  interstitial  substance,  often  furnish  "the  best  conductors 
for  the  propagation  of  contagious  neoplasms".  From  just  such  considera- 
tions the  value  of  the  cellular  theory,  or  the  theory  of  anastomosing  ele- 
ments of  the  tissue,  becomes  clear.  For  it  is  not  established  whether  in- 
fectious materials  or  cells  from  the  focus  of  disease  are   transported  by 


—  991  — 

way  of  the  plasma,  through  the  blood,  to  remote  places.  The  heterologous 
neoplasms  are  parasites  in  the  sense  that  they  are  as  well  "destructive  in 
the  beginning  as  spoliative  in  their  course".  In  deciding  whether  a  form 
is  to  be  considered  physiological  or  specific,  nothing  determines  the  ques- 
tion save  the  abnormal  localit}r  in  which  it  is  found,  and  the  existence  of  a 
fluid,  which,  conveyed  to  neighboring  parts,  produces  in  them  a  contagious 
and  unfavorable  effect. 

As  regards  tuberculosis,  Virchow  (following  the  theory  of  Reinhardt, 
who  distinguished  a  genuinely  neoplastic  form,  and  an  inflammatory  form 
in  which  no  tubercle  exists)  accepts  a  genuine  tuberculosis  and  a  caseous 
pneumonia,  which  may  become  tuberculous.  In  agreement  with  Malassez, 
he  regards  the  formation  of  nodules  as  the  characteristic  of  the  process. 
Reeenth*,  however,  Virchow  accepts  the  existence  of  a  bacillary  and  a  non- 
bacillary  form  of  tuberculosis. 

As  Virchow  himself  intimated,  the  preceding  theory,  subsequently 
expanded  in  its  details  and  modified  in  a  few  points,  tended  to  oppose 
from  the  outset  the  current  views,  and  particularly  those  of  Rokitansky 
and  the  Vienna  school,  which  chiefly  cultivated  gross  pathological  anat- 
omy and  effected  the  domination  of  this  branch  in  medicine.  Now  micro- 
scopic anatomy  or  microscopic  pathological  anatomy  was  destined  to  oc- 
cupy the  place  of  the  latter.  Still  more  did  VirchowTs  theory  antagonize 
the  systems  of  rational  and  physiological  medicine,  for  he  declared  it 
necessary  ''to  rise  by  independent  experience,  empirical  observation  and 
investigation,  to  a  pathological  physiology,  i.  e.  a  physiolog}'  which  teaches 
the  course  of  vital  phenomena  under  pathological  conditions."  The  first 
object  was  undoubtedly  attained.  In  this  sense  we  might  speak  of  a 
Rerlin  school  of  micro-pathological  anatomy.1  The  role  of  the  chemical 
erases  of  the  Vienna  school  was  now  taken  by  the  morphological  erases, 
and  to  this  doctrine  vitalistic  views  (those  of  Haller-  and  Rrown)  were 
added. 

The  cellular  theory,  like  all  theories,  is  to  be  regarded  as  an  historical 
expression  of  the  scientific  tendency  of  a  certain  period;  as  a  theorj- 
whose  proper  fundamental  ideas  must  be  considered  only  as  partiall}'  new, 
and  whose  duration  too,  as  a  whole,  is,  like  that  of  all  theories,  limited. 
Many  important  points  of  this  theory  have  already  become  obsolete  in 
consequence  of  more  recent  microscopic  interpretations,  which,  as  we  all 
know,  alwa}-s  and  everywhere  undergo  rapid  changes.  Yet  undoubtedly, 
in  common  with  few  other  earlier  theories,  it  enjoys  the  enduring  excellence 


1.  How  great  honor  was  paid  to  investigations  in  microscopic  anatomy  may  be  in- 
ferred from  a  satirical  expression  of  Karl  Vogt  :  "  If  1  succeed  in  inventing  a 
specific  method  of  hardening  or  coloring  specimens,  which  permits  500  sections 
to  be  made  out  of  a  piece  from  which  heretofore  only  one  hundred  could  be  made, 
I  have  as  good  a  claim  to  promotion  in  university  matters  as  a  useful  suhaltern 
has  to  the  civil  service.''     i  Psysiologische  Forschungen  am  Meer,  1881). 


—  992  — 

that  no  theoretic  system  of  therapeutics  has  been  built  upon  it1  b}'  its 
author,  and  that  in  his  hands  it  continues  to  be  what  it  was  originally 
intended  to  be  —  a  scientific  theory. 

Virchow,  like  Roeschlaub  (whose  general  views  he  adopts  in  many 
points),  defines  disease,  one  of  whose  chief  characteristics  is  '•danger", 
as  "one  of  the  possible  phenomena  under  which  the  life  of  individual 
organized  bodies  may  manifest  itself.  The  sole  ground  of  all  phenomena, 
healthy  as  well  as  morbid,  is  only  life  itself,  and  a  disease  detached  from 
other  life,  existing  beside  it,  and  being  for  itself,  has  no  existence.  What 
we  call  disease  is  a  mere  abstraction.  Life  is  cellular  activity  (?).  and 
the  cell  is  not  the  simple  vessel  of  life,  it  is  itself  the  living  part.  Life  is 
something  given,  something  rendered  possible  by  inheritance  onlj*,  and 
therefore,  besides  the  forces  permanently  united  to  matter,  there  must  be 
given  a  permeating  force  which  is  transmitted  mechanically  (?)  from 
member  to  member.  Whence  this  force  took  its  origin  experience  has  not 
}'et  divined,  but  this  deficiency  does  not  warrant  us  in  denying  its  exist- 
ence. Accordingly  we  distinguish  in  the  living  body  two  kinds  of  forces  : 
the  molecular  forces  and  the  exciting  and  excited  vital  force,  b}'  the  com- 
bined action  of  which  in  the  individual,  organic  elements,  the  elementary 
or  cell  forces,  which  we  are  in  the  habit  of  regarding  as  vital  force  in  the 
wider  sense  of  the  term,  are  brought  into  action"  —  a  definition  which  in 
importance  and  precision  has  no  advantage  over  those  of  an  earlier  date. 
The  continuance  of  life  is  ascribed  (as  by  Brown)  to  a  succession  of 
permanent  external  influences,  the  vital  stimuli,  which  always  keep  awake 
"the  tension  of  the  solid  particles."  "The  unity  of  the  living  body  is 
founded  only  in  the  dependence  of  its  living  parts  upon  each  other,  a 
dependence  accomplished  by  means  of  the  nerves,  the  circulation  and  im- 
mediate  anastomoses  or  contacts The  vital   force   is  regenerated 

from  the  molecular  forces  in  the  process  of  nutrition.  No  vis  medicatrix 
naturae  exists  as  a  special  reserve  force,  and  the  cures  of  nature  are  not 
generall}*  different  from  those  of  art.  The  latter  rather  avail  themselves 
of  the  existing  physiological  arrangements  and  forces  of  the  bod}-,  in 
order  by  the  artificial  induction  of  more  favorable  conditions  to  bring 
about,  if  possible,  an  adjustment  of  the  disturbances."  "  The  task  of  the 
physician  is  to  weaken  or  destroy  the  predispositions,  and  to  facilitate  the 
adjustment  of  disturbances  once  begun." 

As  regards  the  practical  bearing  of  these  abstractions,  in  which 
Virchow,  instead  of  striving  after  originalit}'  in  his  definitions,  relies- 
chiefl}'  and  intentionally   upon  definitions   already  existing  —  yet   he  fre- 


It  was  done,  however,  by  Dr.  Sen  ussier,  in  his  "Abgekiirzte  Therapie,  gegriindet 
auf  Histologic  und  Cellularpathologie".  Dr.  C.  H.  Schauenburg  (died  1876)  went 
still  further,  inasmuch  as  he  called  Baunscheidtism,  i.  e.  the  acupuncture  of  the 
Chinese  and  Japanese,  modified  and  turned  to  profit  by  the  turner  C.  Baun- 
scbeidt  (died  1860  in  Endenich  near  Bonn),  a  genuine  "Cellulartherapie  ". 


—  993  — 

quently  employs  new  words  for  old  ideas  —  we    must  finally  quote  the 
following  remark  : 

"Such  abstractions  are  necessary  in  explaining  a  theor}'  and  in  the 
use  of  language,  for  by  them  alone  can  mutual  understanding  be  accom- 
plished. In  practice,  however,  in  the  comprehension  of  the  individual 
case,  they  must  be  abandoned,  since  they  are  attended  with  the  danger  of 
leading  one  to  lose  sight  of  the  patient  in  the  disease,  the  reality  in  the 
idea.  The  patient  alone  is  the  object  of  medical  activit}T,  and  the  physi- 
cian must  never  forget  that  his  ultimate  aim  is  one  of  humanity." 

The  life  of  Virchow  is  distinguished  from  that  of  the  modern  German  university 
teacher  by  the  fact  that  he  attained  very  early  the  highest  grade  in  the  career  of  the 
learned,  to  wit  the  professorship.  After  studying  in  Berlin  from  1839  to  1843  at  the 
Pepiniere,  he  presented  for  his  doctor's  degree  the  dissertation  "  De  rheumate, 
praesertim  corneae."  He  was  then  appointed  assistant  physician  in  the  Charite  hos- 
pital, where  he  subsequentljr  became  prosector  and  privatdocent.  Although  ordered 
by  the  government  to  Silesia  in  1847  as  an  expert  for  the  investigation  of  the  causes 
and  means  of  getting  rid  of  an  epidemic  of  famine  tj'phus,  he  soon  became  a  political 
irreconcilable  in  Berlin,  and  therefore  settled  as  a  professor  in  Wiirzburg  in  1849. 
Here  he  found  a  reception  when  there  was  no  place  for  him  in  North  Germany.  For 
the  second  time  he  was  sent  from  here  in  1852  into  the  Spessart,  to  investigate  an 
epidemic  of  famine  typhus.  But  as  early  as  1856  he  returned  to  Berlin  to  assume  the 
chair  of  pathological  anatomy,  in  which  he  introduced  the  subject  of  microscopic 
anatomy,  to  which  Rokitansky  had  given  insufficient  attention,  and  thus  gave  to  his 
chair  a  new  direction.  Three  years  later,  at  the  request  of  the  Swedish  government, 
Virchow  went  to  Norway  to  study  the  leprosy.  —  That  Virchow  plays  a  prominent 
part,  not  only  as  a  medical  theorist,  but  (like  many  German  professors  since  the 
"  Demagogenzeit")  as  a  firm  but  stubborn  man  of  advanced  ideas  in  the  Prussian 
House  of  Deputies,  is  well  known.  A  pupil  of  the  great  physiologist  and  pathological 
anatomist  Johannes  M'uller  (1801-1858,  Handbuch  der  Physiologie  des  Menschen, 
1835)  and  of  Schonlein,  for  each  of  whom  he  delivered  a  memorial  address,  Virchow 
developed  a  great  capacity  for  work  and  singular  versatility  as  a  teacher,  investigator 
savant  and  popular  writer,  as  well  as  a  political  deputy  — -in  this  capacity  he  origin- 
ated the  term  "  Culturkampf "  —  and  recently  as  a  hygienist  and  anthropologist  or 
archaeologist.  He  professes  to  be  a  great  admirer  of  Harvey,  whose  picture  is  the 
only  one  permitted  to  hang  in  his  study.  Among  his  numerous  works  we  may  men- 
tion the  "  Cellularpathologie"  (1st  edition  1858,  4th  edition  1871),  translated  into 
French  by  Picard  and  into  English  by  Frank  Chase  (1860);  Gesammelte  Abhand- 
lungen  1856-1862;  Virchow's  Handbuch  der  speciellen  Pathologie  nnd  Therapie, 
1854;  Archiv  fiir  pathologische  Anatomie,  Physiologie  und  klinishe  Medicin;  Can- 
statt's  Jahresberieht  (continued);  Mittheilungen  fiber  die  in  Oberschlesien  herr- 
schende  Typhusepidemie,  1848;  Id.  im  Spessart,  1852;  Einheitsbestrebungen  in  der 
Medicin,  1849;  Pathologie  der  Geschwfilste,  1866,  translated  into  French  by  Arons- 
sohn  ;  Lehre  von  den  Trichinen,  1875,  etc.  In  his  treatise  on  tumors  Virchow  carries 
out  the  division  of  these  growths  originally  adopted  by  Job.  Mtiller  in  1838,  and  which 
classifies  them  according  to  their  microscopic  elements.  Virchow,  however,  studied 
the  subject  and  named  tumors  in  accordance  with  the  results  of  more  recent  investi- 
gations and  views,  particularly  his  own.  While,  however,  Miiller,  according  to 
Fleischmann,  declared  the  ideas  heterologous  and  homologous  inadmissible  as 
regards  tumors,  Virchow  adopts  again  these  terms,  but  understands  by  heterologous 
tumors,  those  which  contain  tissues  different  from  those  of  the  locality  in  which 
63 


—  904  — 

they  are  developed,  and  by  homologous,  those  whose  tissues  are  similar  to  those  of 
their  locality. 

Virchow  has  had  among  his  pupils  a  great  number  of  notable  pro- 
fessors and  physicians.  We  may  notice  among  these  :  E.  Le}-den  (born 
1832),  formerly  in  Strassburg,  now  in  Berlin  ;  Fried.  Dan.  von  Reckling- 
hausen (born  1833),  professor  in  Strassburg;  Julius  Cohnheim  (1839-1884) 
of  Demmin  in  Pomerania,  professor  of  pathological  anatomy  in  Leipsic 
and  author  of  valuable  investigations  on  inflammation  and  the  embolic 
processes,  as  well  as  the  first  inoculator  of  tubercle  in  Germany.  Cohn- 
heim in  1867,  by  his  discover}'  of  the  diapedesis  of  the  white,  membrane- 
less  blood-  or  plasma-corpuscles  through  pores  in  the  uninjured  walls  of 
the  vessels  during  the  process  of  suppuration,  damaged  decidedly  the 
cellular  pathology  of  his  teacher,  who  believed  that  pus  was  derived  from 
the  cells  of  the  connective  tissue.1  H.  W.  Gottfried  Waldeyer,  professor 
in  Berlin  ;  Felix  Hoppe-Se3ler  (Handbuch  der  physiologisch-chemischen 
Analyse,  1858),  professor  in  Strassburg  ;  W.  Kiihne,  professor  in  Heidel- 
berg, author  of  papers  on  the  "retina-purple"  (1877),  discovered  by  Franz 
Boll  in  Rome.  Kiihne  proved  it  to  be  a  photo-chemical  portion  of  the 
retina.  Georg  Eduard  Rindfleisch,  professor  in  Wiirzburg ;  E.  Klebs 
(Handbuch  der  pathologischen  Histologie),  professor  in  Zurich  and  the 
champion  of  the  germ  theor}'  of  disease  ;  Liebreich  ;  Anton  Biermer,  the 
discoverer  of  progressive  pernicious  ansemia ;  Georg  A.  Liicke  ;  Vic. 
Friedreich  (1825-1882)  in  Heidelberg,  author  of  works  on  diseases  of  the 
heart,  on  phjsical  diagnosis,  muscular  atrophy  etc.;  Alexander  Diesterweg, 
who  wrote  a  cellular  physiology  and  has  demonstrated  how  far  theoretical 
considerations  can  be  carried  ;  and  many  others.  All  of  these  men  are 
microscopic  and  pathological  anatomists  of  the  first  rank. 

Finally  we  must  direct  attention  to  one  of  the  results  of  Virchow's 
theory,  a  school  to  which  the  present  popularity  and  general  recognition  of 
German  medicine  abroad  was  first  due.     We  refer  to  the  German  so-called 

School  (or  Medicine)  of  the  Natural  Sciences, 

of  which  Virchow  is  the  intellectual  father.  This  school  seeks,  chiefly  b}* 
means  of  pathological  anatomy  and  microscopy,  experimental  physiology 
and  pathology  and  the  natural  sciences,  or  rather  by  their  methods,  to 
render  medicine  also  an  "exact"  science.  "  Medicine  as  an  applied  science 
thrives  only  in  the  broad  field  of  the  natural  sciences  in  general"  (Virchow) 
is  the  creed  of  this  school. 

To  it  belong,  with  the  characteristic  predominance  of  "exact"  clinical 
investigation,  those  representatives  who  unite  in  maintaining  the  "Deutsche 
Archiv  fiir  klinische  Medicin".  At  their  head  stand  the  Munich  clinician, 
Huo-o  von  Ziemssen,  and  the  pathological  anatomist  of  Erlangen,  F.  A. 


1.  M.  H.  Dutrochet  too  in  1824  had  observed  the  diapedesis  of  the  bloodcorpucles  (not 
simply  of  the  white  corpuscles)  in  the  larva  of  the  toad,  and  regarded  it  as  im- 
portant in  nutrition. 


—  995  — 

Zenker,  the  former  (after  Virchow's  example)  the  editor  of  a  voluminous 
cyclopaedia  of  pathology.  Indeed  this  form  of  publication  is  characteristic 
of  the  literary  productions  of  the  school  of  the  natural  sciences,  the 
individual  sections  being  discussed  by  specialists  in  each  department. 
The  school  of  natural  history,  on  the  other  hand,  pursued  a  different 
system,  in  which  voluminous  text-books  were  written  b}T  a  single  author, 
while  in  the  New  Vienna  School  almost  all  the  important  teachers  wrote 
each  a  single  special  work  in  his  own  department.  Among  the  physicians 
of  the  school  of  the  natural  sciences  we  may  notice  :  A.  Geiger  in  Wiirz- 
burg ;  C.  Gerhardt,  formerly  in  Wiirzburg,  now  in  Berlin,  who  likewise 
edited  a  c}'clopa?dia  of  the  diseases  of  children  ;  W.  Ebstein  in  GrSttingen  ; 
H.  Nothnagel,  formerly  in  Jena,  now  in  Vienna  ;  Th.  H.  Jiirgensen  and 
C.  Liebermeister  in  Tubingen  ;  A.  Biermer,  formerly  in  Zurich,  now  in 
Breslau  ;  Mannkopf  in  Marburg  ;  Th.  Weber  in  Halle  :  0.  Heubner  in 
Leipsic  ;  H.  Senator  in  Berlin  ;  Franz  Obernier  (died  1882)  in  Bonn  ; 
Lichtheim  in  Bern  ;  G.  Merkel  in  Nuremberg  ;  W.  Erb  in  Heidelberg  ; 
A.  Vogel  in  Dorpat,  author  of  a  text-book  of  the  diseases  of  children 
which  has  enjoyed  numerous  editions  (a  new  one  recently  under  the 
direction  of  Phil.  Biedert  in  Hagenau);  C.  Bartels  (1811-1878)  in  Kiel  ; 
H.  Ruble  in  Bonn  ;  0.  W.  Leube,  formerly  in  Erlangen,  now  in  Wiirzburg 
etc.  etc. 

A  branch  of  the  school  of  pathological  anatomy  and  the  natural 
sciences,  combining  therewith  a  tendency  to  etiology  and  hygiene,  is  the 
Munich  clinical  school  of  the  natural  sciences  and  hygiene.  To  it  belong 
among  others  :  Ludwig  von  Buhl  (1816-1880),  who  introduced  patholog- 
ical anatomy  into  Munich  ;  Franz  Xaver  von  Gietl  (born  1803)  ;  Jos.  von 
Lindwurm  (1824-1874);  von  Pettenkofer,  Buchner,  Franz  Seitz,  Jos.  Bauer, 
H.  von  Bock,  Max  Joseph  Oertel,  Krieger  in  Strassburg  etc. 

While  with  the  physicians  alread}7  mentioned  the  subject  of  hygiene 
-occupies  the  second  place,  in  the  school  of  the  natural  sciences  and 
hygiene  it  advances  to  the  front.  In  this  school  we  must  reckon  those 
physicians  who  belong  to  the  "Verein  fur  oftentliche  Gesundheitspflege", 
among  whom  we  may  mention  :  Georg  Varrentrapp  and  Alex.  Spiess  in 
Frankfort  ;  Karl  Reclam  (1821-1887),  professor  in  Leipsic,  a  hj-gienist  and 
propagandist  of  cremation  in  Germany  and  a  popular  hygienic  writer  ;  L. 
Hirt  in  Breslau  ;  A.  W.  Hofmann  in  Leipsic  ;  Gottisheim  in  Basel ;  Both 
in  Dresden  ;  Fr.  Sander  (1835-1878)  in  Hamburg  ;  Miirklin  in  Wiesbaden  ; 
Sonderegger  in  St.  Gall  etc.  As  in  this  school  the  element  of  practitioners 
counterpoises  that  of  university  professors,  it  is  to  be  hoped  that  through 
its  influence  the  seed  may  be  sown  for  a  combination  of  investigation  and 
practice  similar  to  that  of  English  medicine. 

The  splitting  up  of  medicine  into  specialties,  and  the  increase  of  its 
subordinate  branches  in  the  school  of  the  natural  sciences,  resulted  in 
danger  to  the  unity  of  medical  science.  A  return  to  the  method  which 
•combines  science  and  practice,  the  clinico-practical  method,  is  again  sought 


—  996  — 

by  the  <;Zeitschrift  flir  klinische  Medicin"  under  the  management  of  Fr. 
Th.  von  Frerichs  (1819-1885)  and  E.  Leyden.  "  Medicine  in  our  day 
seems  threatened  with  being  cast  too  deeply  in  the  shade,  both  in  its  life 
and  its  literature,  by  the  subordinate  branches.  It  seems  here  and  there 
to  be  forgotten  that  medicine  is  the  alma  mater,  that  from  it  all  the  sub- 
ordinate branches  derived  their  origin,  that  the  latter  without  medicine 
are  incapable  of  any  permanent  growth.  It  seems  to  be  entirely  forgotten 
that  in  the  department  of  medicine  is  treated  the  greatest  part  of  the 
questions  which  occupy  our  care  and  our  thoughts  daily  and  hourly  at  the 
bedside.  Medicine  is  not  a  part  of  the  science  of  healing,  it  is  the  very 
heart  of  that  science,  and  this  heart  should  not  be  hidden  and  covered  up 
by  simple  outworks.  German  medicine  too  has  a  right  to  a  special 
representation,  for  it  stands  upon  its  own  feet.  It  is  independent,  and 
therefore  self-conscious  ;  it  does  not  sail  in  the  navigable  waters  of 
foreign  nations.  It  was  an  error,  weighty  and  pregnant  with  disaster  to 
German  medicine,  when  Rokitansky  in  184b'  expressed  the  conviction  that 
pathological  anatomy  must  be  the    foundation    not  only  of   professional 

science  but  also  of  professional  treatment Therapeutics  needs  for 

us  ph}-sicians  a  special  study,  for  it  is  the  end  and  object  of  our  proper 
labor"  (Frerichs). 

Frerichs  was  born  in  Aurich  and  studied  from  1838  in  Gottingen  and  Berlin 
under  Schoenlein  and  Dieffenbach.  In  1842  he  settled  down  to  practice  in  his  native 
city,  but  in  the  following;  year  went  again  to  Prague  and  Vienna,  and  in  1846  to 
France,  Holland  and  Belgium,  and  finally  settled  in  Gottingen  as  a  privatdocent.  In 
1850  he  was  called  to  Kiel,  served  as  a  physician  in  the  Schleswig-Holstein  war,  went 
then  in  1851  to  Breslau  as  a  professor,  and  in  1859  became  Schoenlein's  successor  in 
Berlin.  His  call  to  Breslau  was  due  to  the  recommendation  of  Stromeyer,  and  he 
was  the  first  professor  in  Breslau  to  employ  the  German  language  in  his  lectures 
(1851).  His  chief  works  are:  "Klinik  der  Leberkrankheiten ",  1859-1862,  which 
received  the  Monthyon  prize  of  the  Paris  Academic;  "  Bright'sehe  Nierenkrankheit 
und  deren  Behandlung",  1881;  "  Ueber  die  mensehliche  Galle",  1845;  Ueber  die 
chemische  Zusammensetzung  der  Galle",  1841;  "  Ueber  Staphylom  der  Hornhaut", 
1847,  etc.,  etc.  in  Journals.  In  Wagner's  ''Handworterbuch  der  Physiologie "  he 
wrote  the  article  on  "Digestion".  "Ueber  Diabetes"  was  his  last  work  and 
was  never  finished.  —  As  a  practitioner  Frerichs  was  very  popular,  and  acquired  a 
fortune  of  millions. 

Under  the  title  of 

o.  Seminalism  or  Seminal  Vitalism, 

the  exceedingly  diligent,  versatile  and  eloquent  professor  E.  Bouchut  of 
Paris  has  recently  published  a  theory  which  advances  the  claim  that  it 
does  not  leave  out  of  view  the  benefit  of  the  sick,  for  whom  (?)  systems 
of  medicine  are  created  ;  indeed,  that  it  grants  nothing  to  hypothesis,  but 
everything  to  observation.  It  is  at  all  events  a  characteristic  fact  that 
this  newest  French  theory  is  again  a  vitalistic  theory,  so  that  it  seems  as 
if  vitalism  alone  was  privileged  in  France,  since  the  French  have  of  them- 
selves   brought   forward   scarcely    any   other   than    vitalistic   theories,   or 


-  997  — 

adopted  them  in  a  modified  form  alwa3rs  from  other  people.  Thus  the}' 
followed  Paracelsus,  the  Iati*o-chemists,  in  a  less  degree  the  Iatro-mechanics 
and  others.  Bordeu  and  Barthez  in  the  last  century  created  the  first 
French  theoiy,  which  was,  as  we  have  seen,  a  vitalistic  theory.  This 
theory  was  followed  by  Bichat,  from  whom  Bouchut,  as  a  matter  of  fact, 
borrowed  much  of  his  S}-stem.  The  doctrines  of  Broussais  stand  in  close 
relation  at  least  to  vitalism. 

Let  us  see  how  far  the  above  programme,  surprising  for  a  theory,  is 
carried  out.     Bouchut  teaches  : 

Beasts  have  an  intelligence  of  instinct,  man  that  of  abstraction. 
No  beast  oversteps  the  limits  of  animal  thought,  which  is  separated  by 
an  abyss  from  the  productive  thought  of  man.  This  division  of  Moquin 
Tandon  and  de  Quatrefages,  instituted  on  the  assumption  of  the  four 
kingdoms  of  nature  —  the  mineral,  vegetable,  animal  and  the  kingdom  of 
man  —  is  a  justifiable  one. 

"  Either  there  are  simply  differences  in  grade  between  minerals, 
vegetables,  beasts  and  man  (who,  according  to  the  realistic  theory  of 
Lamarck  and  Darwin,  is  merel}'  an  improved  ape),  or  the  four  kingdoms 
are  separated  by  impassable  barriers.  In  the  first  case  man  is  the  highest 
of  the  apes  :  in  the  second,  the  abyss  of  the  intellect  separates  him  from 
the  beast.     Man,  however,   does  not  change  his   constitution.     To  this  is 

added  the  moral,  intellectual  and   industrial  perfectibilit}'  of  man 

from  the  stone  age  down  through  the  iron  age  to  the  present  day 

Is  that  animal  instinct  or  ever  changing  fancy,  which  springs  from  the 
love  of  the  useful,  the  good  and  the  beautiful  ?  The  beautiful,  the  good 
and  the  true  in  the  foundation  of  human  consciousness,  and  with  these 
ideas  those  of  a  metaphysical  cause  of  the  harmony  of  the  worlds  under 
one  form  or  another,  this  it  is,  which  Quatrefages  has  called  religiousness." 

There  is  also  a  proper  kingdom  of  man  in  accordance  with  his  spiritual 
nature.  On  the  other  hand,  by  his  physical  constitution,  "through  the 
vital  or  seminal  force,  which  imparts  to  his  germ  the  specific,  individual 
impulse  through  the  'impressibilit}-'  of  all  his  molecular  elements,  through 
the  condition  of  the  living  humors  from  which  he  originates,  and  through 
the  conformation  of  his  solid  parts,  he  approximates  to  animality." 

Through  the  vital  or  seminal  force  these  molecular  elements  com- 
posing the  organs  and  tissues  feel  —  the  first  expression  of  life,  which 
begins  without  definite  structure,  without  nerves  and  without  contractile 
fibres  —  in  their  way,  and  move,  in  order  to  form  the  parts,  in  which 
through  their  own  determination  they  must  take  their  place.  Their 
attributes  are  distinct  from  the  organization  which  they  are  called  upon 
to  create.  They  are  the  attributes  of  life,  not  those  of  a  living  being. 
They  are  called  :  Impressibility,  i.  e.  sensibility  without  nerves  ;  Auto- 
cinesis,  i.  e.  motion  without  definite,  contractile  fibres,  and  Promorphosis, 
or  foreknowledge  of  the  organic  forms  to  be  created.  Among  them  im- 
pressibilit}-  assumes  the  first  rank.     Upon  the  impressibilit}-  of  the  seminal 


—  998  — 

or  vital  force  life  is  dependent.  This  same  force  causes  life  in  beings 
which  have  no  nerves,  like  the  infusoria,  and  maintains  it  in  the  ana- 
tomical, nerveless  elements  of  the  tissues,  of  the  blood,  of  parts  in  which 
the  nerves  have  been  divided,  and  finally  even  after  death  in  certain  mo- 
lecular elements,  which  on  acccount  of  this  impressibility  continue  to  live. 

Impression  and  reaction  are  the  first  and  last  expressions  of  life,  the}' 
condition  the  latter,  and  when  the}-  cease  life  also  ends. 

"  Diseases  are  changed  impressions,  that  is  true,  and  upon  this  aphor- 
ism is  based  the  medical  doctrine  to  which  for  several  years  I  have  owned 
allegiance"  says  Bouchut,  though  without  the  slightest  proof  that  he  here 
makes  no  concessions  to  hypothesis,  as  he  pretends.  The  doctrine  is  not 
even  a  genuine  hypothesis,  but  an  entirely  arbitrary  assumption.  It  is 
also  distinguished  from  Sensitism,  according  to  Bouchut,  by  the  fact  that 
it  asserts  sensibility  without  nerves  —  certainly  something  new  for  the 
present  day  —  and  approximates  closely  to  the  theory  of  Glisson  and 
Bichat  of  an  insensible  or  unconscious  sensibility.  It  represents  the 
application  of  the  fact  (?)  of  a  seminal  force  to  physiology  and  pathology, 
to  that  which  in  the  living  molecules  produces  sensibility  without  nerves. 
This  is  ''Seminalism"  which,  as  we  see,  amounts  to  a  new  word. 

By  the  fecundation  of  the  ovum  the  unconscious  sensibility*  of  the 
molecular  elements  is  created  with  the  aid  of  the  male  vital  force,  which, 
known  of  all  men,  is  deposited  as  something  substantial  in  the  semen, 
and  meets  that  of  the  female  ovum.  This  sensibility  unites  the  elements 
with  each  other  and  groups  them  in  definite  form,  through  a  vital  affinity, 
necessary  for  the  configuration  of  the  tissues  and  organs.  "  Without 
this  obscure  characteristic  that  the}*  —  the  elements  —  feel,  the}*  could 
neither  unite  by  choice,  nor  combine  in  the  order  required  by  the  life  of 
the  species."  If,  however,  the  unconscious  sensibility  exists  only  in  part 
and  is  but  partially  developed,  the  development  of  a  new  being  in  the 
ovum  at  the  place  where  this  deficiency  exists  is  imperfect,  an  organ  drops 
out  in  this  place  or  is  modified  in  form,  and  thus  deformities  arise.  If 
the  unconscious  sensibility  is  diseased  or  morbidly  disposed,  so  also  are 
the  molecular  movements  of  the  ovum,  and  from  the  grouping  of  the 
elements  thus  arising  the  preparation  for  innate  or  hereditary  diseases  in 
the  future  germ  originates.  To  the  special  individual  character  of  the 
unconscious  sensibility,  generated  in  the  ovum  by  the  vital  force,  must, 
however,  be  ascribed  that  special  affinity  —  a  genuine  physiological  and  a 
specific  affinity  —  of  the  ultimate  anatomical  elements,  from  which  spring 
the  differences  in  individuals  of  the  same  species  and  race,  the  varieties, 
the  similarity  to  father  and  mother,  the  great  or  little  growth,  the  color 
of  the  hair  and  beard,  longevity,  the  idiosyncrasies  etc.  All  this  is  mod- 
ified by  sexual  intercourse,  which  mingles  two  different  seminal  forces,  and 
combines  them  in  such  a  way  that  the  impressibility  of  the  new  being  is 
produced.  It  is  also  modified  by  climate,  which  weakens  the  seminal 
forces;    by  custom  ;    by  civilization.  —  In  the  body  of  the  adult  the  un- 


—  999  — 

conscious  sensibility  is  found  in  parts  which  have  no  nerves,  and  in  the 
anatomical  elements  of  the  fluids  and  tissues  which  are  uninterruptedly 
renewed  ;  but  here  it  is  of  less  importance  than  in  the  ovum  and  the 
embryo.  It  acts  now  together  with  the  unconscious  sensibility  of  the 
sympathetic  nerves,  which  comes  from  it,  and  with  the  conscious  sensi- 
bility of  the  ordinary  nerves.  It  occasions  the  generation  and  the  contin- 
uance of  the  constituent  anatomical  elements,  which  are  directed  by  the 
vital  affinity.  The  second  by  mutual  and  general  sympathy  occasions 
the  consensus  among  the  tissues,  and  the  third  finally  brings  about  the 
consciousness  of  the  agreeable  or  dangerous  relations  of  the  individual 
to  the  outer  world.  "  If  the  case  stands  as  these  considerations  and  ex- 
perience prove"  (though  Bouchut  fails  to  give  us  an}'  actual  proof),  "every- 
one will  understand  that  the  metamorphosis  of  the  ovum  into  the  embryo 
and  of  the  embryo  into  the  adult  being,  and  then  the  maintenance  of  life 
through  its  activity  in  the  constituent  elements  and  its  influence  upon  the 
life  of  the  whole,  must  be  ascribed  to  the  presence  of  a  vital  force  and  its 
impressibility." 

The  vital  force  of  man  and  that  of  beasts  are  entirely  different  from 
each  other,  and  the  artificial  experiments  concerning  the  latter  prove 
nothing  as  regards  man.  The  vital  force  of  beasts  never  produces  a  man, 
and  conversely. 

The  separation  of  the  vital  force  from  the  organism  and  the  parts  of 
the  organism  is  a  mere  abstraction.  Since,  however,  this  force  effects  the 
formation  of  the  special  organs,  tissues  and  powers  of  the  organism,  as 
well  as  their  continual  nutrition  and  renewal,  we  must  also  take  into  ac- 
count the  special  peculiarities  of  the  tissues  and  organs  themselves. 

'-  The  bod}-  is  continually  changing,  that  is  true,  and  as  David  says, 
what  was  yesterday  is  not  the  same  as  what  is  to-day,  nor  that  which  will 
be  to-morrow." 

But  the  principle  of  physical  identity  remains  in  the  bod}*,  since  the 
constantly  renewed  mass  is  formed  in  exact  accordance  with  the  original 
plan  of  the  seminal  force  and  its  impressibility.  In  all  the  changes  of  his 
elements  man  is  a  being  identical  with  himself.  "Although  now  life  is 
one,  yet  as  regards  its  functions  it  is  manifold  ;  for  the  blood  causes  life, 
as  well  as  the  circulation  which  moves  the  blood  forward,  the  respiration 
which  vivifies  it,  the  innervation  which  imparts  to  the  tissues  their  tone 
and  necessary  contractility.  All  this  is  a  part  of  the  human  mechanism." 
If  the  respiration  ceases,  the  blood,  no  longer  supplied  with  oxygen,  be- 
comes an  actual  poison  to  the  organs,  and  death  ensues  in  accordance  with 
chemical  laws.  If  any  considerable  portion  of  the  brain  is  destroyed, 
muscular  contractility  is  extinguished,  and.  in  consequence  of  the  inactivity 
of  the  important  organs,  death  may  ensue  mechanically.  If  the  heart 
stands  still,  death  results  from  the  stopping  of  a  part  of  the  wheel-work 
of  the  human  mechanism,  which  we  must  therefore  study  in  order  to  allot 
to  the  vital  force  the  correct  rule  in  pathology. 


—  1000  — 

Bouchut's  idea,  expressed  in  1867,  "  Impression  and  reaction,  this  is 
the  most  abstract  formula  of  etiology,  for  diseases  are  nothing  but  altered 
impressions",  Virchow,  as  Bouchut  declares,  adopted.  In  this  point  the 
views  of  Virchow  certainly  coincide  prett}'  clearly  with  those  of  Bouchut, 
except  that  Virchow  falsely  assumes  three  varieties  of  irritation,  the 
functional,  nutritive  and  formative,  to  which  are  added  the  passive  pro- 
cesses, since  functional  and  nutritive  irritation  are  the  same.  While, 
however,  Virchow  takes  the  cell  as  the  starting-point  of  his  speculations, 
although  it  is  not  the  first  element,  Bouchut  selected  a  higher  stand-point, 
as  he  says,  when  he  adopted  the  disturbances  of  the  impressibility  of 
the  molecular  elements  or  of  the  vital  force  as  the  starting-point  of  his 
pathology  —  and  thus,  as  he  gives  us  to  understand,  made  no  concessions 
to  hypothesis. 

All  internal  and  external  causes  of  disease  modify. more  or  less  the 
vital  force  and  its  impressibility  in  the  fluids  or  at  some  point  of  the 
economy  ;  the}'  increase  or  weaken  that  impressibility  ;  and  from  these  two 
conditions  the  seeds  of  disease,  and  (when  the  impression  is  a  curative 
one)  the  means  of  its  cure  also,  originate. 

"  In  pathogeny  the  increase  of  the  impressibility  of  the  constituent 
elements  acts  upon  the  tissues  and  calls  forth,  according  to  its  nature, 
hyperemia,  inflammation  with  its  sero-fibrinous,  epithelial  or  purulent 
exudations,  certain  active  haemorrhages,  serous  or  gaseous  evacuations, 
hypertrophies  of  the  elements  and  various  tissues  which  form  the  skeleton 
of  the  organs,  the  pyrexiae,  with  their  alterations  in  the  humors,  which  on 
their  part  become  causes  of  disease"  etc. 

Together  with  such  disturbances  arise  the  sympathetic  reflexes,  such 
as  :  fever,  lassitude,  want  of  appetite,  gastric  impurities,  with  or  without 
vomiting  etc. 

Through  this  increase  of  the  impressibility,  and  in  accordance  with 
the  organ  affected,  arise  the  functional  disturbances,  the  plrysico-cheinical 
effects  of  gravity,  of  endosmotic  absorption,  of  erosion  of  the  tissues,  to 
wit :  almost  always  pain,  due  to  the  participation  in  the  process  of  the 
ordinary  nerves  ;  in  the  brain  and  the  meninges,  delirium,  somnolence, 
vomiting,  slowing  of  the  pulse,  convulsions  and  paralysis  ;  in  the  pharynx, 
dysphagia  ;  in  the  bronchia  and  lungs,  cough,  the  various  kinds  of  ex- 
pectoration and  dyspnoea ;  in  the  intestines,  diarrhoea,  dyspepsia  and 
boulimia  ;  in  the  kidneys,  changes  in  the  urinary  secretion  ;  in  the  vessels, 
embolisms  with  their  results,  the  absorption  of  the  more  or  less  poisonous 
morbid  matters  of  wounds  ;  cramps  in  the  hypersemic  or  anaemic  nerves  ; 
in  fevers,  the  alterations  in  the  humors,  which  produce  other  secondary 
disturbances  and  reproduce  the  germ  of  the  evil,  and  finally  the  physical 
effects  of  gravity,  of  absorption  through  endosmosis,  of  obstruction  by 
morbid  matters,  of  erosion  through  the  acrid  character  of  the  evacuations  etc. 

From  diminution  of  the  impressibility  arise  :  atroplrv,  softening,  fatty 
degeneration  of  the  elements  and  tissues,  certain  passive  haemorrhages, 


—  1001  — 

certain  atonic  congestions,  which  are  likewise  accompanied  by  sympathetic 
reflex  phenomena,  all  attended  with  local  and  more  or  less  pronounced 
disturbances  of  function. 

The  local  diseases  arising  from  an  increase  or  diminution  of  the  im- 
pressibility become  generalized  by  endosmotic  or  capillary  absorption, 
since  the}'  call  forth  an  alteration  in  the  blood,  or,  while  they  remain  local 
indeed,  they  yet,  through  the  medium  of  the  reflex  action  of  the  great 
sympathetic  nerve  and  directly  through  the  ordinary  nerves,  affect  the 
whole  economy  of  the  body. 

All  this  is  demonstrated  by  experience  and  observation. 

"  I  will  accept  as  experience  the  new  theory  of  pus-formation  set  forth 
by  Virchow's  pupil  Cohnheim,  and  so  contradictory  to  that  of  his  master." 
According  to  this  theory  a  suppuration  arises  in  irritated  but  nerveless 
structures  through  a  diapedesis  of  the  white  blood-corpuscles.  By  means 
of  amoeboid  movements,  i.  e.  movements  originating  without  known 
contractile  organs,  the  leucocytes  press  between  the  epithelial  lamellae 
and  form  a  focus  of  suppuration,  "whose  epithelial  cells  and  their  elements 
have  felt  something  which  has  not  reached  the  consciousness  of  the  sub- 
ject. Yet  the  leucocytes  themselves,  since  they  change  form  and  place, 
have  manifested  a  sensibility  unperceived  by  us,  and  this  suffices  to 
demonstrate  experimentally  the  fact  that  the  impressibility  called  into 
play  is,  in  some  way  or  another,  the  cause  of  the  inflammation  of  the 
tissue"  —  a  conclusion  which  certainly  lacks  nothing  in  boldness,  while, 
by  a  rash  as  well  as  surprising  turn  which  seems  characteristic  of  Bouchut, 
it  skips  over  a  whole  row  of  intermediate  steps  otherwise  necessary  to  form 
•a  logical  method. 

Bouchut  now  enumerates  the  individual  diseases  originating  in  altera- 
tions in  the  impressibilitj'. 

From  an  excessive  impressibility  of  the  vital  force  arise  : 
"  Meningitis,  cerebritis,  coryza,  otitis,  diseases  of  the  eyes,  pharyngitis,  tonsillitis, 
laryngitis,  bronchitis,  pneumonitis,  pleuritis,  endopericarditis,  gastritis,  enteritis, 
dysenter}r,  acute  hepatitis  and  nephritis,  adenitis,  phlebitis,  rose,  gout,  osteochondritis, 
periostitis  and  all  primitive  inflammations  of  the  various  tissues;  all  active  conges- 
tions of  the  lungs,  liver,  kidneys,  brain  and  spleen  ;  globular  plethora,  haemitis;  active 
hasmorrhages  of  the  brain  without  primaiy  injury  of  the  capillaries;  certain 
haamorrhages  from  the  nose,  lungs,  intestines,  kidnej'S  etc.;  certain  catarrhs  of  the 
nose,  bronchia,  stomach  and  intestine;  the  flatulence  of  hysteria  and  inflammatory 
dyspepsia;  the  hypertrophies  of  the  cellular  and  fibrous  tissues,  of  the  epithelial, 
adipose,  glandular,  pigmentary,  cutaneous  or  mucous  tissues  etc.;  certain  acute 
diseases  of  the  skin  dependent  upon  a  predisposition  of  the  vital  force ;  eruptive 
fevers,  from  which  the  exanthem  ordinarily  springs  etc.;  diabetes,  which  irritation 
•of  the  fourth  ventricle  calls  forth,  as  well  as  contusions  of  the  occiput  and  senile 
weakness." 

From  diminution  of  the  impressibility  arise  : 

"  Grave  jaundice,  albuminous  nephritis,  amyloid  liver,  fatty  degeneration  of  the 
■constituent  elements,  the  so-called  caseous,  ulcerative  inflammations  of  the  lungs, 
fatty  adenitis,  phymatoid  troubles  ;  all  tuberculous  affections  of  the  meninges,  the 


—  1002  — 

brain,  the  pleura,  lungs,  liver,  intestine,  peritoneum,  the  bronchial  or  mesenteric 
glands,  the  bones  etc  ;  certain  passive  congestions  of  the  lungs  in  fevers  and  severe 
diseases,  or  resulting  from  the  acute  stage  of  bronchopneumonia ;  certain  passive 
haemorrhages  depending  upon  destruction  of  the  blood  in  fevers  or  in  scurvy,  or 
resulting  from  fatty  degeneration  of  the  capillaries  and  vessels,  or  obstacles  in  the 
vascular  apparatus  occasioned  by  ulcerations  of  the  vascular  tissue  at  a  certain  point, 
etc.;  softening  of  the  tissues,  especially  of  the  bones  caused  by  rhachitis,  softening  of 
the  brain,  genuine  molecular  gangrene,  which  prepares  the  way  for  cerebral 
haemorrhages  and  paralyses,  etc.;  partial  or  general  atrophy  of  the  constituent 
elements  of  the  tissues,  atrophj-  of  the  organs  or  of  the  morbid  products  of  by-gone, 
chronic  inflammations  ;  catarrhal  discharges  in  chronic  inflammations  of  the  mucous 
membranes,  certain  glandular  discharges  and  the  chronic  effusions  of  the  serous 
membranes;  certain  diseases  of  the  blood  characterized  by  an  excess  of  its  watery 
element,  diminution  of  the  number  of  its  red  corpuscles,  increase  of  the  white  cor- 
puscles, decrease  in  the  proportion  of  albumen,  all  of  which  occasion  congestive  and 
ischsemic  neuroses,  certain  forms  of  hysteria  and  hypochondria,  and  finally  all  forms 
of  nervousness." 

Diseases  caused  by  an  excessive  impressibility  of  the  vital  force, 
followed  by  a  diminution  of  this  impressibility  are  : 

Caseous  pneumonia  after  ordinary  inflammation,  chronic  congestion  of  the  liver 
after  acute  inflammation,  obstruction  alter  inflammation  of  the  intestine,  atrophy 
of  the  kidneys  after  nephritis  etc.;  gall-stones,  salivary  concretions,  renal  calculi; 
exudations  which  give  rise  to  adhesions,  obstructions  of  the  veins  after  phlebitis, 
embolisms  after  endocarditis  etc.;  anaemia,  hydrsemia,  leucocytosis,  gout,  scrofula, 
syphilis  etc. 

From  anomalies  of  the  impressibility  arise  the  mental  or  moral 
diseases. 

Therapeutic  actions  are  merely  altered  impressions.  Remedies  excite 
or  diminish  the  impressibility  of  the  elements  or  the  tissues,  and  in  this 
way  the  vital  force  produces  reaction  and  reflex  acts,  both  of  which  give 
rise  to  curative  effects. 

Under  the  title  of  remedies  which  alter  the  impressibility  Bouchut  employs 
alcohol,  wine,  iron,  manganese,  cinchona,  arsenic  in  small  doses,  the  bitter,  stimu- 
lating and  aromatic  etc.  remedies,  which  show  themselves  most  useful  in  the 
cachexias,  in  herpetic,  cancerous  and  tuberculous  lesions,  and  in  certain  alterations 
of  the  humors  in  fevers.  Cold  water,  sea  and  river  bathing  for  a  short  period, 
exercise,  amusements,  travelling,  baths  in  compressed  or  rarefied  air,  inhalations  ol 
oxygen  and  an  exclusive  meat  diet  belong  also  in  this  cla^s. 

Stimulants,  increasing  the  diminished  impressibility  are;  cathartics  and  especi- 
ally the  salts  of  soda  in  certain  mucous  fluxes  or  gaseous  formations  in  the  intestine  ; 
then  the  carminatives  with  their  odoriferous  principle  and  the  ethereal  oils,  which 
cure  certain  forms  of  diarrhoea  or  flatulence.  The  same  indications  are  fulfilled  in 
catarrhal  conjunctivitis,  mucous  discharges  of  the  urethra  and  vagina  etc.  by  nitrate 
of  silver  and  the  milder  caustics,  and  by  the  balsamic  remedies  in  catarrhal  troubles 
of  the  bladder,  the  bronchia  and  the  urethra. 

Local  excitation  of  the  impressibility  is  produced  by  the  revulsive  plasters  in 
certain  atonic  dropsies,  by  inunctions  of  iodine,  as  well  as  by  nitrate  of  silver  in  the 
eye,  warm  alcohol  in  the  tunica  vaginalis  testis  etc. 

The  weakened  impressibility  is  excited  in  the  following  "beautiful"  example: 
"  We  have  before   as  a  beautiful  case  of  adynamic  scarlet  fever,   almost  fatal  and 


—  1003  — 

accompanied  with  delirium.  We  now  endeavor  to  diminish  the  impressibility  by  cold 
ablutions,  while  the  temperature  is  40-41  C,  the  pulse  up  to  160  and  the  eruption 
crimson  in  color.  In  two  hours  the  temperature  becomes  lower,  the  pulse  is  slower 
and  the  fading  eruption  pursues  its  course  to  convalescence." 

Leeches  and  venesection  diminish  the  impressibility.  Digitalis,  veratria  and 
bryonia  prove  similarly  curative  in  acute  internal  inflammations. 

The  impressibility  of  the  constituent  elements  themselves,  however,  is  diminished 
by  antimony,  emetics,  mercury  and  iodide  of  potassium. 

Emetics  employed  to  remove  a  foreign  body  from  the  larynx  and  bronchia, 
cathartics  administered  to  remove  fa?cal  collections  impacted  in  the  intestine,  riding 
and  artificial  respiration  after  the  cure  of  pleuritis,  and  similar  procedures  are 
impressions  upon  the  vital  force  called  forth  by  the  physician  for  the  purpose  of 
curing  his  patient. 

"  Finally  we  must  place  in  this  class  the  chemical  and  surgical  means  employed 
by  the  physician  to  destroy  worms  or  vegetable  parasites,  to  dissolve  renal  and 
vesical  calculi  and  gall-stones  etc.  The  disturbances  of  the  impressibility  were  con- 
cerned in  the  alterations  of  the  humors  and  organs,  in  the  changes  which  the  calculi 
etc.  occasion,  and  which  became  a  source  of  danger  to  the  whole  of  the  viscera.  All 
efforts,  however,  to  cure  them  by  dynamic  means  would  be  ridiculous.  The  treat- 
ment here  is  the  business  of  chemistry  and  surgerj'." 

The  preceding  theory,  chronologically  the  last  but  one  of  our  century 
—  it  was  published  in  1873  —  so  far  as  general  medicine  is  concerned, 
manifestly,  in  abstraction  of  its  premises  and  the  boldness  of  its  conclu- 
sions, yields  to  none  of  its  predecessors  —  proof  enough  that  even  in  exact 
France  Bichat's  programme  of  transforming  medicine  into  a  natural  science 
is  far  from  accomplished. 

p.   The  Modern  Parasitic  or  Germ  Theory.1 

The  birth  of  the  idea  of  the  parasitic  origin  of  diseases  very  short]}* 
after  the  invention  of  the  microscope  we  have  alreacly  had  occasion  to 
notice,  and  we  have  recorded2  in  their  proper  place  the  older  facts  and 
views  upon  this  subject.  We  will  here,  however,  emphasize  once  more 
the  fact  that  at  that  time  microscopic  animals  (animalcnla,  subsequently 
called  infusoria)  were  regarded  as  the  agents  of  infection,  while  at  the 
present  day  the  lowest  order  of  plants  is  believed  to  be  the  infecting 
material. 

The  development  of  the  modern  parasitic  theory  stands  in  the  closest 
relation  with  that  of  the  doctrines  of  the  generatio  aequivoca,  putrefaction 

1.  Consult  C.  Gussenbauer :    "Septhamie,    Pyohamie   mid   Pyo-Septhaniie  ",   18S2;. 

E.  Zieglev  "Lehrbuch  der  allg.  path.  Anatomic",  4th  ed.,  1886;  Fr.  Loefner 
"Vorlesungen  iiber  die  geschichtliche  Entwicklung  der  Lehre  von  den  Bacte- 
rien",  1887;  Naegeli  "Die  niederen  Pilze",  1877;  G.  Marpinann  ''Die  Spalt- 
pilze"  etc.,  1884  ;  the  reviews  in  Canstatt  and  Schmidt's  "  Jahresberichten  "  for 
the  last  few  years  etc. 

2.  See  under  Leeuwenhoeck,  Kircher,  Lange  etc.,  and  also  O.  F.  Miiller.    The  latter 

introduced  the  terms,  vibrio,  bacillus,  nionas,  termo.  Those  of  bacterium  and 
spiroclneta  we  owe  to  Ehrenberg.  Herm.  Hoffmann,  professor  of  botany  in 
Giessen,  distinguished  the  bacteria  from  the  micrococci  even  in  name,  in  oppo 
sition  to  Hallier,  who  regarded  bacteria  as  grades  of  development  of  micrococci. 


—  1004  — 

and  fermentation,  miasm  and  contagion,  in  general  of  the  causes  of  dis- 
ease included  in  experimental  pathology.  We  can  sketch  here  only  the 
chief  features  of  this  development,  and,  indeed,  these  only  so  far  as  the 
questions  seem  to  be  tolerably  well  settled. 

Ehrenberg  still  regarded  the  "infusoria"  (1838)  as  animals.  On  the 
other  hand,  Felix  Dujardin  (1841)  had  some  doubts  as  to  the  correctness 
of  this  idea,  and  Maximilian  Perty,  as  earby  as  1852,  affirmed  that  most 
of  the  forms  classified  as  infusoria  might  with  equal  justice  be  assigned 
to  the  vegetable  kingdom.  Naegeli  then  assigned  them  to  this  kingdom 
(schizomyceten),  and  Ferd.  Jul.  Cohn  completed  the  proof  of  their  vege- 
table nature  and  perfected  the  classification  of  the  lowest  forms  of  vege- 
table life. 

In  the  development  of  the  germ  theory  of  diseases  the  French  and 
Germans  were  the  most  prominent  workers,  though  the  English,  Americans, 
Italians  etc.  also  took  a  share  in  the  discussion.  The  investigation  began 
in  the  twenties,  but  assumed  its  present  direction  in  the  third  and  fourth 
decennia  of  the  present  century. 

The  experiments  of  Haller  (the  creator  of  experimental  pathology) 
were  renewed  by  M.  H.  B.  Gaspard  (1788-1871)  in  1822.  Gaspard,  how- 
ever, injected  into  the  veins  of  animals  not  simply  putrescent  matters,  but 
also  the  blood  of  other  animals  suffering  from  the  effects  of  such  injec- 
tions. —  A  special  impulse  to  the  theory  of  parasitism  was  given,  how- 
ever, by  Bassi's  discovery  (1835)  of  the  cause  of  the  disease  of  the  silk- 
worm, quickly  succeeded  by  the  proof  of  the  existence  of  both  animal 
and  vegetable  exciters  of  disease.  Schoenlein  demonstrated  (1839)  the 
fungus  of  favus,  and  Bemak  subsequently  produced  the  disease  experi- 
mentall}-.  Donne  advanced  the  view  (1837)  that  "vibriones"  were  the 
cause  of  syphilis.  Benucci  (1834)  again  taught  us  how  to  find  the  itch- 
mite,  and  Kramer  showed  the  male  animal,  though  Hebra  was  the  earliest 
unconditional  defender  of  Wichmann's  idea  of  the  etiolog}'  of  the  disease. 
J.  Vogel  discovered  the  oidium  albicans  (1840),  H.  IT.  S.  and  John  Good- 
sir  the  sarcina  ventriculi  (1841),  C.  F.  Eichstedt  the  fungus  of  pityriasis 
versicolor,  Malmsten  and  Grub}*  that  of  herpes  tondens  etc.  The  weight- 
iest influence  upon  the  development  of  the  germ  theory  was  exercised, 
however,  by  Davaine's  discovery  of  the  bacillus  anthracis  (Communica- 
tion faite  a  la  Soci^te  de  Biologie,  1850)  and  his  experiments  in  inocula- 
tion, and  the  investigations  of  Pollender  and  Branell,  published  at  a  later 
period.1 

The  modern  theory  of  the  production  of  diseases  through  infection 
found  further  powerful  support  in  the  investigations  relative  to  the  essence 
of  the  processes  of  fermentation  and  putrefaction,  with  which  the  pro- 
cesses of  disease  were  at  once  compared.  Cagniard  Latour  and  Schwann 
in  the  same  year  (1837)  proved  that  the  yeast  cells,  which  were  known 
even  to  Leeuwenhoeck,  were  actual  vegetable  forms,  capable  of  growth, 

1.   They  had,  however,  observed  the  bacillus  anthracis  in  1849.     (H.) 


—  1005  — 

and  Luclwig  Boehra,  a  year  later,  showed  their  existence  in  the  stools  of 
cholera  —  an  accidental  discovery  which  led  to  the  conjecture  that  the 
process  of  fermentation  was  also  concerned  in  the  causation  of  that  dis- 
ease. One  year  earlier  (1836)  Franz  Schulze  produced  the  far  m6re  im- 
portant proof  that  the  fermentation  of  fluids  could  occur  only  in  the 
presence  of  extremely  minute  vegetable  organisms,  which  existed  every- 
where in  the  air ;  that  when  air  was  entirely  excluded,  or  admitted  only 
through  sulphuric  acid,  or  after  preceding  heating  or  filtration  through 
pure  cotton  (H.  Schroeder  and  Th.  von  Dusch),1  the  process  of  fermenta- 
tion did  not  take  place.  —  Chevreul  and  Pasteur  then  proved  that  animal 
solids  also  continued  free  from  decomposition  and  putrefaction  when 
protected  from  the  access  of  germs.  That  in  those  cases,  however,  where, 
in  spite  of  all  precautions  to  prevent  the  entrance  of  germs,  fermentation 
and  putrefaction  still  occurred,  there  existed  "Dauerformen"  (permanent 
forms),  destructible  only  by  moist  heat  (steam),  was  shown  by  Jul.  Ferd. 
Cohn.  Pasteur  then  demonstrated  (1857  and  later)  that  fermentation  and 
putrefaction  were  caused,  not  b}'  chemical  "ferments"  (Liebig),  but  simply 
by  the  vital  processes  of  lower  organisms.  The  latter  he  divided  into 
those  which  work  only  in  the  presence  of  ox}-gen  —  aerobes  —  and  do  not 
subsequent!}'  die,  and  others  which  work  without  oxygen  —  anaerobes  — 
and  after  action  perish.  Pasteur  also  assumed  specific  forms  of  organisms 
for  each  variety  of  fermentation  and  putrefaction,  and  thus  a  great  stride 
forward  was  made.  —  Hallier  then  studied  in  "cultures"  the  development 
of  the  lower  fungi,  but  came  to  the  erroneous  conclusion  that  his  "mic- 
rococcus" was  the  primitive  form  of  all  the  different  varieties.  The  motion- 
less organisms  he  classed  among  the  fungi  ;  those  possessed  of  motion, 
among  the  algre.  This  view  was  opposed  by  Herm.  Hoffmann  and  de 
Bary,  who  demonstrated  that  a  metamorphosis  of  the  micrococcus  into 
bacteria  could  not  take  place.  Through  the  influence  of  Hallier,  however, 
the  "micrococcus"  was  long  regarded  as  the  primitive  form  of  the  material 
of  contagion.  With  this  was  united  the  question  whether  these  organisms 
occasioned  diseases  through  the  withdrawal  of  nutriment  from  the  infected 
bodies,  or  through  the  decompositions  which  they  excited  in  those  bodies. 
Another  question  arose  as  to  whether  the  morbific  power  of  these  organisms 
resided  in  their  formed  elements  or  in  their  fluid  constituents,  that  is  in 
which  of  the  two  the  infectious  principle  inhered.  This  question  was 
raised  by  Chauveau  in  1868. 

By  the  investigations  thus  sketched,  and  particularly  through  the 
teachings  of  Hallier,  the  theory  of  a  contagium  vivum,  for  which  Henle  as 
early  as  1821  had  labored  as  an  earnest  pioneer,  though  it  remained  still 
unproven,  became  current  in  medicine.  In  German}"  Klebs  (now  pro- 
fessor in  Zurich)  became  the  prominent  champion  of  this  theory.     In  his 

1.  Hermann  Hoffmann  subsequently  proved  that  fermentation  did  not  occur  after  a 
fluid  had  been  boiled,  provided  only  that  the  neck  of  the  retort  was  bent  down  so 
that  nothing  could  drop  from  the  air  into  it. 


—  1006  — 

investigations  (Ueber  Septicaemia  and  Pyaemia  ;  Beitriige  zur  path.  Anat. 
der  Schusswunden,  1872)  lie  still  stood  squarely  upon  the  principles  of 
Hallier,  designating  his  "microsporon  septicum"  as  the  cause  of  wound- 
diseases,  and  declaring  that  this  must  be  introduced  into  the  bod\-  from 
without.  By  means  of  "fractional  cultures''  he  also  endeavored  to  exhibit 
the  pure  germ.  Though  he  still  found  numerous  opponents,  he  excited 
active  investigation  into  the  specific  character  of  the  exciters  of  disease. 

The  first  complete  theory  on  this  subject,  a  theory  still  based  upon 
the  principles  of  Hallier,  was  brought  forward  by  Karl  Hueter  (1838-1882), 
Prof,  of  Surgery  in  Greifswald,  in  1873. 

According  to  Hueter,  all  diseases,  whether  internal  or  external,  depend  upon  the 
entrance  of  "Pilzmonaden  "  (fungoid  monads)  into  the  body.  Primary  and  second- 
ary wound  diseases  in  particular  depend,  not  upon  an  "irritant  in  chemical  solution, 
a  poison  originating  in  the  chemistry  of  putrescence",  but  for  the  most  part  upon 
"a  living  irritant,  represented  by  the  monads  as  the  exciters  of  putrefaction  and 
inflammation  (Monadamie,  diphtheritic  processes),  by  an  organic  irritant  (Monaden), 
a  poison  contained  in  the  most  essential  inflammatory  product  of  the  pns-corpuscles, 
i.  e.  the  monads  creep  into  the  pus-corpuscles,  infect  these  and  through  them  the 
blood  and  the  entire  organism"  etc. 

This  theory  has  now  become  antiquated,  but  at  the  period  when  it 
was  brought  forward  it  furnished  a  plausible  explanation,  not  only  of 
pathological  processes,  but  also  of  the  memorable  success  of  Lister  in  the 
treatment  of  wounds. 

The  views  of  Klebs  were  opposed  particularly  Lry  Billroth,  who 
declared  that  fungi  had  no  essential  importance  in  the  processes  of  decom- 
position and  disease  ;  that  they  existed  everywhere  in  the  air  and  in  water, 
and  did  not  develop  in  the  body  until  through  putrefaction  in  it  there 
arose  the  "ferment  of  putrefaction"  (Fiiulnisszymoid),  or  through  inflam- 
mation the  ''phlogistic  ferment"  (phlogistische  zymoid),  which  supplied 
favorable  feeding-grounds  for  the  "coccobacteria  septica".  Billroth  was 
also  an  opponent  of  the  specific  character  of  the  lower  organisms  as 
exciters  of  disease. 

Trie  pioneer  investigations  of  Herm.  Hoffmann,  J.  Schroeter  and  par- 
ticularly of  Colin,  prepared  the  way  for  the  downfall  of  Hallier's  prim- 
itive .  "micrococcus"  and  the  pathological  doctrines  based  directly  or 
indirectly  thereon.  By  cultivation  of  these  organisms  upon  various  solid 
and  nutritive  materials  (potatoes,  bread,  albumen  etc.)  they  demonstrated 
the  existence  of  specifically  different  fungi,  and  Colin  classified  them  and, 
in  accordance  with  their  action,  distinguished  between  saprogenous  and 
pathogenous  bacteria.  The  latter  formed  the  various  contagia,  and  a 
specifically  different  contagium  for  each  disease.  Colin  likewise  discovered 
the  form  of  fructification  (spores)  of  the  bacteria. 

The  experimental  proofs  of  Davaine  (and  particularly  Robert  Koch, 
who  demonstrated  the  development  of  bacteria  from  spores)  that  anthrax 
was  caused  by  the  bacillus  anthracis  and  by  this  alone,  aided  the  views 
now  current  to  secure  a  victoiy.     Koch  also   advanced  the  microscopic 


—  1007  — 

investigations  by  improvements  in  the  methods  of  staining  the  bacteria 
(establishing  the  color-reaction  as  diagnostic  of  definite  species  etc.)  and 
the  preparation  of  "pure  cultures",  and  demonstrated  that  in  the  living 
body  evidence  of  the  difference,  and  of  the  pathogenic  importance,  of  the 
various  fungi  was  best  obtained  by  inoculation. 

An  account  of  the  innumerable  questions  and  investigations  in  this 
department  of  modern  pathogenesis,  of  the  various  views  on  certain  ques- 
tions etc.,  does  not  fall  within  the  compass  of  our  brief  sketch.  Nor  are 
we  able  to  furnish  a  consistent  theor}-,  simply  because  such  an  one  does 
not  exist.  One  fact  alone  is  agreed  upon,  to  wit,  that  certain  of  the 
lower  fungi,  as  parasites  within  or  upon  the  body,  excite  diseases  (infec- 
tious diseases).  As  regards  the  modus  operandi  of  these  parasites  two 
main  theories  are  held.  According  to  one  theor}*,  these  parasites,  by 
their  development,  deprive  the  body  of  its  nutriment  and  endanger  life 
particularly  when,  thronging  in  the  blood,  they  deprive  this  of  the  oxygen 
necessary  for  existence.  According  to  the  other  theorjT,  they  threaten 
life  by  occasioning  decompositions  which  engender  putrid  poisons 
(ptomaines).  These  latter  poisons  were  first  isolated  b}r  P.  L.  Panum  in 
1856,  and  have  been  recently  specially  studied  by  Brieger  (Ueber  Ptomaine, 
Berlin,  1885-86).  They  act  differently  upon  bodies  according  to  the 
variety  of  the  alkaloidal  poison. 

Metschnikoff  regards  the  white  blood-corpuscles  as  antagonists  of 
these  parasites  (thus  explaining  the  cases  of  recovery  from  parasitic 
diseases),  and  in  this  point  of  view  calls  them  "phagocytes".  On  the 
other  hand  E.  Salmon  and  Theodore  Smith  (Transactions  of  the  Wash- 
ington Biological  Society,  Feb.  22d,  1886)  were  the  first  to  demonstrate 
that  sterilized  nutritive  solutions  or  germ-free  products  of  change  of 
matter  of  the  virulent  exciters  of  disease,  when  injected,  afford  protection. 
A.  Chauveau  as  early  as  1880  had  brought  forward  evidence  of  the  prob- 
ability of  this  fact,  and  Hans  Buchner  in  1879  admitted  the  possibility 
of  depriving  bacteria  of  their  virulence.  Pasteur,  however,  believes  he 
has  demonstrated  that  by  continued  cultures  (also  a  sort  of  bacillary 
Isopathy)  "  debilitated  "  germs  act  as  prophylactics  against  the  corre- 
sponding parasitic  diseases,  and  he  even  thinks  he  has  confirmed  this  by 
his  inoculations  against  hydrophobia  —  a  view,  at  all  events,  still  open  to 
doubt. 1 

Inasmuch  as,  according  to  Lotze,  we  cannot  foretell  the  future,  but 
merely  prepare  ourselves  for  it,  it  is  wisest  to  refrain  from  all  criticism  of 
the  fate  of  the  germ  theory,  although,  from  the  almost  universal  enthusiasm 
in  its  behalf  at  the  present  moment,  a  skepticism  based  upon  the  history 
of  the  past  disposes  one  to  doubt  its  permanence. 

The  chief  diseases   regarded  as  of  parasitic   origin    at  present  are  : 


1.  The  protective  inoculations  against  cholera  too  in  Spain  have  proven  very  weak, 
and  the  experiments  of  a  physician-  of  Odessa  have  resulted  equally  unsatis- 
factorily. 


—  1008  — 

anthrax  (Davaine,  1850)  ;  relapsing  fever  (Obermeier,  1873)  ;  gonorrhoea 
and  blenorrhcea  neonatorum  (Neisser,  1879)  ;  glanders  (Struck,  1882, 
LoefHer  and  Schiitz)  ;  syphilis  (Sigm.  Lustgarten,  1884)  ;  diphtheria 
(Oertel,  Letzerich,  Klebs)  ;  typhus  (Eberle,  Klebs)  ;  tuberculosis  (Koch, 
1882)  ;  cholera  (Koch,  1884)  ;  lepra  (Armauer-Hansen)  ;  actinomycosis 
(Bollinger  in  cattle,  1877;  Israel  in  man,  1884):  septicaemia  (Klebs); 
erysipelas  (Fehleisen)  ;  pneumonia  (Friedlander)  ;  malarial  fever  (Klebs, 
Tommasi-Crudeli,  Marchiafava);  malignant  oedema  (Koch);  tetanus  (Carle 
and  Rattone,  Nicolaier,  Roeschlaub  assumed  a  tetania  occasioned  b}' 
bacilli)  ;  cancer  (Scheuerlen  ;  priority  contested  by  Dr.  Gr.  Rappia  and 
Prof.  Domingo  Freire  of  Rio  Janeiro) ;  yellow  fever  (microbe  claimed  to 
have  been  discovered  by  Freire)  ;  dysentery  (bacillary  diphtheritis  of  the 
large  intestine) ;  cholera  nostras  (Finkler  and  Prior)  ;  scarlet  fever  (Coze 
and  Feltz,  '72)  ;  variola  and  vaccina  (Keber.  Zulzer,  Weigert,  Klebs); 
acute  yellow  atrophy  of  the  liver  (Klebs,  Waldeyer,  Eppinger);  endocarditis 
(Ziegler);  haemophilia  neonatorum  (Klebs,  Eppinger);  trachoma  (Sattler); 
keratitis  (Leber — aspergillus)  ;  ulcus  rodens  corneae  (Sattler)  ;  gonorrhoeal 
rheumatism  (Petrone,  Kammerer). 

If  the  bacterial  theon'  of  infection,  constantly  threatening  life  by 
such  numerous  pathogenic  varieties  of  infecting  organisms,  must  be  looked 
upon  as  a  gloomy  one,  the  anti-bacterial 

Phagocyte  Theory  of  Metschnikoff, 

professor  of  zoology  in  Odessa,1  is  adapted  to  make  one  feel  more  com- 
fortable, inasmuch  as  it  brings  into  view  the  possibility  of  an  antagonism 
to  these  infecting  organisms,  and  explains  the  method  of  nature's  cures. 
Metschnikoff  observed  that  the  wandering  cells  —  the  white  blood- 
corpuscles —  after  the  manner  of  amoebae,  surround,  hold  fast,  digest 
("devour",  hence  "phagocj'tes")  and  thus  render  harmless  the  bacteria 
which  have  entered  the  body.  His  observations  were  first  made  upon  the 
Daphniadae,  subsequently  upon  living  frogs  and  also  upon  warm-blooded 
animals.  In  monkeys  inoculated  with  the  spirilla  of  relapsing  fever, 
during  the  afebrile  interval  he  found  the  spirilla  absent  in  the  blood,  but 
enclosed  in  the  cells  of  the  spleen  and  "devoured"  by  the  latter,  so  that 
this  organ  is  to  be  regarded  as  the  proper  curative  agent  of  this  disease. 
(A  similar  action  probably  takes  place  in  all  infectious  diseases  accom- 
panied with  swelling  of  the  spleen,  and  thus  a  considerable  portion  of  the 
hitherto  unknown  function  of  this  organ  would  be  explained.)  The 
tubercle  bacilli  found  enclosed  in  cells  in  cases  of  tuberculosis  Metschnikoff 
also  declares  are  thus  rendered  harmless.  The  giant  cells,  however, 
originate  from  the  irritation  of  these  enclosed  bacilli.  In  these  typical 
giant-cells,  discovered  by  Paul  Langhans  (1848-1888),  the  bacilli,  accord- 
ing to  Metschnikoff,  are  less  readily  colored,  and  arc  also  (?)  half-dead. 
If  the  bacilli  are  entirely  "devoured"  by  the  phagocytes,  spontaneous  cure 

1.  Elias  Metschnikoff  now  resides  in  Paris. 


—  1009  — 

of  the  tuberculosis  occurs.     But  if  the  number  of  the  bacilli  is  too  great 
to  be  thus  devoured,  the  individual  perishes  of  the  disease. 

The  prophylactic  effects  of  inoculation  are  explained  on  the  theory 
that  by  means  of  this  operation  the  wandering  cells  are  prepared,  as  it- 
were,  for  subsequent  accidental  irruptions  of  similar  pathogenic  bacteria,, 
are  habituated  or  compelled  thereby  to  at  once  devour  such  organisms- 
when  they  enter  the  body  spontaneously,  and  thus  to  render  them  harm- 
less. Inoculation  would  thus  be  a  sort  of  training  or  education  of  the 
phagocytes. 

The  immunity  of  many  persons  from  infectious  diseases,  so  far  as 
it  is  not  effected  by  inoculations,  would  by  analogy  be  explained  on  the 
theory  that  with  such  individuals  the  phagocytes  are  from  the  outset  so 
constituted  that  they  at  once  render  harmless  any  stray  bacteria  which 
come  within  their  domain  by  immediately  devouring  them.  This  explains 
with  equal  facility  why  all  persons  exposed  to  the  action  of  pathogenic 
bacteria  in  epidemics  do  not  develop  the  disease,  and  further,  the  immunity 
often  possessed,  e.  g.  by  physicians,  which  latter  may  be  regarded  as  due 
to  the  fact  that  their  phagocytes,  during  their  intercourse  with  bacteria 
of  all  kinds  or  with  the  sick,  by  degrees  train  themselves,  as  it  were,  for 
their  anti-bacterial  duties,  which  in  this  case  may  be  looked  upon  as  pre- 
paratory or  prophylactic.  When,  however,  in  spite  of  the  phagocytes,  the 
patients  die  of  infectious  diseases,  the  fact  is  to  be  explained  by  the 
excessive  number  of  the  bacteria  present,  which  is  so  great  that  the 
phagocytes  are  unequal  to  the  task  of  "devouring"  them  all.  (Met- 
schnikoff.) 

From  the  account  thus  given  it  will  be  seen  that  the  phagocyte  theory 
has  the  characteristics  of  a  good  theory  ;  that  is,  it  is  very  natural,  is 
readily  understood,  is  adapted  to  explain  a  great  number  of  facts  hereto- 
fore not  readily  explicable  and  is  founded  upon  observed  facts. 

It  completes  too  the  modern  theory  of  infection  on  its  therapeutic 
side,  and  while  it  deprives  that  theory,  as  it  were,  of  its  hopelessness,  it 
offers  compensation  and  consolation,  especially  as  it  also  preserves  a  place 
for  medical  activity  —  chiefly  in  training  the  phagocytes  by  inoculation. 

Of  course  the  phagocyte  theory  has  its  opponents,  who  declare  that 
diseases  are  cured  by  the  cessation  of  the  process  of  development  of  the 
bacteria  in  consequence  of  their  death.  This  explanation  must  he 
accepted  particularly  for  those  diseases  which  run  a  typical  course  (pneu- 
monia, intermittent  fever  etc.),  a  course  which  would  be  inexplicable  on 
the  theory  of  Metschnikoff,  —  Sudden  recoveries  too  can  be  explained 
only  on  the  supposition  of  the  sudden  dying  out  or  sudden  excretion  of 
the  causative  bacteria,  for  a  sudden  devouring  of  these  organisms  is 
inconceivable. 

Among  the  opponents  of  the  theory  of  Metschnikoff  are  :     Ehrlich, 
Baumgarten  in  Konigsberg,  C.  Weigert  in  Frankfort-on-the-Main,  Arthur 
Hanau  in  Zurich  etc. 
64 


—  loio  — 

The  many  horrors  of  the  bacillary  theory,  with  its  invasion  of  germs 
and  its  inevitability,  would  be  relieved  by  the  pretty  theory  of  Met- 
schnikoff",  should  the  latter  become  realized.  The  theory,  however,  is  too 
pretty  to  be  true.  Yet  it  illustrates  once  more  the  experience  of  the  last 
few  centuries,  that  each  new  theory  is  the  mother  of  still  another  new  one. 

[In  the  United  States  a  theory  of  infection  by  cryptogamic  vegeta- 
tions was  advanced  by  Dr.  J.  K.  Mitchell  of  Philadelphia  as  early  as  1849. 
Dr.  J.  H.  Salisbury  (now  best  known  for  his  theory  of  the  therapeutic 
effects  of  large  draughts  of  hot  water)  also  in  the  sixties  believed  he  had 
discovered  the  cause  of  syphilis.  gonorrhoea,  malaria,  measles  and  rheum- 
atism in  certain  microscopic  algoid  vegetations.  His  observations,  how- 
ever, were  not  confirmed  by  subsequent  observers,  and  the  whole  subject 
had  fallen  into  comparative  obscurity  until  revived  by  the  publication 
of  an  English  translation  of  "Ziemssen's  Cyclopaedia"'  about  1874. 
Bacteriology  became  at  once  the  chief  subject  of  medical  discussion  in 
the  journals  and  societies,  and  has  since  been  pursued  with  a  never  waning 
interest. 

In  the  absence  of  suitable  laboratories  for  the  careful  study  of  modern 
bacteriology  and  the  scarcity  of  physicians  prepared  for  such  work  by 
their  previous  education,  it  is  not  surprising  that  the  United  States  has  as 
yet  contributed  little  original  work  to  this  attractive  but  difficult  depart- 
ment of  pathology.  The  most  eminent  of  the  laborers  in  this  field  have 
been:  Drs.  George  M.  Sternberg,  U.  S.  A.,  Thos.  E.  Satterthwaite,  T. 
Mitchell  Prudden  and  Edward  Curtis  of  New  York  ;  II.  C.  Wood  and  H.  F. 
Formad  of  Philadelphia ;  William  Osier,  now  of  the  Johns  Hopkins 
University,  Baltimore  ;  W.  T.  Belfield  and  Nicholas   Senn  of  Chicago  etc. 

The  recent  erection  and  endowment  of  several  pathological  labora- 
tories, provided  with  suitable  apparatus  and  a  competent  staff  for  the 
stud}'  of  bacteriology,  leads  to  the  hope  that  ere  long  the  United  States 
ma}'  take  an  honorable  position  in  this,  as  in  other  departments  of  medical 
investigation. 

The  pathological  laboratory  of  the  Alumni  of  the  College  of  Physicians  and 
Surgeons  of  New  York  was  opened  in  1878  ;  The  Carnegie  Laboratory  of  New  York, 
in  1885;  the  Loomis  Laboratory,  also  of  New  York,  in  1886;  the  Hoagland  Labor- 
atory of  Brooklyn,  in  1888,  and  the  laboratory  connected  with  the  Johns  Hopkins 
Hospital  in  Baltimore  during  the  present  year  (1889).    H.] 

3.    PHYSICAL  EXAMINATION  OF  THE  SICK, 

The  practical  medicine  of  our  century  has  undoubtedly  gained  many 
important  and  permanent  advantages  by  our  improvements  in  the  diag- 
nosis of  the  phenomena  and  pictures  of  disease,  an  art  which  has  been 
pushed  to  a  point  not  only  unattained,  but  even  undreamed  of  in  by-gone 
ao-es.  In  fact,  according  to  all  appearances,  later  generations  will  recog- 
nize as  the  actual  advances  of  our  day,  not  so  much  the  theories  brought 
forward  to  gain  a  greater  insight   into  the  essence  of  morbid   life   (which 


—  1011  — 

the}*  too  have  been  unable  to  attain),  as  its  diagnostic  procedures,  which 
have  proven  in  very  man}*  ways  so  decidedly  useful  to  the  practice  of( 
medicine.  Yet  undoubtedly  a  number  of  these  methods  the  future  will 
condemn  and  drop  as  originally  overestimated.  The  theories  of  our  cen- 
tury, like  those  of  earlier  date,  will  doubtless  claim  a  place  in  the  history 
of  medical  culture,  but  our  methods  and  means  of  diagnosis  will  remain, 
at  least  in  part,  firmly  and  permanently  established  in  medical  practice. 
For,  as  the  great  Haller  with  resigned  modesty  affirmed  emphatically  of 
himself  and  his  time,  medical  theory,  even  to-day,  fails  to  penetrate  to  the 
essence  of  nature,  but  the  inventive  mind  in  diagnosis  has  been  able  to 
facilitate  the  detection  of  a  greater  part  of  the  external  phenomena  of 
morbid  life  than  was  the  case  in  earlier  times. 

Our  aids  to  practical  knowledge  in  medicine  are  derived  from  the 
natural  sciences,  so  highly  developed  in  our  day,  and  which  medicine  has 
fortunately  and  successfully  rendered  subservient  to  itself  in  the  depart- 
ment of  diagnosis.  If  we  must  make  any  charge  against  this  tendency 
of  the  present  age,  it  must  be  based  upon  the  fact  that  it  employs  too 
much  and  too  exclusively  the  senses  as  armed  by  the  natural  sciences,  to 
the  exclusion  of  simple  Hippocratic  investigation  by  the  unaided  senses, 
which  is  often  sufficient  in  ordinary  cases,  and  thus  inflicts  too  frequently 
upon  the  sick  an  unnecessary  annoyance.  Moreover  we  are  constantly 
seeking  too  earnestly  for  new  methods  of  investigation,  from  which  fre- 
quently originate  exaggerated  ideas  of  new  procedures  and  the  neglect 
of  therapeutics. 

The  physical  diagnosis  of  our  own  day  took  its  origin  in  the  18th 
century.  Our  system  of  accessories  has  been  built  up  entirely  upon 
Auenbrugger's  percussion  —  the  German  "corner-stone  of  all  modern 
diagnosis". 

The  first  impulse  came  directly  from  Auenbrugger's  invention,  and 
was  given  by  the  famous  and  humanely  great  physician-in-ordinary  of 
Napoleon  I.,  baron 

Jean  Nicolas  Corvisart-Desmarets  (1755-1821).  a  native  of 
Dricourt  in  Champagne. 

In  1808  Corvisart  translated  the  treatise  of  the  German  reformer  of 
diagnosis,  and  by  this,  as  well  as  by  his  treatise  upon  diseases  of  the  heart 
published  in  conjunction  with  his  pupil  Horeau,  he  contributed  largely  to 
the  development  of  the  medicine  of  the  19th  century. 

Corvisart  received  his  first  instruction  from  a  priest  who  was  likewise  a  relative, 
and  was  originally  destined  to  the  law.  Yet  when  he  came  to  Paris  he  devoted 
himself  to  medicine,  and  was  a  distinguished  pupil  of  Vicq  d'Azyr.  Antoine  Petit, 
Louis,  Desault,  Bucquet,  Portal,  Desbois  de  Rochefort  and  others.  In  1705  lie  was 
appointed  professor  in  the  medical  clinic  of  the  Charite,  a  department  established 
hy  his  predecessor  and  teacher  Desbois.  Subsequently,  together  with  Barthez,  he 
was  appointed  ordinary  physician  of  the  First  Consul,  and  then  of  the  Emperor 
Napoleon,  who  in  this  appointment  once  more  gave  evidence  of  his  proverbial  insight 
into  practical  capacity  and  greatness  of  character.     On  receiving  this  appointment 


—  1012  — 

Corvisart  resigned  his  position  as  a  professor.  He  clung  to  Napoleon  with  inviolable 
faithfulness,  yet  always  preserved  his  independence  and  his  frankness,  a  thing  which 
few  others  ventured  to  do.  "Sire",  he  exclaimed  after  the  birth  of  the  King  of  Rome, 
addressing  himself  to  the  Emperor,  "this  prince  must  crown  all  your  wishes  !  Recall 
your  career:  in  less  than  ten  years  a  simple  officer  of  artillery,  then  captain,  general 
of  brigade,  general-in-chief,  First  Consul,  emperor,  spouse  of  an  archduchess  of 
Austria,  father  of  a  prince.  Having  reached  so  dizzy  a  height  of  fortune,  rarely 
attained  by  anjr  mortal,  I  beg  your  majesty  to  stop !  Fortune  may  turn ;  you  may 
yet  fall."  "That  I  call  the  speech  of  a  genuine  peasant",  said  Napoleon,  yet  his 
opinion  of  Corvisart  was  expressed  as  follows:  "He  is  an  honest  and  able  man,  but 
a  little  rude"  (Isensee).  After  the  death  of  Napoleon  Corvisart  declined  all  public 
office.  He  died  of  a  disease  of  the  heart,  an  affection  of  which  he  had  made  a  special 
study,  and  in  this  respect  met  the  same  fate  as  many  important  physicians.— Besides 
his  great  frankness,  Corvisart  was  adorned  with  the  greatest  love  for  the  truth,  with 
beneficence,  and  with  benevolence  towards  all.  In  a  word  he  was,  what  Hensler 
demanded  above  all  of  a  great  physician,  a  thoroughly  good  man.  Accordingly 
among  all  his  contemporaries  Corvisart  had  the  most  eminent  physicians  for  his 
biographers,  a  Dupuytren,  a  Cuvier,  the  alienist  Guillaume  Marie  Andre  Ferrns 
(1784-186H)  and  Etienne  Pariset  (1770-1847;  born  at  Grands,  near  Neufchateau  in 
Champagne,  General  Secretary  of  the  Academie  de  Medeeine),  the  eloquent  author 
of  numerous  so-called  eloges,  and  a  poet  likewise.  —  Corvisart's  chief  work  was  the 
"  Essai  sur  les  maladies  et  les  lesions  organiques  du  cceur  et  des  gros  vaisseaux", 
1806,  republished  twice,  the  last  time  in  1818.  His  grandnephew  Lucien  Corvisart 
was  ordinary  physician  of  Napoleon  III.  and  the  Prince  Imperial,  and  died  in  1882, 
aged  71  years. 

As  a  clinical  teacher  and  pathological  anatomist  Corvisart  exercised 
an  extensive  influence.  The  coryphaei  of  the  French  school  of  path- 
ological anatom}',  a  Bayle,  Laennec  and  Dupuytren,  were  educated  by 
him.  As  a  diagnostician  he  enjoyed  the  greatest  reputation,  a  statement 
proven  by  the  anecdote  that  he  once  diagnosticated  —  or  accidentally 
guessed,  which  requires  less  credulity  on  our  part  —  the  disease  of  which 
a  person,  whose  picture  only  had  been  shown  to  him,  died  —  of  course  it 
was  a  cardiac  affection. 

It  was  a  pupil  of  Corvisart's  who  supplemented  the  discover}'  of 
Auenbrugger  by  the  equally  useful  discovery  of  auscultation.     This  was 

Rene  Theodore  Hyacinthe  Laennec  (also  Laennec,  la  Ennec,  even 
Leinek  in  the  effort  to  establish  his  German  descent ;  1781-1826),  who  has 
been  already  mentioned  as  an  eminent  pathological  anatomist. 

Laennec  descended  from  a  respectable  family  in  the  little  city  of  Quimper  in 
Bretagne,  and  was  born  Feb.  17,  1781.  His  father,  who  became  a  widower  at  an 
early  period,  neglected  the  education  of  his  children,  but  soon  brought  them,  includ- 
ing the  future  discoverer  of  auscultation,  to  his  brother,  one  of  the  first  physicians  of 
Nantes  and  a  man  in  every  way  distinguished.  The  latter,  however,  was  able  to  do 
little  towards  the  preliminary  scientific  education  of  the  boy  Laennec,  since  all  the 
schools  were  closed  for  a  long  period  during  the  Reign  of  Terror,  and  he  himself  found 
his  time  too  much  occupied  by  the  demands  of  his  profession.  Instead  of  schools 
there  were  hospitals  and  camps,  to  which  the  feeble  lad  always  accompanied  his 
uncle,  and  these  formed  the  means  of  educating  the  youthful  Laennec  for  his  future 
profession.     The  zeal  manifested  for  medicine  at  even  so  early  a  period  of  his  life 


—  1013  — 

soon  directed  attention  to  Laennec,  and  accordingly  he  was  nominated  assistant  in 
one  of  the  military  hospitals  and  subsequently  even  appointed  a  field-surgeon  in  the 
war  carried  on  by  the  government  against  the  refractory  department  of  Morbihan. 
At  the  close  of  this  campaign,  which  probably  tended  to  strengthen  his  delicate  frame 
and  of  which  he  has  written  a  description,  he  went,  a  youth  of  nineteen,  to  Paris,  and 
with  wonderful  perseverance  and  the  best  success  filled  up  the  gaps  in  his  school 
education.  Latin  and  Greek  he  acquired  so  thoroughly  that  he  knew  how  to  write 
well  in  both  languages  —  certainly  very  exceptional  ability  for  a  modern  Frenchman. 
His  medical  studies  too  he  pushed  with  restless  zeal.  In  the  year  1815,  after  having 
published  numerous  important  papers  (a  thesis  which  questioned  the  existence  of 
Hippocrates,  another  on  the  importance  of  Hippocrates  to  practical  medicine,  others 
on  acephalocysts.  angina  pectoris  Heberdenii,  cancer,  peritonitis,  aneurism  of  the 
heart,  tubercle  etc.),  he  made  in  the  Societe  de  1'  Ecole  his  first  experiments  with  the 
stethoscope.  His  instrument  at  this  time  was  about  ten  inches  long,  with  a  diameter 
of  about  four  inches,  and  contained  in  its  thoracic  extremity  an  obturator,  upon  which 
he  laid  great  stress.  The  invention  of  this  instrument  was  due  to  accident.  In  order 
to  hear  the  sounds  of  the  heart  more  clearly,  he  employed  on  one  occasion  with  a 
lady  a  cylindrical  roll  of  paper,  and  then  immediately  constructed  upon  the  same 
principle  the  instrument  now  used  everywhere.  In  the  year  1806  he  was  appointed 
physician  to  the  Hopital  Beaujon,  and  in  1816  received  a  similar  appointment  in  the 
Hopital  Necker.  In  1819  appeared  his  work  "Del  auscultation  mediate,  ou  traite 
du  pronostic  des  maladies  des  poumons  et  du  cceur,  etabli  principalement  a  1'  aide 
de  ce  nouveau  moyen  d'  exploration,"  which  was  speedily  translated  into  all  the 
languages  of  Europe.  From  the  year  1820,  however,  his  feeble  body  yielded  more 
and  more  to  that. disease,  the  knowledge  of  whose  pathological  anatomy  he  had  most 
promoted,  and  in  spite  of  frequent  and  long  interruptions  in  his  duties  as  professor 
in  the  Paris  faculty,  where  he  had  conducted  the  clinic  for  internal  diseases  from 
1823,  and  in  spite  of  a  sojourn  in  his  native  place,  he  succumbed  to  phthisis  on 
August  13,  1826,  at  the  early  age  of  45,  though  not  until  he  had  completely  performed 
his  life's  task. 

Laennec's  slight  appreciation  of  his  own  immortal  services  to  medicine  was 
remarkable,  though  not  entirely  inexplicable.  On  the  other  hand,  the  delicate, 
insignificant-looking  man  prided  himself  particularly  on  his  skill  in  riding  and  in 
mechanical  tasks.  As  a  man  he  is  said  to  have  been  distinguished  for  great  goodness 
of  heart,  an  incorruptible  sense  of  justice  and  a  rare  tolerance  for  views  differing 
from  his  own,  as  well  as  for  an  energy  not  to  be  quenched  by  bodily  disease.  As 
regards  the  recognition  and  the  success  of  his  labors,  the  French  Laennec  met  a  fate 
entirely  different  from  that  of  the  German  Auenbrugger.  Recognition,  honor  and 
fame,  with  a  brilliant  position,  followed  close  upon  the  publication  of  his  well-known 
work. 

Among  the  other  French  coryphaai  in  percussion  and  auscultation  we  must 
mention  especially  A.  Aran.  Bouillaud,  Andral,  Gendrin,  Beau,  Jean  Baptiste  Barth 
(1806-1877)  of  Saargemund,  a  pupil  of  Louis,  physician  to  the  Hotel-Dieu,  President 
of  the  Academie  de  Medecine  and  the  physician  of  Thiers;  Henri  L.  Roget,  who,  in 
conjunction  with  Barth,  published  in  1841  a  well-known  "  Traite  pratique  de  1'  aus- 
cultation", translated  into  most  of  the  modern  languages;  Briquet;  Louis  (Youssure 
precordiale  in  diseases  of  the  heart);  Chauveau  ;  Recamier;  V.  Collin  (pericardial 
friction  sound);  Fournet;  Trousseau:  M.  Fauvel  (1813-1884),  Vice-president  of  the 
Academie  de  Medecine  and  an  epidemiologist;  A.  Raciborskj7 ;  Briancon;  Andry; 
Monneret;  Rilliet  and  Barthez ;  Bergeon ;  Moreau  de  St.  Ludjere  (Cystoscope)  ; 
Duroziez ;  Parrot  (died  1883)  of  Paris,  who  became  famous  as  a  physician  to 
children  ;  Rouanet,  who  explained  the  sounds  of  the  heart  bjr  closure  of  the  valves  in 
1832  ;  H.  Damoiseau  (curved  outline  of  the  dullness  in  pleuritic  effusion,  1844)  etc. 


—  1014  — 

In  Germany  Laennee's  method  was  first  recommended  by  Marx,  but  it  was  first 
employed  extensively  at  the  clinics  of  the  famous  Peter  Krukenberg  (1788-1865) 
and  Schonlein. 

[In  England  the  treatise  of  Laennec  was  translated  by  Dr.  John  Forbes  in  1821, 
and  the  same  author  published  in  1824  "Original  cases,  with  dissections  and  obser- 
vations, illustrating  the  stethoscope  and  percussion  in  the  diagnosis  of  the  diseases 
of  the  chest".  Robert  Spittal  (1804-1852)  of  Edinburgh  was  an  eminent  cultivator 
of  physieal  diagnosis  and  author  of  a  "Treatise  on  auscultation  in  diseases  of  the 
chest",  1830.  William  Stokes,  the  famous  clinician  of  Dublin,  published  in  1824  an 
"  Introduction  to  the  use  of  the  stethoscope",  and  in  1837  appeared  his  "  Treatise  on 
the  diagnosis  and  treatment  of  diseases  of  the  chest''.  Dr.  Chas.  J.  B.  Williams  of 
London  also  published  in  1828  "A  rational  exposition  of  the  physical  signs  of  the 
diseases  of  the  lungs  and  pleura",  and  the  suhject  of  auscultation  and  percussion 
was  discussed  freely  and  thoroughly  by  Sir  James  Clark,  Richard  Townsend  of 
Dublin  (Tabular  view  of  the  principal  signs  furnished  by  auscultation  and  percussion, 
and  of  their  application  to  the  diagnosis  of  the  diseases  of  the  lungs,  1832),  James 
Hope  (A  treatise  on  diseases  of  the  heart  and  great  vessels  etc.,  1832),  Peter  Mere 
Latham  (Lectures  on  diseases  of  the  heart,  1845)  ;  Walter  H.  Walshe  of  London, 
the  eminent  author  of  "Physical  diagnosis  of  diseases  of  the  lungs"  (1843)  and 
"Practical  treatise  on  diseases  of  the  heart"  (4th  ed.,  1873);  Henry  M.  Hughes 
(1805-1858),  physician  to  Guy's  Hospital  (Clinical  introduction  to  the  practice  of 
auscultation  etc.,  2d  ed.  1854);  Richard  P  Cotton  (1820-1877),  physician  to  the 
Hospital  for  Consumption  and  Diseases  of  the  Chest  at  Brompton  (Clinical  lectures 
on  the  physical  diagnosis  of  phthisis,  1862)  ;  Horace  B.  Dobell  (Demonstrations  of 
the  diseases  of  the  chest  and  their  physical  diagnosis,  1858);  Peyton  Blakiston 
(1801-1878)  of  Birmingham,  and  others. 

Manuals  of  physical  diagnosis  were  also  published  by  Michael  Ryan  of  Edinburgh 
(1837),  D.  Spillam  of  Dublin  (1837)  and  Patrick  S.  K.  Newbigging  of  Edinburgh, 
who  translated  the  work  of  Barth  and  Roger  in  1847.  In  the  United  States  the 
method  of  Laennec  made  but  slow  progress,  partly-  in  consequence  of  the  inertia 
and  indifference  of  the  profession,  partly  from  the  wide-spread  prejudice  against 
"Frenchified"  novelties,  and  partly  from  the  difficulty  of  verifying  by  autopsical 
examination  the  conditions  established  by  physical  exploration  during  life.  The 
"  Manuel  de  clinique,  ou  des  methodes  d'  exploration  en  medecine,  et  des  signes 
diagnostiques  des  maladies"  etc.  of  Louis  Martinet  is  said  to  have  been  translated 
into  English  by  Jones  Quain  of  London  and  published  at  Philadelphia  in  1827,  and 
the  "Rational  Exposition"  etc.  of  Dr.  C.  J.  B.  Williams  appeared  from  the  press  of 
Carey  and  Lea,  Philadelphia  in  1830.  Yet  the  "Lexicon  Medicum  "  of  Robert 
Hooper,  of  which  an  American  edition  was  published  by  the  Harpers,  under  the  care 
of  Dr.  Samuel  Akerly  of  New  York,  in  1831,  does  not  even  mention  the  subject  of 
auscultation,  though  an  edition  of  Samuel  Cooper's  "Dictionary  of  Practical  Surgery", 
published  by  the  same  firm  in  1830  under  the  editorship  of  Dr.  David  Meredith  Reese, 
devotes  a  short  paragraph  to  its  consideration.  In  1836  the  Massachusetts  Medical 
Society  published  in  its  "  Library  of  Practical  Medicine"  three  dissertations  on  the 
question,  "How  far  are  the  external  means  of  exploring  the  condition  of  the  internal 
organs  to  be  considered  useful  and  important  in  medical  practice?"  These  disser- 
tations were  submitted  in  competition  for  the  Boylsto'n  Prize  by  the  now  famous 
physician,  poet  and  wit,  Dr.  Oliver  Wendell  Holmes,  Dr.  Robert  W.  Haxall  of 
Richmond,  Virginia,  and  Dr.  Luther  V.  Bell  (1806-1862)  of  Derryr  New  Hampshire. 
The  Boylston  Medical  Committee  awarded  the  gold  medal  to  the  dissertation  of  Dr. 
Holmes,  but  also  voted  the  sum  of  $50  to  the  authors  of  the  other  two  dissertations, 
and  decided  to  publish  all  three  papers  in  "  a  volume  to  be  distributed  gratuitously 


—  1015  — 

to  each  Fellow  of  the  Society,  and  to  ever}-  other  respectable  physician  in  Massachu- 
setts." Dr.  Bell  in  his  dissertation,  after  giving  an  account  of  Laennec's  invention 
of  the  stethoscope,  adds  in  a  note  : 

"  I  have  no  means  of  knowing  to  what  extent  the  practice  of  exploration  of  the 
chest  has  been  adopted  in  the  United  States.  In  the  larger  towns  and  cities,  I  am 
aware,  it  has  been  considerably  and  successfully  cultivated,  but  in  the  interior  of 
New  England,  at  least  by  the  great  body  of  practitioners,  it  has  been  neglected." 

Dr.  Holmes  also  says  : 

"At  the  present  day  it  is  well  known  that  some  practitioners  of  a  certain  merit, 
and  particularly  some  who  pride  themselves  on  strong  sense  and  intuitive  sagacity, 
habitually  neglect  and  depreciate  the  value  of  the  phj-sical  signs,  even  of  thoracic 
disease. " 

It  will  thus  be  seen  that  the  advantages  of  Laennec's  method  were  by  no  means 
general!}'  recognized  in  the  United  States  even  as  late  as  1836.  It  should,  however, 
be  recorded  that  Dr.  James  Jackson,  Jr.,  of  Boston,  whose  untimel}"  death  deprived 
medicine  of  one  of  her  most  promising  and  devoted  students,  while  pursuing  his 
medical  studies  in  Paris,  communicated  to  the  Societe  Medicale  d'  Observation  in 
1833  a  paper  on  a  prolongation  of  the  expiratory  sound  as  an  important  sign  of  the 
early  stage  of  phthisis.  The  value  of  this  sign  is  now  universally  recognized.  Dr. 
John  Collins  Warren  (1778-1856)  of  Boston,  the  eminent  surgeon,  had  also  published 
as  early  as  1809  a  paper  entitled  "Cases  of  organic  diseases  of  the  heart;  with  dis- 
sections" etc.  But  the  earliest  systematic  treatise  on  the  diagnosis  of  thoracic 
diseases  written  by  an  American  physician  was  the  work  of  Dr.  W.  W.  Gerhard 
(1809-1872)  of  Philadelphia,  a  pupil  of  Louis,  who  in  1836  published  his  treatise  "On 
the  Diagnosis  of  Diseases  of  the  Chest".  Two  years  previously  had  appeared  the  "Illus- 
strations  of  pulmonary  consumption"  etc.  b}'  Dr.  Samuel  George  Morton  (1799-1851) 
of  Philadelphia.  Gerhard's  work  was  succeeded  in  1856  by  the  standard  treatise  of 
the  late  Dr.  Austin  Flint  (1812-1886),  entitled  "  Physical  exploration  and  diagnosis 
of  diseases  affecting  the  respiratory  organs",  which  continues  to  be  one  of  the  most 
popular  works  upon  the  subject  of  auscultation  and  percussion.  The  "  Practical 
Treatise  on  Phthisis  Pulmonalis"  of  Eh-.  L.  M.  Lawson  (1812-1864)  of  Kentucky, 
which  appeared  in  1864,  also  deserves  notice  in  this  connexion.  The  now  almost 
universal  plan  of  removing  extensive  pleuritic  effusions  by  aspiratory  thoracentesis 
is  very  largely  due  to  the  ingenuity  of  Dr  Morrill  Wyman,  who  invented  in  1850  a 
suitable  aspirator,  and  to  the  energy  and  determination  of  Dr.  Henrj-  I.  Bowditch  of 
Boston,  who  adopted  and  forcibly  advocated  the  operation  at  a  period  when  it  had 
few  friends. 

Among  the  more  modern  cultivators  of  physical  diagnosis  it  will  be  sufficient  to 
mention,  besides  those  already  noticed,  Alfred  L.  Loomis  and  James  R.  Learning  of 
New  York,  J.  M.  Da  Costa  (Medica!  Diagnosis,  1864)  of  Philadelphia.     H.] 

The  interpretation  and  conception  of  auscultatory  phenomena  by 
Laennec  were  essentialby  different  from  those  to  which  Skoda  gave  cur- 
rency. Laennec  investigated  and  regarded  them  as  pathognomonic  signs 
of  perfectly  definite  morbid  conditions  of  the  viscera,  and  formed  empirical 
categories  of  sounds,  while  Skoda,  in  a  manner  truly  scientific,  formed  his 
memorable  physical  rules  upon  the  basis  of  the  principles  of  acoustics. 
Laennec  too  believed  that  the  results  of  mediate  auscultation  might  be 
essentially  different  from  that  practised  with  the  ear  alone.  —  Like  Auen- 
brugger  and  Corvisart  he  practised  percussion  with  the  simple  fingers. 

An  entirely  new  department  of  auscultation  was  opened  in  1821  by 


—  1016  — 

J.  A.  Lejumeau,  Alcomte  de  Kergaratlec  (died  1877),  when  he  applied 
this  art  to  the  diagnosis  of  pregnancy  and  the  life  of  the  foetus,  without 
knowing  that  Matthias  Mayor  as  early  as  1818  had  observed  the  foetal 
heart  sounds,  so  that  Lejumeau  is  to  be  considered  the  discoverer  onl}'  of 
the  uterine  souffle.     On  the  other  hand, 

Lisfranc  was  the  first  to  emplo}-  the  methods  of  physical  investiga- 
tion in  surger}-. 

Laennee's  instrument  of  course  underwent  in  the  progress  of  time  innumerable 
modifications  and  combinations,  the  enumeration  of  all  of  which  would  be  impossible. 
First  the  obturator  was  dropped  as  useless  and  injurious.  Then  the  instrument  was 
made  of  the  most  various  materials,  ranging  in  course  of  time  from  fir-wood  to  silver 
and  hard-rubber.  Then  it  was  made  shorter  and  smaller  in  diameter  (Piorrj-,  Louis), 
as  well  as  combined  with  the  pleximeter  (Piorry).  The  ear-plate,  originally  fastened 
to  the  body,  was  made  removable,  and  either  flat  or  hollowed  out  (Yernon-Walden- 
burg),  and  two  cones  of  different  size  were  fitted  to  the  body  proper  for  auscultation 
of  the  lungs  and  the  vessels  etc.  Among  the  special  forms  of  the  stethoscope  are: 
the  (Schlauch-Glashiitchen)  stethoscope  of  A.  Groux  (died  1878),  to  which  the  Paris 
physicist  Konig  added  a  closed  resonator  with  an  elastic  membrane  of  caoutchouc; 
the  stethoscope  of  Landou/y  (polystethoscope),  with  several  tubes  at  one  end,  so  that 
several  persons  can  listen  to  the  same  murmur  at  once  ;  the  binaural  stethoscope  of 
Scott  Alison,  with  two  tubes  and  ear-funnels,  with  which  one  can  listen  to  the  heart 
and  lungs  at  the  same  time;  the  stethoscope  of  Leared  and  Cainmann,1  which  with 
two  ear-tubes  has  a  single  thoracic  extremity  ;  the  stethoscope  of  Hutchinson ;  that 
of  the  author  with  three  adjustable  extremities,  immovable  ear-plate  and  conical 
lumen  (Medic.  Diagnostik,  2d  edition,  Enke,  Stuttgart,  1863;  Zur  Percussion, 
Auscultation  und  Phonometrie,  187H).  The  solid  akuoxylon  has  been  discarded  by 
P.  Niemeyer  himself.  G.  Gerhardt  used  so-called  resonators. — The  adjustable  ends 
of  the  stethoscope  have  been  filled  with  water  (Alison),  and  the  instrument  thus  con- 
verted into  a  "  hydrophone";  or  it  has  been  combined  with  an  electric  chime  of  bells 
(sphygmophone  of  Upham),  or  with  the  thermometer  (Eugene  Woillez,  died  1882), 
etc.,  etc.  The  best  stethoscope,  however,  continues  to  be  the  ear  itself  in  ordinary 
cases,  where  modest}-,  cleanliness  and  propriety  permit  its  use. 

Pierre  Adolphe  Piorry  (1794-1879)  of  Poitiers, 
from  1835  physician  to  the  Hotel-Dieu  and  a  year  later  physician  to  the  Hopital  de 
la  Pitie,  in  1840  appointed  professor  of  patholog}-  and  in  1866  retired, 
invented  in  1826  the  pleximeter  for  the  practice  of  mediate  percussion. 
He  likewise  devised  the  so-called  "Dermographie",  and  was  the  first  to 
include  the  abdominal  organs  in  the  department  of  physical  diagnosis 
(1835),  at  the  period  when  Bouillaud  was  cultivating  particularly  the 
investigation  of  the  heart. 

Piorry  was  an  extremely  fertile,2  but  also  a  whimsical  writer,  as  is  manifest  from 

1.  Cammann's  binaural  stethoscope  was  completed  in  1852  and  described  in  the  New 

York  "Medical  Times"  for  January,  1855.  The  double  stethoscope  of  Dr.  Leared 
was  exhibited  at  the  International  Exhibition  in  London  in  1851.  It  consisted  of 
two  gutta-percha  tubes  attached  to  the  chest-piece  at  one  extremity  and  at  the 
other  to  the  ear-pieces.    II. 

2.  Among  his  works  are  the  "  Traite  sur  la  percussion  mediate",  1828;  "  Clinique 

medicale",  1832;  "Traite  des  alterations  du  sang",  1833;  "  Traite  de  medecine 
pratique  et  de  patholooie  iatrique  ou  medicale",  1842-51;  "  Traite  du  diagnostic 
et  de  semeiologie  ",  3  vols.,  1836-37  etc. 


—  1017  — 

his  devoting  his  attention  particularly  to  the  nomenclature  of  disease.  Among  some 
of  his  curious  titles  we  may  mention  hypersplenotrophie,  dysgastronervia,  cardiodys- 
neuria  etc.  His  hints  on  the  examination  of  the  sick  and  on  practical  tact  are 
manifestly  borrowed  from  real  life.  Thus  he  says  :  "The  art  of  examining  a  patient 
demands  long  study  and  extensive  knowledge.   .  .  .  The  examination  should  generally 

be  short,  so  as  not  to  weary  the  patient (a  thing  not  infrequently  forgotten) 

To  ask  a  question  twice  is  better  than   once,   and  to  examine  a  patient  a 

second  time,  after  an  interval  of  24  hours,  is  better  than  a  single  examination 

Emphasis  and  arrogance  should  be  avoided  without  becoming  commonplace 

Questions  must  be  answered,  however  useless  they  may  be,  for  in  the  eyes  of  the 
world  they  have  a  great  value,  and  the  physician  cannot  neglect  these  little  nothings 
when  related  to  him  by  the  patient The  physician  should  behave  with  firm- 
ness but  with  courtesy,  unite  cold-bloudedness  with  a  certain  amount  of  feeling,  and 
in  important  matters  stand  firmly  upon  what  he  regards  as  for  the  good  of  the  patient. 
Prejudices  which  he  cannot  overcome  he  must  know  how  to  yield  to  (though  always 
giving  them  his  censure),  unless  the}'  are  unaccompanied  with  danger.  These  pre- 
cautions the  physician  should  not  neglect  if  he  desires  to  make  his  fortune  in  this 
world,  where  savoir  faire  often  commands  more  success  than  reason  and  sound  under- 
standing"— plain  counsels  which  the  practical  Frenchman  or  Englishman  teaches  his 
pupils,  while  in  Germany,  to  their  loss  be  it  said,  physicians  must  improve  upon  the 
faults  of  inexperience  by  the  teachings  of  daily  life  alone.  —  Piorry's  diagnostic 
armamentarium  consisted  of  a  taper  for  illumination,  a  tongue  spatula,  magnifying 
glass,  warm  water,  grease  for  anointing  the  finger,  the  stethoscope  and  pleximeter, 
tape  measure,  rectal  and  vaginal  specula,  dressing-forceps  and  tweezers,  oesophageal, 
rectal  and  urethral  sounds,  nitrate  of  silver  for  marking,  a  test-tube,  nitric  acid  and 
other  reagents,  litmus  paper  and  graduated  glasses  (Kratzmann). 

The  form  of  Piorry's  ivory  pleximeter,  by  means  of  which  he  tested 
the  feeling  of  resistance  upon  which  he  laid  great  emphasis,  was  that  of  a 
tolerably  large  semicircle  with  two  lateral  rims  and  a  centimeter  scale  upon 
the  straight  edge. 

The  latter  was  also  applied  to  Traube's  zither-like  pleximeter  with  adjustable 
rims,  to  the  oval  glass  pleximeter  of  W.  Hesse,  and  to  other  forms  of  this  instrument. 
That  the  pleximeter  was  and  is  made  circular,  very  large  and  very  small,  oval  etc., 
or  of  wood,  leather,  ivory,  caoutchouc  etc.,  is  a  matter  of  course.  The  most  useful, 
though  not  the  most  elegant  in  form,  is  the  trowel-shaped  pleximeter  of  Eugen  Seitz 
in  Giessen  (modified  variously:  the  perpendicular  into  a  horizontal  plate  in  the 
author's  instrument),  while  the  cylindrical  pleximeter  of  the  physician  next  mentioned 
consists  of  rolled  caoutchouc  (187H). 

Max  Anton  Wintrich  (1813-1882), 
of  Sferzing  in  the  Tyrol,  may  be  looked  upon  as  the  improved  German  Piorry.  He 
continued  until  the  close  of  his  life  extraordinary  professor  in  Erlangen,  in  spite  of 
the  fact  that  he  was  a  beloved  teacher  and  a  popular  physician.  He  was  the  inventor 
of  the  percussion  hammer,  and  of  the  acoustic  sound  for  the  investigation  of  vesical 
concretions.  The  latter  instrument  has  been  recently  combined  with  the  microphone. 
The  sound  was  first  put  to  acoustic  use  in  1819  by  Jean  Joseph  Reynaud,  a  physician 
who  also  wrote  on  pectoral  fremitus  in  1816.  Wintrich  was  also  the  inventor  of 
linear  percussion,  and  was  a  physical  diagnostician  of  equal  acuteness  and  conscien- 
tiousness. His  knowledge  of  acoustics  far  exceeded  that  of  Skoda,  who  adopted  a 
nomenclature  applied  to  musical  instruments  and  not  derived  from  acoustics.  Yet 
Wintrich  was  unable  to  keep  himself  entirely  free  from  the  influence  of  Skoda. 
Seitz  made  his  percussion  hammer  of  horn,  others  of  other  materials,  but  no  substan- 
tial advantage  was  gained  by  any  of  these  modifications. 


—  1018  — 

The  combined  diagnostic  procedure  of  Autopliony  was  invented  by  Hourmann 
as  a  distinct  method  of  physical  examination,  though  the  subject  had  been  already 
studied  by  Bricheteau  (1834)  and  Taupin  (1839).  It  has  as  little  value  for  the  prac- 
titioner as  the  combination  of  percussion  and  auscultation  entitled  acouophony,  and 
brought  forward  by  the  American  physicians  Cammann  and  Clark1  (1843).  C. 
Gerhardt  practised  auscultation  cfi  the  sounds  of  the  heart  and  lungs  by  means  of  a 
tube  introduced  into  the  pharynx,  and  Verardini  (1873)  even  investigated  uterine- 
sounds  by  means  of  a  stethoscope  introduced  into  the  vagina  and  placed  against  the 
portio  vaginalis,  a  procedure  which  he  dignified  with  the  name  of  "  Intravaginal  aus- 
cultation"! Both  these  procedures  are  mentioned  merely  to  show  how  far  the  method 
of  Laennec  has  been  run  to  seed.  Phonometry,  brought  forward  by  the  author  in 
L872,  may  be  practically  less  independent  and  rather  applicable  to  the  control  of 
percussion,  while  its  greater  scope  probably  lies  in  the  department  of  theory.'  W. 
Hamburger  (died  1872),  a  practitioner  at  Gabel  in  Bohemia,  taught  auscultation  of 
the  oesophagus  (Klinik  der  Oesoph.-Krankheiten). 

The  method  of  Spirometry  seems  destined  to  attain  greater  importance 
than  the  procedures  last  mentioned,  though  it  cannot  be  readily  practised 
in  the  life  of  the  ordinary  practitioner.  It  was  brought  forward  in  an 
available  form  by  John  Hutchinson  in  1846. 

The  method  was  introduced  to  general  attention  in  Germany  by  Samosch  in  1840, 
though  professor  J.  Yogel  in  Giessen  had  used  it  as  early  as  1848,  and  Gustav  Simon, 
the  now  famous  surgeon  of  Heidelberg,  wrote  a  description  of  Vogel's  expeiiments. 
They  were  followed  in  Germany  by  Stellwag,  who  according  to  Phobus,  simplified 
the  original  spirometer,  and  by  Jahne,  Albers,  Haser,  Kuchenmeister  and  particu- 
larly Wintrich,  who  constructed  an  improved  instrument.  —  Even  before  Hutchinson, 
other  physicians  had  occupied  themselves  with  similar  investigations,  though  without 
having  any  adequate  apparatus.  Among  these  were  Edward  Kentish  (died  1832), 
Abernethy  and  Thompson.  The  method  was  afterwards  tested  by  Walshe,  Green, 
Davies  and  Pereira  in  England. 

Pneumatoscopy,  i.  e.  the  stud}-  of  the  expired  air  (chief!}'  as  to  its- 
proportion  of  carbonic  acid)  by  means  of  a  special  apparatus,  first  intro- 
duced by  Wintrich  in  1852,  has  as  yet  attained  little  popularity.  The 
same  ma}*  be  said  of  the  recently  proposed  investigation  of  the  amount 
of  the  respiratory  pressure,  the  so-called  "Pneumatometry'',  and  the  Anap- 
nography  of  French  physicians,  which  by  means  of  a  kind  of  spirometer 
fitted  to  the  nose  marks  the  respiratory  curves.  Pneumatometry  was 
employed  by  Dr.  Ph.  Biedert  in  the  diagnosis  of  the  course  of  diseases  of 
the  lungs,  and  Pneumatotherapy  originated  with  J.  Hauke  in  1870. 

Mensuration,  which,  as  we  know,  finds  its  application  as  well  in  sur- 
gery as  in  medicine  and  obstetrics   (pelvimetry  etc.),   is  of  larger  scope 

1.  Auscultatory  percussion  was  presented  to  the  profession  in  a  paper  prepared  by 

Drs.  G.  P.  Cammann  and  Alonzo  Clark,  and  published  in  the  "New  York 
Quarterly  Journal  of  Medicine  and  Surgery",  July,  1840.  The  method  has  never 
come  into  very. general  use.    (H.) 

2.  According  to  the  "Presse  nied.  beige"  (No.  16,  1875),  J.  Grasset  in  "Montpellier 

med.''  has  called  attention  to  a  new  side  of  this  procedure.  He  concedes  its 
diagnostic  utility,  though  he  disputes  the  identity  of  the  results  of  percussion 
and  phonometry.  See  "  Zur  Percussion,  Auscultation  und  Phonometrie  "  by  the 
author. 


—  1019  — 

than  the  procedures  last  mentioned.  Besides  the  centimeter  measure  (a 
most  useful  instrument  in  the  requirements  of  medical  practice)  and  the 
callipers,  other  special  instruments  have  been  gradually  invented  and 
furnished  with  names.  Some  of  these  are  designed  for  particular  pur- 
poses, e.  g.  for  investigation  of  the  thorax,  like  Sibson's  Thoracometer 
(properly  chest-measurer,  1847),  Quain's  Stethometer  (1850),  Alison's 
Stethogoniometer,  the  Cyrtometer  of  Woillez  (1838)  etc.  F.  Biegel  in 
1873  brought  forward  the  Stethograph,  to  exhibit  graphically  the  respira- 
tory movements.  All  these  complicated  methods,  however,  are  better 
suited  to  clinical  instruction  than  to  everyday  practice,  and  are,  on  the 
whole,  of  little  practical  value. 

That  the  scale,  which,  as  we  know,  was  already  utilized  by  Sanctorius, 
has  been  einplo}-ed  under  various  new  forms  as  a  means  of  physical  inves- 
tigation, particularly  in  determining  the  condition  of  nutrition,  we  need 
merely  mention.     It  suffices  too  merely  to  mention  the  fact  that 

The  Loupe,  in  the  department  of  optical  accessories,  has  been  employed 
both  for  magnifying  purposes  and  for  illumination.  Oblique  illumination 
was  employed  by  R.  Liebreich  in  1855,  though,  according  to  Otto  Becker, 
it  had  been  already  recommended  by  Himly  in  1805.  The  microscope, 
however,  has  become  one  of  our  most  important  means  of  exploration  (in 
forensic  medicine  also),  particularly  since  the  days  of  Schonlein,  for  only 
by  its  aid  can  we  diagnosticate  certain  forms  of  disease. 

In  passing  to  a  consideration  of  the  most  important  diagnostic  aid  in 
diseases  of  the  inner  parts  of  the  eye  we  need  only  refer  cursorily  to  the 
apparatus  for  testing  the  distinctness  of  vision,  such  as  the  test  types  of 
Jager,  Hermann  Snellen  (an  oculist  of  Utrecht)  etc.,  spectacles,  prisms  and 
the  optometer.  The  powerful  aid  to  the  oculist,  to  which  reference  has 
been  just  made,  the  ophthalmoscope,  was  invented  by  professor  Hermann 
Ludwig  Helmholtz  in  the  year  1851. 

History  informs  us  that  Mery,  as  early  as  1704,  by  the  accidental  observation  of 
the  reddening  of  the  pupil  of  a  cat  held  under  water,  laid  the  first  foundation  stone  of 
the  ophthalmoscope.  His  observation  was  repeated  b}'  P.  de  la  Hire  (1640-1718)  in 
1709.  Gruithuisen  (1810),  A.  P.  Prevost  ( 1810),  Esser  (1826),  Hassenstein  (1836), 
Behr  (183!)),  Cumming  (1846),  E.  Briicke  (1847),  and  especially  A.  Kussmaul1 
(1845),  and  C.  L.  von  Erlach  in  Berne  followed  with  investigations  on  the  subject  of 
the  red  pupil  and  explanations  of  the  fact,  without,  however,  artificially  illuminating 
the  fundus  of  the  eye. 

1.  Born  in  1822  at  Graben  near  Uarlsruhe,  practised  in  Kandern,  then  became  a 
professor  successively  in  Erlangen,  Freiburg  and  Strassburg  and  was  retired  in 
1888.  We  record  here  an  observation  made  by  this  famous  Strassburg  clinician 
at  the  opening  of  the  Naturforscherversammlung  in  1885,  and  which  is  as  honor- 
able to,  as  it  is  characteristic  of  its  author  :  "  Let  us  ask  openly,  gentlemen,  what 
is  all  our  medicine  without  compassion  and  the  power  of  self-denial  ?  When 
science  is  struggling  for  knowledge  and  truth  she  requires  men  of  arms,  bold  in 
combat  and  cool  of  understanding;  but  when  she  descends  from  her  lofty  position 
to  the  sick  and  stricken,  she  must  put  on  the  mantle  of  humility,  and  in  forbear" 
ance  and  gentleness  bear  in  her  bosom  a  warm  heart." 


—  1020  — 

The  ophthalmoscope  presupposed  an  answer  to  the  question  why  it  is 
that  our  pupil  looks  black.  The  explanation  of  this  fact,  according  to 
Helmholtz,  is  that  when  we  look  at  the  eye  of  another  person  an  image  of 
our  own  pupil  only  is  formed  in  his  eye  and  reflected  directly  back  to  the 
pupil  of  the  observer,  so  that  the  latter  does  not  see  anything  of  the 
fundus  of  the  observed  e}*e,  particularly  as  in  ordinary  examination  of 
the  eye  of  another  all  lateral  rays  of  light  are  shut  off  by  the  observer's 
own  head.  If  a  third  eye  could  be  slid  in  between  the  observing  and 
observed  eye  without  concealing  the  one  eye,  this  eye,  would  receive  an 
image  of  the  fundus.  Of  course  this  is  impossible.  The  first  problem, 
therefore,  was  to  illuminate  artificially  the  fundus  of  the  eye  to  be  observed, 
and  to  place  this  illuminating  apparatus  between  the  two  ej'es.  But  this 
plan  alone  rarefy  suffices  to  enable  us  to  see  the  fundus  oculi  clearly.  "As 
our  eyes  can  unite  into  an  image  only  divergent  or  parallel  ra3-s,  the  raj's 
of  light  reflected  from  the  fundus,  which  are  always  convergent,  must  be 
made  to  diverge.  This  l'esult  was  attained  by  the  addition  of  a  dispersion- 
lens  behind  the  illuminating  mirror.  Helmholtz  also  combined  four  trans- 
parent glass  plates  so  as  to  form  an  angle  of  incidence  of  60°,  and  Ijv 
means  of  these  reflected  into  the  eye  to  be  observed  the  rays  of  a  light 
placed  at  one  side,  and  added  also  behind  this  transparent  illuminating 
apparatus  a  dispersion-lens.  Both  these  united  into  a  convenient  instru- 
ment formed  the  original  ophthalmoscope  of  Helmholtz,  which  was  liable 
only  to  the  objection  that  its  use  required  great  practice. 

The  principle  once  established,  numerous  improvements  were  next  made  in 
Helmholtz's  instrument.  It  was  followed  by  the  ophthalmoscopes  of  Follin,  Ruete, 
Coccius,  Epkens,  Stellwag  von  Carion,  Burow,  von  Hasner,  Klaunig,  Saemann, 
Zehender  and  others.  Those  of  Ed.  Jager  and  Liebreich  are  usually  regarded  as  the 
handiest  and  most  convenient. 

The  ophthalmoscope  has  now  been  in  use  only  about  a  third  of  a 
century,  and  yet  it  is  diffused  over  the  whole  world.  Such  unexampled 
recognition  did  it  receive  even  during  the  first  years  after  its  invention, 
an  evidence  how  much  more  sensitive  modern  medicine,  since  the  days  of 
Auenbrugger,  has  become  to  new  means  for  the  promotion  of  medical 
knowledge.  Germany  may  also  be  justly  proud  of  this  work  of  an 
inventive  and  scientific  mind  ! 

The  biography  of  the  inventor  of  the  ophthalmoscope  is  very  simple,  yet  so  much 
the  richer  in  results  and  investigations. 

Hermann  Ludwig  Helmholtz  was  born  in  Potsdam,  August  Ml,  1821.  After  com- 
pleting his  studies  in  his  native  city,  he  became  an  arm}-  physician  there  (1842), 
until  his  appointment  as  professor  of  physiology  in  Konigsberg  in  1849.  In  1847, 
following  in  the  footsteps  of  Robert  Mayer,  he  wrote  his  famous  work  on  the  con- 
servation of  force  (Ueber  die  Erhaltung  der  Kraft).  Subsequently  (1855)  he  settled 
in  Bonn  and  then  in  Heidelberg  (1858).  Among  his  works  are  the  phenomenal 
treatise  "Die  Lehre  von  den  Tonempfindungen  "  (1862,  3d  edition  1870),  a  book  on 
ph3Tsiological  optics,  a  treatise  on  acoustics  by  Tyndall  and  Helmholtz  etc.  Since 
1870  Helmholtz  has  been  a  member  of  the  Berlin  faculty. 


—  1021  — 

By  the  invention  of  the  ophthalmoscope  the  whole  department  of 
ophthalmology  was  revolutionized,  and  in  many  respects  newly  con- 
structed. To  the  ophthalmoscope  alone  German  ophthalmolog}'  also  owes- 
its  advances,  surpassing  those  of  all  other  nations,  so  that  now  German 
oculists,  as  by  far  the  most  skilful  and  most  popular  of  specialists  in  this 
department,  have  borne  the  invention  of  Helmholtz  into  all  parts  of  the 
globe. 

E.  Bouchut  in  1863  christened  the  examination  of  the  eye  with  the 
opthalmoscope  "Ct'rebroscopie",  because  by  this  means  inferences  might 
be  drawn  regarding  acute  and  chronic  diseases  of  the  meninges  and  the 
brain  itself.  With  equal  justice,  however,  we  might  speak  of  Renoscopy 
with  the  ophthalmoscope,  because  by  its  aid  Bright's  disease  may  also  be 
diagnosticated. 

In  importance  for  its  particular  department  the  laryngoscope  is  a 
diagnostic  means  quite  equal  to  the  ophthalmoscope. 

Laryngoscopy  was  first  practised  in  an  imperfect  way  by  Benjamin  Guy  Babing- 
ton  (1829),  P.  Baumes  in  Lyons  (1838),  with  a  prism  in  1844  by  the  Scotchman 
Adam  Warden  of  Edinburgh,  while  the  Scotch  surgeon  Liston  in  1840  constructed 
an  instrument  similar  to  our  present  laryngoscope.  The  Spanish  teacher  of  singing 
in  London,  Manuel  Garcia,  in  1855  brought,  forward  a  small  laryngoscope,  which, 
however,  he  used  simply  for  physiological  researches.  Senn  in  Geneva  also  invented 
a  special  laryngoscope.  The  instrument  was  emplojed  in  the  diagnosis  of  disease 
almost  simultaneouslj-  by  TUrck  and  Czermak.  Special  laryngoscopes  have  been 
brought  forward  by  Tobold  and  Lewin  in  Berlin,  Fr.  Semeleder  in  New  York.  Storck 
in  Vienna,  von  Bruns  in  Tubingen,  C.  L.  Merkel  (1812-1876)  in  Leipsic  and  others. 

The  ear  speculum  also  depends  upon  the  principle  of  the  reflection 
of  light,  and  a  large  number  of  varieties  of  this  instrument  speedily 
followed  the  invention  of  the  laryngoscope.  Among  the  inventors  of 
aural  specula  were  W.  Kramer  (died  1875),  one  of  the  earliest  pioneers 
of  this  department  in  German}-  (auscultation  of  the  ear)  ;  Baron  A.  von 
Trftltsch  in  Wiirzburg,  the  earliest  (1860)  special  professor  of  aural  med- 
icine ;  Julius  Erhard  (died  1873)  in  Berlin  ;  Adam  Politzer,  Joseph  Toyn- 
bee  (1815-1866;  of  London,  John  B.  Brunton  (inventor  of  the  otoscope  in 
1861)  and  others.  The  majority  of  nasal  specula  are  constructed  in 
accordance  with  the  laws  of  reflected  light,  but  that  of  Frlinkel,  on  the 
contrary,  depends  upon  simple  dilatation  of  the  nose,  like  the  earlier  oral 
specula  of  Heister,  Langenbeck,  A.  Liter  (1802-1883),  Charriere  (died 
1876),  Matthieu  pere  (died  1879).  The  aural  probe  of  Hermann  Wendt 
(1837-1875)  should  also  be  mentioned  here.  —  Rhinoscopy  was  first 
essayed  unsuccessfully  in  1807  by  Phil.  Bozzini  (1773-1809)  of  Mayence, 
a  practising  physician  in  Frankfort  (Der  Lichtleiter  etc.  1807),  and  by  Sir 
William  Wilde  (died  1876)  in  Dublin.  Czermak  was  the  first  to  apply  the 
method  successfull}\  —  The  primeval  (Hippocratic) 

Rectal  speculum,  like  the  modern  instrument  of  Weiss,  worked  with 
a  catch,  while  the  rectal  speculum  of  Fergusson  likewise  utilized  the 
reflection  of  light.     The  latter  is  also  the  case   with  the  instrument  for 


—  1022  — 

the  investigation  of  the  mucous  membrane  of  the  urethra  and  bladder, 
the  so-called 

Endoscope  of  A.  J.  Desormeaux,  Jr.,  (1863),  Fiirstenheim  in  Berlin, 
Griinfeld  in  Vienna,  Nitze  in  Dresden  (electric  illumination  of  the  internal 
surface  of  the  bladder),  whose  predecessors  were  Bozzini  and  Segalas. 

One  of  our  most  important  diagnostic  procedures  is,  as  we  all  know 
the  eraploA'ment  of  the  vaginal  speculum.  The  Ancients  (e.  g.  Paul  of 
./Egina).  as  well  as  the  Arabians,  had  special  instruments  for  the  investi- 
gation of  the  uterus  and  vagina.  P.  Franco  (15tJl)  invented  a  new  spec- 
ulum, and  his  example  was  followed  b}'  others.  But  the  most  lasting 
influence  upon  the  employment  of  this  instrument  was  exercised  by  the 
Paris  physician  and  successor  (1821)  of  Corvisart,  Joseph  Claude  Anthelme 
Recamier  (1774-1856),  who  in  1818  reintroduced  it  to  the  profession. 

Recamier  was  born  at  Rochefort  in  the  deparment  of  Ain,  was  appointed  in 
1801  physician  to  the  Hotel-Dieu  and  employed  the  speculum  vaginae  in  his  course 
here  as  early  as  1805.  In  1821  he  succeeded  Corvisart  and  in  1830  resigned  his 
position,  but  resumed  his  lectures  as  a  professevr  Ubre  in  1837.  In  1842  he  became 
a  member  of  the  Academie.  The  speculum,  forgotten  since  the  days  of  Puimann  and 
Dazan  (Proksch).  has  continued  in  popular  use  and  has  undergone  innumerable 
modifications.  Popular  vaginal  specula  are  the  bivalvular  instrument  of  Ricord,  the 
trivalvular  speculum  of  Segalas,  the  cylindrical  milk-glass  speculum  of  Mayer,  in 
sets  of  different  sizes  with  an  obturator,  etc.  All  of  these  instruments,  however, 
yield  in  practical  usefulness  to  the  duckbill  speculum  of  Dr.  J.  Marion  Sims  (1813- 
1883)  of  the  United  States.  The  bath-speculum  of  Martin  (died  1875)  is  useful  for 
therapeutic  purposes. 

The  so-called  "Splanchnoscope"  of  J.  B.  Fonssagrives  (1860),  professor 
in  Montpellier.  J.  Briick  (1868)  and  Milliot  is  of  as  little  importance  as 
the  endoscope. 

The  employment  of  the  Spectroscope  for  the  detection  of  sugar,  blood- 
stains etc.  forms  one  of  our  most  recent  diagnostic  procedures. 

The  application  of  electricity  to  the  determination  of  the  central  or 
peripheral  seat  of  diseases  of  the  nervous  system  by  the  susceptibility  of 
the  latter  to  irritation,  and  the  emploj'ment  of  the  same  agent  to  differ- 
entiate cases  of  real  and  apparent  death,  as  recommended  by  M.  Rosen- 
thal, professor  in  Vienna,  in  1872,  are  other  examples  of  modern  diag- 
nostic methods. 

Needles  and  callipers  serve  to  test  the  sensibility,  as  in  the  aesthe- 
siometer  of  Sieveking,  the  bara?sthesiometer  for  testing  the  sense  of 
weight,  the  algesiometer  and  algesiochronometer  of  F.  Bjoernstroem  of 
Upsala  (1876),  etc. 

That  chemistry  has  also  been  made  subservient  to  diagnosis  is  proven 
by  the  daily  examinations  of  urine  etc.  in  our  clinical  institutions  and  at 
the  bedside  of  private  patients,  and  the  same  may  be  said  of  microscopic 
examinations.  Chemical  investigations  enjoy  the  not  inconsiderable 
advantage  that  they  are  able  to  establish  the  existence  of  minimal  quan- 
tities of  matter,  and  can  follow  the  latter  in  a  way  quite  unattainable  in 


—  1023  — 

other  modes  of  investigation,  i.  e.  into  the  very  tissues  themselves.  The 
boiling  of  the  fluids  of  the  body  as  an  aid  to  diagnosis  likewise  belongs 
among  the  physical  methods,  e.  g.  albumen  in  urine,  demonstrated  by  Dr. 
John  Blackall  (1771-1860)  of  Exeter  in  England  (1813). 

For  determining  the  specific  gravity  of  fluids,  particularly  of  urine, 
-we  employ  the  areometer  or  urinometer  invented  by  Johann  Florian  Heller 
of  Vienna  in  1849. 

New  forms  have  been  given  to  the  old-fashioned  sounds  and  catheters, 
and  to  bougies,  which  were  used  at  an  earlier  period,  and  these  instruments 
have  been  improved  in  applicability  by  being  manufactured  of  caoutchouc. 
The  porcelain-tipped  probe  of  Nelaton  is  an  ingenious  invention  to  deter- 
mine the  presence  of  metallic  foreign  bodies,  particular^  those  of  lead. 
The  uterine  sound  of  Kiwisch1  is  also  an  invention  of  our  time.  —  When 
probes  are  ineffective,  as  where  the  skin  is  unbroken,  we  emplo}',  besides 
the  probe-trocar  (e.  g.  of  Wintrich,  St'dillot  and  others)  the  so-called 
"akidopeirastische  Apparat"  of  Middeldorpff,  i.  e.  acupuncture  needles  of 
special  form,  used  like  probes,  and  which  were  brought  before  the  pro- 
fession in  Giinsburg's  "Archiv"  in  1856. 

We  should  also  mention  here  the  universal  employment  of  the  ther- 
mometer for  diagnostic  (therapeutic  and  prognostic)  purposes,  in  the 
mouth,  rectum,  axilla,  vagina,  and,  indeed,  the  uterus,  of  all  sorts  of 
patients  of  all  ages,  a  practice  revived  in  our  day  by  Traube,  Felix  von 
Barensprung  (1822-186-4)  and  Wunderlich.  Indeed  this  method  is  so 
thoroughly  diffused  that  even  from  America  P.  F.  Da  Costa  Alvarenga 
(died  1883)  has  excited  some  attention  in  German}'  by  a  work  on  ther- 
mometry. Recently  too  Paul  Niemeyer  has  used  the  thermometer,  together 
with  the  lrygroineter,  barometer  etc.,  for  the  purpose  of  hygienic,  in  con- 
trast to  clinical,  diagnosis. 

In  France,  after  the  example  of  Boerhaave,  De  Ha'en  and  others,  and  before  the 
revival  of  the  use  of  the  thermometer  by  the  Germans  just  mentioned,  this  instrument 
was  employed  by  Goupil  as  early  as  1798,  and  his  example  was  followed  by  Piorr3r, 
Andral,  Chossat,  Monneret  and  others,  though  without  rendering  the  theimometer  so 
popular  as  it  has  recently  become  everywhere.  Buniva  as  early  as  1801  measured 
the  internal  temperature  of  the  uterus,  finding  it  more  than  29°  R.  (97}°  F.) 

[The  thermometrical  investigations  of  the  Scotchman,  George  Martin  (De  simi- 
libus  animalibus  et  animalium  calore  libri  II.,  London,  1740),  of  the  Dublin  anatomist 
George  Cleghorn  (Treatise  on  the  Diseases  of  Minorca,  London,  1751)  and  particul- 
arly of  James  Currie  (Medical  reports  on  the  effect  of  water,  cold  and  warm,  as  a 
remedy  in  fever  and  other  diseases,  London,  1797),  should  be  mentioned  in  this  con- 
nexion. According  to  Haeser,  Currie  was  the  first  physician  to  make  anjr  extensive 
use  of  the  thermometer  at  the  bedside.  Sir  Humphrey  Davy-  also  determined  the 
bodily  temperature  by  the  thermometer  beneath  the  tongue  in  1798. 

1.  According  to  Schroeder  the  uterine  sound  was  first  employed  by  Levret  as  early 
as  1771.  His  example  was  followed  by  Chambon,  Vigarous,  Desormaux,  Dance 
and  particularly  Samuel  Lair  (Nouvelle  niethode  de  traitement  des  ulceres, 
ulcerations  et  engorgement  de  1'  uterus,  1828).  The  practice  was  revived,  and 
special  sounds  invented  almost  simultaneously  by  Simpson  of  Edinburgh  (1843), 
Huguier  of  Paris  and  Kiwisch  of  Prague.     H. 


—  1024  — 

In  the  United  States  Dr.  Elisha  North  published  in  1808  a  "  Treatise  on  Malig- 
nant Epidemic  Spotted  Fever,  or  Cerebro-Spinal  Fever",  in  which  he  tells  us  that  it 
will  be  well  always  to  ascertain  the  degree  of  the  patient's  temperature  by  a 
thermometer.  The  use  of  the  thermometer,  however,  was  not  popularized  in  this 
country  until  after  the  appearance  of  Wunderlich's  work  in  1870,  and  the  publication 
by  Dr.  Edouard  Seguin  (1812-1880)  of  New  York  of  a  "Medical  Thermometry  "  in 
1871.     H.] 

A  novelty  useful  enough  for  scientific  purposes,  but  readily  dispensed 
with  in  practical  life,  is  the  "Sphygmography"  introduced  in  the  year  1863 
by  E.  J.  Marey  of  the  College  de  France,  the  successor  of  Claude  Bernard 
in  his  chair  in  the  Academie.  Mail's  instrument  was  improved  and 
named  the  "Angiograph"  in  1872  by  Leonard  Landois,  professor  in  Greifs- 
wald.  Sphygrnography  labors  under  the  objection  that  it  does  not  show 
the  qualities  of  the  pulse  appreciable  to  the  touch  only,  and  that  it,  like 
many  of  the  methods  now  under  consideration,  relegates  the  exercise  of 
the  unaided  senses  to  a  position  of  obscurity.  S.  Th.  Stein,  a  physician 
of  Frankfort,  has  brought  forward  recently  a  photosphygmograph.  [A 
"sptrygmoscope"  was  invented  by  the  ingenious  S.  Scott  Alison  of  London, 
the  inventor  also  of  a  "differential  stethoscope",  and  the  use  of  the 
sphygmograph  has  been  studied  and  discussed  in  England  b}'  John  Burdon 
Sanderson  and  Fred.  A.  Mahomed  (1849-1884)  of  London,  the  latter  best 
known  for  his  enthusiastic  exertions  in  the  cause  of  the  "Collective  Inves- 
tigation Society";  Balthazar  Foster  and  James  Sawyer  of  Birmingham. 

In  the  United  States  the  instrument  has  been  discussed  b}T  Edgar 
Holden  (The  Sphygmograph  :  its  Physiological  and  Pathological  Indica-- 
tions,  1874  —  the  Stevens  Triennial  Prize  Essay),  who  modified  in  some 
respects  the  instrument  of  Mare}*;  Samuel  B.  Ward  of  Albany,  N.  Y.,  and 
Frank  Woodbury  of  Philadelphia,  who  studied  the  American  instrument 
of  Pond.     II.] 

On  the  other  hand,  the  simple  counting  of  the  pulse  by  the  watch, 
a  method  which  (particularly  as  the  result  of  Louis'  investigations)  has 
become  popular  in  our  day  everywhere,  enjoys  the  advantage  of  demon- 
strating more  satisfactorily  any  increase  or  diminution  of  the  pulse-beat. 
A  pulse-watch  or  "Angiometer"  has  been  invented  by  L.  Waldenburg 
(1837-1881),  professor  in  Berlin. 

Inspection  and  palpation,  the  oldest  of  medical  methods  of  investiga- 
tion, and  which  to-da}T  too  form  the  introduction  to  eveiy  diagnostic  pro- 
cedure, have  met  with  some  extension  in  our  day.  We  need  only  mention 
the  application  of  palpation  to  the  investigation  of  the  impulse  of  the 
heart,  of  peritoneal  friction  (Despres,  1834),  of  vocal  fremitus  (J.  Jos. 
Begnaud,  1816),  of  cardiac  fremitus  (the  Author),  and  its  more  extended 
employment  in  gynaecology.  Under  this  head  belongs  too  the  bold  pro- 
cedure of  the  Heidelberg  surgeon  Simon,  who  pushes  his  whole  hand 
through  the  anus  into  the  bowels,  or  presses  his  finger  into  the  bladder, 
regardless  of  rupture  of  the  sphincters.  Such  varieties  of  palpation, 
which  should,  at  all  events,  be  employed  only  in  cases  of  extreme  necessit}', 


—  1025  — 

are  only  possible  with  the  aid  of  the  modern  adjuvant,  chloroform,  dis- 
covered [independently  in  1831  b}-  Mr.  Samuel  Guthrie  of  Sackett's 
Harbor,  N.  Y.,  and]  by  Soubeiran  in  France,  studied  by  Liebig  and  named 
b\r  Dumas.  [This  agent  was  first  employed  b)'  the  method  of  inhalation 
in  1832  by  Prof.  Eli  Ives  of  New  Haven  in  a  case  of  pulmonary  disease, 
but  its  use  as  an  anaesthetic  is  due  to  Sir  James  Young  Simpson  of  Edin- 
burgh, who  in  November  1847  employed  it  as  a  substitute  for  ether,  and 
introduced  it  in  this  capacity  to  the  profession.]  Previously  to  tljis  the 
dentist  Horace  Wells,  of  Hartford,  Conn.,  had  employed  nitrous  oxide, 
and  had  in  1844  discovered  the  anaesthetic  effects  of  ether,  a  discovery 
which  he  communicated  to  the  chemist  Dr.  C.  T.  Jackson  (died  1880  in 
Somerville,  Mass.)  and  the  dentist  W.  T.  G.  Morton  of  Boston,  both  of 
whom  claimed  the  discover}-  as  their  own,  and  at  first  employed  ether  as 
a  secret  remedy.1  —  A  new  means  of  inspection  is  the  observation  of  the 

1.  I  have  preferred  to  leave  the  text  of  this  passage  unchanged,  as  conveying  to  the 
American  reader  an  idea  of  the  views  of  an  intelligent  German  physician  in  18ST 
relative  to  the  famous  "  ether  controversy  ",  which  agitated  this  country  about 
the  middle  of  the  present  century.     The  facts  of  the  case  seem  to  be  as  follows  : 

Horace  Wells  in  1844  succeeded  in  demonstrating  the  practicability  of  surgical 
anaesthesia  with  nitrous  <.%id£,  though  he  failed  to  establish  the  reliability  of  the 
method.  He  seems  in  fact  to  have  become  disgusted  with  his  want  of  success, 
and  to  have  practically  abandoned  the  subject  for  more  than  two  years.  He 
likewise  essayed  upon  himself  the  effects  of  ether,  but  also  gave  up  this  agent 
because  he  found  its  inhalation  too  disagreeable. 

The  exhilarating  and  anaesthetic  effects  of  ether  were  quite  generally  known 
for  many  years  previous  to  its  employment  as  a  surgical  anaesthetic.  According 
to  Dr.  J.  Marion  Sims,  a  tumor  was  removed  from  the  neck  of  a  Mr.  Venables 
by  Dr.  Crawford  W.  Long  of  Georgia  on  March  .SO,  1842,  the  patient  having  been 
previousty placed  profoundly  under  the  influence  of  ether,  and  anaesthesia  with 
this  agent  was  employed  by  this  same  surgeon  in  other  operations  of  later  date, 
but  prior  to  1846.  No  account  of  these  operations,  however,  was  published  until 
1S49,  three  years  after  Morton  had  introduced  the  method  to  the  profession.  Dr. 
Maroy  of  Hartford,  Conn.,  is  also  said  to  have  removed  a  wen  from  the  head  of 
a  sailor  under  the  influence  of  ether  in  January  1845,  but  though  the  patient 
became  insensible  and  the  operation  was  successful  per  se,  Dr.  Marcy  yet  advised 
Wells  to  stick  to  nitrous  oxide  as  the  safer  and  pleasanter  ana'sthetic  agent.  It 
was  not  until  October  16,  1846,  when  Morton  anaesthetized  a  patient  in  the 
Massachusetts  General  Hospital  with  ether  for  the  removal  of  a  tumor  of  the 
neck  by  Dr.  John  Collins  Warren,  that  the  safety  and  reliability  of  ether  as  an 
anaesthetic  agent  were  fairly  established  and  placed  before  the  profession,  and 
the  merit  of  this  demonstration  is  due  entirely  to  the  dentist  W.  T.  G.  Morton. 
Dr.  Jackson  claimed  to  have  suggested,  the  use  of  ether  to  Morton,  but  he  never 
demonstrated  its  safety  and  reliability,  and  these  were  the  new  and  decisive  points 
which  led  to  the  general  employment  of  ether  as  an  anaesthetic.  The  first  account 
of  these  operations  under  the  influence  of  ether  was  published  in  the  Boston 
Medical  and  Surgical  Journal,  Nov.  18,  1846.  The  new  anaesthetic,  under  the 
title  "Letheon",  was  patented  conjointly  by  Morton  and  Jackson,  but  it  was  soon 
discovered  that  their  letheon  was  nothing  but  pure  sulphuric  ether,  and  the 
patent  came  to  nought.  Wells  committed  suicide  in  1848,  Morton  died  of  apoplexy 
in  New  York  in  1868  and  Jackson  died  insane  in  1880  —  sic  transit  gloria  mundi  ! 
(H.  G.  Bigelovv.)  H. 
65 


—  102G  — 

visible  impulse  of  the  heart,  the  palpation  of  which,  like  the  investigation 
of  the  vocal  fremitus  and  the  friction  sound  in  many  cases  of  pericarditis, 
pleuritis  and  peritonitis,  must  in  many  respects  be  regarded  as  a  novelty. 
Troni  what  has  been  said  it  will  be  seen  that  Diagnosis,  the  aim  of  all 
practical  medical  research  at  the  sickbed,  and  the  basis  of  thoughtful 
treatment,  has  been  greatly  promoted  and  facilitated  in  our  clay.  The 
physician,  as  we  know,  must  be  at  each  instant  so  complete  a  master  of 
this  art  —  and  often  under  what  conditions  !  —  that  he  is  able  to  apply  it 
instantly  and  effectivel}*.  By  this  facilit}',  and  the  treatment  founded 
thereupon,  the  practice  of  medicine,  in  spite  of  all  efforts  to  degrade  it  into 
a  mere  trade,  remains  and  will  remain  a  true  and  genuine  art  ! 

4.     SURGERY. 

Surgery  has  always  presented  in  its  development  a  much  pleasanter 
picture  of  steady  progress  than  that  offered  by  medicine  proper,  for  its 
objects  and  its  practice  do  not  necessitate  the  illumination  of  dark  paths 
by  the  torch  of  theoiy,  which  diffuses  far  more  soot  than  light.  Accord- 
ingly Chamisso  calls  surgery  the  seeing  portion  of  the  healing  art.  Thus 
too  the  surgeiy  of  our  century,  in  accordance  with  the  character  of  the 
people  who  have  shared  in  its  development,  but  unaltered  by  the  opinions 
of  schools  and  their  often  varying  methods,  has  striven  vigorously  and 
steadily  after  a  perfection  based  upon  the  foundation  of  experience,  and 
for  principles  which  the  past,  and  particularly  the  18th  century,  had  taught. 
If  the  16th  century  opened  the  way  for  the  checking  of  haemorrhage,  and 
established  this  art  in  its  scientific  position,  and  if  the  17th  century 
accomplished  the  same  results  in  the  simplification  and  improvement  of 
the  art  of  dressing  wounds  ;  if  too  the  18th  century  gave  a  scientific  eleva- 
tion, so  far  as  its  means  would  permit,  to  i>oth  these  methods,  so  in  our 
own  century  surgeiy  stands  upon  a  scientific  level  with  medicine  proper, 
though  its  objects  are  far  more  accessible,  direct  and  comprehensible  than 
those  of  the  latter  science,  and  its  position  more  favorable,  so  that  its 
progress  has  been  almost  constant  and  uninterrupted.  In  full  possession 
of  the  results  of  a  normal,  surgical  and  topographical  anatony,  almost 
perfect  in  its  development  (a  position  which  admits  of  both  boldness  and 
certainty  in  treatment),  it  has  likewise  been  able  to  utilize  in  an  eminently 
practical  way  the  acquisitions  of  pathological  anatomy,  appying  them  as 
well  to  diagnosis  as  to  operative  and  therapeutic  aims.  Of  the  advances 
in  physiology  too,  and  in  the  branches  accessor}*  to  this  science,  it  has 
been  able  to  avail  itself,  without  becoming  a  servant  to  that  science  and 
its  methods.  Microscopic  pathological  anatomy  in  particular  has  become 
of  extended  importance  in  surgical  knowledge  and  practice.  By  it,  above 
all,  our  knowledge  of  secondary  wound-diseases,  of  the  fate  of  the  secre- 
tions of  wounds  and  their  effects  upon  the  organism,  of  the  character  of 
the  different  forms  of  tumors  and  their  methods  of  growth  and  diffusion 
etc.,  has  been   rendered  clearer,  and  thus  many  fruitful  facts  and  views 


-  1027  — 

have  been  contributed  to  surgical  treatment.     In  addition  to  observations 
in  pathological  anatomj",  numerous   investigations   relative  to  the   process 
•of  healing,  pursued  upon  accidental  cases  or  upon  wounds  produced  exper- 
imentally, upon  operations  on  the  lower  animals  etc.,  have  inured  to  the 
advantage  of  surgery.     Above  all  the  external  conditions  of  the  healing 
process  have  been  observed  more  attentively  than  in  the  entire  past,  and 
consequently  the  after-treatment  of  wounds,  both   local  and  hygienic,  has 
been  brought  more  into  the  foreground.     Indeed   this  treatment,  as  the 
•century  has  advanced,  has  become   more   and  more  careful,  particularly  in 
military  surgery,  a  science  which,  as  regards   its  methods  and  results,  has 
been   largely  transformed  bj*  the  improvements  mentioned,   by  the  better 
and  more  speed}'  transportation  of  the  wounded  through  the  invention  of 
George    Stephenson    (1781—1848),   and    finally    b}-    the    adoption    of   the 
barrack-system   and  the  plan  of  distributing  the   wounded   in  numerous 
depots.     Above  all  amputations,  so  frequent  at  an  earlier  date,  have  largely 
disappeared,  and   military  surgery,  as   well   as  hospital  and  civil  surgery, 
has  inclined  rather  to  the   preservation   of  wounded   parts   and   members, 
than  to  their  removal.     Thus  has  grown  up  to  the  scientific  and  rational, 
so-called    conservative    surgery    of  our    century.     Its    establishment    has 
been  greatly  aided  by  the  science  of  statistics,  which  is  of  more  decided 
importance  in  surgery  than  in  medicine,  because  the  relations   and  pro- 
cedures of  the  former  are  more  uniform  and  more  readily  inspected  than 
those  of  medicine.     A  characteristic  stamp  has  been  impressed  upon  the 
surgery  of  our  century  by  the  bold  and  somewhat  unexpectedly  successful 
practice  of  visceral   surgery,  i.  e.  the  surgery  of  the  cavities  of  the  bod}', 
from  the  ligation  of  the  great  internal  vessels  to  the  extirpation  of  ovarian 
tumors,  the  spleen,  kidneys,  larynx  etc..  a  practice  which  contrasts  strongly 
with  that  of  earlier  surgery,  which   was,  on  the  whole,  rather  a  surger}7 
of  the  outer  membe&s,  if  such  an  expression  is  permissible.1     In  accordance 
with  this  conservative  tendency  of  surgery,  resections  and   decapitations 
(to  which  the  invention  of  the  chain-saw  b}'  James  Jeff'ray  in  1806  gave 
an  impulse),  rather  than  the  earlier  amputations  and  exarticula,tions,  have 
been  cultivated,  and  so  far  as  Germany  is  concerned  this  practice  was  also 
introduced  into  militar}'  surgery  b}'  Bernhard  von  Langenbeck,  Stromeyer 
and  Esmarch.     To  resection  was   added  the  osteotomy  of  Bernhard  von 
Heine   (1800-1846)    and  A.  Mayer  in  Wiirzburg,   and  the  so-called  sub- 
cutaneous osteotomy  of  B.  Langenbeck  (1854),  performed  by  means  of  a 
drill  and  saw.     Another  great  advance  was  the  subcutaneous  tenotomy 

1.  Much  extravagance  has  been  displayed  on  this  subject,  and  particularly  in 
Germany  less  attention  has  been  devoted  not'infrequently  to  the  final  result  than 
to  the  temporary  success  in  the  operation.  But  operations  should  be  only  the 
means  of  restoring  health,  not  simple  measures  for  self-aggrandizement,  and  the 
permanence  of  the  success  should  be  looked  to  more  frequently  than  is  often  the 
case.  [In  the  United  States  too  the  well-known  formula  "  The  operation  was 
entirely  successful,  but  the  patient  —  died"  meets  the  eye  more  frequently  than 
is  becoming  in  a  humane  profession.] 


—  1028  — 

introduced  permanently  into  surgeiy  by  Stromeyer,  who  performed  his  first 
operation  of  this  nature  in  1831.     We  should  also   mention  the  improve- 
ment in  plastic  operations,  among  which  should  be  counted  the  operation 
of  osteoplast}-   introduced   by    B.    Langenbeck   in   1^59.     The   operations 
mentioned,  and  other  operative  methods,  some  of  them   tedious  and  diffi- 
cult, were  certainly  greatly  facilitated,  in  fact  almost  conditioned,  by  the 
discovery  of  the  anaesthetic  effects  of  ether  and  chloroform,   one  of  the 
most  beneficent  discoveries  ever  made.     The  rapid  operations  of  an  earlier 
date  now  disappeared,  and  instead  of  rapidity  of  method,  the  security  of 
the  patient  and  the  certainty  of  success  were  now  demanded.     Pain  was 
no  longer  the  occasion  for  an  avoidance  of  more  tedious,  but  safer  methods 
of  procedure.     Another  advance  in  surgery,  not  so  beneficent,  however,  in 
its  results,  was  the  rubber  bandage  of  Estnareh,  introduced  in  1873  for  the 
production  of  artificial   anaemia.     This    invention,  which,   like  almost  all 
great  inventions,  was  preceded  by  individual,  though  not  methodical  exper- 
iments,  was   anticipated    b}*    the   revival    of    arterial    torsion    (Amussat, 
Thierry,  Velpeau,  and  Fricke,  all  in   the  same  year   1829),  by  more  rapid 
methods  of  ligation,  by  compression  and  aplatissement,  suture,  acupunct- 
ure, galvano-puncture,  injection  etc.,  all  of  which  combined  to  give  to  the 
surgeon   the   control    of    bleeding   vessels.     Pain   and    haemorrhage,   the 
greatest  antagonists  of  the  humanely  thoughtful  and   sensitive   surgeon, 
by  the  two  methods  mentioned   were  not,  indeed,  put  entirely  out  of  con- 
sideration, but  assumed  in  operative    methods  the  position  of  only  inci- 
dental factors.     The  local  anaesthesia  of  Benj.  W.  Richardson   (18G6)  also 
serves  to  control  pain,  while  ecrasement.  brought  forward  by  E.  Chassaignac 
(1858),  and  the  use  of  the  galvano-cautery  introduced  b}-  A.  Th.  Middel- 
dorpff  in  1854,  are  directed  against  haemorrhage.     On  the  other  hand,  the 
actual  cautery,  the    moxa  etc.  faded    from    sight  more    and  more,    to   be 
replaced  in  many  respects  by  electrolysis,   introduced  by  Nelaton  (1864), 
and  the  massage  of  Mezger. 

Among  the  operative  procedures  of  permanent  value.  Lithotripsy,  an 
operation  .known  even  to  the  Byzantine  physicians,  and  for  which  instru- 
ments were  invented  by  Sanctorius,  was  practised  by  Antonio  Ciucci  of 
Arezzo  in  the  17th  century,  but  its  permanent  introduction  into  practice 
was  due  to  Gruithuisen,  Civiale  (1820),  Heurteloup,  Leroy  d'Etiolles  and 
B.  Stilling.1  Orthopaedic  surgery,  or  subcutaneous  tenotomy,  was  intro- 
duced by  Delpech  in  1816,  but  it  was  first  practised  systematically  by  L. 
Stromeyer  (1831),  and  popularized  in  France  particularly  by  Jules  Guerin, 
although  Sir  Astley  Cooper  and  Dupuytren,  by  their  division  of  the  fasciae 
and  muscles,  had  suggested  the  principles  of  this  branch.  On  the  other 
hand,  the  so-called  "Heilgymnastik"  of  Ling,   the   "Streckcuren"  of  Jac. 

1.  In  this  connexion  the  "  Lithotrity  by  a  Single  Operation  ",  introduced  to  the  pro- 
fession by  Prof.  Henry  J.  Bigelow  of  Boston  in  187s,  deserves  notice  as  an 
improvement  which  has  met  with  prompt  and  deserved  recognition  by  surgeons 
both  at  home  and  abroad.    II. 


—  1029  — 

von  Heine  etc.  have  proved  to  be  of  merely  ephemeral  importance.  Neu- 
rotomy and  neurectomy  were  studied  as  special  methods  by  Schuh,  A. 
Wernher,  Nussbaum  (nerve-stretching,  1872)  and  others,  and  the  cavity  of 
the  larynx  was  rendered  accessible  to  surgical  treatment  by  Bruns.  An 
advance  of  the  most  humane  importance  is  found  in  the  improvement  of 
the  operation  for  vesico-vaginal  fistula  by  Jobert  de  Lamballe  (1852), 
by  the  late  Gustave  Simon,  Bozeman  and  others,  as  the  result  of  which 
success  in  the  operation  is  the  rule  instead  of  the  exception,  as  was  the 
oase  before  their  day.1  Even  the  greatest  operative  procedures,  like  ovari- 
otom}-,  by  the  aid  of  improved  methods  and  more  modern  principles  of 
after-treatment,  have  been  conducted  to  success  by  Spencer  Wells  (in  1877 
he  had  performed  ovariotomy  800  times),  Koeberle1  and  others.  On  the 
other  hand,  ligation  of  the  great  vessels,  which  was  frequently  undertaken 
at  the  beginning  of  the  century,  particularly  during  the  study  of  the  col- 
lateral circulation,  is  now  abandoned. 

The  use  of  animal  fibres,  e.  g.  catgut,  for  sutures,  introduced  by  Sir 
Astley  Cooper  and  Philip  Syng  Physick,2  the  suture  with  Carlsbad  needles 
and  the  lead  suture3  of  Dieffenbach  in  operations  upon  the  palate,  the 
silver  wire  suture  of  J.  Marion  Sims  (1857),  the  iron-wire  suture  of 
Simpson  (1859),  the  horse-hair  suture  of  Simon  etc.,  are  some  of  the 
novelties  in  the  suture  line  introduced  into  surgical  practice.  Collodion4 
was  employed  in  effecting  sutures  b}'  B.  von  Langenbeck  and  Burow, 
the  so-called  serres-fines  were  recommended  by  Vidal  (1849),  and  the. 
early  removal  of  sutures  was  revived  by  Bruns.  Finally  the  antiseptic 
method  has  recently  found  a  special  application  even  to  the  material 
of  ligatures. 

As  regards  bandages,  the  introduction  of  plaster  of  Paris  by  Larrey, 
(1824),  Eaton,5  C.  A.  F.  Kluge  and  Dieffenbach  (the  principles  for  its 
employment  were  set  forth  by  F.  L.  Froriep  as  early  as  1817),  at  first 
attracted  little  attention  in  general  practice,  until  the  Dutchman  A. 
Mathijsen  (1805-1878,  died  in  Hanover)  brought  forward  in  1852  the  use 

1.  Vidal  de  Cassis  as  late  as  1839  declared  :  "1  do  not  believe  that  there  exists  in  the 

science  of  surgery  a  well  authenticated  complete  cure  of  vesico-vaginal  fistula". 
The  procedure  of  Jobert  de  Lamballe  has  been  almost  entirely  superseded  by 
that  of  J.  Marion  Sims  and  its  modifications.  Sims's  method  was  published  in 
1852,  and  the  "button  suture"  modification  of  Nathan  Bozeman  was  brought 
forward  in  1856.    Simon's  work  appeared  in  1854.    H. 

2.  Dr.  Physick  used  strips  of  French  kid.     H. 

3.  The  subject  of  metallic  ligatures  was  studied  by  Dr.  H.  S.  Levert  of  Mobile, 

Alabama,  while  a  student  under  Dr.  Physick  in  Philadelphia,  and  his  conclusion 
as  to  their  innocuous  character  was  published  in  the  American  Journal  of  the 
Medical  Sciences  in  1829.  Dr.  Warren  Stone  of  New  Orleans  is  believed  to  have 
been  the  first  to  apply  a  wire  ligature  to  a  human  artery  in  1859.     H. 

4.  Collodion  was  first  applied  to  surgical  purposes  by  Mr.  J.  Parker  Maynard,  a 

student  of  medicine  in  Boston,  in  1847.     H. 
■5.   Eaton  was  the  English  consul  at  Bassora  and  author  of  "A  Survey  of  the  Turkish 
Empire",  London  1798.     H. 


—  1030  — 

of  the  gypsum  bandage.  After  this  the  plaster  bandage  was  employed 
entirely  too  extensively  until  recently,  when  surgeons  are  beginning  to 
avoid  it.  It  was  always  actively  opposed  b}T  Stromeyer.  The  starch 
bandage  introduced  by  Louis  Jac.  Seutin  (1793-1863)  of  Nivelles  in  1840, 
like  the  gutta  percha  bandage  of  Uytterhoeven  in  1851  and  the  water- 
glass  bandage  of  A.  Mitscherlich,  was  never  so  generally  employed.  Bon- 
net introduced  wire-splints,  others  adopted  metal  splints  etc.,  as  the  sup- 
port for  the  dressings. 

In  the  treatment  of  wounds,  while  the  greatest  cleanliness  and  con- 
stant ventilation  occup}'  the  first  place,  permanent  cold  irrigation  was 
brought  forward  by  Bognetta.  A.  Berard,  Velpeau  and  others,  instead  of 
the  cold  dressings,  which  required  constant  change.  On  the  other  hand, 
B.  von  Langenbeck  (born  1810)  proposed  permanent  baths  of  warm  water 
for  the  extensive  wounds  of  amputation.  The  most  attention  and  the 
most  extended  approval,  however,  have  been  aroused  by  the  antiseptic 
dressings  of  Sir  Joseph  Lister,  first  of  Glasgow,  then  in  Edinburgh,  in 
1869  the  successor  of  Syme  and  since  1877  professor  in  King's  College, 
London.  This  dressing  is  based  upon  the  emplo}Tnent  of  carbolic  acid 
discovered  by  Bunge  in  1834.  It  has  awakened  in  Germany,  as  well  as 
elsewhere,  the  parties  known  as  Antiseptists  and  Aseptists.  By  the  aid 
of  Wells's  (?)  anaesthesia.  Lister's  dressing  and  Esmarch's  bandage,  the 
surgen'  of  our  centur}-  is  able  to  conduct  operations  to  a  successful  termi- 
nation without  pain,  without  suppuration  and  without  bleeding —  a  result 
never  heretofore  accomplished,  and  indeed  scarcely  thought  possible. 

That  a  large  number  of  new  operative  methods  and  numerous  improve- 
ments in  the  instrumental  apparatus  of  our  highly  developed  surgery  and 
surgical  technics  have  appeared,  is  a  matter  of  course. 

Many  forms  of  disease  have  been  better  differentiated,  and  new  forms 
discovered  or  rediscovered. 

Among  the  individual  departments  of  surgical  science,  general  sur- 
geiy  and  the  theory  of  tumors  have  certainly  in  our  century  experienced 
the  most  extensive  and  fundamental  changes  and  advances.  Next  to  these 
we  may  rank  military  surgery,  with  the  railroad  transportation  of  the 
wounded  after  the  American  example,  the  barrack-system,  also  first  exten- 
sively used  in  America  and  the  decisions  of  the  Geneva  Convention, 
brought  into  existence  by  Henri  Dunant  in  1H64. 

In  our  day,  however,  ophthalmology,  otology  and  dentistry  have 
detached  themselves  from  general  surgery  still  more  than  heretofore,  so 
that  these  branches  are  studied  and  practised  as  entirely  distinct  depart- 
ments. Although  too  modern  specialism  has  developed  least  in  the  direct 
line  of  surgery,  yet  specialists  in  surgery  taken  from  the  ranks  of 
thoroughly  educated  physicians  (in  place  of  the  half-educated  surgeons 
of  an  earlier  day)  could  certainly  only  elevate  the  art  of  operative  surgery, 
which,  in  contrast  to  the  past,  is  involved,  on  the  whole,  but  little  in  general 
practice.     For  surgery,  besides  natural  gifts,  demands  in  particular  more 


—  1031  — 

special,  technical  knowledge,  education  and  dexterity,  than  the  average 
overburdened  general  practitioner  in  Germany  can  acquire. 

If  surgery  has  accordingl}'  gained  infinitely  in  the  intensity  of  its 
scientific  study,  the  operative  practice  of  surgery  has  lost  its  extensive 
cultivation  in  our  century,  since  even  in  periods  of  war  it  is  almost  exclu- 
sively the  cor}'phaei  of  surgery  who  have  opportunity  to  gather  operative 
experience.  Hence  it  results  that  eminent  surgical  practitioners,  particu- 
larly operative  surgeons,  of  whom  there  were  not  a  few  among  the  surgeons 
of  the  olden  time,  have  become  at  the  present  day  almost  a  rarity. 

This  state  of  affairs  is  evidently  also  partialljr  a  result  of  the  extremely  antiquated 
methods  of  instruction  in  the  theory  of  operations  which  prevails  almost  everywhere, 
according  to  which  the  student  can  onty  exceptionally  learn  by  actual  practice  how 
to  open  a  furuncle  or  an  abscess,  while  operative  practice  on  the  cadaver,  which 
occasionally  bores  even  the  teacher,  likewise  awakens  no  interest  in  the  pupil,  and 
gives  exercise  to  no  skill  other  than  that  of  mechanical  cutting  and  sawing,  a  prac- 
tice the  taste  for  which  has  been  already  exhausted  by  anatomical  dissections.  All 
exercises  upon  the  living  body,  indeed  every  imitation  of  practice  upon  the  living, 
are  lacking,  and  prominent^  among  these  the  practice  of  venesection..1.  Yet  these 
examples  of  actual  practice  might  readily  be  exhibited,  if — with  few  exceptions — old 
habits  and  convenience  did  not  oppose  the  custom  and  permit  nothing  more  to  be 
done  than  had  been  done  by  our  forefathers,  and  if  a  pupil  was  not  loooked  upon  as 
a  troublesome  adjunct  to  the  position  of  teacher.  But  from  mere  observation  no  one 
can  acquire  presence  of  mind  and  dexterity,  as  Dieffenbach  especially  has  empha- 
sized, and  that  the  practising  ph}Tsician,  in  the  absence  of  these  qualities,  often  suffers 
injury  in  his  whole  subsequent  career,  is  frequently  to  be  laid  to  the  charge  of  his 
almost  entirely  theoretical  instruction. 
At  the  beginning  of  the  century 

a.  The  French, 

who  naturalized  pathological  anatomy  in  modern  surgery  and  have  ever 
been  distinguished  as  surgeons  by  their  fertility  of  invention,  dexterity  in 
operating,  eloquence  in  demonstration,  excellence  in  observation  and  skill 
in  determining  the  indications  of  the  case,  but  in  a  less  degree  for  their 
after-treatment,  were  the  recognized  leaders  in  surgery.  The  foundation 
of  this  preponderance  was  laid  b}*  the  labors  of  the  great  Desault,  and 
upon  this  foundation  his  successors  continued  to  build.  From  the  school 
of  Desault  descended  the  barber-surgeon 

Alexis  Boyer  (1757-1833),  of  TJzerches  in  Limousin, 
made  a  baron  bj-  Napoleon,  and  an  eminent  teacher  and  surgical  author,  who  did 
not  neglect  the  advances  made  by  foreign  authorities.  He  was  a  professor  in  the 
Charite,  first  surgeon  of  the  emperor  and  author  of  a  work  in  eleven  volumes  entitled 
"  Traite  des  maladies  chirurgicales  et  des  operations,  qui  leur  conviennent",  Paris, 
1814-26,  which  survived  numerous  editions — the  fifth  edited  by  his  son  Philippe — and 
'  several  translations.2  Boyer  enjoyed  the  reputation  of  extreme  soberness  and  of  the 
most  careful  observation.     He  laid  great  weight  upon   the  after-treatment,  and   in 

1.  Consult  "J.  H.  Baas,  "Neue  Metbode  der  Operationsiibungen  an  Leichen  ",  1867. 

2.  It  was  partially  translated  by  our  own  countryman,  the  eminent  surgeon  Alexander 

Hodgdon  Stevens  (1789-1869),  and  published  1815-1828.     H. 


—  1032  — 

operating  placed  more  importance  upon  the  safe  employment  of  the  means  already 
possessed,  than  upon  boldness  and  the  indention  of  new  methods. 

Before  and  contemporary  with  him.  at  the  beginning  of  the  present 
century,  lived  the  following  eminent  representatives  of  French  surgery  : 
Jos.  Francois  Louis  Descharnps  (1740-1 824)  of  Chartres.  surgeon  to  the 
Charite.  who.  among  other  things,  advocated  resection  in  cases  of  compli- 
cated fractures:  Pierre  Lassus  (1741-1807),  professor  in  the  Ecole  de 
Saute  (Traite  eleiaentaire  de  medecine  operatoire,  2  vols..  1794);  Desault's 
successor.  Philippe  Jos.  Pelletan1  (1747-1829).  teacher  in  the  Ecole 
pratique,  the  College  de  Chirurgie  and  the  Hotel-Dieu  (removed  with  A. 
Dubois  in  1828),  author  of  a  "Clinique  chirurgicale  etc.";  Pelletan's  assistant 
in  the  Hotel-Dieu.  Bruno  Giraud  (died  1811)  of  Dampierre,  and  finally 
Lallement  (died  1830).  chief  surgeon  of  the  Salpelriere. 

The  -Vitalisf 

Balthasar  Anthelme  Riciierand  (1779-1840)  of  Bellay  in.Ain, 
made  a  baron  like  Boyer.  was  professor  of  surgery  in  Paris  and  a  rival 
of  Dupuytren.  though  far  behind  him  in  ability.  His  character  suffered 
so  greatly  from  ambition  and  vanity  that,  quite  in  contrast  with  his  sur- 
gical contemporaries,  he  showed  himself  often  dogmatic  and  ungrateful. 
By  this  conduct  he  seriously  injured  the  influence  of  his  scientific  activity, 
and.  in  spite  of  constant  restlessness  and  brilliant  natural  gifts,  he  was 
never  able  to  obtain  permanent  popularity.  Richerand  also  advocated 
better  after  treatment.  His  '-Xosographie  et  therapeutique  chirurgicales", 
3  A-ols..  1S05-6.  was  a  famous  work  in  its  da}'. 

The  third  surgeon  honored  with  the  rank  of  baron   under  the  empire, 

Jean  Dominhjue  Larrev  (1760-1842)  of  Baudean  in  the  department 
of  Hautes  Pyr(mt'es,  Surgeon-in-chief  to  la  grande  armt'e.  was  recognized 
and  admired  above  all  others,  as  well  for  his  character  —  Napoleon  I.,  who. 
like  Bismarck,  had  great  respect  for  surgery,  but  less  for  medicine,  called 
him  the  most  virtuous  of  men  —  as  for  his  services  to  surgery.  As 
Napoleon,  in  spite  of  his  constant  wars,  was  able  to  accomplish  noble  work 
in  the  departments  of  administration  and  justice,  so  Larrev.  notwith- 
standing his  continual  campaigns,  found  leisure  to  write  a  large  number  of 
important  works.  In  character  he  was  good-natured,  eternally  busy  and 
full  of  philanthropy  and  self-sacrifice. 

Larrey  had  studied  in  Toulouse  under  the  direction  of  his  uncle  Alexis  Larrey.  and 
in  1787  was  appointed  a  navv-surjeon.  This  position,  however,  he  gave  up  in  order 
to  continue  his  education  in  Paris  for  3  years  under  Desault.  In  the  year  1 7 'J  12  he 
joined  the  Army  of  the  Rhine,  and  on  this  occasion  invented  the  so-called  "ambulances 
volantes".  For  the  next  22  years,  until  the  battle  of  Waterloo,  Larrey  continued  to 
share  in  the  campaigns  of  the  Republic  and  the  Empire,  participating  in  <*>0  great  battles 

1.  Lassus  and  Pelletan  made  the  post  mortem  upon  the  body  of  Louis  XVII,  as  the 
records  prove,  and  found  the  cause  of  bis  deatb  to  be  neglect  or  scropbulusis. 
Pelletan  took  the  heart  home  with  him,  but  it  was  stolen  by  his  pupil  Tillos  and 
never  returned  to  him  until  the  death  of  the  purloiner  in  1817.  It  was  then 
entombed  in  St.  Denis. 


—  1033  — 

and  400  engagements,  during  which  he  was  himself  wounded  three  times.  He  died  in 
Lj'ons  while  on  a  tour  of  inspection.  The  Bourbons  left  him  in  his  position  as  well 
as  his  offices,  and  after  his  death  three  statues  to  his  memory  were  erected  in  France. 
—  His  chief  works  were  entitled :  "  Dissertation  sur  les  amputations  des  membres 
a  la  suite  des  coups  de  feu  etc.";  "Relation  historique  et  chirurgicale  de  1'  expedi- 
tion de  1'  armee  d'  Orient  en  Egypte  et  en  Syrie";  "  Memoires  de  medecine  militaire 
et  campagnes"  ;  "Recueil  de  memoires  de  chirurgie"  ;  "Clinique  chirurgicale  exercee 
particulierement  dans  les  camps  et  les  hopitaux  militaires  depuis  1792  jusqu'  en 
1829"  ;  "Memoires"  on  yellow  fever  and  cholera,  on  penetrating  wounds  of  the  chest 
etc.  His  son  Hippolyte  Larrey  is  also  a  member  of  the  Academie  de  Medecine  and 
an  eminent  surgeon  still  living  in  Paris. 

Larrey  was  as  eminent  a  surgeon  as  he  was  experienced  as  an  operator. 
Among  other  operations  he  performed  disarticulation  of  the  hip-joint 
(already  practised  twice  on  the  same  person  by  the  Surgeon  La  Croix  of 
Orleans  in  17-48),  and  executed  200  amputations  in  a  single  da}'.  He  was 
too  the  chief  advocate  of  primary  amputations  etc.  A  wonderful  organizer 
in  affairs  pertaining  to  military  surgery,  and  a  humane  and  indefatigable 
physician,  he  was  idolized  by  the  soldiers  and  honored  by  Napoleon  and 
most  of  the  French  surgeons.  He  was  likewise  the  medical  witness  of 
the  most  famous  epoch  of  French  history  !  Larrey  still  held  the  moxa  in 
great  esteem  and  called  it  his  "bonne  amie",  while  he  was  also  partial  to 
cold  dressings. 

None  of  the  numerous  military  surgeons  of  this  epoch  rivalled  Larrej'  in  reputa- 
tion. Next  to  him,  besides  Percy,  who  has  been  mentioned  before,  stood  perhaps: 
Baron  Nicolas  Heurteloup  (1750-1812)  of  Tours;  Louis  Seb.  Saucerotte  (1741-1814) 
of  Luneville,  who  revived  the  theory  of  contre-coup,  brought  forward  b.y  Paul 
Ammann  in  1674;  Joseph  Noel  (1753-1808),  professor  at  the  Val-de-Grace  and  then 
in  Strassburg ;  Boizot  and  Benezeck,  whose  place  was  taken  by  Larrey ;  Dupont- 
Thomassin;  Lagresie;  Etienne  Billard  Sr.  (1730-1808);  Mathieu  Laurent  Michel 
Manne  (1734-1806),  who  wrote  a  famous  work  on  the  diseases  of  the  bones;  N.  P. 
Gilbert  (1751-1814);  Pierre  Duret  (1745-1825),  who  was  the  first  surgeon  after  Littre 
to  successfully  perform  the  operation  for  the  formation  of  an  artificial  anus;  Pierre 
Louis  Delaporte  (1773-1853),  who,  after  Abernethy,  tied  the  external  iliac  artery  ; 
J.  A.  Fleury  (1758-1835),  not  to  be  confounded  with  the  hydropathist  L.  J.  D.  Fleury, 
who  with  Lubanski  introduced  the  Priessnitz  treatment  into  France  and  gave  it  a 
rational  form  ;  and  others. 

The  most  brilliant  and  fortunate  French  surgeon  of  our  century, 
equally  famous  as  a  keen  diagnostician,  bold  and  dexterous  operator,  fluent 
and  untiring  clinician  and  teacher,  a  physician  cautious  in  his  after-treat- 
ment, a  master  and  yet  prudent  in  his  determination  of  the  indications, 
an  enlightened  physiologist,  well-versed  in  normal  and  pathological 
anatomy  —  in  a  word  a  man  endowed  with  rare  gifts  for  his  profession, 
was  unquestionably  the  baron 

Guillaume  Dupuytren  (1777-1835)  of  Pierre-Bufflere  in  the  depart- 
ment of  Haute  Vienne,  who  in  1815  became  the  successor  of  Pelletan.  The 
professor  of  operative  surgeiy  and  physician-in-chief  of  the  Hotel-Dieu, 
he  maintained  until  his  death  the  predominance  of  French  surgery,  and 
collected  and  instructed  an  immense  number  of  talented  pupils,  not  only 


—  1034  — 

from  France,  but  also  from  foreign  lands  and  particularly  from  Germany, 
In  his  day  he  rendered  special  service  to  our  knowledge  of  the  subject 
of  fractures  (particularly  complicated  fractures)  and  dislocations  and  their 
treatment,  to  that  of  the  subcutaneous  division  of  muscles  and  the  resec- 
tion of  the  facial  bones,  both  of  which  operations  he  was  the  first  to  per- 
form ;  to  the  explanation  of  the  entrance  of  air  into  the  veins,  the  theory 
of  cysts,  enterotomy,  the  subject  of  amputation  etc.  It  was  through  his 
labors  that  pathological  anatomy  was  first  utilized  in  surgery,  and  he  intro- 
duced the  division  of  tumors  (according  to  the  simple  macroscopic  view) 
into  homo?oplastic  tumors,  i.  e.  those  corresponding  to  the  normal  tissues, 
and  heteroplastic,  or  those  depending  upon  abnormal  tissue-formation. 

Dupuytren  was  the  son  of  a  poor  lawyer,  and,  like  many  other  of  the  famous 
French  surgeons,  beginning  life  in  want,  he  studied  in  poverty  and  died  in  wealth. 
At  the  age  of  three  years  he  was  stolen  by  a  wealthy  lady  of  Toulouse,  who  was 
charmed  bvr  his  eminent  beauty.  His  father,  indeed,  brought  him  home  again,  but 
at  the  age  of  twelve  delivered  him  to  an  officer,  who  took  him  with  him  to  Paris  in 
order  to  have  him  educated.  After  the  completion  of  his  preliminary  education,  he 
was  encouraged  to  study  medicine  by  Thouret,  who,  as  we  have  already  seen,  intro- 
duced vaccination  into  France,  and  by  his  uncle,  the  famous  Girondist,  Vergniaud. 
Poor  as  he  was,  Saint  Simon  thought  he  might  find  in  him  a  follower,  but  was  dis- 
appointed [in  his  expectations.  Dupuytren  devoted  himself  at  once  with  fervent 
zeal  to  anatomy,  and  as  early  as  his  eighteenth  year  was  given  the  position  of 
prosector.  In  1801  he  was  made  demonstrator  of  anatomy  in  place  of  A.  M.  T. 
Dumeril,  and  in  this  position  he  laid  the  foundation  of  the  famous  Musee  Dupuytren. 
He  also  devoted  attention  to  physiology,  and,  founded  in  1803  the  short-lived  Societe 
Anatomique.  At  the  same  time  he  applied  for  the  position  of  a  surgeon  of  the 
second  class  in  the  HOtel-Dieu.  and  under  the  protection  of  Boyer  won  the  place  in 
in  opposition  to  Roux,  Tartra,  Hedeloffer  and  Maygrier.  With  the  same  perseverance 
which  he  had  heretofore  displayed  in  the  study  of  anatomy  he  now  devoted  himself 
to  surgery.  In  1808  he  was  appointed  adjunct  superior  surgeon  to  the  Hotel-Dieu, 
and  in  1S12  professor  of  operative  surgery,  in  opposition  to  Roux,  Marjolin  and 
Tartra.  Three  years  later  he  was  appointed  first  surgeon  of  this  hospital,  and  he 
continued  to  hold  this  position,  with  constantly  increasing  reputation,  until  the  time 
of  his  death.  In  spite  of  his  enormous  activity  in  the  Hotel-Dieu  — in  the  year  1808 
he  had  the  charge  of  2353  patients,  368  of  whom  he  operated  upon,  to  say  nothing  of 
the  treatment  of  178  cases  of  fracture  and  dislocation,  and  the  opening  of  300 
abscesses  —  and  his  didactic  lectures,  to  which  he  devoted  three  hours  a  day,  he  yet 
attended  to  a  private  practice  which  extended  all  over  France,  so  that  he  finallj-  devised, 
in  his  will  a  fortune  of  4-7  millions  of  francs,  and  was  able  to  offer  the  exiled. 
Charles  X.  another  million.  Before  his  death,  in  addition  to  other  legacies,  he  gave 
200,000  francs  to  establish  a  chair  of  pathological  anatomy,  to  which  he  nominated 
Cruveilhier.  This  legacy,  however,  was  subsequently  devoted  to  the  establishment 
of  the  anatomical  museum  which  bears  Dupuytren's  name.  In  the  year  1833 
Dupuytren  was  visited  by  a  slight  stroke  of  apoplexy.  He  then  made  a  visit  to 
Ital}-,  where  he  was  treated  like  a  prince,  and  subsequently  attended  several  bathing- 
resorts,  without,  however,  giving  up  his  duties  in  the  Hntel-Dieu.  Two  years  after 
this  attack  he  died  of  empyema.  He  had  intended  to  be  operated  upon  by  Sanson, 
but  finally  refused  the  operation,  saying  that  since  death  was  inevitable  he  would 
rather  die  at  the  hands  of  God  than  of  man.  His  funeral  obsequies  were  those  of  a 
prince.  —  His  chief  works  were :    "  Lecons  orales  de  clinique  chirurgicale  faites  a 


—  1035  — 

l'Hotel-Dieu  de  Paris,  edited  by  Brierre  de  Boismont  and  Buet,  and  subsequently  by 
tbe  former  and  Marx;  Traite  theorique  et  pratique  des  blessures  par  armes  de1 
guerre",  edited  by  A.  Paillard  and  Marx,  with  various   "Memoires". 

Dupuytren,  "The  Napoleon  of  Surgery",  possessed  great  ambition,  and 
drew  upon  himself  the  enmity  of  many  by  his  persecution  of  everyone 
who  might  in  any  way  become  his  rival. 

Contemporary  with  him,  and  his  rival  in  ability  though  not  in  fortune 
and  brilliant  characteristics,  was 

Jacques  Mathurin  Delpech  (1777-1832)  of  Toulouse,  the  first 
strictly  scientific  student  and  cultivator  of  orthopaedic  surgery  in  France. 
In  the  latter  capacity  he  performed  in  1816  the  first  subcutaneous  tenotomy 
of  the  tendo  Achillis.  He  was  likewise  the  pioneer  of  autoplastic  surgery 
in  France. 

Delpech  studied  in  his  native  city  and  was  a  pupil  of  Alexis  Larrej7,  though  he 
received  his  doctor's  degree  in  Montpellier.  To  enlarge  his  education  he  went  to 
Paris,  where  he  taught  by  day  and  devoted  his  nights  to  private  study  under  the 
pressure  of  many  privations.  In  1812  he  was  appointed  a  professor  in  Montpellier, 
where  he  erected,  at  his  own  expense,  a  large  orthopaedic  institute,  in  which,  so  far 
as  his  other  professional  duties  would  permit,  he  devoted  himself  to  this  new  depart- 
ment of  surgical  practice.  While  on  his  way  to  this  institution,  he,  as  well  as- 
his  coachman,  was  shot  by  a  patient  upon  whom  he  had  operated  for  varicocele, 
and  who  thought  that  through  Delpech's  indiscretion  he  was  prevented  from  contract- 
ing marriage.  The  bodies  of  both  victims  were  dragged  by  the  frightened  horses  to 
the  gates  of  the  institute.  Delpech's  chief  works  were  entitled :  "  Memoire  sur  la 
complication  des  plaies  et  des  ulceres  connue  sous  le  nom  de  pourriture  d'  hopital", 
1815;  "  Chirurgie  clinique  de  Montpellier",  1823-28;  "  De  1'  orthomorphie  "  etc.r 
1829. 

A  surgeon  of  no  less  reputation  and  no  less  merit,  famous  as  a  dex- 
terous and  rapid  operator,  was 

Philibert  Jos.  Roux  (1780-1854),  of  Auxerre,  Dupuytren's  successor 
in  the  Hotel-Dieu. 

His  labors  on  the  subject  of  resections,  particularly  resection  of  the  elbow-joint, 
and  on  that  of  staphylorraphy  and  plastic  surgery,  were  of  especial  importance. 

Jacques  Lisfranc  (1790-1847),  of  Saint  Martin,  physician  to  the 
HSpital  de  la  Pitie\ 

was  the  first  to  apply  phj-sical  investigation  to  surgery,  and  to  assume,  and  strive  to 
secure  for  this  science  complete  precision.  He  invented  new  methods  for  disarticu- 
lation of  the  shoulder  (in  conjunction  with  Champesme,  1815),  for  amputation  between 
the  tarsus  and  metatarsus,  which  had  been  performed  by  William  Hey  in  1803 
(though  not  brought  forward  as  a  special  method),  for  amputation  of  the  cervix  uteri, 
resection  of  the  lower  jaw,  lithotomy  in  women  (through  the  vestibulum  vagina',  in 
front  of  the  urethra)  etc.  He  was  an  extremely  skilful  operator,  and  particularly  a 
rapid  operator  (flap  amputation  from  without  inwards).  His  chief  works  were: 
"Clinique  chirurgicale  de  1'  HApital  de  la  Pitie ",  3  vol.,  1841-43;  "Precis  de 
medecine  operatoire",  3  vol.,  1845-47. 

Surgeons  of  less  importance  were  : 
Pierre  Augustin  Beclard  (1785-1825)  of  Angers, 
who  was  best  known  as  an  anatomist,  while  his  son  Jules  Beclard  (1818-1887),  professor 


—  1036  — 

in  Paris,  distinguished  himself  as  a  physiologist  (Traite  elementaire  de  physiologie 
humaine  etc.,  1855;  De  la  chaleur  produite  pendant  le  travail  de  la  contraction 
musculaire;  Precis  d'  histologic  etc.) 

Jean  Nicolas  Marjolin   (1770-1850)  of  Ray  in  the  department  of 
Haute  Saone, 
physician  to  the  Hopital  Beaujon,  a  better  teacher  than  operator: 

Charles  Maingault  (died  1840)  of  Paris, 
who  published  in  in  1822  a  famous  "  Medecine  operatoire  etc.",  with  life-sized  plates 
of  the  various  operations: 

Louis  Jos.  Sanson  (1790-18-11)  of  Paris, 
a  favorite  of  Dupuytren,  whom  he  succeeded  in  the  surgical  clinic  at  Paris.  A  keen 
observer,  eminent  diagnostician,  important  operator  (he  proposed  recto-vesical  inci- 
sion for  vesical  calculus  in  1815),  and  popular  teacher  and  practitioner,  in  conse- 
quence of  chronic  ill-health  he  died  so  poor  that  the  expense  of  his  burial  was  defrayed 
by  subscription : 

Germain  Jules  Cloquet  (1790-1883)  of  Paris,  physician  to  the 
Hopital  St.  Louis,  professor  of  surgery,  fellow  of  the  French  Academie  and 
a  Baron. 

He  was  an  extremely  fruitful  writer  on  anatomy- — he  published  a  magnificent 
atlas  —  pathological  anatomy,  hernia,  operative  surgery,  worms  etc. 
The  name  of 

Jean  Civiale  (1792-1867)  of  Thiezac,  in  Paris,  has  become  famous 
from  its  association  with  the  re-invention  of  the  beneficent  operation  of 
lithotrity,  to  which  attention  was  first  directed  in  our  century  by 

the  already  mentioned  Gruithuisen  in  Munich  and  Amussat,  and  for  which  the  first 
instrument  was  invented  by  Leroy  d'Etiolles.  .  This  instrument,  however,  did  not 
answer  the  desired  purpose,  and  the  first  actual  lithotrity  was  performed  by  Civiale1 
with  his  "Litholabe''  in  1824.  The  operation  was-opposed  by  Larrey,  Sanson,  Velpeau 
and  others.  Among  the  well-known  lithotomists  were  Souberville  (after  the  method 
of  Frere  Come),  Gillard  (the  high  operation)  etc. 

Jean  Zulima  Amussat  (1796-1856)  of  Saint-Maxent  in  the  depart- 
ment of  Deux-Sevres, 

a  physician  of  Paris,  acquired  especial  fame  by  his  re-invention  of  torsion  of  the 
arteries,  a  method  indicated  by  the  Ancients,  according  to  Haeser,  but  which  has 
been  approved  and  preserved  in  the  case  of  small  arteries  alone.  Amussat  was  also 
a  champion  of  powerful  and  long-continued  taxis  in  strangulated  hernias,  of  cauterisa- 
tion in  hemorrhoidal  tumors  etc.  Like  L.  Aug.  Mercier  (inventor  of  a  straight 
•catheter  with  a  short  curve),  he  popularized  the  practice  of  catheterism  with  straight 
catheters.  Amussat  was  never  a  professor  in  the  university,  but  he  held  at  his 
residence  so-called  "Conferences",  which  were  attended  by  the  most  famous  physi- 
cians of  his  time,  e.  g.  Sir  Astley  Cooper,  Dieffenbach,  Langenbeck  etc.  In  1878  a 
statue  in  his  honor  was  erected  in  his  native  place.  —  His  son  Alphonse  Amussat 

1.  His  original  idea  was  to  dissolve  the  calculi  chemically,  but  he  was  convinced  by 
Tlienard  of  the  impossibility  of  this  method.  He  then  proposed  merely  to  break 
off  fragments  of  the  stone,  so  as  to  determine  its  chemical  nature.  His  "  Litho- 
labe" consisted  of  two  straight  metal  tubes  fitting  each  other,  the  inner  of  which 
terminated  in  three  elastic  arms,  closed  by  retraction  into  the  outer  tube.  If  the 
stone  was  seized,  an  iron  rod  from  without  was  rubbed  forcibly  against  the  knob. 


—  1037  — 

(1821-1873)  also  distinguished  himself  as  a  surgeon,  devoting  himself  particularly  to- 
the  development  of  the  galvano-cautery. 

The  Baron  Charles  Louis  Stanislas  Heurteloup  (1793-1864)  of  Paris, 
inventor  of  the  "Percuteur  courbe  a  marteau"  and  the  artificial  leech,  and 

Ludwig  L.  Jacobson  (1783-1843),  ordinary  physician  to  the  king  of 
Denmark, 

were  also  encased  in  the  invention  of  instruments  for  the  performance  of  lithotrity. 
Both  presented  their  apparatus  to  the  Academie  in  the  year  1831.     Recently 

Charles  Gabriel  Pravaz  (1791-1853)  of  Pont  de  Beauvoisins,  a 
surgeon  of  Lyons, 

has  won  a  name  often  mentioned,  particularly  in  the  science  of  therapeutics,  by 
means  of  his  syringe,  originally  designed  for  the  injection  of  chloride  of  iron  into 
vascular  tumors  in  order  to  effect  coagulation  of  their  contents.  With  the  same 
object  he  also  employed  the  electric  current  in  1834. 

Auguste  Vidal  (1803-1856)  of  Cassis,  physician  to  the  Hopital  du 
Midi  in  Paris 

and  a  pupil  of  Moullaud  of  Marseilles,  became  the  earliest  guide  of  manj'in  the  study 
of  surgery  by  his  "Traite  de  pathologic  externe  et  de  medecine  operatoire",  5  vols., 
1838-41,  subsequently  edited  in  German  by  Bardeleben  and  frequently  reprinted  in 
both  France  and  Germany  down  to  very  recent  times. 

One  of  the  most  celebrated  surgeons  as  well  as  wealthiest  surgical  practitioners 
in  Paris  —  he  left  three  millions  of  francs  —  was 

Antoine  Jos.  Jobert  de  Lamballe  (1799-1867)  of  Matignon  in  the 
department  Cotes  du  Nord. 

Starting  from  the  deepest  povertj'  and  laboring  under  the  sternest  necessities,  he 
finally  became  a  professor  and  a  member  of  the  Academie.  He  was  an  extremely 
zealous  surgical  writer  (Traite  theorique  et  pratique  des  maladies  chirurgicales  du 
canal  intestinal,  1829;  Sur  ^invagination  et  les  sutures  intestinales  ;  Des  plaies  d' 
armes  a  feu,  1833  etc.),  and  an  operator  of  merit,  particularly  in  the  cure  of  vesical 
fistulas  and  lesions  of  the  uterus.  In  his  "  Traite  des  fistnles  vesico-uterines  "  etc., 
L852,  of  147  cases  he  reports  82  cured,  27  improved,  26  deaths  and  12  unimproved.  — 
The  eminently  practical  and  famous  Paris  surgeon, 

Alfred  Armand  Louis  Marie  Velpeau  (1795-1868)  of  Breche, 
a  pupil  of  Bretonneau  and  in  1834  successor  to  Boyer  as  professor  of  clinical  surges, 
was  a  popular  teacher  and  fertile  author,  who  devoted  his  attention  to  pure  mid- 
wifery as  well  as  surgery.  His  earliest  writings  related  to  midwiferj'  and  the  histoiy 
of  development  (Traite  elementaire  de  lart  des  accouchements  etc.,  1829,  often 
reprinted;  Embryologie  ou  ovolojiie  humaine  etc.,  1833).  Before  the  appearance  of 
the  latter  work  he  published  his  "Nouveaux  elemens  de  medecine  operatoire",  3  vols., 
1832,  while  his  last  work  was  a  treatise  on  diseases  of  the  breast  and  the  mamn.aiy 
region  (1853). 

Pierre  Nicolas  Gerdy  (1797-1856)  of  Loches, 
like  Velpeau  descended  from  povertjT,  but  from  1833  a  professor  in  Paris,  acquired 
reputation  particularly  by  his  activity  in  the  study  of  bandaging  (Traite  des  bandages 
et  appareils  de  pansement,  1826);  as  well  as  by  the  so-called  radical  operation  for 
the  cure  of  hernia  by  means  of  invagination  of  the  skin  of  the  scrotum  and  stitching 
in  place  the  fold  of  integument  formed  upon  the  finger  and  pushed  up  against  the 
abdominal  ring.     He  likewise  discussed  the  subject  of  resections. 


—  1038  — 

Philippe  Frederic  Blandin  (1798-1849)  of  Aubiguy,  the  successor 
of  Richerand  as  professor  of  operative  surgery, 
was  a  distinguished  practitiouer  and  operator. 

"We  should  also  mention  here 

P.  Fr.  Moreau  and  his  son,  of  whom  the  father  performed  in  1792  the 
first  total  resection  of  the  elbow-joint,  while  the  son  in  1816  published  his 
own  and  his  father's  experience. 

A  surgeon  of  a  reputation  as  extensive  as  well-founded  was 

Amedee  Bonnet  (1S02-185S)  of  Amberieux  in  the  department  of  Ain, 
physician  to  the  Hotel-Dieu  in  Lyons,  who  rendered  important  service  to  surgery  by 
his  treatment  of  diseases  of  the  joints  with  immovable  dressings,  i.  e.  b}-  fixation  of 
the  diseased  joints.  His  "  Traite  des  maladies  des  articulations"  appeared  in  1845, 
with  several  later  editions.  Bonnet  also  performed  enucleation  of  the  bulb,  without 
removal  of  the  ocular  muscles  (18-42). 

Less  known  outside  of  France  than  the  surgeons  already  mentioned,  were  :  P.  A. 
Beclard  (1785-1835);  Ulysse  Trelat  at  the  Charite ;  Jean  Jos.  Reynaud  (17721-18-12) ; 
Jean  Bapt.  Joach.  Clemot  (1776-1852);  Jean  Francis  Reybard  (1790-1863),  thora- 
cocentesis (1841) ;  Achille  Cleophas  Flaubert  (1784-1846)  of  Mezieres,  professor  in 
Rouen;  Louis  Mathurin  Fouillioy  (1790-1S4S) ;  G.  Goyrand  (1803-1866,  subcutaneous 
excision  of  loose  cartilages  in  the  joints);  D.  G.  Belmas;  Pouteau  of  Lyons; 
Demeaux,  who  did  good  service  in  the  study  of  hernia,  Stanislas  Laugier  (1799- 
1872)  of  Paris,  Roux's  successor;  Auguste  Berard  (1802-1846),  of  Varsins  in  the 
department  of  Maine-et-Loire,  also  in  Paris,  brother  of  the  physiologist  Piejre  Honoie 
Berard  (1797-1858);  Louis  Jacques  Begin  (1793-1859)  of  Liege;  Robert  Jos.  Henri 
Scoutteten  (1799-1871)  of  Lille,  who  wrote  on  hydrotherapeutics,  exarticulation  of 
the  foot  between  the  astragalus  and  os  naviculare  and  cuboides,  the  oval  method  of 
amputation  etc. ;  Jean  Bapt.  Lucien  Baudens  (1804-1857)  of  Aire  (Baudens'  method 
of  amputating  the  foot,  of  resecting  the  shoulder  etc.)  His  "Clinique  des  plaies  d' 
armes  a  feu  ",  1836,  and  "  Memoires"  on  strangujated  hernia  and  the  ice-treatment  of 
wounds  widely  diffused  his  name.  —  The  Belgian 

Jules  (jIuerin  (1801-1886)  of  Boussy,  who  must  not  be  confounded 
with  Alphonse  Guerin  of  the  Hotel-Dieu  (author  of  the  occlusive  wadding  dressing), 
has  obtained  great  reputation  as  one  of  the  earliest  orthopaedic  surgeons  and  the 
proprietor  of  the  orthopaedic  institution  at  Passv\  He  practised  tenotomy,  and  we 
have  from  his  pen  a  very  good  compendium  of  operations. 

Besides  Guerin  and  Delpech,  who  has  been  already  mentioned,  Henri  Bouvier 
(died  1877,  Bouvier's  corset),  member  of  the  Academie  and  an  eminent  physician  of 
children,  Tavernier,  Duval,  Lachaise  and  others  devoted  themselves  to  orthopaedic 
surgery. 

The  most  Learned  among  the  modern  French  surgeons, 

Joseph  Francois  Malgaigne  (1806-1865)  of  Charmes-sur-Moselle. 
professor  of  operative  surgery  in  Paris  from  the  year  1850,  in  addition  to  surgical 
anatomj-,  operative  surgery,  experimental  surgery,  the  surgery  of  fractures  and  dis- 
locations etc.,  also  devoted  his  attention  to  the  history  of  his  branch.  Malgaigne  as 
a  practitioner  and  operator  was  not  a  man  of  very  considerable  importance,  but  he 
was  an  extremely  active  and  fruitful  surgical  author.  His  chief  works  were: 
"  Traite  d'anatomie  chirurgicale  et  de  chirurgie  experimental  ",  1838;  "  Manuel  de 
medecine  operatoire",  1834  (8th  edition  by  Leon  Le  Fort,  1875) ;  "  Oeuvres  com- 
pletes d'Ambroise  Pare",  3  vols.,  1840;  "  Essai  sur  l'histoire  et  la  philosophie  de  la 


.      —  1039  — 

chirurgie",  1847,  and  "Traite  des  fractures  e.t  des  luxations",  1842-1855.  On  the 
other  hand  the  "  Surgeon  of  the  Second  Empire  ", 

Auguste  Nelaton  (1807-1874),  of  Paris, 
body-surgeon  to  Napoleon  III.  (his  physician-in-ordinary  was  Conneau,  18t>3— 1877), 
wrote  but  little,  and  was  eminent  particularly  as  a  surgical  practitioner.  His 
reputation  became  world-wide  through  the  invention  of  his  ingenious  probe,  by  which 
he  detected  the  presence  of  the  musket-ball  in  the  body  of  Garibaldi.  His  extremely 
flexible  catheter  of  vulcanised  caoutchouc  was  improved  and  patented  by  Jacques. 
Nelaton  was  made  an  officer  of  the  Legion  of  Honor  in  1866,  and  a  Senator  of  the 
empire  in  1868.  His  only  important  writings  were  a  "Traite  des  tumeurs  de  la 
mamelle",  1839,  and  "Elements  de  pathologie  chirurgicale",  5  vols.,  1844-60. 
Another  famous  surgical  practitioner  of  Paris  was 

Jules  Nicolas  Demarquay  (1814-1875)  of  Longueval  in  the  depart- 
ment of  the  Somme, 

who  also  held  the  chair  of  a  professor.  Demarquay  distinguished  himself  also  as  a 
hygienist  and  an  authority  in  dietetics,  and  it  was  through  his  influence  that  the 
Esmarch  bandage  became  popularized  in  France.  His  chief  writings  were  entitled  : 
"Des  tumeurs  de  l'orbite",  1853;  "  Essai  sur  une  pneumatologie  medicale",  1866; 
"  Sur  les  blessures  ",  1861 ;  "  Sur  la  gangrene  du  penis  ",  1870 ;  "Sur  le  traitement  de 
tetanos  "  1871 ;  "  Sur  l'osteomyelite  ",  1872  etc. 

Pierre  Salomon  Segalas  (1792-1875)  of  St.  Palais,  was  an  eminent  and  busy 
practitioner  in  Paris.  —  Philippe  Boyer,  like  the  younger  Larrey,  did  all  honor  to  the 
name  of  his  father,  though  he  did  not  nearly  rival  the  latter  in  reputation,  while  con- 
versely the  younger  Paul  Louis  Benoit  Guersant  (1800-1869),  whose  father,  a  con- 
temporary of  the  elder  Boyer,  remained  unknown,  rendered  himself  famous  by  his 
treatise  "  Notices  sur  la  chirurgie  des  enfants",  1864-67.  The  names  of  Charles 
Pierre  Denonvilliers  (1808-1872)  and  J.  F,  Jarjavay  (1819-1868),  professor  of  clinical 
surgery  in  Paris  (Des  operations  applicables  aux  corps  fibreux  de  l'uterus,  1850), 
also  extended  beyond  the  limits  of  their  native  country,  and  the  same  may  be  said  of 
Eugene  Follin  (1823-1867)  of  Harfleur,  who  devoted  his  study  chiefly  to  ophthalmos- 
copy and  the  ophthalmoscope  (Traite  elementaire  de  pathologie  externe,  1862, 
continued  by  his  friend  Simon  Duplay).  In  special  circles  the  following  surgeons 
likewise  attained  fame:  M.  A.  Jamain  (died  1862);  Cesar  Alphonse  Robert  (1801- 
1864)  of  Marseilles,  professor  in  Paris;  Jos.  Gensoul  (1797-1858;  partial  resection  of 
the  jaw,  the  first  in  our  century  in  1825)  in  Lyons;  Adolphe  Lenoir  (1802-1866)  of 
Meaux,  surgeon  to  the  Hopital  Necker  in  Paris;  Louis  Marie  Michon  (1802-1860)  of 
Blangy,  president  of  the  surgical  society  in  Paris;  A.  D.  Valette,  professor  in  Lyons 
(invagination  in  hernia);  F.  M.  G.  Roustan;  Pierre  Charles  Huguier  (1804-1873), 
the  inventor  of  the  hj-sterometer ;  Morel-Lavallee  (1811-1865);  Auguste  Liegeois 
(died  1871);  L  Jos.  Bauchet  (1826-1865);  Auguste  Richard  (died  1872) ;  Laborie 
and  Em.  Foucher  (died  1867).  Karl  Heinrich  Ehrmann  (1792-1878),  professor  of 
anatomy  and  surgery  (the  latter,  as  well  as  midwiferj',  was  united  with  the  chair  of 
anatomy  until  1836)  in  Strassburg,  should  be  mentioned  here  from  the  fact  that  he 
performed  in  1844  the  first  laryngotomy  for  laryngeal  polypus.  Dr.  Alexandre 
Canquoin  (1795-1881)  of  Dijon  was  the  inventor  of  the  chloride  of  zinc  paste,  which 
bears  his  name.  —  Considerable  fame  as  an  operator  and  a  surgical  writer  was  ac- 
quired by  Ch.  E.  Sedillot  (1804-1883,  professor  and  member  of  the  Academie)  in 
Strassburg,  through  his  subperiosteal  resections  and  his  Traite  dc  medecine  operatoire, 
bandages  et  appareils",  a  work  published  in  conjnnction  with  L.  Legouest  and  often 
reprinted.  E.  Chassaignac  (1805-1879)  has  been  already  mentioned  as  inventor  of 
the  ecrasement  lineare,  and  we  also  owe  to  him  the  modern  system  of  drainage  in 


—  1040  — 

surgery  by  means  of  tubes  of  caoutchouc  (1859),  though  the  same  plan  was  employed 
by  Hippocrates,  Celsus,  Gui  de  Chauliac,  Pare,  Brunschwigk  and  others.  Chas- 
saignac  likewise  described  solution  of  the  epiphyses  of  bones  (called  by  him  bone- 
typhus,  osteomyelite  essentielle,  and  by  Wernher  osteochondritis  epiphysaria,  which, 
however,  had  been  already  discussed  by  the  German  Reichel  in  the  18th  century. 
The  name  of  J.  D.  Soupart  is  associated  with  the  operation  of  amputation  with  four 
flaps.  Bernard  and  Huette  furnished  a  well-known  "Traite  de  medeeine  operatoiie''. 
—  Among  the  French  surgeons  of  the  present  day  the  most  famous  are:  J.  G  Mai- 
sonneuve  (born  1809)  ;  Fred.  Bouisson  and  Serre  in  Montpellier ;  L.  Oilier  in  Lyons; 
L.  Gosselin  at  the  Charite;  J.  E.  Petrequin  (1808-1876)  in  Lyons  (galvanopuncture 
in  aneurisms,  1845);  Aug.  Adolphe  Reynaud;  H.  F.  Dolbeau  (1831-1877);  Louis 
Alfred  Richet  with  A.  Guerin  and  Cusco  at  the  Hotel-Dieu  in  Paris;  Terrillon  and 
Benj.  Auger  at  the  Hopital  St.  Andre;  Just  Marie  M.  Lucas-Championniere.  an 
earnest  follower  of  Lister;  Jules  Pean  (laparotomy,  extirpation  of  the  spleen; 
resection  of  the  stomach  in  1879,  before  Billroth)  ;  Paul  Ollivier ;  Ch.  Sarazin  ;  Leon 
Clement  Voillemier  (1809-1878);  Joachim  Giraldes  (1808-1875);  J.  L.  Reverdin, 
professor  in  Geneva  (transplantation  of  skin  upon  ulcerated  surfaces,  (1872)  j1  Paul 
Broca  (1824-1880),  senator  etc.,  surgeon  to  the  Hopital  des  Cliniques,  an  eminent 
anatomist,  anthropologist  and  surgeon,  who  proposed  anaesthesia  by  means  of  hypnot- 
ism or  staring  at  a  glittering  point.  This  method  had  been  made  known  by  the 
English  physician  James  Braid  of  Manchester  (1841)  and  Esdaile  in  Calcutta  (1852). 
Broca  also  gave  his  name  to  the  so-called  "  Broca' s  convolution",  the  third  left 
frontal  convolution  of  the  brain,  which  he  designated  as  the  seat  of  the  faculty  of 
articulate  speech.  His  chief  works  were:  "Traite  des  anevrismes  et  leur  traitement", 
1856;  "Traite  des  tumeurs",  1863;  "Atlas  d'anatomie''  with  Bean  and  Bonamy 
He  published  in  all  about  300  writings.  We  should  also  mention  Aristide  Verneuil 
(established  the  first  successful  gastric  fistula  in  man)  at  the  Hopital  de  la  Pitie, 
where  Leon  Labbe  also  labors;  Tillaux  at  the  Hopital  Lariboisiere ;  Felix  Guyon 
and  Desormeaux  at  the  Hopital  Necker;  also  Eugene  Boeckel  in  Strassburg  (gaha- 
nocaustic)  and  E.  Koeberle,  the  famous  ovariotomist  (Resultats  de  statistique  de 
l'ovariotomie,  1868),  in  spite  of  their  originally  German  names,  should  be  counted 
among  the  French  surgeons.  Jules  Rochard,  chief  physician  of  the  French  marine 
and  a  morbid  revancheur,  whom  we  have  followed  chiefly-  in  the  preceding  catalogue, 
has  distinguished  bimsslf  as  an  author  on  marine  surgery  and  a  skilful  historian  of 
modern  French  surgery'.  (Histoire  de  la  chiiurgie  francaise  au  dixneuvieme  siecle, 
Paris,  1874).  He  admits  the  decade  nee  cf  French  surgery  in  the  second  half  of  our 
century,  but  thinks  the  Germans  have  stolen  their  ideas  from  the  French,  very  much 
as  the  French  populace,  educated  and  uneducated,  r.fter  the  war  of  1870-71,  thought 
the  German  soldiers  had  stolen  all  their  clocks.  In  reply  to  Billroth's  declaration 
that  French  surgery  at  the  present  day-  is  behind  the  age,  Verneuil  recently  (1888) 
protested  that  the  French  merely7  operated  less  frequently  than  some  other  nations, 
were  more  conservative  and  especially  more  cautious  in  undertaking  bold  operations 
of  doubtful  result  —  a  reply  which  contains  considerable  truth. 

Among  the  surgeons  of  French  Switzerland  Matthias  Mayor  in 
Lausanne  (simplification  of  the  dressing  of  wounds  and  catheterisme  force 
etc.)  and  Charles  Theophile  Maunoir,  professor  in  Geneva,  were  particularly 
prominent. 

1.  Prof.  Frank  H.Hamilton  (1813-1886)  of  Buffalo,  N.  Y.,  as  far  back  as  1847  pro- 
posed the  operation  of  skin-grafting  in  the  Buffalo  Medical  and  Surgical  Journal, 
and  a  full  account  of  a  successful  case  performed  by  this  surgeon  may  be  found 
in  the  New  York  Journal  of  Medicine  for  185-i.     (Gross.)     H. 


—  1041 


b.  The  Italians, 

after  the  time  of  Scarpa,  never  obtained  a  decided  influence  upon  the  surgery  of  our 
centurj',  although  they  possessed  good  surgeons  in  great  abundance.  Almost  all  of 
them,  however,  contented  themselves  with  following  the  lead  of  other  nations.  The 
best  known  Italian  surgeons  were  probabty  Luigi  Porta  (1800-1875),  professor  in 
Pavia,  and  Aloysio  Vanzetti  (born  1809)  in  Padua,  the  latter  famous  for  his  digital 
compression  of  arteries  in  the  treatment  of  aneurism,  a  disease  whose  operative 
treatment  has  always  been  a  favorite  subject  of  studjr  with  Italian  surgeons.  Giov. 
Batt.  Monteggia  (1762-1815;  Instituzioni  di  chirurgia,  Milan,  1802);  P.  Mariano  in 
Padua;  G.  Regnoli ;  Cesare  Ruggieri  ( 1 768-1828)  in  Padua;  Federigo  Pajola  in 
Venice;  Emiliani  in  Fa'enza,  who  performed  ovariotomy  in  1815,  after  it  had  been 
already  done  by  Robert  Houston1  in  Glasgow  in  1701,  by  l'Aumonier  in  Rouen  in 
1781,  and  by  Ephraim  McDowell  of  Danville,  Kentucky  in  1809,  were  likewise  eminent 
surgeons.  We  should  also  mention:  de  Negri;  Zanetti;  R.  Gritti  ;  Luigi  Ciniselli 
in  Cremona  (1805-1879),  who 'advocated  galvanopuncture  even  in  aneurism  of  the 
aorta;  Bruno  in  Turin,  ordinary  physician  of  King  Victor  Emmanuel ;  Pasquale  Landi 
in  Siena  ;  Domenico  Peruzzi;  Enrico  Bothini  in  Novara ;  Federico  Allesandrini  in 
Chiari ;  Luigi  A  mabile  in  Naples  (Transplantation  of  skin  after  Reverdin)  ;  Panizza  ; 
F.  Palasciano,  CI.  Romano  in  Naples;  A.  Riberi  in  Turin  ;  Tizzoni  (amputation  with 
a  periosteal  flap);  del  Greco  in  Florence;  Cipriani  (died  1883)  professor  in  Rome; 
Albanese,  the  surgeon  of  Garibaldi  in  Palermo;  F.  Rizzoli  (died  1880)  in  Bologna 
(osteoclast  1847,  etc.),  who  exercised  great  influence  upon  modern  Italian  surgery 
and  left  the  colossal  fortune  of  six  millions  of  francs  for  the  maintenance  and  exten- 
sion of  a  model  orthopaedic  institute,  upon  which,  during  his  lifetime,  he  had  already 
expended  two  millions;  Durante;  Prandina  ;  Signorini  (1797-1844)  in  Padua,  who 
recommended  an  intro-retroversio  cornata  or  chilissochisorafia  (what  a  barbarous 
name!)  as  a  radical  procedure  in  hernia,  and  performed  in  1842  the  first  total  extir- 
pation of  the  lower  jaw;  P.  Mariano  in  Padua;  Constanzo  Mazzoni  (1825-1885),  a 
famous  teacher  and  operator,  president  of  the  Supreme  Board  of  Health  in  Rome, 
and  a  surgeon  well  informed  in  the  history  of  his  art;  Francesco  Cortese  (1801-1883) 
physician  of  the  general  staff  in  the  Italian  army,  also  of  Rome  etc.  —  Among  the 
eminent  Italian  ophthalmologists  were  Giovanni  Battista  Quadri  (1780-1851),  professor 
in  Naples,  and  Francesco  Flarer  in  Pavia,  both  very  famous  pupils  of  the  school  of 
Beer  in  Vienna;  Giovanni  Baratta  (Osservazioni  pratiche  sulle  principale  malattie 
degli  occhi,  Milan  1818)  and  Antonio  Quaglino  (born  1817),  a  famous  ophthalmol- 
ogist of  Pavia. — At  the  beginning  of  the  century  Italian  surgery  inclined  partly  to  the 
Vienna  school  and  partly  to  the  Parisian  or  French.  The  latter  was  entirely  the 
case  with  the  surgery  of  the 

c.  Spanish, 

who,  since  the  time  of  Gimbernat,  have  been  able  to  point  to  no  surgeon  whose  ser- 
vices have  been  sufficiently  important  to  arouse  any  continued  attention  in  foreign 
countries. 

On  the  other  hand,  Spanish  surgery  has  recently  displayed  a  lively  interest  in  the 
advances  of  foreign  lands,  and  particularly  those  of  France,   and  we  will  merely 

I.  The  ovariotomies  of  both  Houston  and  Laumonier  were  accidental,  or  at  least 
incidental  to  other  operations,  and  not  deliberately  planned  and  executed  as 
primary  operations.  The  first  deliberate  and  intentional  ovariotomy  proper  was 
performed  in  1809  by  Ephrain  McDowell  of  Kentucky,  of  whom  we  shall  speak 
hereafter.  (H.) 
66 


—  1042  — 

mention  by  name  here  some  few  of  the  Spanish  surgeons  who  have  developed  and 
presented  their  surgical  experience  in  the  journals  after  the  modern  style:  Creus; 
Yincente  Urquiola  (lithotrity);  Augustin  Maria  de  Ovieto  (perineal  section);  Santiago 
Garcia  Vasquez  ;  Antonio  Romero  Linares;  Gonzalez  Olivarez  in  Valladolid ;  Pas- 
cual  Candela  y  Sanchez;  Maria  Augusto  Llacayo  y  Santa  etc.  There  is  also  in  Spain 
no  lack  of  reports  of  cases  published  in  the  journals.  Spanish  ophthalmology  until  a 
short  time  ago  belonged  chiefly  to  the  sphere  of  the  Saints,  particularly  to  St.  Lucia, 
and  it  is  only  recently  that  human  specialists,  mostly  pupils  of  the  French  school, 
have  taken  possession  of  this  department.  Among  these  we  may  mention  particularly 
Jago  Delgado  (18:50-187.3)  in  Madrid.— To  judge  from  the  number  of  students,  we 
should  expect  to  find  the  condition  of  medicine  in  Spain  very  flourishing.  In  1877- 
78,  in  the  almost  incredible  number  of  49,287  students  of  all  departments,  we  find 
21,620  students  of  medicine  and  2,530  of  pharmacy. 

d.  The  English,1  . 

The  proper  creators  of  the  so-called  conservative  surgery  (inaug- 
urated by  Henry  Park  and  Charles  White),  with  Sir  Astley  Cooper  at  their 
head,  at  once,  like  the  French,  utilized  the  results  furnished  by  patho- 
logical anatomy.  In  this  the}-  were  powerfully  influenced  by  the  example 
of  their  own  great  investigators  in  this  department,  John  Hunter  and 
Matthew  Baillie.  The  advances  in  physiology  and  pathology  were  like- 
wise equally  utilized  in  practice.  Equally  inventive  with  the  French, 
and  bolder  when  necessity  demands,  not  fond  of  novelties,  but  rather  firm 
in  their  attachment  to  tradition,  the  surgeons  of  England  are  less  showy 
in  word  and  resolution,  than  quiet  and  sober  in  both  these  directions. 
Yet  in  execution  they  are  prudent  and  calm.  Then  too  the  most  careful 
local  and  dietetic  treatment,  as  well  as  a  particular  attention  to  the 
h}*gienic  management  of  the  case,  were  very  early  regarded  in  English 
surgery  as  a  portion  of  the  surgeon's  duty  at  least  as  important  as,  and 
frequently  surpassing  in  importance,  the  performance  of"  the  operations 
themselves.  In  this  point  of  view  modern  surgical  practice  owes  to  the 
English,  and  particularly  to  Lister,  the  greatest  practical  advances,  which 
far  outweigh  in  the  beneficence  of  their  action  the  American  discovery  of 
anaesthesia  and  the  German  invention  of  Esmarch's  bandage.  The  fact 
that  English  surgeons  have  not  abandoned,  so  strictly  as  the  German,  the 
practice  of  medicine  proper,  also  lends  to  English  surgery  a  partially  med- 
ical character,  if  such  an  expression  may  be  used. 

The  most  celebrated  representative  of  English  surgery  in  our  centur}- 
was  unquestionably 

1.  In  the  collaboration  of  the  sections  on  English  and  American  medicine  in  the 
19th  century  it  has  been  judged  wisest  to  avoid  disfigurement  of  the  page  by  the 
introduction  of  numerous  brackets  to  indicate  precisely  the  additions  and  altera- 
tions of  the  translator.  As,  however,  the  author  has  given  the  translator  a  carte 
blanche  to  remodel  them  as  seemed  best  in  his  judgment,  it  is  but  just  that  he 
should  also  assume  the  responsibility  of  all  errors  and  omissions  in  these 
sections.    (II.) 


—  1043  — 

Sir  Astley  Paston  Cooper  (1768-1841)  of  Brooke  in  Norfolk,  sur- 
geon to  Guy's  and  St.  Thomas's  Hospital  in  London  and  ordinary  surgeon 
to  George  IV.  and  Queen  Victoria. 

Cooper,  a  man  endowed  with  all  graces  of  person,  was  the  fourth  son  of  a 
clergyman  in  good  circumstances,  who  instructed  his  own  children.  At  the  age  of 
14  he  removed  with  his  parents  to  Yarmouth,  where  the  following  incident  determined 
his  choice  of  his  profession.  One  of  Cooper's  comrades  fell  from  a  wajron  and  injured 
his  femoral  artery  in  such  a  way  that  all  his  other  playfellows,  terrified  by  the  profuse 
bleeding,  ran  away.  Cooper,  however,  remained  by  him  and  resolutely  bound  his 
handkerchief  firmly  about  the  bleeding  limb,  so  that  time  was  gained  for  the  arrival 
of  a  surgeon,  who  then  undertook  ligation  of  the  wounded  vessel.  From  that  moment 
Cooper  embraced  the  plan  of  becoming  a  surgeon,  and  accordingly  at  the  age  of  15 
he  became  an  apprentice  to  the  apothecary  Turner  in  his  own  town.  In  his  16th 
year,  however,  he  left  this  position  in  order  to  study  in  London  under  the  direction 
of  his  uncle  William,  who  was  surgeon  to  Guy's  Hospital.  Soon  after  he  associated 
himself  with  Cline  at  St.  Thomas's  Hospital,  and  three  years  later  —  in  1787 — he 
went  to  Edinburgh.  From  Edinburgh  he  returned  to  London,  delivered  lectures,  and 
after  some  failures  in  the  beginning,  finally  became  a  more  popular  lecturer  than  any 
teacher  before  or  since  his  time.  Having  married  in  1791  a  relative  of  Cline,  he 
made  a  trip  to  France  for  scientific  purposes,  and,  on  his  return,  began  an  extensive 
private  practice,  which  brought  him  in  annually  about  £21,000,  so  that  he  died  a 
millionaire.1  In  1821  he  was  made  a  baronet.  In  1828  he  married  a  second  time, 
but  left  no  children  by  either  wife.  A  year  previous  to  this  marriage  he  had  been 
appointed  surgeon  to  the  king.  Subsequently  Cooper  withdrew  from  his  position  as 
a  teacher,  but  enjoyed  no  long  rest,  and  died  with  asthmatic  troubles  at  the  age  of  73 
Bright  and  Chambers  were  his  attending  physicians.  His  body  is  entombed  in  the 
chapel  of  Guy's  Hospital,  and  a  monument  to  his  memory  was  subsequently  erected 
in  St.  Paul's. — Sir  Astley  Cooper  was  a  fertile  author.  His  chief  works  were:  "The 
Principles  and  Practice  of  Surgery",  London,  1824-27;  "The  Anatomy  and  Diseases 
of  the  Breast",  1829;  "  1'he  Diseases  of  the  Testis",  1880;  "  On  Dislocations  and 
Fractures",  1822  etc.  —  Cooper's  motto  was:  "We  should  first  observe  and  then 
think."  Brodie  in  his  memorial  address  for  Cooper  said  he  was  one  of  the  most 
influential  and  most  popular  of  men,  always  manifested  an  unfailing  zeal  for  his 
profession,  could  never  be  unoccupied,  and  united  good4ieartedness  and  charitable- 
ness with  a  practical  knowledge  of  mankind.  "Probably  the  time  is  no  longer  remote 
when  it  will  be  a  question  whether  Cooper  was  an  expert  operator  or  not.  This 
much,  however,  we  must  all  certainly  acknowledge,  that  his  published  writings  will 
be  studied  by  physicians  also  as  long  as  surgery  continues  to  be  practised."  To 
this  A.  Lee  adds,  "  He  was  not  only  a  distinguished  surgeon,  but  a  thoroughly  good 
man  in  the  best  and  strictest  sense  of  the  term."— Cooper's  boldness  in  operation,  a 
quality  which  astonishes  us,  though  its  advantages  are  often  doubtful  (and  the  same 
is  still  more  true  of  certain  modern  operators),  is  evidenced  by  the  single  fact  that 
in  1817  he  was  the  first  surgeon  to  tie  the  abdominal  aorta.  The  operation  was  per- 
formed upon  Charles  Hudson,  a  doorkeeper  of  Parliament,  and  the  patient  never- 
theless survived  48  hours.  Cooper  in  1801  performed  the  first  paracentesis  of  the 
membrana  tympani. 

A  colleague  of  Cooper's  at  St.  Thomas's  Hospital,  as  well  as  his  first 

1.  Jeaffreson  says  :  "The  highest  amount  Sir  Astley  received,  in  any  one  year  was 
£21,000.  This  splendid  income  was  an  exceptional  one.  For  many  years,  how- 
ever, he  achieved  more  than  £15,00;j  per  annum."     (H.) 


—  1044  — 

pupil,  was  Benjamin  Travers,  who  has  been  alread}'  mentioned.  Travers 
was  associated  with  Sir  Astley  Cooper  in  the  publication  of  the  "Surgical 
Essays"  (1818),  was  appointed  Surgeon  Extraordinary  to  the  Queen  in 
1837,  Surgeon-in-ordinaiy  to  Prince  Albert  in  1840  and  Serjeant  Surgeon 
to  the  Queen  in  1857.  He  devoted  much  attention  to  the  treatment  of 
diseases  of  the  eye,  and  we  owe  to  him  the  popularization  of  the  admin- 
istration of  mercury  in  iritis,  both  simple  and  specific.  Among  his  best 
known  works  were  his  "Observations  on  the  pathology  of  venereal  affec- 
tions", 1830  ;  "An  inquiry  into  that  disturbed  state  of  the  vital  functions,, 
usually  denominated  constitutional  irritation",  1824;  "Principles  and 
practice  of  opthalmic  surger}-",  1839.     He  died  March  6,  1858. 

Frederick  Tyrrell  (1797-1843),  a  nephew  and  pupil  of  Sir  Astley 
Cooper,  was  a  surgeon  distinguished  as  a  diagnostician  and  operator,  and 
particularly  eminent  as  an  ophthalmic  surgeon.  He  also  edited  "  The 
lectures  of  Sir  Astley  Cooper  on  the  principles  and  practice  of  surgery r 
with  additional  notes  and  cases",  London,  1824-27,  and  wrote,  among  other 
works,  "A  practical  work  on  the  diseases  of  the  e}'e  and  their  treatmentr 
medically  and  by  operation",  1840. 

Eminent  surgeons  before  the  time  of  Tyrrell  were:  Sir  William  Blizard  ( 1 743— 
1835),  surgeon  to  the  Magdalen  and  London  Hospitals,  and  the  first  to  tie  the 
superior  thyroid  artery  for  the  cure  of  goitre;  John  Clarke  (cauliflower  excrescence); 
John  Cunningham  Saunders  (1773-1810),  founder  of  the  London  Ophthalmic  Infirm- 
ary in  Moorfields,  a  quarter  of  London  ;  Alexander,  of  the  Royal  Infirmary  for 
Diseases  of  the  Eye,  a  famous  ophthalmic  surgeon  who  declared  instillations  of 
extract  of  belladonna  a  specific  against  iritic  adhesions  etc.;  John  Walker  of  Man- 
chester, author  of  "The  principles  of  ophthalmic  surgery"  etc.,  London,  1834;  Arthur 
Jacob  (1790-1874)  of  Dublin  (membrana  Jacobi,  1819);  Phipp;  Prichard  (first 
enucleation  of  the  bulb  for  sympathetic  ophthalmitis  in  man,  1851);  Mac  Keown  in 
Belfast,  who  in  1874  extracted  a  fragment  of  steel  from  the  interior  of  the  eye  by 
means  of  a  magnet  etc.  In  fact  until  very  recent  times  almost  all  the  famous 
English  surgeons  were  also  oculists  of  skill.     We  may  further  mention  : 

Joseph  Henry  Green  (1791-1863),  a  nephew  of  Cline  and  colleague 
of  Sir  Astley  Cooper  at  St.  Thomas's  Hospital,  who,  besides  his  skill  in 
surgical  diagnosis  and  his  operative  dexterity,  distinguished  himself  as  a 
good  physician  and  anatomist. 

Other  distinguished  surgeons  of  Guy's  Hospital  during  the  present  century  were: 
Charles  Aston  Key  (1810-1849),  a  pupil  of  Sir  Astley  Cooper,  well  known  as  an 
accomplished  operator,  who  e.  g.  tied  the  subclavian  artery  in  14  minutes;  John 
Morgan  (died  1847),  a  very  skilful  operator.  Both  the  surgeons  mentioned  were  con- 
temporaries with  Cooper.  Among  the  more  recent  surgeons  of  this  hospital  are: 
John  Hilton  (1804-1878),  Surgeon-extraordinary  to  the  Queen;  Thomas  Bryant 
(Practice  of  Surgery);  John  Birkett;  Arthur  Edward  Durham;  G.  H.  Howse. — 
At  St.  Thomas's  Hospital  we  find  Frederick  le  Gros  Clark,  Sir  William  Mac  Cormac 
(born  1836),  Surgeon-in-chief  of  the  Anglo-American  Ambulance  in  1870-71,  whose 
"Notes  and  recollections  of  an  ambulance  surgeon",  1871.  were  translated  into 
German  byStromeyer;  John  Simon,  the  famous  Medical  Officer  of  the  Board  of 
Health,  and  subsequently  of  the  Privy  Council;  Sidney  Jones-  Mr^  WagstafF  etc. 
Among  its  earlier  teachers  were  John  Flint  South  (1797-1882),  who  translated  and 


—  1045  — 

improved   Chelius's  "  Handbuch  der  Chirurgie"   (18-47);  Macmurdo;  Samuel  S0II3' 
(1S03-1871)  and  Campbell  de  Morgan  (1813-1876). 

The  name  of  Cooper  is  also  favorably  known  through  Samuel  Cooper 
(1781-1848),  professor  of  surgery  in  London  and  surgeon  to  the  University 
Hospital,  at  an  earlier  period  a  militar}'  surgeon,  whose  "First  lines  of  the 
practice  of  surgery",  1807,  "Treatise  on  the  diseases  of  the  joints",  1807, 
and  "Dictionary  of  practical  surgery",  1809,  were  all  popular  works. 
Bransby  Blake  Cooper  (1792-1853),  the  nephew  and  adopted  son  of  Sir 
Astley  Cooper  as  well  as  his  biographer,  likewise  contributed  to  the 
eminence  of  the  name,  though  he  was  less  celebrated  as  an  operator  than 
■as  a  teacher  and  author.  He  was  surgeon  to  Gu3*'s  Hospital,  and  author 
of  "Surgical  essays  etc.",  1833,  "Lectures  on  anatomy  etc.",  1829-32. 

The  following  physicians  and  surgeons  bearing  the  name  of  Cooper  are  also 
known:  Gerard  Cooper  in  New  York;  James  Cooper  ip  Norwich;  John  Cooper  in 
Liverpool;  Langston  Cooper  in  Lexington;  Thomas  Cooper  Jr.,  in  Philadelphia. 
Robert  Cooper  and  Thomas  Cooper  Sr.,  were  of  an  earlier  date. 

Sir  Benjamin  Collins  Brodie  (1783-1862), 
professor  of  anatomy  and  surgery  in  the  Royal  College  of  Surgeons,  surgeon-in-chief 
"to  St.  George's  Hospital  and  ordinary  surgeon  to  Queen  Victoria,  is  usually  regarded 
as  a  surgeon  of  the  first  rank.  He  was  an  extremely  zealous  observer  —  he  kept  a 
record  of  all  his  important  cases  from  the  beginning  of  his  career — a  distinguished 
surgical  investigator  and  a  practitioner  eminent  for  his  security  in  operating.  He  was 
also  an  eminent  anatomist,  pathological  anatomist  and  physiologist.  His  after- 
treatment  was  very  simple.  We  find  evidence  of  Brodie's  calmness  and  the  clearness 
of  his  observation  in  the  fact  that,  basing  his  action  upon  statistics,  the  older  he 
became,  the  less  frequentlj'  he  operated.  His  chief  works  were:  "  Pathological  and 
surgical  observations  on  diseases  of  the  joints",  1818;  "Lectures  illustrative  of  certain 
nervous  affections",  1837  ;  "  Lectures  on  diseases  of  the  urinary  organs",  1832,  and 
various  lectures  on  important  subjects  in  therapeutic  and  operative  surgery,  intro- 
ductory lectures  delivered  in  the  hall  of  the  Royal  College  of  Surgeons  etc. 

A  colleague  of  Brodie's  in  St.  George's  Hospital  and  a  famous  operator 
and  practitioner  was  Thomas  Rose.  Later  surgeons  to  the  same  hospital 
were:  Robert  Keate,  Serjeant-Surgeon  to  Queen  Victoria  (1837);  Caesar 
Hawkins  (179S-1884),  the  most  eminent  representative  of  an  eminent 
medical  family,  finally  consulting  surgeon  to  St.  George's  and,  after  the 
•death  of  Brodie,  Serjeant- Surgeon  to  Queen  Arictoria ;  George  Gisborne 
Babington  (1795-1856);  Catler,  and  still  more  recently  G.  Pollock,  Sir.  M. 
Prescott  Hewitt,  surgeon  to  the  Prince  of  Wales  and  Surgeon-extraordinary 
to  the  Queen  ;  Timothy  Holmes  of  St.  George's  Hospital,  whose  great 
text-book  of  Surgery  entitled  "A  system  of  surgen',  theoretical  and  prac- 
tical etc.",  London,  1860-64,  is  similar  to  the  work  of  Billroth  and  Pitha ; 
Johnson;  Thomas  Tatum  (1802-1879);  J.  Rouse;  T.  P.  Pick;  J.  W. 
Haward  and  E.  R.  Rowland. 

The  famous  military  surgeon 
George  James  Guthrie  (1785-1856), 
professor  of  anatomy  and  surgery  in  the  Westminster  Hospital  in  London,  might  be 
•called  the  Larrey  of  England,  inasmuch  as  he  accompanied  Wellington  upon  all  his 


—  104(3  — 

campaigns,  as  Larrey  did  Napoleon  I.  He  also  shared  with  Larrey  many  character- 
istics, above  all  those  of  operative  ability  and  modesty.  Like  Larrey  too  he  favored 
early  operations,  and  with  Thomas  Rose  and  William  Fergusson  Sr.  was  a  represen- 
tative of  the  Portuguese  or  anti-mercurial  treatment  of  syphilis.  Guthrie  was  like- 
wise an  ophthalmic  surgeon  of  ability.  His  chief  works  were:  "A  treatise  on  gun- 
shot wounds,  on  inflammation,  erysipelas.  Being  a  recoid  of  the  opinions  and 
practice  of  the  surgical  department  of  the  British  army,  at  the  termination  of  the 
wars  in  Spain,  Portugal,  France  and  the  Netherlands,  in  1814  and  1815  ",  London, 
1827,  6th  edition  1855;  "Lectures  on  the  operative  surgery  of  the  eye"  etc., 
1823,  etc. 

Colleagues  of  Guthrie  in  the  Westminster  Hospital  were  the  eminent 
surgeon  James  Wardrop  (1782-1869).  particularly  known  as  an  oculist 
and  pathological  anatomist  of  the  eye  (An  essay  on  the  patholog}'  or  mor- 
bid anatomy  of  the  human  eye,  Edinburgh,  180S).  who  performed  enu- 
cleation in  sympathetic  ophthalmitis:  Sir  James  Mac  Gregor  (1771-1858) 
Surgeon-extraordinary  to  the  Queen  and  Medical  Director  of  the  British 
army;  Dr.  Neil  Arnott  (1788-1874),  the  inventor  of  the  hydrostatic  bed, 
whose  "Elements  of  physics  etc.",  1827.  ran  through  its  first  edition  in  a 
single  week  and  by  1832  had  enjoyed  no  less  than  five  editions  ;  Richard 
Anthony  Stafford,  an  eminent  practitioner,  who  introduced  the  first  useful 
instrument  for  the  internal  division  of  strictures  of  the  urethra  (1S28); 
Joseph  Amesbury  (1795-  ?  ),  who  rendered  good  service  by  his  study  of 
severe  fractures,  false  joints  and  their  treatment;  William  Lynn  (1753- 
1837)  ;  Sir  Anthony  Carlisle  (1768-1840),  an  eminent  anatomist,  who 
studied  the  diseases  of  old  age  (1818).  More  recent  teachers  in  the  West- 
minster Hospital  were  Carsten  Holthouse  (born  1810);  Brook;  Hillman 
and  Power.  Holthouse  and  Hillman  taught  the  principles  and  practice  of 
surgery,  Brook,  descriptive  and  surgical  anatomy. 

At  St.  Bartholomew's  Hospital  taught  Abernethy's  pupil 
Sir  William  Lawrence  (1783-1867), 
surgeon   of  Queen  Victoria,  and  highly   esteemed   as   a   diagnostician  and  operator. 
He  was  likewise  acquainted  with  German  surgery,  and  wrote  many  important  works: 
"A  treatise  on  ruptures"  etc.,  1810;   "Lectures  on  surgery,  medical  and  operative" 
etc.,  1832;    ''A  treatise  on  the  venereal  disease  of  the  eye",  1880,  etc. 

To  the  same  hospital  belonged  :  Henry  Earle  (1789-1838),  son  of  Sir 
James  Earle  (1755-1817).  the  latter  the  inventor  of  the  treatment  of 
hydrocele  by  injection  (1791).  Henry  Earle  invented  a  special  fracture- 
bed,  but  was  less  famous  as  an  operator  than  his  father.  John  Painter 
Vincent  also  attained  little  eminence  as  an  operative  surgeon.  After  their 
day  surgery  was  represented  in  this  hospital  by  :  Sir  James  Paget  (born 
1814),  Serjeant-Surgeon  to  the  Queen,  an  eminent  pathologist  and  among 
the  moderns  the  most  important  investigator  of  the  subject  of  tumors- 
(Lectures  on  surgical  pathology  ;  Lectures  on  tumors  etc.,  1851);  Fred- 
erick Carpenter  Skey  (1798-1872),  whose  '^Principles  and  practice  of 
operative  surgery",  1850,  defends  the  principles  of  conservative  surgery  -T 
Wormald  ;    William    S.    Savory  ;    Richard     Holmes     Coote    (1817-1872); 


—  1047  — 

Luther  Hoklen  ;  George  William  Callender  (1830-1879)  and  Thomas 
Smith.  —  Among  the  teachers  at  the  Charing  Cross  Hospital  were  the  very 
learned  T.  J.  Pettigrew  (born  1791)  and  the  famous  surgeon  John  Howship 
(died  1S41),  author  of  "  Practical  observations  in  surgery  and  morbid 
anatomy  etc.'",  London,  1810,  with  numerous  other  works.  Their  places 
have  been  recently  taken  by  Henry  Hancock  (1809-1880)  and  Canton. 
The  present  professor  of  surgery  at  the  Charing  Cross  Hospital  Medical 
School  is  Mr.  Barwell. 

John  Lizars  (1783-1860), 
professor  of  surgery  in  the  University  of  London  and  subsequently  in.  Edinburgh,  and 
a  pupil  of  John  Bell,  distinguished  himself  as  a  bold  operator  and  a  zealous  and 
fertile  surgical  writer.  As  early  as  among  the  twenties  of  the  present  century  he  had 
performed  several  times  extirpation  of  the  ovary,  and  liad  treated  chronic  hydroce- 
phalus by  operation.  Among  his  more  important  works  were  "Observations  on 
extirpation  of  diseased  ovaria "  etc.,  Edinburgh,  1825;  "A  system  of  practical 
surgery",  ISMS;  "Hydrocephalus  chronicus  treated  by  operation",  1S21  :  "A  system 
of  anatomical  plates"  etc.,  101  plates,  London,  1822-26. 

University  College  Hospital  from  its  foundation  to  the  present  da}' 
has  enjoj'ed  a,  long  line  of  eminent  surgeons.  We  have  already  men- 
tioned Samuel  Cooper,  and  add  the  famous  names  of  Robert  Liston  (1794- 
1847).  who  distinguished  himself  by  his  resections,  particularly  of  the 
elbow  joint  (A  treatise  on  practical  and  operative  surgery,  1837);  Richard 
Quain.  Surgeon  Extraordinary  to  the  Queen,  and  with  William  Sharpey 
editor  of  the  5th  edition  of  Jones  Quain's  Human  Anatomy  :  John  Eric 
Erichsen,  author  of  ';  The  science  and  art  of  surgery",  a  surgical  text- 
book long  famous  in  the  United  States  and  recently  becoming  popular  in 
Germany  ;  Thomas  Wharton  Jones  (born  1808).  a  famous  ophthalmologist; 
John  Marshall  (Outlines  of  physiology,  human  and  comparative  etc.'', 
1867),  who  lectures  on  operative  surgery,  and  Christopher  Heath  (born 
1835),  author  of  numerous  surgical  treatises.  To  these  should  be  added 
Berkeley  Hill,  surgeon  also  to  the  Lock  Hospital,  author  of  "Syphilis  and 
local  contagious  disorders",  186S  ;  -The  student's  manual  of  venereal  dis- 
eases 1877.  etc.     The  famous 

Sir  Charles  Bell  (1774-1842), 
who  has  been  already  mentioned,  and  who  was  surgeon  to  the.  Middlesex  Hospital 
until  called  in  1836  as  professor  of  medicine  to  Edinburgh,  distinguished  himself  as 
an  operator,  but  was  less  popular  as  a  practitioner.  He  was  an  opponent  of  vivisec- 
tion. Among  his  more  important  writings  were:  "A  system  of  operative  surgery", 
London,  1807;  "Institutes  of  Surgery  etc.",  Edinburgh,  L838 ;  "  Illustrations  of  the 
great  operations  of  surgery,  trepan,  hernia,  etc.",  London,  1821,  etc.  The  Bridge- 
water  treatise  entitled  "The  hand,  its  mechanism  and  vital  endowments,  as  evincing 
design",  London.  1834,  is  an  ingenious  and  well-known  work  of  this  author. 

Bell  had  as  his  colleague  in  the  Middlesex  Hospital  the  eminent  physiologist  and 
surgeon  Herbert  Mayo  (died  L852),  who  became  entangled  in  the  toils  of  Mesmerism. 
Among  their  successors  were  Alexander  Shaw.  Charles  Hewitt  Moore  (1821-1870)  and 
T.  Henry.  The  present  surgeons  of  this  hospital  ate  John  W.  Hulke,  George  Lawson 
and  Henrv  Morris. 


—  1048  — 

The  University  of  Edinburgh  acquired  great  reputation  from  its  pro- 
fessor of  surgery  James  Syme  (1799-1870),  who  deserves  much  credit  for 
his  introduction  of  resection  into  practice.  His  name  is  also  preserved  in 
operative  surgery  by  his  method  of  amputation  through  the  ankle-joint 
(Treatise  on  excision  of  diseased  joints,  1831),  an  operation  for  which  in 
1846  he  was  able  to  show  20  successes  in  24  cases.  The  name  of  the 
older  James  Jeffray,  professor  of  anatomy  and  surgery  in  the  University 
of  Glasgow,  who,  as  already  remarked,  devoted  considerable  attention  to 
resection,  is  preserved  by  his  chain-saw  (Cases  of  the  excision  of  carious 
joints.  By  H.  Park  ....  and  P.  F.  Moreau  ....  with  observations. 
Illustrated  by  engravings.  Glasgow,  1806),  while  that  of  the  Edinburgh 
surgeon  and  obstetrician  Sir  James  Young  Simpson  (1811-1870),  the 
inventor  of  acupressure,  is  indissolubly  associated  with  the  introduction  of 
chloroform. 

At  the  outset  Simpson  had  to  defend  himself  in  all  seriousness  against  the  attacks 
of  the  English  religious  bigots,  who  seemed  to  regard  his  effoJts  to  abolis-h  suffering 
in  surgical  and  obstetrical  operations  as  a  sin  against  the  Holy  Spirit.  His  chief 
work  on  this  suhject  was  entitled  "Anaesthesia;  or  the  employment  of  chloroform  and 
ether  in  surgery,  midwifery  etc.",  1849.  We  owe  to  Simpson  also  the  popularization 
of  the  uterine  sound  and  the  introduction  of  the  sponge-tent  lor  dilatation  of  the 
cervix  uteri  (1849). 

Thomas  Annandale  and  Joseph  Bell  should  also  be  mentioned  among 
the  surgeons  of  the  University  of  Edinburgh. 

In  Dublin  Sir  Philip  Crampton  (1777-1858),  Surgeon-in-Ordinary  to 
the  King,  obtained  reputation  by  his  performance  of  resection  of  the  knee- 
joint  as  earl}r  as  1823.  He  also  devoted  much  attention  to  the  treatment 
of  aneurism.  Crampton's  pupil,  Bawdon  Macnaraara,  surgeon  to  the 
Meath  Hospital,  has  written  "On  the  treatment  of  stricture  by  the  imme- 
diate plan"  etc.,  while  Patterson  in  Glasgow  performed  gastrotomy  several 
times  for  abdominal  tumors.  George  H.  B.  Macleod,  Begius  Professor 
of  Surgery  in  the  University  of  Glasgow,  was  surgeon  of  the  English  arm}' 
before  Sebastopol  in  the  Crimean  war,  and  author  of  "Outlines  of  surgical 
diagnosis"  (1864),  with  other  works. 

Thomas  Blizard  Curling  (born  1811),  surgeon  to  the  London 
Hospital  (1849),  obtained  great  reputation  in  Germany  by  his  excellent 
work  on  "Diseases  of  the  Testis",  1843,  and  among  his  distinguished 
colleagues  at  this  hospital  were  John  Adams  (1806-1S77),  Jonathan 
Hutchinson  (born  1828),  a  prominent  contributor  to  Holmes's  "System 
of  Surgery"  and  Beynold's  "  System  of  Medicine";  William  John  Little 
(born  1810),  founder  of  the  Boyal  Orthopredic  Hospital,  who  was  cured 
of  clubfoot  by  Stromeyer  and  introduced  the  practice  of  tenotomy  into 
England  (Treatise  on  ( club-foot  and  analogous  distortions,  1839)  ;  Carr 
Jackson,  and  the  eminent  George  Critchett  (1817-1882).  The  latter 
was  distinguished  chiefly  as  an  ophthalmic  surgeon,  and  introduced  into 
practice  the  methods  of  iridodesis,   "re-adjustment"  in  the  operation  for 


—  1049  — 

strabismus,    blepharotomy,    scoop-extraction     in    cataract,    abscission    of 
staphyloma  etc. 

King's  College  Hospital,  however,  united  in  its  Faculty  a  great  num- 
ber of  the  most  important  surgeons.  Here  Sir  William  Fergusson  (1808- 
1877),  Serjeant-Surgeon  to  the  Queen,  displayed  his  activit}'.  Of  him  it 
was  said  that  he  had  "the  eagle's  eye,  the  lion's  heart  and  the  lad3*'s  hand". 
His  "System  of  practical  surgery-'  appeared  in  1842.  With  Fergusson 
were  worthily  associated  John  Wood,  his  successor  in  the  chair  of  clinical 
surgeiy,  which  he  now  holds  ;  Sir  William  Bowman  (born  181G),  Consult- 
ing Surgeon  and  Vice-President  of  the  London  Ophthalmic  Hospital  in 
Moorfields,  and  a  successful  cultivator  of  microscopic  anatomy ;  Richard 
Partridge  (1805-1870),  an  eminent  teacher  of  anatomy,  and  Peter  Charles 
Price  (1832-1864),  a  distinguished  representative  of  conservative  surgery. 
For  a  time  Sir  Thomas  Watson  (1792-1882),  President  of  the  College  of 
Plysicians  (18G2-67)  and  Physician-in-Ordinary  to  the  Queen,  was  attached 
to  this  school.  Its  present  professors  of  surgery  are  Mr.  Wood,  Mr.  Lister 
and  Mr.  Henry  Smith. 

Finally  we  mention  as  representatives  of  English  military  surgery  : 
Sir  G.  Logan,  Physician  of  the  General  Staff';  Maclean,  Surgeon  General 
and  professor  of  military  surgery  in  the  school  at  Netley  ;  Edmund 
Alexander  Parkes  (1819-1876)  of  Warwick,  a  famous  writer  on  military 
hygiene  (A  manual  of  practical  hygiene  etc..  1864);  Joshua  Henry  Porter 
(died  in  Afghanistan  in  1880),  Deputy  Surgeon-General  ;  Thomas  Long- 
more  (born  1816),  Surgeon  General  and  Honorar}T  Surgeon  to  the  Queen, 
professor  of  Military  Surgeiy  in  the  Army  Medical  School  at  Chatham, 
•and  author  of  numerous  treatises  on  military  surgeiy  and  tygiene  ;  Mac' 
Kinnon,  Deputy  Surgeon-General  and  teacher  of  operative  surgeiy  in 
Netley  ;  Gordon  K.  Hardie,  who  enjoys  the  same  rank,  and  Surgeon- Major 
Becker  of  Aldershott.  —  We  must  also  mention  Sir  Charles  Locock  (1799- 
18*75),  Physician- Accoucheur  to  the  Queen,  who  officiated  at  each  of  her 
nine  accouchements  and  received  in  1857  the  title  of  Baronet ;  Sir  Hemy 
Thompson  (born  1820)  in  London,  the  eminent  specialist  in  the  surgeiy 
of  the  urinary  organs,  who  performed  lithotomy  upon  the  emperor 
Napoleon  III.  (1873)  ;  Patrick  Heron  Watson,  Surgeon-in-Ordinary  of  the 
Queen  in  Scotland  ;  William  Donald  Napier,  who  improved  the  operation 
of  lithotomy  ;  Lund,  professor  in  Owen's  College,  Manchester  ;  William 
Coulson  (1802-1877),  an  eminent  specialist  in  lithotripsy  and  lithotomy  ; 
Alexander  Ogston  (born  1844),  Regius  Professor  of  Surgeiy  in  the  Uni- 
versity of  Aberdeen  (operation  for  genu  valgum)  ;  and  Sir  Joseph  Lister 
(born  1827),  the  successor  of  Syme  in  Edinburgh  and  of  Fergusson  in 
London,  the  inventor  of  the  antiseptic  treatment  of  wounds,  of  whom  we 
have  already  spoken.  Prof.  Annandale,  formerly  Syme's  assistant,  suc- 
ceeded Lister  in  Edinburgh. 


—  1050.— 

Among  the 

e.  Americans, 

who,  like  their  English  kinsmen,  have  a  special  talent  for  surgery,  and  to 
whom  modern  surgery  owes  the  great  and  enduring  acquisitions  of  anaes- 
thesia, the  system  of  distributing  the  sick  and  the  use  of  barrack- hospitals, 
as  well  as  the  first  great  series  of  operations  upon  the  cavities  of  the  body 
(the  13  ovariotomies  of  McDowell),  so  characteristic  of  the  surgery  of  the 
19th  century,  we  may  mention  : 

John  Collins  Warren  (1778-1856), 
son  of  John  Warren,  the  first  professor  of  anatomy  and  surgery  in  Harvard  College, 
who  was  for  many  years  surgeon  to  the  Massachusetts  General  Hospital  and  the  most 
eminent  operator  in  New  England.  He  performed  the  operation  of  staphylorrapby 
in  1820,  was  the  first  surgeon  to  administer  ether  for  the  purpose  of  surgical 
anaesthesia,  and  probably  performed  the  first  successful  operation  of  paracentesis 
pericardii.  He  was  the  founder  i  1.828)  of  the  Boston  Medical  and  Surgical  Journal, 
and  the  author  of  a  treatise  on  tumors. 

Wright  Post  (1766-1828), 

an  eminent  surgeon  of  New  York,  professor  of  surgery  and  subsequently  of  anatomy 
in  Columbia  College,  who  performed  many  creditable  operations. 

Philip  Stng  Physick  (1768-1837), 
a  pupil  of  John  Hunter,  professor  of  surgery  in  the  University  of  Pennsylvania  in 
1805,  and  called  by  Gross  the  "Father  of  American  Surgery."  He  was  one  of  the 
ablest  physicians  and  surgeons  of  Philadelphia  for  many  years,  but  left  no  works  to 
preserve  his  fame.  We  owe  to  him  the  tonsillotome  which  bears  his  name,  and  which 
he  presented  to  the  profession  in  1828,  and  we  have  already  referred  to  his  employ- 
ment of  animal  ligatures  (buckskin).     The  indefatigable  and  versatile 

Nathan  Smith  (1762-1829), 
a  professor  in  Dartmouth,  Yale  and  Bowdoin  Colleges,   and  in  his   day   perhaps  the 
best  "all  round"    medical  practitioner  of  New  England.     He  probably  anticipated 
Brodie  in  the   performance  of  trephining   for  the   relief  of  abscess  of  the   bone,    an 
operation  which  Smith  carried  out  in  the  latter  part  of  the  18th  century. 

Ephraim  McDowell  (1772-1830), 
of  Danville,  Kentucky,  whom  the  Americans1  regard  as  the  inventor  of  ovariotomy, 
though   his  claim   is  not  justified  by  history,   in  spite  of  the  fact  that  he  received  a 
statue  as  the  first  ovariotomist  in  1877. 

John  Syng  Dorsey  (1783-1818)  of  Philadelphia, 
a  nephew  of  Physick,  professor  of  anatomy-  in  the  University  of  Pennsylvania,  and 
the  first  surgeon  in  the  U.  S.   to  tie  the  external  iliac  artery.     Dorsey's  "Elements  of 

1.  Not  the  Americans  only.  Carl  iSchroeder  says  :  "  Ephraim  McDowell  of  Kentucky, 
however,  was  the  first  man  to  perform  ovariotomy  in  a  rational  and  deliberate 
manner.  This  he  did  in  December,  1809,  on  the  person  of  a  Mis.  Crawford.  The 
case  was  successful,  and  the  patient  died  in  1841.  at  the  age  of  79  years. 
McDowell  performed  the  operation  thirteen  times  in  all,  and  in  eight  of  his  cases 
the  cure  was  complete. 

''The  honor  of  having  been  the  first  to  perform  ovariotomy  in  a  methodical 
manner,  for  the  radical  cure  of  ovarian  tumors,  cannot  be  denied  McDowell, 
although  a  few  cases  of  accidental  ovariotomies  were  recorded  at  an  earlier  date." 
See  also  note  page  10-11.  McDowell's  cases  were  first  published  in  the  "Eclectic 
Repository  and  Analytic  Review"  for  April,  1817. 


—  1051   — 

Surgery",  Philadelphia,  1813,  was  the  second  surgical  text-book  published  in  this 
country,  and  enjoyed  for  many  years  a  merited  popularity.  Its  author  was  cut  off  at 
the  early  age  of  35,  just  as  fame  was  opening  before  him.  The  American  s-urgeon 
whose  name  is  best  known  abroad,  however,  and  whose  reputation  is  no  less  extensive 
in  his  native  country,  was 

Valentine  Mott  (1785-1865)  of  New  York, 
a  native  of  Glen  Cove,  Long  Island.  He  was  a  pupil  of  Cooper,  Abernethy  and 
Bell,  and  yielded  to  none  of  his  teachers  in  the  boldness,  brilliancy  and  success  of 
his  operations.  Mott  was  professor  of  surgery  in  Columbia  College  and  the  College 
of  Physicians  and  Surgeons,  New  York,  1809-1826,  and  again  1830-1840;  in  Rutger's 
Medical  College  1826-1830,  and  in  the  New  York  University  Medical  College  1840- 
1860.  He  tied  for  the  first  time  the  arteria  innominata  in  1818,  an  operation  which 
was  repeated  in  1830  by  Dr.  Richard  Wilmot  Hall  of  Baltimore,  in  1859  by  Dr.  E.  S. 
Cooper  of  San  Francisco,  and  in  18H4  by  Dr.  A.  W.  Smyth  of  New  Orleans.  The 
last  case  alone  was  successful  in  preserving  the  life  of  the  patient.  Gross  says 
of  Mott : 

"No  surgeon,  living  or  dead,  ever  tied  so  many  vessels,  or  so  successfully,  for  the 
cure  of  aneurism,  the  relief  of  injury,  or  the  arrest  of  morbid  growths.  The  cata- 
logue, inclusive  of  the  celebrated  case  of  the  innominate  artery,  comprises  eiyht 
examples  of  the  subclavian  artery,  fifty-one  of  the  primitive  carotid,  two  of  the 
external  carotid,  one  of  the  common  iliac,  six  of  the  external  iliac,  two  of  the  in- 
ternal iliac,  fifty-seven  of  the  femoral,  and  ten  of  the  popliteal  ;  in  all  one  hundred 
and  thirty-eight." 

Benjamin  W.  Dudley  (17S5-1870j, 
a  pupil  of  Sir  Astley  Cooper,  Abernethy,  Cline,  Larrey,  Dubois,  Boyer  etc.,  who 
founded  in  1817  the  Medical.  Department  of  the  University  of  Transylvania  at 
Lexington,  Kentucky,  and  was  the  professor  of  surgery  and  anatomy  in  this  institu- 
tion until  its  suspension  in  1859.  Dudley  was  to  the  United  States  west  of  the 
Alleghany- mountains  what  Mott  was  to  the  East  —  facile  princeps.  He  was  a  par- 
ticularly successful  lithotomist,  and  is  said  to  have  performed  this  operation  100 
times  in  succession  without  a  failure  or  a  death.  He  employed  the  lateral  operation 
exclusively,  and  was  fond  of  using  the  gorget.  Dudley  was  also  a  pronounced 
advocate  of  the  use  of  the  roller  bandage,  a  partiality  which  in  the  hands  of  his  less 
prudent  pupils  occasionally  led  to  disaster.  In  1828  he  trephined  the  skull  for  the 
relief  of  epilepsy,  probably  the  first  operation  of  this  nature  performed  in  the 
United  States. 

George  McClellan  (1796-1847), 
a   bold    and    brilliant    operative    surgeon    and    popular    teacher,     who    founded    the 
Jefferson    Medical  College   of  Philadelphia    and   was   its  professor  of  surgery   from 
1825-1838.     His  '"  Principles  and  Practice  of  Surgery  "  was  edited   by    bis   son    Dr. 
John  H.  B.  McClellan. 

Reuben  Dimond  Mussey  (1780-1866), 

professor  of  surgery  in  the  Ohio  Medical  College,  1838-52,  and  in  the  Miami  Medical 
College,  1852-60.  He  was  a  bold  and  successful  surgeon,  and  in  1837  removed  the 
entire  scapula  and  clavicle. 

Thomas  Dent  Mutter  (died  1859), 
professor    of  surgery  in    the   Jefferson    Medical    College    of  Philadelphia,   who  left 
his  surgical  museum  to  the   College   of  Physicians   of   Philadelphia,  together  with 
$30,000   for  its  increase   and   the   endowment   of  the   "Mutter"   lectureship   in   that 
institution. 


—  1052  — 

J.  Kearney  Rodgers  (1793-1857), 
a,  pupil  of  Wright  Post,  Sir  Astley  Cooper,  Abernethy  and  Sir  Benj.  Brodie,  founder, 
with  Dr.  Edward  Delafield,  of  the  New  York  Eye  and  Ear  Infirmary  and  surgeon  to 
the  N.  Y.  Hospital.     In   181(5  he  tied  the  left  subclavian  artery  between  the  scaleni, 
an  operation  which  rendered  him  famous. 

John  Rhea  Barton  (died  1871), 
an  expert  lithotomist,  best  known,  however,  from  the  operation  devised  and  executed 
by  him  in  1835  for  the  relief  of  angular  anchylosis  of  the  knee.  He  was  also  the  first 
to  suggest  the  use  of  the  bran  dressing  in  the  management  of  compound  fractures, 
and  has  given  his  name  to  a  fracture  of  the  lower  end  of  the  radius,  which  he 
described. 

William  Gibson  (1784-1868), 
a  pupil  of  Sir  Charles  Bell,  who  succeeded  Physick  in  the  chair  of  surgery  in  the 
University  of  Pennsylvania  in  1818,  and  continued  to  hold  this  position  until  com- 
pelled by  ill  health  to  resign  in  1854.  He  was  the -first  surgeon  to  tie  the  common 
iliac  artery,  and  published  in  1824  "The  Institutes  and  Practice  of  Surgery",  a  work 
which  survived  nine  editions. 

Alexander  Hodgdon  Stevens  (1789-1869), 
professor  of  surgery  in  the  College  of  Physicians  and  Surgeons  of  New  York  and  an 
eminent  clinical  teacher.     He  translated  a  portion  of  Boyer's  surgery  in  1815,  edited 
Cooper's  "  First  Lines  of  Surgery"  in  1822,  and  published  several  original  and  valu- 
able memoirs.     Stevens  was  also  one  of  the  surgeons  to  the  New  York  Hospital. 

John  Watson  (1807-1862), 
a  native  of  Londondeny,  but  brought  up  from  childhood  in  New  York,  one  of  the 
surgeons  to  the  New  York  Hospital  and  founder  in  1836  of  an  infirmary  for  cutane- 
ous diseases,  known  as  the  Broome  Street  School  of  Medicine,  in  which  he  was 
associated  with  Dr.  H.  D.  Bulkley.  Watson  was  an  excellent  classical  scholar  as 
well  as  surgeon,  and  on  his  death  left  to  the  New  York  Hospital  a  valuable  collection 
of  the  medical  writings  of  the  great  physicians  of  Antiquity  and  the  Middle  Ages. 
His  "  Medical  Profession  in  Ancient  times",  1856,  is  a  charming  little  work  and  leads 
us  to  regret  that  the  writer  was  unable  to  pursue  further  that  vein  of  activit}'  in 
which  he  was  so  well  adapted  to  succeed.  As  a  surgeon  he  is  best  known  as  the  first 
in  this  country  to  perform  cesophagotomy  for  the  relief  of  organic  stricture  of  the 
oesophagus.     The  case  was  reported  in  1844. 

Amos  Twttchell  (1781-1850),  of  Keene,  New  Hampshire, 
one  of  the  ablest  surgeons  of  New  England,  who  in  1807  tied  the  primitive  carotid 
successfully  in  a  case  of  secondary  haemorrhage. 

Dixi  Crosby  (1801-1873), 
professor  of  surgery  in  Dartmouth  College,  who  in   1836  removed  the  entire  arm,  in- 
cluding the  clavicle  and  scapula,  for  an  osteosarcomatous  tumor. 

Gurdon  Buck  (1807-1877)  of  New  York, 
surgeon  to  the  New  York  Hospital  and  to  St.  Luke's  and  the  Presbyterian  Hospital 
in  New  York  City,  whose  method  of  extension  by  means  of  strips  of  adhesive  plaster 
and  the  weight  and  pulley,  introduced  in  1851,  together  with  his  success  in  autoplastic 
surgery,  have  rendered  his  name  famous. 

Samuel  D.  Gross  (1805-1884), 
professor  af  surgery  in  the  Jefferson  Medical  College  of  Philadelphia,  a  fruitful  writer, 
able  surgeon  and   popular  teacher,   best  known  for  his  great  "  System  of  Surgery ", 
which  appeared  in  1857  and  has  survived  six  editions. 


—  1053  — 

Willard  Parker  (1800-1884), 
professor  of  surgery  in  the  College  of  Physicians  and  Surgeons  from  1839  to  1870, 
surgeon  to  the  New  York  Hospital  etc.,  a  bold  and  independent  surgeon  and  popular 
teacher,  who  revived  in  1867  the  method  of  incision  into  perityphlitic  abscesses 
originally  performed  in  1848  b}-  Mr.  Hancock  of  London,  and  in  1846  performed  for 
the  first  time  the  operation  of  perineal  cj-stotomy  for  the  relief  of  chronic  cystitis 
depending  upon  hypertrophy  of  the  prostate  gland.  He  was  also  the  first  surgeon  in 
America  to  ligate  the  common  carotid  and  vertebral  arteries  after  ligation  of  the 
subclavian,  in  order  to  prevent  haemorrhage  from  the  anastomosing  vessels. 

James  Rushmore  Wood  (1816-1882), 
who,  in  conjunction  with  Dr.  Isaac  E.  Taylor  and  several  other  prominent  physicians 
of  New  York,  founded  in  1861  the  Bellevue  Hospital  Medical  College  in  that  citj', 
and  occupied  the  chair  of  Operative  Surgery  and  Surgical  Pathology  in  that  insti- 
tution until  1868.  He  performed  most  of  the  major  operations  of  surgery,  and  partic- 
ularly prided  himself  upon  the  removal  of  the  entire  lower  jaw  for  phosphor-necrosis 
in  1856.     In  this  case  the  jaw  was  reproduced  from  the  periosteum. 

Joseph  Pancoast  (1805-1882), 
who  succeeded  McClellan  in  the  professorship  of  surges  in  the  Jefferson  Medical 
College  of  Philadelphia  in  1838,  and  was  professor  of  anatomy  in  the  same  institution 
1841-1874,  an  eminent  surgeon  who  happilj'  combined  prudent  caution  with  boldness 
and  skill  in  operation.  His  well-known  "  Treatise  on  Operative  Surgery "  was 
published  in  1844  and  ran  through  several  editions. 

Frank  Hastings  Hamilton  (1813-1886), 
professor  of  surgery  in  Bellevue  Hospital  Medical  College,  New  York,  1862-1875, 
best  known  as  one  of  the  surgical  attendants  of  the  late  President  Garfield  and  author 
of  a  treatise  "On  Fractures  and  Dislocations",  1859,  which  ran  through  several 
editions  and  has  been  translated  into  various  languages.  His  early  practice  of  skin- 
grafting  has  been  already  noticed. 

John  Murray  Carnochan   (1817-1887), 

a  pupil  of  Valentine  Mott,  and  for  many  years  professor  of  surgery  in  the  New  York 
Medical  College  which  became  extinct  in  1864.  Among  the  original  operations  of 
Dr.  Carnochan  his  ligation  of  the  femoral  artery  for  the  relief  of  elephantiasis  of  the 
lower  extremity  ( 1851),  and  his  exsection  of  the  superior  maxillary  nerve  beyond  the 
ganglion  of  Meckel  (1856),  have  contributed  most  to  render  his  name  famous.  He 
also  exsected  the  entire  ulna  in  1853,  Dr.  Robert  B.  Butt  of  Virginia  having  exsected 
the  .lower  two  thirds  of  that  bone  in  1825.  Carnochan  wrote  an  able  memoir  on  con- 
genital dislocations  of  the  hip-joint  in  1850,  and  was  the  author  of  other  valuable 
works  on  operative  surgerj'. 

Henry  Berton  Sands  (1830-1888), 
professor  of  Surgery  in  the  College  of  Physicians  and  Surgeons,  New  York,  and 
Surgeon  to  the  New  York  and  Roosevelt  Hospitals,  whose  celeritj-  of  thought,  expres- 
sion and  action  was  only  equalled  by  his  accuracy  and  precision.  As  an  operator 
Dr.  Sands  was  distinguished  by  the  conservative  boldness  and  skill  of  a  great  prac- 
titioner, and  by  a  conscientiousness  which  led  him  to  avoid  all  operative  measures  of 
doubtful  advantage.  Unfortunately  for  the  profession  his  busy  life  and  untimely  death 
deprived  him  of  all  opportunity  for  communicating  the  results  of  his  rich  experience 
to  his  colleagues,  though  a  few  able  monographs  attest  the  soundness  of  his  judgment 
and  the  facility  and  accuracy  of  his  pen. 

Samuel  W.  Gross  (1837-1889), 
professor  of  the  Principles  of  Surgery  and  Clinical  Surgery  in  the  Jefferson  Medical, 


—  1054  — 

College,  Philadelphia,  a  worthy  son  of  Samuel  D.  Gross,  the  eminent  surgeon  already 
mentioned.  Dr.  Gross  was  a  learned,  bold,  and  yet  careful  surgeon,  and  an  eloquent 
and  earnest  teacher.  He  had  made  a  special  study  of  tumors  of  the  breast,  and  his 
"Treatise  on  Tumors  of  the  Mammary  Gland",  1880,  is  probably  his  best  known 
work. 

.1.  Mason  Warren  (1811-1867)  of  Boston, 

the  son  of  John  Collins  Warren  and  himself  an  eminent  surgeon; 

Alfred  C.  Post  (1806-1886), 
a  well-known  and  highly  esteemed  surgeon  of  New  York. 

Among  our  numerous  excellent  surgeons  of  more  or  less  local  celebrity  we  may 
mention  George  Hayward  (1791-1863)  of  Boston;  Richard  S.  Kissam  (died  1822)  of 
New  York;  Warren  Stone  (1808-1872)  of  New  Orleans;  Nathan  K.  Smith  (1797- 
1877  I  of  Baltimore,  inventor  of  the  well-known  "  anterior  splint  "  for  fractures  of  the 
leg  and  thigh  :  Josiah  C.  Nott  (1804-1873)  of  Mobile,  who  e.xsected  the  coccyx  for  the 
relief  of  coccj^odynia  as  early  as  1832;  Joseph  Hartshorne  (1779-1850),  William  E. 
Horner  i  1  7'.i.".-1853)  of  Philadelphia :  Horace  A.  Ackley,  of  Cleveland,  Ohio,  who  is 
said  to  have  removed  the  entire  lower  jaw  in  1850  for  the  relief  of  osteosarcoma ; 
Paul  F.  Eve  (1806-1877)  of  Nashville,  Tenn.,  a  skilful  lithotomist  and  general  surgeon 
and  a  popular  teacher,  whose  "Collection  of  remarkable  cases  in  surgery",  1857,  is 
well  known;  John  T.  Bodgen  (1826-1882)  of  St.  Louis:  Erskine  Mason  (1832-1882) 
of  New  York;  George  Alex.  Otis  (1830-1881),  Surgeon  and  Brevet  Lieut.  Col.,  U.  S. 
A.,  a  pupil  of  Malgaigne,  Civiale,  Nelaton  etc..  and  the  lamented  author  of  the  un- 
finished "Surgical  History  of  the  War",  1870;  Ernst  Krackowizer  (1821-1875),  a 
native  of  Spital  in  Austria,  but  an  eminent  practitioner  in  New  York;  William  H. 
Van  Buren.(1819  1883),  .lames  L.  Little  (1836-1885),  both  of  New  York ;  Joseph 
C.  Hutchinson  -  L827-1887)  of  Brooklyn;  Hazard  A.  Potter  (1810-1869)  of  Geneva, 
N.  Y. ;  Jacob  Randolph  (1796-1848)  of  Philadelphia,  who  in  1831  introduced  the 
practice  oflithotrity  into  the  United  States;  Eli  Geddings  (1799-1878)  of  Charleston, 
S.  C.  ;  Daniel  Brainard  (1812-1866)  of  Chicago,  inventor  of  the  method  of  sub- 
cutaneous perforation  of  the  bones  in  anchylosis  etc.  (1854);  Horatio  G.  Jameson  ' 
(1792-1856?)  of  Baltimore;  George  C.  Blackman  (1819-1871)  of  Cincinnati ;  Alden 
March  I  1795-1869)  of  Albany  ;  Hugh  Holmes  McGuire  (1801-1875)  of  Virginia  ;  and 
George  W.  Norris  (1809-1875)  of  Philadelphia. 

Among  the  more  eminent  living  members  of  the  medical  profession  in 
the  United  Stales,  who  devote  the  most  of  their  attention  to  surgery,1  it 
will  be  sufficient  to  mention  :  Henry  J.  Bigelow  of  Boston,  professor  of 
surgery  in  Harvard  University  for  thirty-three  years  (resigned  in  1882), 
who  performed  in  ]So2  the  first  excision  of  the  hip-joint  in  the  U.  S.  and 
invented  (1878)  the  method  of  "Lithotrity  by  a  Single  Operation";  John 
Collins  Warren,  also  of  Boston  ;  Thomas  M.  Markoe,  professor  of  surgery 
in  the  College  of  Physicians  and  Surgeons,  New  York;  Stephen  Smith, 
professor  of  clinical  surgery  in  the  University  of  the  City  of  New  York  ; 
Lewis  A.  Sayre,  Prof,  of  orthopaedic  and  clinical  surgery  in  Bellevue  Hosp. 
Med.  Coll..  X.  Y.;  Alexander  B.  Mott,  son  of  the  famous  Yalentine  Mott, 
Prof,  of  clinical  and  operative  surgery  in  Bellevue  Hospital  Medical 
College;    Robert  F.  Weir,  surgeon  to  the  New  York  and   Bellevue  Hos- 

1.  Prof.  S.  D.  Gross,  writing  in  1876,  says  "It  is  safe  to  affirm  that  there  is  not  a 
medical  man  on  this  continent  who  devotes  himself  exclusively  to  the  practice  of 
surgery."     (H.) 


—  1055  — 

pitals  ;  J.  Williston  Wright,  professor  of  surgery  in  the  Medical  Depart- 
ment of  the  Universit}-  of  the  City  of  New  York  ;  Lewis  A.  Stimson, 
Prof,  of  clinical  surgery  in  the  same  institution  ;  John  A.  Wyeth  ;  Arpad 
G.  Gerster  ;  Frederick  Lange  ;  George  A.  Peters;  William  Petmold, 
Emeritus  Prof,  of  Clinical  and  Military  Surgery  in  the  College  of  Phys. 
and  Surgeons,  New  York,  and  the  introducer  of  subcutaneous  tenotomy 
into  the  United  States  ;  J.  W.  S.  Gouley,  William  T.  Bull,  Fred.  S.  Dennis, 
Chas.  McBurney,  Chas.  K.  Briddon,  Benjamin  Howard,  Joseph  W.  Howe, 
all  of  New  York  ;  Charles  B.  Nancrede,  senior  surgeon  to  the  Episcopal 
Hospital  etc.,  Philadelphia  ;  W.  H.  Pancoast,  Prof,  of  Anatom}',  Jefferson 
Med.  Coll.,  Philadelphia  ;  J.  Ewing  Mears,  Lecturer  on  Gynaecology  in 
the  same  institution  ;  D.  Hayes  Agnew,  Prof,  of  Surgery  in  the  University 
of  Pennsylvania,  Philadelphia  ;  John  Ashurst  Jr.,  Prof,  of  Clinical  Surgery 
in  the  University  of  Pennsylvania  ;  W.  W.  Keen,  Prof,  of  Surgery  in  the 
Woman's  Medical  College,  Philadelphia  ;  John  H.  Packard,  Surgeon  to  the 
Episcopal  Hospital,  Philadelphia  ;  Henry  H.  Smith,  Emeritus  Prof,  of 
Surgery  in  the  University  of  Pennsylvania;  John  H.  Brinton,  Prof,  of 
Clinical  Surgery  in  Jefferson  Medical  College,  Philadelphia  ;  Thos.  G. 
Morton,  H.  Lenox  Hodge  and  Addinell  Hewson,  all  of  Philadelphia  ■ 
Julius  F.  Minor  of  Buffalo,  N.  Y.;  Christopher  Johnson  and  L.  McLane 
Tiffany  of  Baltimore;  Moses  Gunn  and  C.  T.  Parkes  of  Chicago  ;  Nicholas 
Senn  of  Milwaukee,  Prof,  of  Surgery  in  Bush  Medical  College,  Chicago 
and  inventor  of  the  recent  method  of  rectal  insufflation  of  hydrogen  oas 
in  the  diagnosis  of  gastrointestinal  injuries  ;  C.  H.  Mastin  of  Mobile  ; 
Hunter  McGuire  of  Richmond  (tied  the  abdominal  aorta  in  1868);  Joseph 
Bansohoff,  P.  S.  Connor  and  T.  A.  Beamy  of  Cincinnati  ;  Gustave  C.  E. 
Weber  of  Cleveland  ;  E.  M.  Moore  of  Rochester,  N.  Y.;  R.  A.  Kinloch 
of  Charleston,  S.  C;  Duncan  Eve,  Nashville,  Tenn.;  T.  G.  Richardson  of 
New  Orleans;  Frederick  Hyde  of  Syracuse,  N.  Y.,  and  numerous  others. 

The  histoiy  of  the  introduction  of  surgical  anaesthesia  has  been 
already  given  on  a  preceding  page,  and  the  honor  of  this  beneficent  system 
duly  assigned  to  its  American  authors. 

The  credit  of  the  employment  of  collodion  as  a  means  of  uniting 
wounds  has  also  been  accorded  to  John  Parker  Maynard,  a  medical  student 
of  Boston  in  1848.  His  example  was  soon  followed  by  Dr.  Whitney  of  the 
same  city,  and  then  in  Europe  by  Simpson  and  Malgaigne. 

That  the  admirable  barrack  and  distribution  systems,  as  well  as 
numerous  improvements  in  the  transportation  of  the  wounded,  are  due 
especially  to  American  physicians  is  well  known.  Thomas  W.  Evans,  an 
American  dentist  residing  in  Paris,  particularly  distinguished  himself  as  a 
writer  on  these  subjects.  (La  commission  sanitaire  des  Etats-Unis,  son 
origine,  son  organisation  etc.,  Paris  18G5  ;  History  of  the  American  ambu- 
lance established  in  Paris  during  the  siege  of  1S70-71,  London,  1873,  etc.) 

Recenthy  J.  Marion  Sims  (1813-1883)  of  New  York  (where  he  estab- 
lished in  1855  the  Woman's   Hospital)   has  again   demonstrated  the  fact 


—  105G  — 

that  American  surgeons  possess  in  an  eminent  degree  the  qualities  of 
inventiveness  and  operative  dexterity. 

As  German  ophthalmology  has  found  its  representatives  in  Liebreich 
in  London  and  George  Frick  in  Baltimore,  so  also  now  it  is  represented 
in  the  United  States  by  Hermann  Knapp  in  New  York  and  George  Reuling 
in  Baltimore. 

The  surgery  of 

f.  The  Germans, 

which,  until  the  second  third  of  the  present  century,  was  largely  tributary 
and  subordinate  to  foreign  surgery,  particularly  that  of  France,  after  this 
time  developed  rapidly  and  vigorously,  so  that,  indeed,  even  the  French 
of  late  acknowledge  its  superiority.  This  rapid  development  was  chiefly 
due  to  the  efforts  of  Kern,  Graefe,  who  was 'the  first  to  establish  a  sur- 
gical clinic  in  Berlin  with  ten  beds,  Dieffenbach,  who  demonstrated  that 
German  surgeons  were  able  to  rival  the  French  in  operative  skill  and 
boldness  (Bergmann)  as  well  as  in  elegance  of  writing,  Stromeyer.  B. 
Langenbeck  and  Esmarch.  Kern  became  eminent  for  his  simplification 
and  improvement  of  the  treatment  of  wounds  ;  Graefe  for  his  revival  of 
plastic  operations  ;  Dieffenbach,  for  all  his  enthusiastic  work  and  his 
genius.  The  most  important  service  of  Stromeyer  consists  in  his  exten- 
sion of  tenotomy  to  new  departments,  while  with  Langenbeck  and  Esmarch 
he  embraced  a  conservative  tendenc}',  and  thus  opened  new  paths  even  in 
military  surger}^,  by  introducing  into  the  surgical  practice  of  the  battle- 
field the  system  of  resections  before  practised,  especially  in  hospitals,  by 
Textor  and  Jager.  Esmarch  too,  b}T  his  introduction  of  an  artificial 
anaemia,  has  perfected  a  s}-stem  both  Surgical  and  humane,  the  importance 
of  which  will  probabl}*  not  be  fully  appreciated  until  a  future  period.  By 
this  system  he  has  levelled  the  road  for  physicians  in  general,  enabling 
them,  and  showing  them  the  way  to  operate  well,  by  teaching  them  how 
the  more  easily  to  carry  on  the  "blood}'  struggle  for  life  and  death'',  as 
Dieffenbach  calls  operative  surgery,  before  which  the  majorit}-  of  them 
recoil ;  -'for  it  is  less  the  dread  of  cutting  than  of  its  results,  the  bleeding," 
which  appalls  them,  "and  he  who  feels  himself  master  of  the  haemorrhage 
will  manage  the  knife  with  unshaken  hand."  As  the  result  of  the  advances 
mentioned,  an  operative  heroism  in  cutting  has  arisen,  a  heroism  which  no 
longer  pays  sufficient  regard  to  indications,  prognosis  etc.,  and  endeavors 
to  shine  simpl}r  by  manual  dexterity. 

One  of  the  chief  departments  of  German  surgeons  is  general  surgery  r 
and  the  most  important  representative  of  this  branch  among  the  moderns 
was  the  premature^  deceased  0.  Weber  (1827-1867),  professor  in  Heidel- 
berg, who  fell  a  victim  to  diphtheritic  infection  contracted  b}r  sucking  the 
larynx  of  a  patient  upon  whom  he  had  performed  tracheotomy. 

A  great  and  extensive  influence  upon  the  course  of  surgery  was 
acquired  at  the  beginning  of  the  present  century  by  the  famous  professor 
of  surgery  in  Vienna, 


—  1057  — 

Vincenz  VON  Kern  (1769-1829)  of  Graz.  This  was  the  result  as 
well  of  his  eminent  position  in  the  grandest  university  of  the  da}'  (which 
permitted  and  compelled  him  to  educate  many  pupils),  as  of  the  spirit  of 
his  teachings,  in  which,  following  the  traditions  of  the  old  Vienna  school 
and  particularly  the  doctrines  of  Stoll,  he  laid  great  weight  on  good 
observation  and  simple  rational  operative  treatment,  as  well  as  medical 
management  and  after-treatment.  Still  more,  he  plainly  declared  the 
indivisibility  of  surgery  and  medicine.  The  after-treatment  of  wounds  he 
simplified  almost  too  much,  contenting  himself  with  merely  dressing  them 
with  moist  cloths. 

Kern,  like  all  surgeons  who  sprung  from  the  18th  century,  had  pursued  a  surgical 
career  from  the  ranks  upward.  In  his  travels,  which  in  themselves  formed  undoubt- 
edly an  excellent  means  of  education,  he  had  visited  many  places,  and  had  been  in 
Salzburg,  Trieste  and  Venice,  and  finally  came  to  Vienna.  From  this  city  he  went 
as  ordinary  physician  to  Hildburghausen,  having  obtained  this  position  through  the 
aid  of  Leber,  an  influential  teacher  of  surgery  who  has  been  already  mentioned. 
After  the  decease  of  his  sovereign  and  patron,  Kern  visited  France  and  Italy,  and 
then  studied  medicine  under  Stoll,  taking  the  degree  of  the  doctorate.  In  1797  he 
was  appointed  a  professor  in  Laibach,  and  in  1805  became  professor  of  practical 
surgery  in  the  University  of  Vienna.  "With  the  assistance  of  Ad.  von  Stiff!  (1760- 
1836),  the  influential  physician-in-ordinary,  Protomedicus  and  Director  of  Instruc- 
tion, Kern  founded  an  institution  for  the  education  of  operative  surgeons,  in  which 
the  latter  were  required  to  practise  operations  upon  the  cadaver,  using  even  the  very 
table  employed  in  operations  upon  the  living  patients.  '  This  practice  was  continued 
down  to  18G7,  when  Billroth  put  an  end  to  it.  In  1824  Kern  resigned  his  position. 
His  principal  works  were  entitled:  "Die  Leistungen  der  chirurgischen  Clinik  der 
hohen  Schule  zu  Wien  von  1805-1824",  Vienna,  1828;  "Annalen  der  chirurgischen 
Clinik  zu  Wien"',  1807;  "Anwendung  des  Gliiheisens"  ;  "  Beobachtungen  und  Bemer- 
kungen  aus  dem  Gebiete  der  praktischen  Chirurgie",  1828;  "Abhandlung  iiber  die 
Verletzungen  am  Kopfe  und  die  Durchbohrung  der  Hirnschale",  1829;  "Avis  aux 
chirurgiens"  etc.,  1809.  In  this  latter  work  Kern  recommends  the  open  treatment 
of  operative  wounds,  dressing  them  with  simple  cold  compresses  and,  after  the  occur- 
rence of  union,  with  merely  a  few  strips  of  adhesive  plaster.  If  suppuration  set  in 
dressings  of  hike-warm  water  were  to  be  employed.  In  contrast  to  the  preceding 
abuse  of  salves  and  charpie  which  originated  in  the  days  of  itinerant  and  empiric 
surgical  practitioners,  these  principles  were  a  decided  reform.  Kern  regarded  the 
access  of  air  as  wholesome,  while  according  to  Lister  it  is  to  be  shunned  like  the 
plague. 

A  contemporary  of  Kern  and  a  teacher  at  the  Josephinum  was 
Chr.  B.  Zang,  who  enjoyed  the  reputation  of  a  good  operator.     His 
principal  work  was  entitled  "Darstellung  blutiger  heilkunstlerischer  Opera- 
tionen",  1818-1824.     Kern's  successor  in  the  University  was 

Joseph,  Baron  von  Wattmann  (1789-1866),  a  professor  in  Laibach, 
Innsbruck  and  after  1824  in  Vienna,  where  he  also  held  the  position  of 
surgeon-in-ordinary. 

Von  Wattmann  was  particularly  famous  as  an  operator,  and  acquired  great  favor 

and  high  esteem.     He  wrote  among  other  works:   "  Ueber  die  Vorlagerungen  in  der 

Leistengegend",  1815;    "  Versuche  zur  Heilung  des  Noli  me  tangere";   "  Sicheres 

Heilverfahren  bei  dem  schnelleintretenden  Lufteintritt  in  die  Vene  und  dessen  gerichts- 

67 


—  1058  — 

arztliche  Wichtigkeit",  1843;  "  Handbuch  der  Chirurgie",  new  edition  1848  etc. 
He  also  constructed  a  skeleton  with  joints  united  elastically  so  as  to  aid  in  the 
demonstration  of  luxations,  and  invented  methods  for  the  treatment  of  contraction 
of  the  urethra  after  amputation  of  the  penis,  for  restoration  of  the  nose,  a  cysto- 
tome  etc. 

Zang's  chair  in  the  Josephinum  was  taken  after  his  death  by 

Michael  Hager  (1795-1857)  of  Transylvania, 
professor  of  surgery  and  a  teacher  in  the  Institute  for  operative  surgeons.     His  chief 
works  were:  "Die  chirurgischen  Operationen ",  1831;   "Die  Anzeigen  zu  Amputa- 
tionen,  Exarticulationen   und  Trepanationen,  die  Nervenkrankheiten  und  die  Aus- 
w'uchse  am  menschlichen  Korper",  1849,  etc. 

A  pupil  and  assistant,  of  Kern  was  the  Prague  surgeon 

Ignaz  Fritz  (died  1843)  a  Croat, 
whose  last  assistant  and  successor 

Franz,  Baron  von  Pitha  (1810-1875),  of  Rakom  in  Bohemia, 
a  pupil  of  Fritz,  Krombholtz,  J.  G.  Ug  and  Jungmann,  was  from  1857  until  its  closure 
in  1873  a  professor  in  the  Josephinum  at  Vienna.  On  Dec.  29,  1875,  after  an  illness 
of  two  years,  he  succumbed  to  the  fate  of  his  predecessor  Huncowzky.  Von  Pitha 
is  well-known  from  his  participation  in  the  editorship  of  the  great  "Manuals"  of 
Virchow  and  Pitha-Billroth,  to  the  former  of  which  he  supplied  the  article  on 
"  Krankheiten  der  mannlichen  Geschlechtsorgane",  and  to  the  latter  that  on  "Die 
Krankheiten  der  oberen  und  unteren  Extremitaten  ".  In  1859  and  again  in  1866,  at 
the  wish  of  the  Emperor,  he  officiated  at  headquarters  as  chief  of  the  field  medical 
service,  and  rendered  himself  chiefly  useful  in  the  development  of  military  hygiene 
in  Austria,  doing  away  with  the  lower  surgeons  of  the  time  of  the  Theresianum. 

Although  Pitha's  activity  was  contemporary  with  the  New  Vienna  School,  the 
proper  surgical  representative  of  the  latter,  however,  was 

Franz  Schuh  (1805-1865),  of  Scheibbs  in  Austria. 

The  assistant  and  successor  of  Wattmann,  professor  in  Salzburg  (1836), 
Primararzt  in  Vienna  (1837),  in  1841  extraordinary,  and  in  1842  ordinary  professor 
of  surgery  and  state-counsellor,  Schuh  introduced  the  microscope  and  the  tendency 
to  pathological  anatomy  into  surger}',  and  was  also  an  eminent  operator.  Besides 
minor  writings  in  the  journals,  his  chief  works  were  entitled  :  "  Die  Erkenntniss  der 
Pseudoplasmen ",  1851;  "  Pathologie  und  Therapie  der  Pseudoplasmen ",  1854; 
"  Ueber  Gesichtsneuralgia  und  Nervenresektionen  ". 

Jos.  Dittel  and  Fried.  Wilhelm  Lorinser  should  also  be  mentioned  as  famous 
surgeons  of  the  Vienna  school. 

If  the  reputation  of  having  introduced  into  German  surgery  the  younger  branch 
of  pathological  anatomy  belongs  to  Schuh,  the  greatest  credit  is  due  to 

Conrad  Johann  Martin  Langenbeck  (1776-1851),  of  Horneburg  in 
Hanover, 

as  the  founder  of  German  surgical  or  topographical  anatomy.  Langenbeck  was 
Surgeon-General  of  the  Hanoverian  army,  Medical  Counsellor,  and  from  1814  pro- 
fessor of  anatomy  and  surgery  in  Gottingen,  where  he  founded  the  anatomical  theater 
(1830),  and  the  surgical  and  ophthalmic  clinic  of  this  university.  He  was  distin- 
guished for  his  indefatigable  industr}',  and  was  widely  known  as  a  brilliant  operator, 
particularly  as  a  rapid  operator  —  he  is  said  to  have  performed  a  disarticulation  of 
the  shoulder  while  a  colleague  who  was  present  turned  around  to  take  a  pinch  of 
snuff.  In  the  determination  of  the  indications  Langenbeck  enjoyed  less  celebrity,  a 
fact  to  which  his  frequent  practice  upon  the  battlefield  may  perhaps  furnish  the  solution. 


—  1059  — 

He  favored  the  open  treatment  of  wounds,  avoiding  all  sutures.  He  cultivated  oph- 
thalmology, like  all  the  earlier  surgeons,  as  a  part  of  surgery,  and  we  owe  to  him  the 
operation  of  iridokleisis,  i.  e.  the  healing  of  a  part  of  the  iris  in  the  corneal  wound, 
for  the  sake  of  forming  an  artificial  pupil  (1817).  As  a  writer  too  Langenbeck  was 
very  active.  His  chief  works  were  entitled  :  "  Einfache  und  siehere  Methode  des 
Steinschnitts  ",  1802  ;  "Handbuch  der  Anatomie",  1806  ;  "Erfordernisse  zur  Bildung 
des  Wundarztes",  1805;  "Abhandlung  iiber  Leisten- und  Schenkelbriiche '' ;  "Noso- 
logic und  therapie  der  chirurgischen  Krankheiten  ",  5  vols.,  1822-1834;  "  Icones 
anatomicse",  1836;  "Langenbeck's  Bibliothek  fiir  Chirurgie  und  Ophthalmologic" 
and  "  Neue  Bibliothek"  etc.,  etc.  —  His  son  Max  (1818-1877)  too,  a  physician  in 
Hanover,  published  some  works  en  surgerj'  and  ophthalmology,  and  in  1849  es- 
tablished the  fact  that  the  crystalline  lens  changes  its  form  in  the  process  of 
accommodation.  Among  Langenbeck's  pupils  Billroth  mentions  the  recently 
deceased  Swiss  physicians  Locher-Zwingli  in  Zurich  and  Mieg  in  Basel.  —  Langen- 
beck's brother,  Rudolph  Adolph  Langenbeck,  counsellor  and  director  of  the  hospital 
in  Riga,  is  the  uncle  of  the  Berlin  surgeon. — G.  F.  Langenbeck,  court-phj-sician  and 
Physicus  in  Bremervoerde,  wrote  on  fractures  of  the  neck  of  the  femur. 

Georg  Friedrich  Holscher  (1792-1852)  of  Miuden 
was  an  important  teacher  of  surgery  and  ophthalmology  in  the  school  of  surgery  in 
Hanover,  an  industrious  writer  and  the  editor  of  an  influential  journal  (hannoverische 
Annalen).  Having  received  a  finished  education  in  England  —  he  was  a  pupil  of  Sir 
Astley  Cooper  —  he  translated  in  1821  Brodie's  work  on  the  diseases  of  the  joints,  and 
subsequentl}'  published  a  number  of  journalistic  articles. — In  1830  he  was  appointed 
surgeon-in-ordinary.  — A  colleague  of  Holscher's  in  the  same  institution  was  the 
eminent  clinician,  pathological  and  surgical  anatomist,  phjTsiologist  and  physical 
diagnostician 

G.  Wedjdmeyer  (1792-1829), 
Staff-physician  and   Court-surgeon,  and   the   author  of  a   treatise  entitled     'Unter- 
suchungen  iiber  den   Kreislauf  des  Bluts  und  insbesondere  iiber  die  Bewegung  des- 
selben  in  den  Arterien  und  Capillargefassen  ",  1828. 

Georg  Spangenberg  (1780-1849), 
a  teacher  in   the  school  of  surgery  in  Hanover,  Staff-surgeon,  translated  Guthrie's 
work  on  gun-shot  wounds. — Among  the  universities  of  northern  Germany  the  young 
university  of  Berlin   attained   almost  at  once   a  great  reputation   as  a  school   for 
surgeons.     This  was  chiefly  due  to 

Joh.  Nepomuk  Rust   (1775-1840)  of  the  castle   Jokannisberg  near 
Jauernick, 

a  surgeon  descended  from  the  old  Austrian  school,  who  was  general  phj-sician  to  a 
division  in  the  Prussian  army  during  the  Hundred  Days,  and  after  the  close  of  the 
campaign  a  professor  in  Berlin.  —  Rust  was  particularly  eminent  as  a  clinical  teacher, 
in  which  capacity  he  followed  the  Socratic  method.  As  a  skilful  operator  he  was 
less  famous.  His  literary  reputation  is  found  edchiefly  upon  his  works  on  ulcers  and 
diseases  of  the  joints  (Helkologie,  2  vols.,  1811  and  1844;  Arthrokakologie ;  Theoret. 
praktisches  Handbuch  der  Chirurgie,  mit  Einschluss  der  syphilitischen  und  Augen- 
krankheiten  ;  in  alphabetischer  Ordnung,  18  vols,  1830-36  ;  Aufsiitze  und  Abhand- 
lungen  aus  dem  Gebiete  der  Medicin,  Chirurgie  und  Staatsarzneikunde  etc.,  3  vols, 
1834-1840)  and  the  "  Magazin  fiir  die  gesammte  Heilkunde"  (1816-1846),  which  he 
founded.  Rust  was  the  inventor  of  many  instruments,  a  partisan  of  the  actual 
cautery  in  inflammatory  diseases  of  the  joints,  mercurial  inunction  in  syphilis  and 
moist  dressings  for  wounds.     He  was  likewise  the  reformer  of  medical_ affairs  in 


—  10G0  — 

Prussia,  and,  among  other  improvements,  introduced  the  division  of  Prussian  surgeons 
into  those  of  the  first  and  second  classes. 

A  still  more  capable  teacher,  and  a  surgeon  of  great  eminence  as  an  operator  of 
independence,  an  ophthalmologist  and  an  operative  oculist  —  he  used  both  hands 
with  equal  dexterity  —  was  the  ingenious 

Carl  Ferdinand  yon  Graefe  (1787-1840)  of  Warsaw, 
first  a  practising  physician  and  then,  at  the  age  of  24  years,  a  professor  in  Berlin. 
During  the  war  for  independence  he  was  appointed  "Generalarzt",  but  after  the  close 
of  the  war  he  resumed  his  position  as  a  teacher  and  became  very  influential  in  the 
development  of  German  surgery,  particularly  operative  surgery,  and  an  extremely 
popular  practitioner.  His  extraordinary  zeal  and  eminent  gifts  as  a  teacher  were 
brilliantly  shown  by  the  fact  that  he  had  his  pupils  operate  themselves  in  his  presence, 
as  was  subsequently  done  by  Stromeyer.  Von  Graefe  cultivated  plastic  surgery, 
particularly  blepharoplasty,  staphyloplasty,  rhinoplasty  etc.,  but  also  devoted  atten- 
tion to  the  diseases  of  the  vessels  (Angiectasie,  ein  Beitrag  zur  Cur  und  Erkenntniss 
der  Gefassausdehnung,  1808)  and  ophthalmology  (Behandlung  der  iigyptischen 
Augenentziindung),  though  in  the  latter  branch  he  has  been  far  surpassed  by  his 
distinguished  son.  He  also  invented  numerous  methods  of  operation  (including 
dactylomyleusis,  i.  e.  amputation  with  the  chisel,  which  had  been  practised  by 
Scultetus)  and  instruments.  Jij  his  work  entitled  "Rhinoplastik,  oder  die  Kunst  den 
.  Verlust  der  Nase  organisch  zu  ersetzen",  1814;  "Xormen  fur  die  Ablosung  grosser 
Gliedmassen  ",  1812,  he  inaugurated  the  plastic  surgery  of  our  century. — Graefe  died 
very  suddenly  of  typhus  (according  to  others  he  suffered  a  "tragic"  fate)  while  on  the 
road  home  from  Hanover,  whither  he  had  been  called  to  an  operation  upon  the  eyes 
of  the  then  Crown  Prince,  subsequently  King  George  V.  The  operation  was  neces- 
sitated by  a  sympathetic  ophthalmia,  was  performed  b}r  Jaeger,  and  was  unsuccess- 
ful in  its  results. 

L.  J.  von  Bierkowski,  subsequently  professor  of  surgery  in  Kasan,  gave  a  des- 
cription of  the  teachings  and  methods  of  the  two  famous  Berlin  surgeons  (Anato- 
mische-chirurgische  Abbildungen,  nebst  Darstellung  und  Beschreibung  der  chirur- 
gischen  Operationen  von  Von  Graefe,  Kluge  und  Rust,  1827,) 

A  colleague  of  the  two  eminent  surgeons  just  mentioned  was 

J.  C.  Jungken  (1793-1875), 
professor  and  medical  Privy  Counsellor  in  Berlin,  who  was  especially  famous  as  an 
oculist.      He  retired   in   1868  after  teaching  for  50  years.      His  chief  works  were 
entitled:    "Die  Lehre  von  den  Augenkrankheiten  ",  often  republished;    Augenkrank- 
heiten  in  der  belgischen  Armee";   "Die  Anwendung  des  Chloroformes",  etc.,  etc. 

Ernst  Blasius  (1802-1875)  of  Berlin, 
also  recently  deceased,  studied  under  Jungken  and  became  a  professor  in  Halle. 
He  was  a  pupil  of  the  Friedrich-Wilhelminstitut,  graduated  in  1823  and  for  the  next 
four  years  served  as  an  army-surgeon.  In  1839  he  was  appointed  professor  in  Halle 
in  the  place  of  Wutzer.  In  1867  he  resigned  his  position.  —  Blasius  was  a  famous 
teacher  and  operator,  in  the  latter  capacity  well-known  for  his  elliptical  method  of 
amputation  and  his  refracture  of  badly  united  bones  by  means  of  the  osteoclast. 
His  chief  works  were:  "  Handbuch  der  Akiurgie"  (3  vols.,  Halle  1830-32)  with1 
"  Akiurgischen  Abbildungen"  (1831-1833);  "  Lehrbuch  der  Akiurgie"  etc.  —  The 
eminent  surgical  writer  and  historian 

Traugott  Wilhelm  Gustav  Benedict  (1785-1862)  of  Torgau, 
professor  in  Breslau,  also  came  from  Berlin.     His  chief  works  were  entitled  "  Lehr- 
buch der  allgemeinen  Chirurgie  und  Operationslehre",  1842;   "Kritische  Darstellung 
der  Lehre  von  den  Verbanden  und  Werkzeugen  der  Wundiirzte",  1827;    "Clinische 


—  1061  — 

Beitrage  aus  dem  Gebiete  der  Wundarzneikunst  und  Augenheilkunde",  etc.      Beside 
him,  as  an  active  surgical  writer  and  also  historian  of  surgerj',  we  may  place 

Joh.  Gottlob  Bernstein  (1748-1835), 
author  of  a  "  Practisches  Handbuch  fur  Wundarzte"',  5th  edition,   1820  etc.     "  Ge- 
schichte  der  Chirurgie  vom  Anfami  etc",  1823. 

C.  W,  Wutzer  (1789-1858), 
mentioned  above,  a  famous  teacher  and  professor  successively  in  Munster,  Halle  and 
Bonn,  was  a  pupil  of  the  Friedrich-Wilhelminstitut  in  Berlin.  His  chief  works  were 
entitled  "Allgemeine  und  specielle  Chirurgie",  1844;  "  Operationslehre",  1846,  both 
published  from  lectures.  Wutzer  was  also  the  inventor  of  a  method  of  invagination 
in  hernia,  which  was  much  discussed  in  its  daj7.     Before  him  the  quixotic 

K.  A.  Weinhold  (1762-1829), 
who  had  served  from  the  ranks  up,  was  professor  of  surgery  in  Halle.  His  chief 
Works  were:  ''Die  Kunst  veraltete  Hautgeschwtire  zu  heilen",  1811;  "Ueberdie 
abnormen  Metamorphosen  der  Highmorshohle",  1810;  "Anleitung  den  verdunkelten 
Krystallkorper  im  Auge  des  Menschen  jederzeit  bestimmt  mit  seiner  Kapsel  umzule- 
gen",  1809,  etc.  etc.  By  the  way  he  proposed,  in  order  to  prevent  pauperism,  that 
all  men  should  be  rendered  incapable  of  generation  by  the  operation  of  infibulation, 
until  they  were  manifestly  able  to  support  a  familj". 

Carl  Heinrich  Dzondi  (1770-1835), 
originally  a  painter,  officiated  still  earlier  as  professor  of  clinical  surgery  in  Halle. 
He  afterwards  established  a  surgical  and  ophthalmic  private  clinic,  and  is  particularly 
well-known  for  his  treatment  of  syphilis  with  corrosive  sublimate,  though,  according 
to  Proksch,  this  method  had  been  practised  long  before  in  his  part  of  the  country. 
In  the  school  of  surgery  established  by  C.  C.  von  Siebold  in  Wiirzburg  his   son 

Barthel  von  Siebold  (1774-1814), 
became  his  father's  successor  in  the  chair  of  surgerj-,  though  he  never  attained  his 
father's  fame. 

Franz  Casp.  Hesselbach  (1759-1816) 
was  Siebold's  colleague  in  the  chair  of  anatomy,  though  he  also  wrote  on  surgical 
subjects,  particularly  inguinal  hernia.     His  son 

Adam  Caspar  Hesselbach, 
professor  of  surgery  and  surgeon-in-chief  to  the  general  hospital  in  Bamberg,  wrote 
an  excellent  monograph  on  the  same  subject  entitled  "  Die  Lehre  von  den  Einge- 
weidebriichen  ",  1829,  second  part  1830,  a  work  still  regarded  as  master]}".  The 
Aulic  Counsellor  of  Saxony  —  most  aulic  counsellors  at  the  present  day  are  found  in 
Wurtemberg  and  Baden  — 

Burkhard  Wilh.  Seiler  (died  1844) 
also  rendered  siood   service   in   the  study  of  the  subject  of  hernia.     He  translated 
Scarpa's  work  and  made  some  additions  to  it.     A  bold  operator  and  famous  surgeon 
was 

Joh.  Nepomuk  Salter  (1766-1840), 
physician  to  the  island  of  Reichenau  and  subsequently  in  Constance.     (Extirpation 
of  the  entire  uterus;   Sauter's  suspensory  etc.) 

Barthel  Siebold's  successor  was 

Cajetan  von  Textor  (1782-1860), 
professor  of  surgery  in  Wiirzburg  from  1816,  and  famous  as  the  inaugurator  of  con- 
servative surgerj-  (resections)  in  Germany.     He  also  translated  the  great  work  of 
Boyer  and  was  the  author  of  the  memorable  treatise  "  Ueber  die  Wiedererzeugung 


—  1062  — 

der  Knochen  nach  Resektionen  beirn  Mensehen",  1842,  which  passed  through 
numerous  editions.  Von  Textor  also  wrote  "  Grundziige  zur  Lehre  der  chirurgischen 
Operatiouen  mit  bewaffneter  Hand  ".  Trepanning  he  discarded,  and  was  in  general 
an  advocate  of  expectant  surgery.  His  son  Carl  von  Textor  (1815-1880),  professor 
extraordinary  in  Wtirzburg.  likewise  rendered  himself  well-known  as  a  surgeon. 
Among  the  pupils  of  Cajetan  von  Textor  who  devoted  special  attention  to  re- 
sections were  : 

Michael  Jaeger  (1795-1838  . 

formerly  professor  in  Erlangen.  and 

Franz  Hied. 
born  in   Kempten  in  1810,  and  from   ^47  to  1884  a  professor  in  Jena.     He  is  the 
author  of  a  treatise  entitled  "  Die  Resektionen  der  Knochen  ",  1846;  contains  Jager's 
portrait  and  two  copperplates. 

The  deceased  L.  Schillbach  in  Leipzig,  likewise  a  pupil  of  the  "  Old  Textor", 
also  advocated  resections  i  Beitrage  zu  den  Resektionen  der  Knochen,  1861,  etc.). 
Hermann  Demme  Sr.  (1803-1867),  professor  in  Bern,  also  received  his  education  in 
Wurzburg.  His  gifted  son  Hermann  Carl  Demme  I  1831-1864  acquired  a  sad  reputa- 
tion by  his  thoughtlessness,  i  Militarchirurgische  Studien.  2d.  edition  1863 ;  Patho- 
logische  Anatomie  des  Tetanus:  Die  Veranderung  der  Gewebe  durch  Brand.) 

The  successor  of  Textor  in  1^6  was 

Wexzel  von"  Lixhart  (1821-1877)  of  Selowitz  in  Moravia, 
widely  known  by  his  "  Compendium  der  Operationslehre '".  He  sprung  from  the 
Prague-Vienna  school  and  was  a  pupil  of  Dumreicher.  A  dextrous  operator  and 
learned  topographical  anatomist,  he  published  in  1866  his  :'  Vorlesungen  iiber  Lnter- 
leibshernien",  a  subject  which  seems  to  have  been  a  hobby  in  Wurzburg  since  the 
days  of  Hesselbach.  , 

A  predecessor  of  Jaeger  and  professor  in  Erlangen  from  1797  was  the  eminent 
surgeon 

Berxhard  Gottlob  Schreger  (1766-1825), 

who  devoted  his  attention  particularly  to  the  subject  of  operations  and  dressings,  as 
well  as  to  orthopa?dic  surgery.  His  chief  works  were  :  "  Handbuch  der  chirurgischen 
Verbandlehre  ",  1323;  ''  Grundriss  der  chirurgischen  Operationen  ",  3d.  edition  1825; 
"  Chirurgische  VerSuche".  1811-1818.  full  of  suggestive  observations,  in  which  even 
history  is  not  neglected:   "  XUchtlicher  Streckapparat"  etc. 

Less  famous  were  the  two  following  Bavarian  surgeons: 

M.  Koch,  who  proposed  to  do  away  with  ligation  of  vessels,  replacing  it  with 
manual  pressure,  and  who  also  wrote,  among  other  things,  upon  disarticulation  of  the 
lower  jaw,  1831,  and  his  follower 

Philipp  Wii.helm  (1798-1840  of  Wlirzbnrg,  professor  in  Munich  and  author 
of  "  Clinische  Chirurgie'',  1880:  ''Leber  den  Bruch  des  Schliisselbeins ",  1822. 
Franz  Chrlstoph  von  Rothmund,  who  celebrated  in  1883  the  60th  anniversary  of  his 
reception  of  the  Doctorate,  acquired  little  reputation  abroad,  while  Aug.  Rothmund  Jr. 
in  Munich  distinguished  himself  as  an  oculist. 

Great  reputation  as  a  practitioner,  and  as  the  author  of  the  text-book  of  surgery 
most  frequently  republished  among  all  those  of  German  origin,  was  enjoyed  by  old 

Max  Jos.  vox  Chelius  (1794-1S76)  of  Mannheim. 
a  surgeon  schooled  in  the  wars  for  independence,  and  educated  in  Landshut  tuuder 
Walther  i,  Vienna  and  various  other  German  and  French  universities.     Chelius  was 
at  first  a  hospital  physician  in  Ingolstadt,  but  was  subsequently  ennobled,  and  from 
1817  enjoyed  the  positions  of  professor  and  Privy-Counsellor  in  Heidelberg,  to  whose 


—  1063  — 

university  he  for  a  long  period  attracted  numerous  pupils.  According  to  the  historian 
Georg  Weber,  the  University  of  Heidelberg  owes  its  international  character  to 
Chelius.  His  teachers  were  Kern,  Beer  and  Zang.  It  was  Chelius  who  introduced 
at  Heidelberg  the  surgical  and  ophthalmological  clinic.  According  to  Weber, 
Chelius  was  "a  man  of  reactionary  disposition  (in  whose  opinion  Sand  was  regarded 
as  phj'sically  strong  enough  to  be  beheaded)  with  aristocratic  manners,  though  on 
his  mother's  side  of  very  humble  origin,  a  crafty  practitioner,  who  required  his  fees 
to  be  always  paid  in  gold,  though  ever  ready  to  assist  the  poor,  and  the  only  pro- 
fessor in  Heidelberg  who  in  his  day  kept  a  carriage."  His  chief  works  were 
"  Handbuch  der  Chirurgie  ",  1822,  8th  edition  1S57,  a  book  translated  into  six  different 
languages,  though  discarded  by  Stromeyer  because  it  did  not  contain  a  single  idea 
original  with  Chelius;  "  Ueber  die  Blasenscheidenfistel  ",  1844:  "Zur  Lehre  von  den 
schwammigen  Auswlichsen  der  harten  Hirnhaut ",  1831:  "Ueber  die  Anwendung 
kalter  und  warmer  Umschlage  bei  Kopfverletzungen  ";  "  Handbuch  der  Augenheil- 
kunde",  1839-1844.  —  His  son  Franz  von  Chelius,  professor  and  private  surgeon  in 
Heidelberg,  has  not  as  yet  attained  as  an  author  and  practitioner  the  reputation  of 
his  father. 

Phil.  Franz  yon  Walther  (1782-1849)  of  the  village  of  Burr- 
weiler  in  the  Bavarian  Palatinate,  son  of  an  official  of  that  village,  exer- 
cised as  a  teacher,  surgical  writer,  operator  and  oculist  for  a  long  time 
the  greatest  influence  upon  the  development  of  German  surgery.  He  was 
a  professor  successively  in  Landshut  (1S04),  Bonn  (1819)  and  Munich 
(1830),  founder  of  the  surgical  clinics  in  the  two  former  universities, 
Bavarian  Prh^-Counsellor  and  Surgeon-in-ordinary  etc.  The  house  in 
which  he  was  born  has  been  supplied  with  a  tablet  to  his  memory. 

Walther' s  pupils  (among  whom  were  Chelius  and  the  eminent  Bavarian  surgeons 
already  mentioned,  with  numerous  physicians  I  were  scattered  throughout  all  Germany, 
and  particular]}-  South  Germany.  He  defended  above  all  the  indivisibility  of  surgery 
and  medicine  ("A  complete  surgery  embraces  in  itself  medicine  also,  just  as  a  perfect 
medicine  comprehends  surgery"),  as  did  Kern,  and  as  the  result  probably  of  this  feel- 
ing he  was  a  Systematist  in  surgery,  embracing  the  views  of  the  school  of  natural 
philosophy,  after  having  ahead}-  cultivated  even  animal  magnetism.  As  an  operator 
he  was  extremely  conscientious,  possessed  of  great  presence  of  mind,  and  a  model  of 
carefulness  in  the  after-treatment,  even  applying  his  own  dressings.  As  regards  the 
latter,  a  true  associate  of  Richter  and  Kern,  he  strove  to  remove  from  surgical  dress- 
ings everything  artificial  and  professional.  Walther  was  a  diligent,  extremely  fertile 
and  ingenious  writer.  Besides  numerous  independent  works,  he  edited  the  famous 
"Journal  flir  Chirurgie"  in  union  with  Griife,  and  subsequently  with  Ammon  in 
Dresden.  His  chief  works  were  his  "System  der  Chirurgie",  1843,  6  vols.:  "Lehrbuch 
der  Augenkrankheiten  ",  2  vols.,  1849;  "  Abhandlungen  aus  dem  Gebiete  der  prakti- 
schen  Medicin,  besonders  der  Chirurgie  und  Augenheilkunde",  1819;  "  Neue  Heilart 
des  Kropfes,  nebst  Geschichte  eines  durch  die  Operation  geheilten  Aneurysmal  der 
Carotis",  1817;  "  De  ligatura  carotidis  communis",  1831;  "Die  Chirurgie  in  ihrer 
Trennung  von  der  Medicin",  1806;  "Merkwtirdige  Heilung  eines  Eiterauges",  1819 
etc.,  etc. 

A  famous  surgeon,  surgical  writer  and  operator  was  Friedrich  Pauli  (died  1868) 
of  Landau,  a  pupil  of  Walther  and,  as  Stromeyer  says,  the  first  surgeon  to  perform 
the  operation  for  strabisrnus.  A  popular  surgical  practitioner  too  was  "  old  "  Julius 
Bettinger  (1802-1887),  physician  and  surgeon  to  the  Palatinate  hospital  in  Franken. 
thai. 


—  1064  — 

J.  L.  G.  Fricke  (1790-1842)  of  Brunswick,  physician  to  the  hospital 
in  Hamburg  and  Director  of  the  Medico-chirurgical  Institute  in  that  city, 
acquired  considerable  reputation  as  a  surgeon  and  operator. 

His  name  is  known,  to  every  physician  by  Fricke' s  forceps.  Fricke  wrote 
"  Geschichte  einer  durch  den  Lebensrnagnetismus  geheilten  Epilepsie",  1812;  "In 
niemoriam  defuncti  Immanuel  Baggesen",  1826  ;  "Annalen  der  chirurgischen  Abtheil- 
ung  des  allg.  Krankenbauses  in  Hamburg";  "  Episiorrapbie  ";  "  Die  Bildung  neuer 
Augenlieder",  1829  etc.  —  In  conjunction  with  Friedr.  Wilh.  Oppenheim  (born  1709), 
who  had  been  for  a  long  time  an  army-surgecn  in  Russia  and  Turkey,  he  edited  a 
"Zeitschrift  fur  Medicin". 

The  following  surgeons  also  deserve  notice  as  litbotomists :  Christian  von  Klein 
(1740-1815)  in  Stuttgart;  the  Wurtemberg  country-surgeon  Michael  Zett  (1778-1864), 
who,  according  to  Renz,  performed  107  lithotomies  with  only  three  deaths. 

Johann  Friedrich  Dieffenbach  (1794-1847)  of  Konigsberg,  pro- 
fessor in  Berlin,  was  a  born  surgeon  and  particularly  ingenious  operator, 
full  of  enthusiasm  and  indefatigable  in  the  pursuit  of  that  profession  for 
which  he  felt  an  internal  calling.  Fertile  in  the  invention  of  new  measures 
and  methods  for  the  attainment  of  the  objects  before  him,  often  devising 
them  in  the  very  performance  of  the  operation,  he  was  brilliant  in  the 
establishment  of  the  indications,  quick  in  forming  his  opinions,  courageous 
in  carrying  them  into  execution  and  in  the  highest  degree  dexterous  in 
the  manipulation  of  instrumental  aids,  preferring  the  simplest  to  the 
more  complicated  and  not  despising  the  most  trifling,  if  it  seemed  to  be 
adapted  to  the  object  in  view.  In  spite  of  a  hot-blooded  temperament 
and  profound  s}Tmpathies,  he  was  safe  and  calm  in  operative  measures,  as 
well  as  careful  and  circumspect  in  the  after-treatment.  As  a  writer 
Dieffenbach  was  possessed  of  a  plastic  force,  an  internal  truthfulness,  a 
clear  and  classic  language,  though  his  words  were  extremel}7  simple,  unless 
the  inspiration  of  the  moment  or  warm  enthusiasm  for  the  subject  con- 
strained him  to  the  employment  of  lofty  expressions  of  his  thoughts  and 
feelings.  He  wrote,  as  he  labored,  from  experience  and  for  practical  life, 
not  from  and  for  the  closet  of  the  learned.  Dieffenbach  won  during  his 
life  a  reputation  almost  undisputed  at  home  and  abroad,  and  he  enjoyed 
a  fame  almost  as  unquestioned  after  a  death  which  carried  him  off  sud- 
denly, in  the  midst  of  complete  activity,  with  reputation  and  brilliancy 
undimmed,  so  that  the  fortune  which  showed  herself  almost  unswervingly 
true  to  him  in  life,  so  far  as  the  nature  of  the  case  admitted,  abandoned 
him  not  even  in  death.  A  rare  man  and  a  still  rarer  fate  !  He  often 
said  "I  dread  to  die  —  that  is  a  painful  struggle  ;  but  death  is  beautiful  !" 

That  Dieffenbach,  in  addition  to  ingenious  natural  gifts  and  profound 
knowledge  in  his  favorite  department,  was  also  complete  master  of,  and 
employed  practically,  all  the  sciences  accessory  to  surger}-  —  particularly 
the  chief  of  these,  the  anatomy  and  physiology  of  his  time  —  need  only  be 
mentioned. 

Dieffenbach  sprung  from  a  family  of  upper  Hesse,  which  could  point  to  many 
men  of  talent,  poets,  writers  on  belles-lettres,  spirited  travellers,  so  that  many  sides 


—  10G5  — 

of  the  surgeon  and  author  Dieffenbaeh  must  be  regarded  as  inherited.  The  latter 
was  the  son  of  the  prematurely  deceased  Conrad  Dieffenbaeh,  teacher  in  the  city* 
school  in  Konigsberg.  Dieffenbaeh  was  designed  for  the  ministry,  and  accordingly, 
after  receiving  his  preparatory  education  from  the  year  1809  in  the  gymnasium  at 
Rostock,  he  attended  the  university  of  Greifswald.  During  the  war  for  independence 
he  fought  among  the  Mecklenburg  mounted  riflemen.  After  the  close  of  the  war, 
however,  he  resumed  the  study  of  theology  in  the  university  mentioned  above,  but 
subsequently  diverted  his  attention  to  medicine.  He  then  went  to  Bonn  (wheie, 
according  to  H.  Heine,  he  prepared  himself  for  his  future  career  as  an  operator  by 
cutting  off  the  tails  of  all  the  dogs)  under  the  teaching  of  Walther,  and  in  1821  he 
went  as  a  travelling  physician  with  a  blind  lady  to  France,  where  Dupuytren  and 
Larrey  gave  him  special  advantages.  In  1822  he  wished  to  go  bj-  way-  of  Marseilles 
to  Greece,  but  was  unable  to  accomplish  his  desire,  and  returning  to  Germany  he 
took  his  degree  of  doctor  in  Wurzburg.  His  dissertation  had  for  its  subject  the 
"Transplantation  thierischer  Stoffe".  Removing  now  to  Berlin,  he  speedily  won 
practice  and  reputation  as  an  operator,  so  that  in  18150  he  was  appointed  surgeon  to 
the  Charite  and  a  member  of  the  Board  of  Examiners.  In  1832  he  was  nominated 
professor  extraordinary,  travelled  again  in  183G  to  France,  and  in  1840  became 
Grafe's  successor  and  president  of  the  surgical  and  ophthalmological  clinic.  In  1841 
he  visited  Vienna,  and  in  1843  St.  Petersburg.  As  a  teacher  and  operator  of  the  first 
rank  he  educated  numerous  students  and  attracted  many  physicians  to  the  university 
of  Berlin.  He  was  also  a  member  of  the  order  pour  le  merite.  —  Dieffenbaeh' s  chief 
merits  are  that  he  perfected  plastic  operations  in  their  widest  sense,  that  he  extended 
tenotomy  over  a  wider  field  and  particularly  to  the  muscles  of  the  eye,  and  in  general 
that  he  simplified  and  reconstructed  the  theory  and  technique  of  operative  surgery. 
Like  Wurtz,  Desault  and  almost  all  great  surgeons,  he  was  an  opponent  of  trepan- 
ning. —  By  some  he  was  charged  with  an  excessive  fondness  for  operations,  a  feeling 
to  which  his  marvellous  dexterity'  may  perhaps  have  contributed.  His  works  were 
entitled:  "Transfusion  des  Blutes  und  Infusion  der  Arzneien",  1828;  "  Chirurgische 
Erfahrungen,  besonders  iiber  die  Wiederherstellung  zerstorter  Theile  des  menschlichen 
Korpers  nach  neuen  Methoden",  1829-34;  "Anleitung  zum  chirurgischen  Yerbande", 
by'  Henkel  and  Dieffenbaeh,  1829;  "Anleitung  zur  Krankenwartung",  1832;  a  trans- 
lation of  Roux's  work  on  "  Staphylorraphie  "  and  Serre's  "  Eyes  of  Insects",  1828; 
"  Physiologisch-chirurgische  Erfahrungen  bei  Cholerakranken ",  1832;  essays  on 
transfusion,  infusion,  experiments  on  transplantation  in  animals  —  he  learned  to 
operate  upon  animals  himself- — transplantation  of  completely  separated  portions  of 
skin  (according  to  Rohlfs  he  was  the  first  to  transplant  pieces  of  the  cornea  in  man), 
injuries  of  the  rectum,  cleft-palate,  staphylorraphy,  imperforate  anus,  urethral  strict- 
ures, the  velum  palatinum  in  men  and  the  mammalia,  injuries  of  the  head,  the  twisted 
suture,  cutting  off  ligatures,  disarticulation  of  the  femur,  extirpation  of  ovarian 
tumors,  new  methods  for  the  restoration  of  eyelids  and  lips,  for  the  reconstruction  of 
the  depressed  nose  from  the  stump  of  the  old  organ,  the  treatment  of  fissure  of  the 
palate,  the  treatment  of  ectropium,  precocious  development  of  a  child  which  men- 
struated at  the  age  of  19  months,  treatment  of  vesico-vaginal  fistula,  laceration  of  the 
thumb,  division  of  the  sterno-clerdo-mastoideus  and  other  muscles,  operations  for  the 
cure  of  stammering,  on  strabismus  and  its  cure  by  a  surgical  operation  etc.  His 
chief  work,  however,  was  "Die  operative  Chirurgie",  2  vols.,  completed  by  J.  J. 
Buhring;  and  his  last  work,  "Der  Aether  gegen  den  Schmerz",  1847  (Compare  Isen- 
see).  —  To  establish,  so  far  as  space  permits,  the  statements  already  made,  we  quote 
the  following  passages : 

"  The  division  of  the  inferior  rectus  by"  itself  for  downward  squint  1  have  under- 
taken once  only  in  more  than  3000  operations  for  strabismus,  for  only  a  single  case 


—  1066  — 

of  this  kind  has*' presented  itself  tome  —  a  Prussian  officer  who  had  a  downward  squint 
in  one  eye.  In  nystagmus  bulbi,  however,  I  have  often  performed  this  division  in 
conjunction  with  that  of  the  other  muscles  of  the  eye. 

The  inferior  rectus  muscle  is  somewhat  thicker  than  its  opponent,  the  rectus 
superior.  It  originates,  in  common  with  the  external  and  inteinal  recti,  from  a  flat, 
tendinous  band  on  the  lateral  surface  of  the  bod}'  of  the  sphenoid,  which  projects 
through  the  superior  orbital  fissure  into  the  orbit  and  divides  into  three  points.  The 
muscle  passes  forward  through  the  orbit  and  is  attached  to  the  under  and  anterior 
part  of  the  bulb  upon  the  sclerotic.  This  point  is  distant  three  lines  from  the  edge  of 
the  cornea. 

The  preparations  for  this  operation  are  the  same  as  for  division  of  the  other 
muscles  of  the  eye.  After  the  lids  have  been  strongly  separated  by  the  speculum, 
the  patient  leans  his  head  back  upon  the  breast  of  an  assistant  and  fixes  his  gaze 
upon  the  ground.  The  fold  of  the  conjunctiva  is  then  raised  by  the  tenaculum,  on 
the  lower  side  of  the  external  border  of  the  cornea  in  the  transparent  part,  and 
divided.  The  transverse  wound  should  be  at  least  one-third  of  an  inch  long.  The 
eye  is  now  more  strongly  depressed,  the  scissors  are  pressed  in  more  deeply  and  the- 
cellular  tissue  covering  the  muscle  is  cut  through.  Ii  the  muscle  is  sufficiently 
denuded  a  passage  is  made  with  the  scissors  beneath  its  fibres,  a  blunt  hook  intro- 
duced, the  cellular  tissue  behind  the  muscle  loosened  by  pressing  backwards  with  the 
closed  scissors,  the  eyeball  still  further  depressed  and  the  muscle  then  divided  as  far 
back  as  possible,  or,  if  it  is  desired  to  perform  tenotomy,  the  tendon  is  divided  ip 
front  of  the  hook." 

"  It  is  with  no  feeling  of  cheerfulness  that  the  surgeon  acts,  when  a  feeble  ray 
only  of  hope  for  the  preservation  of  his  patient  constrains  him  to  the  performance  of 
a  deep  and  bloody  operation,  by  which,  even  at  best,  he  may  merely  save  the  life  of  a 
miserable  cripple.     Such  has  always  been  my  experience  when  forced  to  perfoim  this 

operation  (disarticulation  of  the  os  femoris) From  the  outset  we  can  imagine 

from  the  results  of  amputation  of  the  femur  how  profound  must  be  the  influence  upon 
the  entire  circulation  and  upon  the  nutrition  of  the  body  of  an  operation  which  takes 
away  from  the  body  one  fifth  of  its  entire  mass.  We  should  likewise  recognize  our 
great  indebtedness  to  Larrej-,  who  in  the  beginning  of  the  present  century  rescued  from 
oblivion  this  operation,  not  yet  an  hundred  years  old  and  rarely  practiced.  Although 
too  under  unfavorable  circumstances  he  attained  no  brilliant  results,  yet  it  is  suffi- 
cient io  start  with,  that  of  seven  men  devoted  to  death  he  was  able  to  save  two,  a 
mortality  which  in  all  probality  will  greatly  decrease  under  the  influence  of  more 
opportune  performance  under  favorable  circumstances"  —  a  view  which  unfortu- 
nately has  not  been  confirmed  by-  experience. 

In  regard  to  his  operative  surgery,  which  is  regarded  as  a  classical  masterpiece, 
Dieffenbach  said:  "I  wish  that  mine  too  were  such  a  book  (as  Richter's).  It  has 
been  to  me  no  unpleasant  task,  but  an  agreeable  occupation,  and  this  stamp  I  wish 
to  have  impressed  upon  it.  .  .  .  These  are  no  melancholy  reflections  in  the  evening 
of  my  life,  but  occurrences  not  only  of  the  day  before  yesterday,  but  of  yesterday  and 
even  of  to-daj',  viewed  with  the  glow  of  youth  and  in  the  actual  present.  ...  It  has 
been  my  effort  to- influence  the  ideas  of  my  young  readers,  to  show  them  pictures  of 
life  whose  outlines  are  sketched  in  blood  "  — he  had  his  own  heart's  blcod,  with  which 
genius  ever  paints,  upon  his  palette —  "and  thus  to  avoid  wearying  their  recollection 
with  unprofitable  matters,  by  which  the  intellect  is  injured." 

"Of  all  the  branches  of  medical  science  operative  surgery  is  most 
adapted  to  carry  awa}'  you  young  men  with  enthusiasm.  The  man  of  feel- 
ing shudders  at  the  thought  of  plunging  the  knife    into   the   flesh   of  a 


-  1067  — 

fellow-man,  of  doing  this  in  cold  blood,  of  moving  the  knife  here  and 
there,  of  cutting  still  deeper,  of  being  sprinkled  with  a  shower  of  bloodr 
in  the  midst  of  the  cries  of  anguish  of  the  poor  mutilated  patient,  and 
yet  of  thinking  and  feeling  !  Operative  surgery  is  a  bloody  struggle  for 
life  with  disease,  a  struggle  for  life  and  death.  Audacity  and  insensibility 
cannot  here  win  the  victory,  but  calmness  and  enthusiasm,  knowledge  and 
dexterity.  Without  a  certain  natural  disposition  for  this  branch,  without 
being  thoroughly  permeated  by  it,  and  without  a  fiery  devotion  to  it,  he 
who  dedicates  his  life  to  operative  surgery  will  alwa}'S  continue  a  beginner. 
He  ma}'  have  studied  thoroughly  all  branches  of  medical  science,  he  may 
be  acquainted  with  all  the  surgical  operations  and  the  various  methods 
for  their  performance  as  taught  b}'  different  masters,  he  ma}T  be  able  to 
perform  them  upon  the  cadaver  and  upon  the  living  patient,  and  yet  he 
will  remain  merely  a  subordinate  in  his  surgical  practice.  This,  however, 
makes  the  true  surgeon  —  to  be  able,  and  to  know  how,  to  execute  that 
which  is  not  written  in  the  books,  to  invent  new  methods  —  not  a  new 
bandage  or  a  new  knife  —  to  be  always  an  inventive  Odysseus,  and  under 
the  most  difficult  circumstances  to  be  capable  of  winning  the  battle  at 
once  without  any  council  of  war.  The  painter  learns  to  draw  carefull}', 
to  mix  and  lay  on  the  colors,  to  copy  correctl}'  —  and  then  paints  inde- 
pendently, paints  his  own  ideas,  his  fancies.  Anj-one  can  learn  to  make 
verses,  but  to  write  poetry  cannot  be  learned,  it  is  a  faculty  innate  in  the 
poet.  One  ma}T  also  learn  to  use  the  knife,  but  often  he  is  compelled  to 
cut  differently  from  what  he  has  learned  in  the  books.     That  is  operative 

surgery The  best  surgeons  are   recognized  only  by   the    clearness 

of  their  thought  and  the  simplicit}*  of  their  expressions The  best 

surgeons  have  alwa\'S  been  the  best  writers,  the}'  may  be  recognized  by 
their  style,  and  the  writings  of  old  Pott,  of  our  August  Gottlieb  Richter 
and  of  Astley  Cooper  might  be  read  in  our  schools  as  models  of  style."  — 
Dieffenbach  from  his  imaginative  style  might  be  called  the  Romancist  of 
Surgery. 

From  among  Dieffenbach's  pupils 

A.  Th.  Middeldorpff  (1824-1860), 
professor  in  Breslau,  has  secured  permanent  fame  by  his  introduction  of  the  galvano- 
cautery  into  German  operative  technics.  Among  his  more  important  works  are  : 
"Die  Galvanokaustik ",  1854;  "  Beitrage  zur  Lehre  von  den  Knochenbriichen  ", 
1853;  "  De  polypis  oesophagi  atque  de  tumore  ejus  generis  primo  prospere  extirpato 
commentatio  ",  1867,  and  "  Commentatio  de  fistulis  ventriculi  externis  et  chirurgica 
earum  sanatione  "  etc.,  1858.  — In  the  employment  of  galvanism  Middeldorpff  was 
anticipated  by  Fabre-Palaprat  (1828)  in  electrolysis,  and  particularly  in  the  use  of 
the  galvano-cantery  by  Gustav  Crusell  of  St.  Petersburg  (1847).  The  subject  was 
also  studied  still  earlier  by  even  Recamier  and  Pravaz  (1841),  Steinheil  in  Munich 
and  Heider  in  Vienna  (1844),  John  Marshall  (1850),  Thomas  Harting  and  George 
Waite  in  London  (cauterization  of  the  teeth).  Middeldorpff  was,  however,  unac- 
quainted with  the  labors  of  his  predecessors  in  this  department. 

A.  Burow  (died  1875), 
the  recently  deceased  professor  in  Konigsberg,   is  known   in  surgerj-,  in  addition  to 


—  10G8  — 

man}'  other  matters,  by  his  revival  of  the  open  treatment  of  wounds,  a  method  also 
advocated  bjT  H.  Vezin  and  Bartscher.     Another  pupil  of  Dieffenbach' s, 

H.  J.  Paul  (died  1877)  in  Breslau, 
is  specially  known  from  his  study  of  operative  statistics  to  promote  rational  surgery. 
A  predecessor  of  the  great  surgeon  to  be  next  mentioned  in  the  professorial 
chair  at  Kiel  was  the  famous  and  recently  deceased 

Gustav  Biedermann  Gunther  (born  in  Schandau  near  Dresden  in 
1801,  died  1871), 

finally  professor  in  Leipsic,  who  obtained  much  credit  for  his  operative  teachings  and 
his  surgical  anatomy.  Among  his  best  known  works  are:  "  Leitfaden  zu  den  Opera- 
tionen  am  menschliehen  Korper",  3  parts,  1859-1865;  "  Lehre  von  den  blutigen 
Operationen  am  menschliehen  Korper",  1853-186o,  etc. 

If  it  was  a  pleasure  to  meet  in  Dieffenbach  a  master  as  well  of  German 
literary  style  as  of  German  surgical  art,  the  same  is  the  case  (though  in  a 
modified  way  and  with  altered  shading)  with  respect  to  another  surgeon 
of  German}-,  possessed  of  great  native  and  professional  gifts  and  endowed 
with  eminent  surgical  talents  as  well,  we  mean 

George  Friedrich  Louis  Stromeyer  (1804-1876)  of  Hanover,  suc- 
cessively professor  of  surgery  in  Erlangen  (1838),  Munich  (1841),  Freiburg 
(1842),  Kiel  (1848),  and  from  1854  physician  of  the  general  staff  in  Han- 
over. In  1866  he  was  retired  and  died,  like  Dieffenbach  and  the  great 
John  Hunter,  suddenly  and  painlessly  in  the  midst  of  his  professional 
activity,  just  as  he  was  starting  to  attend  to  his  practice,  and  in  the  midst 
of  the  work,  which  in  his  precious  "  Erinnerungen  aus  dem  Leben  eines 
deutschen  Arztes"  he,  with  the  Psalmist,  has  extolled  as  the  most  beautiful 
and  excellent  in  life. 

Like  Dieffenbach,  Stromeyer  was  a  master  of  language  —  like  many 
surgeons  he  was  also  poetically  gifted  —  only  his  descriptions  lack  some- 
thing of  that  pith}-,  heart}'  force,  the  stamp  of  an  ever  active,  iron  and 
vigorous  will,  which  shows  itself  in  Dieffenbach.  In  its  place  we  find 
sensibility  and  a  certain  bonhomie,  a  yielding,  indeed  sometimes  a  softness 
and  tendency  to  reflection,  combined  with  a  touch  of  resignation  and 
self-limitation.  From  these  we  acquire  the  impression  that  he  might  hold 
the  knife,  as  he  does  the  pen,  with  a  hand  more  easily  disposed  to  tremble 
than  that  of  Dieffenbach,  and  thus  under  certain  circumstances  the  safety 
and  dexterity  of  his  operative  measures  might  be  impaired.  On  the  other 
hand,  Stromeyer  displays  eminent  medical  skill,  particularly  as  a  hospital 
hygienist.  He  is  as  good  a  medical  therapeutist  and  physiologist  as  a 
surgeon,  qualities  which  may  be  due  to  the  fact  that  his  education  was 
finished  under  the  direction  of  English  surgeons.  The  feeling  of  the 
narrow  limits  of  professional  capability  is  more  active  in  Stromeyer  than 
in  Dieffenbach.  The  latter,  like  an  "inventive  Odysseus",  always  holds 
before  us  the  prospect  of  new  ways  and  means  of  aid,  while  Stromeyer 
accepts  those  limits  with  resignation.  "The  art  of  healing  is,  indeed, 
adapted  to  clear  up  errors,  for  we  cannot  deceive  ourselves  over  its  results. 
For  him  who  advances  with  circumspection  the  danger  of  rocking  himself 


—  106(J  — 

to  sleep  in  delusions  for  a  long  time  is  not  great,  for  his  errors  become 
pernicious  to  others.  We  rejoice  in  whatever  we  find  actually  beneficial. 
He  who  is  fortunate  in  this  respect  will  not  tire  in  searching  for  new 
truths,  and  will  not  be  eager  to  drop  what  has  proved  itself  of  value"  (see 
"Erinnerungen").  Finally  Stromeyer  is  pre-eminenth'  a  military  surgeon, 
while  Dieffenbach  is  a  surgeon  of  the  civil  hospital  and  of  daily  practice. 

Stromeyer  was  the  most  ingenious  field-surgeon  of  Germany.  Indeed, 
if  he  did  not  properly  call  military  surgery  into  life  in  Germany,  he  at 
least  emancipated  it  from  foreign  influences.  His  work  "Maximen  der 
Kriegsheilkunst"  (1855)  in  this  way  forms  a  turning-point  in  the  history 
of  this  branch  of  German  surgery.  The  surgeons  of  the  preceding  century 
and  of  the  wars  of  liberation  followed  mainly  the  military  surgery  of  the 
French.  The  want  of  a  deep  national  consciousness,  which  might  have 
created  a  national  military  surgenr,  was  felt  necessarily  by  the  Germans, 
afflicted  as  they  were  with  numerous  native  lands  and  corresponding  feel- 
ings of  nationality.  That  national  feeling,  as  we  know,  was  first  developed 
by  means  of  the  Revolution  of  1848  and  the  Schleswig-Holstein  wars,  and 
it  was  these  two  that,  with  historical  necessity,  called  into  existence  a 
national  military  surgery  and  awakened  in  Stromeyer  its  most  ingenious 
literaiy  representative. 

Sharers  in  the  new  foundation  of  this  branch  of  surgeiy  were  Bern- 
hard  von  Langenbeck  (1810-1887,  originally  professor  of  surgery  in  Kiel, 
and  from  1847  Dieffenbach's  successor  in  the  University  of  Berlin1),  and 
the  native  of  Schleswig,  Friedrich  Esmarch  (born  1823),  since  1857  pro- 
fessor of  surgery  in  Kiel,  both  of  whom  were,  like  Stronger,  active  in  all 
the  wars  since  1848.  It  was  these  three  surgeons  who  introduced  the  so- 
called  conservative  surger}*,  especially  resections,  into  the  practice  of  war, 
and  thereby  marked  out  a  new  era  in  military  surgeiy.  Their  names  will 
therefore  continue  ever  doubly  united  in  history  with  the  warlike  achieve- 
ments of  our  people,  as  those  of  true  patriots  and  founders  of  a  German 
national  military  surgeiy,  won  in  wars  carried  on  for  national  aims. 

Stromeyer's  second  (chronologically,  however,  the  first2)  reform,   was 

1.  After  the  attempted  assassination  of  the  emperor  William  by  Nobiling,  and  as  the 

result  of  his  successful  treatment  of  the  wounds  of  his  imperial  patient,  Langen- 
beck was  made  "  Generalmajor  a  la  suite"  and  "activer  Ofticier",  the  first 
example  of  this  rank  in  a  physician  since  the  days  of  the  Byzantine  empire.  —  A 
work  of  Langenbeck's  entitled  "Vorlesungen  fiber  Akiurgie  ",  and  taken  from 
manuscripts  left  by  the  deceased  surgeon,  was  published  posthumously  in  1888  by 
Prof.  Dr.  Th.  Gluck. 

2.  His  first  description  of  the  operation  appeared  in  Bust's  "  Magazin  ffir  die  ges. 

Heilkunde"  in  1833,  and  the  "  Beitiiige  zur  operativen  Orthopadik "  etc.  in  1838. 
Subcutaneous  tenotomy  was  introduced  into  the  United  States  about  1840  by  Dr. 
Wm.  Detmold  (born  in  Hanover  in  1808,  removed  to  the  United  States  in  1837), 
Emeritus  Prof,  of  Clinical  and  Military  Surgery  in  the  College  of  Physicians  and 
Surgeons,  New  York.  Few  of  Prof.  Detmold's  old  students  will  ever  forget  the 
grim  humor  with  which  he  used  to  describe  his  first  experience  in  the  introduction 
of  the  operation  into  this  country.     (H.) 


—  1070  — 

the  creation  of  operative  orthopa?dia,  that  is  the  application  of  subcu- 
taneous tenotomy  (heretofore  practised  in  special  cases  only  b}r  Delpech 
e.  g.)  to  the  whole  class  of  deformities  of  the  skeleton  depending  upon 
muscular  defects,  particularly  those  of  the  lower  extremities. 

This  apparently  insignificant  operation  has  since  produced  more 
brilliant  results  than  the  method  of  rapid  and  frequent  operation,  still  in 
vogue  at  the  time  of  the  invention  of  tenotomy,  and  the  practice  of  liga- 
tion of  the  great  vessels  carried  on  a  short  time  before.  Stromeyer  also 
recommended  the  operation  of  tenotomy  for  strabismus  in  1838,  but  it  was 
first  performed,  on  his  recommendation,  b}r  Dieffenbach  in  1839. 

Besides  the  surgeons  alread}-  mentioned,.  Bernhard  Beck,  "General- 
arzt"  in  Baden  and  the  son  of  the  oculist  and  aurist  Karl  Jos.  Beck  (1794- 
1838),  well-known  by  his  "  Handbuch  der  Augenheilkunde  (1825)  unci  der 
Krankheiten  des  Gehors"  (1827),  acquired  an  eminent  reputation  b}'  his 
experimental  studies  on  gun-shot  injuries,  and  as  an  author  on  military 
surgery  and  medicine.     He  was  a  pupil  of  Stromeyer. 

Besides  the  above-mentioned  "Maximen",  Stromej'er  wrote  a  memoir  in  the 
Archives  generales  de  medecine  (1833),  by  which  his  operation  of  tenotomy  became 
speedily  known.  In  1838  followed  his  "  Beitr'age  zur  operativen  Orthopadik",  after 
which  appeared  his  "Handbuch  der  Chirurgie"  (1844),  translated  into  Dutch  by 
Donders,  "  Erfahrungen  liber  Schusswunden  im  Jahre  1866''  (1867)  and  "Erinnerun- 
gen  eines  Arztes"  (1875).  In  this  last  work  the  peculiarities  of  Stromeyer  as  an 
author  are  specially  prominent.  —  Esmarch's  first  book  "  Ueber  Resektionen  nach 
Schusswunden",  1851,  excited  immediate  attention.  It  was  followed  by  "  Beschrei- 
bung  einer  Resektionsschiene "  (1859),  "  Beschreibung  eines  kunstliehen  Beines  " 
(1866),  "Ueber  chronische  Gelenkentzundungen  "  (2d  edition  1867,  immobility  of 
the  joint),  "  Verbandplatz  und  Feldlazareth "  (1871),  "  Anwendung  der  Kiilte  in 
der  Chirurgie",  "Der  erste  Verband  auf  dem  Schlachtfelde"  (1869),  "Ueber  kunst- 
liche  Blutleere  bei  Operationen"  (1873). — The  historj-  of  Esmarch's  bloodless  method 
of  operating  teaches  once  again  that  all  important  discoveries  are  preceded  by 
individual  facts  and  practices  of  a  similar  kind,  which,  however,  fail  to  receive  their 
full  value  until  the  flash  of  genius  touches  them  and  raises  them  to  a  legitimate 
whole.  Compressing  bandages  were  used  as  early  as  the  time  of  Chrysippus,  and 
were  employed  even  in  amputations  by  both  ancient  and  modern  surgeons.  Indeed 
ligation  of  the  limb  en  masse  was  practised  by  individual  surgeons.  Thus  the  former 
method  was  practised  by  Clover  (1852),  and  the  latter  method  alone  by  Chassaignac 
(1856),  A.  Richard  (1867),  Silvestri  in  Vicenza  (1871),  and  both  methods  together  by 
F.  Guyon  (1870).  Yet  Esmarch  was  the  first  surgeon  to  elevate  the  two  methods 
together  into  a  practical  and  useful  system.  —  Recently  (1882)  Esmarch  has 
established  a  "  Samariterverein  ",  on  the  model  of  similar  English  societies.  ("Leit- 
faden  fur  Samariterschulen";  "Die  erste  Hilfe  bei  plotzlichen  Ungliicksfallen ", 
1882).  His  "Handbuch  der  kriegschirurgischen  Technik  "  majr  be  called  his  most 
important  book.1 

Christoph  Jacob  Friedrich  Ludwig  Gustav  Simon    (1824-1876) 
of  Darmstadt,  professor  in  Rostock  and  finally  in  Heidelberg,  also  made  his  debut  as 

1.  Prof.  Esmarch  will  be  recollected  in  this  country  for  his  gratuitous  and  hostile 
criticism  of  the  treatment  of  the  wound  of  President  Garfield  by  his  attending 
surgeons.    (H.) 


—  1071  — 

an  author  on  military  surgery,  but  subsequently  turned  his  attention  to  the  surgery  of 
i:he  vagina,  the  kidneys  (he  performed  the  first  extirpation  of  the  kidney  among 
modern  surgeons),  the  bladder  (vesico-vaginal  fistula),  and  the  rectum  (forcible 
manual  exploration  of  the  anus  and  forcible  dilatation  of  the  female  urethra  for  the 
inspection  of  the  bladder).  The  methods  of  operation  and  investigation  in  these 
branches  of  surgery  he  improved  substantially,  though  occasionally  rather  forcibly. 
Simon  was  distinguished  as  a  skilful  and  bold  operator.  He  was  a  pupil  of  Adolph 
Werner,  like 

Heinrich  Adolph  Bardeleben  (born  1819), 
Prof,  of  surgery  in  Greifswald  and  in  1868  the  successor  of  Jiingken  in  Berlin. 
Bardeleben  studied  medicine  first  in  Berlin,  then  in  Giessen  and  subsequently  also  in 
Paris,  and  became  prosector  and  extraordinary  professor  in  Giessen.  By  his  edition 
of  Vidal's  text-book,  and  from  the  fact  that  in  1888  he  took  the  place  of  Bergmann 
in  the  case  of  the  emperor  Frederick1  in  consequence  of  a  characteristic,  but  lament- 
able "doctors'  quarrel",  he  has  become  widely  known  in  both  professional  and  lay 
circles. 

Adolph  Wernher  (born  in  Mayence,  March  20th,  1809,  died  in  the 
same  cit}',  July  14th,  1883) 

was  professor  of  surgery  in  Giessen  and  director  of  the  university  hospital  in  that 
place  from  the  year  1846.  —  The  son  of  a  Hessian  state-counsellor  who  came  from 
Zweibriicken,  Wernher  studied  in  Giessen,  Heidelberg,  Berlin,  London  and  Paris, 
and  as  early  as  1834  was  appointed  an  extraordinarj-  professor.  In  1835  he  was 
promoted  to  ordinary  professor  and  in  1878  he  was  retired. 

Wernher,  who  was  an  eminent  teacher  and  diagnostician  and  a  better  surgeon 
than  operator — he  had  the  misfortune  to  lose  the  sight  of  one  eye  through  a  gonorrhoeal 
ophthalmia  contracted  from  a  patient  —  rendered  good  service  to  surgery  in  the  sub- 
jects of  diseases  of  the  joints,  particularly  of  the  hip-joint;  tumors,  a  subject  which 
he  was  one  of  the  first  surgeons  in  Germany  to  take  in  hand;  hernia  and  trusses;  the 
resection  of  bones  and  nerves,  etc.  He  is  also  the  author  of  one  of  the  best  hand- 
books of  surgery  (2d.  ed.,  1S62),  distinguished  for  its  careful  attention  to  the  litera- 
ture of  the  subject,  particularly  the  French  and  English,  for  its  thoroughness  and  for 
its  constant  regard  to  the  demands  of  practical  use.  His  works  are:  Handbuch  der 
allgemeinen  und  speziellen  Chirurgie,  1846-1857,  I'd.  ed.,  I  vol.,  1862;  Die  angebore- 
nen  Kystenhygrome  und  die  ihnen  verwandten  Geschwiilste  in  anatomischer,  diag- 
nosticher  und  therapeutischer  Beziehung.  Denkschrift  zur  Feier  des  SOjahrigen 
Doctor-Jubilaums  des  Dr.  Wilhelm  Nebel,  Professor  primarius  etc.,  1843;  Beobach- 
tungen  uber  schmerzhafte  Atrophien  der  Mamma,  Cirrhosis  mammse  und  atrophi- 
rende  Sarcome  derselben  ;  Berichte  aus  dem  Hospitale  zu  Giessen,  1848;  Treatises 
on  hernia  and  trusses  in  Langenbeck's  "  Archiv";  others  on  osteochondritis  epiphy- 
saria,  elephantiasis  Arabum,  central  extirpation  of  telangiectatic  tumors,  chirurgico- 
historical  works  etc.  — In  the  neighboring  university  of  Marburg 

Wilhelm  Roser, 

Prof,  of  surgery,  first  known  to  fame  as  the  co-editor  of  the  well-known  journal,  is  an 
eminent  surgical  anatomist  and  physiologist,  as  well  as  a  skilful  operator  and  popular 
practitioner.  Among  his  works  are:  "  Allgemeine  Chirurgie ",  1845;  "Handbuch 
der  anatomischen  Chirurgie'1,  4th  ed.  1864  ;  "Chirurgisch-anatomisches  Vademecum", 
6  editions  up  to  1880;  "  Lehre  vom  Hornhautstaphylome '',  1852;  "  Therapeutisches 
liber  Pyamie  ".  —  Roser  rendered  good  service  in  the  study  of  strangulated  hernia,  a 


1.  The  German  physicians  knew  and  stated  the  truth  as  to  the  cancerous  nature  of 
the  emperor's  trouble  years  before. 


—  1072  — 

subject  in  which  A.  F.  Danzel  also  distinguished  himself. —  The  important  anatomist 
(central  nervous  sj-stem), 

B.  Stilling  (1810-1874)  in  Kassel, 

also  distinguished  himself  as  an  operator  (lithotritj",  ovariotomy  etc.).     Among  the 
pupils  of  Roser  are  : 

C.  Hueter  (1837-1880)  of  Marburg,  professor  in  G-reifswald,  and  W. 
Kiinig  in  Gottingen,  the  successor  of  W.  Baum  (1799-1883)  who  in  1875 
resigned  his  professorial  chair  in  this  universit}',  a  position  which  he  had 
recently  taken  and  filled  with  great  acceptability.  Joh.  Heinrich  von 
Dumreicher,  (1815-1880)  of  Trieste,  baron  von  Oesterreicher,  a  pupil  of 
Wattmann  and,  according  to  his  own  account,  a  man  of  little  erudition,  but 
a  humane  practitioner  of  surgery  and  accordingly  very  busy  and  greatly 
esteemed,  was  a  professor  in  Vienna  from  1849,  while  the  famous  operator 
Johann  von  Balassa,  also  a  scion  of  the  Vienna  school,  died  at  Pesth  in 
the  }*ear  1869,  and  his  successor  C.  A,  Kovacs  (born  1815)  in  1878.  Dittel 
(born  1S15)  in  Vienna.  Blazina  (1812-1885),  professor  of  surgery  in 
Prague.  —  Among  Dumreicher's  pupils  are  :  Ed.  Albert  in  Vienna,  A. 
Mosetig,  Joh  Hofmokl,  C.  Nicoladoni  in  Innsbruck,  V.  van  Ivanchich  and 
others.  —  Karl  Wilhelm,  Bitter  von  Heine  (1838-1877),  Prof,  in  Prague, 
died,  like  his  teacher,  of  diphtheria.  He  was  the  son  of  the  orthopaedic 
surgeon  Jac.  von  Heine  (1799-1878)  in  Canstatt,  scion  of  a  surgical  family 
(we  have  already  mentioned  one  of  its  members,  Bernhard  von  Heine) 
which- originated  with  Georg  von  Heine  (1770-1838),  an  ex-farrier  and 
inventor  of  an  extension  bed,  subsequently  an  honorary  doctor  of  sur- 
gery etc. 

Among  the  representatives  of  modern  surgery,  besides  Hiiter  and 
Konig  are  :  Theodor  Billroth  (born  1819  in  Bergen  on  the  island  of  Biigen), 
Prof,  in  Vienna  and  successor  of  Schuh  (first  extirpation  of  the  larynx, 
1873  ;  resection  of  the  stomach,  an  operation  which  Carl  Theodor  Merrem 
in  1810  had  proved  by  experiment  to  be  possible  ;  Allg.  chir.  Path,  und 
Therapie,  9th  edition,  1880),  whose  ''realistic"  ideas  permitted  him,  in  his 
well-known  book  "Ueber  Lehren  und  Lernen  etc.",  to  make  use  of  the 
following  language :  "  I  did  not  feel  strong  enough  to  undertake  the 
martyrdom  of  a  pure  catheter-professor,  which  would  have  afforded  me  no 
opportunity  for  the  development  by  practice  of  a  comfortable  life,  cor- 
responding to  my  tastes".  Weinlechner,  W.  von  Winiwarter,  Gussenbauer 
in  Prague  etc.,  Bich.  von  Volkmann  in  Halle  (son  of  the  anatomist  and 
physiologist  Alf.  Wilhelm  Volkmann  —  1801-1877  —  in  Halle,  eminent 
also  under  the  pseudonym  of  "Bichard  Leander"  as  a  composer  of  lyric 
poems,  poetic  stories  etc.);  W.  Busch  (1820-1880)  in  Bonn,  who  operated 
upon  the  empress  for  a  strangulated  hernia  ;  F.  Busch  in  Berlin  ;  Tren- 
delenburg in  Bostock,  now  in  Bonn  ;  W.  Heineke  in  Erlangen  ;  A  Liicke 
in  Strassburg ;  C.  Emmert  in  Bern  ;  Edm.  Bose,  some  time  ago  in  Zurich 
(Operationen  am  hiingenden  Kopf);  Socin  in  Basel  ;  Schbnborn,  formerly 
in   Kbnigsberg  (in  place  of  A.  Wagner  who  died  in  1871),  now  in  Wiirz- 


—  1073  — 

burg  ;  Thiersch  in  Leipzig,  whose  predecessor  was  Friedr.  Franke  (died 
1859);  Nussbaum  (bora  1829  ;  nerve-stretching,  1860  ;  combination  of 
injections  of  morphine  with  chloroform  ;  300  ovariotomies,  1880)  in 
Munich;  V.  von  Bruns  (1812-1883),  born  in  Helmstadt,  studied  in  Braun- 
schweig, Tubingen,  Halle  and  Berlin,  began  practice  in  Braunschweig  in 
1837,  became  teacher  of  anatomy  in  the  Collegium  chirurgicum  there  in 
1839,  professor  in  Tubingen  from  1843  to  1882,  one  of  the  most  renowned 
surgeons  of  our  day  (Lehrbuch  der  allg.  Anatomie,  18 11;  Kehlkopf- 
chirurgie,  1865;  Handbuch  der  pract.  Chirurgie,  1854-1860;  Galvano- 
chirurgie,  1S70  ;  Galvanocaustik,  1S77  ;•  Chirurg.  Heilmittellehre,  186-8- 
1873;  Arzneioperationen,  1869,  etc.),  whose  son  Paul  Bruns  is  also  in 
Tubingen  ;  C.  F.  Lohmeyer  in  Gottingen  ;  Fischer  in  Breslau  ;  M.  Schede 
in  Halle  ;  Heinrich  Leisrink  (died  1885),  physician  to  the  hospital  in  Ham- 
burg, who  with  Peter  Ludwig  Panum  (1820-1885)  in  Copenhagen,  Oskar 
Hasse  in  Nordhausen,  Gesellius  in  St.  Petersburg  and  others,  defended  the 
transfusion  of  blood  ;  A.  W.  Schultze  in  Berlin  ;  F.  W.  Ravoth  (1817-1878, 
hernia);  Wilms  (1824-1880),  a  famous  surgical  practitioner  in  Berlin,  who 
with  Langenbeck  and  the  ordinary  physician  Lauer  also  treated  the 
emperor  after  the  attempted  assassination  of  June  2d,  1878  ;  E.  Gurlt 
(wrote  also  on  the  histor}'  of  surgery)  ;  E.  von  Bergmann  in  Berlin  and 
earlier  in  Wiirzburg  ;  H.  Bose  in  Giessen,  a  pupil  of  Wernher  ;  Kronlein, 
professor  in  Zurich  ;  Madelung  in  Rostock  ;  Paul  Yogt  (1844-1885)  in 
Greifswald  ;  F.  E.  W.  Steudner  (1838-1880)  in  Halle  ;  Vine.  Czerny  in 
Heidelberg,  a  pupil  of  Billroth  and  particularly  an  operative  surgeon  ;  H. 
Maas  in  Wiirzburg  (died  1886);  Paul  Kraske  in  Freiburg,  a  pupil  of  Rich. 
Volkmann,  and  numerous  others. 

We  should  also  mention  Dr.  Gustav  von  Lauer  (1808-1889)  of 
Wetzlar,  from  1844  ordinary  physician  of  the  emperor  Wilhelm  L,  from 
1854  a  professor  and  subsequently  Chief  of  the  Department  of  Military 
Hygiene  and  of  the  institutions  for  the  education  of  army-physicians.  It 
is  to  him  especially  that  army-physicians  are  indebted  for  the  fact  that 
since  1873  they  have  enjoyed  the  rank  of  commissioned  officers. 

From  the  large  number  of  eminent  German  ophthalmologists  of  our  century  we 
have  already  mentioned,  besides  those  of  Vienna,  Joseph  von  Hasner  (Ritter  von  Artha, 
born  1815)  and  Albrecht  von  Graefe,1  the  latter  of  whom  through  the  single  method  of 
operation  for  glaucoma  (iridectomy,  1856)  would  have  secured  his  fame  forever,  weie 
it  not  equally  secure  through  the  introduction  into  ophthalmology  of  the  ophththal- 
moscope,  an  instrument  which  opened  a  new  epoch  in  that  science.  Without  making 
pretensions  to  completeness,  we  should  add  further  the  names  of:  Runge  and  Franz 
Reisinger  (1788-1855)  in  Landshut  and  Augsburg,  who  introduced  atiopin  and 
hyoscyamin  as  mydriatics  and  practised  the  transplantation  of  pieces  of  the  cornea  in 
animals  etc.;  Joh.  Christian  Jiingken  (1793-1875)  in  Berlin;  Karl  Heinrich  Weller 
(born  1794)  in  Dresden;  Ludwig  Bohm  (1811-1869)  in  Berlin:  Christ.  Georg  Th. 
Rlite  (1810-1867)  in  Leipzig;  Fr.  Aug.  von  Ammon  (1799-1861 i  in  Dresden,  an 
eminent  oculist,   physician   and  writer,  specially   meritorious   for  his   labors   on   the 

1.   See  page  968. 

68 


—  1074  — 

pathological  anatomy  of  the  e)*e  (Klinische  Darstellungen  der  Krankheiten  und 
Bildungsfehler  des  menschlichen  Auges  etc.,  Berlin  1838-41,  with  an  atlas),  and 
acquainted  also  with  sympathetic  ophthalmia;  his  pupils  and  colleagues,  Joh.  Heinr. 
Beger  (1810-1885)  in  Dresden;  Gust.  Heinrich  Warnatz  of  Camenz  ;  Friedricli  Karl 
Strieker  (born  1816)  in  Frankfort-on-the-Main  (Die  Krankheiten  des  Linsensystems 
nach  physiol.  Grundsatzen,  1845;  Der  Ritter  Taylor ;  Reisehandbuch  fur  Aerzte,  2d 
edition  1845,  with  numerous  historical  works);  Karl  Hecker  (1812-1878),  Prof,  in 
Freiburg  and  a  brother  of  Friedrich  Hecker;  Fried.  Phil.  Ritterich  (1782-1860)  in 
Leipzig,  the  incumbent  of  the  first  (1828)  special  professorship  of  ophthalmology  in 
Germany  ;  August  Burow  (1809-1874)  in  Konigsberg  ;  Ernst  Ad.  Coccius  (born  1825), 
Riite's  successor  as  professor  of  ophthalmology  in  Leipzig;  W.  Zeheuder  in  Rostock; 
Alfred  Karl  Griife  (born  1830)  in  Halfe  ;  H.  Knapp,  formerly  in  Heidelberg,  now  in 
New  York ;  Robert,  Ritter  von  Welz  (1814-1878)  of  Kelheim,  Prof,  in  Wurzburg 
Th.  Leber  in  Giittingen  ;  of  the  medical  family  of  Pagenstecher :  Karl  Pagenstecher 
(died  1865),  Alex.  Pagenstecher  (1839-1880),  a  good  operator,  killed  by  a  ball  from 
his  own  hunting-rifle;  Hermann  Pagenstecher  (Pathol.  Anatomie  des  Auges;  extrac- 
tion with  the  capsule,  recommended  even  by  Beer)  in  Wiesbaden  ;  Rothmund  senior 
and  junior  in  Munich;  O.  Becker  in  Heidelberg,  ( Pathol. -anat.  Atlas  des  Auges; 
Krankheiten  der  Linse  ;  an  edition  of  Donders'  work  on  refraction),  to  whom  the 
author  takes  pleasure  in  here  offering  a  tribute  of  gratitude;  the  deceased  Kiichler, 
who  even  extirpated  the  spleen,  though  unsuccessfully  (Pean  obtained  the  first  success 
in  1877)  ;  Jacobson  in  Konigsberg  (Iridectomie  vor  der  Extraction  als  Methode  etc.) ; 
Weber  in  Darmstadt,  an  eminent  operator  and  investigator;  Hermann  Scbmidt- 
Rimpler  in  Marburg;  Mooren  in  Diisseldorf  (Iridectomie  langere  Zeit  vor  der 
Extraction;  Augenkrankheiten  in  Beziehung  zu  andern  Korperleiden  etc.) ;  Theod. 
Saeinisch  in  Bonn;  Zander;  F.  Horner  in  Zurich;  C.  Schweigger  in  Berlin;  A. 
Nagel  in  Tubingen;  H.  Cohn  in  Breslau,  the  ophthalmo-hygienist;  Manz  in  Frei- 
burg; Dor  in  Lyons,  formerlj-  in  Bern  ;  Pfliiger  in  Bern  ;  Laqueur,  Roeder  and  Jacob 
Stilling  in  Strassburg;  Hirschberg  in  Berlin,  a  practitioner  and  investigator;  Von 
Hippel  in  Giessen  ;  Sattler  in  Giessen,  Erlangen  and  Prague;  J.  Michel  in  Wiirz- 
burg;  IwanofF  (died  1880),  an  important  pathological  anatomist  belonging  to  the 
German  school;  Schiess-Gemuseus  in  Basel;  Kuhnt  in  Jena;  Magnus  in  Breslau; 
Fuchs  and  von  Reuss  in  Vienna;  Samelson  in  Cologne;  Waldau  in  Berlin;  Rudolph 
Berlin  in  Stuttgart;  Mauthner  in  Vienna;  Voelckers  in  Kiel;  Schirmer  in  Greifs- 
wald,  and  others. 

g.  The  Dutch, 

like  the  Italians,  furnish  the  most  striking  proof  that  with  the  grade  of 
development  of  the  political  importance  of  a  people  and  the  general 
culture  associated  therewith,  the  medical  sciences  likewise  rise  and  fall. 
Since  the  17th  century,  the  golden  age  of  Holland,  its  medicine  has  never 
again  attained  a  dominating  influence,  and  least  of  all  the  surgery  of  this 
land,  an  art  to  which  the  Dutch  apparently  possess  little  or  no  natural 
disposition. 

Considerable  reputation  was  gained  by 

Pieter  Hendriksz  (1779-1845), 
professor  in  Groningen  (Ordeelkundige  beschryving  van  eenige  der  voornaamste 
heelkundige  operation  verrigt  in  het  nosocomium  academicum  te  Groningen  1810- 
1815,  Groningen,  1816;  Oratio  de  chirurgorum  nostratium  laudibus,  optimis  exco- 
lendae  artis  chirurgiae  incitamentis,  Groningen,  1820;  Oratio  de  medicina  et  chirurgia 
non  sine  utriusque  damno  separandis,  1829. 


—  1075  — 

Other  notable  surgeons  were:  Sebalcl  Justinus  Brugmans  (1763-1819) 
in  Leaden  ;  Van  der  Meer  (Hist,  operat.  in  div.  cap.  reg.  instit.  c.  tab., 
1829);  J.  van  Maanen  (1770-1854)  in  Groningen  and  Amsterdam  ;  Ant. 
Gerh.  van  Onsenoort  (1782-1841)  in  Utrecht,  who  likewise  devoted  atten- 
tion to  ophthalmology  ;  J.  C.  Broers  (1795-1847)  in  Leyden  ;  Christiaan 
Bernard  Tilanus  (1796-1883),  an  eminent  surgeon  for  45  years  a  teacher 
in  the  Athenaeum  in  Amsterdam,  and  others.  —  Among  the  more  recent 
professors  of  surgery  in  the  universities  of  Holland  are :  Jan  Hissink 
Jansen  (1816-1885),  Hans  Budolph  Ranke  (1849-1887)  of  Kaiserswerth, 
a  famous  operator  and  philanthropist,  and  Willem  M.  H.  Saenger  in  Gro- 
ningen ;  Machiel  Polano  (1813-1878)  and  Frederik  Willem  Krieger  in 
Leyden  ;  L  C.  van  Goudoever  in  Utrecht ;  Ant.  Hendrik  Schoernaker, 
Jan  W.  R.  Tilanus  and  J.  Mezger  (born  in  Amsterdam  in  1839),  who  has 
brought  massage  into  scientific  respect  in  surgery  and  thereby  gained  for 
himself  riches  and  honor,  are  active  teachers  in  Amsterdam.  Tilanus 
succeeded  his  father  in  the  Athenaeum,  founded  in  1632  and  raised  into  a 
university  in  1877.  —  Finally  in  the  single  surgical  specialty  of  ophthal- 
mology Willem  Mensert  (1780-1818)  in  Amsterdam,  as  well  as  van  Onsen- 
oort in  Utrecht,  were  active  workers,  while  Frans  Cornells  Donders  (181 8— 
1889)  in  Utrecht,  where  he  was  Prof,  of  Physiolog}-  —  this  branch  and 
ophthalmolog}r  were  always  taught  by  the  same  professor — by  his 
brilliant  labors  became  the  most  important  representative  of  this  speci- 
alty. 

Donders  began  his  studies  in  1835  at  the  armj-  medical  school  in  Utrecht,  gradu- 
ated at  Leyden  in  1840,  was  for  two  years  a  military-physician  in  Vlissingen  and  the 
Hague,  and  was  then  appointed  teacher  of  anatomy  and  physiology  in  the  army 
medical  school.  In  1847  he  became  a  professor  in  the  university  of  Utrecht  and 
practised  also  as  an  ophthalmologist.  In  1851  he  went  to  London  and  made  the 
acquaintance  of  Bowman,  von  Graefe  and  others,  and  from  this  time  forward  was  a 
co-laborer  with  the  first  two  physicians.  The  "Nederlandsch  Gasthuis  vor  Ooglijders", 
erected  in  1858,  was  placed  under  the  charge  of  Donders.  On  the  death  of  Schroeder 
van  der  Kolk  he  was  appointed  professor  of  physiology,  and  resigned  ophthalmological 
practice  and  teaching  almost  entirely  to  Snellen.  The  new  physiological  laboratory 
erected  in  186(5  was  also  placed  under  the  direction  of  Donders,  who  at  the  age  of  70 
retired  from  active  duties.  His  most  important  works  are:  "Die  Anomalien  der 
Refraction  und  Accommodation",  German  by  O.  Becker,  2d  edition,  Vienna,  1887; 
an  English  translation  by  W.  D.  Moore,  London,  1864;  "Astigmatismus  und  cylindr. 
Glaeser",  Berlin  1862;  "Physiologie  des  Menschen"  (Ernahrung)  2d  edition,  Leipzig, 
1859;  "  Der  Stoffwechsel  als  die  Quelle  der  Eigenwarme  bei  Pflanzen  und  Thieren", 
Wiesbaden,  1847;  "  De  justa  necessitudine  scientiam  inter  et  artem  medicam,  et  de 
utriusque  juribus  ac  mutuis  officiis  ",  Prague,  1853.  Donders  was  also  co-editor  of 
"  Graefe's  Archiv"  and  author  of  numerous  dissertations.  We  owe  to  him  also  the 
so-called  "Donders'  law  of  the  movements  of  the  ocular  muscles";  the  rapidity  of  the 
psychical  process  etc. 

Distinguished  ophthalmologists  of  Belgium  are:  Florent  Cunier  (1812-1853)  and 
Salomon  Louis  Fallot  (1783-1873),  with  Evariste  Warlomont  of  Brussels,  recently  the 
successor  of  Cunier  in  the  editorship  of  the  "Annales  d'oculistique",  which  he 
founded.  —  Among  the 


—  1076  — 

h.  Swedes, 

Carl  Joiiann  af  Eckstrom  (born  1793), 
an  army-surgeon  in  the  war  against  Napoleon,  distinguished  himself  about 
the  beginning  of  the  century  as  a  busy  practical  surgeon  and  surgical 
writer.  —  More  recently  we  should  mention:  Carl  Gustaf  Santesson 
(1819-1886),  Prof,  in  Stockholm  and  a  famous  member  of  the  "Carolinische 
Institut",  and  Jacob  August  Estlaender  (1831-1881),  Prof,  of  surgery  in 
Helsingfors. 

i.  Norwegians. 

In  the  national  university  of  Christiania  Magnus  Andreas  Thulstrup 
(1769-1844)  was  the  first  professor  of  surgery  and  obstetrics.  Karl 
Wilhelm  Boeck  (1808-1875),  Prof,  of  operative  surgery,  diseases  of  the 
skin  and  syphilis  in  the  same  university',  became  famous  as  a  syphilo- 
grapher  (syphilization,  1852).  Christen  Heiberg  (1 799-1 S72)  of  Bergen, 
the  founder  of  a  family  of  physicians,  was  appointed  in  1836  professor 
of  surger}-  and  ophthalmology  in  the  University  of  Christiania,  [and 
surgeon-in-chief  of  the  Ro3'al  Hospital.  His  younger  brother  Johan 
Fritzner  Heiberg  (1805-1883),  Surgeon  General  of  the  Norwegian  army, 
who  exerted  an  excellent  influence  in  elevating  the  position  of  army-phy- 
sicians in  Norwa}" ;]  Hjalmar  Heiberg,  son  of  Christen  and  Prof,  of  patho- 
logical anatomy  and  general  pathology  in  the  University  of  Christiania 
(Die  puerperalen  und  pyamischen  Processe,  1873);  Julius  Nicolaysen,  Prof, 
of  special  and  clinical  surgery  in  Christiana  ;  Johan  S.  A.  Hjort,  Prof,  of 
operative  surger}-  and  ophthalmology  ;  Johan  Lauritz  Bidenkap,  Clinical 
Prof,  of  syphilis  and  diseases  of  the  skin,  [and  Gerhard  Henrik  Armauer 
Hansen  of  Bergen,  a  well-known  student  of  the  leprosy,]  also  deserve  men- 
tion. —  Among  the 

k.  Danes, 

Mathias  Saxtorph  (1740-1800),  Prof,  of  Midwifery  in  Copenhagen,  acquired 
great  reputation,  [and  in  conjunction  with  Urban  B.  Aaskow  (1742-1806) 
and  J.  W.  Guldbrand  (1744-1809),  as  a  Commission  for  the  Advancement 
of  Surgery,  was  influential  in  the  establishment  of  the  Copenhagen  Lying- 
in  Hospital  in  1785.  He  also  prepared  the  first  handbook  of  anatomy  in 
the  Danish  language.]  His  son  Johan  Sylvester  Saxtorph  (1772-1840) 
was  professor  of  surgerj'  and  midwifery  in  the  universit}T  of  Copenhagen, 
[and  the  son  of  the  latter,  Mathias  Hieronymus  Saxtorph,  is  at  present 
professor  of  surgery  in  the  same  institution.]  Anders  Georg  Drachmann 
(born  1810),  an  eminent  specialist  in  orthopaedic  surgery  in  Copenhagen, 
also  merits  notice  in  this  connexion. 

Quite  recently  (1888)  Edmund  Hansen  Grut  has  been  appointed  the 
first  professor  of  ophthalmology  in  Copenhagen,  the  department  of  oph- 
thalmology having  been  heretofore  assigned  to  the  chair  of  surgery.  Grut 
had  organized  an  ophthalmic  clinic  in  Copenhagen  as  early  as  1863. 


—  1077  — 

The  surgery  of  the 

1.  Russians, 

in  our  century-  can  point  to  some  generally  known  and  famous  represen- 
tatives, most  of  whom,  however,  acquired  their  education  in  Germany. 
Among  these  medical  immigrants  into  Russia  were  :  the  ophthalmologist 
Theodor  H.  W.  Lerche  (1791-1863)  of  Braunschweig,  who  established  in 
St.  Petersburg  in  1824  the  first  ophthalmic  clinic  in  Russia  and  became  the 
oculist-in-ordinary  of  the  emperor.  Lerche  was  succeeded  in  the  oph- 
thalmic hospital  by  Christian  Salomon,  the  latter  by  Lerche  Jr.  (died 
1863),  Lerche  by  Robert  Blessig  (1830-1878),  upon  whose  death  the  direc- 
tion of  the  hospital  was  given  to  John  Magawly,  an  Irish  physician,  who 
is  at  present  oculist-in-ordinary  to  the  emperor  and  the  most  eminent 
oculist  in  St.  Petersburg.  Other  well-known  German  surgeons  in  Russia 
are  :  Martin  Wilhelm  von  Mandt  (1800-1858),  formerly  a  professor  in 
Greifswald  and  subsequently  ordinary  physician  to  the  emperor  Nicholas  : 
Joh.  Ferd.  Heyfelder  (1798-1860),  Stromeyer's  successor  in  Erlangen,  who 
performed  in  18-14  the  first  total  extirpation  of  both  superior  maxillary 
bones,  and  Georg  F.  B.  Adelmann  (1811-1888)  of  Fulda.  Prof,  of  surgery 
and  midwifery  in  Dorpat  and  the  father-in-law  of  Bergmann,  the  first  sur- 
geon of  the  first  German  universit}-.  who  was  dismissed  for  the  sake  of 
Mackenzie  by  the  second  German  emperor.  But  among  the  Russians  them- 
selves surgery  has  found  some  distinguished  national  representatives,  as 
e.  g.  Nikolai  Iwanowich  Pirogoff  (Pirogow.  1810-1881).  a  pupil  of  Dieffen- 
bach,  who  retired  from  his  position  in  1866. 

Pirogoff  was  likewise  an  eminent  anatomist  and  the  first  to  study  anatomy  by 
means  of  sections  of  frozen  bodies.  He  was  also  very  active  in  the  introduction  of 
the  system  of  dispersion  of  the  sick  and  wounded,  and  generally  in  the  improvement 
of  militar}-  hygiene  in  Russia.  He  used  his  influence  too  in  the  popularization  of 
the  plaster  of  Paris  splint,  and  a  well-known  amputation  of  the  foot  bears  his  name. 
His  son  Nic.  Iwanowich  Pirogoff  is  a  busy  and  reputable  surgeon  of  St.  Petersburg. 
We  should  also  mention  among  the  native  Russian  surgeons  Julius 
Szymanowski  (1S'29-1868),  Prof,  of  operative  and  military  surgery  in 
Kiew  and  a  surgeon  of  the  first  rank,  who  unfortunately  died  at  an  early 
age.  —  From  these  examples  we  see  that  even  Russia,  which  in  our  cen- 
tury is  striving  to  take  the  lead  in  all  departments  of  civilization,  the 
medical  sciences  participate  among  the  first  in  the  advances  of  general 
culture — -we  have  noticed  the  same  fact  among  the  peoples  mentioned  in 
the  beginning  of  this  work  —  and  then  develop  rapidly  and  grow  lux- 
uriantly. 

Karl  Johann  von  Seydlitz  (1798-1885),  Prof,  of  clinical  medicine  in  the  medic. - 
chirurg.  Academie  at  St.  Petersburg:  Wilhelm  Koch  in  Dorpat  and  Ed.  von  Wahl, 
Prof,  of  surgery  in  Dorpat,  also  merit  notice.      In 

m.  Finland, 

Karl  Daniel  von  Haartman  (1792-1878)  was  an  active  surgeon  and  obstet- 
rician in  the  University  of  Helsingfors,  founded    in    1>27  in  place   of  the 


—  1078  — 

university    at    Abo.     His    successor   in  the   professorship   of   surgery    is 
Fredrik  Salzman. 

5.    MIDWIFERY. 

The  midwifery  of  our  centur}',  particularly  German  midwifery,  is 
specially  distinguished  by  the  fact  that,  although  it  has  been  transferred 
entirely  (ordinary  cases  and  aid  excepted)  into  the  hands  of  men,  it  has 
given  up,  so  to  speak,  the  operative  character  which,  particularly  as  the 
result  of  the  invention  of  the  forceps,  it  still  possessed  in  great  part  in 
the  18th  century.  Operative  interference  accordingl}*  is  limited  as  much 
as  possible,  and  only  permitted  when  all  the  means'  that  allow  the  natural 
forces  to  accomplish  the  parturient  act  have  been  exhausted.  The  deter- 
mination of  these  limits  demanded,  above  all,  the  most  careful  observation 
of  natural  labor,  and  for  this  purpose  public  lying-in  hospitals  have  been 
placed  at  the  service  of  both  teachers  and  students  in  German}7  and  France. 
On  the  other  hand,  however,  the  required  operative  measures  have  been  in 
every  way  perfected  through  our  advances  in  technique,  as  well  instru- 
mental as  obstetrical  proper,  and  the  number  of  our  dynamic  expedients 
has  been  increased.  Both  these  results  have  been  accomplished  by  the 
utilization  of  all  the  methods  standing  at  the  service  of  modern  science. 
Above  all,  it  has  been  an  advantage  to  midwifery  that  it  has  been  studied 
and  taught  by  thoroughly  scientific  men,  and  generall}7  as  a  special 
branch,  without  falling  scientifically  and  practically,  like  other  branches, 
into  the  hands  of  exclusive  specialists,  but  has  always  preserved  its  con- 
nexion with  general  medicine  and  maintained  the  latter  in  its  service. 
Thus  it  has  resulted  that,  in  addition  to  the  physiology  of  labor,  especially 
the  general,  as  well  as  local  diseases  of  the  mother  and  child  during 
pregnancy  and  after  birth,  together  with  the  hygienic  portion  of  midwifeiy 
have  found  eminent  students.  It  has  drawn  too  more  and  more  into  its 
sphere  the  allied  subjects  of  gynaecology  (whose  methods  of  treatment 
have  recently  degenerated  too  much  into  mechanico-ptysical  and  operative 
measures)  and  the  diseases  of  children.  Moreover  it  has  kept  itself  free, 
as  far  as  possible,  from  theoretic  speculations,  and  has  never  lost  sight  of 
the  practical  and  humane  side  of  its  department.  From  all  the  influences 
thus  mentioned  and  to  be  shown  in  the  course  of  our  account  of  this 
branch,  midwifeiy  has  attained  among  the  branches  of  medicine  a  specially 
rounded  and,  if  you  will,  a  more  complete  form,  and  is  surpassed  by  none 
in  its  beneficent  results  in  and  for  our  daily  life.  Indeed  it  even  outstrips 
most  of  the  other  departments  of  medicine  in  a  most  gratifying  way, 
while  the  tolerance  of  the  female  organism  in  respect  to,  and  during,  its 
most  important  physical  function,  contributes  also  its  share. to  the  success 
of  this  important  branch.  One  of  the  most  beneficent  advances  in  mid- 
wifery is  the  cleanliness,  vulyo  antisepticism,  introduced  b\'  Semmelweis, 
and  which  has  deprived  the  lying-in  period  (particularly  in  hospitals)  of 
its  horrors,  as  the  inventions  mentioned  above  have  deprived  labor  of  its 


—  1079  — 

sting.  The  latter  object  has  been  attained  in  a  great  measure  by  the  use 
of  chloroform,  the  chief  boon  offered  by  the  19th  century  to  childbirth. 

a.  The  German?, 

in  this  branch  of  medicine,  speedily  attained  the  precedence,  particularly 
through  the  efforts  of 

Lucas  Johann  Boer  (1752-1835), 
properly  Boogers,  which  latter  name  he  was  forced  to  abandon  because  Joseph  II. 
declined  to  send  to  France  anyone  "afflicted  with  such  a  discordant  cognomen  ". 
Boer  was  born  at  Uffenheim  in  Bavaria,  was  the  son  of  a  falconer  and  was  originally 
designed  for  the  ministry.  While  studying  with  this  object  in  Wiirzburg  he  became 
known  to  C.  C.  von  Siebold,  who  induced  his  parents  to  strip  off  the  gown  of  the 
monk  and  replace  it  with  the  robe  of  the  surgeon.  Subsequently,  on  the  recommend- 
ation of  von  Siebold,  Boer  received  from  the  bishop  of  Wiirzburg  the  means  to  con- 
tinue his  studies  in  Vienna,  but  squandered  them  at  once  in  academic  vices.  Thus 
deprived  of  his  means  of  maintenance  and  in  absolute  poverty,  he  supported  himself 
for-a  long  time  by  watching  with  the  sick,  correcting  proofs  etc.,  until  on  the  advice 
of  Rechberger,  the  ordinar}7  phjsician  of  Maria  Theresa,  he  began  in  1778  the  study 
of  midwifer}',  and  was  speedily  appointed  assistant  and  surgeon  to  the  orphan 
asylum  (1784).  Next,  by  the  aid  of  Joseph  II.,  he  was  enabled  to  visit  first  Holland, 
then  Paris  and  then  London.  In  Paris,  through  the  influence  of  Marie  Antoinette, 
he  was  admitted  into  the  lying-in  institutions  which  were  still  closed  to  men,  and  in 
London  attended  the  private  hospital  of  Leake,  and  in  both  these  cities  he  listened 
to  the  teachings  of  the  most  famous  teachers  of  midwifery.  He  returned  in  1788  by 
way  of  France  and  Italy  to  Vienna,  where  he  was  appointed  surgeon-in-ordinary,  and 
soon  after  professor  of  midwifery  in  the  lying-in  hospital.  The  latter  position  he 
continued  to  hold  until  1822,  in  which  jrear  he  retired  from  active  duty.  Shortly 
after  entering  upon  his  duties  as  professor  of  midwifery  he  had  the  misfortune  to 
lose  an  arch-duchess  whom  he  had  delivered  with  the  forceps,  and  from  whom  he  had 
removed  the  placenta  manually,  and  this  mishap  led  to  an  active  persecution  on  the 
part  of  his  colleagues.  The  emperor  Joseph  II.,  however,  more  clear-sighted,  did  not 
count  his  misfortune  as  a  fault.  —  After  his  retirement  Boer  was  very  active  with 
his  pen. 

Boer's  imperishable  service  to  medicine  is  found  in  the  consistent 
carrying  out  of  a  sober  and  healthy  observation  in  midwifery  (Solayres  de 
Renhac  and  others  had,  indeed,  opened  the  way),  combined  with  a  treat- 
ment free  from  all  artifice  (labor-stools  etc.),  natural,  and  exempt  from  fre- 
quent operations.  The  following  passage  may  serve  as  an  example  of  his 
unprejudiced  method  of  observation  : 

"  One  should  not  form  for  himself  any  ideal  of  imaginary  pains,  and  observe  the 
actual  pains  in  each  individual  case  in  accordance  with  this  supposed  model.  Other- 
wise in  most  labors  he  will  find  something  to  disapprove  and  some  opportunity  for 

dabbling.     On  the  contrary,  every  case  must  be  judged  upon  its  own  merits 

However  It  ng  too  the  function  may  continue  to  be  performed  in  this  natural  way.  it 
never  constitutes  properly  a  difficult  labor,  but  merely  a  tedious  one."  We  should 
never  manage  "as  if  nature  had  given  up  her  work  of  parturition."     (See  Siebold.) 

Diametrically  opposite  principles  were  defended  by 

Friedrich  Benjamin  Osiander  (1759-1822)  of  Zell  in  Wurtemberg, 

originally  a  practising  physician  at  Kirchheim  and  then  professor  of  midwifery  in 


—  1080  — 

Gbttingen.  He  was  a  pupil  of  Stein  in  Kassel,  and  as  such  a  great  advocate  of  the 
forceps,  an  instrument  which  he  handled  with  such  skill  that  when  they  failed  in  their 
object  in  a  contracted  pelvis  he  considered  Cesarean  section  indicated  rather  than 
perforation  of  the  head.  (In  2340  cases  of  labor  he  terminated  1016  with  the  forceps  !) 
He  contested  the  value  of  artificial  premature  delivery,  extracted  in  breech-presenta- 
tions etc.,  and  invented  (an  evidence  of  his  instrumental  bent)  a  great  number  of  in- 
struments, including  a  thimble  for  rupturing  the  membranes,  an  instrument  to 
measure  the  inclination  of  the  pelvis,  a  lever  to  remove  the  foetus  in  abortions,  a 
balance,  a  longimeter  to  determine  the  circumference  of  the  head  etc. 

A  practical  follower  of  Boer's  principles,   though  he  was  not  one  of  his  pupils 
—  he  had  been  educated  in  Wiirzburg  under  C.  C.  von  Siebold — -was 

Wilhelm  Joseph  Schmitt  (1760-1827)  of  Lorch  on  the  Rhine, 
professor  of  midwifery  at  the  Josephinum,  who  advocated  the  connexion  of  midwifery 
and  general  medicine  and,  like  a  true  physician,  emphasized  the  humane  character 
and  mission  of  medical  art.  Hence  he  rejected  all  rash  treatment,  limited  the 
employment  of  the  forceps  and  recommended  in  their  use  the  simple  position  on  the 
back  upon  an  ordinary  bed,  discarding  labor-stools  and  special  labor-beds.  He  like- 
wise called  attention  to  spontaneous  version,  taught  that  agglutination  of  the  os  uteri 
was  one  of  the  hindrances  of  labor,  that  fissures  of  the  skull  were  possible  in  natural 
labor  with  a  contracted  pelvis,  and  approved  of  version  by  the  breech,  the  latter  a 
doctrine  taught  also  by  J.  W.  Betschler  of  Breslau  (died  18G5;  Ueber  die  Hilfe  der 
Natur  zur  Beendigung  der  Geburt,  1844).  Schmitt  likewise  taught  the  spiral  course 
of  the  head  in  labor,  advanced  the  doctrine  of  doubtful  pregnancy  etc.,  and  specially 
emphasized  the  exercise  of  the  sense  of  touch  as  one  of  the  chief  requisites  for  an 
obstetrician.  He  also  distinguished  himself  in  surgery.  — One  of  the  most  eminent 
of  the  skilful  promoters  of  German  midwifery  was 

Justus  Heinrich  Wigand  (1769-1817)  of  Esthonia, 

who  settled  in  Hamburg,  because  through  a  quarrel  with  the  Russian  examiners  he 
could  not  practise  in  his  native  place.  He  devoted  attention  to  cephalic  version, 
particularly  to  its  accomplishment  by  external  manipulation,  was  the  first  to 
recommend  tamponing  the  vagina  in  placenta  prsevia,  after  perforation  of  the  head 
preferred  to  leave  the  completion  of  delivery  to  nature,  after  Cesarean  section 
advised  the  removal  of  the  placenta  through  the  os  uteri  and  in  post  partum 
haemorrhage  recommended  friction  of  the  os  uteri  and  clitoris.  His  most  famous 
work  was  entitled  "Die  Geburt  des  Menschen". 

In  Mayence,  until  the  abolition  in  1798  of  the  university  of  that  city. 
Joh.  Peter  Weid.mann  (1751-1819), 
who  has  been  already  mentioned,  was  an  active  professor.     Subsequently  he  offici- 
ated as  a  simple  teacher  of  midwifery,  neglecting  neither  the  working  of  nature,  nor, 
when  necessary,  the  aid  of  art. 

Ad.  Friedr.  Nolde  (1764-1S13), 
finally  professor  in   Halle,  acquired  a  famous  name  by  his  improved  division  of  the 
doctrines  of  midwifery  into  a  physiological,  pathologico-semeiotic  and  practical  part, 
while  the  younger 

Joh.  Christian  Stark  (1769-1837). 
professor  of  surgery  and  midwifery  in  Jena,  distinguished  himself  by  a  book  for  mid- 
wives  and  by  hospital  reports.     On  the  other  hand, 

Ludwig  Friedrich  von  Froriep  (1779-1847), 

finally  in  Weimar,  attained  equal  distinction  by  means  of  a  good  text-book  (5th 
edition,    1818),    in   which    he  directed  general   attention    to   the   subject   of  artificial 


—  1081  — 

abortion.  He  was  a  pupil  of  Boer.  The  teachings  of  Boer  were  also  embraced  by 
his  pupil 

Joh.  Christ.  Gottfried  Jorg  (1779-1856)  in  Leipzig, 
who  advocated  the  use  of  "  birth-cushions  "  (Geburtskissen)  and  the  removal  of  the 
forceps  before  the  complete  delivery  of  the  head  in  order  to  spare  the  perineum,  and 
invented  a  trepan-like  perforator  (Wechsung  had  indicated  such  an  instrument  as 
early  as  1757),  while  he  was  an  opponent  of  artificial  abortion  and  the  tampon  in 
placenta  praevia.  (Handbuch  der  speciellen  Therapie  fur  Aerzte  am  Geburtsbette, 
1885;  Handbuch  der  Krankheiten  des  Weibes,  1832  etc.) — An  important  and  highly 
deserving  obstetrician,  particularly  as  regards  the  theory  of  the  pelvis  and  the 
mechanism  of  labor,  a  subject  which  he  created  and  built  up  into  a  science,  was  the 
eloquent  and  witty  pupil  of  the  Jesuits  (though,  according  to  Georg  Weber  he  was  by 
no  means  a  follower  of  Jesuitical  principles  in  his  life), 

Franz  Carl  Nagele  (1777-1851)  in  Heidelberg, 
to  whom  we  owe  much  of  our  knowledge   of  the  obliquely  contracted,  rachitic  etc. 
pelvis,  the  determination  of  the  inclination  of  the  pelvis,  computation  of  the  duration 
of  pregnane}',  improvement  of  instruments  (Nagele' s  lock  etc),  and  whose  doctrines 
were  widely  diffused  and  long  accepted.     His  son 

Hermann  Fr.  J.  Nagele  (died  1851), 
who  also  practised  in  Heidelberg,  likewise  rendered  good  service  in  the  study  of  the 
mechanism   of  labor,  the  obliquely  contracted   pelvis,  the  application  of  auscultation 
to  pregnancy  and  labor  etc.     (Lehrbuch  der  Geburtshilfe,  7th  edition,  1873,  edited  by 
W.  L.  Grenser.) — The  father-in-law  of  Nagele  Sr.  was 

F.  A.  May  (1742-1814), 
a  professor  in  Heidelberg,  who  has  been  already  mentioned  as  a  hygienist.     He  was 
the  first  to  recommend   artificial  abortion,  but  this  operation   was  first  performed  in 
Germany  in  1804  by 

Carl  Wenzel  (1769-1827)  in  Frankfort-on-the-Main. 

The  nephew  of  the  elder  Stein, 

Georg  Wilhelm  Stein  (1773-1870), 
was  the  worthy  successor  of  his  uncle  in  Bonn,  and  was  the  earliest  to  call  attention 
to  contractions  of  the  pelvis  due  to  hip-disease,  fractures  and  exostoses. 
The  Berlin  professor  of  midwifery, 

Adam  Elias  yon  Siebold1  (1775-1828), 
a  pupil  of  Boer,  as  well  as  his  more  famous  son,  the  classical  historian  of  midwifery 

Ed.  Carl  Caspar  yon  Siebold  (1801-1861), 
professor  in  Gottingen,  distinguished  themselves  in  many  directions.     The  successor 
of  the  elder  Siebold,  and  the  predecessor  of  Martin,  in  Berlin  was 

Dietrich  H.  W.  Busch  (1788-1858), 

who  was  likewise  an  eminent  gynaecologist.  He  devoted  special  attention  to  cephalic 
version,  cephalotripsy,  artificial  abortion  etc.  (Lehrbuch  der  Geburtskunde,  5th  ed., 
1849;  Geschlechtsleben  des  Weibes  etc.)  The  successor  of  Elias  von  Siebold  in 
Wui'zburg  was 

1.  The  name  of  Siebold  includes  also  two  doctresses  of  midwifery.  The  first  was  an 
honorary  doctress  of  Giessen  and  was  named  Regine  Josepbe  von  Siebold  ;  the 
second  was  Marianne  Theodora  Charlotte  von  Siebold  (1788-1859),  who  married  a 
Heidenreich,  and  who,  after  passing  her  examinations  and  holding  her  disput- 
ation, also  in  Giessen,  became  a  doctor  of  midwifery  and  practised  with  great 
success  in  Darmstadt  and  other  places  to  which  she  was  often  summoned. 


—  1082  — 

Joseph  d'Outrepont  (1778-1845]  of  Malmedy, 
who  discussed   cephalic   and  spontaneous   version   and    artificial    abortion.     In   the 
latter  operation  he  discarded  ergot  as  injurious  to  the  child.     Schoenlein,  with  that 
charity  characteristic  of  medical  colleagues,  is  said  to  have  remarked  of  d'Outrepont 
that  if  the  uterus  was  taken  away  from  him  he  would  have  nothing  whatever  left. 

Under  the  presidency  of  d'Outrepont  C.  J.  Haus  (born  1799)  wrote 
on  auscultation  in  pregnane}',  and  Ad.  Ulsamer  composed  a  treatise  on  the 
same  subject. 

The  versatile  and  original,  but  conceited 

Ferd.  Aug.  Max  Franz  von  Ritgen  (1787-1867)  of  Wulfen  in 
Westphalia, 

professor  of  midwifery  and  at  an  earlier  period  of  surgery  also  in  Giessen,  has  re- 
cently regained  in  many  respects  his  merited  recognition.  The  author  of  a  treatise 
entitled  "  Geburtshilfliche  Operationen"  (1820),  he  discussed  protection  of  the 
perineum,  pelvic  contraction,  artificial  abortion,  the  mechanism  of  labor,  foetal 
positions,  puncture  of  the  membranes,  and  recommended  bandaging  the  legs  in 
haemorrhage  in  order  to  preserve  sufficient  blood  for  the  central  organs  etc.  The 
latter  procedure  was  subsequently  revived  under  the  name  of  "autoinfusion".  Ritgen 
was  a  scion  of  the  school  of  natural  philosophj',  and  embraced  also  the  doctrine  of 
animal  magnetism.  At  a  later  period  he  inclined  to  the  sect  of  natural  historical 
physicians  and  invented  some  marvellous  names  for  diseases,  e.  g.  "  tokodomy- 
codoritis  maligna"  for  diphtheria  of  the  vagina  etc.  At  an  advanced  age  he  drifted 
away  into  alienistic  medicine,  botany,  comets  etc.,  and  also  distinguished  himself  as 
an  investigator  of  the  history  of  the  mechanism  of  labor.  The  results  of  these 
investigations  he  had  published  by  his  pupils  under  the  form  of  inaugural  treatises. — 
Ritgen  was  often  an  opponent  of  the  professor  in  Halle, 

Ant.  Fr.  Hohl  (1794-1862), 
who  rendered  good  service  to  medicine  by  his  labors  on  the  pathology  of  the  pelvis 
(Zur  Pathologie  des  Beckens,  two  parts),  obstetrical  examination  (Die  geburtshilfliche 
Exploration,  two  parts),  the  signs  of  pregnancy,  the  birth  of  malformed  children,  and 
as  author  of  a  verj'  good  text-book  (Lehrbuch  der  Geburtshilfe,  2d  edition,  1862). 

Ant.  Joh.  Jungmann  (1775-1854), 
professor  in  Prague,  was  a  pupil  of  Boer  and  an  influential  teacher. 

W.  H.  Niemeter  (1788-1840)  in  Halle 
discussed  twin-births,  and  invented  an  instrument  for  rupture  of  the  membranes  and 
a  trepan-perforator.  —  An  active  teacher  in  Dresden  was  the  versatile 

Karl  Gustav  Carus  (1789-1869), 
a  follower  of  the   school   of  natural  philosophy   and   the   father  of  the  idea  of  the 
"unconscious".     He  was  a  fertile  writer  on  zootomy,  comparative  physiologj',  the 
symbolism  of  the  human  form,  "Psyche",   "  Physis  "  etc.     In  opposition  to  him 

Ludwig  Jul.  Caspar  Mende  (1779-1869), 
professor  in  Greifswald  and  subsequently  in  Gottingen,  distinguished  himself  as  a 
memorable  writer  on  forensic  medicine  and  an  historian  of  this  department. 

Hermann  Friedricii  Kilian  (1800-1863)  in  Bonn 
rendered  special  service  to  the  subject  of  the  obstetrical  operations. 

I<;naz  Schworer  (1800-1860)  in  Freiburg 
likewise  wrote  on  midwifery  and  forensic  medicine. 

Julius  Victor  Schoeller  (1811-1883) 
was  an  eminent  obstetrical  teacher  in   Berlin  (Die  kunstliche  Fri'ihgeburt  bewirkt 


—  1083  —      ' 

durch  den  Tampon,  Berlin,  1842),  and   inventor  of  an  "  Omphalosoter  "  for  replace- 
ment of  the  prolapsed  cord. 

Joh.  Eug.  Rosshirt  (1795-1872)  in  Erlangen, 

Carl  Christopher  Huter  (1803-1857)  in  Marburg, 
the  earlier 

Hermann  Jos.  Brunninghausen  (1761-1834)  in  Wurzburg, 
inventor  of  a  forceps  and  perforator  and  an  advocate  of  the  use  of  sponge  tents  for 
the  induction  of  abortion,  and  J.  Bapt.  Schmidt  (1822-1884)  of  Forchheim,  professor 
in  the  school  for  midwives  in  Wurzburg,  were  all  capable  obstetricians. 
An  active  teacher  was 

Carl  Alex.  Ferd.  Kluge  (1782-18-14)  in  Berlin, 
under  whose  presidency  C.  A.  Lau  wrote  on  auscultation  in  pregnane}-. 

Franz  Kiwisch  von  Rotterau  (1814-1852), 
professor  in  Wurzburg  and  Prague,  was  an  eminent  gynaecologist  and  obstetrician, 
as  was  also  his  still  more  famous  successor  in  Wurzburg, 

Fr.  Wilhelm  Scanzoni  von  Lichtenfels  (born  1821,  retired  1887) 
in  Prague. 

Both  these  latter  obstetricians  were  educated  in  Prague. 

Among  other  German  physicians  who  have  rendered  service  in  many 
different  wa}'s  to  the  science  of  obstetrics  are  : 

E.  Lumpe  in  Vienna  (Cursus  der  practischen  Geburtshilfe,  3d.  ed., 
1851);  Karl  Sigmund  Franz  Crede"  (born  1819;  Crede's  method  of  expres- 
sion of  the  placenta  ;  instillation  of  a  two  per  cent,  solution  of  nitrate  of 
silver  in  the  prevention  of  blenorrhoeal  ophthalmia  ;  with  Spiegelberg 
editor  of  the  "Archiv  fiir  Gynaecologie")  in  Leipzig ;  Ludwig  Ignaz 
Philipp  Semmelweis  (1818-1865)  of  Ofen.  professor  in  Pesth,  misjudged 
and,  indeed,  persecuted  during  life,  has  won  immortal  honor  b}T  his  revival 
of  Penman's  idea  of  the  communicabiliry  of  puerperal  diseases,  and 
proving  that,  like  pyaemia,  they  were  infectious  and  that  in  Vienna  the}' 
were  caused  by  the  attendants  upon  the  anatomical  course,  who  examined 
parturient  women  with  hands  only  half  clean.  He  also  recommended 
careful  washing  with  chlorine  water  before  each  examination,  and  there- 
after the  mortality  among  lying-in  women  fell  in  two  months  from  12  to  3 
per  cent.  Irritable  as  he  was,  and  galled  b}-  the  attacks  which  his  doc- 
trines (in  which  he  anticipated  the  method  of  Lister)  experienced,  he  died 
in  the  insane  asylum  at  Dobling.  Original  opponents  of  the  teachings  of 
Semmelweis  were  :  Kiwisch,  Virchow,  Scanzoni,  C.  Braun,  Seyfert,  Betschler, 
Roser,  Hecker,  Arnold  and  almost  all  physicians  of  reputation,  who 
expressed  their  dissent  particularly  at  the  "  Naturforscherversammlung" 
at  Spires.  Among  his  followers  were  :  Skoda,  Michaelis  in  Kiel,  Hebra, 
Markusovzky,  Kesmarszky,  Fritsch  —  and  to-day  everybody  !  Semmelweis, 
like  Robert  Mayer,  is  a  witness  that  in  the  19th,  as  well  as  in  the  first 
century,  truth  demands  her  victims,  only  the  discoverers  of  truth  now 
are  no  longer  crucified,  but  their  names  are  simph'  written  upon  the  pro- 
scription-list of  the  lease-holders  of  science,  and  the}T  themselves  handed 


—  1084  — 

over  to  lunatic  asylums  !  G.  A.  Michaelis  (1798-1848),  who  immediately 
and  alone  among  the  obstetricians  accepted  and  followed  the  teachings 
of  Semmelweis,  because  he  believed  that  his  niece,  whom  he  had  confined, 
had  fallen  a  victim  to  the  want  of  cleanliness  of  his  instruments  etc.; 
C.  C.  Th.  Litzmann  (born  1815)  in  Kiel,  who  made  careful  studies  of  nor- 
mal and  deformed  pelves ;  Carl  and  Gustav  Braun  (the  colpeuiynter)  in 
Vienna  ;  F.  H.  Arneth,  J.  Chiari  and  J.  Spath  also  in  Vienna  ;  E.  Martin 
(1809-1875)  in  Berlin,  an  advocate  of  external  version  and  an  eminent 
gynaecologist  ;  Anselm  Martin  (1809-1883)  in  Munich,  extraordinary  pro- 
fessor and  superintendent  of  the  lying-in  hospital  until  1859,  and  then  an 
obstetrician  of  reputation  as  well  as  a  writer  ;  B.  Seyfert  (died  1870)  in 
Prague,  the  author  of  the  Prague  school-forceps  ;  Veit  in  Bonn  ;  Karl 
Schroder  (1838-1887)  in  Berlin,  author  of  a  "Lehrbuch  der  Geburtshilfe" 
(1870,  8th  ed.,  1884)  and  a  "  Handbuch  der  Krankheiten  der  weiblich. 
Geschleehtsorgane"'  (1874,  7th  ed.  1886),  who,  like  so  many  modern  uni- 
versity professors,  owes  to  these  two  text-books  his  extensive  reputation. 
He  was  also  active  in  the  introduction  of  ovariotomy  into  German}-. 
Hecker  (1826-1882)  in  Munich;  Lange  in  Heidelberg;  R,  Olshausen  in 
Halle  ;  O.  Spiegelberg  (1830-1881),  who  advocated  tapping  for  diagnostic 
purposes  in  ovarian  tumors  etc.;  Birnbaum  and  F.  A.  Kehrer  in  Heidel- 
berg, who  wrote  on  comparative  parturition  and  demonstrated  sterility  in 
the  male  by  a  test-coitus  and  subsequent  examination  of  the  collected 
semen;  Frankenhliuser  and  B.  S.  Schultze  (son  of  the  Greifswald  anatomist 
and  physiologist,  Siegmund  Schultze  —  1795-1877  • — and  brother  of  the 
famous  anatomist  and  microscopist  Max  Schultze,  the  investigator  of  the 
retina)  in  Jena  ;  R.  Dohrn  in  Marburg  ;  A.  Hegar  in  Freiburg,  who  per- 
formed the  first  extirpation  of  the  normal  ovaries,  i.  e.  female  castration,  for 
neuralgia,  1872  ;  Freund  in  Strassburg  and  subsequentl}T  in  Berlin  ; 
Kristeller  in  Berlin  and  August  Breisky  (1832-1889)  of  Klattau  in 
Bohemia,  professor  successivel}'  in  Salzburg^  Bern,  Prague  (1874)  and 
Arienna  (1886),  where  he  succeeded  Spaeth.  He  studied  in  Prague  (par- 
ticularly pathological  anatorn}-  under  Treitz  and  gynaecology  under  Seyfert), 
and  is  well-known  as  one  of  the  pioneers  of  obstetrical  antisepticism,  as 
an  operative  gynecologist,  and  as  the  first  describer  of  kraurosis  vulva?  ; 
P.  Miiller  in  Bern  ;  W.  Lange  (born  1813,  shot  himself  1881)  of  Klein-Iser 
in  Bohemia,  a  scion  of  the  Prague  school,  first  in  Innsbruck  and  then 
Nagele's  successor  in  Heidelberg;  A.  Gusserow  (born  1836),  formerly  in 
Strassburg,  now  in  Berlin  ;  H.  Hildebrand  (1833-1882)  in  Konigsberg  ; 
Schwartz  in  Gottingen  ;  F.  Winckel,  first  in  Dresden,  then  in  Munich  ; 
his  successor  in  Dresden,  Gerharclt  Leopold  ;  Kuhn  in  Salzburg  ;  C.  Hen- 
nig  in  Leipzig ;  Virgil,  Bitter  von  Mayrhofer  (181.5— 1877)  in  Innsbruck; 
Schatz  in  Rostock  ;  Zweifel  in  Erlangen  ;  C.  Mayer  in  Berlin  ;  J.  Amman 
in  Munich  ;  L.  Kleinwachter  in  Innsbruck;  Hermann  Beigel  (i 830-1879), 
a  well-known  gynaecologist  of  Vienna,  etc.  Most  of  the  physicians  last 
mentioned  are  likewise  skilful  gynaecologists,  some  of  them  also  devoted 


—  1085  — 

to  the  diseases  of  children,  though  since  the  excessive  growth  of  specialism 
this  is  becoming  more  rare. 

Among  specialists  in  the  diseases  of  children  and  writers  in  this 
department  in  Germany,  which  during  the  course  of  the  present  century 
can  point  to  an  extremely  large  number  of  translations  from  the  English 
and  French,  we  may  notice  the  following  eminent  representatives  :  Ferd. 
Jahn  (System  der  Kinderkrankheiten,  1807)  ;  Jorg  (Handbuch  zum 
Erkennen  und  Heileu  der  Kinderkrankheiten,  1S2G)  ;  F.  L.  Meissner 
(Kinderkrankheiten,  several  editions);  W.  Ran  (Handbuch  der  Kinder- 
krankheiten, 1832);  J.  Wendt  (Kinderkrankheiten,  3d.  ed.,  1835);  A.  Henke 
(Handbuch  der  Kinderkrankheiten,  1831);  Ch.  F.  Harless  ;  J.  L.  Loebisch 
(Studien  iiber  Kinderheilkunde,  1848);  F.  J.  von  Mezler  ;  Schnitzer  and 
Wolff  (Handbuch  der  Kinderkrankheiten,  1843);  E.  Henoch  ;  C.  Hennig 
(Lehrbuch  der  Krankheiten  des  Kindes  in  seinen  verschiedenen  Alterstufen, 
1859);  J.  B.  Ullersperger  (1797-1878);  Alf.  Vogel  (Lehrbuch  der  Kinder- 
krankheiten, 8th  ed.,  1876,  a  new  edition  is  being  edited  by  Phil.  Biedert); 
a  cyclopaedia  under  the  direction  of  Gerhardt ;  and  the  "Journal  f  ur  Kin- 
derkrankheiten". among  whose  contributors  are  F.  J.  Behrend,  A.  Hilde- 
brandt,  Aug.  von  Hauner  (died  1884)  in  Munich,  J.  Bokai  (died  1884)  in 
Pesth,  Mauthner  and  man}'  others. 

b.  The  French 

continue,  far  more  than  the  Germans,  to  occupy  the  same  stand-point  which 
they  held  in  the  18th  century  in  midwifery,  and  are  accordingl}'  still  rather 
inclined  to  instrumental  interference. 

Among  the  well-known  contributions  of  the  French  to  this  depart- 
ment we  may  mention  first  the  application  of  auscultation  to  the  deter- 
mination of  the  life  and  death  of  the  child,  the  existence  of  twin  or 
abdominal  pregnancy  and  the  seat  of  the  placenta,  which  was  first  brought 
forward  b}' 

J.  A.  Leju.meau  de  Kergaradec  (1788-1S77) 
in  1822,  without  knowing  that  Mayor  of  Geneva  had  heard  the  sounds  of  the  foetal 
heart  in  1818;  then  the  so-called  cephalotripsy,  which  was  taught  from  1829  by 

A.  Baudelocque, 
a  nephew  of  the  eminent  obstetrician.     By  this  operation  it  was  believed  possible  to 
deliver  the  child   in   a   pelvis  whose  conjugate  did   not  exceed  two  inches,  without 
perforation  of  the  head. 

J.  P.  Maygrier  (1771-1834) 
reduced  the  96  foetal  positions  of  Baudelocque  to  half  that  number,  and 

Marie  Louise  Lachapelle  (1769-1821), 
chief  midwife  to  the  "Hospice  de  la  maternite"  (opened  in  1797),  who  had  observed 
40,000  cases  of  labor,  reduced  the  number  again  to  22.     On  the  other  hand,  her  pupil 

Marie  Anne  Victoire  Boivin  (1773-1841) 
constructed  and  portrayed  some  curious  foetal  positions. 


—  108(5  — 

Besides  Joseph  Capuron  (17G7-1S50),  Louis  Charles  de  Deneux  (1767- 
1846),  a  pupil  of  Baudelocque,  and 

Claude  Marie  Gardien  (1767-1838), 
a  famous  teacher,  familiar  to  some  extent  with  even   the   contributions  of  foreign 
authorities, 

Antoine  Dubois  (1756-1837), 
the  successor  of  the  elder  Baudelocque  in  the  Maternite,  particularly  distinguished 
himself  as  a  teacher,  and  became  well-known  too  in  a  wide  circle  by  his  confinement 
of  Maria  Louisa.     His  son 

Paul  Dubois  (1795-1871) 
met  with  the  same  good  fortune  in  his  confinement  of  the  second  empress,  and  was 
a  meritorious  cultivator  of  obstetric  auscultation,  while 

E.  Dubois  (died  1877)  in  Paris 
was  a  well-known  gynaecologist. 

J.  A.  H.  Depaul  (1811-1883), 
Prof,  at  the  Hopital  des  cliniques,  also  devoted  attention  particularly  to  obstetrical 
auscultation,  and  was  an  eminent  obstetrician   as  well  as  editor  of  the  "Archives  de 
tocologie  "  etc. 

The  old  obstetrical  reputation  of  Strassburg  was  maintained  by 

Jacob  Friedrich  Schweighauser  (1766-1842), 

Joiiann  C.  C.  Friedrich  Lobstein  (1777-1838)  of  Giessen, 

R.  P.  Flamant  (1762-1832), 
who  as  early  as  1795  revived  the  memorj'  of  cephalic  version,  and 

Jos.  Alexis  Stoltz  (born  1803), 
Flamant' s  successor,  who  was  one  of  the  first  to  practise  artificial  abortion  in  France. 
All  these  physicians  acted  as  a  connecting  link  between  France  and  Germanj*. 

The  surgeon  Armaud  Louis  Marie  Alfred  Velpeau  (1795-1867)  also 
wrote  on  obstetrics,  as  well  as  Francois  Joseph  Moreau  (1789-1862),  [phy- 
sician to  the  Maternite  and  obstetrician  to  the  princesses  of  the  Orleans 
family  (perforation  of  the  perineum)  ;]  F.  Duparcque  (ruptures  etc.  of 
uterus,  vagina  and  perineum);  Lacour  ;  Paulin  Cazeaux  (1808-1862)  [of 
Paris  and  author  of  the  well-known  "  Traite"  theorique  et  pratique  de  1'  art 
des  accouchements",  1840,  8th  ed,  1870;]  Nicolas  ChaiHy-Honore"  (1805- 
1866),  [Chef  de  clinique  at  the  obstetrical  clinic  of  the  Faculty,  and  an 
eminent  obstetrician  of  Paris;]  F.  K.  Bayley ;  Dubreuilhe ;  Joseph 
Dominique  Ernest  Put^gnat  (1809-1876),  [who  was  rather  a  general  prac- 
titioner and  writer  on  various  medical  subjects  ;]  Chassagny  and  Eugene 
Armand  Despr^s  at  the  Hopital  Cochin.  We  should  also  mention  :  A.  H. 
P.  Courty  (1819-1886)  in  Montpellier  ;  Jules  Pean  of  the  Hopital  Saint- 
Louis;  L.  Urd}' ;  Liegeard  ;  Charles  James  Campbell  (1820-1879),  [a  phy- 
sician of  English  parentage  settled  in  Paris,  who  was  active  in  the  intro- 
duction of  obstetrical  anaesthesia  into  France,  and  one  of  the  most  pop- 
ular and  successful  obstetricians  in  Paris  ;  and  others.  To  whom  we  ma}- 
add  St^phane  Tarnier,  Surgeon-in-chief  of  the  Maison  et  Ecole  d'accouche- 
ment  and  inventor  of  a  well-known  forceps,  and  the  gynaecological  authors 
mentioned  on  pp.  906-907.] 


—  1087  — 

c.  Italians. 

Among  the  Italians  no  physician  since  the  days  of  Paolo  Assalini 
(1759—1810)  and  Francesco  Asdruhali  (1756-1832)  has  attained  an}-  high 
reputation  among  foreigners  as  an  obstetrician.  On  the  other  hand,  how- 
•ever,  the  literary  activity  of  Italian  physicians  in  the  department  of  mid- 
wifery has  been  very  livel}-. 

In  181S  men  were  for  the  first  time  permitted  to  visit  the  lying-in 
institutions  of  Parma,  and  a  chair  of  midwifery  was  established  in  Pisa  in 
1839  and  in  Florence  in  18-10.  In  Piedmont  obstetrical  clinics  were 
founded,  in  Venice  and  Palermo  in  1811,  in  Genoa  1852  etc. 

Among  the  Italian  obstetricians  we  should  mention  :  Gennaro  Galbiati 
(1776-1818)  of  Naples  ;  Bigeschi  ;  M.  C  Frari,  author  of  the  first  Italian 
treatise  on  obstetrical  operations  in  1811;  J.  D.  Nardo ;  F.  Marzolo  ; 
Trinchinetti ;  Salvatore  de  Renzi  (1800-1872),  [Prof,  of  the  history  of 
medicine  in  the  University  of  Naples  and  the  well-known  author  of  the 
"  Storia  della  medicina  italiaiia"  (1815-18);]  Yerducci  ;  Ciccone  ;  Fabbri  ; 
Pietro  Vannoni  of  Florence  ;  Biancini  ;  Bongiovanni  ;  Bili  ;  Giuseppe 
Maria  Canella  (1788-1829)  in  Trent;  Pietro  Lazzati  (1830-1871)  in  Milan  ; 
•Cesare  Belluzzi  (auscultation  for  the  determination  of  the  foetal  position); 
Carlo  Massarenti  (on  the  same  subject);  J.  Casati  in  Milan ;  Ferdinando 
Verardini  of  Bologna,  chief  physician  to  the  Ospedale  Maggiore  ;  Eduardo 
Porro  in  Milan  (Porro's  operation  or  "Utero-ovarian  amputation  as  com- 
pletive of  the  Cesarean  operation",  1876);  Antonio  Rota  ;  Aloysio  Valenta 
in  Laibach  (an  Italian  only  in  nationality);  Giustino  Mayer  (1830-1879  ; 
•conversely  a  German  with  an  Italian  Christian  name)  in  Naples  ;  G. 
Calderini  in  Turin;  Teodoro  Lovati  (1800-1872)  in  Pavia  ;  Luigi  Pas- 
torello  (1811-1863)  in  Padua  etc.  —  Still  fewer  names  and  works  relating 
to  midwifery  among  the 

d.  Spaniards 

are  of  sufficient  importance  to  have  attained  general  knowledge  abroad  up 
to  the  present  time.  We  may  notice,  however,  among  their  quite  recent 
writers  on  midwifery  :  Dr.  Torres  (died  1888),  professor  of  obstetrics  in 
Madrid  ;  Francesco  de  Cortejarena  3-  Aldeo  and  Pedro  Brogeras  y  Lopez. 
Schroeder's  work  was  also  translated  into  Spanish  under  the  title  of 
u  Manual  de  las  enfermedadas  de  los  organos  sexuales  de  la  mujer",  by 
A.  Vincencio  in  1887. 

e.  The  English 

in  their  midwifer}-  follow,  on  the  one  hand,  the  principle  of  protecting  the 
mother  by  utilizing  to  their  utmost  the  natural  forces  of  parturition  — 
and  in  this  department  they  have  appropriated  the  use  of  chloroform  to 
a  far  greater  degree  than  any  other  people  —  and,  on  the  other  hand  and 
•connected  therewith,  the  principle  of  preserving  the  mother  rather  than 
the  child,  with  of  course  the  eventual  sacrifice  of  the  latter  for  the  sake 


—  10S8  — 

of  the  mother.  Hence  has  resulted  the  frequency  in  English  practice  of 
perforation  of  the  head  and  of  artificial  abortion,  as  well  as  the  rarity  of 
the  employment  of  the  forceps  in  difficult  labors  and  the  avoidance  of 
Caesarean  section. 

This  trust  in  the  powers  of  nature  and  avoidance  of  the  use  of  the  forceps  went 
so  far  that  in  1819  Sir  Richard  Croft,  obstetrician  to  the  princess  Charlotte  upon 
whose  life  depended  the  hope  of  the  dynasty,  permitted  the  princess  to  remain  in 
labor  52  hours,  when  the  child  was  born  dead  and  the  mother  died  six  hours  later. 
Croft,  however,  shot  himself  through  chagrin  over  his  mismanagement! 

Still  it  would  seem  that  a  revolution  is  taking  place  in  English  opinions! — Since 
when  and  how  this  change  has  gradually  taken  place  may  be  seen  very  readily  from 
the  following  statistics.  "According  to  the  statistical  reports  of  the  Dublin  Lying-in 
Hospital,  under  the  direction  of  Dr.  Joseph  Clarke,  from  1787  to  1794.  in  10,387 
cases  of  labor  the  forceps  were  employed  only  14  times;  six  of  these  cases  terminated 
in  the  death  of  the  mother.  On  the  other  hand,  49  women  were  delivered  by  cranio- 
tomy, 16  of  them  with  fatal  results.  From  1815-1821,  under  the  Mastership  of  Labatt, 
in  21,867  cases  of  labor  the  forceps  were  not  employed  a  single  time.  From  1826- 
1833,  lo\654  (16,414)  cases  came  under  the  direction  of  Collins.  Of  these  24  were 
terminated^  with  the  forceps,  with  fatal  results  in  four  cases,  while  craniotomy 
was  performed  118  times.  Under  Johnson,  from  1842-1845,  in  6,702  labors  the 
forceps  were  used  in  18  cases,  the  crotchet  in  1H  cases  and  the  perforator  in  54  cases,, 
with  8  fatal  results.  Shekleton  again  resorted  to  the  forceps  more  frequently,  in  the 
period  from  1847-1854  using  them  220  times  in  13,748  cases  of  labor,  with  a  fatal 
result  in  15  cases.  From  1869-1873,  Johnston  in  4,634  cases  applied  the  forceps  in 
420  (1:11),  with  34  deaths  (1:12),  while  he  had  only  20  cases  of  perforation  or 
craniotomj-  (1  :  321),  with  fatal  results  in  5  cases.  In  private  obstetrical  practice  too* 
the  forceps  were  for  a  long  time  almost  forgotten.  Thus  Clarke,  in  a  midwifery 
practice  of  almost  fifty  years  and  including  3,878  cases  of  labor,  had  resorted  to  the 
forceps  in  a  single  case  only.  What  an  impulse  has  been  given  to  the  emploj'ment 
of  the  forceps  in  the  last  thirty  years  may  be  inferred  from  the  communications  of 
Churchill.  While  in  the  first  half  of  this  period  the  forceps  were  emploj'ed  once  in- 
351  cases  of  labor,  in  the  last  half  the  proportion  increased  to  1 :  171,  and  in  private 
practice  to  one.in  sixty." 

[According  to  Churchill  (Theory  and  Practice  of  Midwifery,  Phila.,  1863)  the 
relative  frequency  of  the  use  of  the  forceps  among  English,  French  and  German 
obstetricians  was:  among  British  practitioners  1:249;  among  the  French  1:140, 
and  among  the  Germans  1  :  106.  An  examination  of  the  tables  upon  which  these 
conclusions  are  based  shows,  however,  that  they  must  be  regarded  at  best  as  very 
rough  approximations.  Probably  all  we  can  safely  say  is  that  the  forceps  are 
employed  more  frequently  in  German  and  French  obstetric  practice  than  in  British^ 
but  just  how  much  more  frequently  it  is  difficult  to  decide.  Churchill's  tables  likewise 
convey  the  idea  that  face  presentations  e.  g.  occur  almost  twice  as  often  in  German 
practice  as  in  English.  While  I  know  no  reason  for  such  a  fact,  and  hence  doubt  the 
reliability  of  the  statistics,  if  such  is  the  fact,  it  is  easy  to  see  one  reason  why  the  use 
of  the  forceps  is  more  frequent  in  Germany  than  in  Great  Britain.  There  would1 
seem  to  be  also  some  difference  in  the  frequency  of  the  employment  of  the  forceps 
by  English,  Scotch  and  Irish  obstetricians.  Thus  from  the  tables  of  Churchill, 
analyzed,  so  far  as  in  my  power,  with  reference  to  the  school  of  British  obstetricians, 
I  find  that  among  the  English  the  forceps  were  employed  once  in  511  cases;  among 
the  Irish,  once  in  186  cases,  and  among  the  Scotch,  once  in  101  cases.  Still  I  doubt 
whether  any  considerable  reliance  can  be  placed  upon  such  comparisons.     The  dis- 


—  1089  — 

turbing  elements  of  period,  conditions  of  practice  (hospital  or  private),  the  predomin 
ance  of  a  few  large  practitioners  (Ramsbotham  e.  g.  reports  68,435  cases,  in  which 
the  forceps  were  employed  112  times)  combine  to  vitiate  the  conclusions  to  be  drawn 
from  such  statistical  tables  to  a  degree  which  makes  me  very  distrustful  of  them. 
The  tendency  to  an  increased  employment  of  the  forceps  by  British  practitioners,  as 
stated  by  the  author,  is  however  undoubtedly  true.  Whether  the  increased  activity 
of  gj'naecological  practice  is  connected  genetically  therewith  is  a  question  which  has 
aroused  serious  consideration.     H.] 

Among  the  more  eminent  English  obstetricians  of  the  present  century, 
most  of  whom  also  devoted  attention  to  the  diseases  of  women  and 
children,  were  : 

Samuel  Merriman  (1771-1852), 
obstetrician   to  the  Westminster  Dispensary   and   from    1810   to    1825   lecturer   on 
midwifery  and  the  diseases   of  women  and   children   at  the  Middlesex  Hospital  of 
London,  whose  "Synopsis  of  various   kinds   of  difficult  parturition,   with   practical 
remarks,  London,  1814"  was  sufficiently  popular  to  attain  a  5th  edition  (1839); 

Sir  Charles  Mansfield  Clarke  (1782-1857), 
the  son  of  John  Clarke,  an  eminent  London  obstetrician  of  the  last  century.     Sir 
Charles  Clarke  held  the  position  of  surgeon  to  Queen  Charlotte's  Lying-in  Hospital, 
and  lectured  on  midwifery  and  the  diseases  of  women  and  children  from  1804  to  1821. 
He  was  also  ordinary  physician  to  Queen  Charlotte ; 

Augustus  Bozzi  Granville  (1783-1871  ;  his  real  name  was  Bozzi), 
a  native  of  Milan  and  an  alumnus  of  Pavia,  who  settled  in  London  and  acquired  an 
extensive  practice  in  midwifery.  He  was  also  accoucheur  to  the  Westminster  General 
Dispensary,  and  published  in  1819  a  report  on  the  obstetrical  practice  of  that  institu- 
tion in  1818,  from  which  we  see  that  the  forceps  were  employed  five  times  in  640 
cases  of  labor.  His  literary  activitj',  however,  was  directed  more  especially  to  the 
subjects  of  materia  medica,  the  plague,  quarantine  etc. 

Robert  Gooch  (1784-1830), 
physician  to  the  Westminster  Lying-in  Hospital  and  lecturer  on  midwifery  in  the 
medical  school  of  St.  Bartholomew's  Hospital,  as  well  as  a  popular  and  successful 
practitioner  in  London.     His  "Account  of  some  of  the  most  important  diseases  of 
women",  1829,   is  perhaps  his  best  known  and  most  highly  prized  work. 

John  Ramsbotham,  and  his  more  eminent  son, 

Francis  Henry  Ramsbotham  (1800-1868), 
both  lecturers  on  midwifery  at  the  London  Hospital  Medical  School  and  highly 
esteemed  obstetricians.  The  former  published  some  "Practical  observations  in 
midwifery"  etc.,  London,  1821-32,  while  the  elaborate  work  of  the  latter,  "The 
principles  and  practice  of  obstetric  medicine  and  surgery",  London,  1841,  became 
one  of  the  most  popular  text-books  of  English  and  American  students  for  a  long 
period.  The  j*ounger  Ramsbotham  employed  ergot  for  the  purpose  of  inducing 
premature  labor,  a  practice  which  resulted  in  the  death  of  nearly  half  the  children. 

David  Davis  (1777-1841), 
accoucheur  to  the  Queen  Charlotte   Lying-in  Hospital  and  from   1827  lecturer  on 
midwifery  at  University  College,  who  published  in   1825  the  "Elements  of  operative 
midwifery",  and  his  son 

John  Hall  Davis  (1811-1884), 
from  1863  lecturer  on  midwifery  at  the  medical  school  of  Middlesex  Hospital,  and  a 
69 


—  1000  — 

successful  and  popular  London  obstetrician.  He  published  in  1S5S  his  "Illustrations 
of  difficult  parturition",  and  in  1865  a  second  edition  containing  statistics  of  13,783 
deliveries,  from  which  we  see  that  he  was  exceedingly  cautious  in  the  use  of  the 
forceps  (6  times  in  7302  cases) ; 

James  Blundell, 

professor  of  obstetrics  at  Guy's  Hospital  Medical  School  and  physician  to  the  Lying- 
in  Charity  of  London,  and  a  careful  investigator  of  the  subject  of  transfusion.  "The 
principles  and  practice  of  obstetricy  ",  London,  1834; 

Sir  Charles  Locock  (1799-1875), 
a  pupil  of  Brodie  and  James  Hamilton  of  Edinburgh,  physician  accoucheur  to  queen 
Victoria  in  all  her  confinements,  and   lecturer  on   midwifery  at  St.  Thomas's  and 
St.  Bartholomew's  Hospitals,  to  whom  we  owe  also  the  discovery  of  the  efficacy  of 
bromide  of  potassium  in  the  treatment  of  epilepsy; 

Robert  Lee  (1793-1877)  of  Melrose, 
a  pupil  of  the  Scotch  school,  who  settled  in  London  and  became  famous  as  an 
obstetrician,  as  well  as  an  anatomist  and  physiologist.  He  occupied  the  obstetrical 
chair  of  the  medical  school  of  St.  George's  Hospital  for  many  years,  delivered  the 
Lumleian  and  Croonian  lectures  before  the  College  of  Physicians,  and  was  par- 
ticularly distinguished  as  a  student  of  the  anatomy  and  physiology  of  the  uterus. 
Of  his  numerous  works  the  "Elements  of  midwifery"  etc.  (1837),  "The  morbid 
anatomj'  of  the  uterus  and  its  appendages"  (1838)  and  "  The  anatomy  of  the  nerves 
of  the  uterus"  (1841)  are  perhaps  best  known; 

William  Tyler  Smith  (1815-1873), 
physician  accoucheur  to  St.  Mary's  Hospital  and  author  of  a  well-known  and  highly 
esteemed  "  Manual  of  obstetrics,  theoretical  and  practical",  (1858).  In  1860,  chiefly 
through  his  exertions  and  influence,  the  "Obstetrical  Society"  of  London  was 
founded,  an  organization  which  has  contributed  largely  to  the  elevation  of  obstetrical 
practice  in  Great  Britain. 

John  T.  Conquest  (1789-1866),  lecturer  on  midwifery  at  St.  Bartholo- 
mew's Hospital,  Michael  Ryan  (died  1840  or  41)  at  the  North  London 
Medical  School,  Samuel  Ashwell,  author  of  "A  practical  treatise  on  par- 
turition "  etc.,  London,  1828,  etc.  also  deserve  mention. 

Among  the  more  recent  teachers  of  midwifery  at  the  London  medical 
schools  are  :  J.  Braxton  Hicks  and  Alfred  L.  Galabin  at  Gu3''s  Hospital ; 
J.  Matthews  Duncan  at  St.  Bartholomew's  ;  Dr.  Gervis  at  St.  Thomas's  ; 
Dr.  Palfrey  at  the  London  Hospital  Medical  School  ;  Dr.  Black  at  the 
Charing  Cross  Hospital  ;  William  M.  Graily  Hewitt  at  University  College 
Hospital ;  William  S.  Playfair  and  Dr.  Hayes  at  King's  College  Hospital  ; 
Dr.  Edis  at  Middlesex  Hospital ;  Robert  Barnes  at  St.  George's  ;  Alfred 
Meadows  and  Alfred  Wiltshire  at  St.  Mary's  Hospital  ;  Drs.  Potter  and 
Grigg  at  the  Westminster  Hospital  ;  Drs.  Heywood  Smith  and  Fancourt 
Barnes  at  the  British  Lying-in  Hospital,  etc. 

Among  the  more  eminent  obstetricians  of  the  Scotch  school  we  may 
mention  : 

John  Burns  (1775-1850), 
Regius  professor  of  surgery  and  lecturer  on  midwifery  in  the  University  of  Glasgow, 
who  wrote  on  the  anatomy  of  the  gravid  uterus,   "The  principles  of  midwifery"  etc., 


—  1091  — 

(1809),  and  other  works,  and  was  the  first  to  advance  the  view  that  involution  of  the 
uterus  depended  upon  a  resorption  of  its  muscular  fibres ; 

James  Hamilton  of  Edinburgh, 
the  son  of  the  famous  obstetrician  Alexander  Hamilton,  and  the  successor  of  his 
father  in  the  University  of  Edinburgh,    an  eminent  teacher  and   writer   (Practical 
observations  on  various  subjects  relating  to  midwifery,   1836  etc.).     The  Edinburgh 
obstetrician  and  gynaecologist  of  world-wide  reputation, 

Sir  James  Young  Simpson  (1811-1870), 
the  son  of  a  baker,  who  by  dint  of  his  own  exertions  acquired  the  preliminary  edu- 
cation required  to  enter  the  University  of  Edinburgh.  In  1832  he  was  selected  bjr 
John  Thomson,  the  professor  of  pathology,  as  his  assistant,  and  in  1840,  after  a  sharp 
struggle  with  numerous  and  able  competitors,  he  was  appointed  to  the  chair  of  mid- 
wifery now  vacant  by  the  death  of  James  Hamilton.  In  this  position  he  lectured  with 
ever  increasing  popularity  and  soon  acquired  also  an  enormous  practice.  In  1847  he 
was  the  first  to  emplo3r  ether  anaesthesia  in  midwifery  practice,  and  on  November  4th 
of  the  same  year  he  substituted  chloroform  for  ether,  and  laid  the  announcement  of 
the  advantages  of  chloroform  before  the  Edinburgh  Medico-Chirurgical  Society  one 
week  later.  Of  his  other  contributions  to  surgery  and  gynaecology  we  have  space 
merely  to  mention  the  wire  suture,  the  invention  of  acupressure,  the  uterine  sound, 
the  dilatation  of  the  cervix  uteri  by  means  of  sponge-tents  for  diagnostic  purposes,  a 
special  midwifery  forceps  and,  above  all,  his  investigations  into  the  mortality  follow- 
ing operations  in  large  and  small  hospitals,  a  work  which  contributed  largely  to  the 
diffusion  of  correct  views  on  the  subject  of  hospital  hygiene.  Of  his  verjT  numerous 
writings  we  can  notice  only:  "Anaesthesia;  or  the  employment  of  chloroform  and 
ether  in  surgery,  midwifery "  etc.  (1849;;  "Hospitalism"  etc.  (Brit.  Med.  Journal, 
1869);  "Iron-thread  sutures  and  splints  in  vesico-vaginal  fistulas"  (1858);  "On 
acupressure  in  amputations  "  (1860);   "Tangle-tents"  1864. 

John  Pagan  (1802-1868)  of  Glasgow, 
Regius  professor  of  midwifery  etc.  in  the  University  of  Glasgow  and  a  popular  teacher 
and  obstetrician,   who  employed  the   forceps  with  more   freedom   than  most  of  his 
contemporaries  (82  times  in  8684  cases) ; 

Angus  MacDonald  (1836-1886)  of  Edinburgh, 
physician  to  the  Royal  Maternity  Hospital  and  a  highly  esteemed  obstetrician  and 
gynaecologist,  and 

William  Leishman, 
the   present   Regius  professor  of  midwifery  in  the  University  of  Glasgow,  and  the 
well-known  author  of  a  valuable  text-book  "A  system  of  midwifery  "  etc.  (1873). 

To  the  famous  Dublin  school  of  midwifery  belonged: 

Joseph  Clarke  (1758-1834), 
Master  of  the  Dublin  Lying-in  Hospital,  1787-1793,  who  in  the  management  of  10,387 
eases  of  labor  found  occasion  to  use  the  forceps  but  14  times,  though  he  performed 
craniotomy  no  less  than  49  times  ; 

Henry  Maunsell  (1806-1879) 
accoucheur   to  the   Wellesley    Female   Institution    and    assistant   physician    to   the 
Magdalen  Asylum.    In  1835  he  was  appointed  professor  of  midwifery  and  the  diseases 
of  women  and  children  in  the  Royal  College  of  Surgeons  of  Ireland,  and  wrote  "The 
Dublin  practice  of  midwifery  "  (Dublin,  1834). 

Robert  Collins  (1801-1868) 
Master  of  the  Dublin  Lying-in  Hospital  from  1826  to  1833,  and  author  of  "A  practical 


—  1092  — 

treatise  on  midwifery,  containing  the  result  of  16,654  births"  etc.,  in  which  he  em- 
ployed the  forceps  24  times  and  performed  craniotomy  79  times. 

William  Fetherston  H.  Montgomery  (1797-1859), 
the  well-known  author  of  "An  exposition  of  the  signs  and  symptoms  of  pregnane}-" 
(1887),  and  the  chief  agent  in  the  establishment  of  a  chair  of  midwifery  in  the  College 
of  Physicians  of  Ireland  ; 

Fleetwood  Churchill  (1808-1878), 
a  native  of  Nottingham  and  an  alumnus  of  Edinburgh,  who  settled  in  Dublin  and  in 
1856  was  appointed  professor  of  midwifery  and  the  diseases  of  women  and  children 
in  King's  and  Queen's  College  of  Physicians  in  Ireland,  a  position  which  he  con- 
tinued to  hold  until  1864.  Until  his  retirement  in  1875  he  is  said  to  have  enjoyed  the 
largest  gj-naecological  practice  in  Dublin,  and  his  influence  was  exerted  to  increase 
the  frequency  of  employment  of  the  forceps  and  to  limit  the  sphere  of  craniotomy. 
His  valuable  text-books  "On  the  theory  and  practice  of  midwifery"  (1842);  "Outlines 
of  the  principal  diseases  of  females"  etc.  (1838)  are  familar  to  all  English-speaking 
physicians. 

John  Denham  (1804-1887), 
an  eminent  obstetrician  of  Dublin  and  Master  of  the  Rotunda  Lying-in  Hospital; 
Alfred  Henry  MacClintock  (1821-1881), 

obstetrical  assistant  of  Charles  Johnson  in  the  Rotunda  Lying-in  Hospital,  and  in 
connexion  with  S.  L.  Hardy  author  of  a  valuable  report  of  the  obstetrical  service  of 
that  institution.  He  also  edited  for  the  New  Sydenham  Society  an  edition  of  Smel- 
lie's  treatise  on  midwifery,  and  was  the  author  of  an  excellent  gynaecological  treatise 
entitled  "Clinical  memoirs  on  the  diseases  of  women"  (1863). 

Thomas  Edward  Beatty  (1801-1872), 

master  of  the  South-Eastern  Lying-in  Hospital  of  Dublin  and  one  of  the  founders  of 
the  City  of  Dublin  Hospital.     His  literarj*  activity  was  displayed  chiefly  in  contribu- 
tions to  the  Dublin  Quarterly  Journal  and  the  C3-clopa3dia  of  Practical  Medicine. 
Sir  Edward  Burrowes  Sinclair  (1824-1882), 

assistant  physician  to  the  Rotunda  Lying-in  Hospital,  in  which  position  he  published, 
in  conjunction  with  his  colleague  Dr.  Johnston,  a  treatise  on  "Practical  Midwifery" 
containing  the  statistics  of  1H,748  cases  of  labor,  in  which  the  forceps  were  applied 
200  times  and  craniotom_y  performed  130  times.  On  the  retirement  of  Dr.  Churchill, 
Sinclair  succeeded  to  his  position  as  professor  of  midwifery  in  King  and  Queen's 
College  of  Physicians  in  Ireland.  His  chief  writings  relate  to  extrauterine  preg- 
nancy, the  induction  of  premature  labor  and  deformities  of  the  pelvis. 

Thomas  More  Madden  (born  1844), 
obstetric  physician  to  the  Mater  Misericordiae  Hospital  and  consulting  physician  to 
the  National  Lying-in   Hospital  in  Dublin,  and  an  eminent  obstetrician  of  that  city. 
Among  his  numerous  writings  we  may'  notice  "The  Dublin  practice  of  midwifery" 
(1871);   "  Contributions  to  medicine  and  midwifery"  (1874). 

The  English  have  no  official  and  sworn  midwives,  and  the  onl}-  sub- 
stitute for  this  class  are  the  obstetrical  nurses  educated  in  the  various 
obstetrical  schools. 

Gynsecolog}'  is  usually  associated  in  practice  with  obstetrics  and  the 
diseases  of  children,  but  of  course  the  logic  of  circumstances  leads  certain 
physicians  to  devote  their  principal  attention  to  the  subject  of  diseases 
of  women.     Perhaps  the  foundation  of  the  London  "  Hospital  for  Women'" 


—  1093  — 

in  1842  may  serve  to  mark  the  epoch  when  gynaecology  had  advanced  suffi- 
ciently to  claim  the  position  of  an  independent  specialtj7. 

Among  the  numerous  and  very  eminent  gynaecologists  of  Great 
Britain  we  may  mention  :  Charles  Clay  of  Manchester,  who  performed 
ovariotomy  in  1842  ;  S.  Lane  of  London,  who  operated  in  the  following 
year;  Baker  Brown  (1812-1873);  J.  Henrj-  Bennet  ;  Charles  West; 
Edward  John  Tilt;  Arthur  Wynn  Willliams  (1819-1886);  Sir  Thomas 
Spencer  Wells  (born  1818),  the  leading  ovariotomist  of  the  world,  who 
performed  his  first  operation  in  1857  ;  Protheroe  Smith  (born  1809)  ; 
Evory  Kennedy  of  Dublin  ;  Wm.  Graily  Hewitt ;  Thomas  Keith  of  Edin- 
burgh ;  Lombe  Atthill  of  Dublin ;  Bobert  Greenhalgh  ;  J.  Knowlsley 
Thornton  of  London  ;  the  magical  operator  and  despiser  of  antiseptics, 
Lawson  Tait  of  Birmingham  etc. 

Among  the 

f.  Americans, 

during  the  early  years  of  the  present  century,  the  chair  of  obstetrics 
seems  to  have  been  looked  upon  as  a  rather  obnoxious  but  necessaiy 
appendage  to  the  medical  faculty,  and  the  instruction  in  this  branch  was 
accordingly  assigned  to  the  professor  of  one  or  another  of  the  more 
important  branches,  as  the  circumstances  of  each  faculty  appeared  to 
require.  King's  College,  New  York,  was  organized  originally,  as  we  have 
seen,  with  an  independent  chair  of  midwifery,  but  in  the  College  of  Phil- 
adelphia obstetrical  instruction  was  given  by  Dr.  Shippen,  the  professor 
of  anatomy,  the  Medical  Department  of  Harvard  College  was  organized 
without  any  chair  of  obstetrics,  and  if  obstetrical  instruction  was  imparted 
at  all  in  the  Medical  School  of  Dartmouth  College  it  must  have  been  done 
by  the  omniscient  Nathan  Smith,  who  for  twelve  years  constituted  the 
entire  Faculty  of  that  institution.  In  1825  the  same  Nathan  Smith  was 
Prof,  of  the  Theory  and  Practice  of  Physic,  Surgery  and  Obstetrics  in 
the  Med.  Dept.  of  Yale  College,  and  about  the  same  period  Beuben  D. 
Mussey  was  Prof,  of  Anatom}',  Surgery  and  Obstetrics  in  the  Medical 
School  of  Dartmouth  College.  On  the  death  of  Dr.  Tennent,  the  first  pro- 
fessor of  midwifer}'  in  King's  College,  his  chair  was  taken  by  Dr.  Samuel 
Bard,  whom  we  have  heretofore  had  occasion  to  notice,  and  Dr.  Bard  has 
the  honor  of  being  the  author  of  the  first  work  on  the  subject  of  mid- 
wifery published  in  this  countrj'.  This  was  a  "Compendium  of  the  theory 
and  practice  of  midwifery  etc.",  published  in  1S07  and  sufficiently  popular 
to  attain  a  fifth  edition  b}r  1819.  The  sober  conscientiousness  of  Dr. 
Bard's  obstetrical  teachings,  at  least  in  later  life,  may  be  inferred  from  the 
following  extract : 

''  I  confess,  not  without  severe  regret,  that  towards  the  end  of  thirty  years'  prac- 
tice I  found  much  less  occasion  for  the  use  of  instruments  than  I  did  in  the  beginning; 
and  I  believe  we  may  certainly  conclude  that  the  person  who,  in  proportion  to  the 
•extent  of  his  practice,  meets  with  most  frequent  occasion  for  the  use  of  instruments, 


—  1094  — 

knows  least  of  the  powers  of  nature,  and  that  he  who  boasts  of  his  skill  and  success 
in  their  application  is  a  verjT  dangerous  man." 

On  the  organization  of  the  College  of  Physicians  and  Surgeons  of 
New  York  in  1807  the  department  of  obstetrical  instruction  was  assigned 
to  Dr.  David  Hosack,  who  was  also  Prof,  of  materia  medica  and  botany 
and  lecturer  on  surgery.  In  the  following  year,  however,  the  chair  of 
Obstetrics  and  the  Diseases  of  Women  and  Children  was  assigned  to  Dr. 
William  James  Macneven,  an  Irishman  by  birth  and  an  alumnus  of  the 
University  of  Vienna.  Dr.  Macneven's  tastes  inclined  more  to  chemistry 
than  to  midwifery,  and  accordingly,  on  the  reorganization  of  the  faculty 
and  the  consolidation  of  the  two  medical  schools  of  Columbia  (formerly 
King's)  College  and  the  College  of  Physicians -and  Surgeons  in  1814,  he 
was  assigned  to  the  chair  of  chemistry  and  Dr.  John  C.  Osborn  received 
the  chair  of  obstetrics  and  the  diseases  of  women  and  children.  In  1826 
Dr.  Osborn  was  succeeded  by  Dr.  Edward  Delafield.  who  in  1841  was  in 
turn  succeeded  by  Dr.  Chandler  R.  Oilman.  The  latter  in  1843  organized 
the  first  gynaecological  clinic  of  this  college,  and  edited  in  1845  an  Amer- 
ican edition  of  Maunsell's  "  Dublin  Practice  of  Midwifery'.  In  conjunc- 
tion with  Dr.  Theo.  Tellkampf  he  also  published  in  1847  a  translation 
of  Bischoff  s  "  Periodic  Maturation  and  Discharge  of  Ova  in  the  Mam- 
malia and  the  Human  Female".  On  the  death  of  Dr.  Gilman  in  18b'5  he 
was  succeeded  by  Dr.  T.  Gaillard  Thomas,  of  whom  we  shall  speak  more 
fully  hereafter. 

In  the  Medical  Dept.  of  the  University  of  Pennsylvania,  on  the  death 
of  Dr.  Shippen  in  1808.  the  chair  of  obstetrics  was  separated  from  that  of 
anatomy,  and  in  1810  the  former  was  assigned  to 

Thomas  C.  James  (1766-1835), 

a  pupil  of  John  Hunter,  who  had  for  a  considerable  period  been  a  successful  practi- 
tioner of  obstetrics  in  Philadelphia  and  had  been  influential  in  organizing  a  lying-in 
department  in  the  hospital  of  tne  city  alms-house.  Dr.  James  was  obstetrician  to  the 
Pennsylvania  Hospital  for  many  years  and  edited  American  editions  of  Merriman's 
Synopsis"  and  Burns' s  "  Principles  of  midwifery  ".  From  the  year  1825  failing 
health  compelled  him  to  resign  a  large  part  of  his  duties  as  an  obstetrical  teacher  to 
his  assistant,  and  in  1834  he  resigned  his  position  to  the  famous 

William  Potts  Dewees  (1768-1841), 

"a  man  whose  genius  left  its  impress  upon  American  obstetrics  more  decidedly  than 
that  of  any  other  has  done  before  or  since"  (Thomas).  Upon  Dr.  Dewees  had  fallen 
for  nearly  ten  years  the  responsibility  of  the  greater  part  of  the  obstetrical  teaching 
of  the  University  of  Pennsylvania,  and  bis  decided  opinions  and  vigorous  style  con- 
tributed largely  to  elevate  the  grade  of  obstetrical  practice  in  the  United  States. 
His  "Comprehensive  System  of  Midwifery"  (1824),  which  attained  a  12th  edition, 
"Treatise  on  the  Physical  and  Medical  Treatment  of  Children"  (1825)  and  "Treatise 
on  the  Diseases  of  Females"  (1826),  each  of  which  reached  the  10th  edition,  were  all 
works  of  originality  and  sterling  worth.  Of  his  "Midwifery"  his  successor,  Dr.  Hodge, 
declared  that  "it  takes  a  stand  decidedly  in  advance  of  Denman,  Osborne,  Burns  and 
other  Fnglish  authorities  in  general  use  in   our  country  at  that  period,  and  even  of 


—  1095  — 

Baudelocque  himself  in  throwing  aside  from  his  excellent  system  much  that  was  use- 
less and,  it  may  be  said,  imaginative." 

The  mantle  of  Dewees  fell  upon  the  able  shoulders  of 
Hugh  L.  Hodge  (1796-1873), 
a  native  of  Philadelphia,  pupil  of  Caspar  Wistar  and  an  alumnus  of  the  University 
of  Pennsjdvania.  Dr.  Hodge  was  also  a  man  of  originality  and  independence,  and 
his  teachings  bore  the  stamp  of  his  character.  In  obstetrics  he  inculcated  the  use 
of  the  forceps  as  compressors,  the  induction  of  premature  labor  in  deformities  of 
the  pelvis,  synclitism  of  the  foetal  head,  mechanical  support  in  prevention  of  habitual 
abortion  etc.,  and  in  gynaecology  he  emphasized  the  fact  that  enlargement,  tender- 
ness, congestion  and  hypersecretion  of  the  uterus  by  no  means  necessarily  imply 
"  inflammation ",  but  are  perhaps  most  frequently  due  to  mere  "irritation",  the 
result  of  displacement,  and  are  most  readily  and  surely  relieved  by  restoring  the 
uterus  to  its  normal  position  and  retaining  it  there.  His  mechanical  ingenuity  is 
displayed  in  the  invention  of  the  well-known  double  lever  pessary,  ''  Hodge's  forceps" 
(the  instrument  more  generally  used  than  any  other  in  this  country),  a  compressor 
cranii,  craniotomj-  scissors  and  placental  forceps.  Of  his  pessary  Dr.  Thomas  says 
that  by  its  invention  "  he  accomplished  more  for  mechanical  support  of  the  uterus 
than  an}-  one  has  ever  done  before  or  since  his  time."  — 

A  contemporary  of  both  the  foregoing  pl^sicians  was  the  equally  eminent 

Charles  Delucena  Meigs  (1792-1869), 
a  native  of  Bermuda  and  Professor  of  Obstetrics  in  Jefferson  College,  Philadelphia, 
from  1840  to  1862.  He  was  the  first  to  direct  attention  to  cardiac  thrombosis  as  the 
cause  of  sudden  death  in  childbed  (1840),  and  while  quaint  and  antique  in  style,  was 
unquestionably  a  forcible  and  successful  teacher.  His  chief  works  were:  "Woman, 
her  Diseases  and  Remedies"  (1847)-;  "Obstetrics,  the  Science  and  Art"  (1840); 
"A  Treatise  on  Acute  and  Chronic  Diseases  of  the  Neck  of  the  Uterus"  (1850). 
Both  Dewees  and  Meigs  inculcated  the  non-contagious  character  of  puerperal  fever, 
a  doctrine  which  was  strongly  controverted  by  the  famous  Oliver  "Wendell  Holmes 
in  1843.  —  Another  obstetrical  contemporary  of  all  the  three  physicians  just  men- 
tioned was 

Henry  Miller  (1800-1874), 

Professor  of  Obstetrics  and  the  Diseases  of  Women  in  the  University  of  Louisville 
from  its  organization  in  1835,  and  an  influential  writer  and  teacher  for  many  years. 
To  him  we  owe  the  method  of  applying  fluids  to  the  uterine  cavity  by  means  of 
cotton-wrapped  probes,  and  he  was  the  first  physician  west  of  the  Alleghany 
mountains  to  employ  anaesthesia  in  midwifery,  and  one  of  the  first  to  use  the 
speculum  uteri  (Thomas).  His  chief  works  were:  "A  Theoretical  and  Practical 
Treatise  on  Human  Parturition"  (1849),  and  "The  Principles  and  Practice  of 
Obstetrics*'  (1858). 

Another  popular  teacher  and  systematic  writer  on  obstetrics  and  the  diseases  of 
women  and  children  was 

Gunning  S.  Bedford  (1806-1870)  of  Baltimore, 

Professor  of  Obstetrics  in  the  Medical  Department  of  the  New  York  University  from 
about  1840  to  1862,  and  the  founder  of  the  first  gynaecological  clinic  established  in 
this  country  (1841).  Dr.  Bedford  was  a  most  enthusiastic  and  successful  teacher, 
and  his  works  are  still  looked  upon  as  standard  in  their  department  of  medicine. 
He  published  in  1855  "  Clinical  Lectures  on  the  Diseases  of  Women  and  Children", 
and  in  1861,  "The  Principles  and  Practice  of  Obstetrics". 


—  1006  — 

A  distinguished  obstetrician  of  Boston  in  the  first  half  of  the  present  century  was 
Walter  Channing  (1786-1876), 
an  alumnus  of  Edinburgh  and  the  first  Professor  of  Obstetrics  and  Medical  Jurisprud- 
ence (1815-1854)  in  Harvard  College.  Though  author  of  no  systematic  work  in  his 
department,  he  was  a  highly  esteemed  teacher  and  writer,  and  is  particularly  eminent 
as  one  of  the  first  (he  was  preceded  only  by  Dr.  N.  C.  Keep  of  Boston)  in  the  United 
States  to  employ,  and  the  first  to  advocate  in  writing  the  use  of,  anaesthesia  in  mid- 
wifery. His  "Treatise  on  Etherization  in  Child-birth,  illustrated  by  581  cases", 
Boston,  1849.  was  a  convincing  argument  as  to  the  advantages  of  the  new  method. 

The  genial  and  erudite 

John  Wakefield  Francis  (1780-1861)  of  New  York, 
•a  pupil  and  subsequently  the  partner  of  Dr.  Hosack,  with  whom  he  edited  (1810- 
1814)  the  "American  Medical  and  Philosophical  Register",  also  deserves  mention  in 
this  place.  He  held  the  chair  of  obstetrics  in  the  College  of  Physicians  and  Surgeons, 
New  York,  in  1819,  and  subsequently  (1826-1830)  in  Rutgers  Medical  College,  but 
was  more  distinguished  by  his  devotion  to  general  literature,  his  eloquence  and  his 
erudition,  than  as  an  obstetrician.  In  the  latter  capacity,  however,  he  edited  an 
edition  of  Denman's  Midwifery  in  1821,  which  he  supplied  with  copious  and  valuable 
annotations. 

Among  the  more  recent  systematic  writers  on  obstetrics  we  may 
notice  :  William  H.  Byford,  Prof,  of  Obstetrics  etc.  in  the  Chicago  Medical 
College  (A  Treatise  on  the  Theory  and  Practice  of  Obstetrics,  1870)  ; 
William  T.  Lusk,  Prof,  of  Obstetrics  etc.,  in  Bellevue  Hospital  Medical 
College,  New  York  (The  Science  and  Art  of  Midwifery,  1882);  Theophilus 
Parvin,  Prof,  of  Obstetrics  etc.  in  Jefferson  Medical  College,  Philadelphia 
(The  Science  and  Art  of  Obstetrics,  1886),  and  the  various  contributors 
to  the  American  System  of  Obstetrics  edited  by  Dr.  B.  C.  Hirst,  Phila- 
delphia, 1888. 

Obstetric  manuals  of  more  or  less  completeness  have  been  published 
by  :  Valentine  Seaman  (The  midwife's  monitor  and  mother's  mirror,  New 
York,  1800);  Joseph  Warrington  (The  obstetric  catechism,  1842):  Thomas 
F.  Cock  (A  manual  of  obstetrics,  New  York,  1853),  and  the  more  recent 
works  of  A.  F.  A.  King  of  Washington  and  Henry  G.  Landis  of  Columbus, 
Ohio. 

Among  our  almost  innumerable  recent  writers  on  special  obstetric 
themes  we  have  space  to  mention  only  George  T.  Elliot  (died  1871  ;  The 
Obstetric  Clinic,  1868)  ;  Fordyce  Barker  (The  Puerperal  Diseases,  1874) 
and  John  S.  Parry  (Extra-uterine  Pregnancy  etc.,  1876). 

In  Gynaecology,  a  department  in  which  American  medicine  has  won, 
perhaps,  its  most  numerous  and  most  enduring  laurels,  mention  has  been 
already  made  of  the  introduction  of  ovariotomy  by  Ephraim  McDowell  in 
1809.  He  was  followed  by  Nathan  Smith  in  1821,  and  before  1850  no  less 
than  36  ovariotomies  had  been  performed  by  18  operators,  with  a  record 
of  21  recoveries  and  15  deaths  (Thomas).  Most  of  the  obstetricians 
whose  names  have  been  mentioned  above  also  devoted  attention  to  the 
diseases   of   women,  but    the    appearance   of  gynaecology    as   a    distinct 


—  1097  — 

specialty  ma)-  be  said  to  date  from  the  invention  by  Dr.  J.  Marion  Sims 
of  his  well-known  speculum1  in  1852,  and  his  demonstration  of  the  proper 
method  for  the  treatment  of  vesico-vaginal  fistulae.  Dr.  Sims  settled  in 
New  York  in  1853  and,  niainby  through  his  influence,  there  was  established 
in  that  cit}r  in  1855  a  temporary  Woman's  Hospital,  which  speedily 
developed  into  the  magnificent  institution  of  that  name  chartered  in  1858 
and  opened  in  1866.  The  path  thus  opened  by  Dr.  Sims  was  enlarged  and 
improved  by  T.  Addis  Emmet  and  T.  Gaillard  Thomas  of  New  York  and 
Horatio  R.  Storer  of  Boston,  and  to  these  four  physicians  ma}r  be  justlj- 
ascribed  the  foundation  of  American  gynaecology  as  a  special  department 
of  practice. 

Of  the  contributions  of  American  physicians  to  this  department  of 
medicine  it  would  require  a  distinct  volume  to  constitute  a  complete 
record,  and  we  must  content  ourselves  with  merel}"  presenting  the  names 
of  the  more  eminent  of  its  representatives  :  John  Light  Atlee  (1799-1855) 
of  Lancaster,  Penn.,  and  his  brother  Washington  Light  Atlee  (1808-1878) 
of  Philadelphia,  both  eminent  pioneers  in  the  operation  of  ovariotom}-, 
the  former  of  whom  performed  his  first  operation  in  1843  and  the  latter 
in  1844  ;  Alexander  Dunlap  of  Springfield,  Ohio,  who  also  operated  in 
1843  ;  Edmund  Randolph  Peaslee  (1814-1878)  of  New  York,  whose  first 
ovariotomy  was  performed  in  1850  (Human  Histology,  1857  ;  Ovarian 
Tumours ;  their  Pathology,  Diagnosis  and  Treatment,  especially  by 
Ovariotomy,  1872);  Gilman  Kimball  of  Lowell,  Mass.;  Charles  A.  Budd 
(1832-1877)  of  New  York;  J.  C.  Nott  of  Mobile;  W.  H.  Byford  of 
Chicago  (The  Medical  and  Surgical  Treatment  of  Women,  1865);  Horatio 
R.  Storer  of  Boston ;  T.  Gaillard  Thomas  of  New  York  (A  Practical 
Treatise  upon  the  Diseases  of  Women,  1868);  Thomas  Addis  Emmet  of 
New  York  (The  Principles  and  Practice  of  Gynaecology,  1879)  ;  Nathan 
Bozeman  of  New  York  ;  Robert  Batty  of  Atlanta,  Ga.  (extirpation  of  the 
ovaries,  1872);  James  T.  White  of  Buffalo,  N.  Y.;  Alex.  J.  C.  Skene  of 
Brooklyn,  N.  Y.  (A  Text- Book  on  the  Diseases  of  Women,  1889);  Emil 
Noeggerath  of  New  York  (latent  gonorrhoea  in  females,  1872) ;  E.  N. 
Chapman  of  Brooklyn,  N.  Y.  (Hysterology,  1872) ;  William  Goodell  of 
Philadelphia  ;  D.  Ha}'es  Agnew  of  Philadelphia  (Laceration  of  the  per- 
ineum, 1873)  ;  R,  A.  F.  Penrose  of  Philadelphia  ;  the  venerable  Isaac  E. 
Taylor  of  New  York  ;  Edward  W.  Jenks  of  Detroit,  Michigan  ;  Samuel 
€.  Busey  of  Washington  ;  AVilliam  M.  Polk  of  New  York  ;  Ely  Van  de 
Warker  of  Syracuse,  N.  Y.;  H.  P.  C.  Wilson  of  Baltimore  ;  W.  Gill  Wylie, 
Montrose  A.  Pallen  and  Joseph  E.  Janvrin,  all  of  New  York,  etc. 

1.  According  to  Ali  Cohen,  the  Talmudists  were  acquainted  with  a  speculum 
vagina?,  conical  in  shape  and  made  of  lead  with  inverted  edges.  It  was  called 
the  "sipherophot",  and  was  undoubtedly  of  late  Greek  origin.  A  rod  carrying.a 
piece  of  charpie  was  introduced  through  it  by  the  women,  with  the  object  of 
determining  whether  haemorrhages  proceeded  from  the  uterus  or  the  vagina  — 
a  question  of  sexual  ritual.     (Baas). 


—  1098  — 

The  New  York  Obstetrical  Society  was  founded  in  1863,  the  Boston 
Gynaecological  Societ}r  in  1869  and  the  American  Gy narcological  Societ}' 
in  1876.     Among  the 

g.  Dutch 

Adriaan  van  Solingen  (1759-1830)  excited  much  discussion  by  his  maxim 
that  in  labor  "the  smallest  diameter  of  the  head  always  occupies  the  pelvic 
diameter",  while  Gerardus  Vrolik  (1775-1859)  rendered  eminent  service 
to  our  knowledge  of  the  pelvis  and  its  measurements.  Wellenbergh  ; 
Baarth  ;  Hendrik  Jan  Broers  (1815-1876)  in  Utrecht;  Joachim  L. 
Kymmel  (history  of  the  forceps);  Dr.  G.  Salomon  (1774-1864)  of  Konigs- 
berg,  who  emigrated  to  Holland  in  1797  ;  A.  H:  Schoemaker  (1834-1885) 
in  Borne.  (Overyssel);  Jacob  Baart  de  la  Faille  (born  1822)  in  Groningen  ; 
Tjalling  Halbertsma  in  Utrecht ;  Abraham  E.  Simon  Thomas  in  Leyden  ; 
L.  C.  van  Goudoever  in  Utrecht  and  Leopold  Lehmann  in  Amsterdam, 
have  all  distinguished  themselves  as  obstetrical  teachers.  —  Among  the 

h.  Belgians 

Jean  Baptiste  Van  Henvel  (1802-1 883)  of  Brussels  was  widely  known 
through  his  pelvimeter  and  his  forceps-saw,  and  recently  Edouard  Her- 
vieux1 "  of  Paris  has  acquired  considerable  distinction  (Traite  clinique  et 
pratique  des  maladies  puerpe>ales,  suite  de  couches,  Paris,  1870).  — 
Among  the 

i.  Norwegians 

the  following  physicians  have  rendered  themselves  prominent  as  writers 
on  midwifery  and  professors  of  this  branch  in  the  University  of  Chris- 
tiania,  founded  in  1811  :  Magnus  Andreas  Thulstrup  (1769-1844),  also  a 
surgeon,  as  most  obstetricians  of  that  time  were  (and  are  still)  ;  his  suc- 
cessor, tolerably  well  known  also  in  Germany,  Frans  Christian  Faye  (born 
1806),  a  writer  on  midwifery  and  the  diseases  of  women  and  children,  and 
E.  Schoenberg,  still  an  active  teacher  of  this  branch.  —  In 

k.  Denmark 

the  Saxtorphs,  father  and  son,  were  active  and  distinguished  obstetricians. 
The  following  physicians  of  more  recent  date  likewise  deserve  mention  : 
A.  S.  Stadtfeldt,  Emmerick  Ingerslev  and  Frantz  J.  A.  C.  Howitz  (a  gynae- 
cologist and  active  ovariotomist),  all  in  Copenhagen.  —  In 

1.  Finland 

Joseph  Adam  Joakim  Pippingskold,  Prof,  of  Obstetrics  and  Paediatrics  in 
the  University  of  Helsingfors,  is  an  eminent  teacher,  while  in 

1.  As  M.  Hervieux  is  said  to  have  been  born  in  Louviers  (Euie)  and  is  physician  to 
the  Maternite  in  Paris,  I  do  not  know  why  the  author  classes  him  among  the 
Belgians.     (H.) 


—  1099  — 

m.  Sweden 

Frederik  August  Cederschioeld,  son  of  Gustaf  Cederschioeld  (1782-1848), 
is  an  active  teacher  in  Stockholm,  and  in 

D.  Greece 

Miltiades  Welizelos  (died  1887)  was  an  eminent  obstetrician  and  professor 
in  Athens.  He  was  educated  in  Germany,  chiefly  in  Berlin,  and  even 
attained  the  position  of  a  Minister,  doubtless  the  first  obstetrician  who 
ever  won  such  advancement. 


On  the  whole,  as  regards  surgery  and  midwifery  even  at  the  present 
da}7,  the  remarks  of  Sprengel  hold  good  :  "  While  the  physicians  of  the 
most  ancient,  as  well  as  the  most  recent  times  have  so  gravely  miscon- 
ceived their  art  as  to  seek  to  raise  it  to  the  dignity  of  a  science  (an  effort 
utterly  opposed  to  its  very  nature),  true  surgeons,  on  the  contrary,  have 
never  transgressed  the  limits  of  their  knowledge  and  their  capabilities. 
While  the  sons  of  iEsculapius,  to  whom  the  Muses  have  never  been  very 
propitious,  have  ever  made  themselves  contemptible  by  a  fruitless  adher- 
ence to  the  philosophical  schools  of  their  day,  we  never  observe  in  sur- 
gery this  barren  struggle.  While  physicians  have  always  endeavored  to 
conceal  their  want  of  clear  ideas  b\T  a  sill}-  display  of  new  and  pompous, 
foreign  and  incomprehensible  words,  so  in  the  writings  of  the  great  sur- 
geons are  to  be  found  rather  simplicity  and  clearness,  definiteness  and 
dignit}\  Hence  it  has  resulted  that  surgery  has  never  gone  backwards. 
and  that  after  making  some  slight  advances  it  has  never  lapsed  again  into 
the  ancient  barbarity.  .  The  quiescence  which  it  experienced  during  the 
Middle  Ages  is  readily  explicable,  but  since  that  period  it  has  been  held 
back  only  by  the  pressure  which  it  has  suffered  from  the  arrogance  of  the 
physicians."  The  last  statement  is  no  longer  true,  but  the  following 
remark  is  commended  to  the  reflection  of  every  earnest  reader  :  "  In  fact 
my  veneration  for  surgical  art  ....  has  become  greater  and  purer,  the 
more  depressing  the  history  of  medicine  is  to  me  and  to  every  friend  of 
the  truth."  Would  that  medicine  too  might  attain  simplicity  and  clear- 
ness, definiteness  and  dignity  in  its  writings  ! 


—  1100  — 

Particular^'  in  reading  the  history  of  medicine  every  thoughtful 
reader  must  hope  that  the  fatal  inclination  to  philosophical  s}'stems  and 
the  dogmas  of  the  day,  so  manifest  in  medical  art,  may  finall}7  cease;  for 
it  has  been  proven  by  centuries  of  experience  that  neither  one-sided 
idealistic,  nor  yet  one-sided  materialistic  and  mechanical  theories,  can  be 
of  permanent  advantage  to  it.  On  the  contrar}',  it  is  manifest  that  med- 
icine has  always  advanced  only  so  far  as  it  rendered  both  of  these  sys- 
tems useful,  and  while  it  followed  the  only  correct  path  —  the  path  of 
thoughtful  experience. 


FINIS. 


INDEX  OF  NAMES.1 


A. 

Page. 

Aaskow,  Urban  B.  (1742-1806)  1076 
Abaris  (b.  c.  696)  .         .  62 

Abba  Aricha  ...  35 

Abd  el  Letif  (1162-1231)  .     233 

Abd-er- Rahman  (about  1169)  234 
Abelard,  Pierre  (1079-1142)  .  279 
Abella  (11th  century)  .  .  264 
Abenguefit  (Ebn-Wafid),  (a.  d. 

997-1075)  .         .         .227 

Abercrombie,  J.  (1780-1844)  909,  922 
Abernethy,  John  (1764-1831) 

670,  702,  738 
Abildgaard,  P.  C.  (1740-1801)       718 
Abimeron  vid.  Avenzoar. 
AbuBekrbenel  Bedr  (died  1290)  235 
Abulcasem  ( Alzaharavius,  Albu- 

casis,  a.  D.  936-1013)  .  231 
Abul  Salt-Omaja  (1068-1 1 34)  236 
Acerbi,  Enrico  (1785-1827)  .  870 
Acesias  ''before  B  c.  400)  .  114 
Achard,  C.  (1753-1821 )  726  n.  1 

Achenwall,  Gottfr.  (1719-1772)  712 
Achillini.  Alexander  (1463-1525)  297 
Ackermann,  Jac.  Fidelis  (1765- 

1815)  .  .  633,657,883 
Ackermann,  Joh.  Chr.  Gottlieb 

(1756-1801)  .  .  600,  659 
Ackley,  Horace  A.  (1815-1859)  1054 
Acoluthusof  Breslau  (about  1693)  517 
Acrel,  Joh.  Gustav  (1741-1801)  679 
Af  Acrel,  Olof  (1717-1806) 

678,  688,  781 
Acron  of  Agriijentum  (5th  cent. 

b.  c.)  .         .         .  90 

Acton,  William  (1813-1875)  .  922 
Actuarius,  J.  (about  a.  d.  1275)  211 
Acumenes  .         .         .  115 

Adair,  James  M.  (about  1784)     720 

Adala 258 

Adalberon  ('a.  d.  984)  .         258 

Adamantius  of  Alexandria  (about 

a.  n.  350)  .  .  .  .186 
Adami,  G.  Paul  (1739-1795)  .  718 
Adams,  George  (1750-1795)  .  677 
Adams,  John  (1806-1877)      .       1048 


Page. 

Adams,  Joseph  (1756-1818)  .  702 
Adams,  Robert  (about  1857)  912 

Adams,  Samuel  (1738-1828)  .  818 
Addington,  Antony  (about  1753)  656 
Addison,  Thomas  (1793-1860)  916 
Adelmann,  G.  F.  B.  (1811-1888)  1077 
Adelon,  N.  P.  (1780-1852)  .  901 
Adlersfliigel,  G.   S.  Winter  von 

(about  1668)  .  .  .543 
^Egidius  Corboliensis  (ab.  1170)  263 
.Elius  Promotus  (about  a.  d.  40)     145 

.Fhnilius 191 

^Enesidemus  (about  b.  c.  40)  127 
Aepli,  Joh.  M.  (1744-1813)  .  685 
.Eschrionof  Pergamus  (a.d.150)  130 
.Esculapius  (b.  c.  1250  ?)  .  83-84 
Aetius  of  Amida   (about  a.  d. 

502-575)  .         .         201-202 

Agardh,  Karl  Ad.  (1785-1859)  845 
Agastya  .....  40 
Agatharchides  (b.  c.  170)  .  125 
Agathinus  of  Sparta  (about  a.  d. 

90) 165 

Agathotychus  .  .  .  191 
Agnew,  Corn.  R.  (1831-1888)  930 
Agnew,  D.  Hayes  .  .  1055,  1097 
Agnodice  (b.  c.  300)  .         .121 

Agricola,    Georg    (Ackermann, 

1494-1555)  .         .         .370 

Agricola,  Rudolph  (1442-1485)  289 
Agrippa  (about  a.  d.  100  ?)  .  130 
Asjippa  von  Nettesheim  (1486- 

1535)  .         .         .     362-363 

Ahrun  (7th  century)  .  208,22s 
Aikin,  John  (1747-1822)  .     658 

Ainzarbi,  Ebn  el  (d.  1153)  .  234 
Aitken,  John  (d.  1790)  .  676,  686 
Akakia,  Martin  (1539-1588)  .  421 
Akenside,  M.  (1721-1770)  654,  762 
Akerlv,  Samuel  (about  1831)  .  1014 
Alanson,  Edward  (1747-1823)  675 
A  lard  (about  1807)  .  .  .904 
Alavmo,  Marc.  A.  (1590-1662)  550 
Albanese,  Enrico  (born  1834)  1041 
Albers,  J.  F.  H.  (1806-1867)  965 
Albert,  Ed.  (born  1841)     .         .1072 


Where  differences  are  observed  between  the  text  and  the  index,  the  data  of  the 
latter  are  to  be  preferred. 

(1101) 


110:2  — 


Page,  i  Page. 

Alberti,  M.  (1682-1757)   611,  661,  706  !  Alpino,  Prosper  (1553-1617)   368,398 
Alberti,    Salomon    (1540-1600)     429    Althaus,  Julius  (born  1 83 1 )    918,922 


Albertini,  Franc.  (1661-1738)  655 
Albertus  Magnus  (1193-1280)  282,310 
Albicus,  Sigmund  (b.  1347)  .  288 
Albinus.  B.  (1653-1721)  542,  556 
Albinus,    Bernhard    Siegfried 

(Weiss  — 1697-1770)  .     697 

Albinus,  F.  B.  (1715-1778)  .  697 
Albrecht,  E.  (1823-1883)  .  968  n.  1 
Albucasis  (Alzaharavius,  Abul- 

casem,A.  d.  936-1013)  .  231 
Alcadinus  (about  a.  d.  1200)  263 
Alcauamusali  (about  1258)  .  234 
Alcazar,  Andreas  (about  1575)  4i6 
Alcinet  (18tb  century)  .  .  C53 
Alcmaeon  of  Crotona  (b.  c.  500)  89 
Alcon  (about  a.  D.  50)  .  .151 
Alcuin,  Albin  (736-804)  .  256  n.  1 
Alcuindus    (el  Kiridi,    813-873 


417  i 
370, 
596  | 
1044  | 
9631 


A.  D.)  ... 

Aldarete,  Prof,  (about  1550) 

Aldrovandi,  U.  (1522-1605) 

d'Alernbert  (1717-1783) 

Alexander 

Alexander,  W.  (about  1768)    621 

Alexander  of  Aphrodisias  (about 

a.  d.  200)    .         .         .     177,  204   Amoretti,  G.  A. 

Alexander  of  Laodicea  (b.  c.  50)     139  j  Amussat,  J.  Z. 

Alexander  Philaletbes  (a.  d.  20)     125   Amwald,  Georg 

Alexander  of  Tralles  (a.  d.  525- 

605)  .         .         .         .     202-204 

Alexandrinus  von  Neustain,  Ju- 
lius (1506-1590) 

Alexanor        .... 

Alexippus    (4th  century  b.   c.) 

Algazirah  (el  Jezzar,  died  a.  d. 
1004)  .... 

Alghisi,  Tornmaso  (1669-1713) 

Alhervi  (10th  centuiy) 

All  Abbas  (died  994)      . 

Ali  ben  Isa  (11th  century) 

d'Alibert,  Jean  L.  (1766-1837) 

Alison,  S.  Scott  (1813-1877) 

915,  1016,  1024 

Alison.W.  Pultenev  (1790-1859)     915 

Allan,  Robert  (1778-1826) 

Allen,   Benjamin    (about   1700) 

Allen,  Peter  (1826-1874) 

Allesandrini,  Federico    . 

Almeida,  Feliciano  d'  (d.  1726) 

Almeloveen,  Th.  J.  (1657-1712) 

566  n.  4 

Alphanus,  Franciscus         ,         .     264 


373 
h3 

95 

228 
512 
228 
228 
234 
901 


909 
721 
918 
1041 
515 


Althof,Lud\vigChr.(  1758-1832)     719 

Altschul 877 

Alvarenga,  P.  F.  Da  Costa  (died 

1883)  .         .         .         .1023 

Amabile.  Luigi       .         .         .104 
Amand,  Pierre  (died  1720)         .     524 
A  mar,  Joseph  (about  1774)    653,  7i  i 
Amatus  Lusitanus  (1511-1562) 

399,  408,  417 
Amboise,  Adrien  (i  6th  century)  -102 
Amboise,  Jacques  (1558-1606)  402 
Ames,  Nath.  (1708-1764)  801  n.  1 
Amesbury,  Joseph  (1795-?)  .  1046 
Amici,  Giov.  Batt.  (1784-1863)  b53 
Amin-ed-Danla-ebn-el-Talmid 

(1070-1164) 
Amirillius.  Samuel  (?)  . 
Amman,  J. 

Amman,  J.  C.  (1669-1730) 
Ammann,  P.  (1634-1691) 
Von  Amnion.  F.  A.  (1799-1861)  1073 
Ammonius  of  Alexandria  (about 

b.  c.  230)    .... 
Ammonius   Saccas    (about  A.  d. 

175-250)    .... 

(about  1816)    . 

(1796-1856)     . 

(about  1590) 

Amyntas    of    Rhodes      (about 

b.c.  50)  .  .  .  .  126 
Anaeharsis  (b.  c.  592)  .  .  62 
A  naxagoras  (b.  c.  500-428)    .  88 

Anaximander  of  Miletus    (born 

b.c.  611)  ....  88 
Ancell,  Henry  (1802-1863)  .  912 
Andersen,  Carl  Sam.  (died  1777)  695 
Anderson,  McCall  .  .  .919 
Andral,  M.  G.  (1797-1876)  895,  1013 
Andreas  Carystus  (b.c.  210)  .  125 
Andreas  Chrysaris  (a.  d.  140)  181 
Andrea?,  Tobias  (1638-1685)  566  n.  4 
Andrea?,  Valentin  (1586-1654)  .  393 
St.  Andre,   Francois  de  •  (about 

1677)       .         .  .496 

Andre',  Nicolas  (about  1756)  .  655 
Andree,  John  (about  1779)     .  656 

Andriolli,  Mich.  A.  (1672-1713)  496 
Androcydes  (4th  century  b.  c.)  95 
Andromachus    the    Elder  (a.  d. 

60)  ...  143,158 

Andromachus      the       Younger 

(about  a.  d.  54)  .         .         .159 


.  236 
781 

.  1084 
517  n.  1 
517,  542 


124 

181 

871 

1036 

393 


—  1103  — 


Anel,  Dominique  (about  1714)  .  6( 
Anger,  Benjamin  .  .        10-: 

Anguillara,  Luigi  (about  1561)  3( 
Annandale,  Thomas  (born  1838)  10- 
Anstie,  Francis  Ed.  (1833-187-1)  9. 
Anthimus  (5th  century)  .  2- 
Anthony,  Francis  (1550-1623)  4- 
Anti  pater.       .         .         .         .  •  45 1 

Antistius  (b.  c.  44)    .         .         .147: 
Antommarchi,  Franc,   (d.  1838)     699  j 
Antonius  Musa  (a.  d.  10)      .  139,  1471 
Antyllus  (3d  century)         .         .177 
Apemantes  (about  b.  c.  250)   .  126 

Apinus,  Joh.  L.  (168-1-1730)  615 
Apollinaris.  Quirin.  (about  1549)  421 
Apollonides  of  Cos         .         .  93 

Apollonides  of  Cyprus  (a.d.  1 00)  142 
Apollonius  Archistrator  of  Per- 

gamus  (about  a.  d.  80)       .     159 
Apollonius    Biblas    (b.  c.  230- 

200)        ....  128 

Apollonius  of  Cittium  (B.  c.  50)  128 
Apollonius  of  Cyprus  .  .  145 
Apollonius   the    Empiric  (b.   c. 

230) 128 

Apollonius    of    Memphis    (b.  c. 

250)    .  .         .         .  125 

Apollonius  Mys  (b.  c.  10)  .  .  125 
Apollonius    Stratonieus    (about 

b.  c.  240)  .         .         .125 

Apollonius  Ther  (about  b.  c.  198)  125 
Apollonius  of  Tvana  (a.  d.  2-98)  180 
Apollophanes  (i$.  c.  200)  .  .126 
Appun,  Lud.  Ad.  (18th  century)  685 
Apsyrtus  (4th  century)  .  .  191 
Aquinas,  Thomas  (1225orl227- 

1274)       .         .         .          279,  282 
Aran,  Francois  A.    (1817-1861) 

899,  907,  1013 
Aranzi,  Giul.  C.  (1530-1589)    370,  428 
Arbuthnot,  John  (1658-1735)    .     714 
jArce,    Francesco    de    (Arcseus, 

Arceo,  1493-1573)      .         .416 
Archagathus  (b.  c.  219)  .         .  134 

Archigenes  of  Apamea  (a.  d.  48- 

117) 165 

Arculanus,  Johannes  (Giovanni 

d'Arcoli,  died  1484)  294,  301 

Ardern,  John  (about  1370)       269,  306 

Arduino,  Sante  (1430)         .         .     309 

Arejuala,  Don  Juan  Manuel  de 

.  '  (about  1803)       .         .        .653 


Aretgeus   of  Cappadocia  (about 

a.  d.  30-90)  .  .  .166 
Aretius,  Benedictus  (about  1572)  396 
Argelata,  Petrus  ab  (died  1423;  301 
Argenterio,   Griov.    (1513-1572) 

376,  397,  398 
Aristogenes  (4th  century  b.  c. )  115 
Ariston  (5-4  centurv  b.  c.)  .  .  115 
Aristotle' (b.  c.  3S4-321)  .  116,  118 
Aristoxenes  (a.  d.  79)  .  .  125 
Arlt,  Ferdinand  (1812-1887)  .  968 
Armstrong,  George  (died  1781) 

651,  655 
Armstrong,   John    (1709-1779) 

728.  762,  n.  1,  908 
Arnaud,  George  (de  Rousil,  died 

1774)  .  .         ...     675 

Arnemann,  Justus   (1763-1807) 

671,  673 

Arneth,  F.  H 1084 

Arnisiius,  H.    (died  1636)       566,  n.  4 

Arnold 595 

Arnold,  Thos.  (about  1782)  713,  920 
Arnold  of  Villanova  (1235-1312)  268 
Arnott,  Neil  (1788-1874)  .  .  1046 
Arragos,  Guillaume  (1513-1610)  396 
Arsinoe  (b.  c.  275)  .  .  .129 
Artemidorus  (about  b.  c.  250)  126 
Artemisia  (4th  century  b.  c.)  .  95 
Artorius,  Marcus  (about  b.  c.  31)  139 
Asclepiades  of  Prusa  (b.  c.  1 28- 

56)  .  .  .  135-139,  147 
Asclepiades  Pharmacion  (about 

a.  d.  100)  .  .  .  .159 
Asclepiodotus  (5th  century)  .  188 
Asdrubaii,  F.  (1756-1832)  683, 1087 
Aselli,  Caspar  (1581-ir>26)  .  533 
Ash,  John  (about  1788)  .  721 
Ashburner,  John  (about  1834)  632 
Ashurst,  John  Jr.  .  .  .  1055 
Ashwell,  Sam.  (about  1828)  915,  1090 
Aspasia  (5th  century  b.  c.)  .  95 
Aspinwall,  William  (1743-1823)  802 
Assalini,  Paolo  (1759-1840) 

667,  682,  1087 
Astmann,  Chr.  S.  (about  1723)  748 
Astruc,  Jean  (1684-1766) 

496,  656,  663,  680 
Athenaeus  of  Attalia  (about  A.  D. 

69) 164 

Athenion  (about  b.  c.  250)  .  126 
Atlee,  John  L.  (1799-1855)  .  1097 
Atlee,  Wash.  L.  (1808-1878)  .  1097 
A  trey  a 40 


—  1104  — 


Pag». 

Attalus  (a.  d.  195)     .         .         .  144 

Attalus  III.  (b.  c.  138-133)    .  128 

Atthill,  Lombe           .         .        .  1093 

Attwood,  Dr.  (about  17(52)     .  818 

Aubery,  Claude  (died  1596)       .  395 

Auenbrugger,Leop.  (1722-1809)  642 

Auerbach            .         .                  .  977 

Aufidius,  Titus  (about  b.  c.  44)  139 

Augenius,  Thomas  (1527-1603)  376 

Augustin,  F.  L.  (1776-1854)     .  661 

Auspitz,  Heinrich  (1835-1886)  959 

Autenrieth,  J.H.F.  (1772-1835)  936 

Auvity,  Jean  Pierre  (died  1865)  901 

Auzebi,  Pierre  (1736-1791)  .  666 
Auzias-Turenne,  Jos.  Alexandre 

(1812-187U)        .         .         .902 

Avenpas  (died  1138)  .  .  234 
Avenzoar  (Ebn  Zohr,  Abimeron, 

1113-1162)  .         .         .231 

Avernezel  (Abraham  Ben  Meir, 

1093-1168)  .  .  .  234 
Averroes    (Ebn    Roschd,    died 

a.  d.  1 1 98)  .  .  .  232 
Avieenna  (Ebn  Sina,  A.  D.  980- 

1037)            .         .         .         .  229 

Ayala,  Hieron.  de  (about  1672)  515 

Axenfeld,  Auguste  (1825-1&76)  9o3 

B. 

Baader,  Franz  X.  v.  (1765-1841)  937 
Baarth,  .         .         .         .1098 

Baas,   Johann    Hermann   (born 

1838)  .  1018  n.  2,  1031  n.  1 
Babington,  B.  Guy  (1794-1866) 

915,  918,  1021 
Babington,  G.  G.  (1795-1856)      1045 

1 
1 
1 


1: 


Baccelli,  Guido  (born  1832) 
Bacchius  (b.  c.  264) 
Baccius,  Andreas  (about  1571) 
Bache,  Franklin  (1792-1864)     . 
Bachtishua,    family   of    (a.    d. 

750-1050)  .  .  225-226 
Back,  Jac.  de  (about  1649)  .  531 
Bacon,  R.  (1214-1292  or  1298)  283 
Bader,  K.  Fr.  (about  1794) 
Badschdsch,     Ebn     (Avempas, 

A ven  Pas,  died  1138) 
Baer,  K.  E.  v.  (1792-1876)     694 
Baglivi,  Giorgio  (1668-1707)     . 
Baier,   Ferd.    Jac.    (1707-1898) 
Bailey,  Walter  (1529-1592) 
Baillie,  M.  (1761-1823)  654,  701,  910 
Baillou,    Guillaume    (Ballonius, 

1536-1614)  .         .         .409 


923 


655 

234 
935 
499 
727 
406 


Page. 

Bailly,  C.  M.  (about  1825)  .  889 
Bain,  Christof  (about  1540)  .  404 
Baker,  G.  (about  1599)  .  413,  417 
Baker,  Sir  George  (1722-1809)  651 
Baker,  Henry  (died  1774)  654,  677 
Bakody,  Prof.  .  .  .  .877 
Balassa,  Joh.  von  (1812-1869)  1072 
Baldinger,  E.  G.  (1738-1804)  600,  660 
Balfour,  Francis  (about  1767)  678 
Balfour,  William  George  .  916 
Ballard,  Edward  (b.  1818)  916,  921 
Ballhorn,GeorgFr.  (about  1801)  710 
Balmis,  Franc.  X.  (about  1794)  656 
Bamberger,  Heinrich.  v.  (1822- 

1888)  .  .  .  958,  966 
Bang,  Fr.  Ludwig  (1747-1820)  649 
Bang,  James  (1737-1808)  .     688 

Banister,  J.  (about  1575)  417, 430  n. 
Banister,  Richard  (about  1 622)  520 
Banks,  John  T.  (born  1816)  .  916 
Banks,  Sir  Joseph  (1743-1820)  844 
Banzer,  Marcus  (about  1640)  .  518 
Bapst,  Michael  (d.  1603)  .  393 
Baratta,  Giovanni  (about  1820)  1041 
Barba,  Pietro  (about  1642)  544  n.2 
Barbatus,  Hieron.  (about  1676)  536 
Bar  bault,  Antoine  F.  (d.  1784)  700 
Barbeirac,  Charles  (1629-1699)  496 
Barbette,  Paul  (about  1658)  494,  518 
Barchusen,  J.  C.  ( 1 666-. 723)  543,  725 
Bard,  John  (1716-1799)  803,  804 

Bard,  S.  (1742-1821)  618,  809,  1093 
Bardeleben,  H.  A.  (born  1819)  1071 
Barensprung,  Fried.  Wilh.  Felix 

(1822-1864)  .  959,  1023 

Barker,  Fordyce  .         .         .  1096 

Barlow,  John  .         .         .         717 

Barnes,  Fancourt  .  .  .  1090 
Barnes,  Robert  .  .  .1090 
Barnet,  William  (about  1764)  802 
Baron  (about  1841)  .         .     901 

Baron,  John  (about  1827)  710,  911 
Baronio,  Vincenzo  (about  1633)  509 
Barrows,  Thomas  .  .  .917 
Barry,  Edward  (about  1759)  .  503 
Bartels,  C.  (1811-1878)  .  966,995 
Bartels,  E.  D.  A.  (1778-1838)  936 
Barth,  Jean  Bapt.  (1806-1877)  1013 
Barth,  Joseph  (1745-1818)  .  672 
Barthez,  Antoine  Charles  Ernest 

(born  1811)  .  .  901,  1013 
Barthez,  Paul  Jos.  (1734-1806)  626 
Bartholin,  Casp.  Jr.  (1655-1738) 

532  n.  2,  535,  537 


1105 


Page. 

Bartholin,  Casp.  Sr.  (1585-1629)  532 
Bartholin,  E.  (1625-1698)  532  n.  2 
Bartholin,  Thomas  (1616-1680) 

509,  531,  532,  537 
Bartholomlius  (13th  century.)  309 
Bartholow,  Roberts  .  925,  929 
Bartisch,  Georg  (1535-1606)  .  405 
Bartlet,  Mr.  (about  1759)  .  717 
Bartlett,  Ehsha  (1804-1855)  .  925 
Bartlett,  Josiah  (1759-1820)  814  n.  1 
Bartoletti,  Fabrizio  (1581-1630)  486 
Barton,  Benj.  Smith  (1766-1815)  844 
Barton,  John  Rhea  (d.  1871)  .1052 
Barton,  W.  P.  C.  (died  1855)  .  844 
Bartsch,  Jac.  (died  1633)  566,  n.  4 
Bartscher,  Ferd.  (born  1830)  .  1068 
Barwell,  Richard  .         .  1047 

Barzizi,  Cbristoforo  (about  1420)  722 
Barzoi  (Burzweih,  6th  cent.)  218  n.  3 
Basch,  Sam.  Siegf  r.  Karl  ( b.  1 837)  844 
Basedow,  Joh.  B.  (1723-1790)  .  597 
Baseilhac,    Jean    (Frere    Come, 

1703-1781)  .         .         .663 

Bass,  Heinrich  (1690-1754)  615,  668 
Bassereau,  Lckm  (1811-1888)  .  902 
Bassi,  Agostino  (about  1835)  844, 1004 
Bassi,  Laura  (about  1735)  718  n.  1 
Bassus,  Julius  (about  A.  D.  44)  139 
Bastian,  H.  Charlton  .  .  916,  922 
Bate,  William  (1608-1669)  547  n.  1 
Bateman,  Thomas   (1778-1821) 

654,  723,  919 
Battie,  William  (1704-1776)  694,  713 
Battus,  Levinus  (died  1591)  .  394 
Batty,  Robert  .  .  .1097 
Bauchet,  L.  Jos.  (1826-1865)  1039 
Baudelocque,    Auguste    (about 

1836)  .  .  .  901,  1085 
Baudelocque,   Jean  Louis,    Sr., 

(1746-1810)  .  .  .682 
Baudens,    Jean    Bapt.    Lucien 

(1804-1857)  .  .  .  1038 
Bauderon,  Brice  (1540-1625)  547  n.  1 
Bauer,  Jos.  (born  1845)  .  .  995 
Baufet,  Guillaume  de  (1304)  .  331 
Bauhin,  Casp.  (1550-1624)  404,  429 
Bauhin,  Job.  (1543-1613)  .     721 

Baulot,   Jac.    (Beauheu,  1651- 

1714)  .      •  .         .         .514 

Baum,  W.  (1799-1883)  .       1072 

Baume,  Antoine  (1728-1804)  .  726 
Baumer,  Joh.  W.  (1719-1788)  706 
Baumes,  J.  B.  T.  (1756-1828)  633 
Baumes,  Prosp.  F.  (1791-1871)  1021 
70 


Page. 

Baumgarten,  P.  C.  (born  1848)  1009 
Baumgiirtner,     Karl     Heinrich 

(1798-1886)  .  .  843,  941 
Baunscheidt,  C.  (died  1860)  992  n.  1 
Baverius    de    Baveriis     (about 

1480)  .         .         ,         .407 

Bayfield,  Robert  (about  1660)  538 
Bayford,  Thomas  (18th  century)  676 
Bayle,   Antoine    Laurent  Jesse 

(1799-1858)  .  .  .888 
Bayle,  Francois  (1622-1709)  .  496 
Bayle,  Gaspard  L.  (1774-1816)     893 

Bayley,  F.  K 1086 

Bayley,  Rich.  (1745-1801)  676,  816 
Baylies,  William  (died  1767)  .  720 
Bavnard,  E.  (about  1719)  715,  721 
Baynham,  William  (1749-1814)  817 
Baynton,  Thomas  (about  1797)  677 
Bayrus,    Petrus  (Bairo,  Pietro, 

1468-1518)  .  .  .294 
Bazin,  Pierre  A.  E.  (1807-1878)  902 
Bazzicaluve,  A.  M.  (about  1700)  500 
Beale,  Lionel  Smith  (born  1828) 

916  921 
Beard,  Geo.  M.  (1840-1883)  .  '  929 
Beattv,  Thos.  E.  (1801-1872)  1092 
Beau,' J.  H.  S.  (1806-1865)  901,  1013 
Beaus^rand,  N.  (about  1619)  .  543 
Beaumont,  William  (1785-1853)  924 
Becher,  Joh.  J.  (1635-1682)  566,  655 
Beck,  Bernhard  (born  1821)  .  1070 
Beck,  John  B.  (1794-1851)  .  925 
Beck,  Karl  J.  (1794-1838)  937,  1070 
Beck,  Lewis  C.  (1798-1853)  844,  925 
Beck,  Theo.  R.  (1791-1855)  925,  930 
Becker,  0.  (b  1828)  968,  1049,  1074 
Beclard,  Jules  (1818-1887)  .  1035 
Beclard,  Pierre  A.  (1785-1825)  1035 
Becquerel,  Alf.  (1814-1866)  901,  907 
Becquerel,  Ant.    Cesar   (1788- 

1878)  ...  901  n.  1 
Becquerel,  E.  (1804-1878)  .  896 
Beddevole,    Dominique    (about 

1686)  .         .         .         .496 

Beddoes,  Thomas   (1754-1808) 

633,  655,  715 
Bede,  Venerable  (673-735)  .  254 
Bedford,  G.  S.  (1806-1870)  .  1095 
Bednar,  Alois  (about  1856)  .  969 
Beer,  G.  J.  (1763-1821)  672,  750,  937 
Begbie,  J.  W.  (1826-1876)  .  922 
Beger,  Joh.  H  (1810-1885)  .  1074 
Begin,  L.  Jacques  (1793-1859) 

888,  1038 


—  1106  — 


Page. 

Behier.  Louis  Jules  (1813-1876)  900 
Behr,  Carl  (1796-1864)  .  .1019 
Behrens,  C.  B.  (1660-1736)  .  542 
Beigel,  Hermann  (1830-1879)  1084 
Beireis,  Gottf.  Chr.  (1730-1809)  669 
Beithar,  Ebn  el  (died  1248)  .  233 
St.  Bel,  Charles  Vial  (died  1793)  717 
Beichier,  John  (1706-1785)  665,  676 
Belfield,  W.  T.  .  844  n.  1,  1010 
Belinaye,  Henry  (about  1832)  920 
Bell,  Benjamin' (1749-1806)  .  675 
Bell,  Sir  C.  (1774-1842)  908,  1047 
Bell,  John  Jr.  (1763-1820)  675,  697 
Bell,  John  Sr.  (1691-1780)  .  697 
Bell,  Joseph  (born  1837)  .  1048 
Bell,  Luther  V.  (1806-1862)  .1014 
Bellicus  (about  a.  d.  400)  .  145 
Bellingham,  O'Brien  (1805-1857)  914 
Bellingham,  Sam.  (about  1650)  581 
Bellini,  Lorenzo  (1643-1704)  499,  537 
Belloc,  Jean  J.  (1730-1807)  665,  706 
Belloste,  Augustin  (1654-1730)  514 
Belloste,  Mich.  A.  (about  1740)  514 
Belluzzi,  Cesare  .         .         .  1087 

Belmas,  D.  G.  (1793-1864)  .  1038 
Belon,  Pierre  (1518-1564)  .     368 

Bencio,  Hugo,  vid.  Bentius  .  292 
Van  Beneden,  P.  J.  (born  1809)  852 
Benedetti,  Alex,  (died  1525)  298,  302 
Benedict,  Traug.  Wilh.  Gustav 

(1785-1862)  .  .  .  1060 
Benedikt,  Moriz  (born  1835)  .  969 
Benefeld,  G-.  Wilh.  (about  1758)  694 
Benevoli,  Antonio  (1685-1756)  667 
Benezeck  .....  1033 
Benivieni,  Antonio  (died  1502)  301 
Bennett,  A.  Hughes  .  .  .918 
Bennet,  Christ.  (1617-1655)  .  510 
Bennett,  John   Hughes   (1812- 

1875)  .         .         .     632,  915 

Bennet,  Joseph  Henry  .  915,  1093 
Benson,  Charles  (1797-1880)  .  914 
Bent,  James  (about  1774)  .  .  674 
Bentius,    Hugo   (U^one   Benzi, 

died  1439)  .  .  292,  714 
Berard,  Auguste  (1802-1846)  .  1038 
Berard,  P.  H.  (1797-1858)  901,  1038 
Berdraore,  Thos.  (18th  century)  677 
Berends,  K.  A.  W.  (1759-1826)  647 
Berengario,  G.  (died  1550)  415,  426 
Berenice  (b.  c.  300)  .         .129 

Bergeon  .         .         .         .       1013 

Berger,  C.  J.  (1724-1787)  688,  781 
Berger,  J.  Gottf.  v.  (1659-1736)     714 


Page. 

Bergmann,  E.  von  (born  1836)  1073 
Bergmann,  G.  H.  (1781-1861)  657 
Bergmann,  Karl  Geo.  L.  Christ. 

(1814-1865)  .  .  .936 
Bergmann,  Torbern  (1735-1784) 

599,  721,  726 
Bergner,  D.  (about  1780)  .  .  778 
Berkeley,  G.,  bishop  (1684-1753)  720 
Berlin,  Rudolph  (born  1833)  .  1074 
Berlinghieri,  Fr.  Vacca  (1732- 

1812)  .         .         .     618,  638 

Bernard,    Claude    (1813-1878) 

842,  900,  903 
Fra  Bernardo  (Bern.  Maria  de 

Castrogiane,  about  1725)  .  722 
Bernardus  Prow  (about  1155)  265 
Bernatzik,  Wenzel  (born  1821)  963 
Bernhardi,  Joh.  J.  (about  1805)  840 
Bernoulli,  Daniel  (1700-1782)  503 
Bernoulli,  Jean  (1667-1748) 

503,  598.  690 
Bernstein,  Joh.  G.  (1748-1835)  1061 
Bernutz,  Gustav  L.  R.  .  .  907 
Bert,  Paul  (1833-1886)  .         903 

Bertapaglia,  Leon,  (died  1460)  301 
Bertin,  E.  J.  (1712-1781)  700.  705 
Bertillon,  L.  A.  (1821-1883)  906.  907 
Bertin,  R.  J.  H.  (1757-1828)  .  '  038 
Bertini,  George  (about  1587)  .  397 
Bertoletti,  Franc.  (1588-1630)  540 
Berton,  A.  (about  1 837)  .  .  901 
Bertrandi,    T.    Ambrosio  Maria 

(1723-1765)  .  .  .667 
Bertruccio   (Bertrucci,    Bertru- 

tius,  died  1347)  .  297,  301 
Berzelius,  J.  Jac.  (1779-1848)  850 
Besse,  Jean  (17th  centur}-)  533  n.  1 
Besnier  (1609)  .         .         .396 

Betschler,  Jul.  W.  (1796-1865)  1080 
Bettelheim,  K.  (born  1840)  958,  969 
Bettinger,  Julius  (1802-1887)  1063 
Betts.  John  (about  1669)  .         .     493 

Betz;  F 966 

Beverwijck,  Jan  van  (1594-1 647)    531 
Beyer,  Dr.  (about  1762)     .         .     669  j 
Bianchi,  Achille  (died  1876)      .     871 ' 
Bianchi,  Giov.  Battista  (1681- 

1761)  .  .  .  694.  698 
Bianchelli,  M.  (about  1500)    292,  722 

Biancini 1087 

Bianconi,  Giov.  L.  (1717-1780) 

600,  661 
Bichat,  Francois  Xavier  (1771- 

1802)        .         .         .        '640.  7(12 


—  1107  — 


Page. 

Bicker,  Lambert  (about  1757)  693 
Bidenkap,  Job.  L.  (born  1828)  1076 
Bidloo,    Gottfried    (1649-1713) 

518,  537,  539 
Biedert,  Phil.  .  .  995,  1018 
Bienaise,  Jean  (1601-1681)  .  514 
Bierkowski,L.  J.  v.  (1801-1861?)  1060 
Biermayer  (about  1825)  .  .  950 
Biermer,  Anton  (born  1827^  .  994 
Biesiadecki,  A.  (1833-1889)  .  964 
Biett,  Laurent  (1781-1840)  .  901 
Bigelow,  Henry  J.  1028  n.  1,  1054 
Bigelow,  Jac.  (1787-1879)      844,  924 

Bigeschi 1087 

Bilguer,  Joh.  Ulr.  (1720-1796)  669 
Bilharz,  Theodor  (died  1862)    .     852 

Bili 1087 

Billard,  C.  M.  (1800-1832)  .  901 
Billard,  Etienne  Sr.  (1730-1808)  1033 
Billing,  Archibald  (1791-1881)  916 
Billroth,  Theo.  (b.  1819)  1006.  1072 
Binder,  Uldaricus  (about  1506)  398 
Bing,  Janus  (1681-1751)  .  .  688 
Binninger,  J.  Nic.  (born  1628)  540 
Biondo,  Michel  Angelo   (Blon- 

dus,  1497-1565)  .         .     414 

Birch,  John  (about  1779)  .  918 
Bird,  Golding  (1815-1854)  .  912 
Birkett,  John  .         .         .1044 

Birnbaum.  F.  H.  G.  (born  1815)  1084 
Bischoff,  C.  H.  E.  (1781-1861)  634 
Bischoff,  G.  Wilh.  .  .  .  843 
Bischoff,  Ignaz  Rudolph  (1784- 

1850)  .  .  '  .  878,950 
Bischoff,  Th.  L.  W.  von  (1807- 

1882)  .         .         .         .634 

Bishop,  John  (1797-1873)  .  918 
Bisset,  Charles  (1717-1791)  •  .  656 
Bjoernstroera,  Fr.  (born  1833)  1022 
Blache.  Rene  (about  1841)  .  901 
Black,  Dr.       ...  1090 

Black,  Joseph  (1728-1799)  .  598 
Black,  William  (1750-1829)  .  658 
Blackall,  John  (1771-1860)  .  1023 
Blackley,  F.  R.  (about  1839)  914 
Blackman,  Geo.  C.  (1819-1871)  1054 
Blackmore,  Sir  Richard   (1650- 

1729)  .  505  n.  2,  651,  762  n.  1 
Blaes,  Gerh.  (about  1675)  510,  536 
Blaine,  Delabere  (about  1795)  717 
Blair,  William  (about  1798)  .  715 
Blake,  Clarence  J.      .  930 

Blakiston,  Peyton  (1801-1878)  1014 
Blanc  (died  1884)       .        .         .905 


Page. 

Bland,  P.  (1774-1858)  .  .  655 
Blandford,  G.  Fielding  .  .  920 
Blandin,  Phil.  Fr.  (1798-1849)  1038 
Blankaart,  Stephan  (1650-1702) 

494,  518,  541 
Blasius,  Ernst  (1802-1875)  .  1060 
Blasius,  Gerhard  (died  1092)  .  509 
Blatin,  Henri  (1808-1869)  '  .  907 
Blaud  (18th  century)  .  .  655 
Blazina,  Joseph  (1812-1885)  .  1072 
Blegny,  Nic.  de  (1652-1724)  496,  541 
Blessig,  Robert  (1830-1878)  .  1077 
Blicke,  Sir  Charles  (died  1815)  676 
Blizard,  Sir  William  (1743-1835) 

676,  715,  1044 
Blumenbach,    Joh.    Fr.    (1752- 

1840)  .  .  .  600,  660,  695 
Blumenthal,  C.  A.  (about  1800)  673 
Blundell,  James  (1790-1878)  .  1090 
Blundell,  J.  W.  F.  (about  1852)  916 
Blunt  (18th  century)  .         .     655 

Boardman,  Mr.  (about  1805)  .  717 
Bocangelino.  Nicolas  (Bocangel. 

about  1600)  .  .  .409 
Bock,  H.  von  ...         995 

Bock,  Karl  Ernst  (1809-1873)  878 
Bockl,  J.  (about  1585)  .  .  429 
Bockmann,  J.  L.  (about  1787)  631 
Bodenstein,  A.  von  (died  1576)  393 
Boe,    Francois   de  le   (Sylvius, 

1614-1672)  .  .  490.  531 
Boeck,  Karl  W.  (1808-1875)  1076 
Boeckel,  Eugene  (born  1831)  .  1040 
Boehm,  Ludwig  (1811-1869)  .  1005 
Boer,  Lucas  Joh.  (1752-1835)  1079 
Boer,  Thos.  (about  1700)  .  494 
Boerhaave,  A.  K.  (1715-1758)  607 
Boerhaave,  Herm.  (1668-1738) 

494,  603-607 
Boerner,  Nicolaus  (1693-1770)  715 
Bogaerdet,  Hermann  M.  van  de 

(about  1631)  .  .  .  578 
Bogdan,  Martin  (about  1660)  .  521 
Bohm,  Ludwig  (1811-1869)  .1073 
Bohmer,  Phil.  Ad.  (1717-1789) 

680,  684,  695,  707 
Bohn,  J.  (1640-1719)  495,  535,  542 
Bohun,  Lawrence  (about  1610)  578 
Boinet,  Alph.  Alex,  (born  1808)  907 
Boisseau,  Fr.  Gab.  (1791-1836)  888 
Boivin.    Marie    Anne   Victoire 

(1773-1847)  .  .  906.  1085 
Boix   y    Moliner,    Don    Miguel 

Marc.  (18th  century)  .     653 


1108 


Page. 

Boizot 1033 

Bojani  family  ....  302 
Bokai,  Joh.  (1822-1884)  .  .  1085 
Bokelman,  Corn.  (18th  century)  088 
Bolingbroke,     Henry    St.    John 

(1078-1751)  .  .  .590 
Bolognini,  A.  (about  1510)  .  415 
Boll,  Franz  Christ.  (1849-1879)  994 
Bollstadt,  Alb.  of  (1193-1280) 

282,  310 
Bolton,  James  (1812-1809)  .  929 
Bonaciolus,  Ludovicus  (Buonac- 

cioli,  about  1540)  .  .  421 
Bonagentibus,  V.  de  (10th  cent )  438 
Bond,  Phineas  (about  1751)  .  813 
Bond,  Thomas  (about  1709)  .  808 
Bondioli,  Piet.  A.  (1705-1808)  870 
Bonet,  Jean  (1015-1088)  .     490 

Bonet,  Theoph.  (1020-1089)  .  540 
Bongiovanni  .         .         .       1087 

Bonifacius  (1200-1285)  .  .311 
Von  Boninghausen  .  .  876 
Bonn,  Andreas  (1738-1818)  .  678 
Bonnafont,  Jean  P.  (born  1805)  904 
Bonnet,  Amedee  (1802-1858)  .  1038 
Bonomo,  Giov.  C.  (about  1687)  510 
Bontekoe,  Cornel.  (1647-1095)  494 
Bontius,  Jacobus  (died  1031)  .  508 
Boot,  A.  de  (1606-1650)  .  509,  510 
Borch,  Ole  (Borrichius,    1626- 

1090  .  .  .  395,  495,  544 
Borda,  Syro  (1761-1824)  .     870 

Borde,   Andrew  (Boorde,  Perfo- 

ratus,  died  1549)  .  412,  434 
Bordenave,  T.  (1728-1782)  665,  694 
Bordeu,  T.  de  (1722-1776)  624,  601 
Borel,  Pierre  (1620-1089)  509,  514 
Borelli.    Giov.    Alfonso    (1608- 

1079)  .         .       498,  499 

Borgognoni,    Hugo    (of   Lucca, 

died  1252  or  1208)  300,  341,  343 
Borgognoni,  Theod.    (of  Cervia, 

1205-1298)  .         .         .     300 

Bonier,  Fried.  (1723-1761)  .  001 
Born,   Giuseppe    Fr.    (Burrhus, 

Borro,  1025-1095)  512,  539 

Borthwick,  George  (about  1775)  677 
Borsieri  de  Kanilfeld,  Giov.  Batt. 

(1725-1785)  652,  655,  694,  737 
Van  den  Bosch,  H.  (about  1780)  094 
Van    den    Bosch,    I  man   Jacob 

(about  1757)  .  .  .  093 
Bose,  Heinrich  (born  1840)  .  1073 
Bostock,  John  (1773-1840)       .     910 


Page. 

Bosworth,  F.  H.  920 

Botallo,  Leonardo  (b.  1530)  376,  415 
Botlan,  Ebn  (Eluchasem  Emili- 

thar,  died  1052)  .         .     234 

Bottini,  Enrico  (born  1837)  .  1041 
Bottoni,  Albertino  (died  1596)  .  408 
Bouchardat,  Ap.  (1800-1880)  896 
Bouchut,  Ernst  (born  1818) 

901,  907,  996,  1021 
Boudin,  J.  Ch.  M.  (1800-1807) 

898,  900 
Bouillaud,  Jean  B.  (1797-1881) 

888,  1013 
Bouissoq,  Etienne  Fr.  (b.  1813)  1040 
Bouley,  Henri  (1814-1885)  .  717 
Bouneau  (about  1840)  .         901 

Bourdelin,  Claude  (1021-1099)  721 
Bourdet  (about  1757)  .  .  006 
Bourgelat,  Claude  (1712-1779)  716 
Bourgeois,  Louise  (about  1605) 

402,  403,  421 
Bourguignon  ....  903 
Bousquet,  J.  B.  (about  1840)  .  901 
Bouvier,  Sauveur  Henri  Victor 

(1799-1877)  .  .  .  1038 
Bouvray,  de  (about  1040)  .  513 
Bovio,  Tomasso  (about  1592)  .  390 
Bowditch,  Henry  J.  .  925,  1015 
Bowman,  Sir  William  (b.  1810) 

910,  917,  1049 
Boy,  Adrien  Simon  (died  1795)  664 
Boyd,  Robert  (1808-1883)  .  920 
Boyer,  Alexis  (1757-1833)  .  1031 
Boyer,  Philippe  (1801-1858)  .  1039 
Boylston,  Zabdiel  (1080-1700)  800 
Bozeman,  Nathan  .  1029,  1097 
Bozzini,  Phil.  (1773-1809)  1021,  1022 
Bra,  Heinrich  von  (died  1601)  439 
Braid,  James  (1795-1860)  632,  1040 
Brainard,  Daniel  (1812-1806)  .  1054 
Brambilla,  Joh.  Alex.  v.  (1728- 

1800)  ..  .  070,776,778 
Branca  family  .  .  .  302 
Brand,  Ernst  ....  723 
Brandis,  J.  I).  (1702-1846)  634,  936 
Brandreth,  Joseph  (about  1791)  722 
Brasbridge,  Thos.  (about  1578)  413 
Brasdor,  Pierre  (1721-1776)  .  663 
Brassavola,  A.  M.  (1500-1555)  408 
Brauell,  Friedrich  (1803-1882)  1004 
Braun,  Alexander  (1805-1877)  843 
Braun,  Carl  (born  1822)  .  .  1084 
Braun,  Gustav  (born  1829)  .  1084 
Bravo,  Francesco  (about  1571)     409 


1109  — 


Page. 

Bredewardyn,  William  (fl.  1417)  306 
Breisky,  August  (1832-1889;  1084 
Brendel,  Joh.  Gottl.  (171 1-1758)  503 
Brenner.  Job.  Em.  (1745-1816)  710 
Brera,  Valer.  Luigi  (1772-1840)  87U 
Breschet,  Gilb.  (1784-1845)  893,  904 
Bretonneau,  Pierre  (1771— lfct>2)  900 
Brewster,  Sir  D.  (1781-1808)  916,  917  i 
Briancon,P.  A  (about  1828)  956,  1013  | 
Bricbeteau,  Isidore  (1789-1862).  903 
Briekender   (about    1765)  .     782 

Briddon,  Charles  K.  .  .1055 
Brieger,  Ludwig  (born  1849)  .  1007 
Brierre  de  Boismont,  Alexandre 

(born  1797)  .  .  .1035 
Brings,  William  (1641-1704)  .  521 
Brigham,  Am.  (1798-1849)  .  928 
Bright,  Richard  (1789-1858)  .  909 
Bright.  Timothy  (died  1616)  .  413 
Briiii,  Giov.  Tom.  (about  1729)  615 
Brinton,  John  H.  1055 

Briquet,  Paul  (1796-1881)  .  1013 
Brisbane.  John  (about  1769)  .  698 
Brisseau.  P.  (1631  -1717)  514,  515 
Brisseau-Mirbel  (about  1800)  .  689 
Brissot,  Pierre  (1478-1522)  375-376 
Broadbent,  William  Henry  916,  922 
Broea,  Paul  (1824-1880)  .  .  1040 
Brochard.  And.  Th.  (1810-1882)  901 
Broeklesbv,  Rich.    (1724-1797) 

694,  715,  719 
Brodie,    Sir    Benjamin    Collins 

(1783-1862)  .  .  909,  1045 
Broen,  Jan  (about  1700)  .  404 
Broers,  Hend.  Jan  (1815-1876)  1098 
Broers,  J.  C.  (1795-1847)  .  1075 

Brogeras  y  Lopez,  Pedro  .  1087 
Bromfieki;  William  (1712-1792)     674 

Brook 1046 

Brofbeck,  Theo.  (about  1780)  .  624 
Brouardel,  P.  C.  H.  (born  1837)  906 
Broussais,  Casimir  (1803-1847)  888 
Broussais.  Francois  Jos.  Victor 

(1772-1838)  .  .  .884 
Brown,  Baker  (1812-1873)  .  1093 
Brown,  C.  (about  1826)  .  .  909 
Brown,  John  (1735-1788)  .  634 
Brown,  John  (b.  1642)  520,  537,  542 
Brown,  Robert  (1773-1858)  844,  980 
Brown,  William  (about  1778)  .  820 
Browne,  Lennox  .  .  .918 
Browne.  Thos.  Sir  (1605-1682)  508 
Brown  Sequard,  C.  Ed.  (b.  1818)  903 
Brucaeus,  Heinr.  (died  1593)     .     439 


Page. 

Bruch,  Phil.  (1781-1846)  .  843 
Briick,  Julius  (born  1840)  .  1022 

Briicke,  E.  W.  v  (b.  1819)  969,  1019 
Bruckner,  Aug.  (1769-1797)  .  673 
Brugmans,  S.  J.  (1763-1819)  .  1075 
Bruguera,  O.  (about  1563)  .  409 
Bruhier,  Jean  Jacques  .         705 

Bruhier   d'Ablaincourt,   Jean 

(about  1750)  .  .  .682 
Bruin,  Jan  de  (1681-1753)  .  688 
Brunelli  .         .         .    '     .         871 

Brunetto  Latini  (12:20-1295)  .  283 
Brunfels,  Otto  (died  1534)  .  369 
B  runner,  A.  A.  (18th  century)  673 
Brunner,  Balth.  (1533-1604)  .  439 
Brunner,    Job.   C.   (1653-1727) 

495,  536,  963 
Briinninghausen,  Herm.  Joseph 

(1761-1834)  .  .  .  1083 
Brunnow,  E.  G.  v.  (1796-1843)     876 

Bruno 1041 

Bruno,  Giordano  (1548-1600)  .  368 
Bruno   of    Longoburgo    (about 

1252)  ....     300 

Bruns,  Paul  (born  1846)  .  1073 
Bruns,  Victor  von  (1812-1883) 

1021,  1073 
Brunschwisfc,    Hieron.     (about 

1450-1533)  .  .  307,  310 
Brunton.  John  B.  .         .1021 

Bryan  (about  1833)  :  .  912 
Bryant,  Thomas  .         .         .  1044 

Buchan,  Alex.  P.  (1764-1824)  721 
Buchan,  William  (1729-1805)  .  722 
Buchanan,  And.  (1798-1882)  .  916 
Buchanan,  G.  (about  1790)  819.  921 
Buchanan,  J.  R.  .  .  .882 
Buchanan,  Thos.  (1782-1853)  .  917 
Buchholz,  W.  H.  S.  (1734-1798)  705 
Buchmann,  O.  .  .  .  .  877 
Biichner,  And.  El.  (1701-1769) 

615,  655 
Buchner,  Hans  (born  1850)  995,  1007 
Buchner,  Jos.  (1813-1879)  .  876 
Biichner,  Louis  (born  1824)  .  841 
Biichner,  Peter  (18th  century)  657 
Buchwald,  Balth.  Joh.  v.  (1697- 

1763)  .  .  .  088,  781 
Buck,  Albert  H.     .  930 

Buck,  Gurdon  (1807-1877)  .  1052 
Bucknill.  John  Charles  .         920 

Bucquet.  J.  B.  M.  (1746-1780)  1011 
Budd,  Charles  A.  (1832-1877)  1097 
Budd,  George  (1807-1882)         .     915 


—  1110  — 


Page. 

Bufalini,  Maurizio  (1787-1861)  871 
Buffon,  Geo.  L.  L.  (1707-1788)  599 
Buhl,  Ludwig  von  (1816-1880)  995 
Bulkley,  Henry  D.  (about  1850;  926 
Bulkier,  L.  Duncan  .  .  .  927 
Bull,  William  T.  .         .1055 

Bulleyn,  William  (died  1576)  .  413 
Bumstead,  Fr.  J.  (1826-1879)  927 
Buniva,  Mich.  Fr.  (1761-1834)  1023 
Bunsen,  Robert  W.  (born  1811)  851 
Burchart,  Chr.  M.  (1680-1742)  615 
Burdach,  K.  F.  (1776-1847)  .  936 
Burggrav,  Joh.  Ph.  (1700-1775)  615 
Burgundio  of  Pisa  (died  1194)  285 
Burnet,  Thomas  (died  1715)  .  484 
Burnett,  Charles  H.  .  •  .  930 
Burnett,  Swan  M.  930 

Burns,  John  (1775-1850)  .  1090 
Burow,  Aug.  (1809-1875)  1067,  1074 
Burow,  Ernst  .  .  .  .  10. '0 
Burq,  V.  (1823-1884)  .  645,  903 
Burrows,  Geo.  M.  (1771-1846)  920 
Burton,  John  (1697-1771)  .  686 
Busch,  Carl  D.  W.  (1826-1881)  1072 
Busch,  Dietr.  H.  W.  (1788-1858)  1081 
Busch,  Friedrich  (born  1844)  .  1072 
Busch,  Joh.  Dav.  (about  1790)  685 
Busey,  Sam.  C.  ...  1097 

Bussiniere,  de  la  (about  1660)  543 
Busson,  Julien  (about  1750)  .  667 
Busteed.  John  .  .  .  717 
Butini,  J.  Ant.  (about  1776)  .  501 
Butler,  D.  P.  .  .         882 

Butler,  Wdliam  (1534-1617)  395  n.  1 
Butt,  Robert  B.  (about  1825)  .  1053 
Biittner.  Chr.  Gottl.  (1708-1776)  7<>5 
Butts,  Dr.  (about  1510)  .  .  413 
Buwmann.  Jac.  (about  1575)  419  n. 
Buzzard,  Thomas  .  .  .  922 
Buzzi,  Franz  (about  1782)  .  667 
Bvford,  Wm.  H.  .  1096,  1097 

Byrne,  John  ...         929 

C. 

Cabanis,     Pierre    Jean   Georges 

(1757-1808)  .  .  596.  627 
Cabrol,  Barth.  (about  1590)  402.  537 
Cadogan,  Wm.  (1711-1797)  656',  714 
Cadwallader,  Thos.  (1707-1779)  803 
Caalius   Aurelianus   (about  A.  D. 

400 144 

Cagliostro,  A.  (1743-1795)  .  602 
Cagnatus,     Marsilius    (Cagnati, 

died  1610)  .         .         .373 


Page. 

Cagniard-Latour  (about  1836)  9u6 
Caillard  .  .  '  .  .  .899 
Caillault,  CI.  ...         902 

Caius,  Joh.  (Kaye,  Key,  Caye, 

1510-1573)  .  .  372  n.  1 
Caldani,  Floriano  (died  1836)  699 
Caldani,  Marc.  Ant.  (1725-1813) 

694,  699 
Caldera   de    Heredia,    Gasparo 

(about  1658)  .  .  .484 
Calderini,  G.  .         .         .1087 

Caldwell,  Charles  (1772-1853)  .  882 
Caldwell,  Rich.  (1513-1584)  .  418 
Callender,  Geo.  W.  (1830-1879)  1047 
Callianax  (b.  c.  270)  .         .124 

Callicles  (a.  d.  150)  .  .  130 
Callicles,  Mic.  (12th  century)  .  210 
Callimachus  (b.  c.  246)  .  .125 
Callisen,  H.  (1740-1824)  678,  711 
Callisthenes  (about  b.  c.  330)  95,  118 
Calmeil,  Juste  L.  (born  1798)  .  899 
Calmette.  Francois  (about  1677)  496 
Calza,  Luigi  (1737-1784)  .     683 

Camerarius,  R.  J.   (1665-1721)     690 

Cameron,  Dr 921 

Cameron,  Sir  Ch.  A.  .  .  921 
Cammann,   G.   P.  (about  1855) 

1016,  1018  n.  1 
Campagnano  ....  889 
Campbell,  Ch.  J.  (1820-1879)  .  1086 
Campbell,  David  (about  1845)  978 
Campbell,  Wm.  (1788-1848)  .  728 
Campegius,  Svmphorianus  ( Cam- 
pier,  1472-1539)  .  373,  376 
Camper,  Pieter  (1722-1789)  677,  688 
Campolongus,   iEmilius   (about 

1580)  .  .  .  376,398 
Canano,  Giamb.  (1515-1579)  .  426 
Candela  y  Sanchez,  Pascual  .  1042 
De  Candblle,  A.  P.  (1778-1841)  843 
Canella,  Gius.  M.  (1788-1829)  1087 
Cannani,  J.  B.  (about  1540)  .  376 
Canquoin,  Alex.  (1795-1881)  .  1039 
Canstatt,  Karl  Friedrich  (1807- 

1850)  .  .  910,  945,  965 
Cantani,  Arnaldo  (born  1837)  871 
Canton,  Edwin  (died  1885)  .  1047 
Capdevilla,  Ant.  (about  1760)  653 
Capivaccio,  Hier.  (died  1589)  397,  398 
Cappel,  Chr.  Wilh.  (1771-1803)  864 
Capuletti,  Nicolo  (18th  century)  667 
Capuron,  Jos.  (1767-1850)  900,  1086 
Carabelli,  Georg  (1787-1842)  .  968 
Carcano,  L.  G.  (1536-1606)       .     415 


—  1111  — 


Page. 

Cardanus,    Hieronymus    (1501- 

1576)  .  .  363,  376,  722 
Carl,  J.  Samuel  (1667-1757)  .  714 
Carlisle,  Sir  Antony  (1768-1840) 

697,  912,  1046 
Carraichael,  R.  (1779-1849)  914,  922 
Carminati,   Bassiano,   (Giacomo 

Sacchi,  about  1795)  .  715,  870 
Carnochan,  J.  M.  (1817-1887)  1053 
Carpenter,  Wm.  B.  (1813-1885) 

632,  916 
Carpo,  Federigo  (about  1813)  .  870 
Carpue,  Joseph  C.  (1764-1846)  918 
Carrere,  J.  B.  Fr.  (1740-1802) 

652,  721 
Carrichter,  Barth.  (about  1570)  393 
De  Carron,  Jean  (1770-1840)  .  710 
Carron  du  Villards,  Charles  Jos. 

(1800-1860)  .  .  .905 
Carswell,  Sir  Rob.  (1793-1857)  912 
Carter,  R.  Brudenell  .         .917 

Carthauser,  Job.  Fr.  (1704-1777)  748 
Carus,  Karl  Gustav  (1779-1868) 

883,  936,  1082 
Casal,  Gaspar  (died  1759)  .     653 

Casati,  J 1087 

Cascales,  Fr.  Perez  (about  1611)  550 
Casper.  J.  L.  (1796-1864)  .     949 

Cassani,  Francesco  (about  1550)  376 
Cassebohm,  Joh.  Fr.  (died  1743)  695 
Casserio,     Giulio     (1561-1616) 

415,  429,  537 
Cassini  (about  1 690)  .         .     554 

Cassiodorus  (480-573)  .  .  255 
Cassius,  Andreas  (about  1668)  494 
Cassius  Felix  (5th  century)  .  188 
Cassius  the  Iatrosophist  (about 

A.  D.  130)  .         .         .167 

Castell,  Peter  (about  1753)  .  694 
Castelli,  Pietro  (died  1656)  .  486 
Castor  (a.  d.  60)  .  .  .  158 
Castorani,  Raffaele  .  .  .  905 
Castro,  Rodericus  a  (died  1 627)  404 
Le  Cat,  Claude  N.  (1700-1768) 

663,  694 

Catler 1045 

Cato  the  Censor  (b.  c.  234-149) 

132,  191 
Cattam  (18th  century)  .  .  683 
Cattani,  Giuseppina  .  ,  718  n.  1 
Cattier,  Isaac  (about  1656)  .  509 
Cavendish,  H.  (1731-1810)  597.  726 
Dela  Caze,  Louis  (1703-1765)  625 
Cazeaux,  Paulin  (1808-1862)    .  1086 


Cazenave,  P.  L.  A.  (1802-1877)  902 
Cederschioeld,  Fred.  Aug.  .  1099 

Cederschioeld,  G.  (1782-1848)  1099 
Cellarius,     Salomon     (Kellner, 

1676-1700)  .  .  .543 
Celsius,  Andreas  (1701-1744)  598 
Celsus,  Apuleius  (b.  c.  10)  .  158 
Celsus,  A.  C.  (b.  c.  25  to  a.  d.  50)  161 
Cermisone,  Ant.  (died  1441)  .  292 
Cervi,  Giuseppe  (1663-1748)  .  767 
Cesalpino,  Andrea  (1519-1603) 

367,  369.  428 
Cesio,  Carlo  (about  1697)  .  '  537 

Chabert  (about  1753)  .  .  652 
Cbabert,  Phil.  (1737-1814)  .  717 
Chabrol,  Matthieu  (1735-1815)  652 
Chacon,  Dion.  D.  (1510-1596)  416 
Chadwick,  Sir  Edw.  (1799-1887)  920 
Chailly-Honore,    Nic.     Charles 

(1805-1866)  .  899,  1086 

Chalin   de    Vinario,    R.    (about 

1360)  ....     269 

Chamberlen  family,  the  521,  522, 

526  n.  1,  561  n.  1 

Chambers,  W.    F.   (1786-1855)     916 

Chambon  de  Montaux,   Nicolas 

(about  1799)  .         1023  n.  1 

Champier,  vid.  Campegius, 
Chandler,  George  (about  1765)     677 
Chanina  Ben  Chama  (about  A.  D. 

200) 35 

Chanina  Ben  Dosa  (a.  D.  70-120)  35 
Channing,  Walter  (1786-1876)  1096 
Chapman,  Edmund  (about  1735)  687 
Chapman,  E.  N.  ...  1097 

Chapman,  Nath.  (1780-1853)  .  923 
Charaka  (about  b.  c.  1000)  .  40 
Charcot,  Jean  Mart,  (born  1825)  903 
Charidemus  (b.  c.  290-260)  .  126 
Charlton,  W.  (1619-1707)  4^0,  538 
Charmis   of    Marseilles    (about 

a.  d.  33)  .  .  .  149,150 
Charriere  (died  1876)  .  .1021 
Charriere,  J.  de  la  (about  1696)  514 
Chartier,  R^ne  (1572-1654)  .  484 
Chassagny  ....  1086 

Chassaignac,   Charles   Marie  E. 

(1805-1879)  .         1028.  1039 

Chastang,  Elie  .  .  .  .906 
Chauffard,  H.  (1823-1879)  .  888 
Chauliac,  Guy  de  (b.  about  1 300)  305 
Chaumette.  Ant.  (about  1560)  416 
Chausit,  Maurice  .  .  .  902 
Chaussier,  Fr.  (1746-1828)     700,  888 


1112 


Page. 

Chauveau,  Jean  Bapt.  Auguste 

(born  1827)  .  .  .  1007 
Chavasse,  Pye  H.  (1810-1879)  919 
De  la  Chaynaie  (about  1744)  .  716 
Chelius,  Max  J.  v.  (1794-1876)  1062 
Chenot,  Adam  (1721-1789)  .  622 
Cheselden,  Win.  (1688-1752)  673,  697 
Cheshire,  John  (1695-1702)  .  050 
Chesne,   Jos.   du   (Quercetanus, 

1521-1609)      '    .  .     396 

Chesneau,  Nicolas  (about  1670)  509 
Chevallier,  Paul  .         .         .     906 

Chevers,  Norman  (1818-1886)  916 
Chevreul,  M.  E.  (1786-1889)  1005 
Cheyne,    George    (1071-1743) 

502,  050,  714,  722 
Cheyne,    John    (1777-1830) 

912,  919,  922 
Chiari,  Johann  (1817-1854)  .  1084 
Chiarugi,  Vine.  (1759-1822)  .  712 
Child,  Robert  (about  1644)  .  580 
Chirac,  Pierre  (1050-1732)  496,  501 
Chisholm,  J.  G.  ...     930 

Chomel,  A.  F.  (1788-1858)  888.  893 
Chopart,  Francois  (1743-1795)  till.") 
Chossat  .  .  .  .  .  1023 
Christison,    Sir   Robert    (1797- 

1882)  .  .  .  912,  921 
Christophorus    a   Vega   (1510- 

1580)  .         .         .         .376 

Christophorus  de  Honestis  (died 

1392)  .         .         .         .288 

Chrysermus  (about  B.  c.  250)  124 
Chrysippus  (1st  cent.  B.  c.)  .  139 
Chrysippus  of  Cnidos  (b.  c.  340)  114 
Chrysippus  of  Locri  .         .100 

Chrysus  (about  B.  c.  480)  .  100 
Church,  Benjamin  (1734-1776)     818 

Chui 16 

Churchill,  F.  (1808-1878)  919,  1092 
Chvosteck,  Franz  (1834-1884)  .  909 
Ciccone  ....       1087 

Cigna,  Giov.  Franc.  (1734-1790)  694 
Ciniselli,  Luigi  (1805-1879)  .  1041 
Cipriani,  Pietro  (1808-1883)  .  1041 
Cirillo,  Dom.  (1734-1799)  650,  667 
Cirillo,  Nicolo  (1671-1734)  .  722 
Ciucci,  Ant.Filippo  (about  1652)  1028 
Civiale,  Jean  (1792-1867)  .  1036 

Clarelli,  Luigi  de  (about  1744)  615 
Clark,  A.  (1807-1887)  925,  1018  n.  1 
Clark,  B.  (about  1815)  .  .  717 
Clark,  Frederick  le  Gros  .  .  1044 
Clark,  Sir  J.  (1788-1870)      911,  1014 


Page. 

Clark,  J.  (about  1638)  579,  581  n.  1 
Clark,  J.  (about  1785)  .  .  717 
Clark,  John  (1744-1805)  .  723 
Clarke,  Sir  Ch.  M.  (1782-1857)  10H9 
Clarke,  John  .  .  .  .1044 
Clarke,  J.  Jr.  (about  1815)  .  919 
Clarke,  Joseph  (1758-1834) 

087,  1088,  1(191 
Clarke,  Timothy  (about  1004)  .  520 
Claudini,  J.  C.  (died  1618)  .  509 
Clauser,  Christ,  (about  1531)  .  398 
Clay,  Charles  .  .  .  .1093 
Clayton,  John  (1685-1773)  ,  803 
Clearchus  .  .  .  .  118 
Cleghorn,' George  (1710-1789)  1023 
Cleland,  Archibald  (about  1740) 

666,  904,  917 
Clemens,  Theodor  (born  1824)  .  100 
Clement,  John  (died  1572)  .     413 

Clement,  Jules  (1049-1729)  523,  572 
Clementinus,  CI.  (about  1512)  .  398 
Clemot,  Jean  B.  J.  (1770-1852)  1038 
Clendinning,  J.  (about  1835)  .  914 
Cleopatra  (b.  C.  69-30)  .         129 

Cleophantus  (b.  c.  138)  .  .  129 
Clerc  .     '    .  .     902 

le  Clerc,  Daniel  (1652-1728)  .  514 
Clermont,    ('lias.     (Claramontius, 

about  1072)  .  .  .  542 
Cleyer,  Andreas  (about  1075)  508 
Clift,  William  (1775-1849)  .  702 
Clifton,  Francis  (about  1 714)  656,  658 
Cline,  Henry  (1750-1827)  .     670 

Clodius  (about  b.  c.  42)  .  139 

Cloquet,  Germ.  Jul.  (1790-1883)  10:50 
Clossey,  Samuel  (about  1707)  .  808 
Clouston,  Thomas  S.  .         .     920 

Clover,  Jos.  Thos.  (1825-1882)  1070 
Clowes,  William  (about  1575)  .  418 
Clusius,  C.  (Charles  de  l'Ecluse. 

1526-1609)  .  .  .370 
Clymer,  Meredith  .  .  .928 
Cobo,  Diego  del  (15th  century)  306 
Cocehi,  Ant.  (1005-1758)  000,  001 
Coccius,  E.  Ad.  (b.  1825)  1020,  1074 
Cock,  Thos.  F.  .  .  .  1096 
Cockburn,  W.  (about  1090)  501,  508 
Codes,  Bait,  (about  1500)  .  304 
Cohausen,  Joh.  H.  (1665^1750)  547 
Cohen,  J.  Solis  .         .         .     920 

Cohn,  Ferd.  Julius  .         .       1004 

Cohn,  II.  (born  1838)  .  .  1074 
Cohnheim,  Julius  (1839-1884)  994 
Coindet,  T.  E.        .        .        .         903 


1113  — 


Page. 

520 

803 

501 

707  n.  1 

.  717 
906 

.  513 
652 

.  912 
1013 


Col  batch,  John  (about  1C95)     . 
Colden,  Cadwallader  (1G88-177G) 
Cole,  William  (about  1075) 
Coleman,  Ed.  (about  1791) 
Coleman,  Mr.  (about  1795) 
Colin,  Leon  (born  1830) 
Colle,  Giovanni  (died  1031) 
Colle,  R.  P.  (18th  century) 
Colles,  Abraham  (died  1843) 
Collin,  V. 

Collins,  R.  (1801-1868)  1088,  1091 
Collins,  Samuel  (about  1085)  538 

Colnet,  Nicolas  (fl.  1417) 
Colombat-de-1'  Isere,  Marc. 

(1798-1851) 
Colombier,  Jean  (1730-1789) 
Colombo,  Matteo  Realdo  (1490- 

1559)  .         .         .        421,  425 

Colombo,  Michele   (about  1600)     421 
Colomines,  Lucien  (about  1474) 
Colot,  Franyois  (died  1706) 
Colot,  Germain  (fl.  1474) 
Colot,   Laurent    (10th   century) 
Colot,  Philippe  (1593-1656) 
Colquhoun,   J.   C.   (about  1833) 
Columella  (about  A.  D.  20) 
Combe,  Andrew  (1797-1847)     . 
Combe,  G-eorge  (1788-1858)       . 
Frere    Come    (Jean    Baseilhac, 

1703-1781) 
Cornmer,  Jacob  I),  (about  1060) 
Comnena,  A.  (about  a.  d.  1120) 
Comte,  Aug.  M.  F.  (1798-1857) 
Comte,  G.  ... 

Concorregio,  J.  (about  1 439) 
Condamine,    Charles    Marie   la 

(1701-1774) 
Condle,  D.  Francis  (1796-1875) 
Uond iliac  (1715-1780) 
Condorcet  (1743-1794) 
Connor,  P.  S.      .         .         . 
Conollv.  .John  (1790-1860)    . 
Conquest,  John  T.  (1789-1800) 
Conradi,   D.   G.  C.  (1707-1798) 
Conradi,  J.  Fr.  (about  1848)      . 
Conradi,     Joh.    Willi.    Heinrich 

(1780-1861)     .  864,889 

Conring,  Hermann  (1000-1081) 

484,  495,  531,  508 
Constantinus   Africanus  (1018- 

1085)  .         .         .         .257 

Conton,  Dr.  (18th  century)  .  050 
Cooke,  William  (1785-1873)  .  702 
Cooper,    Ant.    A.    (1671-1713)     596 


306 

907 
604 


348 
513 
3(i6 
513 
513 
0  12 
191 
882 
882 

003 
578 
210 
842 
883 
292 

598 
927 
596 
590 

1055 
920 

1090 
072 
905 


Page. 

Cooper,  Sir  Astley  Paston  (1768- 

1841)  .  .  .  909,  1043 
Cooper,  B.  B.  (1792-1853)  .  1045 
Cooper,  E.  S.  .         .         .1051 

Cooper,  Gerard  .         .         .  1045 

Cooper,  James  .  .  .  1045 
Cooper,  John  ....  1045 
Cooper,  Langston  .         .       1045 

Cooper,  Robert  .         .         .1045 

Cooper.  Sam.  (1781-1848)  1014,  1045 
Cooper,  Thomas  Jr.  .         .  1045 

Cooper,  Thomas  Sr.  .  .  1045 
Coote,  Rich.  H.  (1817-1872)  .  1040 
Copeman,  Edward  (1809-1880)  915 
Copernicus  (1473-1543)  .  354  n.  3 
Copho  i  about  1110)  .  .  262 
Copland,  James  (1791-1870)  .  915 
Cordo,  Simon  de  (died  1330)  .  309 
Cordus,  Euric.  (1480-1535)  309,  398 
Cordus,  Valer.  (1515-1544)  309,  437 
Cornaro,  Luigi  (1407-1506)  .  714 
Cornarus,  Dio.  (about  1595)  376,  398 
Cornarus,    Janus  (Joh.  Hagen- 

but,  1500-1558)  .        .     372 

Coraax,  Matth.  (about  1550)  .  421 
Cornil,  Andre  V.  (b.  1837)  904,  906 
Corra,  family  of  (a.  d.  836-973)  227 
Corradi,  Alfonso  (born  1833)  .  871 
Corral  ( 1 8th  century)  .  .  053 
Corrigan,  Sir  D.  J.  (1802-1880)  914 
Cortejarena  y  Aldeo,  Franc,  de.  1087 
Corte,  Claudio  (about  1562)  .  435 
Cortenova,  Albert  of  ( 1 3th  cent.)  3 1 1 
Cortese,  Francesco  (1801-1883)  1041 
Cortese,  Isabella  (10th  century)  390 
Cortesi,  G.  B.  (1554-1030)  509,  512 
Corvin,  Andreas  (about  1597)  304 
Corvisart-Desmarets,  Jean  Nic 

(1755-1821)  .  .  .  1011 
Corvisart,  Lucien  (1811-1882)  1012 
Coschwitz,  Geo.  P.  (1679-1729) 

011,  691 
Cosmas  (3d  century)  .         .      L81 

Costa,  Christobal  da  (10th  cent.)  308 
Da  Costa,  J.  M.  (b.  1833)  925,  1015 
Costanza  Calenda  (about  1425)     204 

Coste,  A 889 

Cothenius,  Christ.  And.  (1708- 

1789)  .         .         .         .719 

Cotton.  Richard  P.  (1S20-1S77)  1014 
Cotngno,  Domenico  (1730-1822) 

654,  055,  698 
Coulson,  William  (1802-1877)  1049 
Counsell,  George  (about  1752)     087 


—  1114 


Page. 

Be  Courcelles,  C.  (about  1739)  697 
Courty,    A.   H.   P.    (1819-1886) 

907,  1086 
Coutanceau,     G.     Bart.     Ange 

(1775-1831)  .  .  .899 
Coutouly,  P.  V.  (about  1788)  .  682 
Covillard,  Jos.  (Couillard,  about 

1633)  .         .         .         .514 

Cowan,  Charles  (1806-1868)  .  912 
Coward,  Wm.  (about  1695)  493,  677 
Cowper,    William     (1666-1709) 

519,  531,  537 
Cox,  Jos.  Mason  (1762-1822)  713 
Coxe,  J.   Redman   (1773-1864) 

711,  815,  923 
Craanen  Theo.  van  (1620-1689)  494 
Crabbe,  George  (1754-1832)  762  n.  1 
Cragie,  David  (1793-1866)  .  911 
Cramp,  Christ,  f about  1786)  .  694 
Crampton,  Sir  Ph.  (1777-1858)  1048 
Cranston.  John  (about  1663)  809  n.  1 
Cranz,  Heinrich  Joh.  Nepomuk 

(1722-1799)  622,  684,  694,  721 
Cratevas  (b.  c.  70)  .  .  .129 
Crato  von    Krafftheim,   Johann 

(1519-1586)  .  .  .  410 
Crawford.  Adair  (1749-1795)  .  H33 
Crawford,  J.  (died  1841)  909 

Crawford,  John  (1746-1813)  .  711 
Crede,  Karl  S.  F.  (born  1819)  1083 
Crescentiis,  Pet.  de  (about  1 250)  3 1 1 
Crescenzo,  Nic.  (about  1711)  500,  722 
Creus  ....  1042 

Crichton,  Sir  A.  (1763-1856)  713,  920 
Crinas  of  Marseilles  (about  a.  d. 

60)  .         .  150,151 

Critchett,  G.  (1817-1882)  917,  1048 
Critobulus  (about  b.  c.  350)  95 
Critodemus  (about  B.  c.  330)  .  95 
Croce,   Giovanni    Andrea    del  la 

(about  1560)  .  .  .415 
Crocius,  Chr.  Fried.  (1623-1673) 

566  n.  4 
Crocker,  Heniy  Radcliffe  .     919 

Croft,  Sir  Rich,  (about  1819)  .1088 
Croll,  Oswald  (1560-1609)  .     394 

Cronstedt.  A.  F.  (1722-1765)  .  599 
Crooke,  H.  (about  1631)  .  538 
Croone,  William  (about  1664)  493 
Crosby,  Dixi  (1801-1873)  .  1052 

Cross,  Francis  (about  1668)  .  493 
Crowther,  B.  (1765-1840)  677,  920 
Cruger,  Simon  (1687-1760)  .  781 
Cruikshank,  Wm.  (1745-1800)  .     697 


Crusell,  Gustav  S.  (1810-1858)  1067 

Cruveilhier,  Edouard          .         .  894 

Cruveilhier,  Jean  (1791-1873)  894 
Ctesias  (b.  c.  416)          .         .     39,  93 

Cube,  Joh.  von  (about  1484)     .  309 

Cullen,  William  (1712-1790)  .  616 
Culleiier,  Francois  Aime  Guil- 

laume  (1782-1841)  .  .  902 
Culpeper,  Nic.  (about  1681)    526  n.  1 

Cumming  (about  1846)      .         .  1019 

Cunier,  Florent  (1812-1853)      .  1075 

Curling,  Thos.   B.   (born  1811)  1048 

Curran,  John  O.     (1819-1847)  915 

Currie,  James  (1756-1805)  723,  1023 

Currie,  William  (1755-1829)     .  815 

Curtis,  Alex.  C.  (about  1660)     .  578 

Curtis,  Edward       .         .         .  1010 

Curtis,  Sir  John  H.  (about  1816)  917 

Curtius,    Matthew    (1474-1544)  376 

Curwen,  John  C.  928 

Curzio  (about  1752)        .         .  654 

Cusack,  James  W.  (1787-1861)  914 

Cuvier,  Baron  von  (1769-1831)  599 

Cydias  of  Mylasa  (b.  c.  250)      .  125 

Cyon,  Elie  von  (born  1843)        .  903 

Cyprian,  Abraham  (about  1690)  525 

Cyrillo,  Nic.  (about  1732)  .  722 
Czermak.  Joh.  Nepomuk  (1828- 

1873)         •         .         .     967,  1021 

Czerny,  Vincenz  (born  1842)     .  1073 

D. 

Dadd,  George  H.  .  .  .717 
Daelmans,  ^Egid.  (about  1694)     494 

Dalbv,  W.  B 918 

Dalechamps,  Jac.  (1513-1588)  416 
Dalhonde,  Lawr.  (about  1722)  802 
Dalmas,  J.  A.  A.  (1799-1844)  899 
Dalton,  John  (1766-1844)  677,851 
Dalton,  John  C.  (1825-1889)  852 
Damianus  (3d  century)  .  .  181 
Damocrates,  S.  (about  A.  D.  26)  159 
Damoiseau,  H.  (about  1844)  .  1013 
Damon,  Howard  F.  .  .  927 
Dance,  Jean  B.  H.  (1797-1832)  894 
Daniel,  Chr.  Fr.  (1753-1798)  612,  705 
Danz,  Ferd.  George  (1761-1793)  662 
Danzel,  August  F.  (born  1822)  1072 
Daremberg,  Chas.  V.  (d.  1872)     907 

Dariot 905 

Dariot,  Claude  (1533-1594)  .  395 
Darlington,  Wm.  (1782-1863)  844 
Darwin,  Chas.  (1758-1778)  720,  724 
Darwin,  C.  R.  (1809-1882)      841  n.  1 


—  1115  — 


Page. 

Darwin,  E.  (1731-1802)  628,  842 

Darwin,  Robert  Waring  S41  n.  1 

Daubenton,  L.  Jean  M.  (1716- 

1709)         .         .         .       652,700 
Davaine,  Casimir  Joseph  (1811- 

1882)  .  .  844,  S52,  1004 
David,  Jean  Pierre  (1737-1784)  665 
Davicl,  Jacques  (1696-1 762)  666.  7S3 
Davies,  Herbert  (1818-1885)  .  1018 
Davies,  John  (about  1840)  .  912 
Davies,  Thomas  (about  1835)  .  912 
Davis,  David  (1777-1841) 
Davis,  John  Hall  (1811-1884) 
Davis,  Nath.  Smith  (born  1817) 
Davy,  Sir  H.  (1788-1829)  851,  1023 
Dawkes,  Thomas  (about  1736)  687 
Dawud  el  Antaki  (died  1596) 
Day,  William  H. 
Daza  Chacon,  D.    (1510-1596) 

Dazan 

Deane.  Edmund  (about 
Dease,  Wm.  (about  1780) 
Decimius,  P. 

Dee,  Arthur  (1597-1651) 
Dee,  John  (1527-1608) 
Deeping,  William  (about  1633)  578 
Deisch,  Joh.  A.  (about  1753)  683  n.  1 
Dekker,  Friedrich  (1648-1 730 ) 
Delacroix  (18th  century) 
Delafield,  Ed.  (1794-1875)  929,  1094 
Delafield,  Francis  .  .  .  925 
Delaisse  (about  1753)  .  .  664 
Delaporte,  Pierre  L.  (1773-1853)  1033 
Delaroque,  Jean  B.  (1787-1858)  893 
Delarue,  Franyois  (about  1820) 
Deleau,  Nicolas  (1797-1862)  . 
Delessert,  Benj. 

Deleurye,  F.  Ange  (about  1770) 
Delsado,  J  ago  (1830-1875) 
Delius,  H.  F.  (1720-1791)  694,  706 
Delpech,  A.  L.  D.  (1818-1880)  906 
Delpech,  J.  M.  (1777-1832)  .  1035 
Demachy,  Jean  F.  (1728-1803)  726 
Demanet,  M.J.  (1747-1831)  .  711 
Deinarquay,  J.  N.  (1814-1875)  1039 
Demeaux  ....     1038 

Demetrius  of  Apamea  (b.  c.  276)  124 
Demetrius  of  Bithynia  (b.  c.  250)  126 
Demetrius  Pepagomenos  (about 

1275)  .... 

Demme,  Herm.  Sr.  (1803-1867)  1062 
Demme,  Herm.  C.  (1831-1864)  1062 
Democedes  (b.  c.  525)     .         .  90 

Democritus  (b.  c.  494-404)        .       90 


1089 

1089 

925 


234 

919 

416 

1022 

1626)     546 

656,  687 

.     149 

485  n.  2 

485  n.  2 


49li 
665, 


660 
904 
844 
681 
1042 


211 


Pape. 

Demosthenes  Philalethes  (a.d.50)  1 25 
Demours,  Ant.  P.  (1762-1832)  666 
Demours,  Pierre  (1702-1795)  606,  700 
Dendv,  Walter  C.  (about  1827)  919 
Deneux,  L.  C.  de  (1 767-1 840)  1086 
Denham,  John  (1804-1887)  .1092 
Denis,  Jean  B.  (died  1704)  512,  513 
Denman,   Thomas  (1733-1815) 

655,  686,  782 
Dennis,  Fred.  S.  .         .         .  1055 

Denonvilliers,     Charles     Pierre 

(1808-1872)  .  .  .1039 
Denvan  (about  1681)  .  .  527 
Deodatus,  C.  (about  1629)  .  486 
Depaul,  J.  A.  11.(1811-1883)  711,1086 
Derby,  Hasket  ....  930 
Derby,  B.  H.  .        .        .        930 

Dcsault,  P.  Jos.  (1744-1795)  .  664 
Desbois    de    Kochefort,    Louis 

(died  1786)  .  .  .  738 
Descartes,  Bene  (1596- 1650)  .  478 
Descemet.  Jean  (1732-1810)  600,  700 
Deschamps,  Jos.  Franyois  Louis 

(1740-1824)  .  .  .1032 
Deshaix-Gendron,  L.  F.  (about 

1770)  ....     666 

Desmarrcs,  Alphonse  .  .  905 
Desmarres,  L.  A.  (1810-1882)  .  905 
Desormeaux.  A.  J.  .         .       1022 

Despars,  Jacques  (Jacobus  de 

Partibus,  died  1465)  .     294 

Desperrieres.  Pois.  (18th  cent.)  056 
Despres,  Armand  (b.  1834)  906,  1086 
Despres,  Charles  D.  (1806-1860)  1024 
Desruelles,  H.  M.  J.  (ab.  1836)  888 
Dessenius,  Bernh.  (1510-1574)  396 
Detmold,  William   (born  1808) 

1055.  1009  n.  2 
Deusing,  Anton  (1612-1606)  .  494 
Deventer,  Hendrick  van  (1651- 

1724)  .         .         .     525,  688 

Deversie,  Alph.  (1798-1879)  .  902 
Devergie,  M.  Nic.  (about  1830)  888 
Dewees,  W.  P.  (1768-1841)  927,  1094 
Dexter,  Aaron  (1750-1829)  .  810 
Diaz,  Francesco  (about  1575)  .  409 
Dick,  Mr.  (about  1825)  .  .  717 
Dickinson,  Bev.  J.  (1688-1747)  804 
Dickinson.  Wm.  H.  (born  1832)  921 
Dickson.  Sam.  H.  (1798-1872)  923 
Diday,  Paul  ....  902 
Diderot  (1713-1784)  .  .  596 
Dieflenbach,  J.  F.  (1794-1847)  1064 
Diego  del  Cobo  (15th  century)     306 


1116  — 


Page. 


5(19 
994 

9(51 

115 
905 

485 
598 


Diemerbroeck,    Isbrand   van 

(1609-1674) 
Diestervveg,  Alex. 
Dietl,  Jos.  (1804-1878) 
Dieuches    ..... 
Dienlafoy,  Georges 
Digby,  SirKenelm  (1603-1665) 
Dillenius,  Job.  Jac.  (1687-1747) 
Dimsdale,  Thomas  (1712-1800) 

709,  723,  752 
Dinus  (14th  century)  .  .  311 
Diodes  of  Carvstus  (b.  c.  350) 

115,  130 
Diogenes,  (b.  c.  400-330)  .       91 

Diogenes  of  Apollonia  (b.  c.  550- 

460)  .         .         .         .114 

Dionis,  Pierre  (died  1718) 

55,  514,  515,  537,  655 
Dionysius  (1st  century) 
Dionysius  "the  Humpbacked"    . 
Dioscorides  (a.  d.  40-90). 
Dioscorides  Phacas  (about  b.  c. 

40) 

Dioxippus  of  Cos  (b.  c.  370)  100, 
Dippel,  Jos.  Conr.  (1672-1731) 
Dirlewang,  Paul  (about  1549)  . 
Disdier,  Henri  F.  (1708-1781) 
Dittel,  Leopold  (b.  1815)  1058, 
Dittrich,  G.  L.  (1815-1859) 
Diversus,   Petrus   Salius    (Salio 

Di  verso,  about  1580) 
Diwisch,  Procop  (1696-176"))     . 
Dix,  John  (about  1841)      . 
Dlauhv.  J.  (about  1850) 
Dobelt,  Horace  B.       . 
Dobson,  Matthew    (about  1775) 
Dockehbarg,  H.  v.  (15th  cent.) 
Dodarfc,  Denys  (1634-1707) 
Dodonseus,  Rembertus  (Dodoens, 

1517-1586)  .         .     370.  410 

Doemling.  J.  Jos.  (1771-1803)  865 
Doeveren,  W.  van  (1730-1783)  693 
Dolirn,  Rudolph  (born  1836  i  .  1084 
Dolaus,  Joh.  (1651-1707)  .     495 

Dolbeau,  H.  P.  (1831-1877)  .  1040 
Dollinger.  Ignaz  (1770-L841)  .  9,'U 
Dollond.  John  (1706-1761)  598,  853 
Domling,  Job.  J.  (1771-1803)  934 
Donato     d'Altomare,     Antonio 

(1508-1566)         .         .  376 

Donato,  Marcello  (d.  about  1600)  408 
Donatus  (a.  r>.  581)  .  247  n.  5 
Donatu's,  Job.  B.  (about  1580)  398 
Donders    Frans  C.   (1818-1889)  1075 


145 
115 
159 

125 
114 

405 
404 

700 

1H72 
917 

408 

59  S 
929 
964 

1014 
657 
307 
501 


Pa4**? 

Dondis.  Giac.  de  (b.  1298)  308,  720 
Dondis,  Giov.  de  (about  1380)  309 
Donne,  A.  (1801-  L878  I  901,  904, 1004 
Donne.  Maria  della  (18th  cent.)  683 
Donnolo   the  Phvsieian   (about 

940)  .  .         259  n.  1 

Donzellini,  Gius.  (about  1707)  500 
Dor,  Henri  .         .         .         .1074 

During,  Michael  (d.  1644)  396,  542 
Dorn.  Gerhard  (about  1580)  .  373 
Dorsey,  John  Syng  (1783-1818)  1050 
Double,  F.  Joseph v  (1777-1842)  898 
Douglas,  James  (1675-1742) 

676,  690.  698 
Douglas,  John  (about  1737)  656,  676 
Douglass,  William  (died  1752)  801 
Dover.  Thomas  (died  1741)  .  652 
Dowse,  Thomas  Stretch-  .         918 

Drachmann.  A.  G.  (born  1810)  1076 
Draco  (b.  c.  350)  .  100  ,  113 

Drake.  Daniel  (1785-1852)  .  924 
Drake.  Roger  (about  1645)  .  531 
Le  Dram  Henri  F.  (1685-1770)  6u3 
Draper,    John    W.   (1811-1882) 

848  n.  1,  925 
Draper.  William  H.  .         .     925 

Drebbel,  Cornelia  (1572-1634)  480 
Dreiincourt,  C.  (1633-1697)  496,  535 
Drescher.  K.  .  .  .  .  966 
Drinkwater,  Mr.  (1668-1728)  522.  687 
Drivere.    Jeremias     (Thriverius 

Bracbelius.  died  1554)  .  376 
Dron  .  .  .  .  .  902 
Drummond,  Adam  (about  1715)  736 
Divander.  Job.  (Eichmann,  died 

1560)  .         .'         .     425 

Dsehemi,  Ebn  (12th  century)  .  234 
Dubini,  Amjelo  (about  1838)  .  852 
Dubois,  Ant.  (1756-1837)  1032,1086 
Dubois.  E.  (died  1877)  .  .1086 
Dubois,  Frederic  (b.  1799)  889,  899 
Dubois.  J.  (Sylvius,  1478-1555)  424 
Du  Bois-Reymond,  E.  (b.  1818)  694 
Dubois,  Paul  (1795-1871)  .  1086 
Dubreuilhe  .  .  .  .1086 
Ducheck,  Adalb.  v.  (1824-1882)  966 
Duchenne  de   Boulogne.  G.  B. 

(1806-1875)  .  .  .  903 
Duchenne-Duparc,  L.  V.  (about 

1859)  ....     002 

Duclos,  S.  C.  (about  1675)  .  721 
Duddell,  Benedict  (about  1733) 

677.  783 
Dudley,  Benj.  W.  (1785-1870)   1051 


1117  — 


Page. 

Dufav,    Charles  Francois  cle  C. 

(1698-1739)  .  .  .598 
Dufour,  Vitalis  (died  1327)  .  287 
Dufton,  William  (died  1859)  917 

Dugos,  A.ntoine  (1798-1838)  .  907 
Duuamel  du  Monyeau,  Henri  L. 

(1700-1782)  .  .  .605 
Duliring,  Louis  A.  .         .         927 

Dujardm-Beaumetz,     Georges 

( born  1833)  .  .  .903 
Dujardin,  Felix  (1801-1860)  .  1004 
Dulaurens,  Andre  (1558-1609)  416 
Dumas,  Charles  L.  (1765-1813)  627 
Dumas,  Jean  Bapt.  (1800-1884)  850 
Dumeril,  Andre  Marie  Constant 

(1774-1860)  .  .  .  1034 
Dumreicher,  Joh.  Heinrich  von 

(1815-1880)  .  .  .  1072 
Dun,  Sir  Patrick  (1642-1713)  .  546 
Duncan,  Daniel  (1649-1735)  .  493 
Duncan,  J.  Matthews  .  .  1090 
Dunglison,  Richard  J.  .  .  924 
Dunglison,  Robley  (1798-1869)  924 
Dunlap.  Alexander  .  .  1097 
Duno,    Taddeo    (Dunus,     1523- 

1613)  .  .  376,  407,  421 
Duparcque,  Frt'd.  (about  1838) 

901,  1086 
Duplav,  Simon  Emmanuel  (born 

1836)         .         .        .901,  1039 

Dupont 1033 

Dupre  (about  1823)  .  .  899 
Dupuv,  John  (died  1745)  .     818 

Dupuytren,  Guil.  (1777-1835)  1033 
Durand-Fardel,    Ch.    L.    Max. 

(about  1873)  .  901,  903 

Durand  de  Gros  .  .  .  903 
Durande,  Jean  Fr.  (about  1770)     720 

Durante 1041 

Duretus,     Ludovicus     (Duret, 

1527-1586)  .  .  372,  398 
Duret,  Pierre  (1745-1825)  .  1033 
Durham,  Arthur  Edward  .  .  1044 
Durham,  Samuel  (about  1685)  546 
Durkee,  Silas  .  .  .  .927 
Duroziez  ....       1013 

Dusch,  Theodor  v.  (born  1824)  1005 
Dust',  (about  1734)  .  .  .680 
Dusieu.  Chas.  F.  (1737-1769)  615 
Dutrochet,  M.  H.  (1776-1847)  848 
Duval,  Vincent  (1796-1876)  .  1038 
Duvernev,  Jos.  Guichard  (1648- 

1730)  .  .  .  514.515 
Dzondi,  Carl  H.  (1770-1835)     .  1061 


E. 


Page. 

909,  1046 
676,  1046 


Earle,  Henry  (1789-1838) 
Earle,  Sir  J.  (1755-1817) 
Earle,  Pliny  (born  1809)    . 
Eaton,  Amos  (1776-1842) 
Eberhard,  Joh.  P.  (1727-1779) 
Eberle,  John  (1788-1838) 
Ebn    Hobal    Muhaddib  ed  Din 

(1117-1203) 
Ebn  Boschd.  vid.  Averroes. 
Ebstein,   Wilhelm    (born  1836) 
Echth,  Joh.  (1515-1544)   . 
Eckstrom,  Carl  J.  af  (1793-?) 

Edis,  Dr 

Ehrenberg,  Chr.  G.  (1795-1876) 

845, 
Ehrenritter  (about  1775) 
Ehrhard,  Joh.  Benj.  (1766-1827) 
Ehrhart,  Jodocus  (1740-1808) 
Ehrlich.  Paul  (born  1854) 
Ehrmann,  Joh.  C.  (1710-1790) 
Ehrmann,  Joh.  C.  (1749-1827) 
Ehrmann,  Joh.  F.  (1739-1794) 
Ehrmann,  K.  H.  (1792-1878)  1039 
Eichstadt.  K.  F.  (born  1816)  844, 1004 
Eisenmann,  Gottf.  (1795-1867)  947 
Elaphos  (about  B.  c.  550) 

J]  1  finger,  A 

Eli  (about  1720)    . 

Eller,  Joh.  Theodor  (1689-1760) 

608,  669,  719 
Ellinger,  Andreas  (died  1582)  .  396 
Elliot,  George  T.  (died  1871)  .  1096 
Elliot,  John  (1747-1787)  .     721 

Elliot,  Robert  (about  1705)  736,  747 
Elliott,  Stephen  (1771-1830)  .  844 
Elliotson,  John  (1788-1868) 

632,  882,  912 
Ellis,  Edward  .  .  .  .919 
Ellis,  William  (died  1785)  .     678 

Ellis,  Sir  Wm.  C.  (about  1838)  920 
Elsiisser,  Joh.  Ad.  (1784-?)  711  n.  1 
Elsberg,  Louis  (1837-1885)  .  926 
Elsholz,  Joh.S.  (1623-1688)  517,  714 
Eisner,  Chr.  Fr.  (1749-1820)  618,  654 
Eluchasem  Elimithar,  vid.  Ebn 

Botlair        .         .        .         .234 
Ely.  John  (1737-1800)  .         802 

Elyot,  Sir  Thos.  (about  1534)  413,  714 
Emerich,  Franz  (about  1552)  .  398 
Emiliani,  (about  1815)  .  871,  1041 
Emmerez,  Paul  (died  1690)  .  512 
Emmert,  Carl  (born  1813)  .  1072 

Emmet,  T.  Addis       .         .         .  1097 


928 
844 
615 
923 

234 

995 

439 

1076 

1090 

1004 
696 
713 
685 

1 009 
683 
673 
683 


100 
968 
667 


1118   — 


Page. 

Erapedocles  (b.  c.  504-443)  .  88 
Endlicher,  S.  L.  (1804-1849)  843 
Engel,  Jos.  (born  1816)  .         963 

Ermemoser,  J.  (1787-1854)  631,  936 
Ennius    Meccius    (about  a.  d. 

150)  ....     168 

Ent,  George  (1604-1689)  .  .  531 
Enz         ....  910 

Enzel,  Christopher  (Encelius)  370 
Epicharmus  of  Cos  (about  b.  c. 

250) 130 

Epicurus  (b.  c.  341-270)  .     136 

Epkens  .  .  .  .  .1020 
Erasistratus   (about  b.  c.  340- 

280)  .  .  .  121-123 
Erastus,  Thos.  (1523-1583)  376,  396 
Erb,  Wm.  H.  (born  1840)  .     995 

Erhard,  Julius  (1827-1873)  .  1021 
Erichsen,  John  Eric  .  921,  1047 
Erlach,  C.  L.  von  (1821-1886)  1019 
Erxleben,    Dorothea     Christine 

(died  1762)  .  .  718  n.  1 
Erxleben,  Joh.  Christ.  Polycarp 

(1744-1777)  .  .  .718 
Eschenbach,  Christ.  Ehrenfried 

(1712-1788)  .  .  .  706 
Eschenmayer,  Karl  Aug.  (1768- 

1852)  .  .  631,  865,  936 
D'Escherny,  D.  (about  1760)  .  656 
d'Eslon  (about  17s0)  .         .     630 

Esmarch,  Fried,  (born  1823)  .  1069 
Espanet,  Alexis  .         .         .     880 

D'Espine,   Jacob   Marc    (1806- 

1860)  .  .  .  899,  904 
D'Espine.  J.  H.  A.  .        .         9<U 

Esquirol,  J.  E.  D.  (1772-1840)  712 
Esser  (about  1826)  .         .1019 

Estienne,    Charles    (Stephanus, 

1503-1564)  .         .         .427 

Estlaender,  Jac.  A.  (1831-1881)  1076 
Etheridge,  George  (about  1580)  413 
Ettinuller,  M.  (1644-1683)  495,  527 
Euclides  (about  B.  c.  400)  .       91 

Eudemus  (b.  c.  15)  .  .  .142 
Eudemus  the  Anatomist  (b.  c. 

290) 124 

Eudemus  of  Rhodes  (b.  c.  260)  118 
Eudoxus  of  Cnidos  (b.  cf.  408- 

355)  .         .         .         93,114 

Euelpides  (about  a.  d.  54)  .  149 
Euelpistus  (1st  cent.  b.  c.  ?)  .126 
Euler.  Leonliard  (1707-1783)  .  598 
Eumelus  of  Thebes  (3d  century)  191 
Euphorbus  (about  b.  c.  40)        .     139 


Page. 

93 

425 

143 

1055 

9 1 9 

1055 

1054 

643 

783 


Eurvphon  of  Cnidos  (about  b.  c. 
400)  .... 

Eustacchi,  Bart,  (died  1574) 
Eutychus        .... 
Evans.  Thomas  W.    . 
Evanson,  Rich.  T.  (about  1836) 
Eve,  Duncan      .... 
Eve,  Paul  F.  (1806-1877)      . 
Eyerell  (born  1740) 
Eysenbarth,  J.  A.  (1661-1727) 

F. 

Fabbn 1087 

Fabre-Palaprat  (about  1828)  .  1067 
Fabre,  Pierre  Ant.  (about  1770)  694 
Fabricius  ab  Aquapendente,  H. 

(1537-1619)  .  415,421,428 
Fabricius,  Heinr.  (d.  1612)  566  n.  4 
Fabricius,  Phil.  C.  (1714-1774)  705 
Fabriz.  Wilhelm  (Fabry,  Fabri- 
cius Hildanus,  1560-1634)  516 
Fagge.  C.  H.  (1838-1883)  919,  921 
Fahrenheit,  G.  D.  (1690-1740)  538 
De  la  Faille,  J.  B.  (born  1822)  1098 
Fakr-ed-Din  el  Razi  (1149-1210)  234 
Falconer,  Wm.  (about  1781)  715,  723 
Falconet,  Noel  (1644-1734)  .  496 
Falcutius,  Nicholas  (died  1412)  291 
Falkner,  Thomas  (1710-1780)  .  698 
Falloppio,    Gabriele    (Fallopius, 

1523-1562)  .  .  415.  427 
Fallot,  Salomon  L.  (1783-1873)  1075 
Fantoni,  G.  Batt.  (1675-1758)  698 
Faraday,  Michael  (1791-1867)  851 
Fame,  Margherita  .  .  718  n.  1 
Farr,  Samuel  (1741-1795)  .     706 

Farr,  William  (1807-1883)  .  920 
Farre,  John  R.  (1774-1862)  .  702 
Fauchard,  Pierre  (died  1761)  666 
Faure,  Jean  F.  (1701-1785)  .  656 
Faust.  Bernh.  Chr.  (1755-1842)  671 
Fauvel,  S.  A.  (1813-1884)  905,  1013 
Favre,  Jean  P.  (about  1656)      .     490 

Fave,  Frans  C 1098 

De"  la  Faye.  George  (1 699-1 781 )  664 
Fehleisen,  Friedrich  (born  1854)  844 
Fehr,  Joh.  M.  (1610-1 688)  .  544 
Felix,  Ch.  Fr.  (died  1703)  572  n.  1 
Feltmann  ( 17th  century)  .     542 

Fergusson,   Sir  W.  (1808-1877) 

1021,  1049 
Fernel,  Jean  (1497-1558)  409.  432 
Ferragius      (Ferraguth,      13th 

century)      .         .         .     265,  285 


—  1119 


Page. 

Ferrari  de  Gradi,  M.  (d.  1472)  294 
Ferraro,  Domenico  (about  1780)  682 
Ferrein,  Ant.  (1693-1769)  501,  666 
Ferri,  Alf.  (b.  about  1500)  415,  417 
Ferriar,  John  (1763-1815)  .  713 
Ferro,    Pasc.    Jos.   (1753-1809) 

622,  657,  710 
Ferrus,    G.  M.   A.  (1784-1863) 

901,  1012 
Feuchtersleben,  Ernst  v.  (1806- 

1849)  .         .         .         .969 

Feuerbach,  Ludw.  (1804-1872)  841 
Le  Fevre,  Nic.  (about  1660)  566  n.  3 
Fichte,  J.  G.  (1762-1814)  '  .  840 
Ficinus,  Mars.  (1433-1499)  .  290 
Fidelis,   Fortunatus   (Fedeli, 

1550-1630)  .  408,  433 

Fieber,  Friedrich  (1836-1883)  .  969 
Filkin  (about  1762)  .         .     674 

Finke,  L.  L.  (1747-1828)  .     657 

Fioravanti,  L.  (about  1564)  .  396 
Firman,  Giles  (about  163-1)  579,  581 
Fischer,  Hermann  (born  1831)  1073 
Fiecher,  Joh.  Nep.  (1787-1847)  968 
Fisk,  John  (about  1637)  579,  584 
Fisonel,  Miljavila  y  (18th  cent.)  638 
Flajani,  Gius.  (1741-1808)  .  667 
Flamant,  R.  P.  (1762-1832)  .  1086 
Flandrin,  Pierre  (1752-1796)  .  717 
Flarer,  Francesco  (about  1828)  1041 
Flaubert,  Achille  C.  (1784-1846)  1038 
Fleischmann,  L.  (1840-1878)  877,  969 
Flemming,  Paul  (died  1640)  566  n.  4 
Flemvng,  Nic.  M.  (about  1740)  615 
Flesselle,  Philippe  de  (d.  1562)  416 
Fleury  (about  1763)  .        .     782 

Fleury,  J.  A.  (1758-1835)  .  1033 

Fleury,  L.  J.  D.  (died  1872)  .  1033 
Flint,  Austin  Jr.  .  .  978  n.  1 
Flint,  Austin  Sr.  (1812-1886)  1015 
Flourens,  P.  (1794-1867)  .     903 

Floyer,  J.  (1649-1734)  493,  546,  722 
Fludd,    Robert    (de   Fluctibus, 

1574-1637)  .  .  .395 
Fliisjuss,    Gregorius    (Fleugaus, 

about  1518)  .  .  .418 
Fodeiv,     Francois      Emmanuel 

(1764-1835)  .  .  657,  888 
Foesius,  A.  (Foes,  1528-1595)  372 
Foglia,  Giov.  Ant.  (about  1620)  550 
Foissac,  M.  (about  1825)    .         .     632 

Foissac,  P 906 

Fob,  C.  (Foili,  Folius,  b.  1615)  530 
Follius,  Jacob  (17th  cent.)      566  n.  4 


Page. 

Follin,  Franc.  A.  E.  (1823-1867) 

1020,  1039 
Folsom,  Chas.  F.  929 

Fond,  de  la  (about  1 843)  .  .  895 
Fonseca,  Rodriguez  da  (d.  1622)  408 
Fonssagrives,  J.  B.  (born  1823) 

906,  1022 
Fontana,  Felice  (1730-1805)  .  693 
Fontanus,    Nicholas    (Fonteyn, 

about  1642)  .  .  .  527 
Foot,  Jesse  (1750-1820)  .  .  656 
Forbes,   Sir  John   (1787-1861) 

632,  911,  1014 
Ford,  E.  (about  1794)  655,  677.  782 
Fordyce,  George  (1736-1802)  .  651 
Fordyce,  William  (1724-1792)  .  651 
Foreest,     Pieter     van     (Petrus 

Forestus,  1522-1597)  398,  411 
Forget,  C.  P.  (1800-1861)  .     900 

Formad,  H.  F.  .         .         .1010 

Forman,  S.  (1552-1614)  485  n.  2 

Formey,  J.  L.  (1766-1823)  .  647 
Forster,  Thomas  (1790-1845)  .  883 
Fossati,    Giov.     Ant.     Lorenzo 

(1786-1874)  .  .  870,  883 
Foster,  Balthazar  .         .       1024 

Fothergill,  A.  (about  1795)  707  n.  1 
Fothergill,    John    (1712-1780) 

651,  655,  719,  739 
Fothergill,  S.  (about  1804)  655,  922 
Foubert,  Pierre  (1696-1766)  .  655 
Foucault,  Leon  (about  1846)  .  904 
Foucher,  Emile  (1823-1867)  .  1039 
Fouillioy,  Louis  M.  (1790-1848)  1038 
Fouquet,  Henri  (1727-1806)  .  625 
Fouquier,    Pierre    Eloi   (1776- 

1850)  .  .  638,  888,  893 
Fourcroy,  A.  F.  (1755-1809)  597,  633 
"Four  Masters",  the  (about  1 270)  300 
Fournet  .  .  .  899,  1013 
Fournier,  Alfred  .  .  .902 
Foville,  Achille  (1799-1878)  .  903 
Fowler,  Lorenzo  Niles  (b.  1811)  882 
Fowler,  Orson  Squire  (b.  1809)  882 
Fowler,  Thomas  (1736-1801)  .  720 
Foy.  Francois  (1793-1867)         .     906 

Foxi  G.  H 927 

Fox,  Tilbury  (1836-1879)  .     919 

Fracassati,  Carlo  (about  1665)  512 
Fracassini,  Ant.  (1709-1777)  .  500 
Fracastori,  Gir.  (1483-1553)  399,  407 
Fragoso,  Juan  (about  1570)  .  416 
Francesco   of  Piedmont  (about 

1330)  .        .        .        .288 


—  1120  — 


Pago. 

Francini,  H.  (about  1607)  .     543 

Francis,  John  W.   (1789-1861) 

923,  930,  1096 
Francis,  Thomas  (about  1570)  413 
Francke,  Aug.  H.  (1663-1727)  595 
Franco,  Pierre  (about  1560) 

402,  403,  1022 
Frank,  Franz  (19th  century)  .  638 
Frank,  Joh.  Peter    (1745-1821) 

618,  657,  706 
Frank,  Joseph  (1771-1841)  .  638 
Frank,  Ludwig  (19th  century)  638 
Frank   von    Frankenau,    Georg 

(about  1679)  .  .  .485 
Franke,  Fried,  (died  1859)  .  1073 
Frankel,  Bern  hard  (born  1836)  1021 
Frankenhiiuser  .         .         .  1084 

Franklin,  Benj.  (1706-1790)  .  598 
Franseri,  Antonio  (18th  cent.)  653 
Frari,  M.  C.  (about  1844)  .  .  1087 
Fraunhofer.  Jos.  v.  (1787-1826)  847 
Frazer,  William  .         .         .919 

Fredault  ....         907 

Frederick  II 310 

Freind.  John  (1675-1728)  494,657 
Freitag,  Joh.  (1581-1641)  .     486 

Frerichs,  F.  Th.  v.  (1819-1885)  996 
Freund,  Willi.  A.  (born  1833}  1084 
Freytag,  Johann  (about  1690)  517 
Frick,  George  (1793-1870)  929,  1056 
Fricke,  J.  L.  G.  (1790-1842)  .  1064 
Fried,  G.  Albrecht  (1736-1773)  683 
Fried,  J.  J.  (1689-1769)  683,  779,  785 
Friedlaender,  Carl  (bom  1847)  844 
Friedreich,  Victor  (1825-1882)  994 
Friedrich,  Isaac  (1388)  .  .  797 
Fries,  El.  Magnus  (1794-1878)  845 
Fritsch,  Heinrich  (born  1844)  .  1083 
Fritz,  Ignaz  F.  (1778-1841)  957,  1058 
Froriep,   Friedrich  Ludwig  von 

(1779-1847)  .  1029,  1080 
Fuchs,  C.  H.  (1803-1855)  .     946 

Fuchs,  Ernst  (born  1851)  968,  1074 
Fuchs,  L.  (1501-1566)  369,  372,  429 
Fugger,  Sig.  von  (about  1510)  377 
Fuller,  Francis  (about  1704)  .  715 
Fuller,  M.  (about  1640)  579,  581  n.  1 
Fuller,  Samuel  (died  1633)  .  579 
Fuller,  Thos.  (1654-1734)  805  n.  1 
Fulton,  Robert  (1765-1815)  .  598 
Furstenheim,  Ernst  (born  1836)  1022 
Fiisz,  Margarethe  (1555-1625)  524 
Fyens,  Johann  (died  1585)  .  411 
Fyens,  Thos.  (1567-1631)       398,411 


G. 

Page. 

Gaal,  Gustav  v.  (born  1818)     .     965 
Gabelshofer,  W.  (about  1600)    .     509 
Gaddesden,  John  (about  1305)     268 
Gaffard       .         .         ...         .     906 

Gafiki,  Abu  Jafer  el  (d.  1075)  236 
Gager,  William  (about  1630)     .     579 

Gairal 904 

Gairdner,  Wm.  T.  (born  1824)  916 
Gaius  (about  a.  d.  54)  .  .  149 
Galabin,  Alf.  L.  .         .         .  1090 

Galbiati,  Gennaro  (1776-1848)  1087 
Gale,  Benjamin  (1715-1790)  .  802 
Gale,  Thos.  (1507-1586)  .  417 
Galen  (a.  d.  131-201  or  210)  168-176 
Galeotti,  P.-  Urb.  (about  1787)  683 
Gales,  Jean  C.  (1783-1854)  .  852 
Galette,  Joh.  Fr.  (18th  cent.)  .  673 
Galezowski,  Xaver  (born  1832)  905 
Galilei,  Galileo  (1564-1642)  .  480 
Gall,  Franz  Jos.  (1757-1828)     .     881 

Gallard,  T 907 

Galli,  Antonio  (18th  century)  683 
Gallois,  Abbe  (about  1665)  .  482 
Galvani,  Luigi  A.  (1737-1798)  598 
Gamgee,  John  .  .  .  .717 
Ganivet.  Jacob  (about  1418)  .  291 
Gantt,  Dr.  (about  1801)  .         711 

Garancieres,  Theophilus  de  (about 

1647')  .  .  .  510  n.  1 
Garbo,  \Dinus  a  (14th  centur}-)  288 
Garbo,  Thomas  a  (died  1370)  .  288 
Garcia  del  Huerto  (da  Horta,  ab 

Horto,  about  1563)  .  .  368 
Garcia,  Manuel  (about  1855)  .  1021 
Gardane,  J.  J.  (about  1775)  656,  707 
Gardiner,  John  (about  1792)  .  656 
Gardien,  Claude  M.  (1767-1838)  1086 
Garengeot,  Bene  Croissant  Jac- 
ques (1688-1759)  .  663,700 
Gargilius  Martialis  (a.  d.  220- 

240)  .  .  .  184,  191 
Garib  ben  Said  (about  830-930)  230 
Gariopontus  (about  1 050)  .     262 

DeGarsault  (about  1755)  .     716 

Garth,  Sir  S.  (1660-1719)  762  n.  1 
Gartshore,  Maxwell  (1732-1812)  687 
Gaspard,     Marie     H.     Bernard 

(1788-1871)  .         899,  1004 

Gassendi,  Pierre  (1592-1655)  .  530 
Gasser,  Lorenz  (about  1750)  .  696 
Gassner,  Joseph  (1727-1779)  .  601 
Gataker,  Thomas  (about  1761)  677 
Gattenhof,  G.    M.   (1722-1788)     694 


—  1121 


Page. 

Gatti,  Angelo  (about  1765)  .  709 
Gaub,  Hier.  D.  (1705-1780)  607,  720 
Gaultier   de  Claubry,  C.    E.   S. 

(1785-1855)  ...  906 
Gauthier,  Job.  L.  (about  1793)  694 
Gavarret,  Jul.  (about  1842)  896,  898 
Gav-Lussac  (1778-1850)  .  850 
Gaza,  Theodorus  (died  1478)  .  293 
Geber  (about  a.  d.  750)  .         235 

Geddings,  Eli  (1799-1878)  .  1054 
Gehema,  J.  A.  (about  1690)  494,  517 
Gehler,  J.  C.  (1732-1796)  655,  685 
Geigel,  Alois  (1829-1877)  966,  995 
Geiger,  Mai.  (about  1650)  509,  569 
Geille   de    St.    Leger,    Charles 

(18th  century)  .  .  .694 
Gelmann,  Georg  (about  1652)  517 
Gelston,  Samuel  (about  1764)  802 
Gemini,  Thos.  (about  1559)  429  n.  2 
Gemusaeus,  Hieronymus  (Gesch- 

maus-,  died  1543)  .  .  372 
Gendrie  d'Angers  (about  1650)  541 
Gendrin,   M.   Aug.   Nic.   (about 

1840)  .  "  .  895,  899,  1013 
Gendron,    Louis  Flor.    Deshaix 

(about  1770)  .  .  .666 
Genga,  Bernardino  (about  1672)  512 
Gensoul,  Joseph  (1797-1858)  .  1039 
Gentilis  del  Fuligno  (d.  1318)  288 
Geoffroy,  Claude  J.  (1686-1752)  726 
Geoffroy,      Etienne      Francois 

(1672-1731)  .  .  723,726 
Gerarde,  John  ( 1 545  - 1 607)  436  n.  1 
Gerardus  a  Solo  (1320)  .  .  269 
Gerbert  (died  1003)  .         .     279 

Gerdy,  Pierre  Nic.  (1797-1856)  1037 
Gerhard  of  Cremona  (1114-1187)  285 
Gerhard,  W.W.(1809-1872)  925,  1015 

Gerhardt,  C 724 

Gerhardt,  K.  Ab.  (1738-1821)  694 
Gerhardt,  Karl  C.  A.  J.  (b.  1833) 

966,  995,  1018,  1085 
Germann,  H.  F.  (1820-1878)  709  n.  1 
Geromini,  F.  Gius.  (1792-1850)  870 
Gersdorf,  Hans  v.  (about  1517)  418 
Gerster,  Arpad  G.  1055 

Gervais,  Paul  (1816-1879)         .     852 

Gervis,  Dr 1090 

Gesellius  .....  1073 
Gesner,  C.  (1516-1565)  370,  376,  404 
Gesscher,  David  v.  (died  1810)  678 
Geuns,  Matth  van  (1735-1817)  694 
Gianozzi,  Thos.  (16th  century)  364 
Gibb,  Sir  Geo.  D.  (1821-1876)  918 
71 


Gibbes,  Robert  W.  (1809-1866)  632 
Gibert,  Camille  M.  (1797-1866)  902 
Gibson,  Benjamin  (1774-1812)  917 
Gibson,  Mr.  (about  1765)  .     717 

Gibson,  Joseph  (about  1726)  .  782 
Gibson,  Thomas  (died  1562)  .  413 
Gibson,  Thomas  (about  1684)  .  538 
Gibson,  William  (1784-1868)  .  1052 
Gietl,  Franz  Xaver  (born  1803)  995 
Giffard,  William  (about  1730)  .  687 
Gijat  el  Geith  (about  1335)  .  234 
Gil,  Francisco  (about  1784)  653,  711 
Gilbert   of  England    (Gilbertus 

Anglicus,  about  1290)  .  267 
Gilbert,  N.  P.  (1751-1814)  .  1033 
Gilbert,  William  (1540-1603)  .  370 
Gillard  .  .  .  .  '  .  1036 
Gilman,  C.  R.  (1802-1865)  .  1094 
Gimbernat,  Ant.  de  (about  1790) 

667,  700 
Gintrac,  Elie  (1791-1877)  .     903 

Gintrac,  J.  M.  H.  (1820-1878)  903 
Giovann,  di  Romani  (about  1520)  414 
Giraldes,  Joachim  (1808-1875)  1040 
Girard,  Gaspard  (1754-1830)  .  717 
Girard  de  Yillars,  L.  (18th  cent.)  694 
Girardi,  Mich.  (1731-1797)  .  698 
Giraud,  Bruno  (died  1811)  .  1032 
Giraud  Teulon,     Marc    Antoine 

(born  1816)  .  .  .905 
Giraudeau  de  St.  Gervais,  Jean 

(1802-1861)  .  .  .902 
Girault,  Jean  (16th  century)  .  416 
Girtanner.   Christ.   (1760-1800) 

633,  638,  656 
Glaser,  Joh.  H.  (1629-1675)  .  540 
Glauber,  Job.  Rud.  (1604-1688)  480 
Glaucias  (b.  c.  260)  .         95,  128 

Ghsson,    Francis    (1597-1677) 

510,  532,  536,  538 
Glover,  John  (about  1660)  .  581 
Gluck,  Th.  .  .  .  1069  n.  1 
Gmelin,  Eberhard  (1753-1809)  631 
Gmelin,  Ferd.  Gottl.  von  (1782- 

1848)  .  .  .  878,  941 
Gmelin,  Joh.  Fried.  (1748-1804)  727 
Gnosidicus  (6th  century  b.  c.)  93,  100 
Goekel,  Eberhard  (born  1636)  495 
Goclenius,  Rud.  (1572-1621)  485,  714 
Goddard,  J.  (1617-1674)  547  n.  1 
Goelicke,  A.  O.  (1671-1744)  611,  661 
Goethe  (1749-1832)  .     842 

Gohl,  Joh.  Dan.  (Ursinus  Wahr- 

mund,  1675-1731)      .      611,  761 


—  1122  — 


Page. 

Gohory,  Jacques  (Leo  Suavius, 

died  1576)  .        .        .395 

Goiffon,  Jean  B.  (1658-1730)  510 
Goldsmith,  Oliv.  (1728-1774)  762  n.  1 
GOlis,  Anton  L.  (1765-1827)  .  656 
Go-mei-schan  (a.  d.  1000)  .       53 

Gooch,  Benjamin  (died  1780)  .  674 
Gooch,  Robert  (1784-1830)  .  1089 
Good,  John  Mason  (1764-1827)  908 
Goodell,  William  .  .  .1097 
Goodoums,  "Win.  (about  1611)  418 
Goodsir,  H.  D.  S.  (about  1845) 

916,  1004 
Goodsir,   John  (1814-1867) 

844,  916,  1004 
Goodwin,  Lyde  (died  1801)  .  818 
Goodwyn,  Ed.  (about  1789)  707  n.  1 
Gorke,  Johann  (1750-1822)  670,  752 
Gordon,  Andr.  (about  1745)  .  724 
Gordon,  Bernard  de  (1285-1318)  267 
Gorgias  (b.  c.  250)  .  .  .126 
Gorgias  of  Leontium  (b.  c.  485- 

378)  ....       90 

Goris,  Gerard  (17th  centur}*)  .  525 
Gorrceus,  Johannes  (de  Gorris, 

1515-1577)  .  .  .372 
Gorres,  Jac.  Jos.  (1778-1848)  935 
Gorter,   Joh.   von    (1689-1762) 

607,  661,  693 
Gorup-Besanez,  E.  F.  v.  (1817- 

1878)  .        .        .        .851 

Gosius  (about  680)  .         208  n.  1 

Gosselin,  Ath.  Leon  (born  1815)  1040 
Gottisheiin,  Friedrich  (b.  1837)  995 
Gottling,  J.  F.  A.  (1755-1809)  727 
Goudoever,  L.  C.  van  (b.  1820) 

1075,  1098 
Goulard,  T.  (about  1760)  664,  720 
Gouley,  J.  W.  S.  .  .  .1055 
Goulin,  Jean  (1728-1799)  .     661 

Goullon  (died  1883)  .         .     876 

Goupil,  Claude  Ant.  (d.  1825)  1023 
Goupil,  Jac.  M.  A.  (1800-1837)  888 
Goupil,  Jean,  E.  (1829-1864)  .  907 
Gourmelen,  Etienne  (died  1593)  416 
Gourraigne,  Hugo  (about  1730)  501 
Goursaud  (about  1750)  .  .514 
Goursault  (about  1750)  .         665 

Goyrand,  G.  (1803-1866)  .  .1038 
Goze,  A.  Ephr.  (1731-1793)  .  852 
Graaf,  Begner  de  (1641-1673)  535 
Griife,  Alb.  v.  (1827-1870)  968,  1073 
Griife,  Alf.  Karl  (born  1830)  .  1074 
Graefe,  C.  Ferd.  v.  (1787-1840)  1060 


Pace. 

Graff,  Maria  S.  (1647-1717)  .  479 
Graham,  James  (about  1780)  632,  773 
Graham,  Thomas  (18U5-1869)  .  851 
Gram,  Hans  B.  (died  1840)  .  880 
Gramann,  Johann  (about  1593)  394 
Grandi,  Matteo  (about  1713)  .  500 
Grant,  William  (about  1780)  656,  728 
Granville,  Aug.  B.  (1783-1871)  1089 
Grapengieser,    C.  J.  C.    (1773- 

1813)  ....     634 

Grapheus,  B.  (14th  century  ?)  294 
Le  Gras  (about  1672)  •  .  .544 
Grasset,  Jos.  .         .         1018  n.  2 

Grattaroli,    Guilhelmo    (Gratta- 

rolo,  1515-1568)  .  .  436 
Grau,  Joh.'  David  (1729-1768)  694 
Graunt,  John  (about  1662)  .  542 
Grauvogl,  von  .        .         .     877 

Graves,  Robert  (1763-1849)  .  721 
Graves,  R.  James  (1797-1853)  914 
Gray,  Asa  (1810-1888)      .•       .844 

Gray,  John  F 880 

Gray,  John  P.  (1825-1886)  .  928 
Grav,  Landon  C.  .  .  .  929 
Gray,  Stephen  (about  1729)  .  724 
Greatrakes,  V.  (1628-1666)  485  n.  2 
Del  Greco  .         .         .         .1041 

Greding,  Joh.  E.  (1718-1775)  .  713 
Green,  Horace  (1802-1866)  .  925 
Green,  John  .  .  .  .  930 
Green,  Jonathan  (about  1835)  919 
Green,  Jos.  H.  (1791-1863)  .  1044 
Green,  J.  Orne  ...  930 
Greenfield,  John  (Jan  Groene- 

veldt,  about  1677)  .  .  417 
Greenhalgh,  R.  .         .         .1093 

Greenhill  .  .  .  .  916 
Greenhow,  Edward  H.  .  .  921 
Greenough,  F.  B.  .         .         927 

Green  way,  H 921 

Gregoires,  the  (18th  century)  .  680 
Gregorius  a  Vulpe  (15th  cent.)  295 
Gregorv,  David  (1661-1701)  618  n.  1 
Greo-ory,  James  (1758-1822)  618,  723 
Gregory,  John  (1724-1773)  618  n.  11 
Gregory,  W.  (1803-1853)  618  n.  1,  632^ 
Grembs,  Franz  0.  (about  1657)  490 
Grew,  Nehemiah  (1641-1712)  .  546 
Griesinger,  W.  (1817-1868)  970,  972 
Griesselich,  L.  .  .  .  .  876 
Griffin,  Daniel  (about  1834)  909,  922 
Griffin,  Wm.  (1794-1848)   '    909,  922 

Griffith,  R.  E 926 

Grigg,  Dr 1090 


112: 


Page. 

Grimaud,  Jean  Charles  M.  G.  de 

(1750-1789)  .  .  .627 
Grimes,  J.  S.  ...         882 

Grimm,  Job.  F.  K.  (1737-1821)  660 
Grisolle,  Augustin  (1811-1869)  899 
Gritti,  Rocco  .  .  .  .1011 
Gross,  Samuel  D.  (1805-1881)  1052 
Gross,  Samuel  W.  (1837-1889)  1053 
Gross,  Wilhelm  (died  1817)  .  876 
Grossi,  Ernst  v.  (1782-1829)  .  911 
Groux,  A.  (died  1878)  .  .  1016 
Grube,  Hermann  (about  1669)  195 
Gruber,  Josef  (born  1827)  .     9li8 

Gruby,  David  (b.  1811)  '  963,  1001 
Gruitliuisen,    Franz    Paula  von 

(1771-1852)  .         889,  1019 

Gruling,  Philip  (1591-1667)  .  181 
Gruner,  Christ.  G.   (1711-1815) 

600,  625,  617,  660,  662,  866 
Grunfeld,  Josef  (born  1810)  .  1022 
Grut,  Ed.  H.  (born  1831)  .  1076 

Guaineri  (Guainierio),  Antonio 

(died  1417)  .  .  .292 
Guani,  (about  1819)  .  .  871 
Guardia,  Jos.  M.  (born  1830)  899 
Guarinoni,  Ch.  (about  1600)  .  551 
Guarna,  Rebecca  (15th  century)  261 
Guattani,  Carlo  (1707-1771)  .  667 
Gubler,  Adolphe  (1821-1879)  906 
Gueneau  de  Muss}r,  Noel  £.  O. 

(born  1813)  .  .  .899 
Guerick,e,  Otto  v.  (1602-1688)  503 
Gu6rin,  A.  F.  M.  (born  1817)  L38 
Guenn,  Jules  (1801-1886)  .1038 
Guenn,  Pierre  (1740-1827)  .  666 
De  laGueriniere,  F.  R.  (ab.  1751)  716 
Guersant,  L.  B  Sr.  (1777-1818)  901 
Guersant,    L.    B.    (1800-1869) 

899,  901,  1039 
Guglielmini,  Dom.  (1655-1710)  500 
Guido  Guidi  (died  1569)  .  .  115 
Guidott,  Thomas  (about  1681)  516 
Guillemeau,  Chas.  (about  1618)  496 
Guillemeau,  J.  (1550-1613)  102.  103 
Guissard,  Pierre  (18th  century)  666 
Guldbrand,  J.  W.  (1714-1809)  1076 
Guldenklee,  T.  v.    (1609-1667) 

509,  540 
Guilelmus     Brixiensis      (Gugl. 

Corvi,  1250-1326)  .  .  269 
Gullv,  James  M.  1808-1881)  .  978 
Gundelsheimer,  A.  (1668-1715)  763 
Gunn,  Moses  ....  1055 
Gunsburg,  Friedr.  (1820-1859)     966 


Page. 

Gunsburg,  Liberal  (about  1845)  965 

G  anther,  F.  A.  (1806-1871)       .  877 

Gunther,Gustav  B.  (1801-1871)  1068 

Giintner,  Franz  X.  (1790-1882)  950 

Giinz,  Justus  Gottf.  (1714-1754)  669 

Gurlt,  Ernst  J.  (born  1825)     .  1073 

Gussenbauer,  Karl  (born  1842)  1072 

Gusserow,  Ad.  L.  S.  (born  1836)  1084 

Gutbrod,  J.  (died  1886)      .       .  965 

Giiterbock,  Ludw.   (born   1814)  913 

Guthrie,   Chas.  G.  (1817-1859)  917 

Guthrie,  George  J.  (1785-1856)  1015 

Guthrie,    Samuel   (about   1831)  1025 

Gutierrez,  Juan  (15th  century)  306 

Guttman,  iEgidius  (about  1575)  391 

Guttman,  Paul  (born  1831)        .  966 

Guy  de  Chauliac  (b.  about  1300)  305 

Guv,  Wm.  Aug.  (1810-1885)  .  920 
Guyon,  J.  C.  F.  (b.  1831)    1010,  1070 

Guyot  (about  1721)  .  .  666 
Gwinne,  Matthew  (d.  1627)     485  n.  2 

Gyer,  Nicholas  (about  1592)      .  413 

H. 

Ten  Haafl,  Gerhard  (1720-1791)  678 
Van  der  Haar,  Jac.  (1717-1799)  678 
Haartman,  K.  D.  v.  (1792-1878)  1077 
Haase,  Joh.  Gottl.  (1739-1803)  696 
Habicot,  Nicholas  (died  1624)  402 
Hack,  Wendelin  (about  1518)  298 
Hadden,  Jac.  van  (about  1660)  494 
Haeckel,  Ernst  H.  (born  1834)  842 
De  Haen,    Anton    (1704-1776) 

620,  694,  737 
Haeser,  Heinrich  (1811-1885)  .  948 
Hafenreffer,  Sam.  (1587-1660)  653 
Hagen,  Carl  Gottf.  (1719-1829)  727 
Hagen,  Joh.  Phil.  (1731-1795)  684 
Hager,  Michael  (1795-1857)  .  1058 
Hahn,  Joh.  Sieg.  (1696-1773)  .  723 
Hahn,  Siegismund  (1661-1742)  723 
Hahnemann,  Samuel  Christ.  Fr. 

(1755-1843)  .  .  720,  875 
Haindl,  Anton  Fr.  (1803-1855)  964 
Halbertsma,  Tjalling,  .         .  1098 

Hales,  Charles  (18th  century)  678 
Hales,  S.  (1677-1761)  598,  657,  697 
Halford,  Sir  H.  (1766-1844)  655,  91 5 
Hall,  John  (about  1565)  .  430  note 
Hall.  John  (about  1620)  .  434  n.  1 
Hall.  Lyman  (about  1776)  814  n.  1 
Hall,  Marshall  (1790-1857)  .  908 
Hall,  Richard  Wilmot  .  .1051 
Halla,  Joseph  von  (1816-1887)     961 


1124 


Page. 

Halle.  Jean  Noel  (1754-1822)  652 
Haller,  Albrecht  v.  (1708-1777) 

660,  689-691 
Halley,  Edmund  (1656-1742)  .  598 
Hallier,  Ernst  (born  1831)  844,  1005 
O'Halloran,  Sylv.  (1728-1807)  677 
Ham,  Joh.  (died  1723)  .  534,  n.  2 
Hamann  (1730-1783)  .  .  596 
Hamberger,  G.  E.  (1697-1755) 

503,  662,  692,  745 
Hamernjk,  Jos.  (1810-1887)  .  961 
Hamey,  Baldwin  (1600-1676)  .  543 
Hamilcar  ....     191 

Hamilton,  Alex.  (d.  1802)  656,  687 
Hamilton,  Allan  McLane  928,  929 
Hamilton,  Frank  H.  (1813-1886) 

1040  n.  1,  1053 
Hamilton,  James  (about  1825)  1091 
Hammond,  William  A.  928,  930 

Hammen,  Ludw.  v.  (1652-1689)  534 
Hanau,  Arthur  N.  (born  1858)  1009 
Hanbold,  Carl  .  .  .  .876 
Hancock,  Henry  (1809-1880)  .  1047 
Hancock,  John  (about  1723;  .  722 
Hannsen  von  Beyreut  (1461)  .  307 
Hansen.  G.  H.  A.  (born  1841)  1076 
Harapli  ben  Kaldaht  (died  a.  d. 

634) 219 

Hardawav,  W.  A.  .  .  .  927 
Harder,  Job.  Jac.  (1656-1711) 

532,  544,  963 
Hardie,  Gordon  K.  .  .  .  1049 
Hardy,  Alfred  (born  1811)  .  902 
Harlan,  Geo.  C.       .  930 

Harless,  J.  C.  F.  (1773-1853)  1085 
Harless,  E.  (1820-1862)  .  966 
Harley,  George  (born  1829)  .  916 
Harper,  Andrew  (about  1789)  .  715 
Harris,  W.  (1651-1725)  493,  527,  547 
Harrison,  Edward  (1766-1838)  902 
Harting,  Thomas  .  .  .  1067 
Hartley,  David  (1705-1757)  .  596 
Hartmann,  Ed.  v.  (born  1842)  841 
Hartmann,  Johann  (1568-1631)  485 
Hartmann,  Joh.  F.  (about  1770)  724 
Hartmann,  Peter  I.  (1727-1791)  748 
Hartmann,  Ph.  Jac.  (1648-1707) 

484,  530,  536,  542 
Hartmann,  Ph.  K.  (1773-1830) 

866,  938 
Hartshorne,  Henry  .  .  .  925 
Hartshorne,  Jos.  (1779-1850)  .  1054 
Hartsoeker,  Nic.  (1656-1725)  .  536 
Harvey,  Gideon  (about  1689)     .     507 


Page. 

Harvey,  William  (1578-1657)  527 
Hasenohrl,  Joh.   Geo.    (Lagusi, 

1729-1796)  .         .         .622 

Haslam,  John  (1764-1844)  713,  920 
Hasner  von  Artha,  J.  (b.  1819) 

968,  1073 
Hassall,  Arthur  H.  (born  1817)  916 
Hasse,  Karl  Ewald  (born  1810)  949 
Hasse,  Oskar  (born  1837)  .  1073 

Hassenstein  (about  1836)  .  1019 

Hasskarl,  Carl  .  .  .  .846 
Hastier,  Friedrich  (about  1756)  718 
Hastings,  Sir  Chas.  (1794-1866)  911 
Hauke,  Ignaz  (1832-1885)  .  1018 
Hauner,  Aug.  von  (1811-1884)  1085 
Hauptmann,  Aug.  (1607-1674)  551 
Haus,  C.  J.  (born  1799)  .  .1082 
Hauschka,  J.  Dominik  .  .  969 
Hausmann  ....  876 
Haiiv,  Rene  Just  (1743-1822)  599 
Havers,  C.  (about  1691)  493,  537,  538 
H award.  J.  W.  ...  1045 

Hawes,  William  (1736-1808)  707  n.  1 
Hawkins,  C.  (about  1739)  '  .  773 
Hawkins,  Caesar  (1798-1884)  .  1045 
Hawkins,  F.  B.  (about  1834)  .  920 
Hawksbee,  Francis  (about  1710)  724 
Haxall,  Robert  W.  .  1014 

Hayes,  Dr 1090 

Haysarth,  J.  (about  1790)  711,  825 
Hays,  Isaac  (1796-1879)  .  .  929 
Havward,  George  (1791-1863)  1054 
Hay  ward,  Lemuel  (died  1821)  802 
Heath,  Christopher  .  .  .  1047 
Hebenstreit,  E.  B.  G.  (1758-1803)  707 
Hebenstreit,  J.  E.  (1701-1757) 

612,  659 
Heberden,  William  (1710-1801) 

650,  707  n.  1 
Hebra,  Ferd.  von  (1816-1880)  958 
Hecker,  A.  F.  (1763-1811) 

660,  864,  938 
Hecker,  Just.  F.  K.  (1795-1850)  660 
Hecker,  Karl  von  (1827-1882)  1084 
Hecker,  Karl  Fr.  (1812-1878)  1074 
Hecquet,  Philippe  (1661-1737)  501 
Hedeloffer  .         .         .         .1034 

Hegar,  Alfred  (born  1830)  .  1084 
Hegel,  G.  W.  Fr.  (1770-1831)  841 
Hegenwald  ....  877 
Heiberg,  Christen  (1799-1872)  1076 
Heiberg,  Hjalmar  (born  1837)  1076 
Heiberg,  Joh.  F.  (1805-1883)  .  1076 
Heide,  Ant.  de  (about  1680)      .     517 


—  1125  — 


1072 
1U72 
1072 
1072 
631 
439 


Heider,  Moritz  (1816-1866)  .  1067 
Heim.  Ernst  Ludw.  (1747-1834) 

710,  751,  941 
Heine,  Bernh.  von  (1800-1846)  1027 
Heine,  Georg  von  (1770-1838) 
Heine,  J.  v.  (1800-1879)  1029 
Heine,  Karl  W.  v.  (1838-1877) 
Heineke,  Walther  H.  (b.  1834) 
Heineeken,  Job.  (1761-1851)  . 
Heinrieh  von  Bra  (died  1601) 
Heinroth,  Job..   Christian    Aug. 

(1773-1843)  .  662,  878,  936 
Heinsius,  Job.  A.  (1745-1803)  724 
Heister,    Lorenz    (1683-1758) 

668,  684,  695,  705,  780 
Heitzraann,  C.  (b.  1836)  927,  959,  968 
Held,    Antonia    Elizabetba  von 

(born  1729)  .  .  718  n.  1 
Heldon.  Ed,  (1542-1618)  434  n.  1 
Heliodorus  (about  A.  D.  100)  .  167 
Heller  (about  1777)  .         .     795 

Heller,  F.  (1813-1871)  963,  969,  1023 
Hellwig,  Christ,  v.  (1663-1721)  611 
Hellwig,  Johann  (1600-1674)  . 
Hehn,  Theodor  (1810-1875)  . 
Helmholtz,  H.  L.  (born  1821) 
Helmont,  Fr.  M.  (1618-1699)  . 
Helmont,  J.  B.  van  (1578-1644) 
Helvetius,  C.  A.  (1715-1771)  . 
Helvetius,  J.  F.  (1630-1709)  496,  544 
Hemerius  (4th  century)  .         191 

Hemmer,  Jacob  (1733-1790)  .  598 
Henckel,  J.  F.  (1712-1779)  669,  684 
Henderson,  W.  .         .         .911 

Hendriksz,  P.  (1779-1845)  .  1074 
Henisch,  Georg  (1549-1618)  566  n.  4 
Henke,    Adolph    Christ.    Heinr. 

(1775-1843)  .  .  864,  1085 
Henle,  Friedrich  Gustav  Jacob 

(1809-1885)  .  845,  972,  1005 
Hennig,  Carl  (born  1825)  1084,  1085 
Henoch,  Ed.  H.  (born  1820)  .  1085 
Henncus  ab  Hermondavilla 

(14th  century)    . 
Henricus  de  Saxonia  (13th  cent.) 

Henry.  M.  H 

Henry,  T 

Henschel,  A.  W.  T.  (1790-1856) 
Henshaw,  Nath.  (about  1664) 
Hensler.  Ph.  G.  (1733-1805)  600,  659 
Hensler,  Ph.  Ignaz  (1795-1861)  631 
Heraclianus  (about  a.  d.  150)  169 
Heraclides  (5th  cent.  b.  c.)  99,  100 
Hsraclides  of  Erythrsea  (b.c.230)    125 


510 

964 

1(120 

487 
486 
596 


269 
282 
928 
1047 
854 
503 


Page. 

Heraclides  of  Tarentum  (b.c.240)  128 
Heraclitus   of  Ephesus    (about 

55U-460  b.  c.)  .  .  .  '88 
Heras  oi  Cappadocia'(B.  c.  30)  129 
Herbart,  Job.  Fr.  (1776-1841)  841 
Herder  (1744-1803)  .         .     596 

Herdmann,  John  (died  1842)  .  638 
Herennius  Philo  (about  a.  d.  20)  158 
Hering,  Const.  (1800-1880)  .  880 
Herlicius,  D.  (1557-1636)  421,  526 
Hermann,  Job.  (1738-18(10)  .  719 
Hermann,  Jos.  (about  1857)  .  961 
Hermann,  Meister  (about  1490)  307 
Hermann,  P.  (1640-1695)  .     479 

Hermannus,  Magister  (13th  cent.)  286 
Hermippus         .  .         .115 

Hermogenes  (about  A.  D.  90)  166  n. 
Hermogenes  (about  b.  c.  250)  126 
Hermolaus  Barbarus  (1454-1493 )  292 
Herodicus  of  Selymbria  (b.    c. 

440)  .  .  .  .  93,99 
Herodotus  (about  A.  D.  100)  .  167 
Heron  (b.  c.  250)  .  .  .126 
Herophilus  of  Chalcedon  (about 

b.  c.  335-280)  .  121,  122,  123 
Herpin,  Th.  (about  1852)  .     903 

Herrera.  C.  P.  (about  1614)  .  550 
Hervieux,  Edonard  .  1098  n.  1 
Hery.  Thierry  de  (died  1599)  .  403 
Herz,  Marcus  (1747-1803)  .  647 
Heschl.  Richard  (1824-1881)    .     964 

Hesse,  W 1017 

Hesselbach,  A.  C.  (1788-1856)  1061 
Hesselbach,  F.  C.  (1759-1816)  1061 
Hesvchius  of  Damascus  (about 

"a.  d.  430)  .  .  .  .188 
Heubner,  J.  O.  L.  (born  1843)  995 
Heuermann,  G.  (1722-1768)  678,  693 
Heurne,    Jan     van    (Heurnius, 

1543-1601)  .         .         .411 

Heurnius,  Otto  (1577-1650)  .  554 
Heurteloup,  Charles  L.  Stanislas 

(1793-1864)  .  .  .  1037 
Heurteloup.  Nic.  (1750-1812)  1033 
Heusinger,  Karl  F.  (1792-1883) 

657,  744 
Heuvel,  J.  B.  van  (1802-1883)  1098 
Hevin,  Prudent  (1715-1789)  .  665 
Hewitt,  Sir  Prescott  G.  .       1045 

Hewitt,  W.  M.  Graily  .  1090,1093 
Hewson,  Addinell  .  .  .  1055 
Hewson,  Thos.  T.  (about  1815)  927 
Hewson,  William  (1739-1774)  697 
Hey,  William  (1736-1819)         .     676 


112(3  — 


Page. 

Hever,  K 966 

Heyfelder,  J.  F.  (1798-1869)  .  1077 
Hibetallah,  Ebp  Dschemi  (12th 

century)  ....  234 
Hicesius  of  Smyrna  (b.  c.  30)  126 
Hicks,  J.  Braxton  .  .  .1090 
Hidalgo  ele  Aguerro,  Bartholo- 
mews (1531-1597)  .  .  416 
Highmore,   Nath.    (1613-1685) 

493,  534,  537 
Hierocles  (4th  or  5th  century)  192 
Hieronymus  of  Lybia  (3d  cent.)  191 
St.  Hilaire,  Aug.  de  (about  1840)  844 
St.  Hilaire  Jaume  .  .  .  844 
Hildebrand,  G.  F.  (1764-1816)  696 
Hildebrand,  H.  (1833-1882) 

1084,1085 
Hildenbrand,  J.Y.v.  (1763-1818)  950 
Hildegarde  (1099-1179)  .  .  255 
Hill,  Berkeley  .  .  922,  1047 
Hill,  James  (about  1772)  .     674 

Hill,  John  (about  1760)  .  844 
Hillairet,  Jean  Bapt.  (d.  1882)  906 
Hillary,  William  (about  1743)  721 
Hillier,  Thomas  .        .         .919 

Hillman 1046 

Hilton,  John  (1804-1878)  .  1044 
Himerius  (4th  century)  .  .191 
Himly,  Carl  (1772-1837)  672,  937 
Himly,  Wilhelm  (1800-1881)  .  937 
Hinton,  James  (died  1875)  .  918 
Hippel,  Arthur  v.  (born  1841)  1074 
Hippocrates  I.  (b.  c.  500)  93,  100 
Hippocrates  II.,    the  Great 

(b.  c.  460-377  or  370)  98-1 1 1 
Hippocrates  family,  the  .  .100 
Hippocrates    the    "  Hippiater  " 

(1th  century  a.  d.)  .  .191 
De  la  Hire,  P.  (1640-1718)  .  1019 
Hirschberg,  Julius  (born  (1843)  1074 
Hirschel.  Bernh.  (d.  1873)  877,  880 
Hirschfeld.  Friedr.  (1753-1820)     673 

Hirst.  B.  C 1096 

Hirt,  F.  W.  L.  (about  1810)  .  710 
Hirt,  Ludwig  (born  1844)  .     995 

Histomachus  .  .  .  .115 
Hittell,  John  S.       .  882 

Hjarne,  Urban  (1641-1721)  .  721 
Hjort,  J.  S.  A.  (bom  1835)  .  1076 
Hoar.  Leonard  (about  1670)  581,  584 
Hoboken.  Nicolaus  (1632-1678)  535 
Hodge,  Hugh  L.  (1796-1873)  1095 
Hodge,  H.  Lenox  .  .  .  1055 
Hodgen,   John  T.    (1826-1882)  1054 


Piige. 

Hodges,  Nath.  (1638-1684)  493,  510 
Hodgkin,  Thomas  (1797-1866)  916 
Hodgson,  Jos.  (1788-1869)  894,  9 Hi 
Hoernigk,  L.  v.  (1600-1667)  .  541 
Hofer,  Wolfgang  (1614-1681)  509 
Hoffbauer,  J.  Chr.  (1766-1827)  713 
Hoffmann,  Ach.  .         .         .688 

Hoffmann,     Christ.     Ludwig 

(1721-1807)  .  .  623,  694 
Hoffmann,  C.  R.  (1797-1877)  852,  948 
Hoffmann,  Friedr.  (1660-1742) 

495,  613,  662,  705,  714,  721 
Hoffmann,  Karl  A.  (1760-1832)  850 
Hoffmann,  Moritz  (1622-1698)  536 
Honing,  Eugen  (1808-1880)  .  933 
Hofmann,  A.  W.  (born  1843)  .  995 
Hofmann,  Hermann       845,  1005  n.  1 

Hofmann,  J 964 

Hofmann,  Joh.  D.  (17th  cent.)  540 
Hofmann,  Kaspar  (about  1570)  392 
Hofmann,    Caspar   (1572-1648) 

396,  484,  530 
Hofmokl,  Joh.  (born  1840)  .1072 
Hohl,  Ant.  Fr.  (1794-1862)  .  1082 
Holbach  (1 723-1 789^)  .  .  596 
Holden,  Edgar  (born'l838)  .  1024 
H olden,  Luther  .         .         .  1047 

Holland,  Sir  Henry  (1788-1873)  915 
Holland,  Phil,  (about  1639)  .  547 
Hollandus.  Isaac  (15th  centur}')  310 
Hollerius,  Jac.  (Houillier,  1498- 

1562)  .  .  .  372,  398 
Hollybush,  Thos.  (about  1560)  413 
Holmes,  Oliver  Wend.  (b.  1809)  1014 
Holmes,  Timothy  .  .  .  1045 
Holmes,  W.  Gordon  .  .  .918 
Holscher,  Geo.  Fr.  (1792-1852)  1059 
Holthouse,  Carsten  (b.  1810)  .1046 
Holtzendorf,  E.  C.  (1688-1751) 

517,  752,  776,  795 
Homberg,  Wilhelm  (1651-1715)  481 
Home,  Sir  E.  (1763-1832)  702,  916 
Home.  Francis  (about  1765)  .  650 
Home,  James  .  .  .  723 
Honain  ebn  Ishak  (A.  D.  809-873)  226 
Hooke,  Sir  R.  (1635-1703)  540,  980 
Hooker,  Sir  W.  J.  (1785-1865)     844 

Hooper,  F.  H 926 

Hooper,  Robert  (d.  1835)  698,  1014 
Hoorn,  Joh.  van  (1661-1724)  525 
Hope,  James  (1801-1841)  911,  1014 
Hoppe,  David  H.  (1760-1846)  843 
Hoppe,  Joh.  (1616-1653)  .     550 

Hoppe-Sevler,  Felix  (born  1825)     994 


—  1127  — 


Page. 

Horekovicz,  Andreas  Dudith  v. 

(1533-1589)  .  397,  398 

Horenburgerin,  Anna  Elisabethe 

(about  1700)  .  .  .524 
Horlacher,  C.  ^ about  1695)  .  517 
Horman,  William  (d.  1535)  429  n.  1 
Horn,  A.  L.  E.  (1774-1848)  .  864 
Home,  Jan  van  (1621-1670)  533,  535 
Horner,  Gust.  B.  (1761-1815)  818 
Horner,  Job.  Fried,  (born  1831)  1074 
Horner,  W.  E.  (1793-1853)  924,  1054 
Horst,  Gregor  (1578-1636)  .  516 
Horst,  Jacob  (1537-1600)  .     367 

Horst,  Joh.  D.  (1616-1685)  509,  540 
Hosack,    David  (1769-1835) 

844,  923,  1 094 
Hossein  el  Isterabadi  (ab,  1155)  234 
Hoster,   John     (Hester,    about 

1590)  .  '  .  .  394,  417 
Hourmann  .  .  .  901,  1018 
Housset,  E.  J.  P.  (about  177-0)  691 
Houston,  John  (1802-1845)  .  914 
Houston,  Robert  (about  1701)  1041 
Hoven,  Fr.  W.  v.  (1760-1838)  864 
Howard,  Benjamin  .  .  .  1055 
Howard,  John  (1726-1790)  .  650 
Howe,  Joseph  W.  .         .       1055 

Howitz,  F.  J.  A.  C.  .  .  .  1098 
Howse,  Henrv  G.  (born  1841)  1044 
Howship,  John  (died  1841)  .  1047 
Huarte,  Juan  (about  1575)  .  409 
Huber,  Joh.  Jac.  (1707-1778)  696 
Hubert- Valleroux,  Marcellin  E. 

(1812-1884)  .  .  .904 
Huddart,  James  (about  1777)  .  851 
Huevel,  J.  B.  van  (1802-1883)  1098 
Hufeland,  Christ.  Wilh.  (1762- 

1836)  .  631,  715,  724,  865 
Huggel,  Joh.  Jac.  (about  1560)  398 
Hughes,  H.  M.  (1805-1858)  916,  1014 
Hughes,  J.  (about  1660)  .     578 

Hugo  (about  1725)  .  646,  709 
Hugo  of  Lucca  (d.  1252  or  1268) 

300,341,  343 
Hugo  Physicus  (died  1199)  277  n.  1 
Hugode*St.  Victoire  (d.  1140)  282 
Huguier,  P.  C  (1804-1873)  907,  1039 
Hulke,  John  W.  1047 

Hull,  A  Gerald  ...  880 
Hulme,  Nath.  (1732-1807)  656,  687 
Humboldt,  A.  v.  (1769-1859)  634,  866 
Hume,  David  (1711-1776)  .  596 
Hunczowsky,  Joh.  (1752-1798) 

670,  1058 


Page. 

Hundt,  Magnus  (1449-1519)  297  n.  3 
Hunter,  J.  (1728-1793)  656,  675.  697 
Hunter,    William    (1718-1783) 

675,  686,  698,  806 
Husson,  H.  Marie  (1772-1853)  899 
Huszty,  Zach.  G.  v.  (1754-1803)  707 
Hutchinson,  John  (1811-1861)  1018 
Hutchinson,  Jon.  (b.  1828)  922,  1048 
Hutchinson,  Jos.G  (1827-1887)  1054 
Huter,  Carl  C.  (1803-1857)  .  1083 
Hiiter,  K.  (1838-1882)  845,1006, 1072 
Huttenbrenner,  And.  (b.  1842)  969 
Huwe,  Johann  (died  1725)  .  688 
Huxham,  John  (1694-1768)  .  650 
Huxholz,  Wolradt  (born  1619)  524 
Huzard,  J.  B.  (1755-1838)  .  717 
Hyde,  Frederick  .  .  .  1055 
Hyde,  J.  Nevins  .  .  .  927 
Hyrtl,  Joseph  (born  1811)  .  969 
Hytell,  Georg  (17th  century)     .     515 

I. 

larchas  the  Gymnosophist  (1st 

century)  .  .  .  .180 
Iberin,  Veronika  (17th  cent.)  .  524 
Iccus  of  Tarentum  (about  B.  c. 

470) 93 

Ilg,  Joh.  Geo.  (1771-1836)  .  1058 
Ingalls,  E.  Fletcher  .  .  .926 
Ingenhousz,  Joh.  (1730-1799)  709 
Ingerslev,  Emmerick  .         .  1098 

Ingolstetter,  Joh.  (1563-1619)  393 
Ingram,  Dale  (about  1767)  656,  721 
Ingrassias,     Giovanni     Filippo 

(1510-1580)  .  .  415,  425 
Tonicus  of  Sardis  (a.  d.  360)  .  185 
Isaac  Juda^us  (a.  d.  830-940)  230 
Isambert,  Emile  (1828-1876)  .  905 
Ishak  ben  Amran  (about  a.  d. 

900) 230 

Ishak  ben  Soleiman  (Isaac  In- 

dseus,  a.  d.  830-940)  .     230 

Ishmael  ben  Elisha  (A.  D.  100)  35,  37 
Isidore  of  Seville  (died  636)  .  254 
De  i'lsle,  Rome  (1736-1790)  .  599 
Itard,  Jean  M.  G.  (1775-1838)  904 
IwanorT,  Alex.  (1836-1880)  .  1074 
Ivanchich,  Victor  von  (b.  1812)  1072 
Ives,  Eli  (1779-1861)         .         .  1025 

J. 

Jaccoud,  Sigismund  (born  1830)  903 
Jackson,  Carr  ....  1048 
Jackson.  Charles.  Thos.  (1805- 

1880)         .        .        .     1025  n.  1 


—  1128 


Jackson,  James  (1777-1867)  711,  923 
Jackson,  James  Jr.  (died  1834)  1015 
Jackson,  John  H.  (b.  1834)  917,  922 
Jackson,  Robert  (about  1798)  722 
Jackson,  Samuel  (1787-1872)  9^3 
Jacob,  Arthur  (1790-1874)  917,  1044 
Jacobi,  Abraham  .  .  925,  927 
Jacob  of  Forli  (died  1415)  .     291 

Jacobson,  Julius  (b.  1828)  .  1074 
Jacobson,  L.  L.  (1783-1843)  .  1037 
Jacobus  •'  Ps3-chrestus  "    (about 

a.  d.  460)    .         .         .         .188 
Jacques,  Krere,  vid.  Baulot. 
Jacquin,  Nic.  J.  v.  (1727-1817)     599 
Jadelot,  J.  F.  N.  (about  1840)     901 

Jadioux 899 

Jaeger,  Eduard  (1818-1884)  .  968 
Jaeger,  Fr.  (1784-1871)  968,  1019 
Jaeger,  G.  F.  (1785-1866)  .     866 

Jaeger,  K.  C.  F.  v.  (1775-1828)  968 
Jaeger,  Michael  (1795-1838)  .  1062 
Jafedi,  el  (about  1341)  .  .  234 
Jahn,  Fr.  (1766-1813)  948,  1085 

Jahne        .  .  1018 

Jaksch,  Anton,  Ritter  von  War- 

tenhorst  (1810-1887)  .     961 

Jallabert,  Louis  (1712-1768)  .  724 
Jamain,  Jean  Alex.  (1816-1862)  1039 
Jamblichus  (about  A.  D  300)  181 
Jamerius  (Jamerus,  13th  cent.)  M00 
James,  M.  Prosser  .  ,  .918 
James,  Robert  (1703-1776)  .  652 
James,  Thos.  C.  (1766-1835)  .  1094 
Jameson,  H.  G.  (1792-1856?)  1054 
Janewav,  Edward  G.  ,         .     925 

Janin,  Jean  (1731-1799)  .  666 
Jansen,  Jan  H.  (1816-1885)  .1075 
Jansen,  Zach.  (about  1620)  .  480 
Jansou,  Samuel  (about  1680)  .  522 
Janus  Damascenus,  vid.  Mesue. 
Janvrin,  Jos.  E.  .         .         .  1097 

Jaquemet,  Hippolyte  .         .     906 

Jarjavay,  J.  F.  (1819-1868)  .  1<»39 
Jasolinus  (about  1668)  .         537 

Jasser  (about  1782)  .         .     667 

Jausseraud,  J.   P.    (18th  cent.)     694 

Jeannel,  J 906 

Jeffray,  James  (about  1806)  .1027 
Jeffries,  B.  Joy  .  .  927,  930 
Jehuda  Hakkadosch  .         .       35 

Jenner,  Edward  (1749-1823)  .  710 
Jenner,  Sir  William  .         .915 

Jenks,  Edward  W.  .         .1097 

Jenty,  C.  N.  (about  1758)       687,  698 


Page. 

Jesla,  Jahjah  ebn  (d.  A.  D.  1 100)  230 
Jest}',  Benjamin  (about  1774)  710 
Jesus,  son  of  Sirach   (2-3  cent. 

B.  c.)  ....       32 

Jewell,  J.  S.       .         .  .     929 

Jezzar,  Ebn  el  (d.  a.  d.  1004)  210,  228 
Joannitius  (a.  i).  b09-873i  .  226 
Jobert  de  Lamballe,  Antoine  J. 

(1799-1867)  .  1021),  1037 
Johannes  ab  Indagine  (ab.  1546)  364 
Johannes  Afflacius  (11th  cent.)  260 
Johannes  Castalius  (12th  cent)  263 
Johannes  de  Tornamira  (about 

1400)  .         .         .         .269 

Johannes,  Magister  (about  1 245)  286 
John  of  Alexandria  (about  A.  D. 

600) 204 

John  of  St.  Amand  (about  A.  i>. 

1200)  .         .         .         .308 

John  of  Avignon  (about  1419) 

291,  306 
John  le  Spicer  (about  1334)  .  335 
John  of  Milan  (about  1100)  .  260 
John  Philoponus  (6th  centuiy)  204 
Johnson  ....  1045 

Johnson.  Charles  (1794-1866)  919 
Johnson,  Christopher  .  .  1055 
Johnson.  Dr  (about  1845)  .  1088 
Johnson.  George  .  .  .  918 
Johnson,  H.  .  .  ,  .  914 
Johnson,  James  (1777-1845)  .  921 
Johnson,  Rob.  W.  (about  1769)     686 

Johnston 1088 

Johnston,  Alex.  (1716-1799)  707  n.  1 


Johnston,  John  (about  1661)  .  714 
Johnstone,  James  (about  1787)  721 
Johnstone,    John    (1768-1836) 

713,  911  n.  1 


Jolly,  Paul  (1790-1879)    . 
Jolyff,  George  (about  1650) 
Jones,  H.  (about  1854) 
Jones,  H.  M.  (born  1834) 
Jones,  John  (about  1572) 
Jones,  John  (about  1683) 
Jones,  John  (1729-1791) 
Jones,  Robert  (about  1782) 
Jones,  Sidney 


906 
533 
916 
918 
546 
493 
816 
638 
1044 


7  J  Jones,  T.  W.  (b.  1808)    916,  917,  1047 

Jordan,  Thos.  (1539-1585)         .  410 

Jorden,    Edward    (about    1631)  546 

Jorg,  Eduard  (1808-1872  ?)      .  1085 

Jorg,  J.  C.  G.  (1779-1856)        .  1081 

Josat,  J.  A.  (about  1856)            .  903 

Josephi,  Wilhelm  (1763-1845)  715 


1129  — 


Joubert,  L.  (1529-1583)  397,  398, 
Jourdan,  A.  J.  L.  (1788-1848) 
Jourdain,  A.  L.  B.  B.  (1734-1816) 
Jsfovdik,  Job.  ;N.    (1776-1841) 
Juler,  Henry  E. 
Julian  the  Elder  (a.  r>.  140) 
Juncker,  Joh.  (1680-1759)     611, 
Jung,  Joachim  (1587-1657) 
Junghuhn,  F.  W.  (1809-1864)  846 
Jiingken,  J.  C.  (1793-1875)  1060,  1 
Jungken,  Job.  H.  (1648-1726) 

517,  527, 
Jungmann,  Anton  Joh.  v.  (1775- 

1854)  .         .  1058,  1 

Jung-Stilling,  J.  H.  (1740-1817) 
Jiirgensen,  Th.  H.  (born  1840) 
Jurin,  James  (1684-1750)  502, 
Jussieu,  A.  L.  de  (1748-1831) 
Jussieu,  Bern,  de  (1699-1777) 
Justamond,  J.  O.  (about  1775) 
Justus,  Otto  (about  1736) 
Juville,  Jean  (about  1773) 

K. 


416 

888 
666 
779 
917 
142 
695 
477 
n.  1 
073 

547 

082 
672 
995 
677 
599 
599 
674 
696 
665 


59 


Kagawa-gen-ets  (fl.  1795) 
Kaltschmidt,  Karl  Fried.  (1706- 

1769)         .         .         .       669,  684 

Kiimpf,   Joh.   Jr.    (1726-1787)  623 

Kampf,  Johann  Sr.  (died  1753)  623 

Kampf,  W.  L.  (about  1756)        .  624 

Kainpfer,  Engelb.   (1651-1716)  508 

Kant,    Immanuel    (1724-1804)  597 

Kaposi,  Moritz  (born  1837)        .  959 

Kapp,   Christ.    E.    (1739-1824)  619 

Karl,  Joh.  Sam.  (1676-1757)     .  611 

Kast,  Thomas  (1750-1820)        .  818 

Kaufmann,  Balth.  (about  1668)  474 

Kaulicb,  Joseph  (1*30-1886)     .  969 

Kauseh,  Joh.  Jos.  (1771-1825)  718 
Keate,  Robert    .         .         .         .1045 

Keber,  G.  A.  F.  (1816-1871)     .  844 

Keen,  W.  W 1055 

Keep,  N.  C 1096 

Kehrer.  Ferd.  Ad.   (born  1837)  1084 

Keilin,  Marg.  (17th  century)      .  524 
Keill,  James  (1673-1719)       502,538 

Keith,  Thomas            .         .         .  1093 

Keller,  J.  G.  C.  (about  1780)     .  778 

Kelling,  Simon  (about  1593)      .  413 

Kempster,  Walter  K.          .         .  928 

Kennedy,  Evory     .         .         .  1093 

Kennedy,   James  (about  1825)  919 

Kennedy,    Peter    (about    1713)  677 

Kentish.  '  Edward    (died  1832)  1018 


Page. 

Kentmann,  Joh.  (1518-1568)  .  370 
Kepler,  Joh.  (1571-1630)  .     539 

Kerf  by  le,  Joh.  (about  1690)  580,  587 
Kerger,  Martin  (about  1663)  .  495 
Kerkring,  Theo.  (i64U-1693)  .  535 
Kern,  Vincenz  von  (1769-1829)  1057 
Kerner,  Just.  (1786-1862;  631,  937 
Kerr  (18th  century)  .         .     676 

Kesmarszky  ....  1083 
Kessler,  A.  E.  (1784-1806)  .  631 
Kestner,  C.  W.  (1694-1747)  .  661 
Ketham,  Joh.  de  (about  1492)  295 
Key,  Chas.  Aston  (1810-1849)  1044 
Keyes,  Edward  L.  .  .  .  928 
Kielmeyer,  K.  Fr.  (17*15-1844)  935 
Kiernan,  F.  (about  1833)  912,  916 
Kiersted,  Hans  (about  1640)  .  578 
Kieser,   Dietrich  Georg  (1779- 

1862)  .  .  631,934,938 
Kilian,  Conr.  Jos.  (1771-1821)  937 
Kilian,  Herra.  Fr.  (1800-1863)  1082 
Kimball,  Gilman  .  .  .  1097 
King,  A.  F.  A.  .  ■  .  1096 
King,  Edmund  (about  1665)      .     513 

Kinloch,  R.  A 1055 

Kirbv,  John  (about  1816)  .     912 

Kircher,  Ath.  (1598-1680)  485.  510 
Kirkbride,  Thos.  S.  (1809-1883)  928 
Kirkland,  Thos.  (1721-1798)  .  676 
Kirkpatrick,  Dr.  (about  1738)  802 
Kissam,  Richard  S.  (died  1822)  1054 
Kissam.    Samuel    (about   1775)     809 

Kissel,  C 977 

Kitchen,  Dan.  H.  K.  .  .  928 
Kite.  Chas.  (about  1788)  707  n.  1 
Kiwisch,    Franz   (1814-1852) 

956,  1U23,  1083 
Klaproth,  M.  H.  (1743-1817)  597,  726 
Klarich,  F.  W.  (1721-1780)  .  724 
Klaunig,  F.  M.  H.  (born  1815)  1020 
Klebs,  Ed.  (b.  1834)  844,  994,  1005 
Klein,  Christ,  von  (1740-1815)  1064 
Kleinwachter,  L.  (born  lb 39)  .  1084 
Kletzinsky,  Vine.  (1826-1882)  969 
Klob,  Jul.  M.  (1831-1879)  844,  964 
Kluge,  Carl  Alex.  Ferd.  (1782- 

1844)  .  (131,  1029,  1083 

Knackstedt.  C.  E.  H.  (174M-1799)  679 
Knapp,  H.  (b.  1832)  930,  1056,  1074 
Kobelt,  Georg  L.  (1804-1857)  966 
Koch,  Dan.  Emil  (about  1780)  624 
Koch,  M.  (about  1831)  .  .1062 
Koch,  Robert  (born  1843)  .  1006 
Koch  (Copus),  W.  (1471-1522)     294 


—  1130  — 


Page. 

Koch,  Wilhelm  (born  1842)  .  1077 
Koch,  W.  D.  J.  (1771-1849)  .  843 
Koeberle,  Eugene  (b.  1828)  907,  1040 
Koelpin,  Alex.  (1731-1801)  .  678 
Koelreuter,  S.  (about  1574)  .  398 
Koerner,  Moritz  (1820-1876)  .  965 
Kolisko,  Eugen  (1811-1884)  .  965 
Kolk,  J.  L.  C.  Schroeder  van  der 

(1797-1862)  .  .  .  1075 
Kolletschka,  J.  (1803-1847)  .  951 
Kolliker,  Rud.  Alb.  (b.  1817)  972 
Kijiiig,  W.  (born  1832)  .  .  1072 
Kopp,  Job.  H.  (1777-1858)  .  876 
Koraes,  A.  (Coray,  1748-1833)  6U0 
Kornthauer,  Hiob  (about  1622)  486 
Kortiira,  C  A.  (1745-1824)  656,  661 
Kortiim,  K.  G.  Th.  (1765-1818)  656 
Kotbi,  Ebn  el  (about  1311)  .  236 
Kotb-ed-Din  el  Schirazi  (1236- 

1311)  .         .         .         .234 

Kovacs,  C.  A.  (1815-1878)  .  1072 
Koyter,  Volcher  (1534-1600)  ..  428 
Kraak,  Job.  (1745-1810)  .  688 
Krackowizer,  E.  (1821-1875)  .  1051 
Krlimer,  J.  C.  A.    (1816-1878) 

852,  1004 
Kramer,  W.  (died  1875)  .  .1021 
Kraske,  Paul  (born  185 1)  .  1073 

Kratzenstein,  C.  G.  (1723-1795)  724 
Krause,  Karl  0.  (1716-1793)  .  694 
Krembs,  Georg  (died  164S)  .  566 
Kreysig,  F.  L.  (1770-1839)  866,  888 
Krieger  .....  995 
Krieger,  F.  W.  (1805-1881)  .  1075 
Krishaber,  Maurice  (b.  1836)  .  905 
Kristeller  ....  1084 

Krito 159 

Kritter  (18th  century)  .  .  673 
Krohn  (about  1770)  .  .  782 
Krombholz,  V.  J.  (1783-1844)  957 
Kronlein,  R.  U.  (born  1847)  .  1073 
Kriiger-Hansen,     Bogislaus     C. 

(1776-1850)  .  .  878,  958 
Kriiger,  Joh.  G.  (1715-1759)  .  503 
Kriiger,  Simon,  (1687-1760)  .  678 
Krukenberg,  P.  (1788-1865)  941,  1014 
Kriinitz,  Joh.  G.  (1728-1796)  .  763 
Krzowitz,     Wenzel    Trnka    von 

(1739-1791)  .  .  622,  737 
Kuchenmeister,   G.  F.  H.  (born 

1821)  ....  1018 
Kiichler,  Heinrich  (1811-1873)  1074 
Kuehn,  Carl  G.  (1754-1840)  .  661 
Kuhn 1084 


Page. 

Kuhn,  Adam  (1741-1817)  .  808 
Kiihne,  Willy  (born  1837)  .     994 

Kuhnt,  Herm.  (born  1850)  .  1074 
Kulmus,  Joh.  Ad.  (1689-1745)  695 
Kundrat,  Hans  (born  1845)  .  969 
Kunkel  von  Lowenstern  (1030- 

1703)  .         .         .         .557 

Kunrat  von  Megenberg  (1307- 

1374)  .         .         .         .287 

Kunrath,  Heinrich  (1560-1605)  394 
Kusemuller,  Friedr.  (18th  cent.)  656 
Kussmaul,  Adolf  (b.  1822)  1019  n.  1 
Kunyngham,  Wm.  (16th  cent.)  413 
Kymmel,  Joachim  L.  .         .  1098 

Kyper,  Albert  (died  1655)  .     554 


Labatt,  Dr.  (about  1820)  .  .1088 
Labbe,  Leon  (born  1832)  .  .  1040 
Labbe,  Phil,  (about  1 660)  .     484 

Laborie,  Jean  E.  (1813-1868)  1039 
Laboulbene,  J.  J.  A.  (b.  1825)  907 
Lacepede,  C.  B.  de  (1756-1828)  599 
Lachaise,  Claude  (about  1828)  1038 
Lachapelle,  M.  L.  (1769-1821)  1085 

Lacour 1086 

Lacuna,  vid.  Laguna. 
Laennec,    Rene    Th.   Hyacinthe 

(1781-1826)  .         1012-1013 

De  Lafosse,  the  two  (18th  cent.)  716 
Lafuente  (18th  century)  .  .  653 
Laghi,  Tommaso  (about  1760)  694 
Lagneau,  Louis  Y.  (1781-1868)  906 
Lagresie  .....  1033 
Laguna,  And.  (1499-1560)  427,  714 
Lagusi,  vid.  Hasenohrl. 
Lair,  Samuel  (about  1828)  1023  n.  1 
Lallemand,  C.  F.  (1790-1854)  888 
Lallement,  A.  M.  (1750-1834)  1032 
Lamarck,   Jean  Bapt.  A.  P.  de 

(1744-1829)  .  .  .843 
Lambert,  A.  B.  (about  1822)  .  844 
Lambert,  Jean  A.  (about  1656)  514 
Lambert,  Nic.  (about  1575)  .  40& 
Lambl,  Damian  von  .         .     967 

Lamzweerde,  Jan   Bapt.  (about 

1683)  .         .         .         .525 

Lancereaux,  Etienne  .         .     902 

Lancisi,  G.  M.  (1655-1720)  510,  536 
Landi,  Pasquale  (born  1817)  .  1041 
Landis.  Henry  G.  .  .  .  1096 
Landois,  Leonard  (born  1837)  1024 
Landolt,  Edmund  (born  1846)  905 
Landouzy,  M.   H.   (1812-1864)   1016 


—  1131 


Page. 

Lane,  S.  .  .  .  915,  1093 
Lanfranc  (1005-1089)  .  .  279 
Lanfranchi  (died  about  1315)  304 
Lang,  Eduard  (born  1841)  .     959 

Lange,  Frederick  .  .  .  1055 
Lange,  Johann  (1485-1565)  372,  398 
Lange,  Job.  Cbr.  (1619-1662)  510 
Lange,  Job.  Cbr.  (1655-1701)  550 
Lange,  Wilbelm  (1813-1881)  .  1084 
Langenbeck,  Bernbard  v.  (1810- 

1887)  .        .  1027,  1069 

Langenbeck,  Conrad  Job.  Mart. 

(1776-1851)  .  .  .  1058 
Langenbeck,  G-.  F.  .         .       1059 

Langenbeck,  Max  (1818-1877)  -1059 
Langenbeck,  B.  A.  (1772-1835)  1059 
Langermann,  Job.  Gottf.  (1768- 

1832)  .  .  .  713,  719 
Langbans,  Paul  (1848-1888)  .  1008 
Langrisb,  Browne  (about  1750)  615 
Lanza,  Vincenzio  (about  1811)  870 
Lanzoni,  Giuseppe  (1663-1730)  512 
Laplace,  Pierre  S.  (1719-1827)  598 
Laqueur,  Ludvvig  (born  1839)  .  1074 
Largus,'Scribonius  (a.  d.  45)  143,  723 
Larrey,  Hippolyte  .         .       1033 

Larrey,  J.  D.  (1766-1842)  798,  1032 
Lasnier,  Bemy  (d.  about  1690)  514 
Lassus,  Pierre  (1741-1807)  .  1032 
Latbam,  Edward  .  .  .  921 
Latbam,  P.  M.  (1789-1875)  912,  1014 
Latbyrion  (or  Satyrion,  3d  cent.)  177 
Latour,  J.  B.  J.  A.  (1805-1882)  899 
Latrobe,  J.  F.  (about  1795)  .  638 
Latz,  Gottlieb  (born  1818)         .     977 

Lau,  C.  A 1083 

Lauer,  Gustav  v.  (1808-1889)  .  1073 
Laugier,  Stanislas  (1799-1872)  1038 
Laumonier,  Jean  Bapt.    (1749- 

1818)  .  .  .  1041  n.  1 
Launay,  Jean  de  (1649-1701)  514 
Lauth,  Tbomas  (1758-1836)  .  696 
Lauverjat,  Th.  E.  (about  1788)  682 
Lavater,  Heinricb  (1569-1623)  485 
Lavater,  J.  C.  (1741-1801)  596,  631 
Lavoisier,  A.  L.  (1743-1794)  597,  726 
Law,  James  .  .  .  844  n.  1 
Lawrence,  Tbomas  (1711-1783)  612 
Lawrence,  Sir  Wm.  (1783-1867) 

917,  1046 
Lawson,  George  .         .        .  1047 

Lawson,  L.  M.  (1812-1864)  .  1015 
Layard,  D.  P.  (about  1776)  687,  717 
Laycock     .....     915 


896 
543 
666 
922 


Layet,  Alex.  E.  (born  1840)  .  906 
Lazzati,  Pietro  (1836-1871)  .  1087 
Leake,  Jobn  (died  1792)  686,  782 
Learning,  James  B.  (born  1820)  1015 
Leared  .  .  .  .  ,1016 
Leber,  Ferdinand  (1727-1801)  670 
Leber,  Theo.  (born  1840)  968,  1074 
Lebert,  Herm.  (1813-1878)  .  900 
Leblanc,  Louis  (about  1779)  .  665 
Lebmacher,  VaL  F.  (died  1797)  684 
Lecanu,  Louis  Bene  (b.  1800) 
Leclerc,  Daniel  (1652-1728)  . 
Lecluse  (abcut  1750) 
Lee,  Henry  .... 
Lee,  B.  (1793-1877)  916,  1090 

Lee-Shee-Tsbin  (about  a.  d.  1 550)  54 
Leeuwenboeck,    Anton    van 

(1632-1723)  .  531,  534,  537 
Lefebure    de   Saint    Tldefont 

(1744-1809) 
Lefferts,  George  M. 
Lefort,  Leon 
Legallois,  Eugene  (1804-1831)  899 
Legouest,  Y.  A.  L.  (1820-1889)  1039 
Legros,  Cbarles  (born  1834)  .  9n3 
Lebmann,  C.  G.  (1812-1863)  .  851 
Lebmann,  Leopold 
Lebrs  ..... 
Leibnitz,  Gottfried  Wilhelm  von 

(1646-1716)  .  595,  798 

Leichner,   Eccard  (about  1676)     495 
Leicbsenring,  C.  D.  (about  1843) 
Leicbsenring,  0. 
Leidenfrost,  J.  G.  (1715-1794) 
Leidesdorf,  Max  (born  1819) 
Leigb,  Chas.  (1650-1710)       4<i3,  546 
Leigh,  Jobn  (about  1785)  .     826 

Leishman,  William  .         .       1091 

Leisrink,  H.  W.  F.  (1845-1885)  1073 
Lejumeau  de  Kergaradec,  J.  A. 

(1788-1877)  .  1016,1085 
Lemery,  Nicolas  (about  1697)  547 
Lemos,  Luiz  (Ludovicus  Lemo- 

sius,  about  1580)  .  373,  398 
Lenseus  (b.  c.  50)      .  .158 

.Lenoir,  Adolphe  (1802-1866)  .  1039 
Lentilius,  Bosinus  (1657-1733)  495 
Lentin,  J.  F.  L.  (1776-1803)  647,  673 
Lentin,  L.  F.  B.  (1736-1804)  647 
Leo  tbe  Iatrosopbist  (9tb  cent.)  208 
Leonsenas,    Job.    Atb.     (about 

1646)  ...  556  n.  1 
Leone,  Carcano  (1536-1606)  .  429 
Leonicenus,    Nic.    (1428-1524)     291 


656 
926 

1 038 


1098 
949 


965 
966 
655 
969 


1132  — 


Page.  | 

Leonides  of  Alexandria  ("about 

a.  d.  200)  .  .     177 1 

Leopold,  Gerhardc  (born  1846)  1084  j 
Lepecq    de    la    Cloture    ( 1736— 

1804)  .  .  .  652,  661 
Lepelletier  de  la  Sarthe,  A.  R. 

J.  (born  1790)     .         .         .     902 j 
Lepois,  Guillaunie  (Willeni  Piso, 

1611-1678)  .         .     544  n.  1 

Lerche,  T.  H.  W.   (1791-1847)   1077  ! 
Lerminier,  Theo.  N.  (born  1770)     895] 
Leroy,  A.  L.  V.  (1742-1816)      .     682 
Leroy  d'Etiolles,  Jean  Jac.  Jos. 

(1798-1860)  .  .  .  1028 
Lessing,  G.  E.  (1729-1781)        .     596 

Letheby,  H 921 

Lettsom,  J.  C.  (1744-1815)        .     652 

Letzerich,  L 844 

Leube,  Wilh.  O.  (born  1842)  .  995 
Leuckart,  F.  R.  (born  1823)  .  852 
Leupold,  J.  M.  (1794-1874)  877,  937 
Leuret,  Francois  (1797-1851)  899 
Levacher  de  la  Feutrie,  A.  F.  T. 

(about  1790)  .  .  .657 
Levasseur,  Louis  (about  1668)  496 
Levert,  H.  S.  .  .  .  1029  n.  3 
Levret,  Andre  (1703-1780)  .  681 

Levy,  Michel  (1809-1872)  .     906 

Lewin,  Georg  R.  (born  1820)  1021 
Leyden,  Ernst  (born  1832)  814,  994 
Libavius,  Andreas  (1516-1616) 

396,  513,  546 
Licetus,  F.  (Liceti,  1577-1657)  531 
Lichtheiin,  Ludwig  (born  1845)  995 
Liebig,  Just,  v.  (1803-1873)  851,  978 
Lieberkiihn,  J.  N.  (1711-1765)  695 
Liebermeister,  Carl  (born  183 ->)  995 
Liebreich,  R.  (b.  1830)  905.  917,  994 
Liegeard  .  .  .  .  '  .  1086 
Liegeois,  Auguste  (died  1871)  1039 
Lieutaud,  Jos.  (1703-1780)  652,  700 
Linacre,  Thos.  (1461-1524)  292-93 
Linares,  Antonio  Romero  .  1042 

Lincoln,  D.  F 929 

Lincoln,  Rufus  P.  .         .         926 

Lind,  James  (1736-1794)  .     656 

Lindley,  John  (1799-1365)  .  844 
Lindsey,  William  L.  .         .     920 

Lindwurm,  Jos.  v.  (1821-1874)  995 
Ling,  Peter  H.  (1776-1839)  659,  1028 
Linhart,  Wenzel  v.  (1821-1877)  1062 
Lining,  John  (1708-1760)  .     804 

Link,  H.  F.  (1769-1851)  .     843 

Linne,  Karl  v.  (1707-1778)       .     599 


Page. 

Lipsius,  Justus  (1547-1606)  .  368 
Lisfranc,  Jacques  (1790-1847) 

907,  1016,  1035 
Lister,  Sir  Joseph  (born  1827) 

921,  1006,  1030,  1049 
Lister,    Martin    (1638-1711) 

493,  509,  536,  546 
Liston,  R.  (1794-1847)  1021,  1047 
Little,  James  L.  (1836-1885)  .  1054 
Little.  Wm.  J.  (b.  1810)  789,  K)48 
Littre,  Alexis  (1658-1725)  .  537 
Littre,  M.  P.  E.  (1801-1881)  842,  907 
Litzmann,  C.  C.  T.  (b.  1815)  .  1084 
Liveing,  Robert  .         .         .919 

Lizars,  John  (1783-1860)  .  1047 

Llacaj'O  y  Santa,  Maria  Aug.  .  1042 
Lobel,  Gustav  (1817-1880)  954  n.  1 
Lobelius,  Matth.  (1538-1616)  370 
Lober,  C.  G.  (18th  century)  .  714 
Lobera    d'Avila,    Luis    (about 

1551)  .  .  409,421,714 
Lobstein,  J.  F.  Sr.  (1736-1784)  696 
Lobstein,  J.  F.  Jr.  (1777-1835)  696 
Lobstein,  J.  G.  (1777-1838)  .  1086 
Locher,  Hans  (1824-1873)  956.965 
Locher-Zwinoli,  H.  (1800-1865)  1059 
Locke,  John  0632-1 704)  .     477 

Locock,  Sir  Chas.   (1799-1875) 

1049,  1090 
Loder,  J.  C.  v.  (1753-1832)  696,  883 
Loebisch,  J.  L.  (1761-1853)  .  K  85 
Loew  (about  1719)  .  .  .  655 
Loew  von  Ersfeld,  Joh.  Fried. 

(1648-1727)  .  .  .554 
Loewenbers,  B.  B.   (born  1836)     904 

Logan,  Sir  G 1049 

Lohmeyer,  C.  F.  .  .  .  1073 
Lombard,  C.  A.  (1741-1811)  .  665 
Lombard,  Henri  C.  (about  1810)  899 
Lommins,   Jodocus  (Joost  van 

Lorn,  about  1560)  .  .411 
Londe,  Charles  (1795-1862)  .  906 
Long,  Crawford,  W.  .  1025  n.  1 
Long,  St.  John  (about  1830)  .  774 
Longet,  Fr.  Achille  (1811-1871)  903 
Longmore,  Thomas  (born  1816)  1049 
Lonicerus,  Adam  (1528-1586)  421 
Lonsdale  (about  1847)  .  .915 
Loomis,  Alfred  L.  .  925,  1015 
Lopez,  Rosier  (about  1590)  .  405 
Lorain,  Paul  Jos.  (1817-1876)  907 
Lorin^,  Edward  (1837-1888)  .  930 
Lorinser,  F.  W.  (b.  1817)  961,  1058 
Lorinser,   Karl   I.   (1796-1853)     949 


1 13:5 


Page. 

Lorry,  A.  C.  (1726-1783)  653,  694,  712 
Lossius,  Friedrich  (about  1672)  5u9 
Lotichius,  J.  P.  (1598-1669)  .  509 
Lotted,  Carlo  M.  (about  1757)  694 
Lotze,  Rud.  H.  (1817-1881)  841,  949 
Loubet,  J.  WA.  (about  1753)  .  664 
Loudon,  John  C.  (1783-1843)  844 
Louis,  Antoine  (1723-1792)  .  6H4 
Louis,  P.  C.  A.  (1787-1872)  .  896 
Loutherbourg,  Mr.  &  Mrs.  (about 

1789)  .         .         .         .773 

Lovati,  Teodore  (1800-1872)  .  1087 
Lowdham,  R.  (about  1679)  509,  52i> 
Lowe,  Peter  (about  1596)  .     417 

Loweg 910 

Lower,  R.  (1631-1691)  .  520,  532 
Loyseau,  Guil.  (about  1617)  .  509 
Lubanski  ....  1033 
Lucas,  Charles  (about  1764)  .  721 
Lucas-Championniere,  Just   M. 

(born  1843)  .  .  .1040 
Lucius  Apuleius  (5th  century)  187 
Liicke,  Georg  A.  (b.  1829)  994,  1072 
Lucretius  (about  a.  d.  400  .  145 
Ludwig,  Christ.  F.  (1751-1823)  702 
Ludwig,   D.  (Ludovicus,  1625- 

1680)  .         .         .         .547 

Ludwig,  Ernst  (born  1842)  .  969 
Ludwig,  Gottlieb  Christ.  (1709- 

1773)  .  608,  655,  695,  705 
Luer,  A.  (1802-1883)  .  .1021 
Lugol,  .).  G.  A.  (1786-1851)  .  902 
Lull,  Rairaond  (1235-1315)  .  266 
Lumpe,  Eduard  (1813-1878)  .  1083 
Lund  .         .         .    ,     .         .  1049 

Lups,  Joh.  (about  1748)  .  693 
Luschka,  H.  v.  (1820-1875)  .  966 
Lusk,  Win.  T.  1096 

Luther,  Martin  (1483-1546)  .  352 
Luther,  Paul  (153  5-1593)  352  n.  3 
Lux,  Joh.  Wilh.  (1773-1850)  877,  879 
Luzuriaga,  Ignacio  (18th  cent.)  653 
Lycus  (a.  d.  150)  .  130,157 

Lycon  of  Troas  (b.  c.  269-226)  118 
Lyman,  Henry  M.  .         .     929 

Lynch,  Samuel  (about  1790)  .  638 
Lynn,  William  (1753-1837)  .  1046 
Lyser,  M.  (about  1653)  .         537 

Lysimachus    (about  b.   c.  335)     115 

M. 

Maanen,  J.  van  (1770-1854)  .  1075 
Maas,  Herm.  (1842-1886)  .  1073 

Mac  Adams,  D.  H.  (about  1836)     919 


Page. 

Macall,  James  .  .  .  .717 
Macartney,  James  (about  1840)  909 
Macaulay  (about  1756)  .  .  686 
Macbride,    David    (1726-1778) 

612,  618,  656 
MacBride,  Peter  (born  1854)  .  918 
MacClintock,  A.  H.  (1821-1881)  1092 
MacCormac,  11.(1800-1886)  916,  921 
MacCormac,  Sir  Wm.  (b.  1836)  1044 
MacDonald,  A.  (1836-1886)  .  1091 
MacDowell  (about  1830)  .  .  914 
Macer,  ^Emilius  Sr.  (b.  c.  10)  .  158 
Macer  Floridus  (12th  cent.)  .  254 
MacGregor,    Sir   James    (1771— 

1858)         .  .     916,  1046 

Machaon  (b.  c.  1184)  .  .  86 
Mackenzie,  Sir  G.  (about  1820) 

882,  883 
Mackenzie,  James  (about  1759)  715 
Mackenzie,  John  N.  .         .     926 

Mackenzie,  Sir  Morell  (b.  1837)  918 
Mackenzie,  Wm.  (1791-1868)  .  917 
MacKeown  ....  1044 
MacKinnon  .  .  .  .1049 
MacKittrick,  J.  (about  1772)  612 
Maclaurin,  Mr.  (about  1780)  .  738 
Maclean  ....       1049 

Mac-Lean,  C.  (about  1797)  722,  920 
Macleod,  G.  H.  B.  (born  1828)  1048 
Macmurdo  ....  1045 

Macnamara,  Rawdon  (b.  1822)  1048 
Macneven,  Wm.  J.  .  .  .1094 
Macnish  ....         882 

Macquer.  Pierre  J.  (1718-1784)  726 
Madai,  Dav.  Sam.  (1709-1780)  612 
Madden,  Thos.  M.  (b.  1844)  .  1092 
Maddox,  Richard  (about  1657)  587 
Madelung,  O.  W.  (born  1846)  .  1073 
Magati,  Cesare  (1579-1647)  .  511 
Magawlv,  John  (born  1831)  .  1077 
Magelardo,  Paolo  (about  1472)  294 
Magendie,    Francois    (1782    or 

1783-1855)  .  .  899,  903 
Magenise,    Daniel     (Maginnis  ? 

about  1768)  .  .  .694 
Maggi,  Bartolomeo  (1516-1552)  415 
Magliari,  Agostino  ,  .  .  722 
Magne,  Pierre  A.  C.  (b.  1818)  .  906 
Magni,  Francesco  (born  1828)  871 
Magnol,  Pierre  (1638-1715)  .  479 
Magnus,  Hugo  (born  1842)  .  1074 
Magnus  of  Alexandria  (a.  d.  350)  184 
Magnus  of  Ephesus  (about  a.  d. 

150) 177 


—   1134 


Page. 

Magny,  Guil.  de  (about  1752)  694 
Mago  (b.  c.  254-140)  .  30,  191 
Mahomed,  Fred.  A.  (1849-1884)  1024 
Maimonides,    vid.     Moses    ben 

Maimon. 
Maingault,  Charles  (died  1840)  1036 
Maisonneuve,  Jac.  G.  (b.  1809)  1040 
Maitland  (about  1717) 
Maitland  (about  1838) 
Maitre-Jean,    Antoine    (Maitre 

Jan,  about  1707) 
Malacarne,  Michele  Vine.  Giac 

(1744-1816)  .  .  667 
Malebranehe,  Nie.  (1638-1715) 
Malfatti,  Job.  (1776-1859) 
Malgaigne,  Jos.  F.  (1806-1865)  1038 
Malmsten,  Henrik  (1811-1883)  1004 
Malpighi,  M.  (1628-1694)  531,  537 
Malton       .  ... 

Manardi,  Giov.  (Manardus,  Joh. 

1462-1536)  .         .     293,  376 

Mandl,  Louis  (1812-1881)  904,  905 
Mandt,  Mart.  W.  v.  (1800-1858)  1077 
Manduyt  (about  1777)  .  .  724 
Manfredi,  Paolo  (about  1668)  512 
Manget,    Joh.   Jac.    (Mangetus, 

1652-1742)  .  .  509,  514 
Manitius,  Joh.  W.  (about  1749)  603 
Manlius  de  Bosco,  J.  J.  (about 

1528) 


7  08 
915 

514 

699 
476 
937 


914 


Mannagetta,  J.  H 
Mamie,  M.  L.  M 
Manuiugham,   Sir 


436 

735 

1033 


(about  1735) 
(1734-1806) 
It.  (d.  1749) 
686,  728  n.  1,  782 
Mannkopf,  Emil  W.  (b.  1836)  .  995 
Mantias  (b.  c.  250)  .  .  .  125 
Manz,  W.  (born  1833)  ...  1074 
Manzolini,  A.  M.  (1716-1774)  683 
Manzona,  A.  (about  1790)  .     638 

Maplet,  John  (about  1694)  .  546 
Mapletoft,  J.  (about  1666)  504  n.  2 
Mapother,  Ed.  A.  .  .  .921 
Mapp,  Mrs.  (about  1736)  .  773 
Maranta,  Bart,  (about  1559)  .  369 
Marat,  J.  Paul  (1744-1793)  .  615 
Marbodus  (died  1123)  .  .  255 
Marcellus  Cumanus   (14th  and 

15th  centuries)  .         .301 

Marcellus  Empiricus  (about  A.  D. 

3S5)  .  "  .  .  .  .187 
Marcellus  of  Sida  (about  A.  D.  138)  176 
Marcellus  Vergilius  (d.  1521)  .  293 
March,  Alden  (1795-1869)  .  1054 
Marchall,   F.  L.  (18th  century)     665 


Page. 

Marche,  M.  de  la  (about  1677)  523 
Marchetti,  Dom.de  (1626-1688) 

531,  537 
Marchetti,  Piet.  de  (1589-1673)  512 
Marcus,  A.  F.  (1753-1816)  766,  864 
Marcus  Artorius  (about  B.  c.  31)  139 
Marcus,  K.  F.  Jr.  (1802-1856)  946 
Marcy,  Dr.  .  .  .1025  n.  1 
Mareleif  (about  575)  .         .     244 

Mareschal,  Georges  (1658-1736)  514 
Maret,  H.  (1726-1786)  .  .  645 
Marey,  Etienne  Jules  (b.  1830)  1024 
Marggraf,  A.  S.  (1709-1782)      .     726 

Mariano,  P 1041 

Mariano  Santo  di  Barletta  (about 

1490-1550)  .  .  376,  414 
Marini,  Girolamo  (about  1723)  667 
Marinus  (about  a.  d.  100)  .     157 

Marion,  Joseph  (about  1722)  .  802 
Mariotte,  Edm.  (died  1684)  .  539 
Marjolin,  Jean  Nic.  (1780-1850) 

1034,  1036 
Markham  (about  1856)  .  .916 
Marklin  .  .         .         995 

Markoe,  Thomas  M.  .         .   1054 

Markusovzky,  Ludwig  (b.  1815)  1083 
Marmontel  (1723-1799)  .  .  596 
Marque,  Jacques  de  (1569-1622) 

402,  514 
Marsh,  Sir  H.  (1790-1860)  914,  919 
Marsh,  James  (1789-1846)  .  851 
Marshall,  Andrew  (1742-1813)  713 
Marshall,  J.  (about  1835)  910,  1047 
Marsilius  Ficinus  (1433-1499)  289 
Marten,  D.  (about  1540)  .     413 

Martialis  (a.  d.  150)  .  126,  157 
Martiano,  Prospero  (about  1627)  484 
Martin,  Anselm  (1809-1883)  .  1084 
Martin.  E.  A.  (1809-1875)  1022,  1084 
Martin,  George  (1702-1743)  502,  1023 
Martin,  Henry  A.  .         .         711 

Martin,  J.  ....     906 

Martin,  Roland  (1726-1788)  .  656 
Martinet,  Louis  (1795-1875)  .  1014 
Martinez,  M.  (1684-1734)  667.  700 
Martiniere,  Pierre  Martin  de  la 

(about  1664)  .  .  .551 
Martinius,  Val.  (about  1628)  .  509 
Martins,  C.  Ph.  v.  (1794-1868)  843 
Martius,  E.  Willi.  (1756-1849)  843 
Marvaud,  Angel  .  .  .  906 
Marx,  K.  Fr.  H.  (1796-1877)  .  878 
Marx,  Marcus  Jos.  (about  1776)  720 
Marzolo,  F 10S7 


1135  — 


Paso. 

Mascagni,  Paolo  (1752-1815)  .  (ill!) 
Masdeval,  Jose  (died  1801)  .  653 
Maseweih,  Jahjali  ebn,  vid.  Mesue. 
Mason,  Erskine  (1832-1882)  .  1054 
Massa,  Nicolo  (1499-1569)  407,  427 
Massard,  Jacques  (about  1680)  496 
Massarenti,  Carlo       .  .         .  1087 

Massaria,  A.  (1510-1598)  .     407 

Mass6,  Jean  (about  1563)  .     435 

Massini  (18th  century)  -  .  638 
Mastalier,  J.  J.  (died  1793)  .  656 
Mastin,  C.  H.  .         .       1055 

Mather,  Rev.  C.  (1663-1728)  800 
Mathysen,  Ant.  (1805-1878)  .  1029 
Mattei,  Cesare  .  .  .  .879 
Matthias,  Georg  (1708-1773)  .  661 
Matthieu,  pere  (died  1879)  .  1021 
Matthis,  Florian  (about  1602)  517 
Mattioli,  Pietro  Andrea  (Mathi- 

olus,  Matthiole,  1501-1577)  369 
Maubray,  John  (about  1724)  687,  782 
Maubray,  John  (about  1738)  .  802 
Mauchart,  B.  D.  (1696-1751)  668,  705 
Maudsley,  Henry  (b.  1835)  632,  920 
Maunoir,  C.  Th.  (1770-1830)  .  1040 
Maunsell,  H.  (1806-1879)  919,  1091 
Mauriceau,  Francois  (d.  1719)  .  523 
Maurocordatus,  A.  (1637-1710)  532 
Maurus  (12th  century)  .  .  263 
Mauthner,  L.  (b.  1840)  968,  1074 

Mauthner,  L.  W.  v.  (1806-1 858)  969 
Maxwell,  Win.  (about  1679)  .  485 
May,  Fr.  Ant.  (1743-1814)  715,  1081 
Mayer  (about  1741)  .         .725 

Mayer,  Aaron  (about  1849)  .  910 
Mayer  C.  E.  L.  (b.  1829)  '  .1084 
Mayer,  Ed.  (about  1839)  .     965 

Mayer,  Giustino  (1830-1879)  .  1087 
Mayer,  Rob.  (1814-1878)  1020,  1083 
Maygrier,    Jacques    P.    (1771- 

1835)  .         .  1034,  1085 

Maynard,  J.  Parker  1029  n.  4,  1055 
Mayo,  Herbert  (died  1852) 

632,  909,  922,  1047 
Mayo,  Thomas  (1790-1871)  .  920 
Mayor,  Joh.  Dan.  (1634-1693)  517 
Mayor,  M.  (1775-1846)  1016,  1040 
Mayow,  John  (1645-1679)  493,  540 
Mayrhofer,  V.  v.  (1815-1877)  1084 
Mazini,  G-iov.  Battista  (Mazzino, 

about  1723)  .  .  .500 
Mazonn,  Julius  Ferd.  (b.  1817)  956 
Mazzoni,  Const.  (1825-1885)  .  1041 
McBurney,  Charles  ."        .     1055 


McClellan,  George  (1796-1847)   1051 
McClellan,  John  H.  B.  .  1051 

McDowell,  E.  (1772-1830)  1050  n.  1 
McGuire,  Hugh  FT.  (1801-1875)  1054 
McKnight,  Chas.  (1750-1791)  817 
Mead,  Richard  (1673-1754)  .  503 
567  n.  1,  651,  658,  722,  765  n.  1 
Meadows,  Allied  .  .  .  1090 
Mears,  J.  Ewing  .  .  .  1055 
Mechitar  (about  1150)  .  .  234 
Meckel,  J.  F  (1714-1774)  684,  095 
Meckel,  Joh.  Fr.  (1781-1833)  951 
Meckel,  Ph.  Fr.  T.  (1756-1803)  696 
Mederer,  Matth.  (1739-1805)  .  670 
Medicus,  Fried.  C.  (1736-1808)  612 
Medina,  Ant.  (about  1750)  .  667 
Medius  (4th  century  b.  c.)  .  115 
Meekren,  J.  van  (died  1666)  .  518 
Megapolensis,  S.  (about  1665)  581 
Megasthenes  (b.  c.  300)  ,       39 

Meges  (b.  c.  20)  .  .  .  143 
Megliorati,  Rem.  (16th  century)  397 
Meibom,  Heinrich  (1638-1700)  537 
Meibom,  Joh.  Heinrich  (Meibo- 

mius,  1590-1655)  484,  517,  547 
j  Meigs,  Charles  D.  (1792-1869)  1095 
i  Meigs,  James  A.  (1829-1879)  929 
!  Meigs,  John  Forsyth  .  925,  927 
i  Meir,  Abraham  Ben  (Avernezel, 

1093-1168)  .  .  .234 
Meissner,  F.  L.  (1796-1860)  .  1085 
Melampus  ....       84 

Melanchthon  (1497-1560)  .  352 
Meldon,  Austin  .         .         .919 

Meletius  (8th  century)  .         208 

Melier,  Franc.  (1798-1866)  906,  907 
Mellin,  Christ.  J.  (1744-1817)  656 
Melitsch,  Joh.  (1763-1811)  .  685 
Mende,  L.  J.  K.  (1779-1832)  864, 1082 
Menecrates  (about  A.  t>.  34)  .  159 
Menem ach us  of  Aphrodisia 

(a.  d.  70)  ...     142 

Mena;mann  (about  1777)  .     795 

Meniere,  Prosper  (1799-1862)  904 
Menius  Rufus  (about  a.  d.  10)  158 
Menjot,  Antoine  (about  1650)  496 
Menodorus  (about  b.  c.  30)  .  126 
Menodotus  of  Nicomedia  (a.  d. 

100)  ....  130 
Meuon  (4th  century  b.  c.)  .     118 

Mensert,  Willem  (1780-1848)  1075 
Mentel,  Jacques  (1599-1670)  .  533 
Mercado,  Luis  (Mercatus,  1520- 

1606)  .         .         .         .409 


1136  — 


Page. 

Mercier,  Louis  A.  (1811-1882)  1036 
Mercklin,  G.  A.  Sen.  (1613-1684)  509 
Mercklin,  G.  A.  (164-4-1702)  509,  517 
Mercuriadis  (15th  century)  .  264 
Mercurialis,  Hieronyrnus  (1530- 

1606)  .  .  373,376,421 
Mercuric,  Scipio  (Geron.  Mercu- 

rii,  died  1602)  .         421,  523 

xMerkel,  C.  L.  (1812-1876)  .1021 

Merkel,  Gottlieb  (born  1835)  .  995 
Merriman,  Sam.  (1771-1852)  .  1089 
Merrem,  Carl  Th.  (1790-1859)  1072 
Mery,  Jean  (1645-1722)  515,  1019 
Mesmer,  Franz  A.  (1731-1815)  629 
Mesnard,  Jacques  (about  1743)  681 
Mesue  the  Elder  (a.  d.  780-857)  226 
Mesue  the  Younger  (died  1015)  230 
Metcalfe,  John  T.  925 

Metlinger,  Bart,  (about  1472)  294 
Meton  (about  b.  c.  432)  .         115 

Metrodorus  .  .  .  .115 
Metschnikoff.  Elias  .  1007,  1008 
Mettrie,  Jul.  Offroy  de  la  (1709- 

1751)  .  .  .  596,  694 
Metzger,  Joh.  Dan.  (1739-1805) 

660,  706,  883 
Meyer,  Eduard  (born  1838)  .  905 
Meyer,  G.  F.  W.  .  .  .8-13 
Meynert,  Theodor  (born  1833)  969 
Meytenberger,  Ort.  (15th  cent.)  309 
Meza,  C.  J.  T.  de  (1756-1844)  661 
Mezger.  J.  .         .         1028,  1075 

Mezler,'  F.  J.  von  (1787-1858)  1085 
Michael  the  Eunuch  (12th  cent.)  210 
Michaelis,  A.  J.  C.  (born  1826)  961 
Michaelis,  C.  F.  (1754-1814)  654,  720 
Michaelis,  G.  A.  (1798-1848)  .  1084 
Michaelis,  Ph.  G.  (about  1796)  657 
Michea,  Claude  F.  (1815-1882)  903 
Michel,  M.  (about  1857)  .  .  904 
Michel,  Julius  (born  1843;  .  1074 
Michel  burg,   P.    Seb.   (Seb.  Au- 

strius,  1510)  .  .  .421 
Michell,  John  (about  1585)  .  394 
Michelotti,  P.  A.  (about  1740)  500 
Michelspacher,  S.  (about  1613)  556 
Michon,  Louis  M.  (1802-1860)  1039 
Middeldorpff,  Albrecht  Theodor 

(1824-1868)  1023,  1028,  1067 
Middleton,  Peter  (d.  1781)  804,  808 
Mieg,  Joh.  Jak.  (1794-1870)  .  1059 
Mieg,  Joh.  Rud.  (1694-1733)  690 
Mtescher,  Joh.  Fr.  (born  1811)  978 
Miles,  Francis  T.  929 


Page. 

Milich,  Jacob  (1501-1559)  .  364 
Miljavila  y  Fisonel  (about  1790)  638 
Millar,  John  (about  1769)  .     654 

Miller,  Edward  (1760-1812)  .  827 
Miller,  Henry  (1800-1874)  .  1095 
Millington,  Thos.  (about  1676)     690 

M  illiat 1022 

Millot,  Jac.  Andre  (1738-1811)  682 
Mills,  Charles  K.  929 

Mihnan,  Sir  Fr.  (about  1782)  .  656 
Miltiades  (about  b.  c.  250)  .  126 
Miltiades  Elaiusius  .  .  .139 
Milton,  John  L.  .  .919,  922 
Minadous,  Thomas  (1554-1604)  527 
Minderer,  Joh.  Martin  (d.  1812)  679 
Minderer,  R.  (died  1621)  485,  546 
Minor,  Julius  F.  .  .  .  1055 
Minot,  Francis  ...  929 
Minot,  Jacques  (about  1680)  .  496 
Miot,  C.  ....         904 

Mirza  Abdul  AH  (19th  cent.)  .  64 
Mistichelli,  Dom.  (abont  1709)  496 
Mitchell,  John  (about  1760)  .  802 
Mite-hell,  John  K.  (1798-1858) 

844,  923,  1010 
Mitchell,  S.  L.  (1764-1831)  633,  827 
Mitchell,  S.  Weir  .  .  .928 
Mithradates    the    Great   (B.    c. 

124-64)  .  .  .  .128 
Mitscherlich,  A.  1030 

Mittelhaeuser,  Joh.  Dan.  (18th 

centur})  .         .  683  n.  1 

Mnaseas  (A.  D.  80)         .  140,  142 

Mnesitheus  of  Athens  (4th  cent. 

b.  c.  ?)  .  .  .  .  115 
Mobius,  Gottfried  (1611-1664)  542 
Model,  Joh.  Georg  (1711-1775)  726 
Moehsen,  J.  C.  W.  (1722-1795)  600 
Mohl,  Hugo  von  .  .  .  843 
Mohr,  Bernard  (died  1849)  .  947 
Mohrenheim,  Jos.  Jac.  v.  (died 

1799)  .  .  670,  679,  688 
Mohsen,  J.  K.  W.  (1722-1795)  659 
Moinichen,  H.  v.  (about  1665)     521 

Moitissier,  A 904 

Moleschott,  Jacob  (born  1822)  841 
Molinelli,  P.  P.  (1702-1764)  615,  667 
Molins,  Edward  (about  1652)  .  519 
Molyneux,  Wm.  (about  1683)  .  531 
Monardes,  Nic.  (1493-1588)  368,  376 
Mondeville,  H.  de  (d.  about  1315)  304 
Mondini,  Carlo  (1729-1803)  .  667 
Mondino  de  Luzzi  (1276-1326)  296 
Monfalcon,  Jean  B.  (1792-1874)     904 


—  1137  — 


Page. 

Monneret,  Jules  Aug.  Edouard 

(1810-1868)  .  899,1013 

Monro,  A.  Sr.  (1697-1767)  674,  697 
Monro,     Alexander    (Secundus, 

1733-1817)  .  .  674,  697 
Monro,  A.  (Tertius,  1773-1859)  674 
Monro,     Donald     (1729-1792) 

657,  674,  715,  721 
Monro,  James  (died  1752)  .     713 

Monro,  John  (1715-1791)  .     713 

Montagnana,  Bart,    (died   1460) 

292,  297,  301 
La  Montague,   J.   (about    1640) 

578,  585 
Montagu,  Lady  Mary  W.  (1690- 

1762)  .         .         .         .708 

Montaigne.   M.  tie  (1533-1592)     368  i 
Montana  de   Monserrate,   Bern. 

(born  about  1482)       .         .     297  j 
Montanus,  J.  B.,  vid.  Monte. 
Monte,  G.  B.  (1498-1551)       373,  376  I 
Monteggia,  Giov.  Battista  (1762- 

1815)      .         .         638,  683,  1041  ■ 
Montesquieu  (1686-1755)  .     596  ! 

Montgellaz,  P.  J.        .         .         .     888  I 
Montgomery,   W.  F.   H.  (1797- 

1859)  ....  1092 

Monti,  Alois  (born  1839)  .     969  I 

Moore,  Chas.  H.  (1821-1870)    .  1047  ' 
Moore,  E.  M.      .  .    '     .  1055  I 

Moore,  James  (about  1800)        .     676 
Moore,  Sam.  P.  (1709-1785)      .     813  | 
Mooren,  Albert  (born  1828)       .  1074  I 
Moquin-Tandon,  Chr.  H.  B.  A. 

(1804-1863)  .  .  .  997 ! 
Morand,  F.  S.  (1697-1773)  .  663  ; 
More,  Marcellus  de  la  (ab.  1510)  418 
More,  Philip  (about  1565)  .  413 
Moreau  de  St.  Ludjere  .  .  1013 
Moreau,  Franc.  J.  (1789-1862)  1086 
Moreau,  Jac.  Jos.  (1804-1884)  903 
Moreau,  P.  Fr.  (about  1816)  .  1038 
Morejon,  A.  H.  (1773-1836)  .  661 
Morel  (about  1674)  .         .512 

Morel,  C.  Basile  (1823-1884)  .  904 
Morel,  J.  (about  1628)  .  .  509 
Morel-Lavallee,  V.  A.  F.  (1811- 

1865)  ....  1039 

Moresehi,  A.  (about  1808)  .  883 
Morestide,  Thos.  (fl.  1417)  .  306 
Morgagni,  G.  B.  (1682-1772)  .  700 
Morgan,  Campb.  de  (1813-1870)  1045 
Morgan,  John  (1  735-1789)  .  807 
Morgan,  John  (died  1847)  .  1044 
72 


694 


144 


Page. 

Morgan,  Thos.  (about  1589)  .  413 
Morgan,  Thos.  (about  1735)  .  503 
Morison,  Robert  (1620-1683)  .  479 
Morris,  Henry  (born  1844)  .  1047 
Morris,  Malcolm  .  .  .919 
Mort,  Jac.  le  (1650-1718)  .     494 

Morton,  Rich.  (1635-1698)  507,  510 
Morton,  Sam.  G.  (1799-1851)  .1015 
Morton,  Thos.  G.  .  .  '  .  1055 
Morton,  William  Th.  G.  (1819- 

1868)  .  .  .  1025  n.  1 
Morveau,  Guj  ton  de (1737-181 6)  726 
Moscati,    Pietro    (1739-1824) 

638,  667 
Moschion    Diorthotes    (Muscio, 

6th  century) 
Mosetig,  Albert  von  (born  1838)   1072 
Moses  benMaimon  (Maimonides, 

1135-1204)  .  .  .233 
Mosse,  Barth.  (1712-1759)  687,  782 
Motard,  Adolph  .         .         .906 

Mott,  Alex.  B.  (1826-1889)  .  1054 
Mott,  Valentine  (1785-1865)  .  1051 
Mott,  Valentine  .  .  845  n.  2 
Motte,  Guillaume  Mauquest  de 

la  (1655-1737)   .         . 
Mouffet,  Th.  (died  about  1600) 
398  n.  1 
Moultrie,  John  (died  1773) 
Mouton,  P.  (about  1760)   . 
Movius  (about  1675) 
Miihlbauer,  F.  H.  (about  1847) 
Miihlenbero-,  Gotthilf  Heinr.  E 

(1753-1815) 
Miihry,  Adolf  (1810-1888) 
Mulder,  G.  J.  (1803-1880) 
Miiller,  Andreas  (1718-1762) 
Miiller,  G.  Fr.    . 
Midler,  Heinrich  (1820-1864) 
Miiller,  J.  H.  (about  1805) 
Miiller,  Moritz  (about  1821) 
Miiller,  O.  F.  (about  1786) 
Midler,  Peter  (born  1836) 
Miinch,  Peter  (1458) 
M untie,  C.  ... 

Mundella,  Aloysio  (died  1553) 
Munniks.  Joh.  (1652-1711) 
Muralt,  Johann  v.  (1655-1733) 
Murchison,  Charles  (1830-1879) 
Murphy,  John  B.  .  .  844  n.  1 
Murray,  J.  A.  (1740-1797)  719,  726 
Murray,  Robert  (died  1673)  .  485 
Mursinna,  C.  L.  (1744-1823)  657,  670 
Musgrave,  Samuel  (1732-1782)     618 


524 

,  510 
818 
666 
527 
965 

844 
949 
851 
694 
879 
935 
864 
876 
599 
1084 
307 
977 
407 
519 
517 
916 


1138  — 


Page. 

Musgrave,  W.  (1657-1721)  493,  656 
Musitano,  C.  (1635-1714)  496,  512 
el  Musly,  Abul  Kasem  Omar  ben 

Ali  (11th  century)  .  .  234 
Musschenbroek,    Pieter   van 

(1692-1761)  .  .  598,724 
Mussey,R.D.  (1780-1866)  1051,  1093 
Mutter,  Thomas  D.  (died  1859)  1051 
Muys,  Jan  (about  1682)  .  .  494 
Muzel,  F.  H.  L.  (1716-1784)  .  765 
Myersbach,  "Dr."  (about  1785)  774 
Mynsicht,  Adrian  (about  1631) 

486,  544,  546 

N. 

Naboth,  Martin  (1675-1721)  .  537 
Nagel,  Albrecht  (born  1833)  .  1074 
Niigele,  Franz  C.  (1777-1851)  1081 
Niigele,  H.  F.  J.  (1810-1851)  .  1081 
Nancrede,  Charles  B.  .         .   1055 

Nancy,  Richard  de  (about  1839)  901 
Nannoni,  Angiolo  (1715-1790)  667 
Nannoni,  L.  (1749-1812)        667,  683 

Napias 906 

Napier,  Rich.  (1559-1634)  485  n.  2 
Napier,  William  Donald  .  .  1049 
Nardi,  Giovanni  (about  1656)  531 
Nardo,  J.  D.  .  '  .  .  .1087 
Nasse,  C.  F.  (1778-1851)  631,  937 
Naumann,  J.  G.  (about  1795)  .  719 
Navas,  Juan  de  (about  1799)  .  683 
Neander,  Joh.  (about  1623)  .  542 
Nebrus  (about  b.  c.  584)  93,  100 

Nebsuchet  .  ?  .  .16 
Nedschib-ed-Din-el-Samarkandi 

(died  1222)  .  .  .236 
Needham,  John  Tuberville  (1713- 

1781)  .  .  677,  697,  717 
Needham,  W.  (died  1691)  526,  535 
Nees  von  Esenbeck,  Christ.  G. 

(1776-1858)  .         631,  843 

Nees  von  Esenbeck,   Th.  Fr.  L. 

(1787-1837)  .  .  .843 
Nefis  ben  Audh  (about  1424)  .  234 
Nefis.  Ebn  el  (Annans,  d.    1288 

or  1296)  ....  234 
Neftel,  William  B.  .         .         929 

Nega,  Victor  J.  (1816-1857)  .  956 
Negri,  M.  (about  1860)  711,1041 
Neifeld,  Ernst  J.  (died  1772)  503 
Neill,  Hugh  (about  1845)  .     918 

Neisser,  Albert  (born  1855)  .  844 
Nelaton,  Auguste  (1807-1874)  1039 
Neligan,  John  M.  (1815-1863)     919 


Page. 

Nemesius  (about  a.  d.  400)  .  186 
Neuter,  G.  Ph.  (about  1720)  .  611 
Nepven  ....         906 

Nerozzi  (18th  century)  .  .  683 
Nessel,  Franz  (born  1803)  .  968 
Nessi,  Giuseppe  (1741-1821)  667,  683 
Nettleship,  Edward  .  .  .  917 
Neubauer,  Joh.  E.  (1738-1777) 

672,  696 
Neumann,  C.  (1683-1737)  714,  725 
Neumann,  K.  G.  (1774-1850)  .  M37 
Neumann,  Isidor  (born  1837)  959 
Neustain,  Alex.  v.  (1506-1590)  397 
Newbigging,   Pat.  S.  K.  (1813- 

1863)  ....  1014 

Newton,  Sir  Isaac  (1642-1727)  480 
Nicander  of  Colophon  (b.  c.  136)  129 
Niceratus  (about  b.  c.  42)  139,  158 
Nicetas  (a.  d.  1075)  .         .210 

Nicholas  (a.  d.  581)      .  247  n.  5 

Nicholas  Myrepsus  (about  a.  d. 

1250)  .         .         .         .211 

Nicholas  Propositus  (about  1140)  262 
Nicholas  of  Reggio  (about  1330)  288 
Nicholls,  F.  (1699-1778)  503,  698 
Nichols,  Charles  H.  .  .  .  928 
Nicias  of  Miletus  (about  b.c.  290)  126 
Nick,  F.  An.  (1780-1832)  .     631 

Nicoladoni,  C.  (born  1847)  .  1072 
Nicolai  (1733-1811)  .         .     596 

Nicolai,  Ernst  A.  (1722-1802)  .  615 
Nicolas-Duranty,  Ernile  .         905 

Nicolaysen,  Julius  (born  1831)  1076 
Nicomachus  ....  116 
Nicon    of    Agrigentum    (about 

b.  c.  49)  .  .  .  .  139 
Niedten,  Fr.  Erh.  (about  1717)  547 
Niemeyer,  Felix  v.  (1820-1872)  967 
Niemeyer,  L.  H.  C.  (1775-1800)  864 
Niemeyer,  Paul  (b.  1832)  967,  1023 
NiemeVer,  W.  H.  (1788-1840)  1082 
Nietzky,  Adam  (1714-1780)  612,  615 
Nifo,  A.  (Nipho,  1473-1546)  367,  399 
Niger,  Sextius  (1st  century)  158  n.  1 
Nigrisoli,  F.  Maria  (1688-1727)  535  i 
Nihell,  Elizabeth  (about  1760)  687 
Nihell,  James  (about  1741)  .  625 
Nileus  (about  b.  c.   260)  .     126 

Nisbet,  Wm.  (1759-1822)  .     919 

Nitze 1022 

Nivet,  Annet  Vincent  (b.  1809)  907 
Noack,  A.  ....     876 

Noble,  Daniel  (about  1845)  .  632 
Noeggerath,  Emil       .         .         .  1 097 


1139 


Noel,  Joseph  (1753-1808)  .  1033 

Noel,  K.  K 883 

Noguez,  Pierre  (about  1725)  ,  723 
Nola,  Francisco  (about  1610)  .  550 
Nolde,  Ad.  Fr.  (1764-1813)  .  1080 
Nollet,  J.  A.  (1700-1744)  .     724 

Nonat,  Auguste  (born  1804)  .  907 
Norris,  Geo.  W.  (1809-1875)  .  1054 
Norris,  Wm.  F.  .         .         .     930 

Norsini,  the  .  .  .  .  302 
North,  Elisha  (about  1808)  .  1024 
North,  John  (1790-1873)  .  919 
Northcote,  W.  (about  1772)  658,  698 
Nose,  Carl  Willi.  (1753-1835)  656 
Nostradamus,  M.  (1503-1566)  364 
Nothnagel,  H.  (b.  1841)  958,  966,  995 
Notker  (9th  century)  .         .     255 

Nott,  John  (about  1793)  \  .721 
Nott,  J.  0.  (1804-1873)  1054,  1097 
Noues,  Guil.  des  (about  1681)  537 
Nourse,  Mr.  (about  1748)  .     736 

Nowack,  J.  (1841-1886)  .  969 
Noyes,  F.  D.  .  .  '  .  .930 
Nuck,  Ant.  (1650-1692)  .  518,  536 
Nufer,  Jacob  (about  1500)  .  403 
Numesianus  (a.  d.  150)  .  130,  157 
Nunnez,  Ildefonso  (about  1615)  550 
Nunnez,  Pedro  (about  1638)  .  523 
Nussbaum,  Joh.  Nepomuk  von 

(born  1829)  .         1029,  1073 

Nuttall,  Thomas  (1786-1859)  .  844 
Nymphodorus  (about  b.  c.  250)     126 


Obermeyer,    Otto    Hugo   Franz 

(1843-1873)  .  .  .844 
Obernier,  Franz  (born  1839)  .  995 
Obizo(died  1138)  .  .  277  n.  1 
O'Brien.  John  (1781-1845)  .  912 
Occo,  Adolph  (1524-1604)  545  n.  1 
Octavius  Horatianus  (about  A.  D. 

380)  .        .        .         .187 

Oddi,  Marco  degli  (1526-1591)  408 
Oddi.  Ocldo  de^li  (1478-1558)  408 
Odhelius,  Joh.  L.   (1737-1816) 

656,  679 
Odo  von  Meudon  (died  1161)  255 
Oeder,  Geo.  Christ,  (1728-1791)  694 
Oesterlen,  Fried.  (1812-1877)  848 
Oertel,  E.  F.  Chr.  (1765-1850)  977 
Oertel,  Max  Joseph  (born  1835)  995 
Ogston,  Alex.  (b.  1844)  921,  1049 
Ohm,  Martin  (1792-1872)  .     847 

Oken,  Lorenz  (1779-1851)      843,  933 


Page. 

Olbers,  H.  W.  M.  (1758-1840)  631 
Olivarez,  Gonzalez  .  .  .  1042 
Oliver,  Thos.  (about  1640)  .  579 
Oliver,  William  (about  1707)  .  721 
Oilier,  Louis  X.  E.  L.  (b.  1825)  1040 
Ollivier  d' Angers,  Chas.   Prosp. 

(1796-LS4  5)  .  901,903 

Ollivier,  Paul 1040 

Olshausen,  P.  M.  (b.  1835)  .  1084 
Olympicus  of  Miletus  (a.  d.  70)  142 
Onasilos  (5th  century  b.  c.)  .  94 
Onimus,  E.  N.  J.  (born  1840)  903 
Onsenoort,  G.  van  (1782-1841)  1075 
Oppenheim,  Fr.  W.  (1799-1852)  1064 
Oppolzer,  Joh.  v.  (1808-1871)  957 
Oppolzer,  Theodore  (1841-1886)  958 
Optatus,  Csesar  (about  1536)  376 
LOrange,  Jacob  (about  1658)  578 
Ordenstein,  Leopold  .         .     903 

Orfila,  J.  M.  B.  (1787-1852)  .  850 
Oribasius  (a.  D.  326-403)  185,  186 
Orriius,  Gustav  (1739-1811)  .  727 
Orred  (18th  century)  .         .     674 

Ortolff  v.  Bayerland  (1 5th  cent.)  309 
Osborn,  John  C.  .  .  .1094 
Osborne,  Wm.  (1732-1808)  686,  782 
Oseibia  (1203-1273)  .         .     233 

Osiander,  F.  B.  (1759-1822)  660,  1079 
Osier,  William  .         .         .  1010 

Otho  Cremonensis  (13th  cent.)  263 
Otis,  Fessenden  N.     .  928 

Otis,  George  Alex.  (1830-1881)  1053 
Ottaviano  da  Villa  (16th  cent.)  414 
Otterbourg,  S.  J.  (1810-1881)  977 
Otto,  A.  W.  (1786-1845)  .     702 

Otto,  Karl  (1795-1879)  .  883,889 
Ould,  Sir  F.  (1710-1789)  686,  782 
DOutrepont,  Jos.  (1778-1845)  1082 
Overkamp,  Heid.  (about  1681)  494 
Oviedo  y  Valdez  (1478-1547)  .  368 
Ovieto,  Augustin  Maria  de  .  1042 
Owen,  Edmund  .         .         .919 

Owen,  Richard  (born  1804)  .  852 
Ozanam,  J.  A.  F.   (1773-1837)     870 


Paauw,    Pieter    (Pavius,   1564- 

1617)  .  .  429,  537,  540 
Pablo,  Juan  (born  1620)  .  .540 
Pacchioni,  Ant.  (1665-1726)  .  536 
Pacchius,  Ant.  (about  A.  D.  20)  158 
Pacini,  Filippo  (1812-1883)  .  844 
Packard,  John  H.  .  .  .1055 
Pagan,  John  (1802-1868)      920,  1091 


1140 


Page. 
Pagenstecher,  A.  (1828-1879)  107-4 
Pagenstecher,  H.  (b.  1844)  844,  1074 
Pagenstecher,  K.  (1824-1865)  1074 
Paget,  Sir  James  (b.  1814)  910,  1046 
Paillard,  A.  L.  M.  (1803-1835)  1035 
Pajola,  Federigo  (1741-1816)  1041 
Palasciano,  Ferdinando  (b.  1815)  K>41 

Palfrey,  Dr 1099 

Palfvn,  Job.  (1649-1730)  519,  680 
Palissy,  Bernard  (died  1590)  .  370 
Palladius   of    Alexandria    (5th 

century)  .  .  .  .188 
Pallas,  Aug.  Fr.  (1731-1812)  .  669 
Pallas,  Simon  (1694-1770)  .  669 
Pallen,  M.  A.  1097 

Palletta,  Giov.  B.  (1747-1832)  667 
Palueci,  Natal  G.  (1716-1797)  667 
Pamphilus    Migmatopoles    (bet. 

A.  d.  14-38)  .  .  .158 
Panaroli,  D.  (d.  1657)  714,  728  n.  1 
Panas,  Photinos  (born  1832)  .  905 
Pancoast,  Joseph  (1805-1882)  1053 
Pancoast,  W.  H.  1055 

Pander,  H.  C.  (1794-1865)  694,  936 
Panizza,  Bart,  (1785-1867)  .1041 
Panizza,  Ludovico  (about  1544)  376 
Pansa,  Martin  (born  1580)  .  714 
Pantechnes  Michael  (about  A.  D. 

1100)  .         .         .         .210 

Panum,  PL.  (1820-1885)  1007,  1073 
Papa,  Jose  del  (1649-1737)  .  496 
Papavoine  (about  1830)  .  .  903 
Papen,  Ambrosius  (about  1580)  421 
Pappendorp,  A.  van (about  1750)  678 
Paracelsus    (Theophrastus   von 

Hohenheim,  1493-1541) 

377-392,  720,  722 
Paradys,  Nic.  (1740-1812)  .  657 
Parchappe  de  Vinay,  Jean  Bapt. 

Max  (1800-1866)  .  .  903 
Parck,  Jan  du  (about  1660)  .  578 
Pare\  A.  (1509-1590)  376,400-402 
Parent,  Willem  (about  1671)  .  494 
Parent-Duchatelet,    A.    J.    B. 

'  (1790-1836)  .  .  .  906 
Pargeter,  Wm.  (about  1792)  .  713 
Parisanus,.Emilius  (1567-1643)  530 
Pariset,  Etienne  (1770-1847)  .1012 
Parish,  Isaac  (about  1832)  909,  928 
Park,  Henry  (1744-1831)  674,  676 
Parker,  Langston  (1805-1871)  922 
Parker,  Willard  (1800-1884)     .  1053 

Parkes,  C.  T 1055 

Parkes,  E.  A.  (1819-1876)    921,  1049 


Page. 

Parkinson,  J.  (about  1800)  715,  922 
Parrish,  Jos.  (1779-1840)  924,  928 
Parrot,  Marie  J.  (1839-1883)  .  907 
Parry,  C.  H.  (1755-1822)  .     908 

Parry,  John  S.  ...  1096 

Parsons,  James  (about  1741)  687 
Partibus,  Jacobus  de,  vid.  Despars. 
Partridge,  Rich.  (1805-1870)  .  1049 
Parvin,  Theophilus  .  .  .  1096 
Pascal,  Blaise  (1623-1662)  .  476 
Pascal,  Jean  (about  1680)  .  496 
Pascal,  J.  H.  P.  (18th  century)  657 
Pascal,  Mich.  Juan  (about  1548)  416 
Pascoli,  Alessandro  (1669-1757)  496 
Pasicrates  (about  b.  c.  40)  .  126 
Passavant,  J.  €.  (1790-1857)  .  631 
Pasteur,  Louis  (b.  1822)  845,  1005 
Pastorello,  Luigi  (1811-1863)  1087 
Patin,  Charles  (1633-1699)  '.  484 
Patin,  Guy  (1601-1672)  .  .  496 
Patritius,   Franciscus   (Patrizzi, 

1529-1597)  .        .        .368 

Patruban,  Karl  v.  (1816-1880)  969 
Patterson  ....  1048 

PaulofiEo-ina  (about  A.  d.  625- 

690)  ■  .  .  . .  205-208 
Paul,  H.  J.  (1824-1877)  .  .  1068 
Paulet,  Jean  J.  (1740-1826)  .  652 
Pauli,  Friedrich  (1804—1868)  .  1063 
Paulini,  Christ.  F.  (1643-1712)  547 
Paulli,  Sim.  (1603-1680)  .  .  714 
Pauly,  Jean  H.  (1806-1854)  .  907 
Pausanias  (4th  century  B.  c.)  .  95 
Paxamos  (1st  century  b.  c  ?)  .  191 
Paynell,  Thomas  (died  1563)  .  413 
Peacock,  Thos.  B.  (1812-1882)  916 
Peale,  Mr.  (about  1814)  .  .  717 
Pean,  Jules  (b.  1830)  907,  1040,  1086 
Peaslee,  Ed.  R.  (1814-1878)  .  1097 
Pechlin,  Job.  Nic.  (1644-1706) 

495,  509,  540 
Pecquet,  Jean  (1622-1674)  531,  533 
Pegel,  Magnus  (about  1604)  513  n.  1 
Peima,  J.  W.  von  (about  1700)  495 
Peiresc,  Fabrice  de  (1580-1637)  533 
Peirson,  Abraham  (about  1667)  580 
Peisse,  Louis  (1803-1880)  .  900 
Pelagonius  (4th  century)  .  .191 
Pelops  of  Smyrna  (a.  d"150)  130,  157 
Pelletan,  Jules  (1805-1873)  .  898 
Pelletan,  Phil.  J.  (1747-1829)  1032 
Pelletier,  Jos.  (died  1842)  .  850 
Pellier  de  Quengsj',  Guillaume 

(about  1787)       .         .        .666 


—  1141 


Page. 

Pemberton,   C.   R.   (1765-1822)     915 
Pemberton,   Henry  (1694-1771) 

502,  677,  697 
.  925 
395 
1097 
925 
920 
912 
665 


Pennock,  C.  W.  (1800-1867) 
Penot,  Bernard   Gr.    (16th  cent.) 
Penrose,  R.  A.  F. 
Pepper,  William 
Pepys,   Sir   Lucas    (1742-1830) 
Percival,  C.  (about  1820) 
Percv,  Pierre  F.  (1754-1825)     . 
Pereira,  Jonathan   (1804-1853)   1018 
Perenotti  di  Cigliano,   Pietro  A. 

(1732-1797)  .  .  .656 
Perfect.  William  (1740-1789)  713 
Perigenes  (about  b.  c.  40)  .     126 

Perkins,  EUsha  (1740-1799)  .:•  825 
Perkins,  F.  Chauncey  .  .  921 
Perrault,  Claude  (1613-1688)  501,  535 
Perrusel,  Henri  .         .         .     906 

Perry,  Charles  f about  1741)  .  502 
Pert}T,  Maximilian  .  .  .  1004 
Peruzzi.  Domenico  .         .       1041 

Pessina,  Ignaz  (1766-1808)  .  718 
Pestalozzi,  Joh.  H.  (1746-1827)  832 
Peter  (about  605)  .  .  .  244 
Peter  of  Abano  (1250-1320)  .  285 
Peter  von  Aichspalt  (ab.  1300)  331 
Peter  Martyr  (1488)  .         .     320 

Peter  of  Wesel  (15th  century)  424 
Peter  the  Spaniard  (died  1277)  286 
Peters,  George  A.  .         .  1055 

Petit,  Ant.  (1718-1794)  667,  681,  700 
Petit,    Francois     Pourfour   du 

(1661-1741)  539,665,700 

Petit,  J.  L.  (1674-1750)  .  .  662 
Petit,  J.  L.  Jr.  (1710-1737)  .  667 
Petrarch  (1304-1374)  .  .  288 
Petraus,  Heinrich  (1589-1620)  396 
Petrequin,  J.  P.  E.  (1809-1876) 

904,  1040 
Petri,  C.  G.  (1633-1718)  .  .  655 
Petrini,  P.  ( 1 8th  century)  .  694 
Petro  (Petronas,  44h  cent.  B.  c.)  114 
Petronius  (about  1035)  .         260 

Petronius  Diodotus  (about  A.  d. 

40)     .         .  .      139,  158 

Petronius    Musa    (about   a.   r>. 

40)  .         .         .         139,  158 

Petrus  ab  Argelata  (de  la  Cer- 

lata,  died  1423)  .  297,  301 
Petrns  Musandinus  (12th  cent.)  263 
Pettenkofer,  M.  v.  (b.  1818)  848,  995 
Pettigrew,  T.  J.  (born  1791)  .  1047 
Peu,  Philippe  (died  1707)  .     524 


Page. 

Peucer,  Caspar  (1525-1602)  364,  394 
Peyer,  Joh.  C.  (1653-1712)  .  536 
Peyligk,  Johannes  (died  1522)  297 
Peyrilhe,  B.  ( 1735-1804)  656,  721 
Peyronie,  Francois  Gigot  de  la 

(1678-1747)  .  .  .662 
Pezold,  J.  N.  (1739-1813)  631,  662 
Pfaff,  Christ.  Heinr.  (1773-1852) 

631,  634,  866 
Pfaff,  Ph.  (18th  century)  .     673 

Pfefferkorn,  W.  G.  (18th  cent.)     656 

Pfeiffer,  A 844 

Pfeizer,  J.  N.  (about  1668)  .  542 
Pfeufer,  C.  (1806-1869)  .  .  972 
Pfluger,  Ernst  (born  1846)  .  1074 
Pfolspeundt,  Heinr.  v.  (1460)  307 
Phaon  (4th  century  b.  o.)  .     115 

Phiidrovon  Rodach,  G.  (1562)  393 
Phayer,  Thos.  (about  1544)  413,  421 
Phecianus  (a.  d.  150)  .  .  130 
Pherecydes  (4th  cent.  b.  c.)  .  115 
Philagrius  (a.  d.  360-375)  .  178 
Pluletas  (4th  century  b.  c.)  .  115 
Philinus  of  Cos  (b.  c.  280)  100,  127 
Philip     of     Acarnania    (about 

b.  c.  340)  .         .         .95 

Philip  of  Csesarea  (about  A.  d. 

117)  .        .         .         .167 

Philipp,  P.  J.  (died  1869)  .     949 

Philistion  of  Locri  (about  370 

b.  c.)  .  .  .  .  114 
Philologus,  Thos.  (abont  1550)  714 
Philonides  of  Dyrrhachium 

(about  b.  c.  42)  .         .     139 

Philotimus  (3-4  cent.  b.  c.)  100,  115 
Philoxenus  (about  b.  c.  260)  .  126 
Philumenus  (about  a.  d.  80)      .     143 

Phipp 1044 

Phobus,  Ludwig  .  .  .  977 
Phobus,  Ph.  (1804-1880)  .     977 

Photius  (A.  D.  865)  .         .     209 

Phryesen,    Laurentius    (Frisen, 

Fries,  died  about  1532)  .  298 
Physick,  P.  S.  (1768-1837)  .  1050 
Piccoli  (18th  century)  .  .  683 
Piccoluomini,  A.  (died  1605)  .  429 
Pick,  T.  P.  .         .         959,  1045 

Pico  of  Mirandola  (H63-1494)     291 

Picot.  C 901 

Pi6dagnel  ....     893 

Pierce,  Robert  (about  1690)  .  721 
Pierchen,  Pehr  (18th  cent.)  .  679 
Pietro  de  Tussignana  (ab.  1250)  308 
Piffard,  Henry  G.       .  927 


—  1142 


Pigavetta,  Fr.  Aut.  (16th  cent.)  443 
Pigray,  Pierre  (1533-1613)  .  402 
Pilcher,  George  (died  1855)  .  918 
Pilz,  Joseph  (1818-1866)  .     968 

Pineau,    Severin    (died   1619) 

402,  525  n.  1 
Pinel,  Ph.  (1755-1826)  638.  711,  712 
Piorry,  P.  A.  (1794-1879;  901,  1016 
Pipelet,  F.  (1722-1809)  .  .  665 
Pippingskold,  Jos.  A.J.  .       1098 

Piquer,  Andres  (1711-1772)  .  653 
Pirogoff.  N.  I.  (1810-1881)  .  1077 
Pirogoff,  Nik.  Iwan.  Jr.  .       1077 

Piso,  Chas.  (1563-1633)  .  508  n.  3 
Piso,  Homob.  (about  1690)  508  n.  3 
Piso,  Nicolas  (died  1590)  508  n.  3 
Piso,  Wm.  (Lepois,  1611-1678) 

508,  544  n.  1 
Pissino,  Seb.  (about  1609)  .     510 

Pitard,  Jean  (1228-1315)  .     303 

Pitcairn,  Arch.  (1652-1713)  494,  501 
Pitcairn,  William  (1711-1791)  913 
Pitha,  Franz  v.  (1810-1875)  .  1058 
Plaatmann  (18th  century}  .     689 

Planer,  Andreas  (about  1579)  398 
Plantade,  Francois  (about  1699)  536 
Platearius,  Joh.  (about  1125).  263 
Platearius,  Matth.  (about  1150)  263 
Platner,  Ernst  (1744-1818)  612,  706 
Platner,  Joh.  Zach.  (1694-1747^ 

668,  705 
Plato  (b.  c.  427-347)  .  111-112 
Platter,  Felix   (Platerus,  Plater, 

1536-1614)      .         .         410,  429 
Playfair,  Win.  S.  1090 

Plempius,  V.  F.  (1601-1671)  .  530 
Plenciz,  Jos.  v.  (1752-1785)  622,  737 
Plenciz,  M.  A.  von  (1705-1786)  622 
Plenck,  J.  Jac.  von  (1732-1807) 

653,  656,  671 
Pleniger,  Andreas  .  .  969,  977 
Pletho,  Georg.  G.  (1355-1452)  289 
Plevier,  Cornelis  (18th  century)  688 
Plinius  Valerianus  (4th  eent.)  187 
Pliny  the  Elder  (a.  d.  23-79)  160 
Plistonicus  (about  b.  c.  300)  100,  115 
Plotinus  (a.  d.  205-270)  .     181 

Ploucquet,  Wm.  G.  (1744-1814) 

612,  705 
Plumbe,  Samuel  (about  1837)  919 
Plutarch  (about  a.  d.  80)  .     714 

Podalirius  (b.  c.  1184)  .  .  86 
Poissonier-Desperrieres    (about 

1767)  .         .         .         .656 


Page. 

Pol ak,  Jac.  Ed.  (19th  century)  64 
Polano,  Machiel  (1813-1878)  .  1075 
Polcastro,  Sigmund  (d.  1473)  293 
Pole  (about  1775)  .  .  .  657 
Poleni,  G.  (about  1724)  .  .  500 
Poli,  Martin  (died  1714)  .  720 
Polidori  (Giac.  Sacchi,  1795)  .  638 
Politzer,  Adam  (born  1835)  968,  1021 
Politzer,  Leopold  (1815-1888)  969 
Polk,  William  M.  .  .  .1097 
Poll,  Hugo  van  de  (about  1754) 

522,  688 
Pollender  .         .         .         .844 

Pollock  .         .         .         .1045 

Pollux  (2d  century)  .         .     157 

Poly  bus  (4th  century  B.  c.)  .  113 
Pomeroy,  Oren  D.  .         .         930 

Pomme,  Pierre  (1735-1812)  .  723 
Pomponazzi,  P.  (1462-1525)  .  367 
Ponce  de  Leon,  Pedro  (d.  1584)  409 
Pons,  Jacques  (1538-1612)  .  364 
Poo  re,  Geo.  Vivian  .  .  .918 
Porcell,  Juan  T.  (1565)  .         409 

Pordasje,  John  (1625-1698)  .  476 
Porphyrius  (a.  d.  233-304)  .  181 
Porro,  Eduardo  .  .  .  1087 
Porta,  Giov.  B.  (1535-1615)  .  367 
Porta,  Luhji  (1800-1875)  .  1041 
Portal,  Antoine(1742-K-32)  661,  700 
Portal,  Paul  (died  1703)  .     524 

Porter,  Daniel  (about  1670)  .  586 
Porter,  Joshua  Henry  (d.  1880)  1049 
Porterfield,  Wm.  (about    1740) 

503,  612,  697 
Portio,  Luc.  Ant.  (about  1682)  496 
Posidonius  (b.  c.  70)  .         .     129 

Posidonius  (a.  d.  360-375)  .  1 78 
Post,  Alfred  C.  (1806-1886)  .  1054 
Post,  Wrisjht  (1766-1828)  .  1050 
Posthitis,  Joh.  (1537-1597)  .  429 
Pot,  John  (about  1625)  .  .  578 
Poterie,  Pierre  de  la  (Peter  Po- 

terius,  about  1645)  486,  546 

Pott,  Johann   Heinrich    (1692- 

1777)  ....     726 

Pott,  Percival  (1713-1788)         .     674 

Potter,  Dr 1090 

Potter,  Hazard  A.  (1810-1869)  1054 
Pouchet,  Fe4ix  A.  (1800-1872)  906 
Pouteau.  C  (1725-1775)  664,  1038 
Powell,  Richard  (1766-1834)  .  655 
Powell,  W.  B.  882 

Power 1046 

Prandina        ....       1041 


—  1143  — 


Page. 

Pratis,  Jason  a  (1487-1558)  .  420 
Pravaz,  Chas.  G.  (1791-1853)  1037 
Praxagoras  of  Cos  (b.  c.  335) 

100,  115 
Praxianax  (3-4  cent.  B.  c.)  .  100 
Preciani  family,  the  .         .     302 

Prescott,  Sam.  (about  1776)  814  n.  1 
Prevost,  Claude  J.  (1672-1753)  706 
Prevost,  A  P.  (about  1810)  .  1019 
Price,  Peter  Chas.  (1832-1864)  1049 

Prichard 1044 

Priessnitz,  V incenz  (1799-1 852)  977 
Priestley,   Joseph    (1733-1804) 

596,  633,  726 
Primerose,  D.  (about  1615)  530  n.  1 
Primerose,  James  (about  1655) 

526  n.  2,  530  n.  1 
Pringle,  Sir  J.  (1707-1782)  650,  798 
Priscianus,  Th.  (about  A.  D.  380)  1 87 
Pritchard,  J.  C.  (1785-1848)  .  920 
Pritchard,  Urban  (born  1845)  918 
Prochaska.  G.  (1749-1820)  634,  935 
Proclus  (411-485  a.  d.)  .  .  181 
Proculus  (b.  c.  20)  .  .  .  145 
Profatius  Judaeus,  (Yacub  ben 

Makir)         .         .         .         .     266 
Proksch,  Joh.  Karl  (born  1839) 

961  and  Addenda. 
ProstJjacuzon  .         .         .     880 

Prost,  P.  A.  (about  1804)  .     892 

Prout,  William  (1785-1850)  .  916 
Prudden,  T.  Mitchell  .        .1010 

Prus,  Clovis  Rene"  (1793-1850)  901 
Psellus,  M.  (a.  d.  1020-1105)  209 
Pserhofer  (about  1854)  .  .  905 
"Pseudo-Gentilis"  .  288  n.  2 

Pseudo-Plinius  (4th  century)  .  187 
Ptolemseus  (about  b.  c.  30)  .  126 
Puccinotti,  F.  (1794-1872)  .  871 
Puchelt,  Fr.  Aug.  (1784-1856)  937 
Pugh,  Benjamin  (about  1748)  687 
Pujol,  Alexis  (1739-1804)  .  656 
Purmann,  Matt.  G.  (1648-1721) 

516,  1022 
Puschmann,   Theodor  (b.  1847) 

vid.  Addenda. 
Putegnat,  J.  D.  E.  (1809-1876)  1086 
Puteus,  Franc,  (about  1562)      .     425 
Putnam,  James  J.  .         .         929 

Puysegur,   the   brothers  (about 

1784)  .         .         .         .630 

Puzos,  Nicolas  de  (1686-1753)  681 
Pyl,  Joh.  Theod.  (1749-1794)  706 
Pythagoras  (b.  c.  580-489)        .       89 


Q. 


Page. 


Quadri,  Giov.  B.  (1780-1851)  1041 
Quaglino,  Antonio  (born  1817)  1041 
Quain,  Jones  (1795-1851)  .  1014 

Quain.R.  (1800-1887)  915,916,  1047 
Quarin,  Joseph  v.  (1734-1814;  647 
Quarre,  Francois  (about  1650)  514 
Quatrefages,  J.  L.  A.  de  (b.  1810)  997 
Quekett,  John  (1815-1861)  .  916 
Quercetanus,  vid.  du  Chesne. 
Quesnay,  F.  (1694-1774)  501,  663 
Quetelet,  A.  J.  (1796-1873)  .  848 
Quin,  Dr.  ....     880 

Quincv,  John  (d.  1723)  805  n.  1 

Quintus  (a.  d.  130)  .  130,  157 
Quiricus  de  Augustis  (ab.  1495)     436 

It. 

Rabelais,  Francois  (1500-1553)  372 
Raciborski,  A.  (1809-1871)  907,  1013 
Racle,  Victor  A.  (1819-1867)  896 
Radcliffe,  Charles  Bland  .  .  922 
Radclifle,  J.  (1650-1714)  649,  651 
Radclifl'e,  J.  N.  (1830-1884)  .  921 
Rademacher,  J.  G.  (1772-1849)  975 
Rae,  James  (1716-1791)  676,  775 
Ragenfrid  (9th  century)  .     262 

Ragskv,  Franz  (died  1875)  .  963 
Rahn,  J.  H.  (1749-1812)  .     719 

Raimann,  J.  N.  v.  (1780-1847)  950 
Rainey,  G.  ....     916 

Ramazzini,    Bernardino   (1633- 

1714)  .         .       496,  509 

Rarabam,  vid.  Moses  ben  Maimon. 
Ramee,  Pierre  de  la  (Petrus  Ra- 
mus, 1515-1572)         .         .     367 
Ramirez,  Gasp.  Bravo  de  Sobre- 

monte  (born  1613)      .         .486 

Ramsbotham,  F.  H.  (1800-1868)  1089 

Ramsbotham,  John  (about  1820)  1089 

Ramsey,  Dr.   (about  1802)         .     711 

Ramskill,  J.  Spence  .         .     922 

Ranchin,  Francois  (1565-1641)     416 

'Rand,  Isaac  Sr.  (1686-1749)      .     802 

!  Randolph,  Jac.  (1796-1848)       .  1054 

iRanke,  Hans  R.  (1849-1887)     .  1075 

!  Ranney,  Ambrose  L.  .         .     928 

!  Ransohoff,  Joseph  .         .       1055 

j  Ranvier,  Louis  (born  1835)        .     904 

I  Rapallo,  Battista  di  (15th  cent.)     414 

i  Raphael  (1483-1520)         .         .     298 

Rapp,  G.  (1818-1885)     876,  956,  965 

Rasori,  Giov.  (1766-1837)       638,  867 

Raspail,  F.  V.  (1794-1878)     852,  904 


1144 


Rat,  le  (1680)    .         .  .     527 

Rathlauw,  Job.  P.  (about  1754) 

(378,  688 
Ratier,  Felix  S.  (1797-1866)  .  906 
Ratzeburg,  J.  F.  C.  (about  1830)  719 
Rau,  Gottl.  Ludw.  (1799-1841)  876 
Rau,  Job.  Jac.   (Ravius,  1668- 

1719)  .  .  .  518,  530 
Rau.  Wilhelm  (1804-?)  .  .  1085 
Raucli,  Ludwig  (1764-1836)  .  777 
Rausse,  J.  H.  .         .         ,     977 

Rau  wolf,  Leonbard  (died  1596)  368 
Ravatou,  Hugo  (about  1750)  .  664 
Ravotb,  F.  W.  (1817-1878)  .  1073 
Ray,  Isaac  (1807-1881)  .  928,  930 
Rayer,  P.  F.  0.  (1793-1867)  888,  902 
Rayger,  Carl  (about  1673)  .     542 

Rayaalde,   Tbos.    (about    1565) 

420  u.  4,  526  n.  1 
Read,  Alexander  (about  1634)  537 
Read,  Alexander  (died  1660)  .  519 
Read,  John  (about  1588)  .     417 

Read,  William  (about  1706)  .  519 
Reamv,  T.  A.  .         .         .       1055 

Reaumur,  R  A.  F.  (K;S3-1757)  598 
Recamier,  J.  C.  A.  (1774-1856) 

906,  1 022  &  Appendix 
Rechberger,  A.  J.  (1731-1792)  684 
Recklinghausen,   Fried.   Dan.  v. 

(born  1833)  .  .  .  !>94 
Reclam,  Karl  (1821-1887)  .  995 
Record.  Francis  (about  1582)  .  413 
Redfern,  Peter  (born  1821)  .  916 
Redi,  Franc.  (1626-1697)  .     535 

Redman,  John  (died  1807)         .     805 

Rees,  Geo.  0 915 

Reese,  David  iMeredith  .  .  1014 
Reese,  John  J.  ...     930 

Rega,  Hendrick  J.  (1690-1754)  615 
Regiomontanus     (Job.     Miiller, 

1436-1476)  .         .         .290 

Regis,  Pierre  S.  (1653-1707)  .  496 
Regnoli,  G.  (1797-1858)  .  .1041 
Reich,  G.  Christ.  (1769-1848)  633 
Reichel,  Georg  C.  (1717-1771)  1040 
Reichenbach,   H.  G.    L.   (1793- 

1879)  ....     843 

Reichenbach,   Karl  von  (1788- 

1869)  .         .         .       631,  632 

Reid,  John  (1808-1849)  .  .  911 
Reid,  Thomas  (1739-1802)  655,  721 
Reil,  Joh.  C.  (1759-1813)  627,  702 
Reimarus,  J.  A.  H.  (1729-1814)  672 
Reinesius,  Thomas  (1587-1667)     484 


I  Pace. 

I  Reinhold,  C.  L.  (1769-1809)  634,  935 
Reinlein,  Jacob  (1744-1816)   622,  671 

i  Reisinger,  Franz  (1788-1855)  1073 
Reiske,  Joh.  J.  (1716-1774)   600,  659 

'Remak,  Rob.  (1815-1865)  903,  1004 
Renatus,  P.  V.  (about  A.  D.  380)  192 
Renaudot,  Theo.  (1 584-1  <i53)  .  486 
Renou,     Jean     de    (Renodaeus, 

about  1615)  .  .  .  546 
Renouard,  P.  V.  (about  1861)  900 
Renucci  (about  1834)  .  852,  1004 
Di  Renzi,  S.  (1800-1872)  871,  1087 
Reovalis  (about  590)  .  .  245 
Reuben,  Levi  ....  882 
Reuchlin.  Joh.  (1455-1522)  .  291 
Reuling.  George  .  .  930,  1056 
Reuss,  Aug.  v.  (b.  1841)  968,  1074 
Reveillc'-Parise.    Joseph    Henri 

(1782-1852)  .  901,906 

Reverdin.  Jac.  L.  (born  1842)  1040 
Reybard,  Jean  F.  (1790-1863)  1038 
Revna,   Francesco  de  la  (about 

15(14)  .         .         .         .435 

Reynaud.  Aug.  Ad.  (1804-?)  1040 
Reynaud,  Jean  Jos.  (1773-1842) 

1017,  1024,  1038 
Reynolds,    H.    R.  (about   1815)     770 
Reynolds.  J.  R.  (born  1828)       .     922 
Rhabanus  Maurus  (774-856)     .     254 
Rhazes    (Abubertus,  Abubater, 
Bubikir,    Abubeter,    a.   d. 
85(»-923)     .         .         .         .227 
Rheginus  (2d  century)       .         .     145 
Rhodion,  vid.  Roeslin. 
Rhodius.  Job.  (1587-1659)        .     509 
Rhyne,  W.  G.  ten  (about  1678)     508 
Riberi,  Alessandro  (1794-1861)   1041 
Ribes,  Francois  (1800-1864)      .     906 
Ricardus,  Magister  (d.  1252)  267  n.  3 
Richard,  Felix  Ad.  (1822-1872) 

1039,  1070 
Richardson,  B.  W.  (b.  1828)  922,  1028 
Richardson,  T.  G.  .  .  .  1055 
Richerand,  A.   B,   (1779-1840) 

627,  1032 
Richet,  Louis  A.  (born  1816)  1040 
Richter,  A.  G.  (1742-1812)  657,  671 
Richter,  Christ.  Fr.  (1676-1711)  612 
Richter,  Geo.  Aug.  (1778-1832)  671 
Richter,  Geo.  G.  (1694-1773)  600 
Ricord,  Philippe  (born  1S00)  902 
Ridley,  Henry  (about  1695)  .  538 
Ried,  Franz  (born  1810)  .       1062 

Riedel,  Joh.  Chr.  (about  1748)     728 


1145 


Page. 

Riegel,  Franz  (born  1843)  .1019 

Rigby,  Ed.  (1747-1821)  633,  687 

Rilliet,  Fred.  (1814-1861)  901,  1013 
Rindfleisch,  G.  E.  (born  1836)  994 
Ring,  John  (1752-1821)  .  .711 
Ringer,  Sidney  .         .         .916 

Rings,  Ant.  W.  (about  1745)  .  737 
Ringseis,  Job.  N.  v.  (1785-1880) 

631,  936 
Riolan,  Jean  (1538-1606)  .     396 

Riolan,    Jean    Jr.    (1580-1657) 

495,  530,  537 
Risueno  d' Amador,    Ben.  Juan 

(1802-1849)  .  .  .  900 
Ritchie  .    '     .         .         .         915 

Ritgen,  F.  A.M.  F.  (1787-1867) 

631,  1082 
Ritter,  J.  W.  (1776-1810)  .     634 

Ritter   von    Rittershain,    Gottf. 

( 1823-1  S8-i)        .         .  .     969 

Ritterich,  Fr.  Ph.  C1782-1866)  1074 
Riva,  G.  (1627-1677)         .      512,  539 

De  la  Rive   A 903 

Riverius,    Lazarus    (la   Riviere, 

158.9-1655)  .  .  486,  509 
Rivinus,  August  Quirin  .  .  53ij 
Rizzoli,  Franc.  (1809-1880)  .1041 
Roberg,  Lars  (1664-1742)  .     649 

Robert,  Cesar  A.  (1801-1864)  1089 
Robertson  (about  1845)  .  .  915 
Robertus,  Joh.  (died  1651)  .  490 
Robin,  C.  P.  (1821-1885)  896,  904 
Robinson,  A.  R.  .         .         .     927 

Robinson,  Beverly  .       '  .         926 

Robinson,  Bryan  (about  1732)  502 
Robinson,  Nicholas  (about  1725)  502 
Rocca,  Bart,  della,  vid.  Codes. 
Rochard,  Jean  F.  (b.  1808)  902,  906 
Rochard,  Jules  (b.  1819)  907,  1040 
Roche,  Louis  C.  G.  (1790-1875)  888 
De  la  Roche,  F.  G.  (1743-1813)  618 
La  Roche.  Rene  (1795-?)  .     924 

Rocheus,  Nicol.  (about  1542)  .  421 
Roch   le  Baillif  de    la   Riviere 

(died  1605)  .  .  .  395 
Rochleder  (died  1872)  .  .  969 
Rochoux,  J.  And.  (about  1845)  899 
Rockwell,  A.  D.  .         .         .     929 

Rodgers,  J.  K.  (1793-1857)  .  1052 
Rodwan,  Ali  (d.  1061  or  1068)  234 
Roderer,  Joh.  Georg  (1726-1763) 

683,  694,  728 

Roeder 1074 

Roeschlaub,  J.  A.  (1768-1835)     862 


Roeslin,  E.  (died  1526)  403,  420 

Roeslin,  E.  Jr.  (died  1553)  .  435 
Rogani,  Leo  (about  1556)  .     399 

Roger,  Henri  L.  (born  1809)  1013 
Roger  (Ruggiero)    df    Palermo 

(about  1210)  .  .  .299 
Rogeriis,  Joh.  N.  de  ( 1 3th  cent. )  204 
Rogeriis,  Johannes  Vitus  de  .  265 
Rogers,  J.  (about  1664)  490.  581,  584 
Rognetta,  F.  (1800-1857)  905,  1030 
Rohlfs,  Gerhard  (born  1831)  224  n.  1 
Rohlfs,  Heinrich  (born  1827)  602  n.  2 
Rohlvves,  Joh.  Nic.  (1755-1823)  719 
Roi,  Hendrik  de  (Regius,  1598- 

1679)  .        .        .        .531 

Rokitansky,  K.  v.  (1804-1878;  950 
Rokitansky,  K.  v.  Jr.  (b.  1839)  951 
Rokitansky,  P.  v.  (born  1843)  951 
Roland  of*  Parma  (about  1250)  300 
Rolander.  Daniel  (18th  century)  720 
Rolfink,  Werner  (1599-1 673)  486,  531 
Rollet  .  ...     902 

Rollo,  John  (about  1797)  .  657 
Romano,  Clemente  (born  1847)  1041 
Romayne,  Nicholas  (1756-1817)  810 
Romuald  IT.  (1153-1181)  .     264 

Rondelet,  G.  (1507-1566)  397,427 
Ronsseus,  Bald,  (about  1597)  .  421 
Roonhuysen,  H.  v.  (about  1663)  518 
Roonhuyseu,  R.  v.  (about  1693)  518 
Roosa,  D.  B.  St.  J.  .         .     930 

Rorarius,      Nicolaus      (Roiario, 

about  1572)  .  .  .  373 
Rosas,  Anton  von  (1791-1855)  968 
Rose,  Edmund  (born  1836)  .  1072 
Rose,  Thomas  ....  1045 
Rosenthal,  Moriz  (b.  1833)  969,  1022 
Rosen    von    Rosenstein,   Nils 

(1706-1773)  .  649,  655 

Roser,  W.  (1817-1888)  970,  972, 1071 
Rosetti,  G.  T.  (about  1 734)  .  615 
Rosshirt,  Joh.  E.  (1795-1872)  1083 
Rossler,  Gottl.  F.  (about  1768)  724 
Rostan,  Leon  (1790-1866)  .  893 
Rota,  Antonio  .         .         .  1087 

Roth,  Wilh.  Aug.  (born  1833)  995 
Rothmund.  F.  C.  v.  (born  1801) 

1062,  1074 
Rothmund,  Aug.  v.  (born  1830) 

1062,  1074 
Rouanet,  J.  R.   de  St.  Pons 

(1797-1865)  .  .  .  1013 
Rouppe,  Ludwig  (about  1764)  656 
Rouse,  J.  ....   1045 


—  1146  — 


Page. 

Rousseau,  Jean  J.  (1712-1778)  596 
Roussel,  Pierre  (1742-1802)  .  682 
Rousset,  Francois  (about  1581)  404 
Roustan,  F.  M.  G.  (1849-1885)  1039 
Le  Roux,  J.  J.  (1749-1832)  .  652 
Roux,  Philibert  J.  (1780-1854) 

1034,  1035 

Rovida 722 

Rowland,  E.  R.  ...  1045 

Rowley,    William    (1743-1806) 

677,  687,  724 
Royer-Collard,  H.  (1802-1850)  906 
Rubini,  Pietro  (1760-1819)  .  871 
Riickert,  J.  Th.  (1800-1885)  .  876 
Rudbeck,  01of(  1630-1 702)  .  521 
Riidiger,  Andreas  (1673-1731)  485 
Rudio,  Eustachio  (died  1611)  429 
Rudolphi,  C.  A.  (1771-1832)  883 
Rueff,  Jacob  (died  1558)  .  .  420 
Ruelle,  Jean  de  la  (1474-1537)  435 
Ruete,  Chr.  G.  T.  (1810-1867) 

1020,  1073 
Rufus,  C.  Yalgius  (b.  c.  12)  .  158 
Rufus  of  Ephesus  (about  a.  d. 

50) 157 

Ruggieri,  Cesare  (1768-1828)  1041 
Riihle,  Hugo  (born  1824)  .     995 

Ruini,  Carlo  (died  1590  ?)  435,  543 
Ruiz,  Hippolyte  .  .  .  844 
Ruland,  Martin  (1532-1602)  .  393 
Rumford,    Count    (Renjamin 

Thompson,  1753-1814)  .  598 
Rumler,  J.  W.  (about  1625)  573  n.  2 
Rumpf,  G.  E.  (1637-1706)  .  479 
Runge,  F.      .  977,  1073 

Rupp,  Heinr.  R.  (died  1719)  .  599 
Rupprecht,  Rernh.  (born  1815)  852 
Rush,     Renjamin     (1745-1813) 

638,  808,  814,  928 
Rusius,  Laur.  (about  1300)  .  311 
Russell,  Richard  (about  1750)  656 
Russell,  Walter  (about  1608)  .  577 
Rust,  Job.  Nep.  (1775-1840)  .  1059 
Rustichelli,  P.  T.  (1310)  .  .  287 
Rusticus   Elpidius    (about   500 

a.  d.)  ....     307 

Rutherford,  Daniel  (1749-1819)  597 
Rutherford,  John  (1695-1779)  738 
Rutty,  John  (about  1757)  .     721 

Ruysch,  Fr.  (1638-1731)  .  531,  537 
Ryan,  Michael  (about  1788)  .  655 
Ryan,  Michael  (d.  1841)  1014,  1090 
Ryff,  Walther  Hermann  (Reiff, 

about  1545)     .        .        420,  429 


S. 

Page. 

Sabatier,  R.  R.  (1732-1811)  664,  700- 
Sabur  ebn  Sahel  (died  864)  .  236 
Sacchi,  Giacomo  (about  1795)  638 
Sacchi,   Pompej.   (Sacco,   1634- 

1718)  .         .         .         .496 

Sacco,  Luigi  (1769-1836)  .     711 

Sachs,  Hans  (1494-1576)  .     476 

Sachs,  L.  Wilhelm  (1787-1848)  878 
Sachs  von  Lewenheimb,  Phil.  J. 

(1627-1671)  .  .  .714 
Sacombe,  Jean  Fr.  (1750-1822)  682 
Saemann  .  .  .  .  .1 020 
Saemisch,  Theod.  (b.  1833)  .  1074 
Saenger,  W.  M.  H.  (born  1833)  1075 
Saaar,  J.'  R.  (1702-1781)  .  .612 
Saillant,  Chas.  J.  (1747-1804)  652 
Saissy,  Jean  Ant.  (1756-1822)  904 
Sajous,  Charles  E.  .  .  .926 
Sala,  Angelus  (died  1637)  396,  485 
Sala,  Joh.  Domin.  (1579-1644)  714 
Saladin  of  Asculo  (about  1447)  309 
Salernus,  Magister  (about  1150)  265 
Sales-Girons^Jean  (1808-1879)  905 
Salicetti,    Guilelmo    (Guilelmus 

Placentinus,  1210-1275)  .  300 
Salisbury.  J.  H.     .         .         844,  1010 

Salmon,  E 1007 

Salmon,   William  (about  1690) 

526,  547,  805  n.  1 
Salmuth,  Phil.  (d.  1626?)  509,540 
Salomon,  Christ,  (about  1830)' 1077 
Salomon,  G.  (1774-1864)  .  1098 

Saltonstall,  Henry  (about  1650)  581 
Salva  y  Campillo,  Franc.  (1751— 

1828)  .  .  .  653,  711 
Salvino  degli  Armati  (d.  1317) 

283  n.  1 

Salzer,  H 966 

Salzman,  Fredrik  (born  1839)  1078 
Salzmann,  Joh.  (1672-1738)  695,  735 
Salzmann,  Joh.  R.  (1573-1656)  540 
Sambucus,  Joh.  (1531-1584)  .  372 
Samelson,  Julius  (born  1841)  1074 
Samonicus,  Quintus  Serenus  (d. 

a.d.  211)  .         .         .184 

Samosch 1018 

Sancassini,  Dion.  (1659-1738)  512 
Sanchez,  Anton  Nunnez  Ribeiro 

(1699-1783)  .  620,656,720 
Sanchez,  Franc.  (1562-1632)  .  '  475 
Sander,  Fr.  (1835-1878)  .  .  995 
Sanderson,  J.  R.  (b.  1828)  921,  1024 
Sandifort,  Ed.  (1742-1814)     678,  697 


—  1147  — 


Page.   ! 

Sandras,  C.  M.  S.  (1802-1856)     903' 
Sandris,  Giacomo  de  (about  1696)  499 
Sands,    Henry    B.    (1830-1888)  1053 
Sanguinetti,    D.     (about    1699)     496 
Sangster,  Alfred         .         .         .     920 
Sanseveriuo,  Dom.   (1707-1760;     694  j 
Sanson,  Louis  Jos.  (1790-1841)    1036  I 
Santa  Cruz,  A.  P.  de  (d.  1650)     484 
Santanielli,  Ferd.   (about  1698)     500  I 
Santa  Sofia,  family  of  ( 1 4th  cent.)     288  : 
Santesson,    C.    G.    (1819-1886)   1076 
Santinelli,  Bart.   (1 7th  century)     513 
Santorini,  Giov.  D.  (1681-1737)     698. 
Santoro,    Santorio     (Sanctorius, 

1561-1635)  497,  498,  511 

Sarazin,  Charles  .         .         .  1040  j 

Sarcone,  M.  (1732-1797)  653, 722,  728  j 
Sass,  Luis  ....     926 

Sassonia,  E.  (1550-1607)  398,  408 
Satterthwaite,  Thos.  E.  .  .1010 
Sattler,  Hubert  (born  1844)  .  1074 
Satyrus  (a.  d.  150)  .  .  .130 
Saucerotte,  Ant.  C.  (1805-1884)  900 
Saucerotte^  Louis  S.  (1741-1814)  1033 
Saulnier,  Gasp,  de  (about  1734)  716 
Saunders,  John  C.  (1773-1810) 

917,  1044 
Saurel,  Louis  Jul.  (1825-1860)  904 
Sauter,  Joh.  N.  (1766-1840)  .  1061 
Sautter,  Jos.  (18th  century)  .  622 
Sauvages,  Fr.  Boissier  de  la  Croix 

de  (1706-1767)  .  501,612 
Saviard,  Bart.  (1656-1702)  .  514 
Savonarola,  G.  M.  (1384-1463  ?) 

293,  722 
Savonarola,  Girol.  (1452-1498)  352 
Savory,  William  S.     .  1046 

Sawyer.  James  .  .  .  1024 
Saxtorph,  Joh.  S.  (1772-1840)  1076 
Saxtorph,  M.  (1740-1800)  688,  1076 
Saxtorph,  Matt.  H.  (born  1822)  1076 
Sayre.  Lewis  A.  1054 

Sbaraglia.  Girolarao  (1641-1710)  536 
Scacchi,  Durante  (about  1596)  415 
Scaliger.  Jos.  J.  (1540-1609)  372,  510 
Scaliger,  Julius  C.  (1484-1558)  372 
Scanzoni,  Fried.  Wilh.  (b.  1821)  1083 
Scaramucci,  G.  (about  1695)  .  500 
Scarborough,  Sir  C.  (about  1676)  538 
Scarpa,     Antonio    (1752-1832) 

638.  667,  699 
Schaarschmidt,  A.  (1720-1791)  684 
Schaarschmidt,   S.   (1709-1747) 

608,  662,  669 


Page. 

Schacher,  Pol.  F.  (about  1740)  661 
Schacher,  Pol.  G.  (1674-1737)  685 
Schacht,  Hermann  (1672-1744)  608 
Schacht,  Hermann  .  .  .  843 
Schacht,  Joh.  O.  (1704-1791)  608 
Schacht,  Lucas  (1634-1689)  .  510 
Schaeffer,  Joh.  G.  (1720-1795;     724 

Schiifer,  J.  C 877 

Selmffer,  Jac.  Chr.  (about  1769)  599 
Schiiffer,  J.  U.  G.  (1753-1826)     619 

Schaller 969 

Sclmlling,  Jac.  (about  1615)  .  514 
Scharlau,  G.  W.  (1809-1861)  .  949 
Schatz,  Christ.  F.  (b.  1841)  .1084 
Schauenburg,  C.  H.  (1819-1876) 

992  n.  1 
Schede,  Max  E.  H.  W.  (b.  1844)  1073 
Schedel,  H.  E.  (about  1828)  .  902 
Scheel,  Paul  (1773-1811)  .     685 

Seheele,  K.  W.  (1742-1786)  597,  7^6 
Scheie!,  J.  G.  (about  1732)  .  683 
Schemer,  Christoph  (died  1050)  539 
Schellhammer,   Giinther  Christ. 

(1649-1716)  .  495,515 

Schelliug,  C.  E.  (1783-1854)  .  936 
Schelling.    F.   W.   J.  v.  (1775- 

1854)  ....     840 

Schelver,  Franz  J.  (1778-1832)  936 
Schenck   von  Grafenberg,    Joh. 

(1531-1598)  .  .  .  410 
Scherf,  J.  C.  F.  (1750-1818)  .  707 
Scheuchzer,  Joh.  J.  (1672-1733)  598 
Scheunemann.  H.  (16th  century)  394 
Scheve,  Gustav  (died  1880)  .  8b 3 
Schieferli,  Rud.  A.  1773-1837)  638 
Schiess-Gemuseus,  H.  (b.  1833)  1074 
Schiff,  Moritz  (born  1823)  .     632 

Schiffner.  Joh.  Christ.  (1780-?)  950 
Schill,  A.  F.  (1812-1839)  .     94!) 

Schillbach.  E.  L.  (born  1825)  .  1062 
Schiller,  Joh.  Casp.  (about  1 760)  797 
Schiller,   Joh.   Christ.  Fried,  v. 

(1759-1805)  .  .  .797 
Schilling  Godf.  W.  (about  1770)  656 
Schirmer.  Bud.  (born  1831)  .  1074 
Schlesel.  Joh.   Christ.  Traugott 

(1746-1824)  •  .  .  705 
Schleiden,  M.  J.  ( 1804-1881)  843 

Schlesinger.  Wilhelm  (b.  1839)  969 
Schlichting.  Jan  D.  (about  1750)  688 
Schmid.  Jos.  G.  (about  1753)  624 
Schmidt,  C.  .  '  .  .  .966 
Schmidt,  Joseph  (about  1649)  517 
Schmidt,  J.  A.  (1759-1809)    672,  937 


—  1148  — 


Page. 
Schmidt,  Job.  B.  (1822-1884)  1083 
Schmidt.  K.  Chr.  E.  (d.  1813;  934 
Schmidt-Rimpler,  H.  (b.  1838)  1074 
Scumitt,  Willi.  J.  (1760-1827)  1080 
Schmucker,  Joh.  L.  (1712-1786  I 

670.  765 
Schneider.  C.  V.  (1614-1680)  538 
Schneider.  F.  C.  (born  1813)  .  069 
Schnetter,  Joseph  .         .         s52 

Schnitzer.  Adolph  (1802-1883)  1085 
Schnitzler,  J.  (b.  1835)  958.  068,  969 
Schoeller,  Jul.  V.  (1811-1883)  1082 
Schoemaker,  A.  H.  (1834-1885) 

1075,  1098 

Schoenberg,  E 1098 

Schoener.  J.  (about  1528)  .     436 

Schoenfelder.  Ph.  (17th  century)  524 
Schoenlein,  Joh.  L.  (1793-1864) 

711  n.  1,  844.  942,  1001 
Schoenlein.  Ph.  (1834-1856)  .  043 
Schbnborn.  K.  W.  E.  J.  (b.  1840)  1072 
Schonkoff.  J.  T.  (about  1685)  517 
Schook.  Martin  (1614-1660;  .  494 
Schopenhauer,  A.  (1788-1^60)  841 
Schrader.  H.  Ad.  (1756-1 836)  843 
Schrader.  Just,  (about  1674)  .  54) 
Schreber,  J.  C.  D.  v.  (1739-1  si  0)  599 
Schreger,  B.  G.  (1766-1825)  .  1062 
Schreiber,  Joh.  F.  (1705-1 700) 

503,  695 
Schrevelins.  Ew.  (1575-1647)  554 
Schreyer.  Joh.  (about  1681)  .  542 
Schrick,  Mich,  (about  1483  i  .  714 
Schroder.  F.  W.  J.  (1733-1778)  720 
Schroder.  J.  (1600-1664)  .     547 

Schroder.  Karl  (1838-1887)  .  1084 
Schroeder.  H.  .         .         .       1005 

Schroeter.  J.        .         .  .  1006 

Schroff.  Karl  von  (born  1844)  963 
Schroff.  Karl  P.  v.  (1802-1887)  963 
Schrfin,  Ludwig     .        .        .        876 

Schroth.   Joh 977 

Schrotter,  Leopold  (born  1837)  968 
Schubert,    Gotth.   Heinrich  von 

(1780-1860)        .         .         .937 
Schubert.  J.  A.  ...     877 

Schuetzerkranz.  H.  (1713-1802)  688 
Schuh,    Franz    (1804-4865) 

951,  1029,  1058 
Schult,  Gerrit  (about  1640)  .  578 
Schulten.  O.  (born  1818)  985  n.  1 
Schnltz,  Fr.  W.  F.  (1775-1831^  843 
Schultz.  Karl  H.  (1708-1871)  843 
Schultze.  A.  W.  (born  1805)      .  1073 


966 

843 

1(1^4 

1074 

1086 
370 


Page. 

Schultze.  B.  S.  (born  1827)  .  1084 
Schultze.  Max  J.  S.  (1825-1874)  1084 
Schultze.  Siegmund  (1795-1877)  1084 
Schultz-Schultzenstein,     C.     H. 

(1798-1871)  .  .  .947 
Schulz.  Pavid  (1732-1823)  .  709 
Schulze,  Franz  .         .         .  1005 

Schulze,   Joh.    H.    (1687-1745) 

615,  658,  705 
Schuster.  K.  ...         966 

Schuyl.  Florentius  (1619-1669)     494 
Schwabe,   Paniel   (about   1635)     517 
Schwa  nda.  M.  (1823-1885)     . 
Schwann,    Theod.    (1810-1882) 
Schwartz,  Jac.  H.  H.  (b.  1821 
Schweigger,  K.  E.  T.  (b.  1830) 
Schweigh-iuser.  Jak.  F.  (1766- 

1842)  .... 

Schwenckfeld,  K.  (1490-1561) 
SchwOrer,  Ignaz  (1800-1860)  1082 
Scoresbv.  William  (1790-1857)  632 
Scotti  (about  1769)  .  718.  795 
Scotus,  Puns  (died  1308)  .     279 

Scotus  Erio-ena,  Joh.  (died  879  »  279 
Scoutteten,  K  J.  H.  (3  799-1871 ) 
Screta,  Heinrich  (about  1686) 
Scribonius  Largus  (a.  d.  45)  143,  158 
Scribonius,  W.  Ad.  (about  1585)  398 
Scudamore,  Sir  C.   (1779-1849) 

911  978 
Scultetus.  Joh.  (1595-1645^  .  517 
Seabury,  S.  (d.  1680)  579.  581  n.  1 
Seaman.  Val.  i  about  1800)  71  I.  1096 
Seaton.  Edward  C.  (1815-1880) 
Sebiz.  Joh.  Albert  (161 5-1  (85) 
Sebiz.  Melchior  -about  1641)  . 
Sebiz,  M.  Jr.  ( 1578-1674- 
Sedechias  (about  850  a.  d.) 
Sedillot,  Chas.  E.   (1804-1883) 

1023,  1039 


1038 
495 


921 

557 

542 

714 

38 


Sedillot.  J. 

See,  (iermain  (born  1818^ 
Seesfer    .... 
Seek.  W.  W.      . 
Segalas.  Pierre  S 


Segnei-,  Joh.  And. 
Seguin,  Ed.  C    . 
Seguin,   Edou.    S. 


(  1702-1875) 
1022, 
(1704-1777) 


906 

903 
852 
930 

1039 
600 
928 


(1-12-1880) 

906,  028.  1024 
Seidel.  Bruno  (about  1562  .     397 

Seiffert,  Chr.  E.  (1770-1839)  .  719 
Seignette.  Pierre  (1660-1719)  544 
Seller.  Burkh.  W.  (1770-1843^   1061 


—  1149 


Seiler,  Carl 

Seitz,  Eugen  (born  1817)  . 
Seitz,  Franz  (born  1811)  . 
Selle,  Chr.  G.  (1748-1800) 
Semeleder,  Priedrich 


Page. 

.  926 
966,  967 

.     995 

612,  647 

968,  1021 


Seminelweis,  Lud.  I.  P.  (1818- 

1865)  ....  1083 

Semon,  Felix  .  .  .  .918 
Senac,  Jean  Bapt.  (1693-1770)  655 
Senator,  Hermann  (born  1834)  995 
Senekenberg,  J.  C.  (1707-1772)  649 
Seneca,   Lucius  Annseus   (a.   d. 

3-65)  .         .         .         .160 

Senguerd,  Wolf,  (about  1681)  .  494 
Senn,  Louis  ....  1021 
Senn,  Nicholas  .  .  1010,  1055 
Sennert,  D.  (1572-1637)  485,  527,  550 
Sepulveda  (died  1572)  .  .  367 
Serachfl,  el  (died  899)  .  .  226 
Serapion  of  Alexandria  (b.c.  270)  128 
Serapion  the  Elder  (a.  d.  802- 

849) 226 

Serapion    the     Younger     (died 

a.  d.  1070)  .         .         .     230 

Serena,  Bart,  (about  1750)  .  667 
Sermon,  Wm.  (about  1671)  526  n.  1 
Serre,  H.  Auguste  (1802-1870)  1040 
Serre,  Joh.  Jac.  J.  (about  1788)  673 
Serres,  Jean  (18th  century)  .  682 
Servet,  Michael  (Servetus,  1509- 

1553)  .        .         .     373-374 

Servili  (about  1740)  .  .  .767 
Servilius    Damocrates    (about 

A.  D.  25)  .  .  .  .  159 
Sethi,  Simeon  (about  a.  d.  1075)  209 
Settala,    Ludovico    (Septalius, 

1552-1632)  .  .  407,722 
Seutin,  Louis  Jac.  (1793-1863)  1030 
Severin,  Peter  (1540-1602)  .  395 
Severino,  M.  A.  (1580-1656)  512,  550 
Severinus  (about  1668)  .  .  537 
Severus,  the  "Iatrosophist"  (5th 

century)  .  .  .  .188 
Severus,  Theod.  (3d  cent.)  177  n.  1 
Sextius  Niger  (about  A.  D.  50)  139 
Sextus  Empiricus  (a.  d.  193)  130 
Sextus  Placitus  of  Papyra  (a.  d. 

370) 186 

Seydlitz,  K.  J,  v.  (1798-1885)  1077 
Seyfert,  Bernhard  (1817-1870)  1084 
Seyler,  Chr.  Jac.  (about  1709)  685 
Shakespeare,  Ed.  O.  .  .  .  930 
Sharp,  Jane  (about  1671)  526  n.  1 
Sharp,  Samuel  (1700-1778)    674.  773 


Page. 

Sharpe  .....  915 
Sharpey,  Wm.  (1802-1880)  916,  1047 
Shaw,  Alex,  (about  1860)  909,  1047 
Shaw,  Peter  (died  1763)  502,  721 
Sheldon,  John  (1765-1808)  .  697 
Sheldrake,  Thos.  (about  1795)  677 
Shekleton  (about  1854)  .  .  1088 
Shew,  Joel  (about  1845)  .  .  978 
Shippen,  Wm.  Jr.  (1736-1808)  806 
Short,  Thos.  (about  1734)  .     721 

Sibson,  Francis  (died  1876)  .  915 
Sichel,  Julius  (1802-1868)         .     905 

Sick,  G.  F 719 

Sick,  Paul  .         .         .         .877 

Siebert,  A.  (1805-1855)  947,  965 

Siebold,  Ad.  E.  v.  (1775-1828)  1081 
Siebold,  Barthel.  v.  (1774-1814)  10»il 
Siebold,  C.  C.  v.  (1736-1807)  671,  779 
Siebold,  C.  T.  E.  v.  (1804-1885)  852 
Siebold,  E.  C.  C.  v.  (1801-1861)  10S1 
Siebold,  Marianne  Theod.  C.  v. 

(1788-1859)  .  .  1081  n.  1 
Siebold,  Regine  Josephe  v.  1081  n.  1 
Siegemundin,   J.    (about  1690) 

524,  563 
Sievekins;,    Sir   Edward    Henry 

(born  1816)  .  .  916,918 
Sigault,  Jean  R.  (about  1777)  682 
Sigmund,  C.  L.  (1810-1883)  .  960 
Signorini,  Bart.  (1797-1844)  .  1041 
Siloranus,  Yal.  A.  (16th  cent.)  393 
Silva,  J.  B-  (1682-1742)  .  .  501 
Silvestri  .         .         .         .1070 

Simeon  ben  Jochai  (13th  cent.)  180 
Simmons,  S.  F.  (1750-1813)  655,  698 
Simon  (1st  century)  .         .     180 

Simon  of  Athens  .  .  .  130 
Simon  de  Cordo  (Simon  Januen- 

sis,  died  1330)  .  .  .  309 
St.  Simon,  C.  H.  de  (died  1825)  842 
Simon,  Fr.  Alex.  (1793-1869)  878 
Simon,    Gustav    (1824-1876) 

1018,  1024,  1029,  1070 
Simon,  John  (1816-1883)  921,  1044 
Simon,  Joh.  Franz  (1807-1843)  946 
Simonius,  Simon  (about  1578)  397 
Simpson,  Sir  Jas.  Young 

1023  n.  1,  1025,  1048,  1091 
Sims,  James  (1741-1820) 
Sims,    J.    Marion    (1813-1883) 

1022,  1055,  1097 
Simson,  Thos.  (about  1752)  .  612 
Sinan  ben  Thabit  (died  942)  .  227 
Sinclair,  Sir  E.  B.  (1824-1882)  1092 


1150  — 


Page. 

Sinclair,  Sir  J.  (1754-1835)  714,  920 
Sinkler,  Wharton  .  .  .  929 
Sinttema,  Em.  (about  1728)  691  n.  1 
Sizer.  Nelson  ....  882 
Skae,  David  (1814-1873)  .  .  920 
Skene.  Alex.  J.  C  .         .1097 

Skev,  Fr.  C.  (1798-1872)  922,  1016 
Skoda,  Joseph  (1805-1881)  .  954 
Slegel,    Paul    Marq.    (Schlegel, 

1605-1653)  .  .  .  531 
Slevogt,  Joh.  Ad.  (1653-1726)  720 
Sloane,   Sir    Hans   (1660-1753) 

651,  765  n.  1 
Slutius,  Andreas  (about  1723)  748 
Smee,  Alfred  (1818-1878)  .  918 
Smellie,  Wm.  (1680-1763)  .  685 
Smet,  H.  (Smetius,  1537-1614)  396 
Smith,  Andrew  H.      .  926 

Smith,  Edward  .  .  .  921 
Smith,  Elihu  H.  (1771-1798)  .  827 
Smith,  Emperor  (about  1657)  587 
Smith,  Henry  .         .         .1019 

Smith,  Henry  H.  .  .  .  1055 
Smith,  Hevwood  .  .  .1090 
Smith,  Hugh  (1730-1790)  .  722 
Smith,  James  (died  1812)  .     808 

Smith,  James  (1771-1841)  .  711 
Smith,  James  Ed.  (1759-1828)  844 
Smith,  J.  Lewis  .         .         .     927 

Smith,  Joseph  M.  (1789-1866)  723 
Smith,    Nathan    (1762-1829) 

811,  924,  1050,  1093 

Nathan  R.  (1797-1877)  1054 

Protheroe    (born   1809)   1093 

Robert  A.  (1817-1884)     921 

Stephen  .         .         .  1054 

Theodore         .        .         .  1007 

Thomas  .         .         .  1047 

Thos.  S.  (1788-1861)      .     920 

W.   Tyler    (1815-1873)  1090 

Philip   C.    (born  1838)     918 

A.  W 1051 


Smith 
Smith 
Smith 
Smith 
Smith 
Smith 
Smith 
Smith 
Smvlv 
Smyth 
Smyth 


J.  C.  (1741-1821)       702, 


'15 

Snape,  Andrew  (about  1686)  .  543 
Snellen.  Hermann  (born  1834)  1019 
Snow,  Joseph  (1813-1858)  921.  922 
Socin,  August  (born  1837)  .  1072 
Socrates  (b.  c.  469-399)  .  .  91 
Solano  de  Luquez.  F.  (1685-1738)  625 
Solavres  de   Renhac.   Fr.   L.  J. 

'  1737-1772)  '.  .  .  681 
Solenander.  R.  (1521-1596)  397,  410 
Solingen.  A  dr.  van  ( 1759-1 830)  1098 
Solingen.    C.    van    (1641-1687)     518 


Page. 

Sollevsel,  Jac.  de  (about  1664)  543 
Solly,  Samuel  (1805-1871)  .  1045 
Solon  (b.  c.  639-559)         .  62,  97 

Sommer,  J.  G.  (1634-1705)  .  524 
Sommer,  J.  S.  C.  (1740-1802)  684 
Sommerino;.  Samuel  Thorn,  von 

(1755-1830)  .  .  .696 
Sonderegger.  J.  L.  (b.  1825)  .  995 
Sonnenfels  (about  1776)  .  671 
Soranus  of  Ephesus  (a.  d.  117)  143 
Sostratus  (about  b.  c.  250)  .  126 
Soubeiran,  Eugene  (1793-1858)  1025 
Souberbielle,  Jos.   (1754-1846)  1036 

Soupart.  J.  I) 1040 

South,  John  Flint  (1797-1882)  1044 
Spach,' Israel  (about  1597)  .  404 
Spadafora,  Bart.  (13th  cent.)  .  311 
Spallanzani,  G.  B.  (about  1818)  '870 
Spallanzani,  L.  (1729-1799)  599,  699 
Spangenberg,  (1.  (1780-1849)  1059 
Spiith.  Joseph  (born  1823)  .  1084 
Spee,  Friedrich  (1595-1635)  .  483 
Spener,  Phil.  J.  (1635-1705)  .  595 
Sperber,  Julius  (16th  century)  394 
Spiegelberg,    Otto    (1830-1881) 

1083,  1084 
Van  Spieghel,  Adrian  (Spigelius. 

1578-1625)  512,  537,  728  n.  1 
Spielmann,  Jac.  R.  (1722-1783)  719 
Spiess,  Alexander  (born  1833)  995 
Spillam,  D.  (about  1837)  .  .  1014 
Spindler.  Joh-  (1777-1840)  .  937 
Spinoza.  Baruch  (1632-1677)  .  478 
Spitta.  Heinr.  H.  L.  (1799-1860)  899 
Spittal.  Rob.  (1804-1852)  911,  1014 
Spitzka.  Edward  C.  .  .  .'  928 
Sprensel.  Kurt  Pol.  Joa.  (1766- 

1833)  .  600,  660,  662,  864 
Spurzheim,  Joh.  C.  (1776-1832)  882 
Squire,  A.  J.  Balmanno  .  .  920 
Staats.  Abraham  (about  1660)  578 
Stadtfeldt.  A.  S.  .  .  .  1098 
Stafford.  Richard  Anthony  .  1046 
Stahl.  GeorgE.  (1600-1734)  608,  721 
Stapf,  J.  Eduard  (born  1788)  .  876 
Stark.  Karl  B.  (1806-1882)  .  948 
Stark.  Karl  Wilh.  (1787-1845)  948 
Stark.  Joh.  Christ.  (1769-1837)  1080 
Stark.  Joh.  C.  Sr.   (1753-1811) 

647,  685 
Stark.  William  (1742-1771)       .     702 

Starke.  W 877 

Starr.  Allen  31.        .         .         .  928 

Starr.  Comfort  (about  1037j       .     579 


1151  — 


Page. 

579 
720 
525 
936 
684 
10S1 


Starrs,  Thomas  (about  1640)  . 
Steer,  Dr.  (18th  century) 
Steeren,  Dio.  van  der  (d.  1691) 
Steffens,  Henrik  (1773-1845)  . 
Steidele,  Raphael  (1737-1821) 
Stein,  Geo.  W.  Jr.  (1773-1870) 
Stein,  G.  W.  (1731-1803)  684,  1080 
Stein,  Signiund  Theod.  (b.  1S40)  1024 
Steinbeck,  Albert  ,  .  .  631 
Steiner,  Job.  (1832-1876)  .     969 

Steinhauser,  H.  ...     966 

Steinheil  ....  1067 
Stellwag  von  Carion    (b.  1823) 

968,  1018,  1020 
Stelwagon,  H.  W.  .  .  .  927 
Steno,  Nic    (Stenson.  Stenonis, 

Stenonius,  1638-1686 1  .  532 
Stephauus,  J.  (about  1625)  .  509 
Stephanus  Magnetes  (12th  cent.)  210 
Stephen  of  Athens   (about  a.  d. 

650)  .         .  .     205 

Stephen  of  Edessa  (6th  cent.)  212.  217 
Stephenson,  G.  (1781-1848)  598,  1027 
Sternberg.  Geo.  M.  .  844,1010 
Steudner,  F  E  W.  (1838-1880)  1073 
Stevens,     Alexander     Hodgdon 

(1789-1869)  1031  n.  2,  1052 

Stevens,  Joanna  (about  1739)  773 
Stevens,  William  (1786-1868)  915 
Stevenson,  Henry  (1721-1814)  802 
Stevenson,  Win.  (about  1779)  656 
Stieglitz,    Johann    (1767-1840) 

631,  865,  878 
Stifft,  Ad  von  (1760-1836)  .  1057 
Stille,  Alfred  (born  1813)  .     925 

Stille.  Moreton  (1822-1855)  .  930 
Stillling,  Benedict  (1810-1879) 

910,  1028,  1072 
Stilling,  Jacob  (born  1842)  .  1074 
Stimson,  Lewis  A.  .         .       1055 

Stoeber.  Victor  (1803-1871)  .  905 
Stoerck,  A.  von  (1731-1803)  621,  720 
Stoffella,  Emil  von  (born  1835)  958 
Stohrer,  Emil  (1840-1883)  .  853 
Stokes,  Wm.  (1804-1878)  913.  1014 
Stoll,  Max.  (1742-1787)  621,  728 

Stolle,  Gottlieb  (1673-1744)  .  661 
Stoltz,  Jos.  Alexis  (b.  1803)  .  1086 
Stone,  Samuel  (about  1671)  .  586 
Stone,    Warren    (1808-1872) 

1029  n.  3.  1054 
Storck,  Karl  (born  1832)  968.  1021 
Storck,  Melchior  (died  1754)  .  622 
Storer,  Horatio  R.  .        .       1097 


Page. 

Stosch,  Aug.  Wilh.  von  (1783- 

1860)  .  .  .  711  n.  1 
Strack,  K.  (1722-1805)  647,  720 

Strambio,  Gaetano  (1755-1831)  638 
Strato  of  Berytus  (b.  c.  280)  .  125 
Strato  of  Lampsacus  (B.  c  280)  118 
Stratonicus  (3d  century)  .  .  191 
Strawbridge,  Geo.  .         .         930 

Strieker.  Salomon  .  .  967.  969 
Strieker,  Wilhelm  (born  1816)  1074 
Stringham,  James  (died  1817)  930 
Strom,  Christian  (1679-1710)  .  608 
Stromeyer,  Chr.  F.  (1761-1824)  710 
Stromever,  Georg  Fried.  Louis 

(1804-1876)  .  .  .  1068 
Strother,  Ed.  (about  (1716)  730  n.  1 
Striippe,  Joachim  (about  1573)  434 
Struthius,  J.  (Strus,  1510-1568)  399 
Struve,  F.  A.  A.  (1781-1840)  851 
Stubbes,  Henry  (1631-1676)  .  494 
Stubbs,  George  (1724-1806)  .  717 
Stukelev.  William  (1687-1765)     656 

Sturcris.'F.  R 928 

Sturm,  Job.  Christ.  (1635-1703)  517 
Stiitz.  W.  A.  (1772-1806)  866,  935 
Suardus,  Paulus  (about  1512)  436 
Sue.  Jean  Baptiste  (1760-1830)  700 
Sue,  Jean  Jos  (1710-1792)  .  700 
Sue,  Pierre  (1739-1816)  .  .  665 
Suevus,  Bernhard  (about  1629)  542 
Sulzberger,  S.  R.  (about  1675)  551 
Susruta  (about  a.  d.  1000)  .  40.  44 
Sussmilch,  J.  P.  (1707-1777)  712 
Sutherland,  James  (about  1677)  747 
Suttons,  the  i  about  1757)  .     709 

Swalve,  Bernhard  (about  T\j64)  494 
Van  der  Swam  ( 1 8th  centiuy)  688 
Swammerdam,  Jan  (1637-1686) 

535.  542 
Swan.  Joseph  (about  1S20)  .  909 
Swedenborg,  I.  (1689-1772)  .  601 
Swediaur,  Franz  X.  (174S-1824) 

656.  927 
Van    Swieten,    G.    (1700-1772) 

619.  720.  737 
Sydenham,  T.  (1624-1689)  504-507 
Svennesis  of  Cyprus  (about  b.  c. 

360)     ...  .114 

Sykes,  James  (1761-1822 )  .  818 
Svlvaticus.  Job.  Baptist.  (1550- 

1621)  .         .         .     373.  376 

Svlvaticus,  B.  (died  1658)  .     509 

Svlvaticus.  Matt.  id.  1342)  .  287 
Sylvius,  J.  (Dubois.  147S-1555)     398 


1152 


Page. 
Syme,  James  (1799-1870)  .  1048 
Svnesius  (about  a.  d.  1150)  .  210 
Szokalski,  V.  F.  (born  1811)  .  905 
Szymanowski,    J.    (1829-1868)  1077 

T. 

Tabarrani,  Piet.  (Tabarini.  1702- 

1780)  .         .         .         .699; 

Taberna?montanus,  Jac.  Theod. 

(died  1590)         .  .369 

Tabor,  John  (about  1724)  .     503 

Tabor,    Robert     (Talbot-Tabor, 

about  1672)  .  .  544  u.  3 
Taehen,  Otto  (Tachenius,  about 

1666)  .         .         .         .496 

Ta°;ault,  Jean  (died  1545)  .     416 

Tagliacozzi,  Casp.  (1546-1599)  302 
Tait,  Lawsou  ....  1093 
Tanaron,  Pietro  P.  (17th  cent.)  667 
Tanner,  Thos.  H.  (1824-1871)  919 
Tanquerel   des  Planches,   L.  T. 

(1809-1862)  .  .  .  906 
Tanturri,  Vincenzo  (born  1835)  871 
Tardieu,  A.  A.  (1818-1879)  .  906 
Targa,  Leon.  (1730-1815)  600.  661 
Tarin,  Pierre  (1725-1761)  .     700 

Tarnier,  Stephane  .         .       1086 

Tartra,  A.  E.  (1775-1840)  .   1034 

Tate,  G.  (about  1830)  .  .  909 
Tatum,  Thomas  (1802-1879)  1045 
Tauler,  Joh.  (1290-1361)  280,4^7 
Taupin  (about  1839)  .  .  .  1018 
Tavernier,  Alphonse  (died  1850)  1038 
Taylor,  Alfred  S.  (1806-1880).  915 
Taylor,  Henry  (about  1669)  .  586 
Taylor,  Isaac  E.  1097 

Taylor,  Sir  John  (1708-1767)  519 
Taylor,  Robert  W.  .  .  927,  928 
Teale,  T.  P.  Sr.  (1801-1868)  .  909 
Teichmeyer,  H.  F.  (1685-1746)  706 
Telesio,  Bernard.  (1508-1588)  .  368 
Tennent,  John  (about  1736)  720,  804 
Tennent.  John  V.  B.  (about  1767)  808 
Tenon.  J.  Rene  (1724-1816)  666,  700 
Tentzel,  Andr.  (about  1629)  .  485 
Terraneus,  L.  (about  1709)  . 
Terrillon, 

YonTextor,  C.  (1782-1860)  . 
Von  Textor,  Carl  (1815-1880) 
Thabit  ebn  Corra  (836-901) 
Thabit  ebn  Sinan   (died  973) 
Thacher,  T.  (1620-1678)         580,  584 
Thackrah,  Charles  Turner  (died 
1833)      ....     915,  920 


Page. 


285 
618 
87 
683 
683 
669 
965 
140 
930 
219 

310 
165 

254 

177 
219 


209 

204 

118 
113 


502 

1040 

1061 

1062 

227 

227 


Thaddaeus  of  Florence  (1215- 

1295)  

Thaer,  Albrecht   (1752-1828) 
Thales  of  Miletus  (b.  c.  639-544 ) 
Thebesius,  A.  C.  (about  1708 
Thebesius.  Joh.  E.  (1717-1758) 
Theden,  J.  Chr.  Ant.  (1 71 4-1 797) 
Theile,  Fr.  Wilhelm  (1801-1879) 
Themison  of  Laodicea  (B.  c.  50) 
Theobald.  Samuel 
Theodocus  (7th  century) 
Theodorich  of  Cervia,  vid.  Bor- 
gognoni      .... 
Tbeodorus  (about  a.  d.  110)   . 
Theodorus  of  Tarsus  (died  (190) 
Theodotius  Severus    (3d  cent.) 
Theodunus  (7th  century 
Theomnestus  (about  480)  191.  244  n.  3 
Theon  of  Alexandria  (a.  d.  390)     185 
Theophanes  Nonnus  (about  a.  d. 

920) 

Theophilus  (Philotheus,  Philare- 

tus.  about  a.d.  630) 
Theophrastus    (Tyrtamus,  b.  c. 
372-285)        .... 
Thessalus  (B.  c.  380)         95,100, 
Thessalus  of  Tralles  (a.  d.  60) 

140,  142,  150 
Tbeudas  of  Laodicea  (a.  d.  70- 

120)     ....  35,  130 

Thevenin,  Francois  (died  1656;     514 
Thevenot  de    St.  Blaise   (about 

1841)      

Thiedeggof  Prague  (1 1th  cent-) 
Thiersch  Karl  (b.  1822)    . 
Thilenius,  G.  (1745-1809)      . 
Tbomas  a  Kempis   (1380-1471) 
Thomas  of  Breslau  ( 14th  century) 
Thomas   de   Cantimpre"    (1201- 

1270)      

Thomas  of  Lesbos  (about  A.  d. 

1150)      

Thomas,  A.  E.  Simon  . 
Thomas,  Ed.  (18th  century) 
Thomas,  T.  Gaillard  .  1094, 
Thomas,  L.  M.  (1848-1884)  . 
Thomasius,  C.  (1655-1728)  485,  595 
Thomassin,  J.  F.  (1750-1828)  .  1033 
Thompson,  Alex,  (about  1700)  502 
Thompson.  E.  Symes  .         .     921 

Thompson,  Sir  H.  (b.  1820)   922, 1049 
Thompson,   Theo.    (1807-1860)     912 
Thompson,  Thos.  (about  1740)  656,687 
|  Thompson,  William  H.       .         .     925 


901 

25,5 

1073 

673 

280 
288 

282 

210 
1098 

056 
1097 

918 


—  1153  — 


Page. 

Thomson,  Adam  (about  1750)  802 
Thomson,  A.  T.  (1778-1849)  911,  919 
Thomson,  George  (about  1670)  493 
Thomson,  John  (1765-1846)  .  910 
Thomson,  William  .         .         930 

Thorbern,  Kanut  (17th  century)  521 
Thorer,  Abraham  (1489-155")  429 
Thorne,  Richard  .  .  .921 
Thornton,  J.  Knowlsley  .       1093 

Thornton,  M.  (about  1780)  814  n.  1 
Thornton.  R.  J.  (about  1790)  .  638 
Thou  ret,  Michel  A.  (1748-1810) 

652,  711,  1034 
Thriverius.  vid.  Drivere     . 
Thruston,  M.  (about  1671).         .     542 
Thulstrup,   M.  A.    (1769-1844) 

1076,  1098 
Thunberg,  Karl  P.  (1743-1828;  598 
Tburinus,  Andreas  (about  1525)  376 
Thurneysser,  Leon.  (1530-1595)  392 
Thymbraeus  (4-3  century  B.  c.)  100 
Tibbits,  Herbert  .  .  .918 
Tiedemann,  F.  (1781-1861)  633  n.  1 
Tiffany,  L.  McLane  .  .  .1055 
Tilanus,  C.B.  (1796-1883)  .  1075 
Tilanus,  Jan.  W.  R.  (b.  1823;  .  1075 
Tilesius  von   Tilenau.  Wilhelm 

Gottlieb  (1769-1857)  .  .  654 
Tillaux,  Paul  (born  1834)  .  1040 
Tilt,  Ed.  John  ....  1093 
Timoni,  Emanuele  (about  1714)  708 
Tissot,  Simon  Andre"  (1 728-1797) 

624,  652,  715,  723 
Titian  (1477-1576)  .  .  .298 
Titsingh,  Abraham  (about  1740)  688 
Titus  Aufidius  (about  b.  c.  44;  139 
Tizzoni,  Guido  (born  1853)  .  1041 
Tobias  of  Modaim  (about  a.  d. 

130) 35 

Tobohl,  Adalbert  (born  1827)  .  1021 
Todaro,  Giacomo  (about  1722)  722 
Todd,  Robert  B.  (1809-1860)  912 
Tode,  Joh.  Clemens  (1736-1805)  678 
Tolet.  Francois  (about  1673)  .  514 
Tollat  von  Vockenberg,  Johann 

(15th  century)  .  .  .310 
Tommasi,  Salvatore(1813-lS88)  871 
Tommasi-Crudeli,  Corrado  (born 

1834)  ....  844,  871 
Tommasini,   Giac.  A.  D.  (1768- 

1846) 867 

Tooker,   William    (about  1597)     413 
Topinard,  Paul  (born  1830)        .     903 
Toro,  Luis  de  (about  1574)    .         409 
73 


Page. 

Torre,  Marc  A.  della  (1473-1506)  298 
Torres,  Dr.  (died  1888)  .  .  1087 
Torres,  Jose  Ignacio  de  (18th 

century)  ....  653 
Torrey,  John  (1798-1873)  .  844 
Torriijiano  Rustichelli   (1306- 

1311)  .         .         .         .287 

Torti,  Francesco  (1658-1741)  652,  719 
Torti,  Raimund  (1603-1678)  .  509 
Tosetti,  Urban  (18th  centurv)  694 
De  la  Touche,  G.  (about  1587)  421 
Tournefort,  Jos.  P.  (1656-1708)  479 
Tourtelle,  Etienne  (1756-1801)  661 
Tovvnsend,R.  (about  1832)  911,  1014 
Toxaris  (b.  c.  592)  ...  62 
Toxites,  Michael  (about  1574)  .  393 
Toynbee,  Jos.  (1815-1866)  918,  1021 
Tozzi,  Luc.  (1640-1717)  .  ..496 
Tragus,  Hieronvmus  (1498-1560)  369 
Trail,  RussellT.  (1812-1877)  978 
Trades,  Balth.  Lud.(1708-17!>7)  647 
Traube,  L.  (1818-1876)  844,  966, 1017 
Trautmann,  Jer.  (about  1610)  .  525 
Travers,  Benjamin  (1783-1858) 

909, 1044 
Treitz,  Wenzel  (1819-1872)  .1084 
Trelat,  TJlysse  (1795-1879)  899,  1038 
Tremlinger,  Oswald  (about  1458)  307 
Trendeleuberg,  Fried,  (b.  1844)  1072 
Treviranus,Chr.  Lud.  (died  1864)  634 
Treviranus,  Gottf.  R,(  1776-1837)  935 
Trew,  Christian  Jac.(  1 695-1769)  695 
Tribunus  (6th  century)  .  .219 
Triller,     D.     W.      (1695-1782) 

600,  659,  709 
Trincavella,  Vettore  (1496-1568) 

376,  407 
Trinchinetti  ....  1087 
Trinks,  Karl  F.  G.  (1800-1868)  876 
Tripier,  Aug.  (born  1830)  .  .  903 
Triquet.  Eugene  H.  (about  1860)  904 
Trithemius  (1462-1516)  .         362 

Troja,      Michele      (1747-1827) 

654,  667,  699,  711 
Von  Troltsch,  A.  F.  (born  1827)  1021 
Tromsdorff,  Joh.  B.  (1770-1837)  727 
Troncbin,  Theo.  (1709-1781)  709 
Trono,  Pietro  M.  (about  1580)  415 
Tropanneger,  C.  G.  (about  1733)  705 
Trotter,  Thomas  (1761-1832)633,656 
Trotula  (Eros,  11th  centurv)  264 
Trousseau,  A.  (1801-1866)  899,  903 
Troxler,  Ignaz  P.  V.  (1780-1866)  935 
Trullius,   Johann    (about  1650)     531 


—  1154  — 


Page. 

Tryphon  (1st  century)  .  .  li'G 
Tschirnbausen.  Ehrenfried  Wal- 

tlier  (1651-1708)    .  .     714 

Tucker,  Robert  (about  1775)  809 
Tudetino,  Dr.  (about  1699)  .  554 
Tudus,  Rabbi  ...  35 

Take,  Daniel  H.  (born  1827)  713,  921 
Tuke,  Samuel  (1784-1857)  .  920 
Tuke,  William  (1732-1822)  .  713 
Tullv,  William  (1785-1859)  .  923 
Tulpius,  Nicolas  (1593-1674)  .  540 
Ttirck,  Ludwig  (1810-1868)  910,  968 
Turine.  Louis  (1751-1819)  .  900 
Turnbull,  Laurence  .  .  930 
Turner.  Daniel  (1667-1741)  653,  809 
Turner.  Edward  (1796-1837)  .  911 
Turner,  John  Win.  (1789-1835)  775 
Turner,  William  (d.  1568)  413,  436  n.  1 
Turquet  de  Mayerne,    Theodore 

(1573-1655)  .  .  396,  559  n.  1 
Tweedie.  Alex.  (1794-1884)  .  914 
Twitcheil.  Amos.  (1781-1850)  1052 
Tyndall,  John  (b.  1820)  .  .  848 
Tyrrell.  Fred.  (1797-1843)  917,  1044 
Tyson,  Edward  (born  1651)  .  537 
Tytler,  James  (1747-1804)    .         826 

U 

Uden,  K.  Fr.  (about  1800)  .  706 
Ullersperger.  J.  B.  (1797-1878)  1085 
Ulloa,  Antonio  de  (1716-1795)  598 
Ulloa,  Juan  de  (18th  century)  .  598 
Ulsamer,  Adam  (1795-?)  .  "  .  1082 
Ulsen.    Dietrich       (Theodorich. 

about  1507)        .         .  294,  310 

Underwood,  M.  (1715-1795)  .  656 
Unzer,  Job.  Aug.  (1727-1799)  611. 715 
Upham  .         .         .         .1016 

Urdy,  L 1086 

Urquiola,  Vincente  .         .       1042 

Ursus  (about  860)  .  .  .  254 
Uwins.  David  (1780-1837)  .  922 
Uytterhoeven,  Andre(1799-1868)  1030 


Vaccher  de  la  Fleutrie,  le  (18th   . 

centurv)  ....     657 

Valcareughi,  Paolo  (died  1780)  500 
Valenta.  Aloysio  .  .  .  1087 
Valentine,  Basil  (about  1450)  310 
Valentini,   Mich.   Bernh.  (1657- 

1729)  .         .      517.  545,  705 

Valerius.  Franc,  (about  1565)  .  398 
Valescus  de  Taranta  (1382-1417)     269 


Page. 

Valette,     Auguste     Dominique 

(1821-1876)  ....  1039 
Valle,  Francesco  (about  1792)  683 
Del  Valle.  J.  F.  (18th  century)  706 
Valleix,  Francois  Louis  Isidore 

(1807-1855)  .  .  .901,  903 
Valleriola,  Franyois  (1504-1580)  407 
Valles,    Francesco      (Vallesius, 

about  1589)     .         .     373,376,409 

Vallin 906 

Vallisnieri.  Antonio  (1661-1730)  535 
Valota,  Horatio  (18th  centuiy)  683 
Valsalva,  Ant.  M.  (1666-1723)  698 
Valverde    de    Harnusco,     Juan 

(about  1 560)  ....  430 
Vandelli,  Dom.  (about  1758)  694 
Van  den  Bergh,    Peter  Jansen 

(about  1660)  .         .         .579 

Van  Buren,  William  H.   (1819- 

1883)  .         .         .     928,  1054 

Van  den  Heuvel,   C.  G.    (about 

1787)  ....  612,618 
Van  der  Heyden.  H.  (1572-1655)  509 
Van  Imbroeck,  G.  (about  1660)  579 
Van  der  Linden,  Job.  Antonides 

(1609-1664)  .  .  .  484.  530 
Van  der  Mve.  Fred,  (about  1627)  509 
Van  der  Meer,  (about  1829)  .  1075 
Van  de  Meersche,  J.   (Jason  a 

Pratis,  1487-1558)  .  .  420 
Van  der  Straten,  Willem  (1593- 

1681) 554 

Van  Swieten.  Ger.  (1700-1772)  619* 
Van  de  Warker,  Ely  .  .  .  1097 
Van  Wv.  G.  J.  (1748-1810)  .  678 
Van  der  Wvl.  C.  8.  (1620-1688)  518 
Van  de  Voorde.  C.  (1650-1720)  509" 
Vanier,  Paul  P.  (about  1844)  901 
Vanini,  Lucilio  (1585-1619)  .  367 
Vannoni,  Pietro  .  .  .  1087 
Vanzetti.  Aloysio  (born  1809)  1041 
Varandaus,  Job.  (died  1617)  .  526 
Varionana,  Bart,  (died  1318)  .  3o9 
Varignana.  G.    (died  1330)  309 

Varolio,   Costanzo    (1543-1575)     42S» 
Varrentrapp.  Georg  (1809-1880)     995F 
Varro,  M.  T.  (b.  c.  11 6-27)         .     158 
Varvanger,   J.  H.    (about  1658)     578 
Vasquez,  Santiago  Garcia  .   1042 

Vasse.   Lovs    (Vassaeus,     about 

1553)  ".  .  .  .  .427 
Vater,  Abraham  (1684-1751)  557 
Vater.  Christian  (1651-1732)  557.  002 
Vaughan.   James    (about  1778)     687 


—  1155  — 


Vaughan,  Thomas  (1621-1666)  485 
la  Vauguyon  (about  1696)  .  514 
Vauquelin,  L.  N.  (1763-1829)  597 
Vavasseur,  Guil.  (about  1544)  457 
Vectius  Valens  (about  a.d.  23)  142,150 
Vega,  Christobal  da  (1510- 1 580)  408 
Vego,  Juan  del  (about  1640)  544 
Vehr,  Irenaeus  (died  1710)  .  556 
Veit,  A.  C.  C.  G.  (born  1824)  .  1084 
Veith,  Job.  Elias  (1789-1885)  718 
Veith,  Job.  Eman.  (1787-1876)  718 
Velasco,  D.  (about  1792)  .  .  667 
Velpeau,     Arraaud    L.    M.     A. 

(1795-1867)  .  .  1037,  1086 
Veltbuysen,  L.  (born  1622)  417  n.  1 
Venel,  J.  Andr.  (1740-1791)  .  673 
Venner,  Tobias  (1577-1660)  714 
Venusti,  Ant.  M.  (about  1562)  421 
Verardini,  F.  (born  1818)  1018,  1087 
Verdier,  Cesar  (1685-1759)  .  700 
Verdier,  Jean  (1735-1820)  .  706 
Verduc,  the  family  .  .  514,  515 
Verduc,  Jean  Bapt.  (about  1700)     515 

Verducci 1087 

Verduyn,  P.  A.  (about  1696)  509,518 
Vergilius,  Marcellus  (died  1521)  293 
Vergniol,  J.  (about  1697)  .  .  50!) 
Verheyen,  P.  (1648-1710)  494,537 
Verla,  Giov.  Bapt.  (about  1677)  540 
Verna,  Giainb.  (about  1716)  .  694 
Verneuil,  Aristide  (born  1823)  1040 
Vernois,  Maxime  (1809-1877)  906 
Verschuir,  Walt.  F.  (1739-1793)  694 
Verzascha,  Bernh.  (born  1628)  509 
Vesalius,  Andreas    (1514—1564) 

376,  423-425 
Vesling,    Johann     (1598-1649) 

530,  533.  537,  556  n.  1 
Vespa,  Giuseppe  (1727-1804)  682 
Vetch,  John  (1783-1835)  .  .  917 
Vetter,  A.  R.  (1765-1806)  .  648 
Vettori,  Leonello(Viclorius,  Leo- 

nellus  Faventinus,  died  1520)  421 
Veyrery,  John  (about  1510)  .  418 
Vezin,  Hermann  (1797-1861)  1068 
Vezosius,  Mmil  (about  1598)  421 
Vianeo  family  ....  302 
Viardel,  Cosme  (about  1671)  .  524 
Viborg,  F.rich  Nil.  (1759-1822)  718 
Vicary,  Thomas  (about  1548)  .  429 
Vicq-d'-Azyr,  Felix  (1748-1794) 

599,  652,  700 
Victorius,   Benedictus  (Vettori, 

born  1481)      .        .        .         .376 


Page. 

Vidal,  Auguste  (1803-1856)      .  1037 
Vidart,  V.  (18th  century)       .         683 
Vidius,  Vidus,  vid.  GuidoGuidi 
Vieussens,  Beymond  (1 641- 1 7 16) 

496,  511,  532 
Vigarous,    Jos.   Marie  Joachim 

(1759-1829)  .  .  .  1023  n.  1 
Vigier,  Jean  (1614-1658)  .  .514 
Vignon  (about  1606)  .         .     496 

Vigo,  Giovanni  de  (1460-151!))  414 
Villalobos,  Franc.  L.  de  (1473- 

1560) 409. 

Villareal,  Juan  de  (about  1611)  550 
Villaverde,  Fr.  (about  1792)  .  007 
Villemore  (about  1516)  .  .  375 
Villerme,  L.  Bene  (1782-1863)  906 
Villemin,  Jean  Ant.  (born  1827)     904 

Vincencio.  A 1087 

Vincent,  John  P.  (about  1840)  1046 
Vincent  de  Beauvais  (died  about 

1264)  ....  282,  310 
Vincentius,  Johannes  .     265 

Da  Vinci,  Leon.  (1452-1519)  298 
Vindician  (about  A.  D.  370)  .  186 
Vircbow,  Rudolph  (born  1821)  993 
Ariridet,  Jean  (about  1700)  .  490 
Virrey,  Pasc.  Fran,  (about  1741)  607 
Visscher,  Jac.  de  (about  1754)  522,688 
Vitet,  Louis  (1736-1809)  .  .  716 
Voelckers,  Karl  (born  1836)  1074 
Vogel,  Adam  Fried.  (1746-1785)  671 
Vogel,  Alfred  (born  1829)  995,  1085 
Vogel,  B.  Christ.  (1745-1825)  671  n.  1 
Vogel,  Jac.  Ch.  (about  1770)  671  n.  1 
Vogel,      Julius        (1814-1880) 

949,  1004,  1018 
Vogel,  Ludwig  (1771-1840)  715,937 
Vogel,  Rud.  Aug.    (1724-1774) 

608.  612,  647,  705 
Vogel,  Sam.  Gottl.  (1750-1837) 

047,  721 

Vogel,  Zacharias  (1708-1772)  671  n.  1 

Vogler,  Valentin  H.  (1622-1677)     714 

I  Vogt,  Karl  (born  1817)     .         .     841 

Vogt,  Paul  (1844-1885)         .       1073 

I  Vogter,  Barthol.  (16th  century)     436 

!  Voider   (about  1690)  .         .     517 

Voigtel,  Fried.  Gott.  (1770-1813)    702 

1  Voillemier,  Leon  Clement  (1809- 

1878) 1040 

Voit,  Karl  von  (born  1831)  .  978 
Voitus,  J.  C.F.  (1745-1 7S7)  .  670 
Volkmann,  A.  W.  (1800-1877)  1072 
Volkmann,  Rich,  von  (  b.  1830)   1072 


1156  — 


Page,  i 

Volpini,  Giambat.  (about  1700)  406! 

Volta,  Alessandro    (1745-1827)  598 

Voltaire  (1094-1778)         .         .  596 

Volter,  Ch.  (17th  century)     .  524  I 

Volz,  Robert  (1806-18*2)  .         .  948 ; 

Voss,  Job.  Jul.  (1 768-1  832)      .  631  i 

Vrancken,  L.  H.  J.  (1773-1  »53)  711  i 

Vrolik,    Gerardus    (1775-1859)  1098, 

Vrolik,  Willem  (1801-1863)  .  936 
Vulpe,  Gregorius  a  (Vulpi,  15th 

century)  .         .  .295 

Vulpian,    Edme    Felix    Alfred 

(1826-1887)  .  '      .         .         .894 

W 

Von  Wachendorf,  E.  J.    (about 

1740) 695 

Wachsmuth,  A.  (1827-1865)  .  956 
Wadsworth,  Oliver  .  930 

Wagler,  Karl  Gottl.  (1732-1778)  728 
Wagner,  Clinton         .         .         .     926 

Wagner,  E 852 

Wagner,  Johann  (1800-1831)  .  950 
Wagner,  Job.  Jacob  (1775-1821)  936 
Wagner,  K.  E:  A.  (1827-1871)  1072 
Wagner,  K.  W.  U.  (1793-1846)  867 
Wagner,   Rud.    (1805-1864)    852,936 

Wagstaff 1044 

Von  Wahl,  Eduard  (born  1833)  1077 
Wahlboni,  Joh.  G.  (1724-1807)  679 
Wainman  (about  1 758)  .  .  674 
Wainwright,  Jer.  (about  1700)  502 
Waite,  George  ....  1067 
Walafrid  Strabo  (807-818)  .  254 
Waldau  .         .         .         .1074 

Waldenburg,  Louis  (1837-1880)  1024 
Waldeyer,  H.  W.  G.  (born  1836)  991 
Waldschmidt,  J.  J.  (1644-1689)  495 
Wale,  Jan  de    (Walseus,  1604- 

1649)  .....  531 
Walker,  John  (about  1834)  .  1044 
Walker,  Thomas  James  .  .  918 
Wallace,  Alfred  R.  (born  1822)  846 
Wallace,  Wm.  (died  1838)  911,  922 
Von  Waller,  Job.  (1811-1880)  961 
Wallerius,  Job.  G.  (1709-1785)  599 
Wallis,     George      (1740-1802) 

656,  677,715 
Walsh,  Philip  Pitt  (about  1787)  687 
Walshe,  W.  H.  (born  1816)  915,  1014 
Walter,  Fried.  Aug.  (1764-1826)  696 
Walter,  Job.  G.  (1734-1818)  654,  696 
Walther,  Job.  Ad.  (born  1781)  883 
Walther,  J.  Th.  .         .         .883 


Page. 

Walther,  Philipp  Franz    (1782- 

living  1882)  .  631,  934,  1063 
Walton,  John  (about  1732)  .  804 
Ward,  Ogier  (about  1837)  .  912 
Ward,  Sam.  R.  .         .         .1024 

Warden,  Adam  (about  1844)  918, 1021 
Wardrop,    James     (1782-1869) 

908,  916,  917,  1046 
Ware,  James  (1756-1815)  .     677 

Ware,  John  (1795-1S64)  .  925 
Warlomont,  E.  (born  1820)  711,  1075 
Warnatz,  Gustav  H.  (.1810-1872)  1074 
Warner,  Joseph  (1717-1801)  677,  677 
Warren,  John  (1753-1815)  .  810 
Warren,   John    C.    (1778-1856) 

1015,  1025  n.  1,  1050,  1051 
Warren,  J.  Mason  (1811-1867)  1054 
Warren,  Joseph  (1741-1775)  fel4  n.  1 
Warrington,  Joseph  .  .  .  1096 
Wartenhorst,  Anton  Jaksch  von 

(1810-1887)  .  .  .  .961 
Waterhouse,  Renj.   (1754-1846; 

711,  810 
Wathen,  Jonathan  (about  1755) 

677,  917 
Watson,    Ebenezer   (died  1886)     918 

Watson,  H.  C 882 

Watson,  John  (1807-1862)  926,  1052 
Watson,  Patrick  Heron  .  .  1049 
Watson,  bir  Thomas  (1792- 
lb82)  .  •  .  .  .916 
Watson,  William  (1715-1788) 
Watt,  James  (1736-1819)  . 
De  Watteville,  Armand 
Von  Wattmann,     Jos.     (1789- 

1866)      

Wawruch,  Andreas  Ignaz  (1782- 

1842)      

Weber,  Adolph  (born  1829) 
Weber,  Aug.  Gottl.  (1761-1807) 
Weber,  Ernst  Heinrich   (1795- 

1878)      ....     936,  939 
Weber,  Fried.  Aug.  (1753-1806)     662 
Weber,  Georg  (about  1849) 
Weber,  Gustav  C.  E.  . 
Weber,  0.  (1827-1867)      . 
Weber,  Theo.    (born  1829)     . 
Webster,  David 

Webster,  Noah  (1758-1813)  . 
Wecker,  Louis  de  (born  1832) 
Wedekind,  Georg  Christ.  Gott- 
lieb (1761-1831)  .  866 
Wedel,  Georg  W.  (1645-1721) 
Wedel,  Johann  W.  (1708-1757) 


1049 
724* 
597 
918 

1057 

950 

1074 

694 


965 
1055 
1050 
995 
930 
826 
905 

,  878 
495 
745 


Page. 

Wedemeyer,  G.  (1792-1829)  .  1059 
WedJ,  Carl  (born  1815)  .  .  967 
Weidmann,    Job.  Peter    (1751- 

1819)  .  .  .  669,  1080 
Weigel,'  Valentin  ^1533-1594)  394 
Weigen,  Josias  (died  1773)  .  083 
Weigert,  Karl  (born  1845)  .  1009 
Weikard,  M.  Ad.  (1742-1803)  638,713 
Weinhold,  K  A.  (1762-1829)  .  1061 
Weinlechner,  Joseph  (born  1829)  1072 
Weir,  Robert  F.  1054 

Weiss  (18th  century;     .         .       1021 
Weisse,  vid.  Albinus 
Weitbrecbt,  Josias  (1702-1747)     695 
Welizelos,  Miltiades  (died  1887)  1099 
Weller,    Karl    Heinrich    (1794- 

1851)  ....  937,  1073 
Wellenbergh  .  .  .  .1098 
Wells,  Chas.  Wm.  (1757-1817)  677 
Wells,  Charlotte  Fowler  .  .  882 
Wells,  Horace  (1815-1848)  1025  n.  1 
Wells,  J.  Soelberg  (1824-1879)  917 
Wells,  Samuel  R.  (died  1875)  882 
Wells,  Sir  T.  Spencer  (b.  1818)  1093 
Welsch,    Georg  Hieron.    (1624— 

1677)  .  .  .510,  540,  542 
Welsch,  Gottfried  (about  1 668)  484 
Von  Welz,  Robert  (1814-1878)  1074 
Wendt,  Hermann  (1837-1875)  1021 
Wendt,  Johann  (1777-1845)  .  1085 
Wenzel,  Carl  (1769-1827)  657,  1081 
Wenzel,  Jos.  (1768-1806)  .  .  657 
De  Wenzel,  Michel  Jean  Baptiste 

(about  1808)  .         .         .     666 

De  Wenzel,  Sr.,  Baron  (d.  1 790)  666 
Wepfer,  Joh.  Jak.    (1620-1695) 

490,  510,  544,  963 
Werber,  W.  J.  A.  (1798-1873)  877 
Werlhof,  Paul  Gottlieb    (1699- 

1767)  .  .  .  645,  646,  770 
Werner  (19th  century)  .  .  631 
Werner.  Ab.  Gottl.  (1750-1817)  599 
Wernuer,  Adolph    (1809-1883) 

1029,  1071 
Wertheim.  Gustav  (1822-1888)  959 
Wessels.  Hermann  (about  1600;  579 
West.  Charles  .  .  .  919,  1093 
Weszpremi.  S.  (about  1766)  622.  685 
Wetsch,  Ign.  Jos.  (1737-1779)  625 
Wever.  Johann    (Wierus,  1515- 

I5S8)  ....  365,  410 
Wharton.  Francis       .         .  .     930 

Wharton,  Thos.  (1610-1673)  536,  538 
White,    Anthony    (about  1821)     674 


Page. 

White,  Charles  (about  1768)  674,687 

White,  J.  C 927 

White,  James  T.  .  .  .1097 
White,  Mr.  (about  1815)  .  .  717 
White,  Thomas  (about  1784)  656 
Whistler,  Daniel  (died  1684)  .  510 
Whitney,  Dr.  .         .         .       1055 

Whytt,      Robert      (1714-1766) 

612,  655,  694,  697 
Wichmann,  Johann  Ernst  (1740- 

1802)  ....  645,  724 
Wickliffe,  John  (1324-1384)  .  352 
Wiederhofer,  Herm.  (born  1 832)  969 
Wiegleb,  Joh.  Chr.  (1732-1800)  726 
Wiel,    Corn.  Stalpaart  van   der 

(1620-1687)  .  .  .  509.  540 
Wieland,   Melchior  (Guilandini, 

died  1589)  ....  369 
Wienholt.  Arnold  (1749-1804)  631 
Wiesenthal,  Andr.  (1762-1798)  818 
Wigan,  John  (about  1732;  658  n.  1 
Wigand,  Justus  H.  (1769-1817)  1080 
Wigolesworth,  Edward  .  .  927 
Wilbrand.  Joh.  Bern.  (1789-1846)  935 
Wilde,  Sir  William  R.  W.  (1815- 

1876)  .  .  .  917,918,1021 
Wilhelm,  Philipp  (1798-1840)  H>o2 
Wilkes,  Samuel  (born  1824)  .  916 
Wilkinson,  E.  (died  1878)  .  911 
Willan,  Robert  (1757-1812)  654,  919 
Von  Willburg,  Ant.  Karl  (about 

1785) 672 

Williams,  A.  W.  (1819-1886)  1093 
Williams,  Charles  J.  B.    (1805- 

1889)  .  .  .  909.914.1014 
Williams,  Elkanah  (1822-1888)  930 
Williams.  H.  W.  .  .  .930 
Williams,  Joseph  (1815-1882)  917 
Williams.  Steph.W.  (1790-U55)  930 
Willis.  Robert  (1798-1878)  .  912 
Willis,     Thomas      (1622-1675) 

492,  509,  51 1 ,  538 
Wilmer,  Bradford  (about  1788)  077 
Wilms,  R.  F.  (1824-1880)  .1073 
Wilson,  Alex.  P.  (about  1835)  655 
Wilson.  George  .  .  717,  9:'  1 
Wilson.  H.  P.  C.  .  .  .  1097 
Wilson.  Henrv  (1838-1877)  .  917 
Wilson.  James  (1765-1821)  702.  978 
Wilson,  Lambert  (about  1(30)  580 
Wilson,     Sir.   W.    J.    Erasmus, 

(1809-1884)  .  .  .916,919 
Wiltshire,  Alfred  .  .  .  1090 
Winckel,  Franz  K.  L.W.  (b.  1837)  1084 


1158 


Page.  | 

Winckelmann,  J.W.  (about  1723)  748 
Windischmann,  KarlJos.  (1775- 

1839)  ....  866,934, 
Winiwarter,  Alex,  von  (b.  1848)  1072  \ 
Winkeltnann,  Aug.  (about  1803)  934  j 
WinslOw,  Jacob   Benig.  (1669- 

1760) 699  1 

Winslow,    Forbes    (1810-1874)     920 
Winston,  Thos.  (1575-1655)   538,  736 
Wintarus    (about  800)      .       256  n.  2  ; 
Winter,  Friedrich    (1712-1760)     693 
Winter  von  Adlersfliigel,  G-.  S. 

(about  1668)  .         .         .     543 , 

Winternitz,  Wilhelra    (b.   1835) 

969,  977  [ 
Winther  von  Andernach  (1487- 

1574)  .  .  .  371,376.306 
Winthrop,  John  Jr.  (1606-1676)  579 
Wintrich,    M.    A.    (1812-1882) 

»i]6,  1017,  1023 
Wintringham,  Clifton  Jr.  (1710- 

1794) 503 

Wintringham,  Clifton  Sr.  (1689- 

174d)      .         .         .         .         .     656  i 
Wirdig,  Sebastian  (d.  1687)    483,  485  ' 
Wirsuug,  Christ,  (about  1568)  536  n.  1 
Wirsung,  Georg  (died  1643)       .     53ii  : 
Wiseman,  Richard  (1625-1686) 

509  n.  1,  519 
Wishart,  John  Henry  (b.  1791)  917  • 
Wislooki,  Theophil  (1815-1881)  964 
Wistar,  Caspar  (1761-1818)  .  923 
Withering,  William  (1741-1799)  720 
Withof,  Job.  Phil.  Lorenz  (1725- 

1769)  ....     695 

Wittelshijfer,  Leop.  (1818-1888)     969 
Wittieb,  Joh.  (1537-1596)         .     421  ; 
Wittie,  Robert  (died  1684)     .         546 
Wittvver,  Phil.  Lud.  (1752-1792)     661 
Wlooton,  Van    (about   1700)     .     509  i 
Woakes,  Edward     .         .         .         918 
Woillez,  Eugene  J.  (1811-1882)  1016 
Wolcot,  John    (1738-1819)     762  n.  1 
Wolcott,  Oliver  (1726-1797)    814  n.  1  | 
Wolf,  Caspar   (1532-1601)         .     404 
Wolf,  Ivo  (1615-1693)  .         .         509 
Wolf,  Joh.  Chr.  (1673-1723)     .     509 

Wolf,  P 876  j 

Wolff 1085  ! 

Wolff,  Caspar  Fried.  ( 1 735-1794)  694 
Wolff,  Christian  (';  678-1 754)  .  595 
Wolfart,  C.  Chr.  (1778-1832)  .  631 
Wollaston,    William    Hyde,    Sr. 

(1766-1828)  .         .    '     .         .917 


Page. 

Wolstein,  Joh.  Gott.  (1738-1820) 

716,  718 
Wonnecke  (Dronnecke),  Johann 

(about  1484)  ....  309 
Wood,  George  B.  (1797-1879)  924 
Wood,  Horatio  C.  .  .  929,  1010 
Wood,  James  B.  (1816-1882)  1053 
Wood,  John        ....   1049 

Wood,  Mr 917 

Wood,  Thomas  (about  1752)  .  806 
Woodall,  John  (about  1626)  417,520 
Woodburv,  Frank  .  .  .1024 
Woolhouse,  J.  T.  (1650-1730)  519 
Woolveridge,  Jas.  (about  1670)  526  n.  1 
Wootton,  Thomas  (about  1607)  577 
Worm,  Glaus  (1588-1654)  .  531 
Wormald  .         .         .         .1046 

Wrabetz.  Joachim  (born  1740)  593 
Wray  (Bay),  John  (1627-1705)  479 
Wrede,  Hugo  von  (about  1724)  71 0 
Wren,  Sir.  Christ.  (1632-1723)  520 
Wright,  J.  Williston  .  .  .1055 
Wright,  William  (1735-1819)  722 
Wrisberg,  H.  A.  (1739-1808)  684,  696 
Wuertz,  Felix  (1518-1575)  .  418 
Wunderlich,  K.  A.   (1815-1877) 

950,  970 
Wutzer,  CarlWilh.  (1789-1858)  1061 
Wyeth,  John  A.  1055 

Wylie,  W.  Gill        .         .         .       1097* 
Wyman,  Morrill         .         .         .1015 

X. 

Xenocrates      of       Aphrodisias 

(about  a.  D.  70)  ...  1 59 
Xenophon  of  Cos  (a.  d.  53)  .  143 
Xenophon  of  Cos  (B.  c.  290)  115,  125 
Xenophon  the  Methodist  .  145 


Yearsley,  James    (about   1848)     918 
Yonge  (Young),  James    (1646- 

1721)  .  .  .  509  n.  1,520 
Youatt,  William  (1777-1847)  .  717 
Young,  Thomas  (1773-1829)  697,  916 
Yperman,  Jehan  (1297-1329)  .  306 
St.  Yves,  Chas.  de    (1667-1736)     665 


Zaccarelli   (about  1549)     .         .     415 
Zacchias,  Paolo  (1584-1659)     .     541 
Zachary,  Lloyd  (about  1751)     .     813 
Zacuto,  Abraham  (Zacutus  Lusi- 
tanus,  1575-1642)  .         .416,  509 


1159  — 


Fried,    (died  1859) 


966 
1074 
1041 


Zam  miner 

Zander 

Zanetti 

Zang,  Christ.  Bonifacius  (1772- 

1835) 1057 

Zannaro,    Jac.     (17th    century)  512 

Zapata,    Giov.  B.    (about  158U)  396 
Zehender,     Karl    Wilhelm   von 

(born  1819)         .         .      1020,  1074 

Zehetraayer,  Franz    (died  1816)  965 

Zeissl,    Hermann     (1817-1884)  961 

Zeller,  Simon  (1746-1816)  684 
Zenker,  Friedrich  Albert    (born 

1825)      ....     852,  995 

Zeno  of  Cyprus  (a.  d   330)        .  184 

Zeno  of  Laodicea  (b.  c.  210)     .  125 

Zeno  the  Stoic    (340-260  b.  c.)  137 

Zerbis,  Gabriel  de    (1468-1505)  297 

Zett,  Michael  (1778-1864)        .  1064 

Zeuxis  (about  b.  c.  50)  .         .  125 


Zeuxis  the  Empiric  (b.  c.  250)  128 
Ziehl,  Franz  .         .         .     844 

Von  Ziemssen,    Hugo    Wilhelm 

(born  1829)    .         .  .     994 

Ziermann,  J  E  L.  (about  1820)  631 
Zimara,  Marc.  Ant.  (died  1532)  367 
Zimmermann,  Joh.  Georg(1728- 

1795)  .  .  624,  646.  692,  751 
Zinn,  Joh.  Gottfr.  (1727-1759)  693 
Zittmann,  Joh.  Friedrich  (1071- 

1757)  .         .         .  517,  542 

Zoilus  (about  A.  d.  69)  .  .  149  ( 
Zopyrus  (about  b.  c.  70)  128,  130 
Zoroaster  (about  b.  c.  500  ?)  .  25 
Zorzi,  Francesco  G.  (died  1536)  363 
Ziickert,  J.  F.  (1737  1778)  715,  721 
Zweifel,  Paul  .  .  .  .1084 
Zwelfer.  Johann  (about  1652)  547 
Zwinaer,  Jacob  (1569-1610)  .  396 
Zwinger,  Theod.  (1533-1588)  372,396 


—  1160  — 


INDEX  OF  SUBJECTS. 

A. 

Academic  freedom  ....  .  .  327 

Acupuncture 

Adulteration  of  drugs 

Advertising,  medical 

Alchemj' 

Alexandria,  the  School  of 

Almanacs 

American  medicine 

Amulets 


53,  58,  61,  992  n.  1 

159 

52,  577,  82-1-25 

182,  183  n.  2,  235 

118-126 

353  n.  1,  364,  454  n.  1,  801 
577-588,  711,  799-828,  923-930 
.  53,  63,  69,  144,  184,  204,  224  n.  1,  772 
Anatomy,  Egyptian,  20  —  of  the  Talmud,  37 — Indian,  49  —  Chinese,  55 
— in  Alexandria,  121-122 — in  Rome,  157  —  in  Salerno,  259  —  revival 
of,  295-298  —  reform  of,  422-430  —  discoveries  in,  527-541  —  in  18th 
century,  688-700  —  human  dissection  in,  259,  295-296,  445-446,  555- 
557,  581,  734-737,  806-807,  815-816. 

Anatomical  collections 119,  169,  532 

Anesthesia      .         .     53,  262  n.  2,  300,  305,  1025- in  midwifery  1091, 1096 

Antimony 310,  396 

Antiphlogistic  theory,  the 633 

St.  Antony's  fire .         .         .         .314 

Apothecaries,    Egyptian,    23  —  Chinese,  52  —  Turkish,   66  —  Greek,    97 

—  Roman,   154-155  —  Byzantine,  214 —  Arabian,  224,  235 —  Italian, 

275-276  -  mediaeval,  329,  344-346  -  465,  467-469,  573-574,  793-794 

— English,  789-790  —  in  American  colonies,  585,  819-820. 

Arabian  medicine  ........  215-238 

Arabists  281,  284,  484 

Archiater  143,  147,  148,  244 

Army-surgeons  ....     94,152,213,342.343,795-799,823 

Artificial  limbs 245 

Asclepiadae,  the .  85,  91 

Astrology       ....  223,  267,  290,  333,  362  n.  3,  364,  291 

Astronomy         ..........        479-480 

Asylums  for  the  insane  ...         66,  347,  469,  713,  767-768,  813 

At'hletae,  the '.94 

Auscultation 47,  92,  103,  145,  1012-1016 

Autopsy       .         . .         .     127  n.  2 


Bacteria 191  n.  1,  510,  599,  844-846,  1003-1008 

Balneology,     138  n,  1, 139, 154, 329,  336-338,  437  n.  1  &  2,  567,  721-723,  761 
Barbers   and   barber-surgeons,      303  n.  1,  328,  329,  335  n.  1,  336-338,  561, 
775,  783,  790 

"  Bedlam  " 434 

Bezoary  230,  773  n.  2 

Births,  registry  of         .         .         .         .         .         .         .         .  39  n.  2 

Black  Death,  the  315,  316 

Bone-setters  ..........     335,  586 

Botany  in    Antiquitv,  118  —  in  16th  century,  368-370  —  in  17th  century, 
479  —  in  18th  century,  598-599  —  in  19th  century.  843-846  —  botan- 
ical gardens,  128,  158,  346,  557,  739 
Bougies,  invention  of, 292,  301,  417 


—  1161  — 

Brandy,  use  of 228,  269 

British  Medical  Association,  organization  of  the  .        .        .  911  n.  1 

Broussaism 884-889 

Brunonian  System,  the  ........  634-638 

C. 

Cesarean  section       ...         37,  46,  83,  132,  248,  305,  403-404,  525 

Castration 212,  247 

Catheter,  the  .  123,144,163,231 

Cautery,  the  actual         ....  45,  72,  104,  167,  206,  221,  231 

Cabala,  the  .........        180,  362-363 

Celibacy,  clerical 272,  355 

Cellular  Vitalism,  modern 980-994 

Cerebrosoopie 1021 

Charlatanism       .       95,  151,  155,  339,  455,  552,  571-572,  771-774,  823-825 
Chemistry     .     235-236  —  in  17th  century,  480-481  —  in  18th  century,  597 

—  in  19th  century,  849-851  — chemical  laboratories,  557 

Chemical  System,  the  modern  ......      978-980 

Chiromancy 364 

Chloroform,  discovery  of,  1025 — use  of  in  midwifery,         .         .  1091 

Cinchona,  the  history  of  .         .         .         .         .         .         .         .         544 

Circulation,  the         " 374,  528-532 

Climatic  treatment  .........         725 

Clinical  instruction      .         .  142.  152.  221,  237,  446-447,  554,  737-738 

Clysterization       ..........     623-624 

Colleges,  American  medical      ........         804 

College  of  Physicians.  London 292  n.  2 

College  of  Surgeons.  London  .......  335  n.  1 

College  of  Physicians  &  Surgeons,  New  York     .....     809 

Columbia  College,  New  York  .......         809 

St.  Come,  College  de 303 

Constitutio  Criminalis  Carolina,  the         .....  432  n.  2 

Crudity,  coction,  crisis         .         .         .         .•        .         .         .         .         .102 
Crusades,  influence  of  the       .......  270-271 

Culbute,  the         .         .         . 47,105,227 

Curriculum,  the  medical  .         .     256,  277,  445,  447-448,  554,  733,  739 

D. 

Dartmouth  College,  Medical  Department  of        .         .         .         .         .811 

"  Darwinism  "  ..........     841-2 

Deaf-mutes,  instruction  of  .         .         .         .         .        409  n.  1,  517  n.  1,  540 

Dentistry  —  Egyptian,  19  —  Chinese,  53  —  Roman,  150,  162  —  Arabian, 
221  —  me'diaeval.  262,   300,   301— French,   515,  666  —  German,   673 

—  in  Vienna.  968 

Dermatology  —  in   France,   901-902  —  iu  England.   919  —  in  the   United 

States   926-927 
Diphtheria'—.         .         .         .     166,  202,  240  n.  1,  439,  550,  588.  729,  827 
Dispensatories  —  .         235,  236,  369  n.  1.  436-437,  546-547,  820 

Dissection  — by   the  Talmudists,    37  —  Indian.   49  —  Roman,   157  — in 

Salerno,  259  —  in  Montpellier,  266  —  mediaeval.  295-298,  309— modern, 

372  n.  1,   445-446,   449,  555-557,  581   (in  U.  S.),  734-737,  806,  815 

fin  U.  S.) 
Doctor,  the  title  —  327-328  —  in  the  U.  S..  582  n.  1  — "  Doctor  teutonicus  ", 

572  —  "  Doctor  bullatus  ",  566  n.  2. 
Doctresses       .         .     95,  210,  248  n.  1,  259,  264.  339,  341,  1081  n.  1,  1085 


—  1162  — 

Dogmatic  School,  the 112-110 

Dublin  School,  the 912-9U 

Dysentery 549,  729 

E. 

Eclectics,  the  School  of .         .165 

Eclectic  System,  the ,         .  603-608 

Etlessa,  the  School  of  .         .         .  .         .         .         .     217  n.  1 

Electrotherapeutics  —  143,  301,  370,  723-724  —  French.  903  —  English, 

918  —  in  the  U.  S.,  929  —  in  Vienna,  909 
Embalming,  the  process  of    .        .         .         „         .         .         .         .         .21 

Empirics,  the  School  of 127-129 

"Encyclopaedists",  the .  590 

Endoscope,  the 1022 

Epidemics  — in  Antiquity,  75  n.  1,    133  n.  1,    188-190 — in   Middle    Ages, 

311-321  —  in  16th  century,  437-440  —  in  17th  century,  547-551  —  in 

U.  S.  during  17th  century,  588  — in  18th  century,  727-730 — in  U.  S. 

during  18th  century,  827 
Episynthetics,  the  School  of  .         ...         .         .  1 65 

Ergotism  314,  439,  549-550,  729 

Essenes  or  Therapeutae,  the  .......       36,  180 

Excitement,  the  Theory  of  862-867 

Experts,  medical 342,  565 

F. 

Facies  Hippocratica,  the 103 

Faculties,  French,  abolition  of  the  ......  774 

Flagellantes,  the 317-318 

Fees,  medical  —  Egyptian,  17-18 —  Persian,  27  —  in  Talmud,  38  —  Indian, 
43  —  Chinese,  52  -  Japanese,  60  -  in  Turkey,  67  —  among  the  Sclavs, 
73  —Greek,  97  —  Roman,  151  —  Arabian,  223 —  mediaeval,  275,  334 
—  modern,  451-452,  460,*568-569,  570,  583,  587,792,793,821-822 
Foetus,  determination  of  the  sex  of  the  .  38,  46,  88,  105,  113,  117,  144 
Forensic  medicine —  in  China,  56  —  the  Alemannic  code.  2-15  —  the  Lango- 
bard  code,  245  —  in  16th  century,  432-433  —  in  17th  century,  408  n.  1, 
541-542  —  in    18th  century,   705-706  —  in  the   United   States,  930 

G. 

Galvanism     ............     634 

"  Gaseous  Oxyd  of  Azote " .         .         633 

Gastrotomy  .         .         .         .         .         .         .         .         .         .517,  555  n.  1 

Generalized  Chymismus    .........        633 

Geneva  Convention,  the         ........  1030 

Geography,  medical 657 

(I .Tin-theory,  the 906,  921-922,  1003-1008 

<J old,  therapeutic  use  of 229,  291,  395  n.  1 

Gout  ...........  65»i 

Grecists  281,484 

Graduation  ceremonies  —  in  Salerno,  259  —  in  Germany,  562-563,  747  n.  1 
Gunshot  wounds       .      298,  301,  307,  401,  414,  415,  418-419,  516,  519  n.  1, 

1039,  1046 
Gvmnasts,  the         .         .         .         . 91,  93 


—  1163  — 

Gynaecology  —  Egyptian,  20  —  Jewish,   34,  38  —  Indian,  46  —  Greek,  95 

—  Hippocratic,  105  —  Platonic,  112  —  Aristotelian,  117  —  in  Alexan- 
dria,   123,    129,   206  —  in  Rome,   143-144,   149,    155  —  Galenic,    174 

—  Arabian,  224,  226,  227,  232  —  in  Salerno,  264  —  in  16th  century, 
404-405— in    17th  century,  526  —  in   19th  century,  French,  906-907 

—  German,  1079-1084  —  English,  1087-1093  —  American,  1096-1098 

H. 

Haemorrhage,   control  of      .      104,  115,  123,  162,  201,  231,  304,  305,  400. 

1070,  1091 
Harvard  University,  Medical  Department  of  580,  809-10 

Herbals    ............         436 

Hippiatrics,  the  books  on     ........  209 

Hippocratists,  the  ........  98-111 

History  of  Medicine       .         .       115,125,221,233,542-543,657-661,907, 

924,  1052 

Hoffmann's  (Christ.  Ludwig)   Theory 623 

Hoffmann's  (Friedrieh)  Mechanico-Dynamic  System     .         .         .     613-610 
Homoeopathy      .         .         .         .         .         .         .         .         .         .        871-879 

Hooping-Cough      .         .         .         .         .         .         .         ...         .    440,  550 

Hospitals  —  Chinese,  56-57  —  Roman,  153  —  in   the  Eastern   Empire,  213 

n.  1,   252  —  Arabian,  220,  224-25  —  mediaeval,  244  —  monastic,  251- 

52,  256  —  of  the  Crusaders,  274  —  military,  466  —  for  lepers,  563  —  in 

the  17th  century,  563-64  —  in  the  English  Colonies  of  North  America. 

586  — in  the  18th  century,  738,  768-770  —  in  the  English  Colonies  of 

North  America,  812-13. 
Humanists,  the  .         .         .         .      V         .         .         .  289,  352  n.  2 

Humane  Society  of  London,  the  ......     707  n.  1 

"  Hungarian  Disease  ",  the        ........         439 

Hydropathy  ....  41,  114,  139,  722-723,  969,  977-978 

Hydrophobia—        .  .         .        36,  90,  105,  125,  177,  178,  202,  845  n.  2 

Hygiene  —  public  —  Jewish,  34  —  Japanese,  62  —  Greek,  88  n.  1  —  Roman. 

131,  153  —  Arabian,  225  —  in  mediaeval  England,  273-74—  mediaeval. 

276,  348  —  in  leprosy,  313  —in  the  16th  century,  433-34,  438,  464-1  5 

—  in  the  17th  century,  541  n.  2,  545  n.  4,  548,  565  — in  the  18th  cen- 
tury, 706-711,  715  —  in  the  English  colonies  of  North  America,  827- 
28  — in  the  19th  century,  905-906,  920-921,  995. 

private  —  in   Egypt,   18  —  Hippocratic,    107  —  in   16th  century,   438 

—  in  18th  century,  714-715. 

military  —  of  ancient  Persians,  26  —  Turkish,  66  —  Greek,  94-95 
— -Roman,  152  —  Byzantine,  213  —  Norwegian,  249  n.  1  —  in  the 
15th  century,  342-43— in  the  16th  century,  458,  465  —  in  the  17th 
century,  575-76  —  in  the  18th  century,  795-799,  823  —  in  the  19th 
century,  1027,  1032,  1049,  1068-69,  1077. 

I. 

Iatro-Chemical  System,  the 490-497 

Iatro-Mathematical  System,  the        ....         .         .         497-504 

Iatrosophist,  the  title  .         „         .         .         .         .         .         .  l<s'i 

Income  of  physicians  —  in   Egypt,    17-18 — in  Persia,   27 — in  India.  4  3 

—  under  the  Roman  Empire,  149,  151,  155  —  mediaeval,  325-326  —  in 
16th  century,  444,  451-452,  464—  in  17th  century.  559,  566,  567  n.  1 
568  — in  18th  century,  745-746,  751-752,  763,  704 

Indentures  of  apprenticeship,  medical         .         .         .         .         .         .     805 


—  1164  — 

Infarctus,  the  doctrine  of  ...  623-624 

Infibulation 162 

Influenza 314,  439,  550,  588,  729 

Inoculation  of  small-pox     ....  48,  53,  707-709,  800-802 

Insane,  treatment  of  the  .         347  n.  1,  434,  542,  6o9,  705,  767-8,  813, 

920,  928,  969 
Instruction,  medical  and  surgical  —  in  Egypt,  16,  68  —  Jewish,  35  —  Indian, 
42,  43  —  Chinese,  53  —  Japanese,  57,  59  —  Turkish,  ti5,  66  —  modern 
Greek,  67  —  ancient  Greek,  91-94  —  in  Alexandria,  119-120  —  in 
Rome,  148-152—  in  the  Eastern  Empire,  211-212 —  Arabian,  217- 
224  —  in  Monte  Cassino,  257  —  in  Salerno,  258-59  —  in  Montpellier, 
266  —  mediaeval,  242-43,  247,  275,  276  monastic,  255-56  —  in  the 
mediaeval  universities,  277-78,  293  note,  323-325,  326  n.  3.  328, 
329,  3^4  —  in  the  16th  century,  440-449,  457,  459  —  in  the  17th  cen- 
tury, 553-558,  559-560  —  in  the  English  Colonies  of  North  America, 
580-582  —in  the  18th  century,  733-744,  749-750,  753-54,  774-775, 
776-777,  779-780,  781-783,  785-787,  788-789  —in  the  United  States, 
791,  804-812  —in  the  19th  century,  858-860. 
Irritability,  the  doctrine  of  .......     692-694 

Isopathy 879 

Itch-mite,  discovery  of  etc. 510,  645,  852,  960 


Jewish  phvsicians  .  32.  35,  230,  231,  233,  234,  248,  262,  265.  332, 
451,  452  n.  2,  465,  750-751,  797 

Journalism,  medical  —  Japanese,  57,62  —  in  the  17th  century,  482  —  in 
the  18th  century,  601  —  in  the  United  States,  827  —  in  the  19th  cen- 
tury, 853-856,  969. 

K. 

Kidneys,  removal  of  the         .........     92 

King's  College,  N,  Y.,  Medical  Department  of  ...        808-809 

King's-Evil,  treatment  of 268  n.  2 

Knee-elbow  position  in  obstetrics       ......        144.  226 


Laboratories,  chemical —  557,  566  —  pathological  in  the  U.  S.         .       1010 

Labor-stools .         .         .     33,  104,  143.  572 

Lacteals,  discovery  of  the 122,  532-533 

Laparotom}'     ..........     46.  116,123 

Larvngology         ....  904-5,  918-19,  925-26,  967-68,  1021 

Leeches 129,167.178,229 

Leprosy  .  .  .  33,  45,  190,  206,  267,  300,  312-314,  437-438,  563 
Libraries,  medical  ....  120,  215  n.  3,  323  n.  1,  581,  811-812 
Licenses,  medical         .         27,  43,  51,  96,  148,  222,  275.  564,  753,  757-758. 

760,  788,  826. 
Ligation  of  arteries  .         .         .  162,165,201,304,305,400 

Literature,  American   medical — in  the   17th  centurv,   584 — in   the   19th 

century,  826-827. 
Lithotomy  —  Indian,  46  —  in  the  Oath,  92  —  in  Greece,  96  —  in  Alexan- 
dria, 124  —  in  Rome,  162,  178  —  in  the  Eastern  Empire,  201  —  Arabian, 
231  —  at  Monte  Cassino,  257—  mediaeval,  302,   570,  673,  817,   1051, 
1054. 
Lithotrity 124,  231  —  by  a  single  operation,  1028 


—  1165 


M. 


Magi,  the 25 

Magic  and  Mysticism  in  Aucient  Medicine         ....        179-182 

Magnetism,   animal 629-632 

Malarial  diseases 549,  728 

Massage  61,  138,  337  n.  3 

Materia  Medica  —  Egyptian,  22-23  —  Jewish,  35  (Talmudic)  36  —  Indian, 
-18-19  —Chinese,  52-53,54-55-  Japanese,  58— Persian,  64  —  Homeric, 
87  —  Hippocratic,  107-108  —  Roman,  154-155,  158-159  —  Galenic, 
175  _  Byzantine,  211,214  —  Arabian,  227,  228, 229,  230,  237  —  monas- 
tic, 253-255,  256  — of  Salerno,  263  —  mediaeval,  333  —  of  Paracelsus, 
389-391)  — in  the   16th  century,   435-436— in  17th  century,  544-545 

—  in  18th  century,   598-599,  719-720. 

Measles 241,  730 

Medical  Department  of  the  Continental  Army         ....         823 

Medical  Police,  see  "  Hygiene,  public  ". 

Medical  Relations  —  in  the  age  of  Hippocrates,  94-98 —  under  the  Roman 
Empire,  145-  156,  182-188  —  in  the  Byzantine  Empire,  211-215  —  under 
tlie  Arabians,  215-225  —  during  the  Middle  Ages,  322-348  —  in  the 
16th  century,  440-470  —  in  the  17th  centuiy,  551-577  —  in  the  English 
Colonies  of  North  America,  577-588  —  in  the  18th  century,  730-799 

—  in  the  American  Colonies,  799-828. 

Medicine,  Ancient  —  Egyptian,  13  (modern)  68  —  Persian,  24  (modern)  64 
Assyrian,  28  — Phoenician,  29  —  Jewish,  30  (Talmudic)  36  —  Indian, 
38  -£■  Chinese,   50  —  Japanese,  57  —  Scythian,  62  —  Mongolian,  63 

—  Siamese,  63  —  Turkish,  65  —  Modern  Greek,  67  —  Abyssinian,  68 

—  Negro,  69  —  Celtic,  71  —  Scandinavian,  72  —  Sclavic,  73  —  among 
the  Esquimaux,   74  —  among  the  American  Indians,  74  —  Aztec,  74 

—  Ancient  Greek,  81  —  Mythical  and  sacerdotal,  83  —  Homeric,  86 

—  in  the  Greek  Schools  of  Philosophy,  87-91  —  of  the  Asclepiadae 
and  Gymnasts,  91-94  —  of  Hippocrates  and  the  Hippocratists,  98-111 

—  of  Plato,  111-112  — of  the  Dogmatists,  112-116  —  of  Aristotle  and 
his  followers,  116-118  — of  the  School  of  Alexandria,  118-130—  of  the 
Romans,  130-134  — Greco-Roman,  134-188  — of  Galen,  168-178. 
Mediceoal — Greco-Christian,  199-215  —  Greco-Arabian,  215-238  —  in 
the  West,  242-250  —  Christian  (monastic),  250-270  —  of  Monte  Cassino, 
257  —  of  Salerno,  258-265  —  of  Montpellier,  265-269  —  influence  of 
the  Crusades,  legislation,  the  universities  and  Scholasticism  upon,  270- 
234  —  of  the  12th  and  13th  centuries,  284-286  —  of  the  llfth  century,  286- 
288  —  of  the  loth  century,  288-295. 

Of  modern  times  —  of  the  16th  century,  359-399,  406-413  —  Italian,  407- 
408  —  Spanish,  408-409  —  French,  409-410  —  German,  410  —  Dutch, 
410-411  —  English,  411-413  —  of  the  17th  century,  475-511  —  in  the 
English  Colonies  of  North  America,  577-588 — of  the  18th  century,  589- 
657  —  in  the  English  Colonies  of  North  America,  799-828  —  in  the  19th 
century,  839-1026. 
Membrana  tympani,  artificial        .         .         .         .         .         .         .     518,  918 

Mercury  118,  159,  211,  228,  620 

Metallic  tractors,  Perkins'    ........  825 

Metalloscopy 645,  903 

Meteorology 598 

Methodism,  medical 135-142 

Microscope,  the,  and  microscopy           .         .         .      479,  480,  853,  904,  916 
Middle  Ages,  the 195-199 


—  11CG  — 

Midwifery  —  Egyptian.  20  —  Jewish,  33, 3-1  —  Indian,  43,  46,  47  —  Chinese, 
5  J-54  — -  Japanese,  59  —  Siamese,  (53-64  —  Turkish,  65  —  Negro,  70 

—  Sciavic,  73 —  Aztec,  74 —  in  Sandwich  Islands,   76  —  Greek,    95 

—  Hippocratic,  104-5  —  Roman,  143-144,  151,  155,  162  —  Galenic, 
174  _  Byzantine,  202,  207  —  Arabian,  221,  224,  226,  228  —  mediaeval, 
253.  261,  299,  340-41  —  in  the  ltJthcenhiry,  463-4,  419-421,  461-463 

—  in  the  17th  century,  521-526,  560-561,   5ti3,  572,  573  —  Italian,  523 

—  Spanish,    523  —  French,    523-4  —  German,   524-5  —  Dutch,  525 

—  Swedish.  525-6  —  English,  521-2,  526  n.  1  —  in  the  American 
Colonies,  585-6 — in  the  ISth  century,  679-688,  755-6,  779,  780,  782, 
785  —  French,  680-682  —  Italian.  6S2-3  —  Spanish,  683  —  German, 
683-85  —  English,  685-87  —  Dutch,  688  —  Danish.  688  —  Swedish 
6-18  —  Russian,  688  —  in  the  American  Colonies,  807.  818-819  —  in  the 
19th  century,    1078-1099  —  German.    1079-85  —  French,     1085-86 

—  Italian.  1087  —  Spanish,  1087  —  English,  10S7-1093  —  American, 
1093-1098  —  Dutch.  1098  —  Belgian,  1098  —  Norwegian,  1098 
—Danish,  1098— Finnish,  1098— Swedish,  1099-modern  Greek,  1099. 

Miliary  fever  .........     550-51,  730 

Mineralogy 370.  599 

Mineral  waters         ........  546,  720-721 

Monastic  gardens         .........  256 

Monte  Cassino,  the  school  of  .         .         .         .         .         .         .  257 

Montpelher,  the  school  of 265-269,  624 

Moxa,  use  of  the 45,43,58,517,1033 

Mythology,  medical  —  Egyptian,  14  —  Persian,  25-26  —  Phoenician,  29 
■*—  Indian,  41  —  Chinese,  54  —  Japanese.  57-58 —  Mongol,  63  —  Scan: 
dinavian,  72  —  Prussian,  72  —  Sciavic,  73  —  Esquimaux,  74  —  Aztec, 
74-75  —  Greek,  83-84—  Roman,  131-32. 

N. 

"  Nations",  the,  in  the  Universities       ....      325  n.  1  &  2,  441 

Natural  History,  the  School  of 940-949 

Natural  Philosophy,  the  School  of        ....         .  931-940 

Natural  Sciences,  the  School  of  the 994-996 

Neo-Platonic  School      .         .         .         .         .         .         .         .         .  181 

Nervous  Patholog}',  the      ........         616-619 

Nestorian  Schools 217-218 

Newspapers,  origin  of,  483  —  in  the  English  Colonies  of  North  America,  5S4 
Nineteenth  Century,  characteristics  of  the    .....    831-S39 

"  Nisus  formativus  ',  theoiy  of  the    .......       695 

Nostrums      ........      214,  466  n.  1,  577,  765 

Numerical  method,  the 712,897-898 

Nurses  and  nursiBg 144,  251-52,  340,  466,  469 

O. 

Oath,  the  Hippocratic  .         .         .         .         .         .         .         .         .91 

'•  Obstruction"  of  the  liver 269 

•  Od  ",  the 631 

Old  Age.  the  diseases  of   .         . 901 

Ophthalmology  —  Egyptian,  19  —  Turkish.  ^ —  Hippocratic,  104  —  Roman, 
149-150^162,  177-78,  187  —  Byzantine,  207  —  Arabian,  221,  224  n.  3, 
229.  231  —mediaeval.  247.  294.  263  n.  1,  302,  305,  339-340  —  in  the 
16th  century,  105-406.  461  —  in  the  17th  century,  512.  514-515,  517,  518, 
519,  520,  521,  570  —  in  the  ISth  ce?itury,  063.  665,  666,  667,  672,  673, 
677.  678.  7^3.  824  —  in  the  19th  century  { English  ),  917  —  in  the  United 
Suites.  929-930  — German,  968  — French,  905. 


—  1167  — 

Ophthalmoscope,  invention  of  the 1019-1020 

Orthopaedia 514,  673,  1069  n.  1 

Otology    ......     515,  666,  673,  904,  917-918,  930,  968 

Ovists  and  Aniinalculists 534 


Paediatrics  ....     144,  294,  421,  655-56,  901,  919,  927,  969 

Papyri,  medical .         .         .         .         .15 

Paracelsists 484-486 

Parasitic  diseases  .         .         .         .         .         .  .  852,  1008 

Pathological  anatomy        .         .         .  430,  540,  700-702,  889,  907,  964 

"  Pennalism  " 472  n.  1,  558,  742 

Percussion,  see  also  Physical  Diagnosis     .         .         .  642-44,  1011-12 

Periodeutae,  the     .         .         . 90,  94 

Pharmacology  —  in  Antiquity,  128-29,  159  —  mediaeval,  308-310,  333  —  in 

the  16th  century,  435-437  —  in  the  17th  century,  543-47,  574  —  in  the 

18th  century,  719-720,  821. 
Pharmacopoeias  —  Persian,  64  —  Arabian,  236  —  first  official  in  Germany, 

369  n.  1  —  in  the  16th  centuiy,  436  —  in  the  17th  century,  546-547 

—  first  in  the  United  States,  820. 

Pharmacy  —  Egyptian,  22-23  —  Chinese,  52-53  —  Greek,  97  —  Roman, 
154-155  —  Arabian,  220,  235 — monastic,  256  —  mediaeval,  275-76, 
344-46  —  in  the  16th  century,  467-69  —  in  the  17th  century,  546,   562 

—  in  the  18th  centuiy,  725-27,  754. 

Philology 371-73,  599-600 

Philosophy  and  Philosophers  —  Greek,  87-91  —  Platonic,  111-112  —  of 
Aristotle,  116-118  —  the  scholastic,  278-280  —  of  the  16th  century, 
361-67  —  of  the  17th  century,  475-78  —  of  the  18th  century,  594-97 

—  of  the  1 9th  century,  834-37,  839-842. 

Phlebitis,  theory  of 894 

Phlogistic  theory,  the        ........  632-633 

Phonometry 1018 

Phrenology 881-884 

Physical  Diagnosis,  modern  .  .  .  .  642-44,964-67,1010-1024 
Physicians-in-Ordinary  -  .  .94,  147,  268,  450,  453,  559,  566,  751-752 
Physiology  —  Egyptian,  20  —  Talmudic,  37  —  Indian,  49  —  Chinese,  55 

—  in  the  Greek  schools  of  philosophy,  87-91  — of  Hippocrates,  101- 
102,  105,  108  —  Platonic,  111-112  —  of  Praxagoras,  115-116  —  of 
Aristotle,  117-118  —  of  Herophilus  and  Erasistratus,  121-22  —  of 
Roman  anatomists,  157 — of  Galen,  170-71,  172-73  —  of  Paracelsus, 
385-86  —  in  the  16th  century,  431-32  —  of  Van  Helmont,  488  —  of 
Sylvius,  490-91  —  of  Willis,  493  —  of  the  Iatro-mathematicians,  497 

—  of  Harvey,  529  —  in  the  17th  century,  527-540  —  of  Boerhaave, 
605-606  —of  Stahl,  608-609  — of  Brown,  635-36  —  in  the  18th  cen- 
tury, 688-700. 

Physiological  medicine     ....     884-89  —  in  Germany,  970-972 

Physics  and  physicists  .......        598,  847-48 

Pilgrimages  of  children  .         .         .         .         .         .         .         .         318 

Plague,  the — of  Antoninus,  189  —  of  Cyprian,  190  —  of  Justinian.  238- 
240  —  of  Orosius,  189  —  in  the  16th  century,  438  —  in  the  17th  cen- 
tury, 548  —  in  the  18th  century,  727. 

Plica  Polonica 314 

Pneumatic  cabinet,  the     .         .         .         .         .         .         .         .         .         503 

Pneumatic  School,  the  ........      163-1 65 

Positivism  in  medicine     .........  842 


—  1163  — 

Post-graduate  medical  schools  in  the  United  States     .         .         .      860  n.  2 

Press,  the  daily 483,  584 

Printing,  invention  of  ........      288  n.  3 

Prostitution 155-56,  271-74 

Pyaemia,  theory  of .     894,  9^5 

Q. 
Quarantine 348,  827  n.  1,  828 

R. 

Rademacher,  system  of  ........  075-77 

972-74 

.  260-62 

291,  512  n.  1 

674 

.   510  n.  1 

46,  162,  299,  302 

1021 

97 

393  n.  1,  394 


Rational  Medicine 

Regimen  Sanitatis  Salerni,  the 

Rejuvenation,  the  ancient  art  of 

Resection  of  bones 

Rhachitis    ..... 

Rhinoplasty 

Rhinoscopy         .... 

Rhizotomists,  the  . 

Rosicrucians,  the 

Royal  Society  of  London,  foundation  of  the  .  .  482  n.  1 

S. 

Salaries,  medical  —  in  Greece,  94  —  in  Rome,  147,  148, 151, 152  —  mediaeval, 
325-26,  332,  343  —  in  the  16th  century,  444,  450,  451,  464  —  in  the 
17th  century,  559,  565,  566,  575-76,  586  —  in  the  18th  century,  745, 
747,  757,  759. 

Salerno,   the  school  of  258-265 

Saxon  leeches    ..........  254  n.  2 

Scarlet  fever 190,  550,  730 

Schools,  medical  —  Egj-ptian,  16,  68  —  Phoenician,  29  n.  2  —  Jewish,  35 

—  Indian,   42-43  —  Chinese,   56-57  —  Japanese,  57  —  Turkish,   65 

—  modern  Greek,  67  —  ancient  Greek,  84,  87,  94,  111-112,   116-118 

—  in  Alexandria,  118-120  —  Roman,  148,  152,  183  n.  3  —  Bvzantine, 
183  n.  3,  212  —  Nestorian,  218  — Arabian,  219,  220,  224  —  mediaeval, 
242  n.  1,  243  —  monastic,  255-56  —  Monte  Cassino,  257  —  Salerno, 
257-59  —  Montpellier,  265-66,  624  —  the  universities  (mediaeval) 
276-78,  (modern)  481  —  in  the  English  Colonies  of  North  America, 
581,  806-811  —  universities  of  the  18th  century,  600  —  learned  socie- 
ties, 600  —  in  England,  787-88  —  in  the  United  States,  791  —  univer- 
sities and  colleges  of  the  19th  century,  858-59  —  the  Old  Vienna 
School,  619-622  — the  New  Vienna  School,  949-970. 

Scholasticism         ...  278-280 

Scrofula  . 268  n.  2,  656 

Scurvy 314,  438-39,  551,  656 

Seminal  Vitalism 996-1003 

Septicaemia    ............    657 

Smallpox  .     208,  210, 228,  240,  241,  257  n.  2,  262,  439,  551 ,  588,  729-730 

Societies,  medical  and  scientific     .         .         .      481-82,  600,  812,  857,  1098 
Spagyrists      .  .  ...  ...      392-96 

Specialties  and  specialists  —  in  Egypt,  17  —  in  Greece,  96  —  in  Rome,  149 
— mediaeval,  339  —  in  the  16th  centurv,  302, 452, 459  —  in  the  19th  cen- 
tury,  900  —  French,  901-907  —  English,  916-922  —  in  the   United 
States,  925-930  —  in  Vienna,  964-970. 
Spectacles 160,  267,  283  n.  1,  406  n.  1 


—  1169  — 

Specula  —  aural,   1021  —  nasal,  1021  —  rectal,  1021-22  —  vaginal,  206, 

207  n.  2,  1022,  1097  n.  1. 
Spermatozoa,  discovery  of  the     ........     534 

Sphygmograph,  the 1024 

Spirometry  .  .  1018 

State- Medicine  -  in  Antiquity,  94,  147, 148  —  mediaeval,  245,  331-32,  341- 

42  —  in  the  16th  century,  432-33,  463-65  —  in  the  17th  centur}',  541- 

42,  565  —  in  the  18th  century,  705-706. 

Statistics,  medical 542,  896-98 

Statutes  and  ordinances,  medical  —  Chinese,  51  —  Turkish,  65  n.  1  —  Roman, 

148  —  Alemannie,    245-247  —  mediaeval,  273-274,  275-76,   345-346 

—  university  statutes  of  the  16th  century,  447-449  —  of  the  17th  cen- 
tury, 562-63  —  in  the  English  Colonies  of  North  America,  581,  583, 
585,  587-88  —  university  statutes  of  the  18th  century,  743,   747-48 

—  Prussian,  753-55  —  in  the  English  Colonies  of  North  America,  811, 
819,  821,  826,  828. 

Stethoscope,  the 1012-13,1016 

Stimolo  and  Contrastimolo,  the  doctrine  of     .         .         .         .  867-871 

Student-life  —  in  the  Eastern  Empire,  211-212  —  mediaeval,  325  —  in  the 

16th  century.  441-43  —  in  the  17th  century,  554,  557-58,  562  —  in  the 

English  Colonies  of  North  America,  581-82  —  in  the  18th  century, 

733-34,  739-743. 

Succussion  103,  144,  203 

Surgery — ■  Egyptian,  18-19  —  Jewish,  34,  36  —  Indian,  45-46  Chinese, 
53  —  Homeric,  86  —  Greek,  92,  93, 116, 165. 167, 185-86—  Hippocratic, 
103-104  —  Alexandrian,  123,  177-78  —  Roman,  132,  134,  137,  149, 
152,    161-63  —  Galenic,    174  —  Byzantine,    201-202,    206-207,   213 

—  Arabian,  221.  222.  227,  229,  231,  232  —  mediaeval,  245,  247  — of 
Saxon  leeches,  254  n.  2  —  military,  242-43  —  in  the  15th  century.  298- 
307,  334-35.  336-340  —  Italian.  299-302  — French.  302-306  —  Dutch, 
306  —  English,  306  — ■  Spanish,  306  — German,  307  —  in  the  16thce?itury, 
399-403,  414-419,    456-46L   —  Italian,  414-16  —   Spanish,    416-17 

—  English,  417-18  —  German.  41  8-19  —  military,  465-66  —  in  the  11th 
century,  511-521,  559-560,  561-62,  569-71  —Italian,  511-512—  French, 
512-515  —  Spanish,  515  German,  515-18  —  Dutch,  518-19— English, 
519-521  —Danish,  521  — military,  575-76  —  in  the  English  Colonies 
of  North  America,  585  —  in  the  18th  century,  662-679,  753-54,  758-59, 
774-75,  776-77,  779-80,  781,  783,  786-89  —  French,  602-07  —  Italian, 
667  — Spanish,  667  —German,  668-673  — English,  673-677 —  Dutch, 
677-678  —  Danish,  678  —  Swedish,  678-79  —  Russian,  679  —  in  the 
English  Colonies  of  North  America,   816-18  —  military,   795-99,  823 

—  in  the  19th  century,  1026-1078  —  French,  1031-1040  —  Italian,  1041 
—Spanish,  1041-42—  English,  1042-49— American,  1050-56— German, 
1056-1074—  Dutch,   1074-75  —Swedish,   1076—  Norwegian,  1076 

—  Danish,  1076  —  Russian,  1077  —  Finlandish,  1077-78. 
Superstition  — in  the  16th  century,  352-53,  362-367  — in  the  18th  century, 

590,  601-602,  772-73  —  in  the  19th  century,  839. 
Sweating  sickness,  the  ........     318-319 

Symbols,  alchemistic  and  chemical    .......        574 

Symphyseotomy  082 

Systems,  theories  and  schools  of  medicine  —  medicine  in  the  Greek  schools 
of  philosophy,  87-91  —  Hippocratic  medicine,  101-111  —  the  Platonic 
philosophy   in    medicine,   111-112 —  the  Dogmatic  School,   112-116 

—  medicine  of  Aristotle,  116-118  —  the  School  of  Empirics,  127-130 

—  Methodism,  135-145  —  the  Pneumatic  School,  163-165  —  the  School 


—  1170  — 

of  Eclectics,  165-168  —  medicine  of  G-alen,  170-176  —  Greco- Arabian 
medicine,  215-238 — monastic  medicine,  253-257—  Scholastic  medicine, 
280-283  —  system  of  Paracelsus,  381-396  —  s}-stem  of  Van  Helmont, 
487-490  —  the  Iatro-chemical  system,  490-497  —  the  Iatro-mathemat- 
ical  system,  497-504  —  medicine  of  Sydenham,  505-507  —  the  Eclectic 
System  of  Boerhaave,  604-608— the  system  of  Stahl,  608-612— Mechan- 
ico-Dynamic  System  of  Fried.  Hoffmann,  613-616 — the  Nervous  Pathol- 
ogy of  Cullen,  616-618  —  the  theory  of  Christ.  Ludwig  Hoffmann.  623 

—  the  doctrine  of  the  Infarctus,  623-624  —  the  system  of  Altalism, 
624-628  —  the  system  of  Darwin,  628-29  —  Animal  Magnetism 
(Mesmerism),  629-632  —  the  phlogistic  theorv,  632-33  —  the  antiphlo- 
gistic theory,  633  —  the  "  Gaseous  oxyd  of  azote  ",  033  —  Generalized 
Clrpnismus,  633  —  Galvanism,  634  —  the  Brunonian  System,  634-638 

—  Realism    in    medicine,    638-641  —  Hydropathy,     722-23,    977-78 

—  System  of  Benj.  Rush,  814-15  —  the  Theory  of  Excitement,  862-64 

—  Stimolo  and  Contrastimolo  of  Rasori,  867-871 — Homoeopathy,  871- 
881  —  Isopathy,  879  —  Cranioscopy  (Phrenology),  881-84 —  Physio- 
logical Medicine  (Broussaism),  884-89  —  the  French  School  of  Patho- 
logical Anatomy  and  Diagnosis,  889-907  —  English  Medicine.  908-912 
—the  Dublin  School,  912-914— the  School  of  Natural  Philosophy,  931- 
940  —the  School  of  Natural  History.  940-949  —  the  New  Vienna  School, 
949-969  —  German  Physiological  Medicine,  970-972  — Rational  Medi- 
cine, 972-74  —  the  System  of  Rademacher.  975-977  —  the  Modern 
Chemical  System,  978-980   —  Modern  (Cellular)  Vitalism,  980-996 

—  Seminal  Vitalism,  996-1003  —  Parasitic  or  Germ  Theory,  1003- 
1008  —  the  Phagocyte  Theory  of  Metschnikoff,  1008-1010. 


Talismans .     182,  204 

Tenotomy,  subcutaneous  ......     1055,  1069-1070 

Teretics,  the 127 

Thermometry,  medical      .......      498,  1023-1024 

Tourniquet,  invention  of  the         .......  512 

Trades,  the  diseases  of  .         .         .         „         „         .         .         .         509 

Transfusion „  474,  512-513 

Trichina  spiralis 852 

Trusses ....  206,665 

Typhus  and  typhoid  fever          .....         439,  548-549,  728 

U. 

Unicorn's  horn 401  n.  2 

United  States,  eminent  physicians  of,  in  first  half  of  19th  century,  923-25 
Universities,  European  —  mediaeval,  276-278,  440  n.  1  — of  the  16th  cen- 
tury, 361  —  of  the  17th  centnrv,  4*1  —  of  the  18th  centur}*,  600  —  of 
the  19th  century,  858  —  organization  of,  278-279,  323-324,  440-441  ; 
of  the  English,  "787-788  ;  of  the  Italian,  440  —  the  curriculum,  277, 
326  n.  3,  445,  553,  733-734,  737,  739  —  the  professors,  277-278,  324- 
327,  444-445.  558-559,  743-745  —  language  of,  553,  617  n.  1  —  statutes 
of,  447-449.  747-748  —  the  venia  legendi.  278,  327,  749  —  laboratories, 
557,  739  —  matriculation,  739  —  text-books,  277,  326  n.  3,  553.  —  the 
attendance,  325,  442-43,  554  —  examinations,  739-740  —  academic 
grades,  327-328  —  graduation  ceremonies,  747  n.  1  —  expenses  of  the 
university  course,  328,  562-63,  740. 
University  of  Pennsylvania,  organization  of  the         .         .         .       807-808 


—   1171    — 

ft 

Uroscopy  —  149,   184,   203,  223,   252  n.  2,  255,  333,   334,  398,  453,    765, 
772-773. 

V. 

Vaccination 709-711 

Vedas,  the 40 

Venereal  Disease  —  among  the  Jews,   33  — -  in   India,  45  —  in  Japan,  58 
—in  Antiquity,  129, 177,  206  —  in  the  Middle  Ages,  252,  274—  Syphilis, 
its  early  history,  292,  319-321,  438 —  specialists  in,  542,  5U2  —  use  of 
mercury  in,  383,   415,    620 —  use  of  Potassium  Iodide  in,  911,  922 
—  appearance  of  syphilis  in   Boston,  588 —  students  of  Venereal  Dis- 
ease in  the   18th  century,   656 —  in  the    19th  century,  French,  902  ; 
English,  922  ;  in  the  United  States,  927-28  ;  in  Germany,  960-61. 
Venesection,  dispute  concerning  ......     374-376 

Version,  podalic     .         .         .37,  46,  47,  143,  144,  162,  302,  402,  403,  420 

Veterinary  Medicine—  in  Antiquity,   17,  41,  98,  130,  191-192  — in  the 

Middle  Ages,  215,  224,  310-311,  336,  341  —  in  the  16th  century,  435, 

469  —in  the   17th  century,  543  —  in  the  18th  century,  715-719 —  in 

the  United  States,  717  — in  Germany,  794-795. 

Vienna  School,      ....      the  Old,  619-622  —  the  New,  949-970 

Virginity,  signs  of 205,  244 

Vital  Force,  doctrine  of  the 627 

St.  Vitus's  Dance 318 

Vivisection 121,556 

W. 

Weapon-salve  466 

Witches  and  Witchcraft 365-66,  586 

X. 
Xenodochia 252 

y. 

Yaws,  the 65l> 

Yellow-fever 588,  730,  901 

Z. 

Zend-Avesta,  the 25 

Zoology  —  in  the   16th  century,  370  —  in  the   17th  century,  479  —  in  the 
18th  century,  599  —  in  the  19th  century,  852. 


—  1172  — 

CORRIGENDA  ET  ADDENDA. 

In  addition  to  ordinary  typographical  errors,  and  errors  of  names  and  dates 
corrected  in  the  Index  of  Names,  the  following  corrections  and  additions  are  of 
sufficient  importance  to  require  notice  : 

Page  57,  line  2  from  the  top,  read  ''Arbor"  instead  of  "Harbor." 
61,  line  16  from  the  bottom,  read  "  1884"  instead  of  "  1834." 
"       61,  line  23  from  the  bottom,  read  "Ammasan"  instead  of  "Ammasau." 

67,  line  13  from  the  bottom,  read  "Iatri"  instead  of  "  Tatri." 
"  67,  line  25  from  the  bottom,  read  "Iatri"  instead  of  "Tatri." 
"       69,  line  16  from  the  top,  read   "  Inwulu  "   and   "Isinjanja"   instead   of 

"  Tnwulu  "  and  "  Tsinjanja." 
"       69,  line  19  from  the  top,  read  "  Itongo  "  instead  of  "  Ttongo." 
"       69,  line  14  from  the  bottom,  read  "  Minungo"  instead  of  "  Minnuors." 
"       71,  line  16  from  the  bottom,  read  "  Cattwy  "  instead  of  "  Cettwy." 
'•     138,  line  6  from  the  top,  insert  "general"  before  ''pathology." 
"     177,  line  2  from  the  bottom,  read  "  periscythismus  "  instead  of  "periscin- 

thismus  ". 
"     178,  line  16  from  the  bottom,  read  "  angiology  "  instead  of  :'  anthiology  ". 
"     220,  line  14  from  the  bottom,  insert  "the  university  was"  before  "  founded". 
"     241,  line  13  from  bottom,    read   "  Sveinbjoernsen  "    instead  of  "  Svein- 

bjornsen". 
"    248,  line  3  from  the  bottom,  read  "  Judrun"  instead  of  "  Indrun  ". 
"    283,  line  21  from  the  bottom,  read  "  Autricours  "  instead  of  "  Audicours". 
"     289,  line  20  from  the  top,   read   "booksellers  (Sortimenter)*'   instead  of 

"  agents  (Sartimenter)". 
"     306,  line  10  from  the  bottom,   should   read   "  His  salary  was  £40  a  year 

and  twelve  pence  a  day  for  subsistence  ",  and  a  similar  correction 

should  be  made  in  the  succeeding  line. 
"     338,  lines  5  and  6  from  the  bottom,  should  read     'Slaghoek,  the  uncle  of 

Dneveke,  mistress  etc." 
"     344,  line  12  from  the  bottom,  read  "  Franconian  ",  instead  of  "  French." 
"     348,  line  19  from  the  bottom,  read  "  Sibenziichter  "  instead  of  "  Liben- 

ziichter  ". 
"     352?  line  17  from  the  bottom,  read  "  Chalcondylas  "  instead    of  "  Chal- 

condyles  ". 
i;     361,  lines  14  and  15  from  the  top,  should  read  "for  teaching,  and  not 

(as  they  are  to-day)  for  investigation." 
"     371,  line  16  from  the  top,  read  "  Grrien  "  instead  of  "  Grier  ". 
"     371,  line  23  from  the  top,  read  "  Fossombrone  "  instead  of  "Tossembrone". 
'•     382,  line  12  from  the  bottom,  read  "an  oil-cask"  instead  of  "elephan- 
tiasis." 
"     396,  line  20  from  the  top,  insert  "(Proksch)"  after  "  species". 
"    403,  lines  8  and  7  from  the  bottom,  should  read  :   "  Item  ob  das  kind  sich 

mitt  dem  hindern  erzeugte,  so  soil  die  hebamm  mit  yngelassuer  had 

das  kind  iiber  sich  heben  und  mit  den  fuessen  uszfiihren." 
•'     407,  line  1  from  bottom  read  <pdltv  instead  of  (/>t/Leiv. 
•'    415,  line  6  from  the  bottom,  read  ''  Zeccarelli  "  instead  of  "  Zaccarelli ". 
"    419,  line  1  from  the  top,  read  "  brother  "  instead  of  "  son  ". 
"    434,  line  1  from  the  top,  read  "  Niitzliche  "  instead  of  "  Niitzlichen." 
'■     434,  line  6  from  the  bottom,  read  "  Physic  "  instead  of  "  Physics  ". 
"    436,  line  26  from  the  top,  read  "Alexandrinte  "  instead  of  "  alephanginae". 
''    437,  line  20  from  the  bottom,  read  "  Raitenau  "  instead  of  "  Raitman." 
"     512,  line  2  from  the  top,  read  "  then  "  instead  of  "  than  ". 


—  1173  — 

Page  648,  line  22  from  the  top,  should  read,  "  was  literally  cast  out  of  doors 
by  his  cruel  father,  a  merchant." 

"  649,  line  4  should  read  :  "  On  one  occasion,  when  eight  physicians  were 
sitting  beside  his  dying  bed,  Frank  remarked  etc." 

"    664,  line  8  from  the  top,  strike  out  "  and  ". 

"    665,  line  13  from  the  top,  read  "Josephine"  instead  of  "  Joseph". 

"    685,  line  22  from  the  top,  read  "  Schacher  "  instead  of  "  Schaber  ". 

"     771,  line  8  from  the  bottom,  replace  —  with  755. 

"  906,  line  3  from  bottom  According  to  the  careful  and  independent  investi- 
gations of  Dr.  Baas,  Rt'camier  invented  and  employed  the  speculum 
in  his  clinic  in  1805-6. 

"  933,  line  21  from  the  top,  read  "  highlands  of  Baden  "  instead  of  "  Bava- 
rian highlands  ". 

"    961,  line  15  from  the  top.     This  passage  should  read  as  follows  : 

Hermann  Zeissl  (1817-1884) 
author  of  a  "Lehrbuch"  and  "Compendium"  of  syphilis,  and 

Joh.  Karl  Proksch  of  Vienna 
(born  1840  at  Jaegerndorf  in  Austrian  Silesia),  who  shows  himself  in 
his  works  a  gifted  and  thorough  investigator  of  the  theory  and  literature 
of  syphilis.  An  anti-mercurialist  in  therapeutics,  Proksch  is  the  author 
of  important  works  on  the  history  and  literature  of  his  specialt}7,  and 
has  likewise  written  numerous  severe,  but  just,  critiques,  particularly 
upon  the  writings  of  Zeissl. 
"     969,      To  the  representatives  of  the  New  Vienna  School  should  be  added  : 

Theodor  Puschmann  (born  1847), 
who  since  1879  has  occupied  the  chair  of  the  History  of  Medicine  in 
the  University  of  Vienna,  edited  a  valuable  edition   of  the  works  of 
Alexander  Trallianus,  and  is  the  author  of  numerous  other  medico- 
historical  writings. 
"  1005,  line  6  from  the  bottom,  read  :<  1841 "  instead  of  '4821 ". 


160  The  Cleveland  Medical  Journal 

It  must  not,  however,  be  hastily  inferred  that  Dr  Baas,  while  an 
eminent  medical  historian,  was  a  historian  only.  As  early  as  1874  he  had 
staunchly  advocated  the  contagiousness  of  pulmonary  phthisis,  and  the 
practical  bent  of  his  mind  soon  led  him  to  the  study  of  physical  diagnosis. 
This  study  resulted  in  the  publication  of  his  two  well-known  works,. 
"Zur  Percussion,  Auscultation  and  Phonometrie"  (1877),  and  "Medicin- 
ische  Diagnostik"  (two  editions,  1877  and  1883),  and  in  the  invention  of 
an  improved  stethoscope  and  pleximeter.  In  his  later  years  Dr  Baas  also- 
devoted  much  attention  to  ophthalmology,  and  was  a  frequent  contributor 
to  the  current  journals  on  this  subject. 

Finally,  few  men,  of  any  age  or  country,  have  better  illustrated  in 
life  the  maxim  Nil  humani  a  me  alienum.  Dr  Baas  was  a  connoisseur  in 
music  and  painting ;  equally  interested  in  archeology  and  folklore  and 
an  honored  member  of  the  Wormser  Altertumsverein.  The  popular 
German  journals  Unsere  Zcit,  Gartenlaitbc,  Kosmos,  Blatter  fur  literar- 
ische  Unterhaltung,  etc.,  welcomed  numerous  contributions  from  his  prac- 
tised pen.  As  a  citizen  he  was  a  staunch  defender  of  German  interests 
and  German  honor,  and  displayed  the  deepest  interest  in  the  welfare  and 
advancement  of  his  adopted  city,  in  which  he  was  an  energetic  advocate 
and  supporter  of  the  Paulusmuseum  and  Paulusbibliothek,  institutions 
which  his  physical  infirmities,  alas,  never  permitted  him  to  enter.  By  his 
fellow  citizens  Dr  Baas  was  held  in  the  highest  esteem,  and  but  a  brief 
period  has  elapsed  since  the  celebration  of  his  seventieth  birthdav  offered 
to  his  medical  and  lay  friends  occasion  for  a  happy  demonstration  of  this 
affection  in  the  time-honored  German  way  which  he  loved.  A  well-earned 
recognition  of  his  high  personal  character  and  varied  accomplishments 
was  likewise  offered  to  the  infirm  Xestor  by  the  provincial  government  ii 
Rhenish  Hesse,  which  honored  him  with  the  titles  of  "Professor  und 
Medicinalrat." 

For  the  writer,  who  for  more  than  a  quarter  of  a  century  has  en- 
joyed the  singular  experience  of  an  uninterrupted  correspondence  with 
Dr.  Baas  (whom  he  never  saw),  without  a  shadow  of  difference  or  a 
breath  of  disagreement,  it  remains  only  to  lay  upon  the  green  grave  at 
Bechtheim  the  tribute  of  this  sincere  appreciation  of  his  life  and  character,, 
and  with  bowed  head  and  sad  heart  to  join  reverently  in  the  earnest 
petition  which  marked  the  close  of  his  simple  obsequies  : 

"Heiliger  Gottesfriede  umschwebe  dieses  Grab." 

H.  E.  H. 


Deaths. 


Maria  A.  Weiss,  Cleveland,  Ohio,  died  January  9. 
Geo.  L.  Bowman,  Lorain,  Ohio,  died  January  10,  1910,  aged  57. 
Frank  A.  Stovering,  Cleveland,  Ohio,  died  January  11,  aged  39- 
Geo.  Mitchell,  Mansfield,  Ohio,  died  December  17,  aged  72. 
John  J.  Weeks,  Cleveland,  died  December  9,  aged  81. 
William  W.  Barber,  Cincinnati,  died  December  20,  aged  39. 
William  Murdoch,  Akron,  Ohio,  died  January  2,  aged  67. 
H.  M.  Wagner,  Newark,  Ohio,  died  January  3,  aged  58. 
Russell  P.  Pelton,  Vermilion,  Ohio,  died  January  9,  aged  41. 
Abram  C.  Moore,  Cincinnati,  Ohio,  died  January  7,  aged  83. 
Jesse  L.  Worley,  Washington,  Ohio,  died  January  6,  aged  58. 
Jacob    Schneider,    formerly    of    Cleveland,    died    in    Daytonia,    Fla. 
December  11,  as;ed  64. 


News  Notes  159 

addressed  the  meeting  upon  The  State  Medical  Association.    W.  E.  Lough- 
ridge  spoke  upon  The  Future  of  the  Richland  County  Medical  Society. 

The  Northern  Tri=State  Medical  Association  held  its  twenty-sixth 
semi-annual  meeting  at  Ft.  Wayne,  Indiana,  Tuesday,  January  11,  1910. 
A  very  interesting  program  was  presented,  including  a  paper  entitled 
"Surgical  Diseases  of  Children  as  a  Special  Department,"  by  S.  W.  Kelley 
of  Cleveland. 

The  recent  death  of  Dr  Baas  of  Worms,  the  well-known  historian 
of  medicine,  has  suggested  the  following. 

In  Memoriam. 

Dr  Johann  Hermann  Baas,  Professor  and  Medicinalrat,  honorably 
distinguished  by  his  German  medical  colleagues  as  the  "Nestor  of  Medical 
Historians,"  died  at  his  home  in  the  ancient  city  of  Worms-on-the-Rhine, 
November  10,  1909. 

Born  in  the  market-town  of  Bectheim,  Rhenish  Hesse,  October  24, 
1838,  Dr  Baas  acquired  his  early  education  in  the  schools  of  that  vicinity 
and  in  the  gymnasium  of  the  neighboring  city  of  Worms.  Destined 
originally  for  the  priesthood,  the  scientific  lectures  of  Liebig,  Karl  Vogt, 
Moleschott,  Buchner  and  others  diverted  his  attention  to  the  subject  of 
medicine,  and  he  received  his  medical  degree  from  the  University  of 
Giessen  in  1860.  The  early  years  of  his  practise  were  passed  in  various 
towns  of  Rhenish  Hesse,  but  early  in  the  70's  of  the  last  century  he 
settled  in  the  city  of  Worms,  which  continued  his  home  until  his  death. 

In  his  day,  although  the  University  of  Giessen  announced  in  its 
curriculum  lectures  and  an  examination  on  the  history  of  medicine, 
neither  was  actually  given,  nor  was  even  an  approved  textbook  on  this 
neglected  subject  recommended  to  its  students.  It  was  not  until  Dr  Baas 
had  been  in  practise  for  several  years  that  his  attention  was  directed  *o 
medical  history.  A  younger  colleague  had  in  his  library  a  copy  of  Kurt 
Sprengel's  "Versuch  einer  pragmatischen  Geschichte  der  Arzneykunde," 
an  heirloom  from  his  father.  Dr  Baas  had  never  seen  or  heard  of  the 
work,  but,  rather  as  a  matter  of  diversion,  borrowed  the  book  and  read 
it  with  surprise  and  delight.  Astonished  to  discover  so  many  interesting 
and  important  facts  of  which  he  had  heard  and  knew  nothing,  he  cul- 
tivated diligently  the  novel  subject,  and,  as  he  humorously  remarked,  "In 
the  effort  to  fill  the  immense  gap  in  my  medical  education — I  fell  into  it." 

About  the  same  period  he  began  to  experience  the  early  symptoms  of 
an  insidious  and  progressive  disease  of  the  nervous  system,  which  in  its 
relentless  advance  confined  him  at  first  to  the  house,  then  to  his  office 
chair,  and  finally,  after  a  course  of  36  years,  was  the  indirect  cause  of  his 
death.  This  impairment  of  his  physical  abilit}'  seemed  only  to  stimulate 
to  increased  activity  a  mind  naturally  vigorous,  restless  and  independent, 
and  the  result  of  his  earnest  labor  was  soon  seen  in  the  publication  of 
his  well-known  work :  "Grundriss  der  Geschichte  der  Medicin  und  des 
heilenden  Standes"  (1876),  which,  revised  and  enlarged,  appeared  in  an 
English  dress  in  1889  under  the  title:  "Outlines  of  the  History  of  Medi- 
cine and  the  Medical  Profession"  and  for  the  last  20  years  has  been  the 
standard  work  on  medical  history  in  this  country.  The  original  work 
was  well  received  in  Germany  and  led  to  an  invitation  from  the  Natur- 
forscherversammlung  of  Cassel  to  the  author  to  prepare  for  its  next 
meeting  a  paper  on  the  subject  of  Harvey  and  his  discovery  of  the  cir- 
culation. Unfortunately  the  precarious  health  of  Dr  Baas  prevented  the 
presentation  of  this  paper  in  person,  but  it  was  published  in  1878  under  the 
title:  "William  Harvey,  der  Entdecker  des  Blutkreislauf,  und  dessen  an- 
atomisch-experimentelle  Studie  fiber  die  Herz-  und  Blutbewegung."  This 
was  followed  in  1880  by  a  compendium  of  the  history  of  medicine  entitled 
"Leitfadcn  der  Geschichte  der  Medicin,"  and  in  1896  by  his  last  treatise 
on  this  subject,  "Die  geschichtliche  Entwicklung  des  arztlichen  Standes 
und  der  medicinischen  Wissenschaften."  These  works,  it  is  fair  to  say, 
laid  the  foundation  of  the  recent  increased  interest  of  our  profession  in 
the  subject  of  medical  history. 


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Library  Bureau  Cat.  No.  1137 

Accession  no. 
HC 

Author 

Baas 

Outlines    ... 

Call  no. 

History 


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